BACKGROUND: Rapid and accurate identification of Mycobacterium tuberculosis complex is important in the diagnosis, treatment, and assessment of prognosis of tuberculosis. But, the conventional identification procedures such as niacin test usually requires considerable time. In this study, we compared the diagnostic value of a gene probe method with that of the niacin test for the differentiation of M. tuberculosis complex from mycobacteria other than tuberculosis (MOTT). METHODS: Commercially available gene probe kit(AccuProbeTM, Gen-Probe, Inc. , San Diego, Calif.) and Niacin test strip were used to identify 78 strains of mycobacteria isolated from patients at Asan Medical Center. One ATCC strain (M. tuberculosis complex) and one MOTT strain were used as controls. Polymerase chain reaction(PCR) was used when the above two tests yielded discordant results. RESULTS: Fifty isolates were identified as M. tuberculosis complex by both gene probe method and niacin test. Likewise 25 isolates were identified as MOTT by the both methods. For the remaining 5 isolates, the results of the two tests differed from each other: M. tuberculosis complex by gene probe and MOTT by niacin test. By PCR, however. these strains were identified as M. tuberculosis. The time required for identification was 1 to 2 hours by gene probe method and 1 to 3 weeks by niacin test. CONCLUSION: Gene probe is simple, rapid and reliable and is a very practical diagnostic tool that can be used in any clinical laboratory.
Chungcheongnam-do ; Diagnosis ; Genes, vif* ; Humans ; Mycobacterium tuberculosis* ; Mycobacterium* ; Niacin ; Polymerase Chain Reaction ; Prognosis ; Tuberculosis

Dr. Youn-Sic Chun and coworkers invented the new machine for getting information about the relative effectiveness of the orthodontic appliances and we named it Calorific machine. The author and colleagues used this machine to compare with tooth moving mechanism by 3 types of the insertion method of precision-TPA for derotating the posterior teeth. We measured the distance of tooth movement and found out the rotational center on the occlusal X-ray film and the tooth movement on the occlusogram and then processed paired t-test by SAS program. The results were as follow : 1. In the intermolar width, the mesial insertion method showed the loss of distance, and the other methods(-distal insertion method, mesial expansion method-) showed the increase of distance. 2. In the arch length, the distal insertion method was exhibited as most recommandable way for increasing the arch length. 3. The rotation center of the mesial insertion method for derotating the molar, was located between mesial pit and central pit of the lower 2nd molar. and, in the distal insertion method, it was located between distal pit and distolingual cusp, and in the mesial expansion method was located at distal pit.
Molar ; Orthodontic Appliances ; Tooth Movement ; Tooth* ; X-Ray Film

PURPOSE: To evaluate the incidence of retinopathy of prematurity (ROP) in premature twins, to determine clinical factors associated with ROP development and to analyze differences in severity of retinopathy of prematurity among siblings of multiple-gestation pregnancies. METHODS: We reviewed the records of 154 neonates of premature twins screened for ROP at one neonatal intensive care unit from January 1, 2000 through December 31, 2002. First, we assessed the frequency of ROP and then, we compared clinical factors between ROP and non-ROP groups. Third, we separated the infants into concordant and discordant ROP groups with discordant group defined as siblings with an intersibling difference of at least two stages of ROP between both siblings with ROP and siblings of one with ROP, another without ROP. Between siblings with discordant ROP, multiple clinical factors were compared. RESULTS: ROP was present in 43.5% of premature twins. Clinical factors significantly related to ROP occurrence were birth weight, duration of mechanical ventilation and duration of oxygen exposure (p<0.05). ROP developed more in groups with hypercarbia, patent ductus arteriosus, bronchopulmonary dysplasia and neonatal respiratory distress syndrome. Among the premature twins, 22.1% had discordant ROP. For those infants with discordant disease, only birth weight was related to occurrence or severity of ROP (p<0.05). CONCLUSIONS: There was no significant difference in incidence and risk factors of ROP between infants of single-gestation pregnancies and those of multiple-gestation pregnancies. Of clinical factors investigated, only birth weight was significantly related to intersibling difference of incidence or severity of ROP in premature twins.
Birth Weight ; Bronchopulmonary Dysplasia ; Ductus Arteriosus, Patent ; Humans ; Incidence* ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Oxygen ; Pregnancy ; Respiration, Artificial ; Respiratory Distress Syndrome, Newborn ; Retinopathy of Prematurity* ; Risk Factors* ; Siblings ; Twins*

PURPOSE: We investigated whether infantile vulvar abscesses are predictable features of rectovestibular fistula with a normal anus. MATERIALS AND METHODS: A retrospective analysis of five infants with vulvar abscesses and rectovestibular fistulae with normal anuses was performed. RESULTS: Four cases had a left vulvar abscess, and in one case the vulvar abscess was on the right side. All caregivers reported passage of stool from the vagina. The fistulae were almost uniformly located from the vestibule to the rectum above the anal dentate line, observable by visual inspection and probing under anesthesia. The first two cases were treated with division and closure of the fistulae after a diverting loop colostomy, and the remaining three cases with fistulotomy and curettage. There was no recurrence during the median follow-up period of 38 months. CONCLUSION: This unique rectovestibular fistula should be suspected in female infants with vulvar abscesses, especially when parents report passage of stool from the vagina. Fistulotomy and curettage may be an initial treatment and effective as a temporary diverting colostomy and delayed repair of the fistula.
Abscess/*pathology ; Female ; Humans ; Infant ; Reconstructive Surgical Procedures ; Rectovaginal Fistula/diagnosis/*pathology/surgery ; Retrospective Studies ; Treatment Outcome

BACKGROUND: This study was conducted to analyze the current problems in completing death certificates and to identify the correct method for completing death certificates. METHODS: We reviewed 262 death certificates in three hospitals from March 1 to April 30, 2000, and 119 death certificates in one hospital from March 1 to 31, 2000. We identified major and minor errors and analyzed and compared them retrospectively. RESULTS: A total of 381 death certificates were reviewed: 59 in Seoul National University Hospital, 101 in Ewha Woman's University Hospital, and 102 in Gachon Medical College Hospital, which has no education program for completing death certificates in postgraduate training, and 119 in Samsung Medical Center which has an education program for completing death certificates. 358 certificates(94.0%) had at least one error. There were only 23 death certificates(6.0%) without an error. In 182 cases(47.8%), there was one major error. In 321 death certificates(84.3%), there were more than two errors. A comparison of Samsung Medical Center with the other hospitals showed that the number of total errors was statistically different(p=0.001). CONCLUSION: There were few death certificates without an error in this study. In a hospital which has postgraduate training in completing death certificates, there are fewer errors than in other hospitals which have no training course. Emergency physicians actually certify many deaths, so they must know the correct method of completing death certificates for statistics on morbidity and mortality.
Death Certificates* ; Education ; Emergencies ; Mortality ; Retrospective Studies ; Seoul

We carried out survey on difference in awareness by age bracked and educational level of 182 mothers including their family history for the treatment of febrile convulsion, who had visited the emergency room and OPD of pediatrics, Dae Dong Hospital in Pusan, Korea, during the period from January, 1992, to December, 1992. The results were as follows: 1) The proportion of male and famale febrile convulsion patients was 1.5:1, and the distribution of patients in order of age was in the following; 81 cases(44.5%) of patients having the highest proportion between 1 to 2 years, 41 cases(22.5%) under 1 year, 35 cases (19.3%) between 3 to 5 year and 25 cases(13.7%) over 5 years. 2) The number of 110 cases(60.4%) were carries out by folk remedy, and 72 cases(39.6%) by medical treatment, for the method of treating febrile convulsion, thus folk remedial method being higher than medical treatment. Folk remedy was in the order of "needle picking", "massage", "acupuncturing" and "visit to herb store", and medical treatment was in the order of "visit to hospital", "taking of antipyretics", and "cold compress pad". 3) In comparison of treatment method according to age bracket of mothers of the patients, as the age of mothers of febrile convulsion patients become lower, patients were treated by folk remedy(p<0.05). 4) In comparison of treatment method according to educational level of mothers of the patients, no proportional difference in folk remedy and medical treatment was found(p>0.05). 5)In comparison of treatment method according to family history of mothers of the patients, no proportional difference in folk remedy and medical treatment was found(p>0.05).
Busan ; Emergency Service, Hospital ; Humans ; Korea ; Male ; Medicine, Traditional ; Mothers ; Pediatrics ; Seizures, Febrile*

Gastroparesis is a clinical term for gastric dysmotility or paralysis that presents without mechanical obstruction, but with functional obstruction. Nausea, vomiting, abdominal discomfort and abdominal distension may result from the functional obstruction of gastroparesis. Gastroparesis is frequently associated with such systemic diseases as diabetic mellitus and scleroderma or with certain operations such as vagotomy. Yet gastroparesis is rarely described in older children after viral infection. The authors observed a case of gastroparesis after pyretic symptoms. We report here on this case and its clinical consequences.
Child ; Gastroparesis ; Humans ; Nausea ; Paralysis ; Vagotomy ; Vomiting

PURPOSE: Many studies on the time course of inducible nitric oxide synthase (iNOS) gene expression have been performed in the LPS (Lipopolysaccharide)-induced endotoxemic model, but there have been few experimental approaches to continuous peritonitis-induced sepsis model. We conducted this study to establish basic data for future sepsis-related research by investigating the time course of iNOS gene expression and the relationship with the production of inflammatory mediators in the early sepsis model induced by cecal ligation and puncture (CLP). METHODS: Male Sprague-Dawley rats were operated on by sing the CLP method to induce of peritonitis; and then, they were sacrificed and samples of blood and lung tissues were obtained at various times (1,2,3,6,9 and 12 h after CLP). We observed the expression of iNOS mRNA from lung tissues and measured the synthesis of nitric oxide, IL-1beta , and TNF-alpha from the blood. RESULTS: iNOS mRNA began to be expressed at 3 h and was maintained untill 12 h after CLP. The nitric oxide concentration was increased significantly at 6 h, reached its peak level at 9 h, and maintained a plateau untill 12 h after CLP. TNF-alpha began to be detected at 3 h, increased gradually, and decreased steeply from 9 h after CLP. IL-1beta showed its peak level at 6 h after CLP, and tended to decrease without significance. CONCLUSION: We observed that the iNOS gene was expressed later in peritonitis-induced sepsis than in LPSinduced sepsis. Nitric oxide and key inflammatory mediators were also expressed later in peritonitis-induced sepsis than in LPS-induced sepsis.
Animals ; Gene Expression ; Humans ; Inflammation Mediators ; Ligation ; Lung ; Male ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Peritonitis ; Punctures ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger ; Sepsis ; Tumor Necrosis Factor-alpha

BACKGROUND: TSH stimulates both the adenyl cyclase and phospholipase C (PLC) pathways by binding to a single cell surface receptor that is coupled to G protein, and we examined crosstalk between these two signaling pathways. METHODS: FRTL-5 rat thyroid cells were grown in 6H medium, then incubated with 5H medium before the stimulation. Then cells were incubated for 24 hours with 5H mix containing 1 mCi/L myo-(2-N-3H) inositol. After pretreatment of 100 microM Rp-cAMP, 100 microM forskolin, 50 nM staurosporine, or 100 nM PMA (phorbol-12-myristate-13-acetate), TSH were added in different experiments. After 30 min at 37 degrees C, cells were disrupted and IP formation was determined. RESULTS: Stimulation with 100 microU/mL TSH resulted in a 1.65 fold increase in IP generation. In pursuing the possibility that the two post-receptor events might be linked in some way, we examined the effect of exogenously administrated Rp-cAMP, protein kinase A antagonist, and forskolin, a direct stimulant of protein kinase A, on IP generation achieved at a dose of 100 microU/mL TSH. The pretreatment of 100 M Rp-cAMP at a concentration sufficient to inhibit protein kinase A enhanced TSH-induced IP production. This effect of Rp-cAMP was dose-dependent. Forskolin attenuatedTSH-stimulated increases in phosphatidylinositide turnover. PMA, a protein kinase C (PKC) activator and staurosporine, a PKC inhibitor did not affect TSH-induced IP generation. CONCLUSION: These data suggested that activation of adenylate cyclase/cAMP post-receptor signalling casacde, which results in the protien kinase A activation, has an inhibitory effect on IP turnover activated by TSH.
Adenylyl Cyclases ; Animals ; Colforsin ; Cyclic AMP-Dependent Protein Kinases ; GTP-Binding Proteins ; Inositol ; Phosphotransferases ; Protein Kinase C ; Rats ; Receptors, Thyrotropin* ; Signal Transduction* ; Staurosporine ; Thyroid Gland ; Type C Phospholipases

BACKGROUND: Biochemical bone markers have been suggested to reflect postmenopausal high bone turnover. These markers could be useful in following response to hormone replacement therapy (HRT). But we have few studies about the sequential changes of biochemical bone markers and bone mass after HRT in Korean women, and it is unclear whether women with early menopause have different response to HRT from women with normal menopause. The aims of the present study were to see the sequential changes of biochemical bone markers and bone mass after HRT in Korean women, to examine whether a single baseline biochemical bone marker or a change in biochemical bone marker could predict subsequent bone mass, and to determine the difference of response to HRT between women with early menopause and women with normal menopause. METHODS: Postmenopausal women (n=21) were divided with into three groups according to their age at menopause (AAM): the first group with AAM < or = 43 years (early menopause group, n=7), the second group with 43 years < or = AAM < or = 50 years (n=4), and the third group with AAM > or = 50 years (normal menopause group, n=10). For the HRT, conjugated estrogen (0.625mg per day) and continuous or cyclic medroxyprogesterone (2.5-10mg per day) were administered. Bone mineral density (BMD) was measured at baseline and 12 months and biochemical bone markers were measured at baseline and 3, 6, and 12 months during HRT. RESULTS: Deoxypyridinoline, type 1 collagen N-telopeptide, bone alkaline phosphatase, and osteocalcin were significantly decreased at 3 months, and mean percent changes from baseline of bone resorption markers were larger than those of bone formation markers. At 12 months, BMD was significantly increased at lumbar spine and Ward's triangle. But BMD was not significantly increased at femur neck and femur trochanter. Two baseline bone markers (bone alkaline phosphatase and type 1 collagen N-telopeptide) correlated with changes of BMD but any changes of bone markers at 3, 6 months didn't correlate with changes of BMD. In early menopause group, changes of bone markers and BMD were larger than those in normal menopause group, but the difference between the two groups was not significant. CONCLUSION: All four bone markers showed significant reduction at 3 months, but bone resorption markers were decreased more markedly and rapidly, and some baseline bone markers can predict the change of BMD after HRT. The difference of response to HRT between early menopause group and normal menopause group was not significant.
Alkaline Phosphatase ; Bone Density* ; Bone Resorption ; Collagen Type I ; Estrogens ; Female ; Femur ; Femur Neck ; Hormone Replacement Therapy* ; Humans ; Medroxyprogesterone ; Menopause ; Osteocalcin ; Osteogenesis ; Spine