BACKGROUND: We performed competitive nested polymerase chain reaction (PCR) to evaluate the clinical utility of quantitative measurement of HBV DNA by PCR and it's correlation with other serologic hepatits B markers. Because hepatitis markers such as HBsAg, HBeAg, anti-HBe can not accurately reflect the replication of hepatitis B virus (HBV). METHODS: The internal standard was generated from the HBV core gene by point mutation, which would result in restriction site for the restriction enzyme Eco RI and performed competitive nested PCR followed by densitometric scanning of the amplified products of agarose gel. RESULTS: The sensitivity of nested PCR was 5 molecules in direct observation of agarose gel, but because of the background effect as taking polaroid photo graph it was 50 molecules by using densitometer. When DNA pellets for original 250 microL serum were diluted with 40 microL distilled water the low detection limit was 5.0 x10(3) molecules/microL, however it could be lowered when less diluted. Lower detection limit of densitometer was 6.25 pg by twofold serial dilution of 100 pg of purified HBV DNA PCR products, and regression showed y=0.93x-0.33 (y : density, x : concentration, 6.25 pg considered as 6.25 density). The reproducibility of the densitometer from high concentration was 4.3 +/-0.6 x10(6) molecules/microL(mean +/-SD, CV 14%), and low concentration was 3.7 +/-0.7 x10(4) molecules/microL(mean +/-SD, CV : 20%) Higher concentration of HBV DNA in HBeAg positive cases comparing with HBeAg negative cases was statistically significant (p<0.01). There was no correlation between HBV DNA concentration and serum value of alanine aminotransferase. CONCLUSION: Quantification of HBV DNA should be very useful in clinical follow-up of Post-therapy Patients and in anticipating Prognosis and infectivity of the disease, especially in cases of atypical hepatitis B and hepatitis B without seroconversion of routine hepatitis B markers. The shortcoming of the method seemed to be a rough estimate of HBV concentration as measuring the ratio of specimen/internal standard of two consecutive concentration among 10 folds serially diluted internal standard.
Alanine Transaminase ; Deoxyribonuclease EcoRI ; DNA ; Follow-Up Studies ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Limit of Detection ; Point Mutation ; Polymerase Chain Reaction* ; Prognosis ; Sepharose ; Water

Heterotopic pancreas can be defined as the occurrence of pancreatic tissue at aberrant anatomic sites that lack vascular, neural and anatomic community with the pancreas. A minority of heterotopic pancreas elicit clinical signs or symptoms that can vary according to its location and size, and the involvement of the overlying mucosa. We report here on a case of heterotopic pancreas that was removed by pancreatoduodenectomy under the erroneous diagnosis of distal common bile duct cancer.
Ampulla of Vater* ; Common Bile Duct* ; Diagnosis ; Jaundice ; Mucous Membrane ; Pancreas* ; Pancreaticoduodenectomy

Children with abnormal sex development may present with ambiguous genitalia in the newborn period or lacking of secondary sexual characteristics in puberty. Clinicians should make a prompt and accurate diagnosis and counsel parents on therapeutic options to minimize or avoid medical and psychological complications. 5alpha-reductase deficiency is a rare autosomal recessive disorder of sex development caused by a mutation of the 5alpha-reductase type 2 gene. As a result, there is an abnormality in conversion of testosterone (T) to dihydrotestosterone (DHT) and children with 5alpha-reductase deficiency are born with ambiguous genitalia. Here, we report identical twins who presented with ambiguous genitalia with a 46,XY karyotype and were diagnosed as 5alpha-reductase deficiency.
Child ; Dihydrotestosterone ; Disorders of Sex Development ; Humans ; Infant, Newborn ; Karyotype ; Parents ; Puberty ; Sexual Development ; Testosterone ; Twins, Monozygotic

BACKGROUND: Resistance to penicillin of Streptococcus pneumoniae in clinical isolates has occurred by the development of altered penicillin-binding proteins (PBPs) that have greatly decreased affinity for antibiotics and has been encountered with increasing frequency in Korea. In this study, the identification of altered PBPs of S. pneumoniae in clinical isolates by using polymerase chain reaction (PCR) and relationship of PCR with the conventional antibiotic susceptibility test of penicillin were evaluated. METHODS: Thirty isolates of S. pneumoniae from clinical specimens were used. Four sets of PCR primers of penicillin-sensitive and -resistant S. pneumoniae were designed to amplify (i) PBP 2BS: a 360 base pair fragment of the PBP 2B gene, (ii) PBP 2BCA: a 350 base pair fragment of the class A mutations present in PBP 2B gene, (iii) PBP 2BCB: a 295 base pair fragment of the class B mutations present in PBP 2B gene, and (iv) PBP 1AR: a 434 base pair fragment of the PBP 1A gene. In addition, a set of primers that amplify 273 base pair of the autolysin gene (ALY) was applied in combination with the above to identify S. pneumoniae. PCR results were compared with antibiotic susceptibility test (disk diffusion test and penicillin MIC). RESULT: Among 30 clinical isolates tested, 80% of isolates were penicillin resistant. The results of antibiotic susceptibility test were same as those of PCR methods. Among 24 penicillin resistant isolates detected by PCR methods, 5 isolates revealed PBP 2BCB gene, but 19 isolates revealed both of PBP 2BCB and 1AR genes. Five isolates with PBP 2BCB gene showed lower range of penicillin MIC (0.19 ~ 1.0 g/mL) than 19 isolates with PBP 2BCB and 1AR genes (0.75 ~ 4.0 g/mL). CONCLUSION: Detection of altered PBP genes of S. pneumoniae by PCR may be performed for the study of penicillin resistance. This study indicates that more altered PBPs in 1AR genes are related with higher MICs.
Anti-Bacterial Agents ; Base Pairing ; Diffusion ; Korea ; N-Acetylmuramoyl-L-alanine Amidase ; Penicillin Resistance ; Penicillin-Binding Proteins ; Penicillins ; Pneumonia ; Polymerase Chain Reaction* ; Streptococcus pneumoniae* ; Streptococcus*

We had an opportunity to evaluate a child who developed fever approximately two to three weeks after the open heart surgery for tetralogy of Fallot. His peripheral blood smear showed rings and various stages of Plasmodium vivax. The patient had received packed red blood cells during the surgery and postoperative care, one unit of which was later proved sero-positive for malaria. The possibility of malaria should be included in the differential diagnosis of the patients with unexplained fever after multiple blood product transfusions for the open heart surgery.
Animal ; Blood Transfusion/*adverse effects ; Cardiac Surgical Procedures ; Case Report ; Fever/parasitology ; Human ; Infant ; Korea ; Malaria, Vivax/*transmission ; Male ; *Plasmodium vivax ; Tetralogy of Fallot/*surgery

BACKGROUND AND OBJECTIVES: The use of several approaches, involving different cerebellopontine angles, has enabled vestibular schwannoma removal to be tailored to each patient's pathology and physiological status. The retrosigmoid approach provides simple and direct access to cerebello-pontine angle lesions. SUBJECTS AND METHODS: We retrospectively assessed outcomes in 35 consecutive patients who underwent vestibular schwannoma removal via the retrosigmoid approach. RESULTS: Of the 35 patients, 12 were men and 23 women; their age was 52.5+/-10.4 years (range, 35-75 years). One tumor was small (< or =1 cm), 18 were medium (1-3 cm), and 16 (45.7%) were large (>3 cm). Symptoms included hearing disturbance (31 patients, 89%), tinnitus (14 patients, 40%), headache (12 patients, 34%), vertigo (11 patients, 31%), and facial palsy (9 patients, 25%). Postoperative complications included facial palsy, intracranial hemorrhage, dysphagia, and disseminated intravascular coagulopathy, with facial palsy remaining permanently. Four patients (11.4%) had tumor regrowth, at a mean of 36.3 months after primary surgery. The mean diameter of regrowing tumors was 20.5+/-4.4 mm (range 14.5-25.0 mm). CONCLUSIONS: The retrosigmoid approach for vestibular schwannoma removal was associated with higher rates of facial palsy and hearing loss. This approach, however, can minimize injury to the lower cranial nerve.
Cerebellopontine Angle ; Cranial Nerves ; Deglutition Disorders ; Facial Paralysis ; Headache ; Hearing ; Hearing Loss ; Humans ; Intracranial Hemorrhages ; Male ; Neuroma, Acoustic ; Postoperative Complications ; Retrospective Studies ; Tinnitus ; Vertigo

BACKGROUND AND OBJECTIVES: The use of several approaches, involving different cerebellopontine angles, has enabled vestibular schwannoma removal to be tailored to each patient's pathology and physiological status. The retrosigmoid approach provides simple and direct access to cerebello-pontine angle lesions. SUBJECTS AND METHODS: We retrospectively assessed outcomes in 35 consecutive patients who underwent vestibular schwannoma removal via the retrosigmoid approach. RESULTS: Of the 35 patients, 12 were men and 23 women; their age was 52.5+/-10.4 years (range, 35-75 years). One tumor was small (< or =1 cm), 18 were medium (1-3 cm), and 16 (45.7%) were large (>3 cm). Symptoms included hearing disturbance (31 patients, 89%), tinnitus (14 patients, 40%), headache (12 patients, 34%), vertigo (11 patients, 31%), and facial palsy (9 patients, 25%). Postoperative complications included facial palsy, intracranial hemorrhage, dysphagia, and disseminated intravascular coagulopathy, with facial palsy remaining permanently. Four patients (11.4%) had tumor regrowth, at a mean of 36.3 months after primary surgery. The mean diameter of regrowing tumors was 20.5+/-4.4 mm (range 14.5-25.0 mm). CONCLUSIONS: The retrosigmoid approach for vestibular schwannoma removal was associated with higher rates of facial palsy and hearing loss. This approach, however, can minimize injury to the lower cranial nerve.
Cerebellopontine Angle ; Cranial Nerves ; Deglutition Disorders ; Facial Paralysis ; Headache ; Hearing ; Hearing Loss ; Humans ; Intracranial Hemorrhages ; Male ; Neuroma, Acoustic ; Postoperative Complications ; Retrospective Studies ; Tinnitus ; Vertigo

According to the increase in use of implants in clinical dentistry, new kinds of complications happen. Complications that can happen during implant placement are bleeding, nerve injury, jaw fracture, fenestration of maxillary sinus or nasal cavity, dehiscence, fenestration, injury of adjacent tooth. And complications that can happen after implant operation are infection, bleeding, hematoma, chronic sinusitis, peri-implantitis. Problems that are confronted during implant placement happen by inadequate preoperative treatment plan, inadequate consideration about individual anatomic difference, inadequate operation process and lack of experience of clinician. It is important that clinicians consider possible complications in advance and make a comprehensive treatment plan. We report the patient who was happened ramus fracture during block bone harvesting from ramus of severely atrophic mandible, the patient who came to emergency ward due to postoperative swelling and bleeding and the patient whose implant was migrated to maxillary sinus with a review of literature.
Dental Implants* ; Dentistry ; Emergency Service, Hospital ; Hematoma ; Hemorrhage ; Humans ; Jaw Fractures ; Mandible ; Mandibular Fractures ; Maxillary Sinus ; Nasal Cavity ; Peri-Implantitis ; Sinusitis ; Tooth

Liquid-Based Uterine Cervicovaginal Cytology is known to be a sensitive and effective screening method for cervical neoplasm. MonoPrepTM, ThinPrepTM, and SurePathTM methods have been recently used as Liquid- Based Uterine Cervicovaginal Cytology techniques, and the SurePathTM method has been used in Sung-Yoon Reference Laboratory since 2003. The goal of Liquid-Based Uterine Cervicovaginal Cytology is to separate cervical epithelial cells from non-target cells, red blood cells and neutrophils. This report describes a study which evaluated cellularity, stainability, and cellular changes of epithelial cells in samples processed using a manual technique as compared to samples processed using SurePathTM automated method. The samples processed by means of a manual technique contained a cellularity of epithelial cells similar to that of the samples processed using the SurePathTM automated method. In addition, we compared variable density gradient reagents, including dextran, dextrose, and sucrose, to SurePathTM gradient media in order to evaluate cell fractionation and cellularity of epithelial cells. 10% dextran of gradient media shows good fractionation. The samples processed with 10% dextran demonstrated sufficient cellularity of epithelial cells and shows the fewest cellular changes. In conclusion, using a manual technique on these samples is easier to read than those results obtained using the SurePathTM automated method.
Cell Fractionation ; Cervix Uteri ; Dextrans ; Epithelial Cells ; Erythrocytes ; Female ; Glucose ; Indicators and Reagents ; Mass Screening ; Neutrophils ; Sucrose ; Uterine Cervical Neoplasms

Bone Resorption ; Dental Implants ; Dentistry ; Humans ; Inlays ; Mandible ; Methods ; Osteogenesis, Distraction ; Transplants