BACKGROUND: Outbreaks of multidrug-resistant tuberculosis(MDR-TB) are caused by the low rate of treatment response due to limitation in number of available drugs and high rates of adverse drug side-effects. This study analysed the risk factors for MDR-TB patients, who did not respond to treatment, with an aim to improve the rate of treatment response. METHODS: Retrospective study of 111 MDR-TB patients at National Mokpo Tuberculosis Hospital from Jan. 1996 to Dec. 1998 was made. The patients were separated into tow groups ; group I comprised of patients who were treated successfully and group II comprised of those were not treated successfully. In order to analyze the risk facotrs for treatment faulure, differences between the two groups were compared and the confidence limit regarding the results were tested using an independent t-test, chi-square test and a Fisher's exact tets. RESULTS: The treatment failure rate of MDO-TB patients was 32% (36 patients), and treatment success rate 68%(75 patients). This study found no significant difference between two groups in terms of age, sex, family history, extent of the disease on the chest X-ray, the number of sensitive drugs in the treatment regimen, and the number of sensitive bactericidal drugs in the treatement regimen (p>0.05). However, a past history of pulmonary tuberculosis, cavitary lesions on the chest X-ray, the number of tretaments, the number of resistant drugs and the number of drugs used showed a significant difference(p<0.05). CONCLUSION: The rate of treatment failure in MDR-TB was increased by a past history of pulmonary tuberculosis, cavitary lesions on the chest X-ray, the number of treatments, the number of resistant drugs and the number of drugs used. For improving the treatment response of MDR-TB, every effort should be made to reduce the drug resistance caused by failure of the first treatment.
Disease Outbreaks ; Drug Resistance ; Hospitals, Chronic Disease ; Humans ; Jeollanam-do ; Retrospective Studies ; Risk Factors* ; Thorax ; Treatment Failure* ; Tuberculosis, Multidrug-Resistant ; Tuberculosis, Pulmonary

No abstract available.
Myxoma*

The 6 patients with neglected rupture of the Achilles tendon were treated by end to end anastomosis using the V-Y tendinous flap originated by Abraham in 1975. A tendinous flap was developed over the tendon by making an inverted V incision, which was then repaired in a Y fashion. The postoperative results were satisfactory with no functional disability of the ankle and with recovery of muscle strength for periods of 8 months to 15 months, but slight limited dorsiflexion of the ankle in two cases were noticed. The advantages of this method are: 1. Optimum functional recovery. 2. Recovery of muscle strength and tendon contour. 3. Prevention of late stretching or possible rupture of the healed tendon at the rupture site.
Achilles Tendon ; Ankle ; Humans ; Methods ; Muscle Strength ; Rupture ; Tendons

PURPOSE: The purpose of this study is to evaluate the effectiveness on decrease of the exposure rate of Medpor(R) implant (high-density porous polyethylene) when the suture material is left permanently without removal after continuous vertical suture of conjunctiva and Tenon's capsule with non-absorbable material, polypropylene suture (Prolene(R)). METHODS: We performed 66 cases of Medpor(R) orbital implantation in conjunction with enucleation, evisceration, or secondary orbital implantation between November 1997 and February 2002, and reviewed the charts of patients retrospectively. We divided 66 cases into 2 groups; One is Polypropylene group (P group, 30 eyes), in which conjunctiva and Tenon's capsules were sutured with double shoe string technique by 5-0 polypropylene sutures in one layer, and the other is control group (36 eyes), in which conjunctiva and Tenon's capsules were sutured by 5-0 polyglactin (Vicryl(R)) in separate layer, or Tenon's capsules were sutured by 5-0 Vicryl(R) and conjunctivae were 7-0 silk. We compared P group with control group with regard to the exposure rates, irritations, conjunctivitis and assessed covering of polypropylene suture by conjunctival epithelization. RESULTS: In control group, 5 of 36 eyes (13.8%) had the exposures of Medpor(R) implants, 21 eyes (58.3%) had the irritations, and 10 eyes had conjunctivitis. But, there was no exposure of Medpor(R) implants in all cases of P group, only two of 30 eyes had the irritations, and 3 eyes had conjunctivitis. There were significant differences between the two groups in the rates of exposure and irritations, but in the eyes with conjunctivitis, there was no significant difference between the two groups (Table 5, chi-square test). After 2 months of operation, the wound surfaces were smooth with complete covering of polypropylene suture by appropriate conjunctival epithelization. CONCLUSIONS: Continuous vertical suturing of conjunctiva and Tenon's capsule with non-absorbable polypropylene suture (Double shoestring technique) substantially reduced the exposure of Medpor(R) implant in addition to less inflammations, irritations and more comfortability. We concluded that the suture materials and methods must be considered as the important causes of exposure in enucleation or evisceration using proper Medpor(R) implant.
Capsules ; Conjunctiva* ; Conjunctivitis ; Humans ; Inflammation ; Orbital Implants ; Polyglactin 910 ; Polypropylenes* ; Retrospective Studies ; Shoes ; Silk ; Sutures* ; Tenon Capsule* ; Wounds and Injuries

No abstract available.
Spinal Fractures*

We intended to evaluate the Young's modulus of trabecular bone and apparent density from Computed Tomography(CT) and Spherical Indentation test and to quantify relation ship between them. The distal femurs(31 age, male, left and right) were prepared for exprimentatin and were embedded with repect to anatomical orientation. Then the specimens were scnned at 1 mm intervals on GE9800 CT scanner and the Hounsfield Units(HU, or CT number) were extracted from each CT image. After scanning, the bones were sectioned with diamond saw, producing 8 mm cubes of trabecular bone(72 eachs) from the metaphyseal region of both distal femur. The cubes were mechanically tested in inferior-superior(IS), anteriorposterior(AP), and medial-lateral(ML) direction with custom-made device, Spherical Indentatin Tester. After testing, the real apparent density of specimens were measured. The results of this study showed that the IS modulus was singificantly greater than both the AP and ML modulus and the AP modulus was also greater than ML modulus significantly(p<0.01). A linear relation ship between HU and real apparent density was found to be significant(R2=0.68) and significant power relationship between the apparent density and the tangent moduli(either by CT or physical measures) was also found.
Diamond ; Elastic Modulus* ; Femur ; Humans* ; Male ; Ships

We report a case of primary cutaneous cryptococcosis on the left knee of a 67 year-old woman. She had a large ulcerated and indurated plaque with yellowish purulent exudates on her left knee. A histopathological examination from the lesion showed numerous encapsulated, round spores. Cultures from the lesion showed the presence of Cryptococcus neoforrnans. This may have resulted from an immunosuppressive state due to long-term use of oral corticosteroids.
Adrenal Cortex Hormones ; Cryptococcosis* ; Cryptococcus ; Exudates and Transudates ; Female ; Humans ; Knee ; Spores ; Ulcer

No abstract available.
Abortion, Habitual* ; Cytogenetics* ; Family Characteristics* ; Female ; Pregnancy

The Graf system has supposed advantages with its flexible nature, as compared with rigid fixation. But there have been no reports about effects in the adjacent motion segment after soft stabilization. The purpose of this study was to evaluate the radiologic changes occuring in the adjacent segments of the Graf system and to assess its ability stabilizing the lumbar spine. A retrospective review of radiographs and medical records was undertaken in 32 cases who had been treated with the Graf system in degenerative lumbar spinal disorders. The average age at operation was 52.5 years and the average follow up period was 49.6 months. The results of this study were as follows: clinical assesments based on the Kirkaldy-Willis criteria revealed excellent in 13 cases (40.6%), good in 16 cases (50%), fair in 2 cases (6.3%) and poor in 1 case (3.1%). Radiologically we analysed the adjacent segments in 25 cases except the cases which did not have the correspondence between the clinical findings and the radiological findings, and the fixated segments in 32 cases. The acceleration of degenerative changes were found in the above adjacent segments in 11 cases (44%) and in the below adjacent segments in 5 cases (27.7%). Also, those changes were found in the fixated segments with discectomy in 19 cases (50%) and in the fixated segments without discectomy in 9 cases (37.5%). In conclusion, we think that the Graf system in a lumbar region may biomechanically influence the adjacent segments. The mechanical effects of the device could be changed by the polyester bands which were followed for a longer period of time in the fixated segments. Therefore, randomized prospective studies comparing the Graf system to other treatement methods could provide clear indications for lumbar spinal disorders.
Acceleration ; Diskectomy ; Equidae ; Follow-Up Studies ; Lumbosacral Region ; Medical Records ; Polyesters ; Retrospective Studies ; Spine

BACKGROUND: The pathogenesis of atopic dermatitis is still unknown, but house dust mites are thought to be playing an impor tant role in the development of skin lesions. Atopic dermatitis shows an immediate react,ion to mite allergens in skin prick test, postive IgE-FAST for mite antigens, and higer serum levels of mite-specific IgG4, IgE and IgE immune complexes. This immediate antigen-IgE-initiated reaction, however, is not clinically and histologically relevant to typical skin lesion, eczematization. OBJECTIVE: We tried to show that atopic skin lesions can clinically be induced by the type 1V hypersensitivity to house dust mites and evaluate the histological features of the eczematous skin lesions. METHODS: We investigated patch test reaction to Dermatophagoides farinae and the changes of expression of intercellular adhesion molecule 1(ICAM 1), vascular cellular adhesion molecule 1(VCAM 1), and E selectin on vascular endothelial cells in skin biopsies obtained from positive patch sites. RESULTS: Positive rate is 41%. The patch test has a good correlation with asthma predisposition. In the positive reaction sites, the expression of ICAM 1 is markedly increased, and those of VCAM 1 and E selectin are induced on the vascular endothelial cells. CONCLUSION: D. farinae patch testing represents a diagnostic method besides prick testing in mite induced eczematous dermatitis but better standardization is necessary. D. farinae can activate the endothelial cells and enhance the expression of adhesion molecules, so allergic contact sensitivity to mite allergen is playing an important role in the pathogenesis of atopic dermatitis.
Allergens ; Antigen-Antibody Complex ; Asthma ; Biopsy ; Cell Adhesion Molecules* ; Cell Adhesion* ; Dermatitis, Atopic* ; Dermatitis, Contact ; Dermatophagoides farinae* ; E-Selectin ; Eczema ; Endothelial Cells ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulin G ; Mites ; Patch Tests* ; Pyroglyphidae* ; Skin