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

OBJECTIVE: Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. METHODS: From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. RESULTS: The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively 7.16+/-2.1 and 8.03+/-2.3 in the IFD and pedicle screw groups, respectively, and improved postoperatively to 1.3+/-2.9 and 1.2+/-3.2 in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029). CONCLUSION: Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.
Back Pain ; Follow-Up Studies ; Humans ; Incidence ; Intervertebral Disc ; Muscles ; Operative Time ; Skin ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis

BACKGROUND: A point mutation in the RET proto-oncogene, in medullary thyroid carcinoma (MTC) is well known, but no other genetic causes of MTC have been found. This study was performed to identify the most common DNA copy number changes in MTC by comparative genomic hybridization (CGH). METHODS: Twenty-nine surgically resected MTC specimens were retrospectively selected from patients operated on between 1996 and 2004 at the Asan Medical Center. A review of the clinical data and pathological findings was performed. Congored staining and immunohistochemical stains (calcitonin, chromogranin A and CEA) were processed by tissue microarray. CGH analysis was performed. RESULTS: The Congo-red stain was positive in only 12 cases. The immunohistochemical results were positive in 29 cases for chromogranin A, 26 cases for CEA and 25 cases for calcitonin. DNA copy number changes were found in 23 cases (79.3%). The most frequent change was a gain of 19q (65.5%); less frequent changes were gain of 22 (55.2%), 19p (51.7%), 16p (27.58%), 17q (17.24%), and loss of 4q (27.6%) and 3p (17.24%). CONCLUSIONS: DNA copy number changes of MTC were more common (79.3%) than reported in previous studies. The most frequent changes were gains in 19q, 22 and 19p.

BACKGROUND: The most important acute complication of percutaneous transluminal coronary angioplasty (PTCA) is abrupt closure by dissection and thrombus, which account for the majority of deaths and emergency coronary artery bypass procedures associated with PTCA. We sought to determine the relationship between clinical, angiographic characteristics and abrupt thrombotic closure related to coronary intervention. METHODS: One hundred thirty two patients (61.6+/-8.0 year, 98 male) underwent PTCA or stenting under the diagnosis of acute myocardial infarction were analyzed at Chonnam University Hospital between Jan '97 and Jun '98. Patients were divided into two groups, one, 14 patients (Group A, 61.7+/-8.0 year, 9 male), who developed thrombotic occlusion, and the other, 118 patients (Group B, 61.5+/-8.0 year, 89 male) who did not develop abrupt closure related to the coronary intervention. RESULT: There were no significant differences in age, sex, risk factors, activated partial thromboplastin time, fibrinogen, erythrocyte sedimentation rate, C-reactive protein, location of lesion, branch involvement, lesion severity, AHA/ACC morphology between two groups. The incidence of intra-coronary thrombus was greater in Group A than in Group B (44% vs. 2%, p=0.025). Acute thrombotic occlusion related to the coronary interventions developed more frequently in the lesions within two days after the symptomatic onset (55% vs. 19%, p=0.035) and in the right coronary artery (RCA) lesions (55% vs. 24%, p=0.041). CONCLUSION: Predictors of abrupt thrombotic occlusion during coronary intervention in patients with acute myocardial infarction are intracoronary thrombus, earlier intervenion within 2 days after onset of aucte myocardial infarction and RCA lesion.
Angioplasty, Balloon, Coronary ; Blood Sedimentation ; C-Reactive Protein ; Coronary Artery Bypass ; Coronary Vessels ; Diagnosis ; Emergencies ; Fibrinogen ; Humans ; Incidence ; Jeollanam-do ; Myocardial Infarction* ; Partial Thromboplastin Time ; Risk Factors ; Stents ; Thrombosis

Acquired digital fibrokeratoma is an uncommon, benign fibrous tumor which usually occurs in adults as a solitary lesion. The most frequent locations are fingers and toes and the size of the tumor is generally small, around 3~5 mm. An 18-year-old female presented with a solitary, skin-colored, round and protruded nodule of the left great toe. The size of nodule was 2.5x1.6x1.4 cm. Histopathologic examination revealed typical findings of acquired digital fibrokeratoma. Herein, we report a giant acquired digital fibrokeratoma.
Adolescent ; Adult ; Female ; Fingers ; Humans ; Toes

PURPOSE: This study was to compare short arm double splint allowing forearm rotation with sugar tong splint in terms of loss of reduction and incidence of shoulder stiffness after closed reduction of the distal radius factures. METHODS: From June 2012 to February 2013, we retrospectively reviewed patients with distal radius fractures applied short arm double splint or sugar tong splint after closed reduction. Patients with more than 18 years old, acceptable reduction in X-ray and followed up at least 4 weeks were enrolled. Short arm double splint (SD) group was applied in 47 cases and sugar tong splint (ST) group was 34 cases. Gender, age and fracture types were not significantly different between two groups. The radiographic parameters were measured for palmar tilt, articular step-off, radial length, radial inclination, ulnar variance. The incidence and time of the reduction loss were also evaluated. In functional outcomes, the occurence of ipsilateral shoulder stiffness and the disabilities of the arm, shoulder and hand (DASH) score were evaluated with the medical records or telephone questionnaires at 6 months after initial trauma. RESULTS: Loss of reduction was occured 16 cases in SD group (34%) and 10 cases in ST group (29.4%), which did not differ significantly between the groups (p=0.169). The DASH score and shoulder stiffness were not statistically different between two groups. CONCLUSION: There was no significant difference in loss of reduction after closed reduction of distal radius fractures and functional outcomes in both groups.
Arm* ; Forearm ; Hand ; Humans ; Incidence ; Medical Records ; Radius Fractures* ; Radius* ; Retrospective Studies ; Shoulder ; Splints* ; Telephone

BACKGROUND: In some instances, thyroid cancer may be diagnosed only after resection of a putative or suspected benign nodule. In these cases a complete thyroidectomy is usually recommended to prevent recurrence. We analyzed the frequency of malignancy in the contralateral lobe after a complete thyroidectomy, and assessed the factors that may predict the presence of a malignancy, which might necessitate a complete thyroidectomy. METHODS: Between 1995 and 2001, 65 patients, who initially underwent a lobectomy and isthmectomy, but were finally diagnosed with differentiated thyroid carcinoma, underwent complete thyroidectomies. Their mean age was 39.8 +/- 12.4 years, ranging, 14 to 71 years. After initial surgery, 45 proved to have follicular carcinomas, 18 papillary carcinomas, 1 medullary and 1 insular carcinoma. The mean tumor size was 4.0 +/- 1.8 cm, ranging from 0.3 to 8.5 cm. After a complete thyroidectomy, the presence of a tumor the at contralateral lobe was assessed according to clinical parameters and the pathological findings in the ipsilateral lobe. RESULTS: The first surgeries revealed tumor multifocality in 27 cases, perithyroidal tumor extension in 4 and lymph node metastasis in 1. On completion of the thyroidectomy, 22 of the 65 patients had a malignancy in the contralateral lobe. Age, sex, size or the pathological primary tumor type, were not associated with the presence of additional tumors at the contralateral lobe. Tumor multifocality at the first surgery was the only significant variable to predict the presence of a tumor in the contralateral lobe. CONCLUSION: When thyroid cancer is diagnosed after ipsilateral surgery, the only predictive factor for the presence of a contralateral tumor was multifocality. We believe that a complete thyroidectomy is mandatory in these cases.
Carcinoma, Papillary ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy*

Clear cell sarcoma is a rare malignant tumor representing about 1% of soft tissue tumors. It usually presents in the distal extremities of young adults, frequently attached to tendons or aponeuroses. This slowly progressive tumor tends to recur and results in eventual development of metastatic growth. Early recognition of the disease and prompt wide excision of tumor are essential to get a favorable outcome. We report a rare case of clear cell sarcoma in a 57 year-old female who presented with an erythematous hard nodule on her abdomen.
Abdomen ; Extremities ; Female ; Humans ; Sarcoma, Clear Cell ; Tendons ; Young Adult

Papular elastorrhexis is a rare disorder in which children or adolescents present with asymptomatic, non-follicular, 1~5 mm firm white papules on the trunk and extremities. Histologically, there are focal areas of collagen homogenization with decreased and fragmented elastic fibers. Most reported cases are sporadic, but familial occurrence has been described. We report an uncommon and interesting case of papular elastorrhexis in both a brother and sister.
Adolescent ; Child ; Collagen ; Elastic Tissue ; Extremities ; Humans ; Siblings*

Nevus lipomatosus cutaneous superficialis (NLCS) is a fairly uncommon lesion characterized by ectopic adipose tissue in the dermis. It presents as soft yellowish papules or cerebriform plaques occurring usually on the buttock or thigh with a wrinkled surface. We report a case of NLCS in 38-year-old female who presented reddish brown colored cerebriform tumors on her buttock and was treated by CO2 Laser. To our knowledge this is the first case of NLCS treated by CO2 Laser, path of except by excisional surgery.
Adipose Tissue ; Adult ; Buttocks ; Dermis ; Female ; Humans ; Lasers, Gas* ; Nevus* ; Thigh