BACKGROUND/AIMS: Transfection of the hepatitis B virus (HBV) genome requires the cloning of tandem HBV sequences inserted into a plasmid vector, which is usually screened for by the restriction enzyme digestion of plasmid minipreparation from at least a dozen of bacterial colonies. The aim of this study was to develop a simple alternative screening method for bacterial colonies harbouring tandem HBV sequences by a PCR. METHODS: A set of polymerase chain reaction (PCR) primer was designed to detect the bacterial colonies harbouring "head to tail" dimeric HBV DNA. PCR which amplifies the head to tail junction site of two tandem HBV molecules was performed. RESULTS: PCR products with appropriate size (1.2kb) were obtained. The accurate detection by PCR screening technique was confirmed by enzyme digestion. CONCLUSIONS: These results suggest that PCR screening technique is a simple and rapid method for the identification of bacterial colonies containing tandem HBV sequences.
Clone Cells ; Cloning, Organism ; Digestion ; DNA ; Genome ; Head ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Humans* ; Mass Screening* ; Plasmids ; Polymerase Chain Reaction* ; Transfection

Disibling pansclerotic morphea, a severe form of generalized morphea, has a relentless clisabling course, producing marked contract,ion and joint deformity due to sclerosis of the skin and the deeper structures. We report herein an unusual case of morphea in a 25 year old male who had suffered from chronic recurrent ulceration with scar like sclerotic changes overlying limb folds, ankles, nape and abdomen since 4 years of age. The indurated lesions on the chest and abdomen were ivory colored, sclerotic guttae and plaques having a, violac ous border. At l4 years of age, the skin lesions were diagnostically ambiguous, wherea.s the immunologic results revealed a selective IgA deficiency with partial T lymphacyte inactivation. About 10 years later, the follow up visit showed this severe form of morphea over generalized area and disabling contractures of knees, elbows and alkles, but IgA value returned nearly to the nomal level.
Abdomen ; Adult ; Ankle ; Cicatrix ; Congenital Abnormalities ; Contracture ; Elbow ; Extremities ; Follow-Up Studies ; Humans ; IgA Deficiency ; Immunoglobulin A ; Joints ; Knee ; Male ; Scleroderma, Localized* ; Sclerosis ; Skin ; Thorax ; Ulcer

BACKGROUND: The purpose of this study is to evaluate the functional outcomes of reverse total shoulder arthroplasty (RTSA) and to assess factors affecting the patients' subjective satisfaction after RTSA. METHODS: Forty-three patients (mean age, 75.0 ± 5.2 years) who underwent RTSA for cuff tear arthropathy or irreparable cuff tears with preoperative magnetic resonance imaging and pre- and postoperative radiographs at 1 year, and whose various functional outcomes including pain visual analogue scale (VAS), simple shoulder test, Constant score, American Shoulder and Elbow Surgeons score, and active range of motion were evaluated preoperatively and at the last follow-up (>12 months) were enrolled. The outcome parameter was set as a satisfaction scale. Various clinical and radiographic factors were analyzed, and their correlations with postoperative satisfaction were evaluated. RESULTS: All functional scores, VAS pain score, and active forward flexion showed significant improvement after surgery (all p<0.001). Twenty-nine patients were satisfied with the results and 14 were dissatisfied. The presence of pseudoparalysis (p=0.028) and worse preoperative function (all p<0.05) were related with higher satisfaction. Any radiologic parameters did not affect patients' postoperative satisfaction. CONCLUSIONS: All patients showed a good functional outcome after RTSA, however the patients' subjective postoperative satisfaction was affected by preoperative functional status (higher satisfaction in poor preoperative function), not by radiological findings.
Arthroplasty* ; Elbow ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Range of Motion, Articular ; Shoulder* ; Surgeons ; Tears

We report herein a case of elephantiasis neuromatosa seen in neurofibromatosis patient, who was a 33-year-old male and had been diagnosed at the age of 13. Since that time on, small nodule present on the mid-back area led to develop grotesquely large, dark-brown colored, flabby mass with thick verucoid skin change, measuring about 30 * 20cm in size. Histopathologic examination of excised mass demonstrated moderate hyperplasia of epidermis and typical neurofibroma findings with soft tissue and fibrous tissue overgrowth, but no atypical cells. The electron microscopic study showed many perineurial cells surrounded by the continuous bssal lamina of fibroblsst in the dermal lesion and numerous giant pigmented granules in melanocyte and basal keratinocyte in the cafe-au-lait spot.
Adult ; Cafe-au-Lait Spots ; Elephantiasis* ; Epidermis ; Humans ; Hyperplasia ; Keratinocytes ; Male ; Melanocytes ; Neurofibroma ; Neurofibromatoses ; Skin

PURPOSE: We analyzed the clinical outcome of osteosarcoma developed in distal radius and the effect of delayed treatment on prognosis. MATERIALS AND METHODS: Twelve patients with distal radius osteosarcoma were analysed. We categorized patients into two groups of standard treatment or non-standard treatment. The patients of standard treatment group are all stage IIB and non-standard treatment group includes five stage IIB and one stage III. RESULTS: Five-year overall survival and disease-free survival rates of standard treatment group were 100% and 83%. Five-year overall survival rate of non-standard treatment group was 44%. Between two group, there are differences in age, tumor size, surgery type, symptom duration. CONCLUSION: Distal radius osteosarcoma have good prognosis than other extremity osteosarcoma. Survival rate of non-standard treatment group were lower than standard treatment group. Although the prognosis of non standard treatment group is poorer, the duration till death was longer than that of other sites with similar condition. Further multi-institutional study should be needed.
Disease-Free Survival ; Extremities ; Humans ; Osteosarcoma ; Prognosis ; Radius ; Survival Rate

Contemporary cementing techniques improved the longevity of the cemented total hip replacement. The mechanical strength of acrylic bone cement can be changed by different handling techniques with reduction of the porosity of acrylic bone cement. The greatest improvement of the mechanical properties with reducing the porosity is that of the fatigue strength. We investigated the mechanical properties of the specimens of high viscosity, Palacos R(Merk, Darmstadt, FRG) bone cement with two mixing methods, hand and vacuum mixing. Vacuum mixing improved the ultimate tensile strength by 22.4% compared to hand mixing in previous study. For the uniaxial tension fatigue test, the specimens were cyclically loaded at a maximum stress of 25 MPa at a frequency of 2.5 Hz and to investigate the porosity, scanning electromicroscopic examination was taken in each hand mixed and vacuum mixed specimens. Scanning electromicrogram showed the vacuum mixed specimens to be the more uniform and free of small voids compared with the hand mixed specimens. The results of the fatigue test were analized using Weibull distribution of survival probability, the average number of cycles to failure was 1459±924 cycles in hand mixed specimens, in vacuum mixed specimens, 21491±14956 cycles. The average fatigue life of the vacuum mixed specimens was 15 times loanger than that of the hand mixed specimens by Weibull mean, this differene exists stastically within 95% confidence interval. We could suggest vacuum mixing technique as a method eliminating porosity in a chilled acrylic bone cement and thereby markedly improving the mechanical properties. In cemented joint replacement surgery, a vacuum mixing technique are recommended as a method of preparation of acrylic bone cement
Arthroplasty, Replacement, Hip ; Clothing ; Fatigue ; Hand ; Joints ; Longevity ; Methods ; Polymethyl Methacrylate ; Porosity ; Tensile Strength ; Vacuum ; Viscosity

Background: Transforaminal epidural steroid injection (TFESI) is a conservative treatment for patients with lumbar disc herniation (LDH). However, there are reports of various complications that can occur after TFESI; among these, paraplegia is a serious complication. Case: A 70-year-old woman who was unable to lie supine due to low back pain exacerbation during back extension underwent TFESI. After injection, there was pain relief and the patient was able to lie supine; however, paraplegia developed immediately. Magnetic resonance imaging confirmed cauda equina syndrome (CES) due to nerve compression from L1–2 LDH. We determined that the patient's LDH was already severe enough to be considered CES and that the TFESI procedure performed without an accurate understanding of the patient's condition aggravated the disease. Conclusions It is important to accurately determine the cause of pain and disease state of a patient to establish a correct treatment plan before TFESI is performed.

BACKGROUND: Surgery may have a role when medical treatment alone is not successful in patients with multi-drug resistant (MDR) pulmonary tuberculosis (PTB). To document the role of resection in MDR PTB, we analyzed 4 years of our experience. METHODS: A retrospective review was performed on thirteen patients that underwent pulmonary resection for MDR PTB between May 1996 and February 2000. All patients had organisms resistant to many of the first-line drugs including isoniazid (INH) and rifampicin (RFP). RESULTS: The thirteen patients were 37.5±12.4 years old (mean±S.D.)(M:F=5:8), and their sputum was culture positive even with adequate medication for prolonged periods (109.7±132.0 months), resistant to 2-8 drugs including isoniazid and rifampin. All patients had localized lesion(s) and most (92.3%) had cavities. At least 3 sensitive anti-TB medications were started before surgery in all patients according to the drug sensitivity test. The preoperative FE1 was 2.37±0.83 L. Lobectomy was performed in 11 patients and pleuropneumonectomy in two. Postoperative mortality did not occur, but pneumonia occurred as a complication in one (7.7%). After 41.5±58.9 days (range 1~150 days) follow up, negative conversion of sputum culture was achieved in all patients within 5 months. Only one patient (7.7%) recurred 32 months after lung resection. CONCLUSION: When medical treatment alone is not successful, surgical resection can be a good treatment option in patients with localized MDR PTB.
Follow-Up Studies ; Humans ; Isoniazid ; Lung ; Mortality ; Pneumonia ; Retreatment* ; Retrospective Studies ; Rifampin ; Risk Factors* ; Sputum ; Tuberculosis, Pulmonary*

Ovaries lie near the distal ureter where extracorporeal shock wave lithotripsy (ESWL) of calculi is performed. The question whether ESWL may induce morphological changes in ovary should be investigated in animal experiments. After applying shock waves to ovary of Sprague Dawley female rat, the histopathologic changes within the tissue of ovary were observed immediately after shock waves and after recovery. For animal subjects, 25 healthy rats weighing about 250 grams each were used. Five rats were designated as control, and remaining 20 received shock waves at 20 kV for 1,000 times using Pendulum-ESWL (Lithoring), a third generation lithotriptor. The 20 rats were divided into 4 groups before shock waves, and each group was sacrificed after 1, 7, 14, and 28 days, respectively, in order to compare the observed histopathologic changes. Edema, congestion and hemorrhage were observed in ovary after 1 and 7 days of shock waves, but the edema and congestion were significantly reduced on the 14th day and completely disappeared on the 28th day. There was no ovarian follicular changes or fibrosis on the whole. It is thought that the extracorporeal shock waves have no specific effects on the tissues of ovary, but further studies ate needed to determine its long term effects.
Animal Experimentation ; Animals ; Calculi ; Edema ; Estrogens, Conjugated (USP) ; Female ; Fibrosis ; Hemorrhage ; Humans ; Lithotripsy ; Ovary* ; Rats* ; Rats, Sprague-Dawley* ; Shock* ; Ureter

BACKGROUND/AIMS: The endoscopic mucosal resection has now been adopted for a useful modality in both curative therapy and accurate diagnosis of early gastric cancer. A retrospective study was done to evaluate the indication and the limitation of endoscopic mucosal resection of early gastric cancer. METHODS: We studied 20 cases of early gastric cancer treated by endoscopic mucosal resection in Chungnam National University Hospital from November, 1995 to July, 1997. RESULTS: 1) The size affected the curability: 83. 3% of lesions less than 2 cm and 50. 0% of those larger than 2 cm were resected completely. 2) The depth of cancer invasion affected the curability: 87. 5% of lesion confined to mucosa were resected completely, while all of submucosal cancers were resected incompletely. 3) Among fourteen cases resected completely, three cases of lesions larger than 2 cm were residual cancer and two of those less than 2 cm were recurred locally. CONCLUSIONS: To be a curative therapy by endoscopic mucosal resection of early gastric cancer, we think that careful selection of the lesion, that is lesion less than 2cm and confined to mucosa, is necessary
Chungcheongnam-do ; Diagnosis ; Mucous Membrane ; Neoplasm, Residual ; Retrospective Studies ; Stomach Neoplasms*