Rapid Identification of Mycoplasma Pneumoniae, Mycobacterium Tuberculosis and Staphylococcus Aureus in Pleural Fluid by PCR

PURPOSE: Pleural effusions may develop during the course of bacterial pneumonia. The aim of this study was to evaluate the significance of the polymerase chain reaction (PCR) method for detection of Mycoplasma pneumoniae, Mycobaterium tuberculosis and Staphylococcus aureus from pleural fluid. METHODS: Total 12 samples were obtained from pleural fluid; 2 samples from children with Mycoplasma pneumonia, 5 samples from adults with tuberculous pleurisy, and 5 samples from sterile pleural fluid seeded artificially with staphylococcus aureus. The primers used for our PCR were prepared to amplify M. pneumonia-specific MP5 gene, M. tuberculosis-specific IS6110 gene, and S. aurus-specific femA and mecA gene. The amplified PCR products were detected by ethidium bromide-stained agarose gel electrophoresis. RESULTS: A total of 12 pleural fluid samples were tested by nested PCR using the specific primer set. We could amplify MP5 gene in 2 samples, IS6110 gene in 5 samples, mecA gene in 3 samples, and femA gene in 5 samples. These PCR data were correlated with serolological data, microbiological data and methicillin-sensitivity test result. There were no false-positive results due to cross-contaminating DNA between these 3 organisms. CONCLUSIONS: We conclude that enzymatic amplification of specific gene from pleural fluid might be useful to diagnose the infectious pleural effusion by Mycoplasma pneumoniae, Mycobacterum tuberculosis or Staphylococcus aureus.

Loss of hetorozygosity at p53 exon 4 in Korean colorectal carcinoma / 대한암학회지

No abstract available.

Hand Tumors / 대한정형외과학회잡지

Hand tumors arise from the skin, subcutaneous tissue, tendons, nerves, blood vessels, and bones, and are of many different types. Most of them are benign but malignant lesions also occur, although only rarely. The authors have encountered 115 cases of tumors of the hand at Seoul National University Hospital between 1975 and 1984 and the following results were obtained; l. In our series of 115 cases of hand tumors (bone tumor; 47 cases, soft tissue tumor; 68 cases), most of them are benign (110 cases, 96%). 2. There are no demonstrable differences in the sex and distribution. 3. Of the bone tumors in the hand, enchondroma is most common (25 cases, 53%), followed by giant cell tumor (9 cases, 19%), and osteochondroma (7 cases, 15%). 4. Of the soft tissue tumors in the hand, ganglion is most common (28 cases, 41%), followed by hemangioma (16 cases, 24%), and xanthoma (8 cases, 12%). 5. Of the treatment modalities of bone tumors in the hand, the most frequent one is curettage and bone graft (26 cases, 53%), followed by excision, and en bloc resection and bone graft (8 cases, 16%, respectively). 6. Of the treatment modalities of soft tissue tumors in the hand, the most frequent one is excision (64 cases, 93%). 7. Although giant cell tumor, hemangioma, and lymphangioma are classified as benign histologically, their clinical course appears to be malignant, because of incomplete excision and recurrence.

Chondrosarcoma / 대한정형외과학회잡지

No abstract available in English.

The Effect of Duration of Electrical Stimulation on New Bone Formation / 대한정형외과학회잡지

Experiment of electrical stimulation using direct current on the tibia of normal adult rabbits was performed for the duration of 1 week, 2 weeks, 3 weeks, 4 weeks, 6 weeks, and 8 weeks. The cathodic electrode, Teflon coated Kirschner wire used in clinical work was introduced into the medullary cavity of the proximal tibia from the tibial tuberosity and the anodic electrode was introduced transversely in the metaphysis of distal tibia on the same side. Twenty micro-ampere of direct current was passed continuously through the fixed wires between the proximal and distal tibia on left side. At the end of first week, second week, third week, fourth, sixth, and eighth week, anodic and cathodic electrode were removed and animals were sacrificed and tibia was obtained for specimen, and then X-rays were taken, and the specimens were decalcified and stained with hematoxylin and eosin. The new bone formation in the medullary canal were measured by the degree of filling in the marrow canal as percentage by the point counting method. The results were as follows. First, Endosteal new bone formation is a main feature, and also periosteal reaction was noted in 27 % of cases. Second, In the first week group, new bone formation is minimal and difference between groups, that is, second, third, fourth, sixth and eight week group, the degree of new bone formation is statistically insignificant. Therefore possibility of short term electrical stimulation of duration of two week or four week is contemplated clinically.

Chiari Osteotomy in Old Congenital Dislocation of the Hip / 대한정형외과학회잡지

Twelve neglected congenital dislocations of the hip in ten patients over the age of eight years were treated by open reduction and chiari osteotomy. Reduction was aided by preoperative traction only in two hips, by femoral shortening with preoperative traction in three and by femoral shortening only in seven. The average follow up period in our series is 3 years, ranging from 1 year and 2 moths to 4 years and 5 months. The overall results were good but one case of avascular necrcsis and one case of redislocation were seen. By our experience it is thought that all old and congenitally dislocated hip in the growing age can be reduced by femoral shortening with soft tissue release, and preoperative traction for its reduction is not undispensable. The most problem in the treatment of the old congenital dislocation of the hip is the postoperative partial ankylosis in the affected hip and this problem would be overcome by delicate operative technique and meticulous hemostasis.

Hand Tumor / 대한정형외과학회잡지

Hand tumor may arise as primary growth from any of the tissue present in the hand. Most are benign and malignant are uncommon. The hand is a sensitive organ, has a little potential space and moving parts, so tumors are usually detected early because of pain, impairment of function or swelling. A knowledge of frequency, location and clinical characteristics of hand tumor is invaluable in diagnosis. Usually early susgical measure is the treatment of choice. For the period of 6 years from 1962 to 1977, 29 cases of hand tumor were treated surgically and the results of clinical observation were as follows 1. Of 29 cases, benign tumor was 25 cases (86%) and bone-origin tumor was 18 cases. Enchondroma and enchondromatosis was the most frequent (12 cases). 2. The tumor occurred 22 cases in phalanx, 10 in metacarpal, and 2 in carpal bones. 3. The tumors were treated with excision in 11 cases, curettage & bone graft in 10, amputation in 4, biopsy in 2 and no treamtent in 2. 4. The most frequent site of enchondroma and enchondromatosis were ulnar side, ring and little finger, and of these metacarpophalangeal joints were involved most frequently.

A Clinical Study on Tuberculosis of the Peripheral Bone and Joints of 198 Cases / 대한정형외과학회잡지

Although the incidence of tuberculosis of the bone and joints is being decreased with good nutrition, hygine and the development of preventive medicine, it is still a common disease in our clinic. One hundred and ninty-eight cases of tuberculosis of the bone and joints were studied in the Department of Orthopedic Surgery, Seoul National University Hospital for 10 years from January, 1966 to December. 1975. The results were as follows: 1. Total cases of tuberculosis of the bone and joints were 588 Among them, peripheral bone and joints excluding the spine occupied 198 cases (34%). 2. Sex ratio was 1.7 : 1 (male : female). Age distribution showed the group below 10 years was 78 cases (39%). On the other hand, 7 cases were over 51 years old. 3. More than 50% of patients visited hospital after one year from the onset. 4. One-third of all cases had been given some management before admission and the most common treatment was anti-tuberculous chemotherapy (25%). 5. Erythrocyte sedimentation rate was definitly increased in 41%. 6. Associated tuberculous lesionsoe of extraskeletal system were confirmed in 66 cases (33%). Among them, active pulmonary tuberculosis were 51 cases (77%) 7. Various treatments (conservative, curettage, synovectomy, arthrodesis, etc.) had been carried out. However, surgical managements for saving the range of motion must be considered always before arthrodesis.

Anterior and posterior Correction for Severe Paralytic Scoliosis / 대한정형외과학회잡지

Since anterior approach to scoliosis was first reported by Dwyer in 1969, many orthopedic surgeons have treated scoliosis of a large variety of causes through a direct approach to the anterolateral portion of its convexity. Four cases of severe and paralytic scoliosis were treated by anterior and posterior approaches of the spine at the Department of Orthopedic Surgery of Seoul National University Hospital from April 1975 to April 1977. Among four cases, one case had bony fusion in the posterior element of the lumbar spine with 126 curvature from T11-to L5, which was corrected by lumber anterior discectomy on the first stage and osteotomy in the posterior element between L2 and L3 following Harrington instrumentation, resulting in 86 curvature. The other three cases were treated by Dwyer instrumentation primarily and then posterior fusion including sacrum with Harrington instrumentation 3 weeks after the first anterior approach, resulting in the average 70.1% correction which is compared with the average correction of 53.8% with Harrington instrumentation in our hospital.

A Clinical Study on Pathologic Fractures / 대한정형외과학회잡지

Pathologic fracture occurs in a bone with preexisting stuctual weakness. The author reviewed 30 cases of pathologic fractures in which admission record and X-ray finding was well preserved among 53 cases admitted patients in the department of Orthopaedic Surgery, Seoul National Universty Hospital for 10 years from 1967. The results were as follows: 1.Age & Sex incidence showed even distribution. 2. The most frequent involved site was femur (40%) 3. The underlying etiology was as follows: 2 chronic osteomyelitis 1 homophilia 7 benign tumor 20 malignant tumor 4. metastatic tumor was the most frequent cause in 30 cases. 5. Treatment was as follows: Conservative treatment 4 cases Surgery 21 cases.

Fat Embolism Syndrome: Report of 6 cases / 대한정형외과학회잡지

Fat embolism is one of a rare catastrophic complication after multiple fraetures and extensive soft tissue injury. Many hypothesis on its pathogenesis has been postulated by many writers, still its exact pathogenesis, definite diagnostic criteria and treatment is not established. Nowadays fat embolism is considered as a respiratory insufficiency syndrome, even disseminated intravascular coagulation rather than isolated phenomena after extensive trauma of musculoakeletal system. Respiratory failure associated with fat embolism is a major cause of death, but is usually seIf-limited and is responsive to intensive treatment. Monitoring of blood gas is required for early diagnosis and respiratory supportive treatment with continued monitoring is necessary until resolution. The writers experienced six cases of fat embolism, at the Department of Orthopedic Surgery, Seoul National University Hospital for the period of three years from June 1974 till May 1977. Respiratory support, parenteral steroid and low molecular weight dextran with other supportive measure was a mainstay of treatment. Of six cases, five was recovered without sequalae and one was expired four days after trauma.