Peripheral-Blood-Based PCR Assay to Identify Patients with Childhood Tuberculosis

PURPOSE: There is an urgent need for rapid and accurate diagnosis of childhood tuberculosis. Recently, developments in molecular biology have raised hopes about the possibilities of new strategies for tuberculosis diagnosis. Most of these methods have focused on the application of PCR to sputum samples from patients with suspected mycobacterial disease. We used a nested PCR to detect circuclating Mycobacterial tuberculosis DNA in blood samples from patients with suspected tuberculosis infection. We have propspectively investigated the role of blood-based PCR assay for diagnosis of childhood tuberculosis. METHODS: Our PCR assay is specific for IS6110 insertion element of the M.tuberculosis complex of organisms. We used it to test peripheral blood from 179 children with suspected tuberculosis infection. Results of the PCR assay were compared with tuberculin test and contact history with pulmonary tubercosis patients. A subgroup of 16 patients has blood samples assayed serially to track the PCR signal after treatment. RESULTS: In patients with contact history, 20 out of 30 samples (66.7%) were PCR positive. In patients with tuberculin test positive, 43 out of 78 samples (61.59%) were PCR positive. However there was no significant difference between weak (10-15mm) and strong (>15mm) tuberculin responsor groups. Negative conversion of PCR signal was observed in 14.3% (1/7) of subjects after 2 months of treatment, and 71.4% (5/7) after 3 months of treatment. Positive results of PCR was not observed after BCG vaccination. CONCLUSIONS: We conclude that peripheral-blood-based PCR detection for diagnosis of childhood tuberculosis is technically feasible approach that has a potential important role in diagnosis of childhood tuberculosis.

Lunate Dislocation (A Review of Six Cases) / 대한정형외과학회잡지

Six cases of lunate dislocation were treated in the departments of orthopaedic surgery, Hangang Sacred Heart Hospital and Kangnam Sacred Heart Hospital, Hallym College during the period from March 1, 1978 to August 31, 1982. The results were as follows; l. Among the total 6 cases, two cases had lunate dislocation only and the other four had associated injuries of the same wrist joints. 2. Marupulative reduction was successful in only one case. Five cases were treated by open reduction, and for four of them internal fixation was tried. 3. Postoperative roentgenograms showed acceptable reductions in all cases except one which redislocation occurred. This case showed lunate dorsiflexion instability and was treated with extensor carpi radialis longus tenodesis. 4. The cases with pure lunate dislocation yielded better functional recovery than those with associated carpal injuries.

Modified Weaver and Dunn Technique in the Treatment of Acromioclavicular Separation / 대한정형외과학회잡지

Thirty one cases of acromioclavicular injuries were treated in both Kangnam Sacred Heart Hospital and Hangang Sacred Heart Hospital during the period from May 1974 to April 1981. Three cases were classified to type 2 injuries and twenty eight were type 3. Among 31 cases one of the type 2 injuries was treated with closed reduction followed by thoracobrachial cast and remaining thirty received surgical treatment. Twenty one cases were operated on by technique of Weaver and Dunn, 8 cases by modified Phemister method and one case by Stewart technique. Preperative and postoperative stress film were evaluated and cap the coracoclavicular distance were measured. In twelve complete dislocation the authors modified the original Weaver and Dunn procedure by taking a bone chip along with the acromial end of the coracoacromial ligament. This seemed to provide a strong bony fulcrum for the suture of the ligament to clavicle as well as promoting bone to bone union. The results of this modified procedure were excellent.

A 2 Cases of Ectopic Bone Formation Treated by Radiation Therapy / 대한정형외과학회잡지

It is generally accepted that ectopic bone should be removed after full maturation. Removal of immature ectopic bone was attempted combined with immidiate postoperative irradiation to suppress its recurrence. The authors report two cases immature heterotropic bone resection around elbow joint followed by 2000 Rad midplane irradiation given in ten fractions over fourteen days. The results obtained are as follows: 1. There was no evidence of recurrence after removal of immature ectopic bone. 2. Improved range of joint motion was observed during 3 months and 6 months posteroperatively.

Fibromatosis (Report of Two Cases) / 대한정형외과학회잡지

The authors report two unusual tumors detected in the right scapula and around left aciatic nerve. Although fibromatosis is benign tumor, the nature is notorious for an aggreasive clinical couras with a tendency to recur in high percentage. Recently we have encountered two instances of fibromatosis, and presented with abort discussion of the clinical pathologic aspects with some review in literatures.

Treatment of Diaphyseal Fractures of the Forearm Bones / 대한정형외과학회잡지

In clinical practice fractures of the forearm bones are encoutered as frequently as fractures of other bones. As has been pointed out in many articles, however, the surgical anatomy of the forearm evokes problems in dealing with the diaphyseal fractures of the forearm bones not found in the treatment of diaphyseal fractures of other long bones, The authors have experienced 107 cases of diaphyseal fractures of the forearm bones during the fiveyear period from January, 1972 through December, 1976. A comparison has been made between the two groups one treated by conservative method and the other by open reduction and internal fixation. The results are as follows: 1. The time required for the healing of the fractures was shorter in the conservatively treated group. 2. Restoration of function was more satisfactory in the surgically treated group. 3. Rotational and angulatory deformities were less in the surgically treated group. 4. Forty-one fractures were internally fixed with compression plates, the union rate of which was 100%.