The analgesic efficacy of a single injection of ultrasound-guided retrolaminar paravertebral block for breast surgery: a prospective, randomized, double-blinded study

Background@#The thoracic paravertebral block is an effective analgesic technique for postoperative pain management after breast surgery. The ultrasound-guided retrolaminar block (RLB) is a safer alternative to conventional paravertebral block.Thus, we assessed the analgesic efficacy of ultrasound-guided RLB for postoperative pain management after breast surgery. @*Methods@#Patients requiring breast surgery were randomly allocated to group C (retrolaminar injection with saline) and group R (RLB with local anesthetic mixture).The RLB was performed at the level of T3 with local anesthetic mixture (0.75% ropivacaine 20 mL + 2% lidocaine 10 mL) under general anesthesia before the skin incision. The primary outcome was cumulative morphine consumption using intravenous patient-controlled analgesia (IV-PCA) at 24 hour postoperatively. The secondary outcomes were the visual analogue scale (VAS) scores at 1, 6, 24, and 48 hour postoperatively and the occurrence of adverse events and patient satisfaction after the surgery. @*Results@#Forty-six patients were included, 24 in group C and 22 in group R. The cumulative morphine consumption using IV-PCA did not differ between the two groups (P = 0.631). The intraoperative use of remifentanil was higher in group C than in group R (P = 0.025). The resting and coughing VAS scores at 1 hour postoperatively were higher in group R than in group C (P = 0.011, P= 0.004). The incidence of adverse events and patient satisfaction was not significantly different between the two groups. @*Conclusions@#A single injection of ultrasound-guided RLB did not reduce postoperative analgesic requirements following breast surgery.

Alcohol neurolysis of genicular nerve for chronic knee pain

Radiofrequency neurolysis (RFN) of the genicular nerves has recently become accepted as an effective technique to alleviate knee pain particularly in patients with knee osteoarthritis (OA) or postoperative pain. However, genicular nerve RFN can produce high procedure and equipment costs, longer procedural times, procedure-related pain, and failure rate of over 25%. We are presenting two cases of alcohol neurolysis of the genicular nerve using fluoroscopy and ultrasonography in patients with knee OA or persistent postsurgical pain of the knee. Alcohol neurolysis of the genicular nerve with dual imaging modality can be a cheap, safe and effective method in patients with chronic knee pain.

Child injury death statistics from 2006 to 2016 in the Republic of Korea

This study aimed to analyze changing trends in child injury deaths from 2006 to 2016 and to provide basic data for initiatives to help prevent child injury deaths through improvements in social systems and education. Specific causes of death were analyzed using micro-data of the death statistics of Korea from 2006 to 2016, which were made available by Statistics Korea. Types and place of death were classified according to the KCD-7 (Korean Standard Classification of Diseases and Causes of Death). The data were compared to those of other Organization for Economic Cooperation and Development countries. Changing trends were presented. The number of child deaths by injury was 270 in 2016. The death rate was 8.1 per 100,000 population in 2006, while it was 3.9 in 2016. The death rate of boys was 1.7 times greater than that of girls. Unintentional injury deaths comprised 72.6% of all child injury deaths in 2016, while intentional injury deaths comprised 27.4%. The first leading cause of unintentional injury deaths in infants (less than 1-year-old) was suffocation, while that of children aged 1 to 14 years was transport accidents. The second leading cause of death in infants was transport accidents, that of children aged 1 to 4 was falling, and that of children aged 5 to 14 was drowning. Pedestrian accidents comprised 43.7% of the transport accidents from 2014 to 2016. To prevent child injury deaths by both unintentional and intentional causes, nation-wide policy measures and more specific interventions according to cause are required.

Cause-of-death statistics in 2016 in the Republic of Korea

This study aimed to analyze changes in the causes of death in the Korean population in 2016 and to provide some insights regarding how to cope with related issues of public health and welfare. The causes of death made available by Statistics Korea were classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision as well as the KCD-7 (Korean Standard Classification of Diseases and Causes of Death), which has been modified to fit circumstances in Korea. The total number of deaths was 280,827, which was an increase of 4,932 (1.8%) from 2015. The crude death rate was 549.4 per 100,000 population, which was an increase of 7.9 (1.5%) from 2015. The 10 leading causes of death, in order, were malignant neoplasms, heart diseases, cerebrovascular diseases, pneumonia, intentional self-harm, diabetes mellitus, chronic lower respiratory diseases, liver diseases, hypertensive diseases, and transport accidents. The rank of hypertensive diseases rose from 10th in 2015 to 9th in 2016, while that of transfer accidents dropped from 9th in 2015 to 10th in 2016. The proportion of the number of deaths caused by cancer was 27.8%. The death rate due to cancer was 153.0 per 100,000 population, which was an increase of 1.4% from 2015; 16.5 deaths per 100,000 population were due to colon cancer, and 16.2 were due to stomach cancer. The above trends in causes of death reflect aspects of the population structure, disease patterns, lifestyle, and medical care in present-day Korean society.

A serological study of severe fever with thrombocytopenia syndrome using a virus neutralization test and competitive enzyme-linked immunosorbent assay

Severe fever with thrombocytopenia syndrome (SFTS) is caused by the SFTS virus (SFTSV). The SFTSV appears to have a wide host range, as SFTSV-positive ticks have been isolated from both farm animals and wild rodents. Therefore, it is important to monitor SFTSV-positive animals to prevent the transmission of SFTSV from animals to humans. Previously, we developed a competitive enzyme-linked immunosorbent assay (cELISA) to detect SFTSV-specific antibodies from field animals and compared the cELISA results to those from an indirect immunofluorescence assay (IFA). In this study, cELISA results were compared to and evaluated against the results from both an IFA and a virus neutralization (VN) test of 193 bovine serum samples (including two bovine positive control sera) and 70 horse serum samples. The consistency (98.9%) between cELISA and VN results was higher than that (97.4%) between cELISA and IFA for the bovine serum samples. Similarly, for the horse serum samples, the consistency (88.6%) between cELISA and VN results was higher than that (84.3%) between the cELISA and IFA. These findings indicate that our newly developed cELISA can be used for surveillance or epidemiological studies of SFTSV in animals.

Infant, maternal, and perinatal mortality statistics in the Republic of Korea, 2014

This study aimed to analyze infant, maternal, perinatal, and fetal mortality statistics in the Republic of Korea (Korea), 2014. It was based on the open-access data available from the Statistics Korea website (http://kostat.go.kr/portal/eng/index.action). Recent trends in these vital statistics were also examined. The results of this study constitute a descriptive presentation and analysis of the national data. The number of infant deaths was 1,305 out of 435,435 live births in 2014, and the infant mortality rate was 3.0. The number of maternal deaths was 48. The maternal mortality ratio per 100,000 live births was 11.0. The maternal mortality ratio per 100,000 women of child-bearing age (15 to 49 years old) was 0.37. The number of perinatal deaths was 1,365, and the perinatal mortality rate was 3.1. The number of fetal deaths was 5,317. The fetal mortality rate was 12.1. The trends in those vital statistics in recent years were consistent except for a few findings, including a decrease in the maternal mortality ratio of pregnant women 40 years old and older and a change in the proportions of the causes of infant death, with a decrease in mortality due to neonatal respiratory distress and an increase in mortality due to bacterial sepsis. Although these vital statistics were generally consistent, some aspects varied by year. Pregnant women less than 20 years old should be monitored more intensively for their babies' health. Our findings can serve as basic data supporting the establishment of health policies by the Korean government.

Development and evaluation of a competitive enzyme-linked immunosorbent assay using a monoclonal antibody for diagnosis of severe fever with thrombocytopenia syndrome virus in bovine sera

Severe fever with thrombocytopenia syndrome (SFTS) caused by the SFTS virus (SFTSV), a phlebovirus in the family Bunyaviridae, is an emerging tick-borne infectious disease that impacts humans. This disease manifests as a decreased blood cell count and multi-organ failure, with a case-fatality rate of more than 12% in China. Because vaccines or antiviral drugs for the treatment of this disease are not available, monitoring the SFTS circulation in animals and controlling the tick-mammal cycle are important for preventing SFTS. Monoclonal antibodies against the recombinant nucleoprotein of SFTSV were generated to develop a competitive enzyme-linked immunosorbent assay (cELISA) for the detection of antibodies against SFTSV infection in cattle. The specificity and sensitivity of cELISA was assessed by comparing the results of this assay to those of an immunofluorescence assay (IFA). The results of the cELISA using 416 field bovine serum samples and laboratory-immunized positive sera showed 98.1% consistency with those of the IFA. The cELISA used in this study did not show cross-reactivity with antisera against other viral cattle diseases. The cELISA presented in this study can be applied to detect antibodies against SFTSV in cattle.

Cause-of-death statistics in the Republic of Korea, 2014

This article presents recent trends and statistical indicators related to mortality in the Republic of Korea by analyzing the 2014 cause-of-death statistics. Specifically, we assessed the number of deaths, the crude death rate, the ranking of causes of death, and trends in the death rate from the major causes of death. Causes of death were classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision, as recommended by the World Health Organization. In order to determine the ranking of causes of death, Statistics Korea used the selection list of 56 causes of death from the 80 causes of death list for tabulation mortality statistics recommended by World Health Organization to better fit the Korean situation. The 10 leading causes of death were, in order, cancer, heart disease, cerebrovascular disease, suicide, pneumonia, diabetes mellitus, chronic lower respiratory disease, liver disease, transport accidents, and hypertensive diseases. The top 10 causes of death accounted for 70.5% of all Korean deaths. The ranking of cancer types as causes of death was lung, liver, stomach, colon, and pancreatic cancer. Death rates for heart disease increased from the third in 2013 to the second leading cause in 2014 and the rank of pneumonia moved up from the sixth in 2013 to the fifth in 2014. The mortality rate due to stomach cancer has decreased continuously over time.. This finding may reflect changes in Korean society involving population structure, epidemiological patterns, and lifestyles, including dietary habits.

Changes of characterization of Salmonella Typhimurium isolate following sequential exposures to porcine neutrophil / 대한수의학회지

To develop a live vaccine candidate using an attenuated strain of Salmonella Typhimurium (ST), biochemical properties, plasmid profile, PFGE patterns and pathogenic analysis of the ST isolate were carried out after sequential passage of the ST isolate in porcine neutrophils. By the passage, the ability of the neutrophil-adapted isolate to utilize d-xylose was lost, while the ability of the strain to ferment trehalose was delayed after 2 or more days of the culture. Also, changes including deletion of the gene fragments were observed in PFGE analysis of the neutrophil-adapted isolates. Two plasmids, 105kb and 50kb, were cured in the strain passaged over 15 times in porcine neutrophils. The 50% of lethal dose (LD50) of the parent strain was changed from 1 x 10(5) LD50 to 6 x 10(6) LD50 by the passage in intraperitoneal injection of the strains into mice. These results suggested that bacterial genotypic and phenotypic responses might be globally altered depending on the inside environment of neutrophils.

Alterations of COX-1, 2 mRNA and Protein Expression in Pregnant Rat Kidney / 대한해부학회지

The pregnancy causes the marked changes in maternal renal hemodynamic and volume homeostasis. During pregnancy, renal sodium and water retention result in an expansion of extracellular fluid and plamsma volume. This study was to examine the alteration of expression and localization of COX-1, 2, mRNAs and proteins in the kidneys of non-pregnant (NP) and pregnant rats using RT-PCR, Western blot analysis and immunohistochemistry. Pregnant Sprague-Dawley rats were evaluated on various time sets : days 10.5 (P10.5), 12.5 (P12.5), 17.5 (P17.5), and 19.5 (P19.5). In RT-PCR, COX-1 expression was gradually increased from P10.5 to P19.5 compared with NP rat. COX-2 expression was gradually decreased from P10.5 to P17.5 compared with NP rat, but restored NP level at P19.5. In Western blot analysis, COX-1, 2 proteins were detected in ~70, ~72 kDa, respectively. COX-1 expression was gradually increased from P10.5 to P17.5 and peaked at P19.5 compared with NP rat. COX-2 expression of pregnant rats was slightly decreased compared with NP rat. In NP rat, immunoreactivity of COX-1 was detected in entire collecting duct, glomerular epithelium, and medullary interstitial cells. In pregnant rats, the pattern of cellular labeling and signal intensity of COX-1 protein was identical to NP rat, but signal intensity was markedly increased in the inner stripe of outer medulla and inner medulla at P19.5. COX-2 immunoreactivity of NP rat was detected in the cortical thick ascending limb and macula densa. In pregnant rats, the pattern of cellular labeling of COX-2 protein was identical to NP rat, but signal intensity was slightly decreased. These results suggest that the expansion of extracellular fluid volume and water retention may be partly regulated by COX-1 rather than COX-2 during the pregnancy, especially at late stage.

Decrease of Metagonimus yokogawai Endemicity along the Tamjin River Basin

The Tamjin River which flows from Jangheung-gun via Gangjin-gun to the South Sea was reported to be a highly endemic area of Metagonimus yokogawai infection in 1977 and 1985. However, there were no recent studies demonstrating how much change occurred in the endemicity, in terms of prevalence and worm burden, of metagonimiasis in this river basin. Thus, a small-scale epidemiological survey was carried out on some residents along the Tamjin River basin in order to determine the current status of M. yokogawai infection. A total of 48 fecal samples were collected and examined by the Kato-Katz thick smear and formalin-ether sedimentation techniques. The egg positive rate of all helminths was 50.0%, and that of M. yokogawai was 37.5%, followed by C. sinensis 22.9% and G. seoi 4.2%. To obtain the adult flukes of M. yokogawai, 6 egg positive cases were treated with praziquantel 10 mg/kg in a single dose and purged with magnesium sulfate. A total of 5,225 adult flukes (average 871 specimens per person) of M. yokogawai were collected from their diarrheic stools. Compared with the data reported in 1977 and 1985, the individual worm burdens appeared to have decreased remarkably, although the prevalence did not decrease at all. It is suggested that the endemicity of M. yokogawai infection along the Tamjin River has been reduced. To confirm this suggestion, the status of infection in snail and fish intermediate hosts should be investigated.

Problems faced by Korean patients with chronic liver disease and the role of the Korean Association for the Study of the Liver: Emphases on social discrimination, insufficiency of reimbursement coverage, and deficiency of the welfare system / 대한간학회지

No abstract available.

The development of an efficient rat hepatic cirrhosis model

INTRODUCTION: Applying clinical conditions to on experimental animals forto verifverifyingy the mechanism of disease and drug effects is crucial. Cirrhotic livers induced by Hepatitis B virus are frequent, and eEspecially in Korea where a great deal of more liver-related diseases occurs, cirrhotic livers induced by Hepatitis B virus are frequent, and, such viral-induced cirrhosis, and this often impedes other medical treatments. Therefore, creating a proper elucidating properly deriveding cirrhosis method in animal model to simulate the actual pathophysiology of cirrhosis can benefit future researches. AIMS: We wanted toTe testing various hypotheticalsized methods of inducing cirrhosis in animal models, and we wanted the model to have a with higher rate of reproducibility. METHOD: To induce cirrhotic liver, thioacetamide (Sigma, St. Louis, USA) wasis given either freely via oral intaken or it wasand injected into the peritoneal space ofn Sprague-Dawley(SD) rats. The SD rats wereare divided into four groups: the oOral intake gGroup 1 ((N=10, 0.03%, 13 weeks), the oOral intake gGroup 2 (N=20, 0.04%, 30 weeks), the iIntraperitoneal Injected gGroup 1 (N=10, 300mg/kg, 12 weeks (3 times per week for first 2 weeks, 2 times per week for next 10 weeks) and the iIntraperitoneal Injected gGroup 2 (N=20, 300mg/kg, 2 times per week for 16 weeks). The mMortality rate of the tested subjects is recorded, and a visual test of the livers is performed at the end of the experiment, a visual test of the livers is performed. Also, the extracted liver cells that were dyed with Trichrome are compared to evaluate the extent of the liver cirrhosis. RESULT: For theIn oral intake group 1, no loss of occurred until wWeek 13, and 5 of the SD rats (50%) showed signs of liver cirrhosis by the Trichrome dye test. However, the extent of cirrhosis greatly differed betweenfrom each of the subjects. ForIn the oral intakae group 2, no loss occurred until wWeek 30. 20 of the SD rat (100%) in this group possessed a cirrhotic liver. However, the weight of the cirrhoscirrhotic liversis differed from a minimum of 231g to a maximum of 770g. For theIn Injected Group 1, 4 tested subjects (40%) died between wWeeks 3 and 4; however, the rest of them survived and they all revealed a signs of cirrhosis. ForIn the iInjected Group 2, only 3 tested subjects (15%) died, and after wWeek 16, 17 survivors (100%) showed a signs of cirrhosis. CONCLUSION: The short-term oral administration of thioacetamide only induced a minimal amount of cirrhosis;, thus, a longer period of consumption is suggested. Injection of thioacetamide into the peritoneum resulted in higher death rate when thoacetamide wasis injected frequently. Therefore, selecting a proper method to create a cirrhotic liver, with considering the reproducibility, on cirrhotic liver, the survival rate of the experimental animals, and the length of the experiment, isare strongly suggested for creating an animal model of cirrhotic liverfor further experiments.

Effect of the slice thickness and the size of region of interest on CT number / 대한구강악안면방사선학회지

PURPOSE: To evaluate the effect of the slice thickness and the size of region of interest (ROI) on CT number using quantitative CT phantom MATERIALS AND METHODS: The phantom containing 150 mg/cc, 75 mg/cc and 0 mg/cc calcium hydroxyapatite was scanned with 1, 3, 5 and 10mm slice thicknesses by single energy quantitative computed tomography (QCT). CT numbers were measured on center position of the phantom. Shape of ROI was circular and sizes were 1, 3, 5, 11, 16, 21, 26 and 33mm2 . ANOVA and Tukey's multiple comparison method were performed for statistical compari-son of CT numbers according to different slice thicknesses. Coefficient of variation of CT number measured in each size of ROI was evaluated in same slice thickness. RESULTS: CT numbers had statistically significant difference according to slice thicknesses (p<0.05). As the slice thickness increased, CT number also increased. As the density of phantom became lower and the size of ROI became smaller, the coefficient of variation of CT number increased. When the size of ROI was more than 11mm2 in 1mm slice thickness, 5mm2 in 3mm slice thickness and 3mm2 in 5mm slice thickness, the coefficient of variation became consistent. In 10mm slice thickness, the size of ROI had little effect on the coefficient of variation. CONCLUSION: CT number had variation according to the slice thickness and the size of ROI although the object was homogeneous. The slice thickness and the size of ROI are critical factors in precision of the CT number measurements.

Effect of the slice thickness and the size of region of interest on CT number / 대한구강악안면방사선학회지

PURPOSE: To evaluate the effect of the slice thickness and the size of region of interest (ROI) on CT number using quantitative CT phantom MATERIALS AND METHODS: The phantom containing 150 mg/cc, 75 mg/cc and 0 mg/cc calcium hydroxyapatite was scanned with 1, 3, 5 and 10mm slice thicknesses by single energy quantitative computed tomography (QCT). CT numbers were measured on center position of the phantom. Shape of ROI was circular and sizes were 1, 3, 5, 11, 16, 21, 26 and 33mm2 . ANOVA and Tukey's multiple comparison method were performed for statistical compari-son of CT numbers according to different slice thicknesses. Coefficient of variation of CT number measured in each size of ROI was evaluated in same slice thickness. RESULTS: CT numbers had statistically significant difference according to slice thicknesses (p<0.05). As the slice thickness increased, CT number also increased. As the density of phantom became lower and the size of ROI became smaller, the coefficient of variation of CT number increased. When the size of ROI was more than 11mm2 in 1mm slice thickness, 5mm2 in 3mm slice thickness and 3mm2 in 5mm slice thickness, the coefficient of variation became consistent. In 10mm slice thickness, the size of ROI had little effect on the coefficient of variation. CONCLUSION: CT number had variation according to the slice thickness and the size of ROI although the object was homogeneous. The slice thickness and the size of ROI are critical factors in precision of the CT number measurements.

Reliability and Validity of the Korean Version of the Positive and Negative Syndrome Scale / 신경정신의학

OBJECTIVES: We tested the reliability and validity of the Korean version of the PANSS (PANSS-KV). METHODS: The PANSS ratings were obtained from 101 subjects with DSM-IV diagnoses of schizophrenia or schizophreniform disorder. To study the concurrent validity, the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) were also administrated in 38 patients. Using these data, inter-rater reliability, test-retest reliability, internal consistency, criterion validity and concurrent validity were evaluated. Factor structure was analyzed by the principal axis factoring. RESULTS: The inter-rater reliability of the Korean version of the PANSS was satisfactory in positive (r=0.92) and negative syndrome subscales(r=0.86), but somewhat low in general psychopathology subscale (r=0.78). The test-retest correlations for the 3 PANSS subscales ranged between 0.89 and 0.95, so it showed excellent test-retest reliability. The Cronbach's alpha for the positive, negative and general psychopathology subscales were 0.73, 0.84 and 0.74, respectively and thus the 3 subscales of the PANSS had good internal consistencies. All separate items revealed significant corrected item-total correlations in the positive and negative syndrome subscales, but some items of the general psychopathology subscale showed no or low corrected item-total correlations. The positive and negative syndrome subscales held a high concurrent validity in relation to the SAPS and the SANS. It was confirmed that positive and negative syndromes were independent constructs. The factor analysis by the principal axis factoring produced 5 components: cognitive, excitement, depression, positive and negative. CONCLUSION: These findings prove that the reliability and validity of the PANSS-KV are comparable to those of the original PANSS. So, the PANSS-KV can be widely and extensively used in researches for schizophrenia.

Regulation of LIF Gene Expression by Interleukin-1 in the Mouse Peri-implantation Embryos and Uterine Endometiral Cells / 대한불임학회지

No abstract available.

Evaluation of the Beam Quality of Intraoral X-ray Equipments using Intraoral Standard Films / 대한구강악안면방사선학회지

PURPOSE: This study was to evaluate the beam quality of intraoral X-ray equipments used at Yonsei University Dental Hospital(YUDH) using the half value layer(HVL) and the characteristic curve of intraoral standard X-ray film. MATERIALS AND METHODS: The study was done using the intraoral X-ray equipments used at each clinical department at YUDH. Aluminum filter was used to determine the HVL. Intraoral standard film was used to get the characteristic curve of each intraoral X-ray equipment. RESULTS: Most of the HVLs of intraoral X-ray equipments were higher than the least recommended thickness, but the REX 601 model used at the operative dentistry department and the X-707 model used at the pediatric dentistry department had HVLs lower than the recommended thickness. The slopes of the characteristic curves of films taken using the PANPAS 601 model and REX 601 model at operative dentistry department, the X-70S model of prosthodontic dentistry department, and the REX 601 model at the student clinic were relatively low. CONCLUSION: HVL and the characteristic curve of X-ray film can be used to evaluate the beam quality of intraoral X-ray equipment. In order to get the best X-ray films with the least radiation exposure to patients and best diagnostic information in clinical dentistry, X-ray equipment should be managed in the planned and organized fashion.

The Odontogenic Keratocysts: A Consideration of the Clinical and Radiologic Features / 대한구강악안면방사선학회지

PURPOSE: To determine whether the significant relationship exists between radiographic appearance, whether it is unilocular or multilocular, and its corresponding clinical and histologic features by examining the odontogenic keratocyst clinically, radiologically and histologically. MATERIALS AND METHODS: This study was conducted on 48 cases of odontogenic keratocyst from the files of Dental Hospital, Yonsei University for the years 1982 through 1995. RESULTS AND CONCLUSIONS: The mean age of patients was 30.5 years in the unilocular group and 35.5 years in the multilocular group. The male to female ratio was 1:1.06 in the unilocular group and 1:1.75 in the multilocular group. The chief complaint was swelling in both groups(unilocular 35.1%, multilocular 54.5%). In the occurrence site, the border of the lesion, the displacement and external root resorption of the adjacent teeth, there were no statistically significant difference between the unilocular group and multilocular group, but in the border type, there was statistically significant difference( x2-test, p<0.05). Two recurred cases were observed among 11 cases of odontogenic keratocyst. One was unilocular case and the other was multilocular case.

Rapid Diagnosis of Isoniazid Resistance by Detection of Mutations in katG and inhA of Mycobacterium tuberculosis from Korea

29 isoniazid (INH) resistant isolated strains and INH sensitive reference strain (H37Rv) of Mycobacterium tuberculosis were analysed by polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) and NciI restriction mapping for the detection of mutations in katG gene and inhA gene. The katG gene was divided into 3 parts (Akat, Bkat, Ckat; each part is about 800 bp) and amplified, inhA gene was amplified as a whole. Each of the amplified 800 bp DNA was digested into small fragments of less than 400 bp with restriction enzymes for the direct PCR-SSCP analysis. Firstly, 10 strains were analysed. All the 10 isolates showed clearly distinct SSCP patterns in Bkat from that of the reference strain, but only two isolates showed distinct SSCP patterns in Akat, and no isolated strain showed any distinct SSCP patterns in Ckat. 10 isolates also showed distinct SSCP patterns in inhA. NciI restriction mapping of Bkat showed mutation in codon 463 in 7 strains among 10 isolated strains. With these results an early detection strategy for the INH resistant M. tuberculosis was applied to the rest of 19 isolated INH resistant strains. Firstly, isolates were screened by Ncsl mapping in Bkat, and 13 strains showed mutations in codon 463. Secondly, the rest of 6 INH resistant isolates were analysed by PCR-SSCP with restriction enzyme digestion (PCR-SSCP-RE) in Bkat, and all the strains showed distinct SSCP patterns from that of the INH sensitive reference strain. This proved our strategy as effective and economic and time saving method in early detection of INH resistant M. tuberculosis.