Objective To evaluate the health related quality of life (HRQOL) of patients with chronic hepatitis C(CHC) and the improvement after interferon therapy. Methods Using the SF 36 questionnaire and the hepatitis specific scale derived from the Medical Outcomes Study (MOS), the HRQOL in 67 non cirrhotic patients with chronic HCV infection were evaluated, 38 patients of which were treated with IFN ?2a 3MU( n=31) and CIFN 15 ?g ( n =7), three times a week for 6 months. 12 patients had a sustained viral response (undetectable serum HCV RNA and normal ALT level at 24 weeks post treatment) to interferon therapy. 26 patients had no response. Live biopsies were performed in 23 patients and the diagnosis of chronic hepatitis proved. These scales were self administered by patients at baseline and at 24 weeks post treatment. Patients with chronic hepatitis C were compared with healthy volunteers ( n =40) who were selected as normal controls, the age, sex, education profession were matched between them. Results Compared with healthy controls, patients with chronic hepatitis C at baseline had lower HRQOL on all eight scales of the SF 36 ( P

BACKGROUND: Pulmonary tuberculosis is affected by environmental factors, such as hygiene, nutrition, and socioeconomic status. Recently it has also been shown to be correlated with specific HLA types in foreign countries, although the mechanism underlying this association remains unknown. The aim of this study was to investigate the frequency and contribution of specific HLA alleles to pulmonary tuberculosis in Koreans. METHODS: HLA alleles of 97 patients whose illness was diagnosed as pulmonary tuberculosis by sputum acid-fast bacilli stain, culture, chest X-ray, and clinical evaluation at the Korean National Tuberculosis Association Department of Medical Operation were compared to those of 100 blood donors as controls. The polymerase chain reaction-sequence specific oligonucleotide probes (PCR-SSOP) method was used to define HLA-DQA1, HLA-DQB1, and HLA-DRB1 alleles. RESULTS: Among the patients analyzed by PCR- SSOP for HLA-DQA1 alleles, 63.9% were typed as HLA-DQA1*01, 50.5% HLA-DQA1*03, 22.6% HLA- DQA1*05, 8.2% HLA-DQA1*02, 7.2% HLA-DQA1* 06, and 4.1% HLA-DQA1*04. No difference in the distribution of HLA-DQA1 alleles between patients and healthy controls could be found, with the exception of HLA-DQA1*04, which was more common among controls. Regarding HLA-DQB1 alleles among the patients, 60% were typed as HLA-DQB1*03, 45% HLA-DQB1*06, 21.3% HLA-DQB1*04, 18.8% HLA- DQB1*05, and 11.3% HLA-DQB1*02. The allele distribution of HLA-DQB1 was not significantly different between patients and controls. For HLA-DRB1 alleles, 29.5% were typed as HLA-DRB1*02, 27.4% HLA- DRB1*08, 25.3% HLA-DRB1*04, 23.2% HLA-DRB1* 09, 20% HLA-DRB1*12, and 12.6% HLA-DRB1*13. There was also no difference between patients and controls in the allele distribution of HLA-DRB1. CONCLUSION: In Korea, where tuberculosis is relatively prevalent, pulmonary tuberculosis seems to be independent of HLA-DQA1, HLA-DQB1, and HLA- DRB1, although we found a statistically significant difference in HLA-DQA1*04 frequency between tuberculosis patients and controls.

BACKGROUND: Single egg-based Ogawa medium is used for mycobacterial culture in nearly all tertiary care or medical school-affiliated hospital in Korea. However, it is expected that some mycobacteria would grow so lately or never in only one media, even if mycobacteria are present sufficiently in the specimen. To estimate the efficiency of inoculation to two or more egg-based media for isolation of mycobacteria, positive culture rates and detection time were compared among three media. METHODS: 193 clinical specimens, which referred to laboratory of Pusan National University Hospital for 2 months, including 123 specimens of patients with mycobacteriosis, were processed and inoculated to Eiken, VITE and KT media. The isolates were identified and classified to Mycobacterium tuberculosis and non-tuberculous mycobacteria (NTM) by AccuProbe method. The positive culture results were analyzed by McNemar test and t-test. RESULTS: M. tuberculosis and NTM were isolated in 65 (34.0%) and 14 (7.4%) specimens, resulting in positive culture rates of 41.4%. Of the 123 patients' specimens, 63 cases were positive in culture of VITE media, which were significantly higher than 50 cases of Eiken and 45 cases of KT media. In 43 positive-stained specimens, twelve to twenty samples (29.3-48.8%) failed to grow in at least one media. The colonies were visible at 24.9 to 30.7 days after inoculation, and VITE and KT media detected visible colonies 4.5 and 2.5 days more rapidly than Eiken media, respectively. CONCLUSIONS: Inoculation to two or more egg-based media is useful for increasing culture positivity and early detection of colonies for mycobacterial culture.

BACKGROUND: Gallbladder (GB) polyps are now increasingly detected by ultrasonography. We investigated the prevalence and risk factors of GB polyps in health screening population. METHODS: An ultrasonographic study of GB polyps were conducted in 35,012 subjects who received a paid health screening examination at Samsung Medical Center. Controls, twice the subjects with GB polyp, were randomly selected from the cases with normal GB. The demographic characteristics and biochemical parameters were recorded. RESULTS: The overall prevalence of GB polyps was 2.94% (1,330/15,573). Among them, 3.63% were men, 2.09% were women. In both males and females, the prevalence was highest in their 40s. The diameter of GB polyps ranged from 2 mm to 20 mm (mean 4.5 mm). Most polyps (98.3%) were less than 10 mm in diameter. Of 1,030 subjects, 64% had a single polyp and 36% had multiple polyps. Multiple logistic regression, with reference group of body mass index (BMI, <22.5 kg/m2), showed odds ratio of 1.074 and 1.864 for BMI groups of 22.5-24.9 and 25 or more respectively. In contrast, other demographic characteristics and biochemical parameters, such as age, smoking, alcohol use, glucose, liver function tests, lipid profiles and HBsAg carriage were lack of any relation to GB polyps. CONCLUSIONS: GB polyps are not likely to be rare in Korean adults despite their low prevalence compared to other reports. The body mass index may be a risk factor for GB polyps.

The aims of this research were to establish the incidence of sexual harassment among police women and secretaries; to assess the personal factors associated with sexual harassment; to assess the emotional reaction associated with sexual harasssment. A questionnaire was administered to 42 secretaries and 106 policewomen picked at random from Kampala City. Data obtained was analysed using chi-square test. Results indicated that secretaries and policewomen did not significantly vary on other forms of sexual harassment except sexual assault. Personal variables did not influence sexual harassment except educational and physical attractiveness. A smaller percentage reported negative emotions associated with sexual harassment and similarly a smaller percentage reported risk of contracting HIV from sexual harassment. However; the majority of the participants reported that sexual harassment at work places had decreased in face of the AIDS pandemic. The need to develop an appropriate definition for sexual harassment in Uganda; and the need to develop a reporting system were highlighted. Development of a structure to handle and treat cases of sexual harassment; development of social skills; senstitisation; and self defence programmes for the women were also recommended. Treatment of offenders and victims would include psychotherapy. The continuation and strengthening of AIDS programmes tht had began was also recommended

BACKGROUND: Anesthesia for patients who have had to receive airway reconstruction surgery due to various causes may be the most challenging task in anesthesiology. A 3-year experience, in a consecutive series of 15 patients is herein reviewed. METHODS: We analyzed retrospectively the clinical status, the performed surgery, and the anesthetic management of the patients. RESULTS: The most common cause of airway obstruction was postintubation stenosis of the cervical trachea (6 patients). Tumor (3), trauma (2), tuberculosis (2), radiation (1), and the extrinsic compression (1) of the trachea or the main bronchus were the other causes. The kinds of surgery performed were resection and anastomosis (13 patients), external stent implantation (1), and lymph node excision (1). Airway control was successful during the perioperative period, and surgical death was never encountered. CONCLUSIONS: With careful preoperative evaluation of the status of the airway and close communication between the anesthesiologist and the surgeon, anesthesia during airway reconstruction surgery can be most worthwhile.

To detect causative allergens in type I hypersensitivity diseases, several methods have been used. Among those, skin prick test is easy to perform and sensitive. Several criteria presenting positive reactions have been used. Therefore, we tried to find out more sensitive and specific criteria for deciding a positive reaction on skin prick test in 57 patients(allergic rhinitis; 39, bronchial asthma ; 5, acute urticaria ; 2, chronic urticaria ; 11) with 69 allergens and compared the reproducibility between each positive criteria. We calculated the ratio of wheal size caused by each allergen to that of histamine and defined as "A" in case of it's ratio was over 0.5, "B" in case of over 0.7, "C" in case of over 1.0. The results were as follows, 1. The positive rate of house dust on skin prick test was the highest, and D. farinae, cat fur, D. pteronyssinus, mixture of cat fur, house dust, horse hair, dog hair in order. 2. Mean reproducibilities of four common allergens in each positive criteria were 91% in criteria A, 88% in criteria B, and 82% in criteria C. 3. Comparing between mean reproducibilities by earth positive criteria, in positive criteria between 0.5 and 0.7 and positive criteria between 0.7 and 1.0, there were no significant differences, but in positive criteria between 0.5 and 1.0, statistical significant difference was noted. In conclusion, it was suggested that the ratio of wheal sizes of allergen to histamine greater than 0.7 might be ideal for a positive skin prick test.

BACKGROUND: In recent years, tuberculosis has re-emerged as a major health problem in both industrialized and developing countries. Recent advances in identifying and purifying antigens secreted in active tuberculosis infection have lead to the development of serological assays based on a number of immunodominant antigens. To date, the most sensitive and specific of these antigens has been the 38-kDa antigen. METHOD: Two rapid membrane-based serologic assays using antigen(38-kDa) from mycobacterium tuberculosis for the diagnosis of tuberculosis were evaluated in 22 patients with smear-positive pulmonary tuberculosis, 14 patients with inactive pulmonary tuberculosis, and 9 patients with non-tuberculous lung disease. RESULT: The evaluation of validity(sensitivity, specificity, positive predictive value, negative predictive value, false positivity and false negativity) of STAT-PAK ULTRA FAST(R) were 77.3%, 28.6%, 63.0%, 44.4%, 71.4%, and 22.7% for differential diagnosis of active pulmonary tuberculosis and inactive pulmonary tuberculosis, respectively. The evaluation of validity of STAT-PAK ULTRA FAST(R) were 77.3%, 33.3%, 73.9%, 37.5%, 66.7%, and 22.7% for differential diagnosis of active pulmonary tuberculosis and non-tuberculosis. The evaluation of validity of ICT Tuberculosis were 54.5%, 57%, 66.7%, 44.4%, 42.9%, and 45.5% for differential diagnosis of active pulmonary tuberculosis and inactive pulmonary tuberculosis. The evaluation of validity of ICT Tuberculosis were 54.5%, 100%, 100%, 47.4%, 0%, and 45.4% for differential diagnosis of active pulmonary tuberculosis and non-tuberculosis. CONCLUSION: We concluded no effectiveness of STAT-PAK ULTRA FAST(R) and ICT tuberculosis on serologic diagnosis of pulmonary tuberculosis. In the future, further large-scale study should be needed for serologic diagnosis of pulmonary tuberculosis.

BACKGROUND: IFN-gamma plays an important role in host response to intracellular organisms such as mycobacterium. Human infection with mycobacterium leads to a wide variety of outcomes, ranging from asymptomatic infection to widespread and rapidly fatal disease. Recent reports suggest that alteration of the function of IFN-gamma caused by a defective IFN-gamma receptor gene can explain different host response to mycobacterium. In this study, we investigated the role of IFN-gamma in the development of chronic refractory tuberculosis. METHODS: The LPS-induced TNF-alpha production with or without IFN-gamma priming was compared by using monocytes taken from recently diagnosed tuberculosis, chronic refractory tuberculosis patients and controls. And the IFN-gamma receptor was measured by indirect fluorescent antibody technique to know whether change in the priming effect of IFN-gamma is related to IFN-gamma receptor deficiency or not. RESULTS: The ratio of TNF-alpha produced in response to stimulation with INF-gamma and LPS to LPS alone was 13.5 +/- 7.6 in controls, 10.8 +/- 6.4 in recently diagnosed tuberculosis patients and 6.7 +/- 3.9 in chronic refractory tuberculosis patients. The priming effect of IFN-gamma significantly decreased in chronic refractory tuberculosis patients compared with that in controls (p=0.002). However, IFN-gamma receptor deficiency was detected in one of chronic refractory tuberculosis patients. CONCLUSION: The decrease of the priming effect of IFN-gamma may play an important role in the development of chronic refractory tuberculosis, and in some patients, this may be related to the IFN-gamma receptor deficiency.

We isolated Triton X-100 solubilized protein (TSP) antigen which may be preferentially associated with the cell wall of M. tuberculosis. In this study, the proliferative activities and cytokine mRNA expression patterns of the TSP antigen were investigated in peripheral blood mononuclear cells (PBMCs) and lymph node mononuclear cells (LNMCs) from 4 patients with tuberculous lymphadenitis. The results of the TSP antigen were compared with those of the PPD antigen, known as a major seretory protein antigen of M. tuberculosis. The peak proliferative response to the TSP by PBMCs was observed at 0.1 ug/ml, whereas that of LNMCs was at 1.0 ug/ml. All of the patients showed greater blastogenic responses for the PPD than those for the TSP. IFN-r, IL-2, and IL-2Ru mRNA production from PBMCs after stimulation with the TSP were greatly augmented after 48 hrs, whereas IL-4 and IL-10 mRNA were gradually suppressed. In addition, high levels of IL-12 p40 mRNA were detected by PBMCs to the TSP antigen at 3 hrs. Elevated IFN-r and IL-2 mRNA production were observed in freshly isolated LNMCs, whereas IL-4 mRNA production was undetectable in either freshly isolated or mycobacterial antigen-stimulated LNMCs. Furthermore, IL-10 mRNA expression from LNMCs was markedly increased by the PPD antigen, but it was considerably reduced by the TSP antigen after 18 hrs. These data suggest that the TSP antigen may be a strong inducer of cytokine mRNA such as IFN-r, IL-2, and IL-12 which are involved in Thl cell and macrophage activation, and inhibit IL-10 mRNA production in LNMCs. In conclusion, the TSP antigen can be used as a preferential Thl cell immunogen in tuberculous lymphadenitis.