Osteoarticular tuberculosis (OAT) is an extrapulmonary tuberculosis and accounts for 1 to 3% of all tuberculosis cases. We used an rpoB PCR-plasmid TA cloning-sequencing method to detect and identify tubercle bacilli in surgical specimens from patients suspected of having OAT. By comparing the similarities of the rpoB sequences determined with those in GenBank, Mycobacterium tuberculosis was detected in 23 of 43 samples. Three of the 23 positive samples had mutations at codon 531, which are commonly observed in rifampin-resistant M. tuberculosis strains. Our results suggest that the rpoB PCR-TA cloning-sequencing method developed, which detects M. tuberculosis and which simultaneously determines its rifampin susceptibility, can also be used efficiently for the diagnosis of OAT.The World Health Organization reported that nearly a third of the world's population suffers from tuberculosis (TB). Each year 8 million individuals have active disease, and 2 million deaths occur annually (28). With this resurgence, cases of extrapulmonary TB have also shown an increase. Approximately, 10 to 11% of extrapulmonary TB cases involve joints and bones (1 to 3% of all reported TB cases).Thus, the estimated global prevalence of latent joint and bone TB is approximately 19 million to 38 million cases (17). Moreover, since osteoarticular tuberculosis (OAT) can cause functional disability, it should be accurately diagnosed and treated early.As the identification of mycobacterial species from clinical samples usually requires culture (26), the diagnosis of OAT depends upon microbiologic testing (i.e., smear or culture) and the histologic examination of tissue samples. Although culture is the "gold standard," it may take 6 to 8 weeks before a positive culture is detected (22), unless the radiometric BACTEC 460 method or the nonradiometric BACTEC 960/ Mycobacteria Growth Indicator Tube method (4) is used.In recent years, several nucleic acid-based techniques have been developed for the rapid detection of Mycobacterium tuberculosis in clinical samples. By testing sputa and bronchoalveolar lavage specimens, mycobacteria can be detected and identified by PCR or PCR-linked methods (1, 18). However, unlike pulmonary TB samples, such as sputa and bronchoalveolar lavage specimens, from which tubercle bacilli are concentrated for culture and further testing, joint biopsy samples usually contain only a small number of bacteria. This causes difficulties with culture and staining for acid-fast bacilli (8,17,19) that necessitate the use of molecular biology-based methods.In the present study, rpoB PCR-plasmid TA cloning-sequencing for Mycobacterium species was applied directly to clinical specimens from patients suspected of having OAT without culture. rpoB encodes the ␤ subunit of RNA polymerase (3), and recently, partial rpoB DNA sequences containing the Rif r region, which is related to rifampin resistance, have been used to identify Mycobacterium species (5, 10, 11) and non-Mycobacterium species (12,13,14,15,16).M. tuberculosis is readily dif...

Background: Obstructive sleep apnea (OSA) is associated with diverse health risks, including death. However, the role of OSA as a risk factor for death has never been studied in Asians. This study is aimed at evaluating the infl uence of OSA on the mortality in Korean sleep clinic population. Methods: A total of 2,240 patients who underwent in-laboratory full-night polysomnography due to snoring or sleep apnea were included. The patients were categorized based on apnea-hypopnea index (AHI)/hour. Death records were provided from the Statistics Korea. A Cox-proportional hazard regression model and Kaplan-Meier survival curve were used for analysis and demonstration of the all-cause mortality and cardiovascular mortality. Results: The all-cause mortality risk adjusted for age, sex, body mass index, diabetes, hypertension, cardiovascular diseases, and previous history of stroke was signifi cantly associated with the increased severity of OSA. The adjusted hazard ratio (HR) for all-cause mortality in the severe OSA group (AHI ≥ 30) vs. reference group (5 < AHI) was 2.47 (95% confi dence interval [CI], 1.09-5.57) and the adjusted HR for cardiovascular mortality was 4.66 (CI 1.03-21.08). After adjusting for whether the patients were treated or untreated, the HR for all-cause and cardiovascular mortality in the severe OSA group vs. reference group were 2.14 (p = 0.079) and 4.19 (p = 0.076), respectively. Conclusions: The present study showed that the increased mortality was also associated with the increased severity of OSA in Koreans as shown in the studies performed in the Western countries.

Introduction: Hearing aids (HAs) with frequency lowering have been used for high-frequency hearing loss (HFHL), but their effects on tinnitus relief have not been studied extensively. This randomized double-blind trial was performed to investigate and compare tinnitus suppression effects of conventional type HAs and frequency-lowering HAs in patients with HFHL. Methods: A total of 114 patients were randomized into three groups: conventional HA using wide dynamic range compression, HA with frequency translation, and HA with linear frequency transposition. Participants wore HAs for 3 months and then discontinued their use. The final evaluation was performed at 3 months after cessation of wearing HA (6 mo after the initial visit). The Tinnitus Handicap Inventory (THI) score and additional variables, such as matched tinnitus loudness and visual analog scale scores of subjectively perceived tinnitus loudness, daily awareness, and annoyance, were measured at the initial visit and at 3- and 6-month follow-ups. Results: THI score and most of the additional outcomes were significantly improved at 3 and 6 months (3 mo after HA removal) compared with their initial values in all three groups. The incidence rates of patients with improvements in the THI score by 20% or more were 71.0, 72.7, and 74.3% at 3 months, and 54.8, 51.6, and 59.4% at 6 months for the three groups, respectively. There were no significant differences in primary or additional variables between hearing aid types at either 3 or 6 months. Conclusion: This is a consolidated standards of reporting trials-guided study providing direct evidence for tinnitus suppression effects of HA alone, without accompanying counseling or any other treatments, which lasted for at least 3 months after patients stopped using HAs. HAs effectively suppressed tinnitus in patients with HFHL regardless of the amplification strategy type.