BACKGROUND: An increased frequency of the epsilon4 allele in Alzheimer's disease has been reported, which suggested a functional role of apolipoprotein E isoforms in pathophysiology of Alzheimer's disease. The aims of this study were to determine the frequency of ApoE genotypes in various types of dementia such as Alzheimer's disease, vascular dementia, and Parkinson's disease, to relate epsilon4 and assess risk factors for different types of dementia. METHODS: We assessed the frequency of Apolipoprotein E alleles in 29 patients with Alzheimer's disease, 10 patients with vascular dementia and 9 demented patients with Parkinson's disease. The Apolipoprotein E genotype was determined the polymerase chain reaction (PCR) with sequence-specific oligonuculeotide primers (SSOP) and reverse hybridiza- tion using the INNO-LiPA (Line Probe Assay) Apo E typing kit. RESULTS: Allele frequencies of epsilon2, epsilon3, and epsilon4 were : 0.5, 0.72, and 0.23 in Alzheimer's disease; 0, 0.65, and 0.35 in vascular dementia; 0.6, 0.83 and 0.11 in demented patients with Parkinson's disease. Conculsion : These results indicate that the apolipoprotein E4 allele is associated with not only Alzheimer's disease but also vascular dementia, however not associated with Parkinson's disease. No such an association was observed between the apolipoprotein E alleles and age.
Alleles ; Alzheimer Disease ; Apolipoprotein E4 ; Apolipoproteins E ; Apolipoproteins* ; Dementia ; Dementia, Vascular ; Gene Frequency ; Genotype* ; Humans ; Parkinson Disease ; Polymerase Chain Reaction ; Protein Isoforms ; Risk Factors

BACKGROUND: Early diagnosis of acute myocardial infarction (AMI) is essential for the patient's clinical course. Serum cardiac markers such as creatine kinase MB (CK-MB), myoglobin, and cardiac troponin I (cTnI) supply physicians with powerful methods of diagnosing AMI. We evaluated the usefulness of ACS:CentaurTM for the tests of cardiac markers. METHODS: We used three levels of control materials and 138 patient samples (AMI 49, cardiac diseases other than AMI 41, noncardiac diseases 48). We analyzed precision and linearity of CK-MB, myoglobin and cTnI using control materials. The cutoffs for the descrimination of AMI were determined using receiver operating characteristic (ROC) curve, and sensitivity and specificity of each marker were analyzed. RESULTS: Coefficients of variations (CVs) of within day precision and between day precision were below 4% except cTnI. Linearity analyses showed good results in all the three markers. The cutoffs were 3.7 ng/mL for CK-MB, 121.0 ng/mL for myoglobin and 0.4 ng/mL for cTnI. In the diagnosis of AMI, the sensitivities and specificities were 93.9% and 97.8% for CK-MB, 73.5% and 91.0% for myoglobin and 100.0% and 95.5% for cTnI, respectively. CONCLUSIONS: The tests of cardiac markers using ACS:CentaurTM showed satisfactory precision and linearity, and they are specific and sensitive in the diagnosis of AMI. So, ACS:CentaurTM is useful for the measurement of cardiac markers in the diagnosis of AMI.
Creatine Kinase ; Diagnosis ; Early Diagnosis ; Heart Diseases ; Humans ; Myocardial Infarction ; Myoglobin ; ROC Curve ; Sensitivity and Specificity ; Troponin I

BACKGROUNDS: Metabolic and environmental evaluation can provide a powerful tool for management of patients with urolithiasis. We developed the interpretative reporting system of the analysis of urine stone risk and evaluated the clinical usefulness of this system. METHODS: The analysis of urine stone risk with thirty five cases were performed at Samsung Medical Center from January 1 to June 30, 1999. They were studied using a protocol based on 24 hour urine tests including volume, pH, sodium, potassium, chloride, calcium, phosphate, uric acid, magnesium, citrate, oxalate, ammonium and creatinine. Nitroprusside-cyanide spot test, routine urine analysis, urine culture, and several serum tests including electrolytes, calcium, phosphate, uric acid, creatinine, alkaline phosphatase, parathyroid hormone were also included. The results of physical and chemical analysis of urine stone were considered together. Relative supersaturations were estimated using software program EQUIL. We provided comprehensive interpretation about the specific causes and risks of stone formation in each patient. RESULTS: Hyperoxaluria (57.1%), hypercalciuria (57.1%), natriuresis (51.4%) and hypocitraturia (34.3%) were commonly found at the urine of patients with urolithiasis. The results of urine stone risk analysis based on relative supersaturation and related laboratory findings correlated well with the results of urine stone analysis. Mixed form of calcium oxalate stone was most commonly encounterd. Increased supersaturation with respect to calcium oxalate stone was noted in 23 cases (65.7%), which were frequently accompanied by hyperuricosuria or increased supersaturation with uric acid stone. The pH of urine was generally increased in struvite stones and decreased in uric acid stones. CONCLUSIONS: Analysis of urine composition and determination of urine stone risk were very useful for evaluation of patients with urolithiasis. And the interpretative reporting system of the analysis of urine stone risk can provide meaningful information in the treament and prevention of stone disease.
Alkaline Phosphatase ; Ammonium Compounds ; Calcium ; Calcium Chloride ; Calcium Oxalate ; Citric Acid ; Creatinine ; Electrolytes ; Humans ; Hydrogen-Ion Concentration ; Hypercalciuria ; Hyperoxaluria ; Magnesium ; Natriuresis ; Parathyroid Hormone ; Potassium ; Sodium ; Uric Acid ; Urolithiasis

BACKGROUND: Fighter pilots are frequently exposed to high gravitational acceleration force acting along the body axis from the head to the feet (+GZ) and this gravitational force causes considerable strain on several organ systems, including cardiovascular system and kidneys. Proteinuria had been observed after +GZ stress but the characteristics of urinary protein and the mechanism of proteinuria are not closely investigated up to now. METHODS: A total of 44 student pilots were exposed to +6GZ for 30 seconds using Human Centrifuge and urine samples were collected before and after +GZ load. The amount of urinary protein was measured quantitatively and semiquantitatively with chemistry and dipstick, and the protein components were analysed with electrophoresis. RESULTS: After a total of 44 student pilots were exposed to +6GZ for 30 seconds without anti-G suit, 19 urine samples were positive in dipstick protein test and electrophoresis revealed that their major protein component was albumin. The amount of urinary protein excretion and urinary protein and creatinine ratios (UProt/UCr) were significantly increased to levels of 33.4+/-29.3 mg/dL and 0.239+/-0.203 in comparison with pre-G training levels of 8.8+/-4.3 mg/dL and 0.046+/-0.018, respectively. All 44 urine samples collected the next day of G training were negative in dipstick protein test and had protein levels of 6.8+/-3.0 mg/dL. Of 19 subjects showed proteinuria, 15 performed the same +GZ training again with anti-G suit and so only three urine samples were positive in dip stick protein test. CONCLUSIONS: These results indicates that transient proteinuria can be developed after high +GZ stress most possibly due to increased glomerular permeability of albumin and be effectively protected by the anti-G suit.
Acceleration* ; Axis, Cervical Vertebra ; Cardiovascular System ; Chemistry ; Creatinine ; Electrophoresis ; Foot ; Head ; Humans ; Kidney ; Permeability ; Proteinuria*

BACKGROUND: Lipoprotein lipase (LPL) gene polymorphisms have been found associated with coronary artery disease (CAD) and lipid levels, but their impact is less clearly established. The analysis of associations of LPL gene polymorphisms with CAD and lipid levels in Koreans was investigated. METHODS: Analysis of PvuII (intron 6), HindIII (intron 8), and Ser447-Ter (exon 9) polymorphisms of LPL gene were performed using restriction enzyme digestion of amplified DNA products and lipid levels were analyzed in healthy control subjects (n=228) and patients with CAD (n=166). RESULTS: PvuII, HindIII, and Ser447-Ter sites were in strong linkage disequilibrium. No statistical differences in the genotypic frequencies of PvuII, HindIII, and Ser447-Ter polymorphisms were observed between control and CAD groups. P2P2 genotype had higher triglyceride level in CAD group and lower HDL-cholesterol level in control group than the other genotypes (P1P1, P1P2). H2H2 genotype had higher triglyceride level in CAD group and lower HDL-cholesterol level in control group than the other genotypes (H1H1, H1H2). CONCLUSIONS: Genotypes of LPL PvuII, HindIII, and Ser447-Ter polymorphisms were not associated with CAD. Individuals with P2P2 and H2H2 genotypes, however, had higher triglyceride and lower HDL-cholesterol levels that is known to be the most commmon dyslipidaemia in CAD patients.
Coronary Artery Disease* ; Coronary Vessels* ; Digestion ; DNA ; Genotype ; Humans ; Linkage Disequilibrium ; Lipoprotein Lipase* ; Lipoproteins* ; Triglycerides

BACKGROUND: It had been well known that breast feeding to infants has many advantages and benefits comparing to formula feeding. So, We performed this study to clarify the relationship between immunoglobulin (Ig) levels and diet during newborn period. METHODS: We measured the levels of IgG, IgA and IgM by Array 360 System (Beckman Instruments, CA, U.S.A). Subjects were 29 breast-fed and 13 formula-fed newborns. We evaluated the results and analyzed the change of concentrations of IgG, IgA and IgM according to diet, sex and postnatal period. RESULTS: The levels of IgG, IgA and IgM in breast-fed newborns at postnatal 1-day were higher than formula-fed newborns, but the levels of Ig G and Ig A in formula-fed newborns at postnatal 30-day were higher than breast-fed newborns. CONCLUSIONS: There was no clinical signficance in the difference of IgG, IgA and IgM levels according to diet, sex and postnatal period, respectively.
Breast Feeding ; Diet ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins* ; Infant ; Infant, Newborn*

BACKGROUND: Propofol (2,6-diisopropylphenol) is one of the intravenous anesthetic drugs used for induction and maintenance of general anesthesia as well as for sedation in ICU patients and one-day surgery. The monitoring of propofol in blood helps to maintain anesthetic state and promote earlier recovery. So we attempted to find the rapid and simple method for blood propofol determination. METHODS: We compared the precipitation method with extraction one using whole blood, plasma and deionized water added a fixed amount of propofol. According to the extraction method, propofol was extracted from 500 microliter sample adding KH2PO4, ethyl acetate, and tetra-ethylammonium hydroxide using thymol as an internal standard. For the precipitation method, the precipitating solution (500 microliter) containing thymol was added to a 500 microliter sample, then mixed. After centrifugation, the supernatant was injected into HPLC system. A Waters 2690 separations module, Waters 474 fluorescence and 486 UV detector and a Symmetry column were used. We used Millennium software to control analyzing process and quantify propofol. RESULTS: The precipitation method using thymol as an internal standard and Waters 474 fluorescence detector showed the most excellent results. For the calibration curves, we found very good linearity in whole blood, plasma and deionized water (r> or =9976). Intra-assay and inter-assay coefficient of variation (CV) values of propofol for the precipitation method were 4.4% and 8.9% at 2 microgram/mL of propofol and 2.0% and 6.2% at 8 microgram/mL, respectively. The recovery rates of propofol for plasma and whole blood were 104.1% and 92.7% at 2 microgram/mL and 99.4% and 91.6% at 7 microgram/mL, respectively. CONCLUSIONS: For the measurement of the blood propofol level, the precipitation method using thymol as an internal standard and fluorescence detector seemed to be the rapid and simple method to apply for the clinical purpose.
Anesthesia, General ; Anesthetics ; Calibration ; Centrifugation ; Chromatography, High Pressure Liquid* ; Fluorescence ; Humans ; Plasma ; Propofol* ; Thymol ; Water

Pseudothrombocytopenia is an in vitro phenomenon usually associated with anticoagulant (ethylene diaminetetraacetic acid, EDTA)-dependent IgG platelet agglutinins. Two cases of pseudothrombocytopenia due to EDTA-independent agglutinins are reported. The fingerstick blood smear showed platelet clumping as well as EDTA, citrate and heparin samples. In a case with malaria, serum IgM was 985 mg/dL and serum protein immunofixation demonstrated an additional IgM band which disappeared together with platelet clumping a month later. The increased immunoglobulin (especially, IgM) appeared to be associated with platelet agglutinin. Another case had cold reactive agglutinin because the electronic platelet counts were dependent on temperature. These cases illustrate that pseudothrombocytopenia may be caused by more than one type of agglutinin and can be confirmed by using a direct fingerstick, keeping the sample warm, or drawing the blood into another anticoagulant.
Agglutinins* ; Blood Platelets ; Citric Acid ; Edetic Acid ; Heparin ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Malaria ; Platelet Count

BACKGROUND: As the new diagnostic methods for evaluation of fever of unknown origin (FUO) have been developed, the clinical spectrum of FUO has been changed. Although bone marrow study was commonly used in the evaluation of FUO, it's value has not been established. We evaluated the value of bone marrow study for FUO patients. MATERIAL AND METHODS: The 53 patients with FUO who have been performed bone marrow study from 1991 to 1998 were studied, retrospectively. Radiologic, serologic, hematologic, biopsy of tissue, chemistry, molecular and microbiologic review were included in this study. RESULTS: The etiology of FUO was identified in 31(58.5%) of the 53 patients through bone marrow examination. Of 53 patients, bacterial infection accounts for 12(22.6%); neoplasm 10(18.9%); SLE 3(5.7%); aplastic anemia 2(3.8%); drug induced 2(3.8%); necrotizing lymphadenitis 1(1.8%); hereditary spherocytosis 1(1.8%). Bone marrow examination as confirmative diagnostic method was valuable in 12(38.7%) of 31 patients who's etiology was identified. Of 53 patients, 22 persons (41.5%) showed no abnormal findings in marrow. CONCLUSION: Bone marrow study for FUO was very useful to diagnose hematologic diseases and miliary tuberculosis, but it was considered to be a less useful method for the initial diagnosis for the other diseases.
Anemia, Aplastic ; Bacterial Infections ; Biopsy ; Bone Marrow Examination ; Bone Marrow* ; Chemistry ; Diagnosis ; Fever of Unknown Origin* ; Fever* ; Hematologic Diseases ; Humans ; Lymphadenitis ; Retrospective Studies ; Tuberculosis, Miliary

Systemic nosocomial infection control programs were instituted for the first time in Korea by two university hospitals in Seoul in 1991 when full-time infection control nurses were employed. Since then, infection control programs and activities have been expanded to many university hospitals throughout the country, thanks to an increasing awareness of the importance of preventing nosocomial infections by the government, medical and academic communities and citizens' groups. However, progress has been slow. The tow major problems are: 1) the lack of financial incentives for the hospitals to prevent nosocomial infections ; and 2) a shortage of trained professionals, namely, the infection control nurse and the infection control physician. This review is to summerize the components of cost-effective infection control programs, and the current state of and the problems in the infection control in Korea; and to recommend the clinical pathologist a new role as a infection control physician, which will help not only to activate the infection control programs in the country, but also to reduce the financial loss of the hospital caused by nosocomial infections under the prospective payment system based on diagnosis related groups.
Cross Infection* ; Diagnosis-Related Groups ; Hospitals, University ; Infection Control ; Korea* ; Motivation ; Prospective Payment System ; Seoul