No abstract available.
Epithelium* ; Humans* ; Insulin*

The vaccinations of susceptible children and postpubertal females are the major means to prevent congenital rubella syndrome(CRS). Another means for reducing the CRS is therapeutic abortion or fetal monitoring for women who are infected in the first four months of pregnancy. We couldnt estimate the incidence of CRS in Korea, because there was no surveillance system for rubella and CRS. Nationwide vaccination program for 15months infant had been started early 1980s. So, most women at childbearing age during study period were not received rubella vaccination. We set forth CRS management system for pregnant women in two rural county of Kyonggi province, Korea. In this system, the presence of rubella IgG and IgM antibodies for early pregnant women were examined with MEIA(Microparticle Enzyme Immunoassay) method by IMx automated analyzer Abbott. The infected pregnant women followed up in order to confirm their children CRS. This study was carried out from Mar.1993 to Jun.1994, and pregnant women examined were 874 persons. The results were summarized as follows. The overall positive rate of rubella IgG antibody was 94.5%(826/874). The positive rate was significantly increase as the age increased, and reached 100% in pregnant women who were over 35 years old. This results suggest that a meaningful number of women are infected during childbearing years. The geometric mean titer of IgG of sero-positive subjects was significantly declined as the age increased. On the question about history of URI symptoms and rash in pregnancy, 20.7% of respondents checked on URI symptoms with rash, 13.5% only URI symptoms without rash, and 65.8% no symptoms. However there was no demonstrable association between the rubella like infection history in pregnancy and the rubella IgG and IgM antibody status. Rubella infection rate in pregnant women was 0.9%(95% CI 0.4-1.8%). Two of these 8 infected pregnancies were terminated by therapeutic abortion. One of them was not followed. Five babies had no gross anomalies at birth. In Dec.1996, three of five babies were normal appeared infants. Two of them were not followed. Throughout this study results, we confirmed the need of CRS management system for pregnant women, in Korea.
Abortion, Therapeutic ; Adult ; Antibodies ; Child ; Surveys and Questionnaires ; Exanthema ; Female ; Fetal Monitoring ; Gyeonggi-do* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Infant ; Korea ; Parturition ; Pregnancy ; Pregnant Women* ; Rubella* ; Seroepidemiologic Studies* ; Vaccination

The primary malignant tumor of the peritoneum also known as primary peritoneal carcinoma or primary peritoneal papillary serous carcinoma is rare and involves the peritoneum, especially the pelvic peritoneum of female patients. It is difficult to differentiate histologically between papillary mesothelioma, primary ovarian tumor and primary peritoneal carcinoma. We report two cases of the primary peritoneal carcinoma with clinical presentation and histologic characteristics.
Diagnosis, Differential ; Female ; Humans ; Mesothelioma ; Peritoneum*

BACKGROUND: Clinic-based blood pressure measurements may lead to untoward results in the management of hypertension. Masked hypertension (MH) has been shown to be related to a poor prognosis due to its hidden nature. The purpose of this study is to present the clinical predictors of MH in elderly patients over 65 years with well-controlled clinic blood pressure (CBP) and to evaluate the gap, the 'mask effect' (negative white-coat effect), between CBP and home blood pressure (HBP). METHODS: The BPs of 1,019 treated hypertensive patients were measured by a doctor at an out-patient clinic and by patients themselves at home. Clinical parameters for MH were analyzed in 511 patients with well-controlled CBP (45.6% men, mean age 57.1+/-9.0 years). RESULTS: Among the patients over 65 years (n=113, 46.8% men, mean age 68.4+/-7.3 years) and with well-controlled CBP, the prevalence of MH was 26.5% (30 patients). In multivariate-adjusted analysis, the risk of MH increased with physical inactivity (odds ratio [OR], 2.942; 95% confidence interval [CI], 1.039-8.329; p=0.042), use of beta-blocker (OR, 4.242; 95% CI, 1.528-11.785; p=0.06) and systolic clinic BP (OR, 1.083; 95% CI, 0.017-1.154; p=0.013). Furthermore, HBP correlated well with CBP (r=0.329; p<0.001) and further with degree of ME (r=0.723; p<0.001). CONCLUSION: In looking for MH, it would be useful to carefully assess patients taking beta-blockers, having higher CBP, and who are physically inactive by using self-monitoring home or ambulatory BP monitoring.
Aged ; Blood Pressure ; Humans ; Hypertension ; Male ; Masked Hypertension ; Masks ; Outpatients ; Prevalence ; Prognosis

BACKGROUND AND OBJECTIVES: Morning hypertension is closely related to target organ damage and cardiovascular events. Little data is available concerning the baseline characteristics and comprehensive blood pressure analysis of hypertensive patients on treatment with morning hypertension. SUBJECTS AND METHODS: We evaluated 1,087 hypertensive patients who had taken stable anti-hypertensive medication at least 6 months. The enrolled patients measured their home blood pressure for 7 days. Baseline characteristics and the laboratory data were analyzed. Morning hypertension was defined as a morning blood pressure > or =135/85 mm Hg and systolic or diastolic blood pressure difference between morning and evening exceeding 10 mm Hg. RESULTS: One hundred seventy three patients with morning hypertension showed a preponderance of males, older patients, alcohol consumers, and greater waist circumference and waist-to-hip ratio despite the same body mass index. Impaired fasting glucose and metabolic syndrome were more prevalent in the patients with morning hypertension. The morning hypertensives took more anti-hypertensive drugs and displayed higher blood pressure in the clinic and at home. CONCLUSION: The worse clinical variables and relatively poorly controlled blood pressure of those with morning hypertension supports a potential relationship of morning hypertension with poor cardiovascular outcome. Morning blood pressure should be monitored at home for the optimal treatment of hypertension.
Antihypertensive Agents ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Body Mass Index ; Fasting ; Glucose ; Humans ; Hypertension ; Male ; Waist Circumference ; Waist-Hip Ratio

No abstract available.
Aneurysm* ; Coronary Vessels* ; Stents*

This study was performed to compare clinical and imaging parameters and prognosis of unprovoked pulmonary embolism (PE), provoked PE with reversible risk factors (provoked-rRF), and provoked PE with irreversible risk factors (provoked-iRF) in Koreans. Three hundred consecutive patients (mean age, 63.6 +/- 15.0 yr; 42.8% male) diagnosed with acute PE were included. The patients were classified into 3 groups; unprovoked PE, provoked-rRF, and provoked-iRF; 43.7%, 14.7%, and 41.7%, respectively. We followed up the patients for 25.4 +/- 33.7 months. Composite endpoint was all-cause mortality and recurrent PE. The provoked-iRF group had significantly higher all-cause mortality, mortality from PE and recurrent PE than the unprovoked and provoked-rRF groups (P < 0.001, P < 0.001, and P = 0.034, respectively). Prognostic factors of composite endpoint in the unprovoked group were high creatinine (> 1.2 mg/dL; P < 0.001; hazard ratio [HR], 4.735; 95% confidence interval [CI], 1.845-12.152), C-reactive protein (CRP; > 5 mg/L; P = 0.002; HR, 5.308; 95% CI, 1.824-15.447) and computed tomography (CT) obstruction index (P = 0.034; HR, 1.090; 95% CI, 1.006-1.181). In conclusion, provoked-iRF has a poorer prognosis than unprovoked PE and provoked-rRF. Renal insufficiency, high CRP, and CT obstruction index are poor prognostic factors in unprovoked PE.
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; C-Reactive Protein/analysis ; Creatinine/blood ; Echocardiography ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Pulmonary Embolism/diagnosis/mortality/*radiography ; Recurrence ; Renal Insufficiency/complications ; Republic of Korea ; Risk Factors ; Survival Rate ; Tomography, X-Ray Computed

This study was performed to compare clinical and imaging parameters and prognosis of unprovoked pulmonary embolism (PE), provoked PE with reversible risk factors (provoked-rRF), and provoked PE with irreversible risk factors (provoked-iRF) in Koreans. Three hundred consecutive patients (mean age, 63.6 +/- 15.0 yr; 42.8% male) diagnosed with acute PE were included. The patients were classified into 3 groups; unprovoked PE, provoked-rRF, and provoked-iRF; 43.7%, 14.7%, and 41.7%, respectively. We followed up the patients for 25.4 +/- 33.7 months. Composite endpoint was all-cause mortality and recurrent PE. The provoked-iRF group had significantly higher all-cause mortality, mortality from PE and recurrent PE than the unprovoked and provoked-rRF groups (P < 0.001, P < 0.001, and P = 0.034, respectively). Prognostic factors of composite endpoint in the unprovoked group were high creatinine (> 1.2 mg/dL; P < 0.001; hazard ratio [HR], 4.735; 95% confidence interval [CI], 1.845-12.152), C-reactive protein (CRP; > 5 mg/L; P = 0.002; HR, 5.308; 95% CI, 1.824-15.447) and computed tomography (CT) obstruction index (P = 0.034; HR, 1.090; 95% CI, 1.006-1.181). In conclusion, provoked-iRF has a poorer prognosis than unprovoked PE and provoked-rRF. Renal insufficiency, high CRP, and CT obstruction index are poor prognostic factors in unprovoked PE.
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; C-Reactive Protein/analysis ; Creatinine/blood ; Echocardiography ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Pulmonary Embolism/diagnosis/mortality/*radiography ; Recurrence ; Renal Insufficiency/complications ; Republic of Korea ; Risk Factors ; Survival Rate ; Tomography, X-Ray Computed

A current hypothesis gaining prominence proposes that activation of the telomerase is necessarey for cells to become immortal, or be capable of proliferating indefinitely. The theory suggersts that that almost all cancer cells must attain immortality for progression to malingnant state and, hence, require activation of telomerase. To assess the role of telomerase in the development of mailignant transformation of the uterine cervical carcinoma, telomerase activeiy was measured by using a recently developed sensitive RPR-based telomerase assay(telomeric repeat amplification protocol; TRAP)in benign uterine condition and invasive uterine cervical carcinoma tissues revealed to be telomerase positive (14/16, 88%) which represents a characteristic 6 bp ladder pattern, while none of the 4 cervical tissues with the nonspecific pathologic findings or just chronic cervictis which were obtained by simple bysterenctomy under the diagnoses of benign myoma or uterine prolapse showed any telomerase actiovity. These findings suggest that this enzyme activity may play a key role in the establishment and progression of the uterine cervical carcinoma. This activity of telomerase may influence from the initial stage of tumorigenesis of uterine cervical carcinoma because poitive findings were noticed from the early stage (stage Ia1) to the advanced stage. The results of neoadjuvant chemotherpy which were revealed in final histopathologic specimens following radical hysterectomuy, pelvic and raraaortic lymph nodes dissection (suggestion by Rosen et al,) were one grade IV wiht telomerase poistive, 2 grade III with all positivie, 5grade II with 3 positive 2 negative. The two cases of pelvic lymph node metastasis belong to the group of grade II and their activeities of telomerase were 1 positive and 1negative. The situation of apoptosis induced by antineoplastic chemotherapy has not been related to that of telomerase activeity. Furthemore, the late recurrences has been noticed over 5years follow-up following neoadjuvant chemotherapy and radical surgery for the management of the high risk group of patients (not shown in this study) This measn that the nowday's regimen for induction tumoricidals may have been operating as dual effects (partial restoring and redamaging) to the cell cycle chekpoint. Therefore if telomerase inhibitor will be applied combined whit the induction chemotherapy, unexpected benefits mignt be obtained for the patient with the advanced uterine cervical carcinoma.
Apoptosis ; Carcinogenesis ; Cell Cycle ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Induction Chemotherapy ; Lymph Nodes ; Myoma ; Neoplasm Metastasis ; Recurrence ; Telomerase ; Uterine Prolapse

A current hypothesis gaining prominence proposes that activation of the telomerase is necessarey for cells to become immortal, or be capable of proliferating indefinitely. The theory suggersts that that almost all cancer cells must attain immortality for progression to malingnant state and, hence, require activation of telomerase. To assess the role of telomerase in the development of mailignant transformation of the uterine cervical carcinoma, telomerase activeiy was measured by using a recently developed sensitive RPR-based telomerase assay(telomeric repeat amplification protocol; TRAP)in benign uterine condition and invasive uterine cervical carcinoma tissues revealed to be telomerase positive (14/16, 88%) which represents a characteristic 6 bp ladder pattern, while none of the 4 cervical tissues with the nonspecific pathologic findings or just chronic cervictis which were obtained by simple bysterenctomy under the diagnoses of benign myoma or uterine prolapse showed any telomerase actiovity. These findings suggest that this enzyme activity may play a key role in the establishment and progression of the uterine cervical carcinoma. This activity of telomerase may influence from the initial stage of tumorigenesis of uterine cervical carcinoma because poitive findings were noticed from the early stage (stage Ia1) to the advanced stage. The results of neoadjuvant chemotherpy which were revealed in final histopathologic specimens following radical hysterectomuy, pelvic and raraaortic lymph nodes dissection (suggestion by Rosen et al,) were one grade IV wiht telomerase poistive, 2 grade III with all positivie, 5grade II with 3 positive 2 negative. The two cases of pelvic lymph node metastasis belong to the group of grade II and their activeities of telomerase were 1 positive and 1negative. The situation of apoptosis induced by antineoplastic chemotherapy has not been related to that of telomerase activeity. Furthemore, the late recurrences has been noticed over 5years follow-up following neoadjuvant chemotherapy and radical surgery for the management of the high risk group of patients (not shown in this study) This measn that the nowday's regimen for induction tumoricidals may have been operating as dual effects (partial restoring and redamaging) to the cell cycle chekpoint. Therefore if telomerase inhibitor will be applied combined whit the induction chemotherapy, unexpected benefits mignt be obtained for the patient with the advanced uterine cervical carcinoma.
Apoptosis ; Carcinogenesis ; Cell Cycle ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Induction Chemotherapy ; Lymph Nodes ; Myoma ; Neoplasm Metastasis ; Recurrence ; Telomerase ; Uterine Prolapse