We encountered a case of neonatal altoimmune thrombocytopenia(NAIT) due to anti-HLA-B7+B60+B61. Bilateral cephal hematoma and umbilical hematoma were noted at the time of birth. Purpura developed at the third day. Platelet count was 110,000 at birth and decreased to 66,000/micro liter at the day 4. Prothrombin time and partial prothrombin time were within normal limit. The mother's platelet count was 220,000/micro liter and she had no history of abnormal bleeding. Platelet antibody tests empolying mixed passive hemagglutination and immunofluorescence revealed that the mother's serum was reactive against the platelets from the father and the neonate, but was not reactive with her own platelets. Platelets from eight volunteer group 0 donors were tested with the mother's serum; seven were reactive and one was negative. The positive reactions were lost after chloroquine treatment of platelets. Antigen capture ELISA(ACE) and modified antigen capture ELISA employing monoclonal antibodies against platelet glycoproteins In, IIa, IIb, and IIIa were negative. Mother's serum was tested for lymphocytotoxicity against 49 donor ]ymphocytes and the specificity was found to be anti-HLA-B7+B60+B61. At the 9th day, one unit of platelet concentrate from the mother was transfused and the platelet count of the neonate rose up to 340,000/micro liter. The neonate was discharged at the day of sixteenth and the platelet count remained high thereafter.
Antibodies, Monoclonal ; Blood Platelets ; Chloroquine ; Enzyme-Linked Immunosorbent Assay ; Fathers ; Fluorescent Antibody Technique ; Hemagglutination ; Hematoma ; Hemorrhage ; Humans ; Infant, Newborn ; Mothers ; Parturition ; Platelet Count ; Platelet Membrane Glycoproteins ; Prothrombin Time ; Purpura ; Sensitivity and Specificity ; Thrombocytopenia* ; Tissue Donors ; Volunteers

BACKGROUND AND OBJECTIVES: Attic cholesteatoma which develops from the papillary or retracted from progresses through various anatomic sites such as the mesotympanium, the mastoid process and the epitympanium. Although the most common site for attic cholesteatoma is the lateral attic space, it has also been found frequently in the medial attic space. We hoped to understand the pathogenesis of attic cholesteatoma through clinical analyses in order to contribute to the cholesteatoma treatment. MATERIALS AND METHODS: We chose 60 attic cholesteatoma patients showing attic retraction or perforation. These cases of attic cholesteatomas were classified into either the lateral or the medial types depedning on the main site of occurence. They were further classified into anterior, posterior and inferior types according to the direction of cholesteatomatic progression. CONCLUSION: The accurate assessment and clear understanding of the pathogenesis of different forms of cholesteatoma enabled a successful operation and helped to minimize the operative field.
Cholesteatoma* ; Hope ; Humans ; Mastoid

OBJECTIVES: To identify the psychosocial well-being status in a rural community, and examine the association between the psychosocial well-being status and adverse lipid profile. METHOD: In 2001, we surveyed 575 subjects in Yangpyoung, Kyounggido, including medical examination, fasting-blood sample and questionnaires for the psychosocial well-being status, socioeconomic position and behavioral risk factors. The logistic regression analysis was used to examine explanatory factors of the psychosocial well-being status, and association between the psychosocial well-being status and adverse lipid profiles. RESULT: The association between the psychosocial well-being status and adverse lipid profiles was not strong. The total cholesterol and triglyceridelevels were associated with psychosocial well-being. The adjusted odds ratio for moderate psychosocial well-being relating to total cholesterol was 1.90 (95%CI, 0.82-4.04), but that for triglyceride was 0.65 (95%CI, 0.36-1.21). The HDL-Cholesterol and LDL-Cholesterol level were not associated with the psychosocial well-being status. CONCLUSION: The total cholesterol and psychosocial well-being status were weakly associated, but the between the psychosocial well-being status and adverse lipid profiles were not consistent.
Cardiovascular Diseases ; Cholesterol ; Logistic Models ; Methods ; Odds Ratio ; Risk Factors ; Rural Population ; Social Class ; Triglycerides

OBJECTIVES: The purpose of this study was to evaluate the predictors of metabolic syndrome in shipyard workers in the Southwestern part of South Korea and determine its prevalence. METHODS: The study subjects were composed of 1,198 medical check-up examinees, age 37 to 58 years who were examined in a general hospital from July, 2007 to August, 2008. Information about age, smoking, drinking and exercise was based on data from self-administered questionnaires. We collected job factors, education level and marital status from company personnel data and the indices of metabolic syndrome from the medical check-up. RESULTS: The prevalence of metabolic syndrome among the 1,198 shipyard workers was 15.0%. The prevalence of the components of metabolic syndrome was as follows: 26.9% for central obesity, 31.7% for hypertension, 32.2% for hypertriglyceridemia, 19.2% for low HDL-cholesterolemia and 5.2% for hyperglycemia. Adjusted odds ratio for metabolic syndrome was significantly decreased in productive workers (OR: 0.500, 95% CI: 0.327-0.764). Furthermore, factors such as age, smoking, drinking, exercise, work duration and job type were significantly associated with metabolic syndrome. CONCLUSIONS: Our findings suggest that even though shipyard workers work for the same employer, the prevalence of metabolic syndrome varies to job type, shift work and work duration. Therefore, general metabolic syndrome management programs for shipyard workers should be designed and tailor-made for specified job characteristics to prevent cardiovascular disease more effectively. Also, thorough control and management of the tailor made metabolic syndrome management programs is needed in the early stages of metabolic syndrome for good health outcomes.
Cardiovascular Diseases ; Drinking ; Health Promotion ; Hospitals, General ; Hyperglycemia ; Hypertension ; Hypertriglyceridemia ; Marital Status ; Obesity, Abdominal ; Occupations ; Odds Ratio ; Prevalence ; Questionnaires ; Republic of Korea ; Smoke ; Smoking

BACKGROUND: It has been shown that severe asthmatic attacks are related to airway hyperresponsiveness (AHR). However, there has been no study on AHR measured just after control of acute severe asthma. OBJECTIVE: To determine the degree of AHR following acute severe asthma and to evaluate the safety of AHR measurement in patients just recovering from a severe attack. METHOD: In 23 consecutive asthma patients just recovering from a severe attack (10 severe, 13 near-fatal), all medications except inhaled or systemic steroids were withdrawn temporarily for more than each action time. Then a methacholine bronchoprovocation test was performed in patients with FEV1 > or = 75% of predicted or personal best value. RESULTS: Mean duration required to control asthma was 5.6+/-3.6 days, and methacholine provo- cation test was performed at 12.6+/-5.2 hospital days. The patients showed significantly lower methacholine-PC20 (geometric mean: 0.54 vs 1.64 mg/ml, p<0.05) and steeper slope of dose-response curve (p<0.01) compared to 62 outpatients. Initial FEV1 (r=0.470, p<0.05) and the duration required to control asthma (r=-0.623, p<0.01) were significantly related to methacholine-PC20. However, only 9 patients (39.1%) showed severe AHR, which was not significantly different from outpatients (25.8%). CONCLUSION: These results suggest that AHR is a risk factor of severe asthmatic attack and methacholine challenge just after control of acute asthma is relatively safe.
Asthma* ; Humans ; Methacholine Chloride* ; Outpatients ; Risk Factors ; Steroids

PURPOSE: Femorofemoral crossover bypass (FCB) is a good procedure for patients with unilateral iliac artery disease. There are many articles about the results of FCB, but most of them were limited to 5 years follow-up. The purpose of our study was to analysis the results of FCB with a 10-year follow-up period. MATERIALS AND METHODS: Between January 1995 and December 2010, 133 patients were operated in Samsung Medical Center (median follow-up: 58.8 months). We retrospectively analysed patient characteristics, the preoperative treatment, the operative procedure, and material used. RESULTS: The indications for FCB were claudication in 110 and critical limb ischemia in 23 patients. Three patients were died due to myocardiac infarction, intracranial hemorrhage, and acute respiratory failure within 30 days after surgery. The one-year primary and secondary patency rates were 89% and 97%, the 5-year primary and secondary patency rates were 70% and 85%, and the 10-year primary and secondary patency rates were 31% and 67%. The 5-year and 10-year limb salvage rates were 97% and 95%, respectively. CONCLUSION: Our long term analysis suggests that FCB might be a valuable alternative treatment modality in patients with unilateral iliac artery disease.
Extremities ; Follow-Up Studies ; Humans ; Iliac Artery ; Infarction ; Intracranial Hemorrhages ; Ischemia ; Limb Salvage ; Respiratory Insufficiency ; Retrospective Studies ; Surgical Procedures, Operative ; Transplants* ; Vascular Patency

OBJECTIVES: Lead exposure is known to be associated with high blood pressure, hypertension, coronary artery disease, peripheral arterial disease, left ventricular hypertropy, and electrocardiographic abnormalities. We investigated the association between blood lead and coronary artery calcification and stenosis. METHODS: Between April 2006 and July 2007, 502 adults (345 males and 157 females), who had no history of cardiovascular disease or occupational exposure to lead, were recruited as study subjects. All subjects underwent coronary CT angiography and blood lead measurement. RESULTS: Blood lead levels were distributed from 0.43 to 11.30 (microgram/dL with a geometric mean blood lead level of 2.98+/-1.5 (microgram/dL. The geometric mean blood lead levels were higher in men than women (3.31+/-1.5 (microgram/dL vs. 2.36+/-1.5 (microgram/dL, P < 0.01). Based on a multivariate analysis, a 1 unit ((microgram/dL) increase in blood lead level was associated with a 1.09 (95% confidence interval, 0.92~1.29) and a 1.01 fold (95% confidence interval, 0.63~1.63) greater risk for coronary artery calcification in men and women, respectively. Similarly, a 1 unit (microgram/dL) increase in blood lead level was associated with a 1.25 (95% confidence interval, 1.03~1.51) and a 1.42 fold (95% confidence interval, 0.73~2.75) greater risk for coronary artery stenosis in men and women, respectively. CONCLUSIONS: The results suggest that increased blood lead levels are associated with an increased risk of coronary artery stenosis.
Adult ; Angiography ; Cardiovascular Diseases ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Electrocardiography ; Female ; Humans ; Hypertension ; Male ; Multivariate Analysis ; Occupational Exposure ; Peripheral Arterial Disease

The mucin-hypersecreting biliary papillomatosis is a premalignant neoplasm characterized by intraductal papillary proliferation involving extensive areas of the intrahepatic and/or extrahepatic bile duct. We report a case of mucin-hypersecreting biliary papillomatosis manifested as obstructive jaundice and diagnosed only by microscopy, with a review of literatures. A 74-year-old female, who had a past history of cholecystectomy about 13 years ago, was admitted to our hospital with jaundice. A CT scan showed marked dilatation of intrahepatic and extrahepatic bile duct without intraductal filling defect or extrabiliary mass. During endoscopic retrograde cholangiopancreatography, mucin extrusion from the duodenal major papilla and dilated common bile duct with amorphous filling defects was noted. Percutaneous transhepatic biliary drainage for cholangioscopy was failed. In the operation field, there was a lot of mucin but was no visible mass at the common bile duct with bare eyes and cholangioscopy. However, papilloma was detected at the random biopsy specimen by microscopy. The patient underwent partial resection of common bile duct and choledocho-jejunal anastomosis.
Aged ; Bile Duct Neoplasms/*diagnosis/radiography/surgery ; Cholangiopancreatography, Magnetic Resonance ; Female ; Humans ; Mucins/*secretion ; Papilloma/*diagnosis/radiography/surgery ; Tomography, X-Ray Computed

Here, we report the poisoning case of 10 cows. Several distinct clinical signs such as convulsion, excessive salivation, circling, lateral recumbency, and death were observed. Necropsy and histopathological examination did not reveal any significant abnormal findings. Moreover, no bacteria or viruses were detected in tissue, blood, and feeding food. However, endosulfan was detected from the stomach contents and microbials. Our results strongly suggest that death of cows may be closely associated with endosulfan poisoning.
Animals ; Bacteria ; Cattle* ; Endosulfan* ; Gastrointestinal Contents ; Poisoning* ; Salivation ; Seizures

Superior mesenteric artery (SMA) syndrome is a rare disorder, characterized by compression of the third segment of the duodenum by the mesenteric artery at the level of the SMA, resulting in duodenal dilatation. The most characteristic symptoms are postprandial epigastric pain, fullness, voluminous vomiting, and eructation. The diagnosis may be difficult, but can be confirmed by upper gastrointestinal (UGI) contrast studies. We report a case of SMA syndrome in a 66-year-old patient with hematemesis. Endoscopy showed deep circular ulcerations with bleeding in the distal esophagus. Computed tomography (CT) and an UGI contrast series revealed distension of the stomach and duodenum, with a cut-off in the third portion of the duodenum. We treated the patient conservatively, but the patient's symptoms did not improve. Ultimately, the patient underwent successful gastrojejunostomy with a favorable postoperative outcome.
Aged ; Dilatation ; Duodenum ; Endoscopy ; Eructation ; Esophagus ; Gastric Bypass ; Hematemesis ; Hemorrhage ; Humans ; Mesenteric Arteries ; Mesenteric Artery, Superior ; Stomach ; Superior Mesenteric Artery Syndrome ; Ulcer ; Vomiting