PURPOSE: Hyperhomocysteinemia has been identified as an independent risk factor in arterial and venous thrombosis. Mutations in genes encoding methylenetetrahydrofolate reductase (MTHFR), involved in the metabolism of homocysteine, may account for reduced enzyme activity and elevated plasma homocysteine levels. In this study, we investigated the interrelation of MTHFR C677T genotype and level of homocysteine in patients with arterial and venous thrombosis. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 146 patients who were diagnosed as having arterial and venous thrombosis. We excluded patients diagnosed with atrial fibrillation. We examined routinely the plasma concentration of total homocysteine level and MTHFR C677T polymorphism for evaluation of thrombotic tendency in all patients. Screening processes of MTHFR C677T polymorphism were performed by real-time polymerase chain reaction. RESULTS: Investigated groups consisted of thrombotic arterial occlusion in 48 patients and venous occlusion in 63 patients. The distribution of the three genotypes was as follows: homozygous normal (CC) genotype in 29 (26.1%), heterozygous (CT) genotype in 57 (51.4%), and homozygous mutant (TT) genotype in 25 (22.5%) patients. There were no significant differences among individuals between each genotype group for baseline characteristics. Plasma concentration of homocysteine in patients with the TT genotype was significantly increased compared to the CC genotype (P<0.05). CONCLUSION: We observed a significant interaction between TT genotypes and homocysteine levels in our results. The results might reflect the complex interaction between candidate genes and external factors responsible for thrombosis.
Atrial Fibrillation ; Genotype ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Mass Screening ; Medical Records ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Plasma* ; Real-Time Polymerase Chain Reaction ; Retrospective Studies ; Risk Factors ; Thrombosis ; Venous Thrombosis

No abstract available.
Blood Glucose* ; Fetal Blood* ; Humans ; Infant, Newborn* ; Insulin*

OBJECTIVE: We evaluated the clinical implications of serum ECP and peripheral blood eosinophil counts as indices of airway inflammation during the follow-up of asthmatics (BA). METHODS: We repeatedly measured the serum ECP, peripheral blood eosinophil counts and peak expiratory low rate (PFR) during the follow up of 24 symptomatic BA. RESULTS: Mean serum ECP level of BA at uncontrolled status of airflow limitation was significantly higher than that of controlled state (24.5i3.7 ng/ml rs. 16.2+1.9 ng/ml, p<0.05) and the ECP levels of controlled and uncontrolled status were significantly higher than that of health control subjects (n=10, 10.1+/-2.0 ng/ml, p<0.01 respectively). Pe ripheral blood eosinophils were also significantly increased in uncontrolled status than in controlled status of BA (535.7+/-81.0/1tL vs. 300.4+33.4/micro liter, p < 0.05). In controlled status, 8 BA had higher circulating ECP levels than in uncontrolled status, but with peripheral blood eosinophil counts, only 3 BA had higher levels in controlled status than in uncontrolled status. Variations of PFR correlated with the variations of serum ECP level (r=-0.5370, p<0.01) and variations of peripheral blood eosinophil count (r=-0.6215, p<0.001). CONCLUSION: Measurement of serum ECP and peripheral blood eosinophil count would be useful tools for monitoring the disease activity of asthma, but we could not obtain any more informations from the measureinert of serum ECP levels than from the peripheral blood eosinophil counts.
Asthma* ; Eosinophil Cationic Protein* ; Eosinophils* ; Follow-Up Studies ; Humans ; Inflammation

In this study, clinical effectiveness of Pharmacia CAP system for determination of allergen specific IgE was evaluated depending on the results of Bencard skin prick tests in 100 atopic and 18 nonatopic asthmatics. The Pharmacia CAP specific IgE positive rates were higher as the SPT grades were increased : negative (n=623) (17.8%); + (n=81) (34.6%); 2+ (n=223) (56.5%); 3+ (n=106) (70.8%); and 4+/-< (n=127)3+ (92.1%), respectively. The overall concordant rate between Bencard SPT and Pharmacia CAP system was 81.7% with range of 70.7~92.1%. The Overall sensitivity of Pharmacia CAP system was 80.7%. The sensitivities for 10 allergens, which ranged from 57.5% to 100 %, were as followed; D.pteronyssinus (96.1%), D.farinae (96.7%), cat dander (61.5%), cockroach (65.2%), Aspergillus fumigatus (57.1%), ragweed (62.5%), mugwort (75.0%), Meadow fescue (100%), birch (62.4%), and oak (80.0%), respectively. Overall specificity of Pharmacia CAP system was 82.2%. The specificity of CAP system in nonatopic subjects (n=18, 160 test) was 94.4% which was quite different with the 77.6% of atopic subjects (n=100, 463 test). SPT A/H ratios were significantly correlated with Pharmacia CAP specific IgE concentration (KU/L) in D.pteronyssinus (r=0.520, p<0.001), D.farinae (r=0.490, p<0.001), A.fumigatus (r=0.315, p<0.01), mugwort (r=0.210, p<0.05), ragweed (r=0.213, p<0.05), birch (r=0.232, p<0.05), M.fescue (r=0.410, p<0.001). But, in cockroach (r=0.192, p<0.1), cat dander and oak pollen, SPT A/H ratios were not correlated with the concentration of specific IgE. These results suggest that Pharmacia CAP system is useful for etiologic evaluation of immediate hypersensitivity and quantitative evaluation of specific IgE in atopic asthma.
Allergens ; Ambrosia ; Animals ; Artemisia ; Aspergillus fumigatus ; Asthma* ; Betula ; Cats ; Cockroaches ; Dander ; Evaluation Studies as Topic ; Hypersensitivity, Immediate ; Immunoglobulin E* ; Pollen ; Sensitivity and Specificity ; Skin

BACKGROUND AND OBJECTIVE: House dust mites have been known as the most important allergens in respiratory allergic disease. Since environmental factors may have influences on the pathogenesis of allergic disease, the study using Korean house dust mites for immune and biologic reactions in house dust mite-sensitive allergic disease is considered as significant. MATERIAL AND METHOD: We made two in-house allergenic extracts of Korean house dust mites (D. farinae and D. pteronpsssinus) and performed this study for the allergen standardization by in vivo methods and for the evaluation of the reliabilities for clinical applications. RESULT: As a results of biologic standardization using skin prick test teachnique, the activity of 1: 1,500w/v of D. farinae extract was estimated 1,000 biology unit(BU), concentration that elicits a wheal of the same size as that of histamine dihydrochloride 1mg/ml. The activity of 1: 1,000w/v of D. pteronyssinus was condiered as 1,000BU. The activity of 1:100w/v of both D. farinae and D. pteronpssiuns extracts were considered as 100,000 Allergy Unit(AU), based on intradermal skin testing of 30 subjects with strong sensitive reaction. The concordant rates between results of skin prick test done with 5,000BU/ml concentration of in-house allergenic extracts and thoae with the commercially available allergen(Bencard Co., UK) were 84.6% and 81.0% for D. farinae and D. pteronpssinus, respectively. The wheal erythema size and A/H ratios induced by in-house extracts were significantly correlated with those induced by Bencard allergen. CONCLUSION: This results suggest that in-house extracts of the whole bodies of two house dust mites have good allergenic activities in vivo. It is considered to be clinically useful and reliable allergenic extracts.
Allergens ; Biology ; Dust* ; Erythema ; Histamine ; Hypersensitivity ; Pyroglyphidae* ; Skin ; Skin Tests

PURPOSE: To evaluate the radiological patterns of vascular invasion in peripheral cholangiocarcinomas. MATERIALS AND METHODS: Hepatic arteriography and portography in 20 cases with cholangiocarcinoma including 12 cases with anglographic CT were retrospectively analized. RESULTS: The arteriography showed no arterioportal shunt, hypertrophy of tumor vessel, or tumor staining extending to central portion of the mass in all cases. However, doughnut shaped peripheral tumor staining was seen until late hepatogram phase in 12 cases and compensatory hyperperfusion around the mass was seen in six cases(eight cases if include arterial CT). Encasement of tumor vessel was seen in 12 cases, and hypertrophy of feeding vessel in nine cases. On portogrphy, the filling defect on segmental portal branch could be demonstrated only in 11 cases. Shape of the portal defect was tapered narrowing in six cases, abrupt narrowing in two cases but intraluminal nodular filling defect was not seen. Remainning three cases were difficult to define the shape. On seven cases of CT during arterial portography, three cases showed mass shaped defect and four showed segmental defect but three of them could demonstrate the partially preserved portal flow in defective portal area. CONCLUSION: Hepatic arteriography in peripheral cholagiocarcinoma showed no evidence of hypertrophy of tumor vessels and tumor stain extending to central portion but peripheral staining on late hepatogram phase and compensatory hyperperfusion could be seen. Portal vein was more commonly involved through perivascular connective tissue invasion rather than by direct extension into the portal lumen.
Angiography* ; Cholangiocarcinoma* ; Connective Tissue ; Hypertrophy ; Portal Vein ; Portography ; Retrospective Studies

PURPOSE: To evaluate the radiological patterns of vascular invasion in peripheral cholangiocarcinomas. MATERIALS AND METHODS: Hepatic arteriography and portography in 20 cases with cholangiocarcinoma including 12 cases with anglographic CT were retrospectively analized. RESULTS: The arteriography showed no arterioportal shunt, hypertrophy of tumor vessel, or tumor staining extending to central portion of the mass in all cases. However, doughnut shaped peripheral tumor staining was seen until late hepatogram phase in 12 cases and compensatory hyperperfusion around the mass was seen in six cases(eight cases if include arterial CT). Encasement of tumor vessel was seen in 12 cases, and hypertrophy of feeding vessel in nine cases. On portogrphy, the filling defect on segmental portal branch could be demonstrated only in 11 cases. Shape of the portal defect was tapered narrowing in six cases, abrupt narrowing in two cases but intraluminal nodular filling defect was not seen. Remainning three cases were difficult to define the shape. On seven cases of CT during arterial portography, three cases showed mass shaped defect and four showed segmental defect but three of them could demonstrate the partially preserved portal flow in defective portal area. CONCLUSION: Hepatic arteriography in peripheral cholagiocarcinoma showed no evidence of hypertrophy of tumor vessels and tumor stain extending to central portion but peripheral staining on late hepatogram phase and compensatory hyperperfusion could be seen. Portal vein was more commonly involved through perivascular connective tissue invasion rather than by direct extension into the portal lumen.
Angiography* ; Cholangiocarcinoma* ; Connective Tissue ; Hypertrophy ; Portal Vein ; Portography ; Retrospective Studies

PURPOSE: Lymph node analysis is essential for staging colorectal cancer. Intraoperative lymphatic mapping and sentinel lymphadenectomy remain to be investigated for most gastrointestinal neoplasms. Previous attempts to identify the sentinel node (SN) in solid tumors have used intraoperative techniques. This study describes a novel approach to identify the SN in colorectal cancer using ex vivo lymphatic mapping. METHODS: Eighty-two colorectal cancer patients underwent ex vivo lymphatic mapping and a sentinel lymph node biopsy using isosulfan blue dye following a standard surgical resection between March 2002 and September 2003. Within 5 minutes of resection, colorectal specimens were submucosally injected with isosulfan blue dye in four quadrants. Blue lymphatic channels were identified in the mesentery, and followed to the blue-stained SN(s), which were har vested. The specimens were fixed in formalin and subsequently analyzed in the usual fashion. In patients with T1 or T2 tumors, which were blue-stained nodes, but negative to hematoxylin and eosin staining, were further analyzed by serial section and immunohistochemical staining (IHC). RESULTS: At least one SN was identified in 79 patients of the 82 patients (96.3%). The average number of SNs identified per patient and nodes in each colorectal cancer specimen were 3 (range, 1~7) and 17.1 (range: 11~47). Thirty five patients had lymph nodes containing a metastatic disease. Thirteen patients had metastases in both sentinel and nonsentinel nodes. There were 7 sentinel lymph nodes as the only site of metastatic disease. In 15 patients the sentinel nodes were negative for disease, whereas the nonsentinel lymph nodes contained a metastatic disease (false negative rate = 42.9%). The false negative rates of SN(s) metastasis in the 26 patients with T1 or T2 tumors were 16.7 and 7.7% by H&E and by serial section and IHC. CONCLUSION: Ex vivo mapping of the colon is technically feasible, and may provide a useful approach to evaluate lymph node metastasis in patient with T1 or T2 colorectal cancers.
Colon ; Colorectal Neoplasms* ; Eosine Yellowish-(YS) ; Formaldehyde ; Gastrointestinal Neoplasms ; Hematoxylin ; Humans ; Lymph Node Excision ; Lymph Nodes ; Mesentery ; Neoplasm Metastasis ; Sentinel Lymph Node Biopsy

BACKGROUND: The diastolic transmitral flow velocity pattern has been commonly used to assess left ventricular(LV) diastolic function. The effects of multiple factors(such as, LV preload, afterload and heart rate, etc.) make difficulties in accurate interpretation. METHODS: In order to investigate the diastolic transmitral filling patterns according to the changes of the proload or heart rate, we studied 27 normal subjects with pulsed Doppler echocardiography after the administration of nitroglycerin(0.6mg/tab.) sublingually or atropine(0.5mg/amp.) intravenously. RESULTS: 1) After nitroglycerin administration, the folowings were obtained. ; The systolic blood pressure and LV diastolic filling time(DFT) decreased by 10.1% and 15.3%, respectively(p<0.001), compared with baseline data. The ratio of peak early to late diastolic transmitral flow velocities (E/A) and time-velocity integrals(TVIE/TVIA) decreased by 10.3% and 14.8%, respectively(p<0.01). The early diastolic filling time(Time E) was unchanged. Therefore, we suggest that time E is helpful, compared with the increments of the preload or the diastolic dysfunction. 2) After atropin administration, the heart rate, peak late diastolic transmitral flow velocity(PA) and percent atrial contribution(%AC) significantly increased by 43.6%, 25.1% and 41.4%, respectively(p<0.001). The E/A, TVIE/TVIA and DFT significantly decreased by 42.9%, 38.9% and 43.0%, respectively(p<0.001) compared to the data before drug administration. 3) The heart rate correlated negatively to the E/A, TVIE/TVIA and DFT. It was correlated positively to %AC(r=+0.63; p<0.001). The normalized E/A ratio by DFT(E/A/DFT) didn't correlate. Therefore, E/A/DFT is helpful on the exclusion of the influences of heart rate by the administration of the atropine. CONCLUSION: The decrement of preload or the increment of heart rate changes the diastolic transmitral flow velocity patterns. Therefore, when the diastolic function is assessed by interpretation of the Doppler transmitral flow velocity pattern with pulsed Doppler echocardiogram, the potential influences of preload and heart rate must be taken into account.
Atropine* ; Blood Pressure ; Echocardiography ; Echocardiography, Doppler* ; Echocardiography, Doppler, Pulsed ; Heart Rate ; Humans* ; Nitroglycerin* ; Time

PURPOSE:To identify the main toxic gas released from salted radish in rice bran(Dan-Mu-Ji) and to introduce the radiological findings of the patient who was exposed to the gas. MATERIALS AND METHODS: Chest radiographs and CT scans of one survivor among three men who were exposed to the gas from Dan-Mu-Ji were reviewed. Gas obtained from the closed bottle containing Dan-Mu-Ji was analized by using the gas chromatography. RESULTS: The radiographic examinations of the survivor were suggestive of pulmonary edema with it's rapidly improving consolidations in both lung. The headspace gas within the bottle containing Dan-Mu-Ji was mainly composed with carbon dioxide, ethyl alcohol and hydrogen sulfide, of which hydrogen sulfide was considered the main toxic gas released. CONCLUSION: Under the anaerobic condition, Dan-Mu-Ji released toxic hydrogen sulfide. Inhalation of hydrogen sulfide might produce non-cardiogenic pulmonary edema.
Anoxia* ; Carbon Dioxide ; Chromatography, Gas ; Ethanol ; Humans ; Hydrogen Sulfide ; Inhalation ; Lung ; Male ; Pulmonary Edema ; Radiography, Thoracic ; Raphanus* ; Survivors ; Tomography, X-Ray Computed