No abstract available.
Pancytopenia*

We report a case of generalized plane xanthoma which showed no-rmolipoproteinemia and was not associated with unerlying disorders or other type of xanthomas. A 48-year-old female has noticed well defined, slightly elevated, yellowish plaques which occurred on the periorbital areas, sides of the neck, scapular areas, anterior chest, buttocks and lower extremities for 3 years. Biopsy specimen taken from the neck showed perivascular accumulations of foam cells in the upper and mid dermis. Paper electrophoresis didn't, show elevation of any lipoprotein.
Biopsy ; Buttocks ; Dermis ; Electrophoresis, Paper ; Female ; Foam Cells ; Humans ; Lipoproteins ; Lower Extremity ; Middle Aged ; Neck ; Thorax ; Xanthomatosis*

BACKGROUND: In previous our retrospective study, we concluded that administered fluid volume, duration of operation, operative procedures and anesthetic techniques were the major factors of postoperative urinary retention. However, the administered fluid volume, age, types and duration of the operation confined to hemorrhoidectomy was questioned as a precipitating factor. The high retention rate in spinal anesthesia is also questioned. METHODS: We investigated these possible precipitating factors of urinary retention in healthy patients (n=154) undergoing hemorrhoidectomy. The patients were randomly divided into three different anesthetic techniques: caudal (2% lidocaine 300 mg with 1 : 200,000 epinephrine), spinal (0.5% tetracaine 5 mg with epinephrine 0.1 mg or 5% lidocaine 40 mg) and general (enflurane, N2O, vecuronium). Urinary retentin was searched according to above factors following surgery. RESULTS: The overall urinary retention rate was 46.1%. The retention rate in patients with spinal anesthesia was higher than that in those with other anesthetic techniques (p<0.05). There was no significant difference between patients with lidocaine and tetracaine spinal anesthesia in urinary retention rate. The administered fluid volume in patients with urinary retention was significantly higher than that of patients without retention (p<0.05). Age, duration and types of hemorrhoidectomy did not significantly affect urinary retention rate. CONCLUSIONS: Restriction of fluid administration and avoidance of spinal anesthesia are necessary in reducing postoperative urinary retention following hemorrhoidectomy.
Anesthesia, Spinal ; Epinephrine ; Hemorrhoidectomy* ; Humans ; Lidocaine ; Precipitating Factors ; Retrospective Studies ; Surgical Procedures, Operative ; Tetracaine ; Urinary Retention*

PURPOSE: The dimensionality of examinations provides empirical evidence of the internal test structure underlying the responses to a set of items. In turn, the internal structure is an important piece of evidence of the validity of an examination. Thus, the aim of this study was to investigate the performance of the DETECT program and to use it to examine the internal structure of the Korean nursing licensing examination. METHODS: Non-parametric methods of dimensional testing, such as the DETECT program, have been proposed as ways of overcoming the limitations of traditional parametric methods. A non-parametric method (the DETECT program) was investigated using simulation data under several conditions and applied to the Korean nursing licensing examination. RESULTS: The DETECT program performed well in terms of determining the number of underlying dimensions under several different conditions in the simulated data. Further, the DETECT program correctly revealed the internal structure of the Korean nursing licensing examination, meaning that it detected the proper number of dimensions and appropriately clustered the items within each dimension. CONCLUSION: The DETECT program performed well in detecting the number of dimensions and in assigning items for each dimension. This result implies that the DETECT method can be useful for examining the internal structure of assessments, such as licensing examinations, that possess relatively many domains and content areas.
Korea ; Licensure* ; Methods ; Nursing*

Anomalous origin of one pulmonary artery from the ascending aorta is a rare congenital malfomation. To date, there have been 60 reported cases in the literature. Usually the right pulmonary artery arises form the ascending aorta and other malformations such as patent ductus arteriosus are commonly associated. Early diagnosis is essential because congestive heart failure develops in early life and operation is contraindicated if severe pulmonary vascular changes have occurred. We report a case of anomalous origin of right pulmonary artery from the ascending aorta, which is associated with patent ductus arteriosus and severe pulmonary hypertension. She was diagnosed by digital subtractional angiography and cardiac catheterization.
Angiography ; Aorta* ; Cardiac Catheterization ; Cardiac Catheters ; Ductus Arteriosus, Patent ; Early Diagnosis ; Heart Failure ; Hypertension, Pulmonary ; Pulmonary Artery*

To dtermine the optimal timing for Aortic Valve Replacement in patients of aortic insufficiency is very important, because irreversible myocardial damage can result before symtoms such as dyspnea, syncope and chest pain, appear for the first time. Henry suggested that the echocardiographic index of left ventricular end systolic dimension 55mm could be useful as an indicator of whether to operate or not. But Fioretti, et al., insisted that there was no significant difference postoperatively between those below 55mm and those over 55mm. To determine whether a left ventricular end systolic dimension greater than 55mm is one of the risk factors for AVR in patients with aortic insufficiency, we analyzed the serial echocardiographic examinations of 23 patients who underwent AVR for isolated AI. Group I patients (n=17) had a preoperative left ventricular end systolic dimension less than or equal to 55mm and Group II patients (n=6) had a preoperative left ventricular end systolic dimension greater than than 55mm. 1) left ventricular end systolic dimension decreased in both groups significantly, and there was a statistically significant difference between Group I and Group II at 12 modths after operation. 2) Left ventricular end diastolic dimension also decreased in both groups significantly, and there was a statistically significant difference between Group I and Group II at 12 months after operation. 3) Ejection Fraction was decreased markedly just postoperatively, but it was recovered soon in both groups, and there was no statistically significant differences of the ejection fractions between the two groups postoperatively. 4) SV1+/-RV6 in EKG, as an indicator of LV mass, was also analzed and it revealed significant reduction in both groups postoperatively, but we could not observe statistically significant differences between the two groups from 6 months after the operation. We concluded that the preoperative left ventricular end systolic dimension 55mm could be useful as an index to predict postoperative prognosis and to determine the timing of aortic valve replacement.
Aortic Valve* ; Chest Pain ; Dyspnea ; Echocardiography* ; Electrocardiography ; Humans ; Prognosis ; Risk Factors ; Syncope

OBJECTIVES: Methylenetetrahydrofolate reductase (MTHFR) mutation are commonly associated with hyperhomocysteinemia, and through their defects in homocysteine metabolism, they have been implicated as a risk factor for recurrent spontaneous abortion. Recent report describe that 28-bp tandem repeat polymorphism in thymidylate synthase enhancer region (TSER) that influence enzyme activity would affect plasma homocysteine level. We have investigated the relationship between TSER genotype and plasma homocysteine level in 54 patients with recurrent spontaneous abortion. METHODS: Plasma homocysteine level was measured by fluorescent polarizing immunoassay. MTHFR mutation (C677T and A1298C) was identified by PCR-restriction fragment length polymorphism assay and TSER mutation was analyzed by PCR method. The data were analyzed using the program SAS 8.2 for Windows. RESULTS: Total homocysteine level was significantly higher in MTHFR 677TT genotype (9.80+/-3.87 mumol/L) than MTHFR 677CC genotype (8.14+/-1.74 mumol/L) in Korean patients with unexplained recurrent spontaneous abortion (p=0.0143). However, the plasma homocysteine level was not significantly different in the MTHFR 1298AA (8.42+/-2.65 mumol/L) and 1298CC (6.09+/-0.32 mumol/L; p=0.2058) and, TSER 2R2R (8.61+/-1.68 mumol/L) and 3R3R (8.05+/-2.81 mumol/L; p=0.9319) mutant genotypes, respectively. In this study, we found the combination effects of TSER and MTHFR C677T genotypes. Plasma homocysteine levels were the highest (11.47+/-4.66 mumol/L) in individuals with TSER 3R3R (8.05+/-2.81 mumol/L) and MTHFR 677TT (9.80+/-3.87 mumol/L) genotypes. Individuals with a combination of both TSER 2R2R/2R3R and MTHFR 677CC/CT genotypes (7.69+/-1.77 mumol/L) had lower plasma homocysteine levels than TSER 2R2R (8.61+/-1.68 mumol/L) and MTHR 677CC (8.14+/-1.74 mumol/L) genotypes, respectively. The effect of MTHFR polymorphism in the homocysteine metabolism appears to be stronger than that of TSER polymorphism. CONCLUSION: Although statistically not significant, we found the elevated level of plasma homocysteine in combined genotypes with TSER and MTHFR (C677T and A1298C) in Korean patients with unexplained habitual abortion. In this study, we reported the possibility that TSER polymorphism is a genetic determinant of plasma homocysteine levels in the Korean patients as well as MTHFR C677T polymorphism. A large prospective study is needed to verify our findings.
Abortion, Habitual ; Abortion, Spontaneous* ; Female ; Genotype ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Immunoassay ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2) ; Plasma* ; Polymerase Chain Reaction ; Pregnancy ; Risk Factors ; Tandem Repeat Sequences ; Thymidylate Synthase*

BACKGROUND: The use of single donor platelets (SDPs) has been increased substantially worldwide. But in korea, SDPs are supplied only 11.5% of total platelets transfused and most of them collected in hospital blood center. Korean Red Cross blood center decided to supply and started collection of SDPs from registered and random repeat donors since January, 2000. METHODS: The utilization of platelets including SDPs was analyzed by mail survey from 33 hospitals and by statistical yearbooks of KRC, 2000. The necessity of SDPs and supplementary amounts of SDP in case of need was estimated. RESULTS: Total 483,611 units of platelets (692-80,414 units) and 12,150 units of SDP(0-3364 units) were utilized by 33 hospitals participated mail survey. The mean discard rate of platelets in the 33 hospitals was 1.5% (0%-15%). The total amounts of SDP collection in 19 hospitals among them were 10,031 units. About one third of 29 hospitals investigated, call for to use 100% of SDPs for patients. And most of the hospitals were cooperative using SDPs supplied from KRC. The amounts of SDP used in Big 5 hospitals, which is located in Seoul was 76.1% of total SDPs used in Korea. CONCLUSION: The relevant amount of supplied SDPs would be 80.000 unit/year, which is 50% of total supplied platelets by KRC. Efficient utilization of SDPs needs well organized collection, SDP stock control and supply system by regional groups of KRC blood center. In additionally, donor recruitment and maintenance for substantial supply of SDPs, and the supplementary support from the government is important.
Humans ; Korea ; Postal Service ; Red Cross* ; Seoul ; Tissue Donors*

PURPOSE: Helicobacter pylori infection is probably acquired in childhood and persists as an asymptomatic infection for decades in most individuals. It is unclear why only a minority of those infected develop a clinical manifestation, even in childhood, such as peptic ulcer disease. H. pylori infection activates local immune responses and causes lymphocyte infiltration in the gastric mucosa. We have previously reported that both T and B cells in the lamina propria play important roles in the local immune response of H. pylori-infected children. The aim of this study was to investigate the association between H. pylori genotypes and gastric mucosal lymphocytes. METHODS: Twenty-five H. pylori-infected children (10 with peptic ulcer disease and 15 with gastritis) were enrolled in this study. We investigated the genotypes (cagA, cagE, vacA, and babA2) and evaluated the association with clinical manifestations, histopathology, and gastric mucosal lymphocytes. RESULTS: The prevalence of cagA, cagE, vacA s1m1, and babA2 was 80%, 60%, 84%, and 88%, respectively. The most prevalent (68%) combination of cagA, vacA, and babA2 genotypes was cagA+/ vacA s1m1+/babA2+. H. pylori genotypes were not associated with clinical manifestations, histopathology, or gastric mucosal lymphocytes. CONCLUSION: There was no association between the cagA, cagE, vacA, or babA2 status and gastric mucosal lymphocytes. The role of the host immune response in relation to H. pylori genotypes and disease potential in children needs further studies.
Asymptomatic Infections ; B-Lymphocytes ; Child ; Gastric Mucosa ; Genotype ; Helicobacter ; Helicobacter pylori ; Humans ; Lymphocytes ; Mucous Membrane ; Peptic Ulcer ; Prevalence

Drug-induced thrombocytopenia and purpura have boon developed by many various agents. Rifampin and Pyrazinamide have been known as bactericidal antituberculous drugs, but, the above side effects have been a problem. Especially, hematologic side effects art fatal to patients occasionally. Rifampin-induced thrombocytopenia and purpura have been well known, also, pyrazinamide-induced thrombocytopenia have been reported. A new quilonone agent Ciprofloxacin, has been commonly used in clinics now, but it's side effects are not known well. So, we report a case of a 23-year-old female with thrombocytopenia and purpura after taking Rifampin, Pyrazinamide, and Ciprofloxacin as antituberculous agents.
Ciprofloxacin* ; Female ; Humans ; Purpura* ; Pyrazinamide* ; Rifampin ; Thrombocytopenia* ; Young Adult