No abstract available.
Aged ; False Positive Reactions ; *Histocompatibility Testing ; Humans ; Isoantibodies/immunology ; Keratoplasty, Penetrating ; Male ; Transplantation, Homologous

BACKGROUND: The impact of HLA and KIR ligand mismatching on the outcome of hematopoietic stem cell transplantation (HSCT) remains unclear. Previous reports have identified considerable ethnic differences in the impact of HLA and KIR ligand mismatches, as well as KIR ligand status, on HSCT; however, to date, no data has been acquired in Korean adult patients. METHODS: We investigated the association of high-resolution HLA matching on five loci (HLA-A, -B, -C, -DRB1, and -DQB1), KIR ligand mismatching, and KIR ligand status on the outcome of allogeneic HSCT from unrelated donors in 154 Korean adult patients treated at Seoul National University Hospital. RESULTS: In a multivariate analysis, less than 9/10 allelic matches in five HLA loci was an independent risk factor for acute graft-versus-host disease (GVHD) (grade II to IV) (P=0.019, odds ratio [OR]=2.7). In addition, HLA-A allele mismatching was increasingly prevalent in patients with acute GVHD compared to patients without (61.9% vs. 34.5%, P=0.06). For KIR ligand status, the patient and donor combination of both C1/C1 ligands showed better event-free and overall survival than combinations with C2 ligand patients or donors (P=0.048, P=0.034, respectively) by log-rank test. CONCLUSIONS: Korean adult transplant patients with less than 9 of 10 HLA allele matches in the HLA-A, -B, -C, -DRB1, and DQB1 loci have a higher likelihood of developing acute GVHD (grade II to IV). Impact of KIR ligand status on clinical outcome should be further studied in a larger patient population.
Adolescent ; Adult ; Alleles ; Female ; Genetic Loci ; Graft vs Host Disease/etiology ; HLA Antigens/*genetics/metabolism ; *Hematopoietic Stem Cell Transplantation/adverse effects/standards ; Histocompatibility Testing ; Humans ; Kaplan-Meier Estimate ; Leukemia/mortality/therapy ; Male ; Middle Aged ; Multivariate Analysis ; Receptors, KIR/*chemistry/metabolism ; Republic of Korea ; Risk Factors ; Transplantation, Homologous ; Young Adult

PURPOSE: Despite the high prevalence of headaches in students, their lifestyles have not been well examined. We examined correlation between lifestyle and headache in Korean students. METHODS: We conducted a cross-sectional, school-based study from a randomized and proportional sample of 5,360 male and female students. The questionnaires include demographic data, lifestyle, in addition to specific questions about headache according to International Classification of Headache Disorder II (ICHD-II) criteria. Valid questionnaires were returned by 94.1% (5,039, boys 2,405, girls 2,634) of the sample. Modified criteria changed the item 'duration' in migraine (>1 hour instead of 4 hours). We analyzed the data in terms of exercise, regular eating, sleep time, fluid intake, and caffeine intake. RESULTS: Students on regular exercise have less headache (P=0.03). Students who eat regularly have less recurrent headache (P<0.0001, odds ratio=0.5). Students sleep more have less headache (P<0.0001). Students take more fluid have less headache (P=0.0002). Students take more caffeine have more headache (P=0.0001). CONCLUSION: There seem to be a significant relationship between life style and headache in school children in South Korea. We suggest that changing the lifestyles or habits should be considered to manage and prevent headaches in school children.
Caffeine ; Child ; Eating ; Female ; Headache ; Headache Disorders ; Humans ; Life Style ; Male ; Migraine Disorders ; Prevalence ; Surveys and Questionnaires ; Republic of Korea

OBJECTIVE: To compare the apparent diffusion coefficient (ADC) value using single-shot echo-planar imaging sequences at 3T and 1.5T for differentiation of benign fracture edema and tumor infiltration of the vertebral body. MATERIALS AND METHODS: A total of 46 spinal examinations were included in the 1.5T MRI group, and a total of 40 spinal examinations were included in the 3T MRI group. The ADC values of the lesion were measured and calculated. The diagnostic performance of the conventional MR image containing sagittal T2-weighted fat saturated image and each diffusion weighted image (DWI) with an ADC value with different b values were evaluated. RESULTS: The mean ADC value of the benign lesions was higher than that of the malignant lesions on 1.5T and 3T (p < 0.05). The sensitivity of the diagnostic performance was higher with an additional DWI in both 1.5T and 3T, but the sensitivities were similar with the addition of b values of 400 and 1000. The specificities of the diagnostic performances did not show significant differences (p value > 0.05). The diagnostic accuracies were higher when either of the DWIs (b values of 400 and 1000) was added to routine MR image for 1.5T and 3T. Statistical differences between 1.5T and 3T or between b values of 400 and 1000 were not seen. CONCLUSION: The ADC values of the benign lesions were significantly higher than those of the malignant lesions on 1.5T and 3T. There was no statistically significant difference in the diagnostic performances when either of the DWIs (b values of 400 and 1000) was added to the routine MR image for 1.5T and 3T.
Diffusion ; Echo-Planar Imaging ; Edema* ; Magnetic Resonance Imaging* ; Spine

BACKGROUND AND OBJECTIVES: To evaluate the influence of left bundle branch block (LBBB) on the coronary flow pattern of the left anterior descending coronary artery (LAD). SUBJECTS AND METHODS: 91 patients (M: F=33: 58, mean age: 64+/-14yrs) were divided into the LBBB (n=42), RV pacing (n=26) and control groups (n=23). All patients were examined by a surface ECG, and transthoracic Doppler echocardiograms performed. The QRS duration, the left ventricular ejection fraction (LVEF) and the left ventricular end diastolic volume (LVEDV) were measured. The coronary flow was measured in the distal LAD, with transthoracic Doppler echocardiography, and the percent of the diastolic flow duration (%DD) was expressed as the percentage of the diastolic duration of coronary artery flow divided by the R-R interval. RESULTS: The %DD of the LAD was significantly shorter in patients of the LBBB than the RV pacing group (59.3+/-7.6% in control group, 43.9+/-12.4% in LBBB group, 60.3+/-7.3% in RV pacing group. p<0.01) and the same in patients with a LVEF> or =50% only (58.6+/-6.0% in control group, 49.3+/-10.5% in LBBB group, 59.6+/-5.4% in RV pacing group. p<0.01). In the LBBB group, the %DD of the LAD was positively correlated with the LVEF (p<0.05, r=0.50), negatively correlated with the QRS duration (p<0.05, r=-0.41) and negatively correlated with the LVEDV (p<0.05, r=-0.57). CONCLUSION: Differing from RV pacing, LBBB can itself disturb the coronary flow of the LAD through the shortening of the diastolic duration. Furthermore, systolic dysfunction potentiates the shortening effect of the diastolic flow duration caused by LBBB. However, whether the left ventricular systolic dysfunction is the result of a coronary flow disturbance caused by LBBB, or vice versa, needs further investigation.
Bundle-Branch Block* ; Cardiac Pacing, Artificial ; Coronary Vessels* ; Diastole ; Echocardiography, Doppler* ; Electrocardiography ; Humans ; Stroke Volume ; Ventricular Function, Left

A healthy 55-year-old man was referred for investigation of palpitations. During an episode of palpitation, the ECG documented two types of tachycardia with differing morphologies. One was a narrow QRS complex tachycardia with a heart rate of 140 beats/min. The other was wide QRS complex tachycardia with a heart rate of 210 beats/min. Transformation from one tachycardia to the other occurred spontaneously. Electrophysiological studies revealed two inducible tachycardia, which were shown to represent atrioventricular nodal reentrant tachycardia (AVNRT) and idiopathic left ventricular tachycardia. Radiofrequency catheter ablation of the slow atrioventricular nodal pathway resulted in alleviation of AVNRT. Following the ablation of AVNRT, the wide QRS complex tachycardia was induced during ventricular pacing. The mapping showed that the origin of the ventricular tachycardia was the mid-inferior wall of the left ventricle. Radiofrequency catheter ablation of the ventricular tachycardia resulted in mitigation cure of the idioventricular left ventricular tachycardia.
Catheter Ablation* ; Coronary Artery Disease ; Electrocardiography ; Heart Rate ; Heart Ventricles ; Humans ; Middle Aged ; Stents ; Tachycardia ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Ventricular

BACKGROUND AND OBJECTIVES: From the view point of the molecular aspects, the fate of long standing pressure and volume overloaded atrium in severe MR has not been evaluated. This study was performed to elucidate whether apoptosis of right atrial myocytes is related to atrial changes. SUBJECTS AND METHODS: The medical records of 16 patients (M: F=8: 8, mean age=52+/-12), with severe MR having undergone valve replacement surgery, were retrospectively reviewed. The subjects were divided into 2 groups according to the duration of their symptoms (group I, symptom duration less than 12 months, n=10 and group II, more than 12 months, n=6). Using the atrial myocardium specimens obtained during surgery, TUNEL assays and immunohistochemical staining were performed for the expressions of Fas, Bax and the Bcl family. RESULTS: Apoptotic indices of TUNEL assay were 31.1+/-12.6 and 4.9+/-4.3% in groups I and II, respectively (p<0.01). The Fas expressions were 42.1+/-14.4 and 27.8+/-10.5% in groups I and II, respectively (p<0.05), but in group I, with atrial fibrillation (AF), was 49.3+/-6.9%, which was higher than the 29.2+/-12.5% in group I without AF and group II (p<0.001). The Bax expression in group I patients with a left atrial size less than 4 cm was 19.2+/-10.7%, which was higher than the 7.2+/-6.2% in group I with a left atrial size more than 4 cm and group II (p<0.05). CONCLUSION: Programmed cell death of the atrial myocardium, in severe MR, might be an early molecular pathological change rather than the late sequelae. The causality between programmed cell death and electrical and structural changes of the atrium should be further investigated.
Apoptosis ; Atrial Fibrillation ; Cell Death* ; Humans ; In Situ Nick-End Labeling ; Medical Records ; Mitral Valve Insufficiency* ; Muscle Cells ; Myocardium* ; Retrospective Studies

Pacemaker lead infection is a rare but a dangerous complication. Diagnosis can usually be established by the clinical picture and blood cultures. Transesophageal two dimensional echocardiography might be crucial in the diagnosis by visualizing pacing lead vegetations. Medical treatment alone is rarely successful, and several studies have suggested the infected pacemaker systems should be removed quickly for optimal management. We describe a case of Aspergillus infection in a permanent ventricular pacing lead, which appears to be the first reported case in Korea. A 30-yr-old man was evaluated for the symptoms and signs of congestive heart failure 3 yr after DDD pacemaker implantation. The transthoracic and transesophageal echocardiogram showed a large movable round shaggy mass attached to a ventricular lead in the right atrium. The atrial and ventricular leads were removed during cardiopulmonary bypass, and a new epicardial pacing system was implanted. The functional ventricular pacemaker lead was encased in a large organized thrombus. Histological findings were consistent with Aspergillus infection in a large thrombus attached to a pacemaker lead.
Adult ; Aspergillosis/diagnosis/*etiology/microbiology ; Echocardiography ; Echocardiography, Transesophageal ; Heart Atria/microbiology ; Humans ; Male ; Pacemaker, Artificial/*adverse effects/microbiology ; Thrombosis/diagnosis/*etiology/microbiology

The National Health Information Standards Committee was established in 2004 in Korea. The practical subcommittee for laboratory test terminology was placed in charge of standardizing laboratory medicine terminology in Korean. We aimed to establish a standardized Korean laboratory terminology database, Korea-Logical Observation Identifier Names and Codes (K-LOINC) based on former products sponsored by this committee. The primary product was revised based on the opinions of specialists. Next, we mapped the electronic data interchange (EDI) codes that were revised in 2014, to the corresponding K-LOINC. We established a database of synonyms, including the laboratory codes of three reference laboratories and four tertiary hospitals in Korea. Furthermore, we supplemented the clinical microbiology section of K-LOINC using an alternative mapping strategy. We investigated other systems that utilize laboratory codes in order to investigate the compatibility of K-LOINC with statistical standards for a number of tests. A total of 48,990 laboratory codes were adopted (21,539 new and 16,330 revised). All of the LOINC synonyms were translated into Korean, and 39,347 Korean synonyms were added. Moreover, 21,773 synonyms were added from reference laboratories and tertiary hospitals. Alternative strategies were established for mapping within the microbiology domain. When we applied these to a smaller hospital, the mapping rate was successfully increased. Finally, we confirmed K-LOINC compatibility with other statistical standards, including a newly proposed EDI code system. This project successfully established an up-to-date standardized Korean laboratory terminology database, as well as an updated EDI mapping to facilitate the introduction of standard terminology into institutions.

BACKGROUND AND OBJECTIVES: The formation of thrombi on a permanent pacemaker lead has been reported as a rare complication following the implantation of a permanent pacemaker. However, there is little information about the complications related to modern cardiac pacing. The purpose of this study was to evaluate the factors associated with the formation of a lead thrombosis following the implantation of a permanent pacemaker (P-PM). SUBJECTS AND METHODS: We retrospectively reviewed the medical records of 14 patients (M:F= 6:8, mean age=46+/-11) with P-PM lead thrombus that were detected with a transthoracic echocardiography. The clinical features, type of pacemaker and echocardiographic findings of these patients were analyzed. RESULTS: All thromb us formations had developed in the right atrium (RA), and/or superior vena cava (SVC)(100%, n=14), were mainly in the proximal portion of the RA (71.4%, n=10) and on the ventricular lead (64.3%, n=9). 12 of 14 patients (85.7%), The lead thromboses were atrial fibrillation, with tachy-brady syndrome or sinus pause. Three of the patients had a total SVC obstruction and 1 a thrombus with aspergillosis. The lead thrombus in one patient was completely resolved after thrombolytic treatment. There were no significant differences in the incidences of lead thrombosis in relation to the number of implanted leads, insulation type, echocardiographic parameters. CONCLUSION: Lead thromboses might not be a rare complication following the implantation of a P-PM, and frequently occur in the right atrium of patients with atrial pathology. The necessity for thrombolytic therapy in patients with a lead thrombus should be further investigated.
Aspergillosis ; Atrial Fibrillation ; Echocardiography ; Heart Atria ; Humans ; Incidence ; Medical Records ; Pathology ; Retrospective Studies ; Thrombolytic Therapy ; Thrombosis ; Vena Cava, Superior