No abstract available.
Twins, Conjoined*

BACKGROUND: Hyperhomocysteinemia is considered as a risk factor for coronary artery disease (CAD). In this study, we investigated the relationship between plasma homocysteine concentration and coronary artery disease. METHODS: We measured plasma homocysteine concentration by fluorescent polarization immunoas-say (IMx, Abbott) in 58 healthy controls (39-72 years) and in 37 patients (42-84 years) who were diagnosed with stable angina (11), unstable angina (14), acute myocardial infarction (8), old myocardial infarction (1) and silent myocardial ischemia (3). RESULTS: The risk of CAD was independently associated with old age, decreased HDL cholesterol and hyperhomocysteinemia (P >or=12.8 nmol/L) and adjusted odds ratios were 2.8, 3.4, and 6.0, respec-tively. The risk for CAD in the upper two homocysteine quartiles (P >or=10.8 nmol/L and 8.1- 10.7 nmol/L) was 11.1 (95% CI, 2.5- 49.4) times and 6.3 (95% CI, 1.4- 27.7) times higher than in the lowest quar-tile (<6.9 nmol/L) (P=0.002 and 0.014, respectively). The mean plasma homocysteine values (M +/- SD) were higher in CAD patients (11.8 +/- 7.4 nmol/L) than in the control group (8.0 +/- 2.4 mol/L) (P=0.0006). In the control group, the mean plasma homocysteine concentration in men was signifi-cantly igher than in women (9.1 vs. 7.2 mol/L, P=0.002). Age and logarithmically transformed plasma homocysteine levels exhibited significant positive correlation in controls (r=0.43, P=0.001), ut no significant correlation in CAD patients (r=-0.024, P=0.9). Plasma homocysteine levels were significantly higher in the elderly, male subjects and smokers in the univariate analysis. CONCLUSIONS: Hyperhomocysteinemia is one of the independent risk factors for CAD.
Aged ; Angina, Stable ; Angina, Unstable ; Cholesterol, HDL ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Male ; Myocardial Infarction ; Myocardial Ischemia ; Odds Ratio ; Plasma ; Risk Factors*

BACKGROUND: The primary lymphoma of genitourinary tract is very rare and reported sporadically in Korea. Therefore the aim of this study is to evaluate the clinical characteristics with therapeutic outcome in 15 cases of primary lymphoma of genitourinary tract. METHODS: Reviewed retrospectively medical records of 15 cases with primary lymphoma of genitourinary tract who had been diagnosed from January, 1990 to May, 2002, we analysed the clinical characteristics, stage, disease free survival and overall survival. RESULTS: There were 8 cases of lymphoma of testis, 3 cases of uterine cervix and body, 1 case of ovary, 1 case of vagina, and 2 cases of kidney. The histologic types were all diffuse large B cell, except 5 cases (3 cases T/NK cell, 1 case low grade MALT lymphoma, and 1 case precursor B cell lymphoblastic lymphoma). The median survival duration of all cases is 8.0 months, showing the similarity to that of testis lymphoma (7.0 months). CONCLUSION: In comparison with the prognosis of the lymphomas in uterine body and cervix, it was worse for the testicular and renal lymphoma, even though 3 cases of T/NK cell lymphoma impacted on the prognosis of testicular lymphoma. Therefore, with simultaneous elucidation of the prognostic factors systemically, therapeutic strategy must be continuously sought.
Cervix Uteri ; Disease-Free Survival ; Female ; Kidney ; Korea ; Lymphoma* ; Lymphoma, B-Cell, Marginal Zone ; Medical Records ; Ovary ; Prognosis ; Retrospective Studies ; Testis ; Urogenital System ; Vagina

PURPOSE: The Skin prick test is simple and cheap in diagnosis of allergic diseases. So the skin prick test has been widely used as the initial diagnostic method of IgE-mediated allergic diseases with the merit of fast detection of causative allergens. But the skin test has some difficulties in application for the infants and young children. IgE MAST(multiple antigen simultaneous test) and IgE RAST(radioallergosorbent test) are representative in vitro diagnostic tests in allergic diseases. IgE MAST has several merits, such as cheap price, simultaneous detection of many allergens, and needlessness of gamma counter, but it has been known to have less sensitivity and specificity. We performed this study to know the differences between the availability of IgE MAST and that of IgE RAST in allergic patients who were diagnosed by clinical findings and skin prick test. METHODS: We have studied 35 asthmatic children (over 3 years of age) who visited allergy clinic from September 1993 to May 1995. All of them were positive in skin prick test on one more allergens among 6 allergens(D.p, D.f, house dust, dog, egg, ragweed). IgE MAST and IgE RAST were evaluated simultaneously. RESULTS: The results were as follows 1) Sensitivity of RAST was 87.1% in D.p, 87.1% in D.f, 68% in house dust and the specificity of RAST was 94.1%, 97.1% and 87.5% respectively. 2) Sensitivity of MAST was 90.3% in D.p, 93.5% in D.f, 80% in house dust and the specificity of MAST was 94.1%, 94.1% and 85% respectively. 3) Total sensitivity of RAST was 70.5% and that of MAST was 73.2%, but there were no significant differences between them(p>0.05). 4) Total specificity of RAST was 91.4% and that of MAST was 89.9%, but there were no significant differences between them(p>0.05). 5) The stronger positive skin reaction, the higher sensitivity and specificity of the two in vitro tests. CONCLUSIONS: There was no significant differences between the two in vitro tests for the diagnosis of asthmatic children, and the both test results correlated well. IgE MAST system is easier, faster and has more cost benefit than IgE RAST. So we conclude that the MAST system is available as a screening test in the diagnosis of allergic diseases.
Allergens ; Animals ; Child* ; Cost-Benefit Analysis ; Diagnosis* ; Diagnostic Tests, Routine ; Dogs ; Dust ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Infant ; Mass Screening ; Ovum ; Sensitivity and Specificity ; Skin ; Skin Tests

PURPOSE: We performed this study in order to compare the feasibility and efficacy of the fiberoptic phototherapy with conventional phototherapy and double phototherapy with single phototherapy for the treatment of neonatal hyperbilirubinemia while watching for any possible side effects of the system. METHODS: During the period of February 1994 till June 1995, randomized controlled study was performed. 130 healthy term infants with non-hemolytic hyperbilirubinemia were enrolled, 45 patients received fiberoptic phototherapy, 40 patients received conventional phototherapy and 45 patients received double phototherapy. Criteria for inclusion in the study were 1) after 37 weeks of gestation 2) negative result of a direct coombs test 3) normal hemoglobin and hematocrit 4) no Rh or ABO incompatibility 5) plasma total bilirubin concentration exceed 10mg/dl during the first 3 days of life. RESULTS: 1) The mean total bilirubin decline level after 24 hours was 0.03 2.03mg/dl and the mean indirect bilirubin decline level after 24 hours was 0.12+/-1.35mg/dl in conventional phototherapy group(p<0.01), but in fiberoptic phototherapy group, the mean total bilirubin level was increased 1.26+/-1.68mg/dl and the mean indirect bilirubin level was increased 1.10+/-1.70mg/dl after 24 hours (p>0.01). 2) The mean total bilirubin decline level after 48 hours was 1.25 2.71mg/dl and the mean indirect bilirubin decline level was 1.17+/-1.52mg/dl in conventional phototherapy group (p<0.01). But in fiberoptic phototherapy group, the mean total bilirubin level was increased 0.97+/-2.81mg/dl and the mean indirect bilirubin level was increased 0.29+/-1.80mg/dl after 48 hours (p>0.01). 3) The mean decline levels of 24 hours-total and indirect bilirubin were 0.01+/-1.23mg/dl and 0.09+/-1.13mg/dl, and the mean decline levels of 48hours-total and indirect bilirubin were 0.92+/-1.85mg/dl and 0.99+/-1.08mg/dl (p<0.01), respectively, in double phototherapy group. But there were no statistically significant differences compared with the mean bilirubin decline levels in single phototheray group. 4) There were no significant differences in side effects such as decreased urine volume (p>0.01) or diarrhea(p>0.01) among three groups. CONCLUSIONS: We conclude that fiberoptic phototherapy has less efficacy comparable to that of conventional phototherapy and double phototherapy has no significant differences in effectiveness compared with conventional phototherapy. So we hope further studies on the effects of the fiberoptic phototherapy in preterm infants and in after 48 hours will be done.
Bilirubin ; Coombs Test ; Hematocrit ; Hope ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Neonatal* ; Infant ; Infant, Newborn ; Infant, Premature ; Phototherapy* ; Plasma ; Pregnancy

This study was conducted to identify risk factors to ensure food safety by evaluating cook supervisors' perceived performance of vegetable safety management at Korean food restaurants in Daegu. Recognition of the potential foodborne illness caused by vegetables was 2.60/5 on average. Inspection items with low scores by respondents during food safety inspection by government agencies were "Wash and sanitize vegetables" and "Keep washed and cut vegetables in the refrigerator". As for storage, perceived performance of "Store vegetable in the refrigerator less than 70% of the refrigerator capacity" scored less than 4 out of 5. About 86% of respondents answered "Water-only washing" for vegetable washing. For perceived performance of vegetable cooking, service, and leftover handling, 11 and three items out of 13 were significantly different depending on the size of restaurants and possession of culinary arts certificates, respectively. Based on results, it is necessary to provide food safety training programs for handling vegetables in order to increase knowledge of cook supervisors. In addition, intensive on-site guidance for safety management of vegetables is needed.
Cooking ; Daegu* ; Education ; Food Safety ; Government Agencies ; Restaurants* ; Risk Factors ; Safety Management* ; Surveys and Questionnaires ; Vegetables*

Gonadoblastoma and dysgerminoma developed in a 24-year-old phenotypic female patient with 46,XY pure gonadal dysgenesis. This patient presented with primary amenorrhea. Clinical characteristics showed a typical stigmata of gonadal dysgenesis: primary amenorrhea, sexual infantilism, a small uterus and bilateral streak gonads. A 46,XY karyotype was made by lymphocyte culture. The patient was counseled to undergo a prophylactic bilateral gonadectomy, but she refused. Three years and three months after the initial diagnosis she felt a growing pelvic mass. Bilateral gonadectomy and total hysterectomy were performed. Histological examination revealed gonadoblastoma and dysgerminoma on both gonads. After surgery the patient received radiation therapy and also was started on hormone replacement therapy. Two years and two months after treatment by surgery the patient is well and free of recurrence.
Adult ; Dysgerminoma/*etiology/pathology/therapy ; Female ; Gonadal Dysgenesis, 46,XY/*complications ; Gonadoblastoma/*etiology/pathology/therapy ; Humans ; Ovarian Neoplasms/*etiology/pathology/therapy

Expression of the natural killer (NK) cell antigen CD56 is uncommon in malignant lymphoma, but when it is, it is almost exclusively of the non-B cell lineage and show a preference for the nasal and nasopharyngeal region. T/NK cell lymphoma is known to be aggressive and refractory to treatment. It is highly associated with the Epstein-Barr Virus (EBV), but clinical investigations are rarely reported, that is until recently. We report here, on the clinical features and therapeutic outcomes of patients with T/NK cell lymphomas and its association with EBV. We reviewed fifty-four cases with peripheral T cell lymphomas in the upper aerodigestive tract between Jan. 1987 and Aug. 1998 from the Severance Hospital, Yonsei University College of Medicine. The diagnosis of T/NK cell lymphoma was made according to the expression of the NK cell markers, CD56 antigen and cytoplasmic CD3 epsilon, in tumor specimens, by immunohistochemistry. Epstein-Barr early region (EBER) RNA was detected using in situ hybridization on paraffin-embedded sections. Among the 54 cases with malignant lymphomas occurring in the upper aerodigestive tract, 20 had T/NK cell lymphoma (37%). The primary sites of T/NK cell lymphomas were the nasal cavity, 12 cases (60%), the tonsils, 4 cases (20%), the nasopharynx, 2 cases (10%), and the oropharynx, 2 case (10%). There were no differences between the features, at diagnosis or therapeutic modalities for patients with T/NK cell lymphoma and non-T/NK cell lymphoma. The complete remission rate of T/NK cell lymphomas was lower than non-T/NK cell lymphomas (65% vs 85%, p=0.02). The overall survival of T/NK cell lymphomas was 13 months (1-74 month), which was significantly lower than non-T/NK cell lymphomas [60.6% with a median follow up of 22 months (1-101 month, p=0.02)]. Disease free survival of T/NK cell lymphomas was 22 months (4-66 month), significantly lower than non-T/NK cell lymphomas [73.8% with a median follow up of 22 months (2-95 month), p=0.04]. The overall survival rates for T/NK cell lymphomas were significantly lower than for EBV positive non-T/NK cell lymphomas (p=0.018). EBER RNA was detected in the paraffin-embedded tissue sections of all T/NK cell lymphomas, compared to only 17.6% (6 of 34 cases) for non- T/NK cell lymphomas. In conclusion, as patients with T/NK cell lymphomas showed poor clinical outcomes, and a high association with EBV positivity, clinical trials with more investigational therapeutic strategies, and further research into the relationship of EBV infection with pathogenesis of T/NK cell lymphoma is warranted.
Adult ; Aged ; Digestive System Neoplasms/*therapy/virology ; Female ; Herpesvirus 4, Human/isolation & purification ; Human ; *Killer Cells, Natural ; Lymphoma/*therapy/virology ; Lymphoma, T-Cell/*therapy/virology ; Male ; Middle Age ; Respiratory Tract Neoplasms/*therapy/virology ; Treatment Outcome