M-mode echocardiography has been demonstrated to be a sensitive indicator of the sequential changes occurring in the heart in systemic arterial hypertension. The changes in function as well as anatomic features have been recorded. Previous analysis has focused on the anatomy and systolic function of the left ventricle, analysed in hypertensive heart disease. 13 normal subjects(Group I), 14 hypertensive patients without evidence of cardiac involvement(Group II) and 13 hypertensive patients with echocardiographic evidence of left ventricular hypertrophy(Group III) were compared using M-mode echocardiographic data and clinical. findings. The results are as follows : 1) Mean age are; Group I : 41 years(19-62), Group II : 49 years(25-67) and Group III : 53 years(30-83). There are no significant age difference between Group I and II. Sex ratio are 4:9, 8:6 and 7:6 respectively. 2) Mean arterial pressure are; Group I : 98+/-5mmHg, Group II : 126+/-7 mmHg and Group III : 131+/-101mmHg. 3) Left ventricular posterior wall thickness are; Group I : 0.87+/-0.12cm, Group II : 0.89+/-0.12cm and Group III : 1.32+/-0.18cm(p>0.05 in I vs II). 4) Left atrial dimension are; Group I : 2.77+/-0.68cm, Group II : 2.96+/-0.44cm and Group III: 3.12+/-0.60cm. 5) Left ventricular mass arel Group I : 194+/-51gm, Group II : 192+/-51gm and Group III : 318+/-77gm(p>0.05 in I vs II, p<0.001 in I vs II and II vs III). 6) Ejection fraction are; Group I : 0.57+/-0.09, Group II : 0.60+/-0.01 and Group III : 0.52+/-0.01)p>0.05). 7) Mitral valve EF solpe are; Group I : 113.70+/-23.26mm/sec, Group II : 81.14+/-17.22mm/sec and Group III : 69.92+/-22.70mm/sec(p<0.05 in I vs II, p<0.001 in I vs III and II vs III). 8) AEI are; Group I : 0.70+/-0.04, Group II : 0.56+/-0.07 and Group III: 0.48+/-0.07)p<0.001 in I vs II, I vs III and II vs III). From the above results, the atrial emptying index seems to be an early indicator of abnormalities of left ventricular diastolic compliance in hypertensive patients.
Arterial Pressure ; Compliance ; Echocardiography* ; Heart ; Heart Diseases ; Heart Ventricles ; Humans ; Hypertension ; Mitral Valve ; Sex Ratio

Control of tuberculosis is threatened by widesread emergence of drug resistant Mycobacterium tuberculosis. Rifampin is a key component among therapeutic regimens for the tuberculosis; therefore patients in whom resistance to this drug develop have a poor outlook, particularly if rifampin resistance is associated with resistance to other tuberculosis drugs. The purpose of this study was to detect the mutation in rpoB gene of rifampin resistant M. tuberculosis in Korea and to evaluate the usefulness of the method in clinical aspects. A sample of 80 M. tuberculosis was studied, and it included 40 rifampin resistance isolates and 40 rifampin sensitive isolates by conventional methods. The detection method involved the amplification by polymerase chain reaction (PCR) of the Rif' region and the identification of mutations by single-strand DNA conformation polymorphism analysis (SSCP) of the amplification products (157 bp). Mutation were identified in 39 of 40 rifampin resistant isolates, and in 1 of 40 rifampin sensitive isolates.
Humans ; Korea ; Mycobacterium tuberculosis* ; Mycobacterium* ; Nucleic Acid Conformation ; Polymerase Chain Reaction* ; Rifampin ; Tuberculosis

Control of tuberculosis is threatened by widespread emergence of drug resistance in Mycobacterium tuberculosis. Understanding the molecular basis of resistance might lead to development of novel rapid methods for diagnosing drug resistance. Rifampin is a key component among therapeutic regimens for the tuberculosis; therefore, patients who have drug resistance do not convalesce satisfactorily. The molecular mechanism of resistance to rifampin in M. tuberulosis has been elucidated. Substitutions of a limited number of highly conserved amino acids encoded by the rpoB gene are responsible for the ""single-step"" high-level resistance of M. tuberculosis to rifampin. Currently, two genotype-based protocols allow drug test from minimally grown cultured materials: (i)mutation identification by direct sequencing of PCR-amplified material. and (ii)mutation screening by PCR-SSCP. The purpose of this study is to evaluate the usefulness of the both methods. A sample of 75 isolates of M. tuberculosis was studied, and it inculded 36 rifampin-resistant strains and 39 rifampin-sensitive strains by conventional methods. Mutaions were identified in 36 rifampin-resistant isolates but in none of 39 sensitive isolates. All mutations were clustered within a region of 23 amino acids. Both methods allow detection of rifampin resistance in 2 to 3 days and will thus help in the early management of infection by M. tuberculosis.
Amino Acids ; Drug Resistance ; Humans ; Mass Screening ; Mycobacterium tuberculosis* ; Mycobacterium* ; Rifampin ; Tuberculosis

Background:Insulin dependent diabetes mellitus(IDDM) is known to be a disease characterized by a deficiency of insulin caused by destruction of the pancreatic beta-cells. It has been suggested that the clinical and immunological characteristics of IDDM in Korean are different from those of Caucasian. This study was undertaken to investigate the clinical characteristics and the prevalence of autoimmune markers in type I diabetic children and their prediabetic siblings in Korea. METHODS:Insulin autoantibody(IAA), antiglutamic acid decarboxylase(Anti-GAD) antibody, thyroid autoantibodies such as antithyroid antibody(ATA) and antimicrosomal antibody(AMA), and rheumatoid facter(RF) in 54 type I diabetic children have been measured. Diabetic autoimmune antibodies were also measured in 48 siblings. RESULTS: 1)Clinical characteristics of type I diabetic children were that age of onset was 8.6+/-4.4 years, duration of diabetes was 4.1+/-3.3 years. C-peptide at onset of diabetes was fasting 0.7+/-0.5ng/ml, and postprandial 1.2+/-0.5ng/ml, and HbA1c was 12.5+/-4.3%. 2)The positivity of IAA and anti-GAD antibody of type I diabetic children was 74% and 50% respectively. ATA and AMA positivity of type I diabetic children was 3.7% and 5.6%. however RF was not detected at all. Among the diabetic siblings, 48 persons for anti-GAD antibody, 21 for IAA, 27 for ICA were measured but 1 case was positive for IAA. 3)Clinical characteristics of type I diabetic children were not specific different between IAA and anti-GAD antibody positivity. But the mean age of onset of type I diabetic children was younger in case of both positivity of IAA and anti-GAD antibody than both negativity(7.8 vs 11.4 years old, P<0.05). 4)A case in whose brothers are diagnosed as IDDM has shown that autoantibody of elder brother was positive in both IAA and anti-GAD antibody, and younger brother was also strongly positive in IAA. Another case in whose sisters were IDDM, has shown that, while elder sister was positive in IAA, younger sister strongly positive in both IAA and anti-GAD antibody. 5)In a case of identical twin brother, the elder is type I diabetic child and the younger is normal, elder brother's onset of age was 6 years and 8 months old, and titer of anti-GAD antibody was measured as strong positive. Both ICA and anti- GAD antibody were negative in normal younger brother. First phase insulin release in IV GTT and the insulin levels in oral GTT showed reduction from the normal level in normal brother, and repeat check up showed normal ranges but on-going study is needed under observation. CONCLUSION: The prevalence of autoantibody positivity of type I diabetic children of Korea in this study were IAA 74%, and anti-GAD antibody 50%. Cases with both IAA and anti-GAD antibody positive were shown to be earlier onset. Though titers of auto-antibody in IDDM twins, brothers and sisters were strongly positive, auto-antibodies in siblings of IDDM patients were detected only one case with IAA positive(0.47%). We suggest that the pathogenesis of IDDM in Korean is different from foreign countries in terms of prevalence of autoimmune antibodies and more numbers of diabetic siblings should be tested for further study.
Age of Onset ; Antibodies* ; Autoantibodies ; C-Peptide ; Child* ; Diabetes Mellitus, Type 1 ; Fasting ; Humans ; Infant ; Insulin ; Korea ; Prevalence* ; Reference Values ; Siblings* ; Thyroid Gland ; Twins, Monozygotic

No abstract available.
Congenital Hypothyroidism*

A case of Tuberous Sclerosis, 4 year-old-Korean boy was observed. He had some symptoms about Tuberous Sclerosis which were abenoma sebaceum, seizure, shagreen patch and hypopigmented macule. Diagnosis was confirmed by facial skin biopsy and adenoma sebaceum was noticed.
Biopsy ; Diagnosis ; Humans ; Male ; Seizures ; Skin ; Tuberous Sclerosis*

PURPOSE: School-age children spend more than half of the day at school and teachers or school nurses are responsible for managing students with asthma during school hours. Thus, the teachers' knowledge about asthma is very important for the care of asthmatic school children. METHODS: Total 159 teachers were asked to fill out questionnaire on their knowledge about asthma and their personal profiles. The survey was administered by mail. The questionnaire includes 17 items about pathophysiology, symptoms, precipitating factors, treatment, care and prognosis, which were to be answered by either 'true' or 'false'. The correct or incorrect answers were examined data was statistically analyzed by SPSS. RESULTS: Most teachers were in their thirties (54.7%) and years of teaching experience were from six to fifteen years (50.4%). The teachers who experienced asthma students were 23.6%, and 12.6% were either asthma patients or had asthma patients in their family. They had knowledge about precipitating factors of asthma, but, the knowledge was not correct in detail. Only 34% teachers knew what to do and where to contact in case of asthma attack among the students. Teachers' demographic and professional factors did not affect the knowledge about asthma, except their working experience as school nurses and/or with school nursing asthmatic students. CONCLUSION: The survey results demonstrated that their teachers' knowledge about asthma was not sufficient enough to take good care of the asthmatic students at school including emergency management. Asthma education for the school teachers is required and efficient educational programs for the teachers should be developed.
Asthma ; Child ; Education ; Emergencies ; Humans ; Postal Service ; Precipitating Factors ; Prognosis ; Surveys and Questionnaires ; School Nursing

PURPOSE: Airway inflammation is a characteristic feature of asthma. Sputum analysis can be used as a non-invasive tool to assess severity of the airway inflammation. This study was performed to compare relationships between sputum eosinophils to other parameters of airway inflammation and to evaluate the clinical utility of sputum eosinophils and ECP in childhood asthma. METHODS: Twenty one ashtmatic children and age matched control subjects without history of allergy were enrolled in this study. Their age was from 21 months to 15 years old. The study was performed from January to April of 2001. Ultrasonically nebulized hypertonic saline was used to induce sputum from children. The children were pre-treated with bronchodilator and peak expiratory flow rate (PEFR) was monitored thought-out the procedure. Sample were analysed for total cell count, differential cell count and for concentrations of eosinophil cationic protein (ECP). RESULTS: Asthmatic subjects had a significantly higher proportion of blood eosinophils than the control subjects (279.8+/-187.7/mm3 and 26.5+/-18.5/mm3, P<0.01). Correspondingly, percentages of eosinophil and concentration of ECP were 5.10+/-8.79% and 99.85+/-70.10 microL/L in asthmatic and 0.20+/-0.42% and 1.02+/-2.54 microL/L in control subjects (P<0.01 and P<0.01). Serum eosinophils have no correlation with sputum eosinophils or sputum ECP. There was no correlation between sputum eosinophils and ECP either. CONCLUSION: This study suggests that the proportion of eosinophils and the level of ECP in induced sputum may be sensitive and accurate means of assessing the airway inflammation in childhood asthma, and their relationships with serum eosinophils or serum ECP are to be studied further.
Adolescent ; Asthma* ; Cell Count ; Child ; Eosinophil Cationic Protein* ; Eosinophils* ; Humans ; Hypersensitivity ; Inflammation ; Peak Expiratory Flow Rate ; Sputum*

To characterize the immunopathologic phenotype of the cells in the lesional ti.:sue and to further examine the mechanism of the development of the annular lesions in leprosy, we have studied immune cells (T lymphocyte and its subsets, Langerhans cells, and HLA-DR antigen expressing cells) at different anatomical sites inside, active border, and outside normal skin in the annular lesions of leprosy. We took biopsy specimens from 4 patients of BT type, then processed the specimens by the staining methods eif indirect immunoperoxidase with monoclonal antibodies. In the active border the number of T cell was over 50g of the total cells infiltrated in the dermis. Helper T cells were dominant in number, and about three fourths of the cells were positive for HLA-DR staining. In two patients they had expression of DR antigen on the surfaces of the keratinocytes in the epidermis, in contrast to that of the inside, even the intensities were not. strong. At the inside of the annular lesions T cells were about 40% and the ratio of helper/suppressor T cell was approxiinately 1: 1, However, HLA-DR positive immune cells were not more than 10g among the total infiltrates. Langerha,ns cells were increased in number and in size either in the border or at the inside of the annular lesions. With these results we presume that the T cell mediated imrnune responses against Mycobacterium leprae may play an important role in the formation and extension of the annular lesions in leprosy.
Antibodies, Monoclonal ; Biopsy ; Dermis ; Epidermis ; HLA-DR Antigens ; Humans ; Keratinocytes ; Langerhans Cells ; Leprosy* ; Lymphocytes ; Mycobacterium leprae ; Phenotype ; Skin ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer

OBJECTIVES: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. METHODS: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. RESULTS: In serum lipid profile test, MDD group showed higher cholesterol (197.68+/-42.94 mg/dL vs. 176.85+/-34.68 mg/dL, p=0.044), TG (139.45+/-92.54 mg/dL vs. 91.4+/-65.68 mg/dL, p=0.018), LDL (130.03+/-33.18 vs. 106.62+/-27.08, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant (32.82+/-14.33 ms vs. 40.36+/-21.40ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group (1.13+/-0.11 vs. 0.91+/-0.18, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). CONCLUSION: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.
Anxiety ; Autonomic Pathways ; Cholesterol ; Depression ; Depressive Disorder, Major ; Heart ; Heart Rate ; Humans