BACKGROUND: Bilirubin has been suggested as a antioxidant which protect oxidation of lipids and lipoproteins. Given that oxidized lipids and lipoproteins are known to be atherogenic, low serum concentrations of bilirubin could be associated with the high risk of coronary artery disease (CAD). But few studies have been performed for confirmation of this hypothesis. In this study, we evaluated the relationship between serum concentrations of billrubln and the angiographically documented CAD. METHODS: Eighty five CAD patients and 56 non-CAD patients, classified according to the maximum stenosis of coronary artery at angiography, were enrolled in this study. The degree of the coronary arterial stenosis were subclassified into <10% (non-CAD), 10-49% (mildly stenotic CAD) and > or =50% (severely stenotic CAD). We retro-spectively reviewed serum concentrations of total and direct bilrubin at the time of angiography, compared tine mean concentrations of bilirubin between two groups and evaluated it in relation to the severity of CAD by statistical analysis. RESULTS: The mean concentration of total bilrubin was significant1y lower in CAD group 4han non-CAD group (12.8 micromol/L vs. 15.2 micromol/L, p value=0.04) The mean concentration of direct bilirubin was lower in CAD group than non-CAD group but not statistically significant (3.3 micromol/L vs. 4.2 micromol/L, p value=0.07). Although not significant, the concentration of total bilirubin in severely stenotic group (12.8 CAD group 12.8+/-4.3 micromol/L) was lower than mildly stenotic group (13.5+/-3.8 micromol/L) and non CAD group (15.2+/-7.4 micromol/L ) (p=0.07). CONCLUSIONS: This study showed that low serum concentrations of total bilirubin were associated with the high risk of CAD and supports the hypothesis that serum bilirubin could act as an antiatherosclerotic factor. Further prospective studies are required to confirm the relationship between bilirubin and CAD and to elucidate the most associated fraction of bilirubin and pathogenic mechanism.
Angiography ; Bilirubin* ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Lipoproteins

BACKGROUND: Peripheral T cell lymphoma (PTCL), a prevalent form of non Hodgkin lymphomas in East Asia, can manifest fever, hepatomegaly, lymphadenopathy, pancytopenia and hemophagocytic histiocytosis (HPH). Similar clinicopathologic findings are also frequently encountered in reactive hemophagocytic syndrome (HPS) and malignant histiocytosis (MH) , thus diagnoses could be confused among them. With recent advancement of immunohistochemlal techniques, diagnostic accuracies have been improved and most cases of MH could have been reclassified as PTCL. In this study, we intended to delineate the lineage of atypical malignant cells in bone marrow of subjects which were previously diagnosed as MH or HPS with immunohlstochemical analysis and characterize clinlcophathologic findings of PTCL associated with HPH in the bone marrow. METHODS: Five cases dignosed as HPS, 3 as MH, 3 as presumed MH, and 7 as PTCL on bone marrow examination were enrolled in this study. We performed immunohistochemical stain for CD45, CD3, CD43, CD2O and CD68, then revised the diagnoses and summarized the clinical and morphologic features of PTCL associated with HPH. RESULTS: Eleven out of 18 cases were confirmed as PTCL which were previously diagnosed as MH(1), presumed MH(3) and PTCL(7). Eight cases of 11 PTCL showed HPH mimicking MH with infiltration of the atypical malignant cells, even if the proportion of atypical malignant cells was small on bone marrow aspirates. They manifested fever and hepatomegaly but didn't have lymphadenopathy at the early stage of disease. Subtypes of PTCL with HPH were PTCL, unspecifed (3), angioimmunoblastic T cell lymphoma (1) and undetermined (4). They showed poorer outcome in 3-month survival rate (25%) than in those with PTCL without HPH(100%). CONCLUSION: These results suggest that PTCL associated with HPH should be excluded from MH by immunohistochemical analysis. Considering that prognosis of PTCL with HPH is very poor, accurate and rapid diagnosis is needed for prompt treatment.
Bone Marrow ; Bone Marrow Examination ; Diagnosis ; Far East ; Fever ; Hepatomegaly ; Histiocytic Sarcoma* ; Histiocytosis* ; Lymphatic Diseases ; Lymphohistiocytosis, Hemophagocytic ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral* ; Pancytopenia ; Prognosis ; Survival Rate

BACKGROUND: Chromosomal aberration observed only in a few metaphases may cause the cytogeneticists to have difficulties in making a decision whether it is due to in vivo mosaicism/multiple clones or due to in vitro artifact. This is especially important when the chromosome of concern has been associated with a classical chromosome syndrome, malignancy or its evolution. Therefore, we aimed to establish a range for random chromosomal aberrations among cells from PHA-stimulated blood(PB) and bone marrow(BM) cultures. METHODS: Among the cells from 449 PB and 472 BM specimens referred for chromosome studies from 1997 to 1998, we analyzed the frequency of random aneuploidy, structural abnormalities, and breaks/gaps. RESULTS: The number of cells analyzed was 5,904/4,488(1997/1998) in PB and 4,211/4,124(1997/1998) in BM. The frequency of metaphases with random chromosomal aberrations of BM(32.10%) was much higher than that of PB(5.90%). The most frequent aberration was chromsome loss. Autosome losses were inversely correlated with autosome size(correlation coefficient = -0.83 and -0.72, p<0.01), smaller chromosomes being lost more frequently while autosome breaks/gaps were correlated with autosome size(correlation coefficient = 0.69 and 0.85, p<0.01), in PB and BM. Comparing the data from 1998 to the data from 1997, the frequency of chromosome losses(<0.5% in PB, <2.25% in BM), gains(<0.1% in PB and BM), breaks/gaps(<0.1% in PB, <0.25% in BM), and structural aberrations( Aneuploidy ; Artifacts ; Bone Marrow* ; Chromosome Aberrations* ; Chromosomes, Human, 4-5 ; Clone Cells ; Metaphase ; Quality Control

OBJECTIVE: To evaluate the association between neuralgic pain distribution and the severity of carpal tunnel syndrome (CTS). METHOD: Pain drawings using computerized pain chart system were collected from 131 patients (213 hands) with CTS. The presence and severity of CTS were determined by means of median motor and sensory nerve conduction studies. The severity was divided into 3 classes on the basis of electrophysiological findings: mild (93 hands), moderate (70 hands) and severe (50 hands). The similarities between pain drawing patterns and median nerve dermatome in the hands were evaluated. The pain distributions of the palmar and dorsal sides of each five fingers, palm and dorsum of hand were also evaluated. RESULTS: There were no significant differences in similarity values of pain distribution among the groups of CTS hands divided by severity: similarity values were 0.22+/-0.14 in mild CTS patients, 0.24+/-0.16 in moderate CTS patients and 0.27+/-0.14 in severe CTS patients. In the CTS patients, the pain drawings showed relatively frequent distributions in the palmar side of 2nd to 4th fingers. CONCLUSION: There was no significant correlation between pain drawing patterns and severity of CTS. The pain drawings of patients with CTS indicate distribution to be most frequent in the palmar side of 2nd to 4th fingers.
Carpal Tunnel Syndrome* ; Fingers ; Hand ; Humans ; Median Nerve ; Neural Conduction

BACKGROUND: Growth retardation (GR) has literally hundreds of causes that have differences in prognoses, complications, and responses to treatments. Especially, growth retarded patients resulting from chromosomal disorders should be genetically counseled. To focus the cytogeneticist's attention on specific chromosomal regions, it is important to understand cytogenetic aberrations associated with GR prior to chromosomal analysis. So, we attempted to figure out the cytogenetic findings of patients with GR and support the effective application of cytogenetic studies, accurate diagnosis and genetic counseling. METHODS: Of 203 cases referred for GR, the positive rate and pattern of chromosomal aberrations were retrospectively analyzed with review of associated clinical features. Cytogenetic studies were performd by high resolution banding technique after peripheral T lymphocyte culture and, if necessary, Ag-NOR stain, C-banding and fluorescence in situ hybridization. RESULTS: Forty two (20.7%) patients had abnormal karyotypes. Thirty one (15.2%) patients had well-recognized chromosomal syndromes including Turner, Cri-du-chat, Edward, 13q- and 18p-/ 18q- syndromes. In addition to those, the sporadic chromosomal aberrations of 11 cases were partial monosomy of 11q23, partial trisomy of 1q32, 4p, 9p, and 14q, and ring chromosome 4 and 18, etc. which were not literally established in view of the correlation with phenotype. CONCLUSIONS: The various results of definite or debating chromosomal disorders associated with GR could be used as the data for diagnosis, management, prognosis, and genetic counseling in growth retarded patients. Furthermore, these may provide the background for prospective study to define the new chromosomal disorders.
Abnormal Karyotype ; Chromosome Aberrations* ; Chromosome Deletion ; Chromosome Disorders ; Cytogenetics* ; Diagnosis ; Fluorescence ; Genetic Counseling ; Humans ; In Situ Hybridization ; Lymphocytes ; Phenotype ; Prognosis ; Retrospective Studies ; Ring Chromosomes ; Trisomy

BACKGROUND: Phadiatop test which was developed for screening of atopy in eastern asia area, has not been sufficiently evaluated in Korea. In our previous study, the clinical usefulness of Phadiatop test for screening of atopy was evaluated on atopics and non-atopics defined by the results of skin prick tests with 10 inhalant allergens in Korea. In this study, we evaluated the usefulness of Phadiatop test for screening of atopy based on the level of CAP specific IgE in Korean asthmatics. METHODS: On 136 Korean asthmatics, the level of CAP specific IgE to 10 important inhalant allergens and the level of Phadiatop specific IgE to mixture of 8 important inhalant allergens in Korea were measured. Atopics and non-atopics were defined by the results of CAP specific IgE and the sensitivity, specificity, predictive value of a positive and negative result, and concordance rate of Phadiatop test were estimated. RESULTS: The sensitivity, specificity, predictive values of a positive and negative result, and concordance rate of Phadiatop test were 90.5%, 95.0%, 99.1%, 63.3%, and 91.2%, respectively. CONCLUSIONS: Phadiatop test was very sensitive, rapid and convenient, and corresponded well to the results of CAP specific IgE. We concluded that Phadiatop test is very useful as a screening tool of atopy in Korea.
Allergens ; Asthma ; Far East ; Immunoglobulin E* ; Korea ; Mass Screening* ; Sensitivity and Specificity ; Skin

*Chromosomes, Human, Pair 18 ; Down Syndrome/*diagnosis ; Female ; Genetic Markers ; Human ; Polymerase Chain Reaction/*methods ; Polymorphism (Genetics) ; Pregnancy ; Prenatal Diagnosis/*methods ; *Tandem Repeat Sequences ; Trisomy/*genetics

Purpose: The goal of this study was to follow benign thyroid nodules confirmed by ultrasound (US)-guided core needle biopsy (CNB) after inconclusive cytology on fine-needle aspiration (FNA) biopsy. Methods: Sixty-two thyroid nodules from 62 patients with CNB-confirmed benign histology that initially had inconclusive cytology on FNA were retrospectively included. The thyroid nodules were followed for 38.7 months (median, 27.5 months; range, 6 to 101 months), and the US findings of biopsied nodules, such as the interval change in size, US characteristics, and imaging category based on the Korean Thyroid Imaging Reporting and Data System (K-TIRADS), were evaluated. In addition, patients’ clinical records were reviewed for any further management or newly diagnosed thyroid malignancy. Results: Among 62 cases, three (4.8%) showed interval size growth, while 59 (95.2%) demonstrated no interval change or a decrease in size. There was no upgrade of K-TIRADS category or any newly diagnosed malignancy during the follow-up period. Conclusion US-guided CNB-confirmed benign thyroid nodules with inconclusive cytology on FNA showed a stable status during follow-up, and repeated CNB could be helpful in the management of nodules with inconclusive cytology on FNA.

No abstract available.
Leukemia*

OBJECTIVE: To evaluate the anatomic course of the lateral antebrachial cutaneous nerve (LABCN) and medial antebrachial cutaneous nerve (MABCN) in the forearm. METHOD: We dissected 29 upper extremities of 16 cadavers for LABCN and 20 upper extremities of 15 cadavers for the MABCN. We measured the distance (BT_L) between the biceps tendon (BT) and LABCN on the intercondylar line. The BT is the point at which biceps tendon crosses intercondylar line. The distance (L12) between LABCN and the point of 12 cm distal to BT on the line between BT and radial artery at wrist was measured. The distance (ME_M) between MABCN and medial epicondyle on the intercondylar line was measured. M8 and M10 are the distances between MABCN and the points 8 cm and 10 cm distal to BT on the line from BT to mid-point of flexor carpi radialis and palmaris longus at the wrist respectively. RESULTS: BT_L and L12 were 1.4+/-3.7 mm and 4.4+/-3.7 mm respectively. ME_M, M8 and M10 were 28.6+/-6.9 mm, 18.9+/-8.9 mm and 18.3+/-8.2 mm respectively. The thickness of LABCN and MABCN was 19.1+/-4.9 mm and 13.2+/-4.2 mm respectively. CONCLUSION: The LABCN was emerge just lateral to biceps tendon at the elbow and ran down to radial artery. The anatomic course of MABCN was variable at the elbow and forearm.
Cadaver ; Elbow ; Forearm ; Radial Artery ; Tendons ; Upper Extremity ; Wrist