No abstract available.
Agammaglobulinemia*

Lymphoepithelioma-like carcinoma (LELC) that histologically resembles nasopharyngeal lymphoepithelioma has been reported in various sites including the stomach, salivary gland, lung, skin, thymus, tonsil and uterine cervix. LELC of the stomach was rarely reported after the first report by Burke et al. in 1990. More than 60% of them were associated with Epstein-Barr virus (EBV). Most commonly affecting elderly Asians with slight male predominance (M/F ; 1.2/1), it usually is located in the proximal portion of the stomach and distinguished from lymphoid-rich adenocarcinoma by the absence of definitive glandular differentiation in the LELC. We recently experienced 4 cases of LELC of the stomach associated with EBV. Patients consisted of two Korean females and two Korean males with one in 3rd decade, one in 5th decade and two in 6th decade. The tumors of all cases were located in the proximal portion of the stomach. Gross types were 1 Borrman type I, 2 Borrman type II and 1 early gastric carcinoma type IIc. The size of the tumors varied from 0.8 cm to 7 cm. Microscopic findings were similar in all 4 tumors.; The tumors were composed of syncytial nests of undifferentiated cells having vesicular nuclei with prominent nucleoli, admixed with abundant lymphoplasma cell infiltration in the stroma. Immunohistochemical staining revealed that the tumor cells were reactive for cytokeratin and the stromal lymphocytes were mostly T cells. There were dark hybridization signals in the nuclei of most of the tumor cells but no signals in the stromal lymphocytes in three cases on in situ PCR hybridization and on all cases PCR amplification for EBNA-1. It is concluded that LELCs of the stomach have distinctive histologic characteristics and the usual association with EBV. Further accumulation of these cases will define the prognosis.
Adenocarcinoma ; Aged ; Asian Continental Ancestry Group ; Cervix Uteri ; Female ; Herpesvirus 4, Human* ; Humans ; Keratins ; Lung ; Lymphocytes ; Male ; Palatine Tonsil ; Polymerase Chain Reaction ; Prognosis ; Salivary Glands ; Skin ; Stomach* ; T-Lymphocytes ; Thymus Gland

Werniche's encephalopathy is clinically characterized by the acute onset of global confusion, ataxia, gaze paresis, and nystagmus. It result from a deficiency in thiamine, an essential coenzyme in intermediate carbohydrate metabolism. The prompt use of thiamine prevents progression of the disease and reverses those lesions that have not yet progressed to the point of fixed structural change. We experienced a case of Wemiches encephalopathy associated with hyperemesis gravidarum, which happens to the patient who are injected only dextrose without thiamine. Therefore, we emphasize the need of thiamine replacement in hyperemesis gravidarum.
Ataxia ; Carbohydrate Metabolism ; Female ; Glucose ; Humans ; Hyperemesis Gravidarum ; Paresis ; Pregnancy ; Thiamine

PURPOSE: To assess the role of blood vessels in the formation of peritumoral abnormal signal intensity which exaggerates the size of malignant tumor on MR images. MATERIALS AND METHODS: We performed MR-microangiographic-pathologic correlation using implanted VX-2 carcinoma in 16 rabbit thighs 1-28 days after tumor implantation. The shape and distribution of abnormal vessels were analyzed on microangiography and on histologic examination in correlation with peritumoral abnormal signal intensity on MR images. RESULTS: Dilated peritumoral blood vessels gave rise to irregular, tortuous tumor vessels penetrated into the tumor. With the tumor growth, hypervascular tumor vessels in peritumoral area and central avascular areas were increased. These hypervascular areas on microangiography were corresponded with abnormal signal intensity on MR images. CONCLUSION: Hypervascularity could be a cause of peritumoral abnormal signal intensity which exaggerates the size of experimentally induced malignant musculoskeletal tumors on MR images.
Blood Vessels* ; Thigh

Angiosarcomas are rare tumors that are derived from vascular endothelial cells. They may occur in various sites, including the skin, breast, visceral organs and deep soft tissues. The pleura usually a metastatic site from angiosarcomas. However, thirty one cases of primary pleural angiosarcomas have been reported worldwide. Here, we report a 61-year-old man with a primary angiosarcoma of the pleura with a brief review of the literature.
Breast ; Endothelial Cells ; Hemangiosarcoma* ; Humans ; Middle Aged ; Pleura* ; Skin

BACKGROUND: Cardiac troponin T (cTnT) is a new serological marker for use as a diagnostic toots for acute myocardial infarction (AMI). This study was designed to evaluate tee diagnostic efficiency of troponin T in AMI. METHODS: We determined the reference range of troponin T in 20 healthy adults without previous cardiovascular diseases and chest pain. We evaluated troponin-T, CK, LD, AST and CK-MB in serum of 13 AMI and 5 angina pectoris patients. The patients were arrived at the hospital within 3 hours after onset of (most recent) acute symptoms. Samples were drawn individually at the times of 0, 1, 3, 7, 18 and 24 hours after admission and continued at 6-h intervals for 2 days and 24-h intervals fort 2 weeks. Troponin T was determined by an enzyme-linked immuno-sorbent assay (one step sandwich assay) on an ES-300 analyzer. RESULTS: We found that serum troponin-T concentrations in healthy control adults were below 0.07microgram/L. The peak level of troponin-T concentration of patients with AMI was 22.0microgram/L, mean value, at 7 hours after admission and showed 110 times its discrimination limit value (0.2microgram/L). CK-MB value was normalized within 3 days after admission, but cTnT value remained high above its discrimination limit value until 2 weeks after admission during this study. CONCLUSIONS: The data indicate that the measurement of serum cTnT improves efficiency of serological testings of AMI as compared with conventionally used cardiac enzymes.
Adult ; Angina Pectoris ; Cardiovascular Diseases ; Chest Pain ; Discrimination (Psychology) ; Humans ; Myocardial Infarction* ; Reference Values ; Serologic Tests ; Troponin T* ; Troponin*

BACKGROUND: Family counseling is an essential part of family practice in which patients are cared in psychosocial dimension as will as in physical dimension and the family is dealt with as a whole unit. However, it is little applied in practice. The department of family medicine has made efforts to activate family counseling. This study was done to estimate the patients response on the effect of family counseling that we have performed, and to investigate what clinical problems counseling was held and in what situations the counseling was perceived to be useful by the patients. We hope this study will be useful to establish some useful data and ideas for the development of family counseling in family practice in Korea. METHODS: The subjects of this study are 53 households who received family counseling at the department of family medicine from Oct. 1, 1994 to May 31, 1995. 64 households received counseling during this peroid, but 11 persons who could not be reached by the phone were excluded. Patients demographic charateristics, patients chief complaints, physicians assessrnent on the complaints and major prolems presented in the counseling sessions were identified from the medical records. Patients own estimation of the effect of counseling and the reasons for termination of counseling were inquired through the telephone interview. Finally the association between the usefulness of counseling and some factors was statistically analyzed. RESULTS: Subjects were predominently women(84.9%), especially middle aged. The most common chief complaint was headache complained by 10 subjects (18.9%), and the second and the third were abdominal pain complained by 8 (15.1%) and chest discomfort complained by 7(13.2 %), respectively. The list of physicians assessment included depression(34.0%), physical symptom per se without any assessment(20.8%), family problem(15.1%), somatization(13.2%), and anxiety(9.45). More than half of the subjects(60.4%) had only one session, 26.4% two sessions and 7.5% more than 4 sessions. The most common problem presented in the counseling was marital conflict(28.3%), the second was trouble with in-laws(15.1%), and the third was chronic illness in the family(9.4%). 32.1% replied that the counseling was very helpful, 28.3% somewhat helpful, 17% little helpful, 20.8% never helpful, and 1.9% not sure. The session was experienced to be more useful in the group of duration of symptom less than 6 months, than in the group of longer duration(p<0.05), and in the group with motivation for counseling than in the group without motivation(p<0.05). CONCLUSIONS: About 60% of subjects replied the counseling was useful to them. Symptom duration and patients motivation to participate in counseling showed significant association with the effect of family counseling.
Abdominal Pain ; Chronic Disease ; Counseling* ; Family Characteristics ; Family Practice ; Headache ; Hope ; Humans ; Interviews as Topic ; Korea ; Medical Records ; Middle Aged ; Motivation ; Thorax

BACKGROUND: Family counseling is an essential part of family practice in which patients are cared in psychosocial dimension as will as in physical dimension and the family is dealt with as a whole unit. However, it is little applied in practice. The department of family medicine has made efforts to activate family counseling. This study was done to estimate the patients response on the effect of family counseling that we have performed, and to investigate what clinical problems counseling was held and in what situations the counseling was perceived to be useful by the patients. We hope this study will be useful to establish some useful data and ideas for the development of family counseling in family practice in Korea. METHODS: The subjects of this study are 53 households who received family counseling at the department of family medicine from Oct. 1, 1994 to May 31, 1995. 64 households received counseling during this peroid, but 11 persons who could not be reached by the phone were excluded. Patients demographic charateristics, patients chief complaints, physicians assessrnent on the complaints and major prolems presented in the counseling sessions were identified from the medical records. Patients own estimation of the effect of counseling and the reasons for termination of counseling were inquired through the telephone interview. Finally the association between the usefulness of counseling and some factors was statistically analyzed. RESULTS: Subjects were predominently women(84.9%), especially middle aged. The most common chief complaint was headache complained by 10 subjects (18.9%), and the second and the third were abdominal pain complained by 8 (15.1%) and chest discomfort complained by 7(13.2 %), respectively. The list of physicians assessment included depression(34.0%), physical symptom per se without any assessment(20.8%), family problem(15.1%), somatization(13.2%), and anxiety(9.45). More than half of the subjects(60.4%) had only one session, 26.4% two sessions and 7.5% more than 4 sessions. The most common problem presented in the counseling was marital conflict(28.3%), the second was trouble with in-laws(15.1%), and the third was chronic illness in the family(9.4%). 32.1% replied that the counseling was very helpful, 28.3% somewhat helpful, 17% little helpful, 20.8% never helpful, and 1.9% not sure. The session was experienced to be more useful in the group of duration of symptom less than 6 months, than in the group of longer duration(p<0.05), and in the group with motivation for counseling than in the group without motivation(p<0.05). CONCLUSIONS: About 60% of subjects replied the counseling was useful to them. Symptom duration and patients motivation to participate in counseling showed significant association with the effect of family counseling.
Abdominal Pain ; Chronic Disease ; Counseling* ; Family Characteristics ; Family Practice ; Headache ; Hope ; Humans ; Interviews as Topic ; Korea ; Medical Records ; Middle Aged ; Motivation ; Thorax

No abstract available.
Adult* ; Humans ; Obesity*

BACKGROUNG AND OBJECTIVES: Diet is the basic and principal therapeutic modality for hyperlipidemia. However, diet therapy alone showed variable responses in lowering lipid levels in different studies. This research is to prove the effect of diet and Apo E polymorphism on the variation of serum lipid profile in Korean males. MATERIALS AND METHODS: To evaluate the gene-diet interation, serum total cholesterol (Chol), triglycerides (TG), HDL-cholesterol and LDL-cholesterol (HDLc, LDLc), lipoprotein (a) (Lp (a)), and fasting blood glucose (FBS) were measured with Apo E genotyping in vegeterians (group A, n=154) and in healthy Korean male adults (group B, n=150) of similar mean age (50.1 vs. 49.3). RESULTS: Lipid profiles showed significantly lower levels in group A compared to group B (Chol 168.3+/-30.5 mg/dL vs. 181.3+/-33.4 mg/dL, p<0.001;TG 131.0+/-62.9 mg/dL vs. 149.4+/-76.7 mg/dL, p=0.023;HDLc 56.0+/-11.0 mg/dL vs. 56.9+/-11.5 mg/dL, p=0.509;LDLc 92.5+/-28.1 mg/dL vs 100.6+/-29.9 mg/dL, p=0.016;Lp (a) 22.1+/-14.6 mg/dL vs. 26.9+/-13.8 mg/dL, p=0.004;FBS 85.1+/-14.1 mg/dL vs. 102.7+/-16.6 mg/dL, p<0.001). The Apo E genotyping showed Epsilon3/3, 64.1%; Epsilon3/4, 20.7%;Epsilon2/3, 11.8%;Epsilon2/2, 1.3%;Epsilon4/4, 0.6% in the combined groups. The distribution was similar in both groups. Chol and LDLc were significantly (p<0.05) higher in Epsilon3/4 allele group compared to other allele groups among non-vegetarians. On the other hand, Chol and LDLc were significantly (p<0.01) lower in vegetarians compared to non-vegetarians only in Epsilon3/4 allele group. CONCLUSION: Vegetarian diet significantly lowered Chol, TG, LDLc, Lp (a) and FBS levels. Significant lipid lowering effect of vegetarian diet was noted in Apo E allele Epsilon3/4 group which had significantly higher Chol and LDLc levels without diet intervention. These data suggest that the influence of diet on serum lipid profiles differ according to apo E genotypes.
Adult ; Alleles ; Apolipoproteins E ; Blood Glucose ; Cholesterol ; Diet Therapy ; Diet* ; Diet, Vegetarian ; Fasting ; Genotype ; Hand ; Humans ; Hyperlipidemias ; Lipoprotein(a) ; Male* ; Triglycerides