OBJECTIVE: The purpose of this study was to determine the frequency and distribution of cytogenetically abnormal miscarriages in couples with spontaneous abortions (SA) or recurrent miscarriages (RM). METHODS: Karyotyping of specimens from 164 abortuses with SA and 86 abortuses with RM was successfully performed according to the standard cytogenetic methods using G-banding technique. RESULTS: Among the total 164 cases of SA group, 81 (49.4%) were euploid and the rest (83, 50.6%) showed chromosomal abnormalities. In RM(> or =2) and RM(> or =3) group, 31 (36.0%)/27 (34.6%) cases were euploid and 55 (64.0%)/51(65.4%) cases were abnormal, respectively. A statistically significant difference was found in the rate of cytogenetic abnormality between SA and RM groups (P<0.05). In all groups, women with advanced maternal age (> or =35 years) had a higher rate of chromosome anomalies compared with women younger than age 35 (normal:abnormal = 32.4%:67.6% for > or =35 years and 53.8%:46.2% for <35 years in SA; 19.2%:80.8%/21.7%:78.3% for > or =35 years and 43.3%:56.7%/40.0%:60.0% for <35 years in RM(> or =2) and RM(> or =3), respectively; P<0.05). In SA group, an increase of normal karyotypes was noted with increased gestational age (<10 week, 38.0%; 10-15 week, 53.5%; 16-20 week, 65.7%). In RM group, most of cases were in <10 week and the frequency of trisomies with chromosomes 1 to 10 were increased compared with that of SA. CONCLUSION: There was a statistically significant difference in the frequency and distribution of chromosomal abnormalities between SA and RM groups. Our results will provide useful information for diagnosis and genetic counseling of patients with SA or RM.
Abortion, Habitual* ; Abortion, Spontaneous* ; Chromosome Aberrations ; Cytogenetic Analysis ; Cytogenetics* ; Diagnosis* ; Family Characteristics ; Female ; Genetic Counseling ; Gestational Age ; Humans ; Karyotype ; Karyotyping ; Maternal Age ; Pregnancy ; Trisomy

PURPOSE: The aim of this study was to investigate the alterations of growth and bone metabolism in SDR induced by dexa administration and to evaluate the effects of GH treatment in dexamethasone(dexa) induced growth and bone metabolism in SDR. METHODS: Forty-five female Sprague-Dawley rats(weight 150-170gm) were divided in 3 groups: Group 1(n=15) received normal saline as control, Group 2(n=15) received dexa(1mg/kg/day), Group 3(n=15) received dexa and rhGH(LG Chem, 1IU/kg/day) simultaneously. Group 2 and 3 were injected rhGH daily, 6 days per week. Each group was divided in three subgroups(n=5) and sacrificed at 4, 6, 8 weeks, respectively. RESULTS: In Group 2, the length of tibia and femur and tibia epiphyseal plate thickness decreased significantly at 4, 6, 8 weeks compared to Group 1, respectively. In Group 2, serum IGF-I and PICP level also decreased at 6, 8 weeks and serum ICTP level increased at 4, 6 weeks compared to Group 1 significantly. In Group 3, the length of tibia and femur increased at 4, 6, 8 weeks compared to Group 2 but there was no statistical significance. In Group 3, tibia epiphyseal plate thickness increased significantly at 6, 8 weeks compared to Group 1. In Group 3, serum IGF-I and PICP level increased significantly at 4, 6, 8 weeks respectively compared to Group 2. But serum ICTP level showed no changes between two groups. Serum PTH level increased in Group 2 compared to Group 1, and decreased in Group 3 compared to Group 2 but no statistical significance was noted, respectively. CONCLUSION: Our data suggest that dexa inhibits longitudinal bone growth and interferes with bone metabolism, both inhibiting bone formation and stimulating bone resorption in SDR. Simultaneous GH administration may abolish alterations of growth and bone metabolism induced by dexa in SDR.
Animals ; Bone Density ; Bone Development ; Bone Resorption ; Dexamethasone* ; Female ; Femur ; Growth Hormone* ; Growth Plate ; Humans ; Insulin-Like Growth Factor I ; Metabolism* ; Osteogenesis ; Rats* ; Rats, Sprague-Dawley ; Tibia

Aged ; Caregivers ; Dementia ; Depression ; Empathy ; Epidemiologic Studies ; Humans ; Korea ; Pilot Projects

Objective: The number of patients suffering from dysphagia is increasing in line with societal aging. However, preparing dysphagia diets at home or in welfare facilities is challenging due to the lack of commercially specifically designed products. The thickening agents used to prepare dysphagia meals can be difficult due to changes in viscosity and homogenization. Therefore, this study was performed to prepare dysphagia meals using commercially available foods following the classification system outlined by the International Dysphagia Diet Standardization Initiative (IDDSI). Methods: Commercial foods were categorized as main dishes, side dishes, and snacks. Selected foods were ground or minced, and 1-3 g of thickening agent was added. Following the IDDSI framework, fork flowability, spoon tilt, and gravity flow tests were conducted using a syringe, and based on these evaluations, texture-modified foods were classified as general, minced, ground, or liquid foods. Results: Commercial foods used in the experiment could be used in IDDSI Level 2-7 dysphagia diets after adjusting their structures. Food size and viscosities were appropriately controlled, and an usage manual was developed. Conclusion This study successfully demonstrated the easy incorporation of commercial food products into the dysphagia diets for personal care and welfare facilities. By adopting the described approach, dysphagia patients could be provided various meal options with improved service. In addition, this study suggests possibilities for developing and producing diverse products designed specifically for dysphagia patients.

BACKGROUND: It is known that the Y chromosome or Y-specific sequence is present in about 6% of Turner syndrome (TS) patients and that it predisposes them to gonadoblastoma formation with an estimated risk of 15-25%. In this study, we performed a polymerase chain reaction (PCR) in 32 patients with TS to detect Y-specific sequence. The results were compared with those obtained by the fluorescence in situ hybridaization (FISH) method. METHODS: Cytogenetic analysis was performed by phytohaemagglutinin (PHA)-stimulated peripheral lymphocyte cultures, using G-banding. DNA was extracted from peripheral blood for PCR. Seven different sets of oligonucleotide primers, sex determining region Y (SRY), zinc finger gene on the Y chromosome (ZFY), testis specific protein Y (TSPY), DYZ3, DYF49S1, RNA binding motif protein (RBM), and DYZ1, spanning on centromeres and short and long arms of the Y chromosome were used for PCR. FISH was carried out using X and Y chromosome enumeration probe for Xp11.1-q11.1 (DXZ1 locus) and Yp11.1-q11.1 (DYZ3 locus), respectively. RESULTS: Among 32 patients with TS, four (12.5%) were positive for Y specific sequence by PCR. Of these, two patients were detected previously by a cytogenetic analysis: 45,X/47,XYY and 45,X/46,XY. Only one Y specific sequence, DYZ3, was detected by PCR in the other two patients without cytogenetically obvious Y chromosome. Y signal was not detected by FISH for the last two patients. CONCLUSIONS: It may be reasonable to consider using a PCR method to screen for Y-specific sequences in all patients with TS. Even though we did not demonstrate Y-signal by FISH in patients with PCR positive and cytogenetically no obvious Y chromosome, FISH may be another useful method in TS patient, and futher investigation is nessessary.
Arm ; Centromere ; Cytogenetic Analysis ; DNA ; DNA Primers ; Fluorescence ; Gonadoblastoma ; Humans ; Lymphocytes ; Polymerase Chain Reaction ; RNA ; Testis ; Turner Syndrome* ; Y Chromosome ; Zinc Fingers

It is well accepted that kidney transplantation cannot be done if the recipient has antibodies showing a positive HLA cross-match to the donor. Recently, Schweitzer and his associates used a combination therapy with plasmapheresis, IV gamma globulin, and potent immunosuppression to induce HLA cross-match negative conversion in patients with a positive HLA cross-match to living donors and they reported good results after the trials. Therefore, we treated a patient with combination therapy who had persistent-positive HLA cross-match to multiple living donors. The patient was a 38-year-old female suffering from chronic renal failure and she showed persistent positive HLA cross-match to multiple living donors. Using a combination therapy with plasmapheresis, IV gamma globulin and immunosuppression, we have successfully achieved a HLA cross-match negative conversion in a patient and we did kidney transplantation without any sign of hyperacute or acute rejection. Although we present possibility of a HLA cross-match negative conversion by combination therapy, especially in a recipient with a low titer cross-match positive to a family donor, further long-term study with more patients is needed for evaluation of the efficacy of this trial.
Adult ; Antibodies ; Female ; gamma-Globulins ; Humans ; Immunosuppression ; Kidney Failure, Chronic ; Kidney Transplantation ; Living Donors ; Plasmapheresis* ; Tissue Donors

A case of synchronous multiple primary esophageal squamous cell carcinomas and multiple gastric adenocarcinomas is reported. The lesions were found on gastrofiberscopic examination for the evaluation of dysphagia and epigastric pain. The esophageal lesions were 2 ulceromfiltrating mass lesions at mid- and lower esophagus and 2 lesions were separated by normal mucosa. The main leiosn of stomach was an ulcerative one (Borrmanns type II) on lower body and the accessory lesion was an EGC IIc like lesion on antrum and 2 lesions were independent.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Deglutition Disorders ; Esophagus* ; Mucous Membrane ; Stomach Neoplasms* ; Stomach* ; Ulcer

BACKGROUND: It is generally known that the principle treatment of obesity is life-style modification and behavior therapy for weight reduction. This study was carried out to investigate the effect of office-based education for weight control and behavior modification in overweight patients. METHODS: We selected 119 patients among the overweight or obese (BMI >or=23 kg/m2) patients who visited the Department of Family Medicine at Asan Medical Center. Life styles such as diet, exercise, smoking, and alcohol drinking were evaluated by self-questionnaire. Weight, height, body mass index, waist circumference, waist to hip ratio, and body fat were measured. The patients were divided randomly into two groups, the intervention (n=60) and the control (n=59) group. We educated the intervention group about the importance of weight reduction, life-style modification and provided specific guidelines. Two months later, we measured anthropometric variables and evaluated changes of behavior modification. RESULTS: After two months, 28 patients of the intervention group and 22 patients of the control group were followed up. At the follow-up time, the body weight and waist circumference decreased significantly in the intervention group compared with those of the control group. The exercise time increased significantly in the intervention group compared to the control group. The frequency of fatty meal ingestion decreased significantly in the intervention group. CONCLUSIONS: The office-based education for weight reduction in overweight or obese patients has contributed substantially in changing their life-style and reducing their waist circumference. As a result, we have found that patient education for behavior modification was essential part of comprehensive approach for weight control in overweight patients.
Adipose Tissue ; Alcohol Drinking ; Behavior Therapy* ; Body Height ; Body Weight ; Chungcheongnam-do ; Diet ; Eating ; Education ; Follow-Up Studies ; Humans ; Life Style ; Meals ; Obesity ; Overweight* ; Patient Education as Topic* ; Smoke ; Smoking ; Waist Circumference ; Waist-Hip Ratio ; Weight Loss

Spontaneous intracranial hypotension (SIH) results from spontaneous cerebral spinal fluid leakage, of unknown etiology, at the level of the spine. Physicians' unfamiliarity with SIH and a its varied clinical and radiographic manifestations may contribute to a delayed or erroneous diagnosis. We report an SIH patient whose subdural hematoma (SDH) clinically mimicked meningitis, but who recovered 1 week later, without any neurologic deficit, after an epidural blood patch (EBP) treatment.
Blood Patch, Epidural ; Hematoma, Subdural ; Humans ; Intracranial Hypotension ; Meningitis ; Neurologic Manifestations ; Spine

PURPOSE: Mycoplasma pneumoniae is one of the most common causes of pneumonia in children and adolescents. Though cold agglutinin test and specific antibody test are used in the diagnosis of mycoplasma pneumonia, there are some limitations in early diagnosis. In this study, we evaluated the availability and usefulness of polymerase chain reaction (PCR) in the diagnosis of M. pneumoniae pneumonia and compared it with serologic test. METHODS: One hundred twenty four children who were clinically diagnosed with pneumonia and admitted to Kyunghee Hospital from January 1998 to March 2001 were enrolled. Mycoplasma specific antibody test using commercial kit (Serodia-MYCO II, Fusirebio Inc., Tokyo, Japan) and PCR using mycoplasma DNA obtained from throat swabs were done. The sensitivity and specificity of PCR were evaluated. RESULTS: M. pneumoniae pneumonia was diagnosed when the mycoplasma specific antibody titer was over 1: 160 or when the titer increased more than fourfold during follow-up period. The specificity, sensitivity, false-positive rate and false-negative rates of PCR were 93.0%, 58.3%, 33.3%. and 9.7%, respectively. CONCLUSION: PCR has shown high specificity. But, the positive result in PCR don't correlate with the disease activity and PCR does not have high sensitivity. So PCR must be used alongside with serologic test in the diagnosis of pneumonia. But, it seems possible to improve sensitivity by delicate handling of samples and by improving PCR technology, and PCR will possibly be used in the diagnosis of early infections of M. pneumoniae pneumonia and in the evaluation of treatments in the future.
Adolescent ; Child* ; Diagnosis ; DNA ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pharynx ; Pneumonia* ; Pneumonia, Mycoplasma* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Serologic Tests