BACKGROUND AND OBJECTIVES: Surfactant protein A (SP-A) which plays a role in the innate host defense of lung is also expressed in Eustachian tube. However the genes underlying the susceptibility to otitis media with effusion (OME) are known insufficiently. The current study attempts to evaluate the difference in the allele distribution of SP-A1 and SP-A2 between normal subjects and subjects with otitis media with effusion. SUBJECTS AND METHOD: PCR-cRFLP-based methodology was used to detect SP-A genotypes in the 38 children with OME, and in the 55 normal newborns for control. RESULTS: The frequencies of specific genotypes such as 6A(2), 1A(2) were increased in OME group, but the frequency of 6A3 was increased in control group. CONCLUSION: It is presumed that SP-A alleles may be inductive (6A(2), 1A(2)) or protective (6A(3)) factors for OME. Specific genoytypes of SP-A may be an important determinant for the predisposition to OME.
Alleles* ; Child ; Eustachian Tube ; Genotype ; Humans* ; Infant, Newborn ; Lung ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Pulmonary Surfactant-Associated Protein A*

BACKGROUND AND OBJECTIVES: Standard unfractionated heparin (UFH) has long been used to prevent death and myocardial infarction in patients with acute coronary syndrome and acute occlusion undergoing percutaneous revascularization. However, UFH binds to several plasma proteins, platelets, and endothelial cells producing a highly variable anticoagulant response. In contrast, Low molecular weight heparin (LMWH) exhibits less protein binding and provides more predictable anticoagulant response with reduced need for patient monitoring and dosage adjustment. The purpose of this study was to assess the anti-Xa activities of LMWH in Korean patients with acute coronary syndrome after recommended dose for caucasians and to determine an optimal method of administration of LMWH. MATERIALS AND METHODS: Twenty five patients with acute coronary syndrome were enrolled and allocated to five separate groups (5 patients in each group) by types according to molecular weight (LMWH (A): (molecular weight of 4500 daltons, LMWH (B): molecular weight of 6400 daltons) and methods of administration (Group 1A and 1B: Subcutaneous and subcutaneous injections (SC-SC), Group 2: Intravenous and subcutaneous injections (IV-SC), Group 3A and 3B: Intravenous, subcutaneous and subcutaneous injections (IV-SC-SC). Five groups were as follows: Group 1A: LMWH (A) 1 mg/kg SC every 12 hours, Group 1B: LMWH (B) 100 IU/kg SC every 12 hours, Group 2: LMWH (A) 1 mg/kg IV bolus and 1 mg/kg SC 12 hours later, Group 3A: LMWH (A) 0.5 mg/kg IV bolus, 3 hours later 1 mg/kg SC every 12 hours, Group 3B: LMWH (B) 50 IU/kg IV bolus, 3 hours later 100 IU/kg SC every 12 hours. Anti-Xa activity was measured by amidolytic assay method (Rotachrome, Stago, France) in 555 samples from 25 patients. All the data of anti-Xa activity in each group were plotted along the sequential time and mean values of them were analyzed by Wilcoxon signed rank test. RESULTS: 1)The anti-Xa activity (mean 0.6216+/-0.238 IU/mL) of LMWH (A) was greater than that of LMWH (B)(mean 0.2587+/-0.1709 IU/mL) in the conventional SC-SC method (p<0.001). 2) The anti-Xa activity of LMWH (A) (mean 0.6203+/-0.2383 IU/mL) was also greater than that of LMWH (B)(mean 0.468+/-0.2428 IU/mL) in the IV-SC-SC method (p<0.001). 3) More rapid and effective anti-Xa activities were achieved by IV-SC-SC method compared with conventional SC-SC method. CONCLUSION: This study suggests that immediate achievement and optimum maintenance of anticoagulant activity can be accomplished by IV-SC-SC method rather than conventional SC-SC method in patients of acute coronary syndrome.
Acute Coronary Syndrome* ; Blood Proteins ; Endothelial Cells ; Heparin ; Heparin, Low-Molecular-Weight* ; Humans ; Injections, Subcutaneous ; Molecular Weight ; Monitoring, Physiologic ; Myocardial Infarction ; Protein Binding

BACKGROUND: Spontaneous pneumomediastinum (SPM) is a relatively rare and benign condition that generally occurs in young adults without any precipitating factor or disease. The purpose of this study was to assess whether more uncomforting diagnostic procedures are necessary and to establish standards in the diagnosis and treatment of spontaneous pneumomediastinum. MATERIAL AND METHOD: A retrospective study was done on 18 patients from the hospitals of Hanyang University Seoul Hospital and Hanyang University Guri Hospital between February, 1997 and June, 2004. All patients had presence of mediastinal air without a pneumothorax and no evidence of trauma or barotrauma. RESULT: Among the 18 patients, the majority were male patients with only two female patients. Their mean age was 20.95 years old with standard deviation of 14.3 years. The most common complaints were chest pain, dyspnea, and coughing. Evaluation included simple chest roentgenogram in all patients, 10 patients had a chest tomographic scan, 10 patients had an esophagoscopic exam, 6 patients had a bronchofiberoscopic exam, and 3 patients had an esophagogram done. The mean hospital stay was 10.9 days. All patients were treated conservatively and in a follow-up of 1~8 years only one recurrence was found. CONCLUSION: SPM is caused by alveolar rupture in the pulmonary interstitium leading to dissection of air towards the hilum and mediastinum. Although SPM is a self-limiting condition, evaluation should include chest roentgenogram and chest tomographic scans to rule out any other secondary condition. More aggressive evaluation seems unnecessary.
Barotrauma ; Chest Pain ; Cough ; Diagnosis ; Dyspnea ; Emphysema ; Female ; Follow-Up Studies ; Humans ; Length of Stay ; Male ; Mediastinal Emphysema* ; Mediastinum ; Pneumothorax ; Precipitating Factors ; Recurrence ; Retrospective Studies ; Rupture ; Seoul ; Thorax ; Young Adult

No abstract available.
Gangwon-do* ; Infertility*

BACKGROUND: The role of platelet in the pathogenesis of acute coronary syndrome and cerebral thrombosis is well known and the platelet inhibitors are used widely for primary and sccondary prevention of cardiovascular disease. Aspirin is the least expensive and most widely used antiplatelet agent and its effect is associated with its ability to inhibit plateletthromboxane A2 synthesis. The effectiveness of aspirin is dependent on its ability to block the formation of thromboxane A2. Ticlopidine is another popular antiplatelet agent used today in the era of stent implantation for treating coronary artery obstructive disease(CAOD) with aspirin. The mechanism of action of ticlopidine is clearly different from that of aspirin. It is concluded recently that ticlopidine is an inhibitor of ADP binding to platelets. The inhibition of ADP binding to platelets by ticlopidine is very nicely correlated with its does and the inhibition of platelet aggregation. Therefore, in this study, antiplatelet effect of low dose enteric-coated aspirin in place of aspirin and combined therapy with low does enteric-coated aspirin plus ticlopidine were evaluated in the normal subjects. METHOD: IN twenty normal subjects, platelet aggregation tests with adenosine diphosphate(ADP) and collagen were performed baseline, after I week adminisrtation of enteric-coated aspirin, and in randomly selected ten among twenty normal subjects, I week administration of enteric-coated aspirin and ticlopidine. The maximal aggregation rate was calculated by measuring the maximal change of the light transmittance after addition of aggregating agents. RESULT: Low does enteric-coated aspirin inhibited platelet aggregation in response to collagen significantly. Less than 25% of antiaggregation effect was noted in about 50% of subjects with low dose enteric-coated aspirin when platelet aggregation was induced by ADP. Ticlopidine in combination with low does enteric-coated aspirin potentiated the inhibitory effect significantly on platelet aggregation in response to ADP. CONCLUSION: Effect of low dose enteric-coated aspirin alone on platelet aggregation in response to ADP stimulation was weak and showed variablity, comparing to collagen stimulation. The combined treatment of ticlopidine plus aspirin was synergistically inhibited platelet aggregation responding to ADP stimulation. Therefore to achieve the synergistic inhibition of platelet aggregation to ADP and collagen stimulation, combination theraphy might be a effective regimen.
Acute Coronary Syndrome ; Adenosine ; Adenosine Diphosphate ; Aspirin* ; Blood Platelets* ; Cardiovascular Diseases ; Collagen ; Coronary Vessels ; Intracranial Thrombosis ; Platelet Aggregation ; Platelet Aggregation Inhibitors ; Stents ; Thromboxane A2 ; Ticlopidine*

No abstract available.
Colorectal Neoplasms* ; Fluorouracil* ; Leucovorin*

Sudden sensorineural hearing loss due to the initial manifestation of hematologic disease is very rare. Chronic myelogenous leukemia has been implicated as a causative factor of sudden sensorineural hearing loss. Leukemic infiltration, hemorrhage, infection, and hyperviscosity have been suggested as possible mechanisms in patients with chronic myelogenous leukemia. A 49-year-old male presented unilateral sudden sensorineural hearing loss. The patient was found to have chronic myelogenous leukemia during the work-up for the hearing loss. The WBC count upon admission was 485,100/mm(3). Hemoglobin, hematocrit, and platelet count were within the normal limits. The patient underwent three cycles of leukapheresis and chemotherapy with interferon alpha and hydroxyurea for the treatment of leukemia. The hearing threshold level was 75 dB on admission. It improved to 35 dB when the WBC count fell to 294,000/mm(3), and finally settled at 32 dB two weeks after the termination of chemotherapy when the WBC count was 125,900/mm(3). We present a case of a chronic myelogenous leukemia patient who initially presented with sudden sensorineural hearing loss. We presume that cochlear vessel occlusion as a result of elevated blood viscosity was responsible for this patient's hearing loss. Early onset of sudden deafness in a chronic myelogenous leukemia patient may be due to the hyperviscosity syndrome and be possible to reverse hearing loss through early leukapheresis.
Blood Viscosity ; Drug Therapy ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden* ; Hematocrit ; Hematologic Diseases ; Hemorrhage ; Humans ; Hydroxyurea ; Interferon-alpha ; Leukapheresis ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Leukemic Infiltration ; Male ; Middle Aged ; Platelet Count

Multiple myeloma is a neoplasm of mature and immature plasma cells. Extraosseous tissues are involved frequently in multiple myeloma. The most common sites of involvement are spleen, liver, lymph nodes, and kidneys. Sinus involvement of multiple myeloma is rare but usually presents in secondary extramedullary plasmacytoma. Primary extramedullary plasmacytoma is neoplastic proliferation of plasmacytes in reticuloendothelial tissues and occurs most commonly in head and neck areas. Evaluation of the extent of disease is essential for proper management of this patient. The treatment and prognosis are different according to whether the extramedullary plasmacytoma is primary or secondary. Recently, we experienced a case of multiple myeloma which simultaneously progressed in maxillary sinus in spite of systemic chemotherapy and report with literature review.
Drug Therapy ; Head ; Humans ; Kidney ; Liver ; Lymph Nodes ; Maxillary Sinus* ; Multiple Myeloma* ; Neck ; Plasma Cells ; Plasmacytoma ; Prognosis ; Spleen

PURPOSE: This study aimed to investigate the clinical features of congenital postural deformities and lower extremity asymmetry with respect to the presence of developmental dysplasia of the hip (DDH) in infants with a discrepancy of the limb length referred for suspected DDH. MATERIALS AND METHODS: We retrospectively reviewed the medical records and radiographs of 150 infants who visited Korea University Anam Hospital Orthopedic Clinic for suspected DDH between March 2013 and March 2015. RESULTS: There were greater numbers of infants with a shorter lower extremity on the left side (n=86, 57.3%) than the right. Plagiocephaly was present in 62 infants and trunk curvature in 124 infants (82.7%). Pelvic tilting—indirectly assessed by a skewed direction of the external genitalia in female infants—was present in 62 infants (63.3%). None of the 139 infants with normal physical examination of the hip were diagnosed with DDH. Of those 11 infants with abnormal findings from the hip physical examination, a total of 6 infants were diagnosed with DDH. CONCLUSION: Regardless of the associated findings of congenital postural deformation, all infants diagnosed with DDH had abnormal findings from the physical examination of the hip joint. Thus, we conclude that the hip examination is important as the primary clinical screening in aiding the diagnosis of DDH.
Congenital Abnormalities ; Diagnosis ; Extremities ; Female ; Genitalia ; Hip Joint ; Hip* ; Humans ; Infant* ; Korea ; Lower Extremity* ; Mass Screening* ; Medical Records ; Orthopedics ; Physical Examination ; Plagiocephaly ; Retrospective Studies

No abstract available.
Adult* ; Cytarabine* ; Cytosine* ; Humans ; Leukemia* ; Mitoxantrone*