Difficulties in calculation that hindered the practice of the delta check in the past is now no longer a problem thanks to the development of computers. But, high false positive rates, which creates heavy burden of checking-work load, are still a problem in the practice of the delta check. We propose a new approach to the reduction of false positive rates, naming our method "the multi-item univariate delta check (MIUDC) method". By the multi-item univariate delta check method, we mean a method in which univariate delta checks are performed on multiple items and specimens with the positive univariate delta check in at least k items receive a detailed investigation. Using data collected in the Department of Clinical Pathology at Korea University Guro Hospital via the Korea University Laboratory Information System, our research found that if we put specimens with positive univariate delta check in at least four test items (k=4) under a detailed investigation, check-out volumes will be light and efficiency will be high. As for test items deserving of more interest, total cholesterol, albumin, and total protein are appropriate because the false positive rate associated with them in the MIUDC was zero in a simulation study.
Chemistry, Clinical* ; Cholesterol ; Clinical Laboratory Information Systems ; Korea ; Pathology, Clinical ; Quality Control*

BACKGROUND: A few recent studies have been conducted to analyzing the blood usage with regard to diagnosis of Korean recipients. We performed a study to analyze the usage of blood components. METHODS: Transfused components such as packed red blood cells (RBC), whole blood (WB), fresh frozen plasma (FFP), and platelet components (PLT) were estimated by the principal diagnoses of the patients, who were discharged from February 1998 to January 1999, according to the International Statistical Classification of Diseases (ICD)-10. RESULTS: Eleven percentage (2,227/20,650) of inpatients were transfused. The transfusion rate of hospitalized patients for RBCs, WBs, FFPs, and PLTs was 10.1%, 0.4%, 4.0% and 16.2 %, respectively. There was a difference in the sex ratio (1.6 male/female) in all blood components transfused. Of all investigated blood components (22,523 units), 10,729 units (47.6%) of RBCs, 240 units (1.1%) of WBs, 5,355 units (23.8%) of FFPs, and 6,199 units (27.5%) of PLTs were transfused. The hospitalized patients who received 1 unit of RBCs was 12.9%, and 2 units were most frequent transfused units (25.6%). Seventy-four percent of all 22,523 units were used in four diagnostic categories of highest blood usage; injury and poisoning (29.2%), nonhematologic neoplasms (16.3%), digestive system disease (16.1%) and circulatory system disease (12.5%). CONCLUSION: We performed usage analysis of blood components with regard to diagnosis, comparing the previous studies in other hospitals. This study could provide baseline transfusion information in relation to diagnosis, and help improve the quality control of blood utilization and transfusion practice.
Blood Platelets ; Classification* ; Diagnosis ; Digestive System Diseases ; Erythrocytes ; Humans ; Inpatients ; Plasma ; Poisoning ; Quality Control ; Sex Ratio

Syphilis is easily diagnosed by serologic testing or by identification of the causative organism, Treponema pallidum. Syphilis usually presents a distinct painless primary ulcer or chancre. However, the initial clinical impressions of even the most experienced specialist in sexually transmitted diseases (STDs), may be wrong 40% of the time. We report a case of atypical primary syphilis that was presented with painful ulceration on the penis and showing negative VDRL results. We amplified the DNA polymerase I gene of Treponema pallidum in the penile ulcer lesion to detect syphilis and got the a successful result. The patient was treated with benzathine penicillin G.
Chancre ; DNA Polymerase I* ; Humans ; Male ; Penicillin G Benzathine ; Penis ; Polymerase Chain Reaction* ; Serologic Tests ; Sexually Transmitted Diseases ; Specialization ; Syphilis* ; Treponema pallidum* ; Ulcer

Women with breast implants are increasing in numbers with concerns ranging from possible implant rupture to local breast discomfort secondary to symptomatic capsular contracture and possible association with systemic illness. In cases where implants are removed, breast may result in unfavorable appearances. Mastopexy without reinsertion of implant can be an option in these patients. Ten patients were reviewed, all of them had undergone cosmetic breast augmentation and had the implants removed accompanied by mastopexy. Preoperative and postoperative photographs of all patients were randomly mixed and rated by two surgeons. Also, satisfaction of patient was rated by the patient themselves in five-point scoring method. The patients showed favorable result scores. In many of these cases, the post-removal appearance in conjunction with mastopexy actually results in high satisfaction. This present study allows the authors to offer patients an optimistic view of postoperative results following breast implant removal. The authors have begun to advise selected patients that implant removal accompanied by mastopexy provides a more pleasing aesthetic outcome than implant removal alone.
Breast Implants* ; Breast* ; Contracture ; Female ; Humans ; Research Design ; Rupture

PURPOSE: Estrogen is known to act as both a growth factor and a survival factor for breast cancer. The responsible molecular mechanisms remain, however, to be fully elucidated. We hypothesize that the effect of estrogen relates to its ability to induce the cellular antioxidant defense enzymes. METHODS: In the presence study, we examined the ability of 17beta-estradiol (E2) to regulate the level of phospholipid hydroperoxide glutathione peroxidase (GPX4) protein, which is an anti-oxidative enzyme that can directly reduce both phospholipids and cholesterol-hydroperoxides located in the cell membranes and lipoproteins. RESULTS: E2 elicited a dose- and time-dependent increase in the GPX4 expression in the MCF-7 breast cancer cells, and this up-regulation was blocked by the free radical scavenger N-acetylcysteine (NAC). Additionally, we confirmed that E2 triggered a rapid and transient increase in the intracellular reactive oxygen species (ROS) levels, and this E2-induced increase in the ROS levels was inhibited by pretreatment with NAC. Moreover, such ROS inducers as TGF-beta, TNF-alpha and insulin induced an increase in the level of GPX4 protein. However, estrogen receptor (ER)alpha knockdown by transfection with ERalpha-siRNA did not significantly change the GPX4 protein level that was induced by E2. Furthermore, pre-incubation with the ER antagonist ICI 182,780 did not inhibit E2-mediated GPX4 induction. Conversely, pretreatment of cells with LY294002, a pharmacological inhibitor of phosphatidylinositol 3-kinase inhibitor, suppressed the E2-augmented GPX4 expression. CONCLUSION: Collectively, our data show that E2 may partly provide a survival advantage through the regulation of cellular oxidative homeostasis in MCF-7 breast cancer cells.
Acetylcysteine ; Breast ; Breast Neoplasms ; Cell Membrane ; Chromones ; Estradiol ; Estrogens ; Glutathione Peroxidase ; Homeostasis ; Hydrogen Peroxide ; Imidazoles ; Insulin ; Lipoproteins ; Morpholines ; Nitro Compounds ; Oxidative Stress ; Phosphatidylinositol 3-Kinase ; Phospholipids ; Reactive Oxygen Species ; Receptors, Estrogen ; Transfection ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha ; Up-Regulation

This study examines how acquired capability for suicide, negative urgency, and social support effectuate a suicide attempt. Sixty-three adults having visited an emergency room due to a suicide attempt were studied. The results can be summarized as follows. First, there were no significant sex differences in acquired capability for suicide, negative urgency, and social support. Second, the correlation among suicidal ideation, acquired capability for suicide, negative urgency, social support, and suicide attempts was examined. Results showed that suicide attempts were significantly and positively correlated with suicide ideation, acquired capability for suicide, and negative urgency. However, social support and suicide attempts did not significantly correlate. Third, results of hierarchical regression analysis indicated that acquired capability for suicide and negative urgency significantly predicted suicide attempts even when suicide ideation was controlled, but social support did not significantly explain attempts. In other words, study results imply that suicide attempts increase when acquired capability for suicide and negative urgency are high. Study results offer empirical data for understanding the intrinsic characteristics of individuals attempting suicide.

Purpose: We investigated the association of effector memory (EM) CD8 + T cell and CD4 + T cell immunity with metabolic syndrome (MS). Methods: Surface and intracellular staining of peripheral blood mononuclear cells was performed. Anti-interleukin-7 receptor-alpha (IL-7Rα) and CX3CR1 antibodies were used to stain the subsets of EM CD8 + T cells, while anti-interferon-gamma (IFN-γ), interleukin-17 (IL-17), and forkhead box P3 (FOXP3) antibodies were used for CD4 + T cell subsets. Results: Of the 47 obese children, 11 were female. Children with MS had significantly higher levels of serum insulin (34.8±13.8 vs. 16.4±6.3 μU/mL, p<0.001) and homeostasis model assessment of insulin resistance (8.9±4.1 vs. 3.9±1.5, p<0.001) than children without MS.Children with MS revealed significantly higher frequencies of IL-7Rα low CD8+ T cells (60.1 ±19.1% vs. 48.4±11.5%, p=0.047) and IL-7Rα low CX3CR1 + CD8 + T cells (53.8±20.1% vs. 41.5 ±11.9%, p=0.036) than children without MS. As the serum triglyceride levels increased, the frequency of IL-7Rα low CX3CR1 + and IL-7Rα high CX3CR1 – CD8 + T cells increased and decreased, respectively (r=0.335, p=0.014 and r=−0.350, p=0.010, respectively), in 47 children. However, no CD4 + T cell subset parameters were significantly different between children with and without MS. Conclusion In obese children with MS, the changes in immunity due to changes in EM CD8 + T cells might be related to the morbidity of obesity.

Purpose: We investigated the association of effector memory (EM) CD8 + T cell and CD4 + T cell immunity with metabolic syndrome (MS). Methods: Surface and intracellular staining of peripheral blood mononuclear cells was performed. Anti-interleukin-7 receptor-alpha (IL-7Rα) and CX3CR1 antibodies were used to stain the subsets of EM CD8 + T cells, while anti-interferon-gamma (IFN-γ), interleukin-17 (IL-17), and forkhead box P3 (FOXP3) antibodies were used for CD4 + T cell subsets. Results: Of the 47 obese children, 11 were female. Children with MS had significantly higher levels of serum insulin (34.8±13.8 vs. 16.4±6.3 μU/mL, p<0.001) and homeostasis model assessment of insulin resistance (8.9±4.1 vs. 3.9±1.5, p<0.001) than children without MS.Children with MS revealed significantly higher frequencies of IL-7Rα low CD8+ T cells (60.1 ±19.1% vs. 48.4±11.5%, p=0.047) and IL-7Rα low CX3CR1 + CD8 + T cells (53.8±20.1% vs. 41.5 ±11.9%, p=0.036) than children without MS. As the serum triglyceride levels increased, the frequency of IL-7Rα low CX3CR1 + and IL-7Rα high CX3CR1 – CD8 + T cells increased and decreased, respectively (r=0.335, p=0.014 and r=−0.350, p=0.010, respectively), in 47 children. However, no CD4 + T cell subset parameters were significantly different between children with and without MS. Conclusion In obese children with MS, the changes in immunity due to changes in EM CD8 + T cells might be related to the morbidity of obesity.

Symmetry is an important parameter for breast reconstruction. Contralateral breast frequently provides model to be reconstructed. But hypertrophic and ptotic breast is aesthetically unacceptable. And if the contralateral breast is large, larger flap which is required to reconstruct the breast including the zone of poor vascularity. Therefore, reduction of hypertrophic breasts may be preferable. Many surgeons prefer to perform contralateral procedures at least several months after reconstruction. However authors performed simultaneous contralateral reduction mammoplasty in 18 patients at the same time as pedicled TRAM flap reconstruction. The expected disadvantages of the simultaneous operation are increased hospitalization time, blood loss, and complications. But according to our result, it showed that there was no significant difference in hopitalization time and hemoglobin-decrease. Furthermore, simultaneous operation showed lower complication rate because of the reduced size of the required flap. Our results revealed that TRAM flap breast reconstruction and simultaneous contralateral reduction mammoplasty is a safe procedure. And the results were aesthetically acceptable.
Breast* ; Female ; Hospitalization ; Humans ; Mammaplasty*

OBJECTIVE: Alterations in the immune system occur with aging, and these contribute to an increased risk of infection and malignancy. The age-associated changes in T cell immunity range from single cell function to the maintenance of cell populations. We investigated the kinetics of CD4+ T cell activation and proliferation in young and elderly subjects after stimulating their peripheral blood mononuclear cells with anti-CD3 and anti-CD28 antibodies (Abs). METHODS: The expressions of the activation markers CD69, CD40L and CD25 on the CD4+ T cells from young (n=14) and elderly (n=19) were analyzed at 6, 24 and 48 hours (hrs) of T cell receptor (TCR) stimulation by using flow cytometry. In the same individuals, the CD4+ T cell proliferation was determined at 48 and 96 hrs of TCR stimulation by using the CFSE dilution method. RESULTS: The elderly had decreased CD69 and CD40L expressions on the CD4+ T cells at 6 hrs of stimulation, as compared to that of the young patients. The elderly also had a decreased CD25 expression on the CD4+ T cells at 24 hrs of stimulation. However, the two groups had similar levels of the CD25, CD69 and CD40L expressions at 48 hrs of stimulation. The elderly had decreased CD4+ T cell proliferation at 96 hrs of stimulation, as compared to that of the young, although both groups had similar levels of CD4+ T cell proliferation at 48 hrs of stimulation. CONCLUSION: Our findings suggest that the elderly have altered kinetics of CD4+ T cell activation and proliferation in response to anti-CD3 and -CD28 Ab stimulation, and that such an altered response is governed by the duration of stimulation.
Aged ; Aging ; Antibodies ; CD40 Ligand ; Cell Proliferation ; Flow Cytometry ; Fluoresceins ; Humans ; Immune System ; Kinetics ; Receptors, Antigen, T-Cell ; Succinimides ; T-Lymphocytes