The investigation of systolic time intervals and hemodynamics was performed in 42 patients with liver cirrhosis by noninvascive methods. The patients were divided into four groups according to the presence or absence of anemia and/or ascites: i.e. group I; cirrhosis without anemia and ascites, group II; cirrhosis with ascites only, group III; cirrhosis with anemia only, and group IV; cirrhosis with ascites and anemia. In the resting state of the patients, the systolic time intervals and hemodynamic data were measured by the high speed simultaneous recordings of electrocardiogram, phonocardiogram, carotid and femoral arterial pulse tracings, and compared with those obtained from 155 normal adult subjects. 1. The pulse were increased considerably in group IV, and diastolic blood pressure was elevated in group II with significance. 2. The stroke volume and cardiac output were increased significantly in group III. 3. The peripheral resistance was reduced particularly in group III, and the volume elasticit coefficient was decreased in group IV. 4. The QS1 interval was prolonged significantly in group II and IV, but QS1 interval corrected by multiple regression equation proposed by our laboratory (illustrated in the text) did not show significant difference compared with that of normal subjects. 5. The left ventricular ejection time(LVET) and total electromechanical systole(QS 2) appeared to be shortened in group II and IV, but the corrected LVET and QS 2 were not different significantly from those of the normal subjects
Adult ; Anemia ; Ascites ; Blood Pressure ; Cardiac Output ; Electrocardiography ; Fibrosis ; Hemodynamics* ; Humans ; Liver Cirrhosis* ; Liver* ; Stroke Volume ; Systole ; Vascular Resistance

The investigation of systolic time intervals and hemodynamics was performed in 42 patients with liver cirrhosis by noninvascive methods. The patients were divided into four groups according to the presence or absence of anemia and/or ascites: i.e. group I; cirrhosis without anemia and ascites, group II; cirrhosis with ascites only, group III; cirrhosis with anemia only, and group IV; cirrhosis with ascites and anemia. In the resting state of the patients, the systolic time intervals and hemodynamic data were measured by the high speed simultaneous recordings of electrocardiogram, phonocardiogram, carotid and femoral arterial pulse tracings, and compared with those obtained from 155 normal adult subjects. 1. The pulse were increased considerably in group IV, and diastolic blood pressure was elevated in group II with significance. 2. The stroke volume and cardiac output were increased significantly in group III. 3. The peripheral resistance was reduced particularly in group III, and the volume elasticit coefficient was decreased in group IV. 4. The QS1 interval was prolonged significantly in group II and IV, but QS1 interval corrected by multiple regression equation proposed by our laboratory (illustrated in the text) did not show significant difference compared with that of normal subjects. 5. The left ventricular ejection time(LVET) and total electromechanical systole(QS 2) appeared to be shortened in group II and IV, but the corrected LVET and QS 2 were not different significantly from those of the normal subjects
Adult ; Anemia ; Ascites ; Blood Pressure ; Cardiac Output ; Electrocardiography ; Fibrosis ; Hemodynamics* ; Humans ; Liver Cirrhosis* ; Liver* ; Stroke Volume ; Systole ; Vascular Resistance

To investigate long term effects of CAPD on the left ventricular function in end-stage renal disease patients, M-mode echocardiographic studies and measurement o fsystolic time intervals were performed in 20 CAPD cases, 28 hemodialysis cases and 29 uremic controls. Compared to the uremic control grup, the patients on CAPD treatment revealed significant improvement of ventricular contractility and reduction of volume. On the other hand in hemodialysis group, even though there was improvement of ventricular contractility, volume control was not adequate. In the systolic time interval measurement, it is postulated that increase of PEP/LVET ratio in CAPD group probably results from reduction of volume(preload) rather than from deranged ventricular function.
Echocardiography ; Hand ; Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory* ; Renal Dialysis* ; Systole ; Ventricular Function ; Ventricular Function, Left

BACKGROUND: Intratumoral fibrosis (ITF) is a frequent histologic finding in solid organ tumors. Renal cell carcinoma (RCC) is a highly vascularized tumor with different shapes and degrees of ITF and inflammation. ITF is a poor prognostic factor, especially in breast cancer, and is related to intratumoral necrosis (ITN) and intratumoral inflammation (ITI). However, the significance of ITF in RCC has not been fully studied. In this study, we evaluate the relationships between ITF and other clinicopathologic parameters associated with RCC prognosis. METHODS: ITF was evaluated in 204 clear cell renal cell carcinoma (CCRCC) specimens according to presence and grade of fibrosis, degree of ITI, and presence of ITN. Lysyl oxidase (LOX) expression in tumor cells was also evaluated with clinicopathologic parameters. RESULTS: Among 204 CCRCC cases, 167 (81.7%) showed ITF, 71 (34.8%) showed ITI, 35 (17.2%) showed ITN, and 111 (54.4%) showed LOX expression. ITF correlated with Fuhrman nuclear grade (p = .046), lymphovascular invasion (LVI) (p = .027), and ITN (p = .036). Patients with ITF had a poor five-year overall survival rate (p = .104). CONCLUSIONS: ITF is related to other poor prognostic factors in CCRCC, such as Fuhrman nuclear grade, ITN, and LVI, but ITF itself had no significant correlation with prognosis of CCRCC.
Breast Neoplasms ; Carcinoma, Renal Cell ; Fibrosis ; Humans ; Inflammation ; Necrosis ; Prognosis ; Protein-Lysine 6-Oxidase ; Survival Rate

A study was performed to develop as a screening tool the Simple Evaluation Questionnaire for Screening the Overweight-type Dietary Pattern in 30 to 49 Year Old Adults. We used the data from the 30 to 49 year old subjects who participated in the three surveys - the health behavior survey, the dietary habit survey and the food intake survey - as the National Health and Nutrition Survey 1998. The 3,598 adults were classified into to two body fatness groups of normal (including underweight) and overweight (including obese) on the basis of their relative body weight (RBW). When comparing variables between the two groups, significant differences were found in gender, education, job, employment status, perceived health status, sadness / depression state, stress level, age, number of diseases, age when overweigh-tedness started, maximum body weight, sleep length, drinking pattern (yes / no), amount of alcoholic drinks, frequency of intoxication or drunkeness, amount of alcoholic drinks when drunk, intensity of exercise, frequency of exercise, exercise duration, skipped meals, small meals and drug supplements. In terms of food intake, there were significant differences in the daily food intake in terms of breakfast, dinner, daily kimchi and dairy products. In terms of mealtimes, we found differences in the amount of cooked rice at breakfast, kimchi at lunch, soup / kuk at dinner, fresh vegetables for snacks, fried foods for snacks between breakfast and lunch, and fruits / juices for snacks between lunch and dinner. After developing questions with indicators and analyzing the indicators by logistic regression analysis three times, we chose 10 questions for a simple evaluation of dietary patterns for the overweight-type category in order to give one point each. Among them we selected two questions to add one additional point and one question to add two additional points. The average scores of the overweight and normal groups, as shown by the developed questionnaire, were 5.97 +/-2.36 and 7.36 +/-2.21, respectively. A score of seven points was selected as the cut-off point. We examined the sensitivity, specificity and positive predictive value of the questionnaire to the results of 67%, 59% and 62%, respectively.
Adipose Tissue ; Adult* ; Alcoholics ; Body Weight ; Breakfast ; Dairy Products ; Depression ; Drinking ; Eating ; Education ; Employment ; Food Habits ; Fruit ; Health Behavior ; Humans ; Logistic Models ; Lunch ; Mass Screening* ; Meals ; Middle Aged* ; Nutrition Surveys ; Overweight ; Sensitivity and Specificity ; Snacks ; Vegetables ; Surveys and Questionnaires

Chronic hepatitis is one of the leading cause of hospitalization and death in kidney transplanted patient. Korea is one of the endemic area of chronic hepatitis B. The impact of hepatitis B virus (HBV) infection on the clinical course of renal transplant recipient has been controversial. We describe five Hepatitis B surface antigen (HBsAg) positive renal transplant recipients who transplanted at the KyungHee University Medical Center during the period of January 1992 to July 2000. All these patients have no clinical sign or symptom of chronic hepatitis at the time of transplantation. Mean follow up period was 70 month (range 7-57). Three of 5 patients developed liver cirrhosis with complications during follow-up period. One patient died of fulminant hepatitis due to reactivation of HBV. The remaining one patient is free of disease till now. Four of 5 patients maintained the function of transplanted kidney and only one patient restarted hemodialysis.
Academic Medical Centers ; Follow-Up Studies ; Hepatitis B Surface Antigens* ; Hepatitis B virus ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Hepatitis, Chronic ; Hospitalization ; Humans ; Kidney ; Kidney Transplantation* ; Korea ; Liver Cirrhosis ; Renal Dialysis ; Transplantation

The objective of this study is to define optimal diagnosis and treatment strategies for patients with urachal anomalies in the pediatric age group. The medical records of 21 children who had undergone surgery for urachal anomalies at Severance Hospital, Yonsei University College of Medicine from January 1990 to April 2005 were reviewed. The subjects included 14 males and 7 females (M:F 2:1). The four types of urachal anomalies confirmed were a urachal cyst in 10 patients (47.6%), a patent urachus in 6 (28.6%), a urachal sinus in 4 (19.0%) and a urachal diverticulum in 1 (4.8%) patient. The most common presenting complaint was umbilical discharge (n = 10, 40.0%), followed by abdominal mass (n = 9, 36.0%). Urachal anomalies were diagnosed by ultrasonography in 18 patients, and 7 of them were additionally examined by computed tomography. The remaining patients were diagnosed solely by surgical exploration. Excision was performed in all patients and was supplemented by partial cystectomy in three. Umbilical discharge was the most common clinical manifestation in our patients, suggesting that ultrasonography should be performed in patients with umbilical discharge to differentiate urachal anomalies. We found the most common anomaly to be the urachal cyst, and all patients were successfully treated by surgical excision.
Urachus/*abnormalities/surgery ; Urachal Cyst/*diagnosis/surgery ; Male ; Infant, Newborn ; Infant ; Humans ; Hospitals, University ; Female ; Child, Preschool ; Child ; Abnormalities/diagnosis/surgery

One of the most significant risk factors for prostate cancer (PC) is a family history of the disease, with germ-line mutations in the breast cancer predisposition gene (BRCA) 2 conferring the highest risk. We here report a 56-year-old man presented with painful gait disturbance and diagnosed PC with multiple disseminated bone metastases. The patient had a strong family history of breast cancer with his 2 nieces affected. Furthermore, his aunts and uncles from both sides were diagnosed with stomach, ovarian, and colorectal cancers. His genomic sequencing analysis of the BRCA genes revealed the same BRCA2 deleterious mutation that his breast cancer-affected nieces carried. Previous studies have suggested that BRCA2-mutated PC is associated with a more aggressive phenotype and poor prognosis. Our experience in the present case also indicated the urgent needs for novel treatment modality and PC screening in this high-risk group of patients.
Breast ; Breast Neoplasms ; Colorectal Neoplasms ; Gait ; Germ-Line Mutation ; Humans ; Mass Screening ; Middle Aged ; Neoplasm Metastasis ; Phenotype ; Prognosis ; Prostate* ; Prostatic Neoplasms* ; Risk Factors ; Stomach

BACKGROUND: There is pressure difference depending on the height of hand position when blood pressure is taken, applying the oscillometric electronic digital BP(blood pressure) monitor. Authors have calculated the degree of BP differences, and evaluated the accuracy and effectiveness of the digital BP monitor comparing with the conventional Mercury Sphygmomanometer. METHOD: Randomized sixty cases consisting of in-patients and hospital workers were subjected for this study. BPs were taken at three different levels-nose level, heart level and knee level-on conventional sitting position applying OMRON Digital Automatic Blood Pressure Monitor and conventional Mercury Sphygmomanometer, and statistical analysis was made. RESULTS: At the nose level, systolic BP and diastolic BP were lower with 23.5mmHg and 18.9mmHg respectively, than at the heart level, while at the knee level, they were higher with 21mmHg and 17.5mmHg respectively, than at the heart level. No actual statistical difference of systolic and diastolic values between OMRON Digital Automatic Blood Pressure Monitoring method at the heart level and conventional Mercury Sphygmomanometeric method. CONCLUSION: Present study demonstrated significant discrepancy of BP values, in systolic and diastolic values, depending on the height of measured finger, when OMRON Digital Automatic Blood Pressure Monitor is applied in taking BP on conventional sitting position. However, no actual discrepancy of BP values was noted between two methods when BP is taken at heart level by OMRON Digital Automatic Blood Pressure Monitor and on brachial artery BP by conventional Mercury Sphygmomanometer. Thus OMRON Digital Automatic Blood Pressure Monitor could take the place of Mercury Sphygmomanometer in taking peripheral BP, which subsequently enable us to estimate central artery BP, which is believed to be better clinical index, through this much more handy electrical oscillometric device in the future.
Arteries ; Blood Pressure ; Blood Pressure Monitors ; Brachial Artery ; Electric Impedance ; Fingers ; Hand* ; Heart ; Hydrostatic Pressure ; Knee ; Nose ; Sphygmomanometers*

BACKGROUND: Green Cross HG-II vaccine is recombinant hepatitis B vaccine derived from yeast Hansenula polymorpha. Its immunogenicity and safety using 0-1-6 months vaccination schedule were proven. This prospective study is conducted to evaluate immunogenicity and safety of HG-II according to 0-1-2 months schedule. METHODS: 20 g of HG-II vaccine was given intramuscularly at 0, 1, and 2 months to 118 healthy adults seronegative for hepatitis B markers. Sera were assessed for anti-HBs by radioimmunoassay at 1 months and 7-10 months after completion of vaccination. RESULTS: 113 of 118 (95.8%) completed vaccination schedules. The seroconversion rate at 1 month after completion of vaccination was 93.8% (106/113) and protective titers of anti-HBs developed in 82.3% (93/113). The geometric mean titer (GMT) of anti-HBs was 64.91 mIU/ml in all seroconverted vaccinee. There was no incapacitating serious side effect associated with vaccinations. The seropositive rate at 7-10 months after vaccination was 95.3% (81/85) with protective rate of 84.7% (72/85). The anti-HBs titers were decreased in 51.8% (44/85) of vaccinee. The GMT was 80.04 mIU/ml. The protective rate and GMT were 98.0%, 129.43 mIU/ml in the group with anti-HBs titer > or = 50 mIU/ml at 1 month after vaccination, and 64.71%, 19.62 mIU/ml in the group with anti-HBs <50 mIU/ml. CONCLUSION: Green Cross HG-II vaccine is safe and effective in protecting hepatitis B at 0-1-2 months vaccination schedule. However, the booster injection should be recommended for maintenance of immunogenicity, especially in the vaccinee with anti-HBs titer less than 50 mIU/ml at 1 month after vaccination.
Adult* ; Appointments and Schedules* ; Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; Humans ; Pichia ; Prospective Studies ; Radioimmunoassay ; Vaccination* ; Yeasts