BACKGROUND: Chimerism analysis is an important tool for assessing the origin of hematopoietic cells after allogeneic stem cell transplantation (allo-SCT) and can be used to detect impending graft rejection and the recurrence of underlying malignant or nonmalignant diseases. METHODS: This study included 24 patients who underwent myeloablative allo-SCT. DNA was extracted from nucleated cells (NCs), T cells, and natural killer (NK) cells, and the chimerism status of these cell fractions was determined by STR-PCR performed using an automated fluorescent DNA analyzer. RESULTS: Twenty-three out of the 24 patients achieved engraftment. Mixed chimerism (MC) in NCs, but not in T cells and NK cells, was significantly correlated with disease relapse. MC in all cell fractions was correlated with mortality. Ten patients (41.6%) developed extensive chronic GVHD. Six patients had MC in T cells, and 3 of them had chronic GVHD. Four patients with MC and relapse received donor lymphocyte infusion (DLI), and among them, 3 had secondary relapse. Further, the chimerism status differed among different cell lineages in 6 patients with myeloid malignancies. CONCLUSION: The implications of MC in lymphocyte subsets are an important area for future research. Chimerism analysis in lineage-specific cells permits detection of relapse and facilitates the monitoring of therapeutic interventions. These results can provide the basic data for chimerism analysis after myeloablative SCT.
Cell Lineage ; Chimerism ; DNA ; Graft Rejection ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Killer Cells, Natural ; Lymphocyte Subsets ; Lymphocytes ; Recurrence ; Stem Cell Transplantation ; T-Lymphocytes ; Tissue Donors

The preoperative hearing status is one of the important factors to determine the method of surgical approach to the vestibular schwannoma. It has been widely recognized that the hearing preservation surgery is not valuable if the patient has no serviceable hearing. The worldwide reported cases of hearing improvement after surgical removal of vestibular schwannoma with profound hearing disturbance are extremely rare, and so far, there have been no domestic cases reported. The authors have experienced a case of significant hearing improvement after surgical removal of vestibular schwannoma with preoperative unilateral total deafness but with normal otoacoustic emission response. We report this case with literature review.
Deafness ; Hearing Loss* ; Hearing* ; Humans ; Neuroma, Acoustic*

BACKGROUND: Aspirin resistance (AR) in platelet function assays showed substantial variation depending on the methods used to evaluate it. METHODS: In this study, we prospectively compared the results of Multiplate impedance platelet aggregometry (IPA) with those of light transmission aggregometry (LTA) and VerifyNow(R) system in determination of the prevalence of aspirin resistance (AR) and investigated the correlation between its presence and poor outcome (modified Rankin scale >2) in 105 patients with aspirin after acute ischemic stroke (AIS). RESULTS: After 5 days of using aspirin, 15 patients (14.3%) were classified as aspirin-resistance with the use of IPA, 24 patients (22.9%) by the LTA, and 14 patients (13.3%) by VerifyNow. Good agreement between the results of IPA and VerifyNow, was found (R=0.674, P<0.01). The concordance rate of AR detection was high between VerifyNow and IPA (k=0.72, P<0.01), albeit quite low between LTA and IPA. Regarding on its influence on clinical outcome after AIS, there wasn't any significant relationship between occurrence of poor outcome and the presence of AR in three platelet function assays. CONCLUSION: This study reveals that the incidence of AR in AIS might be highly test-specific. IPA seems to be similar to VerifyNow as a platelet function test.
Aspirin ; Blood Platelets ; Electric Impedance ; Humans ; Incidence ; Light ; Platelet Function Tests ; Prevalence ; Prospective Studies ; Stroke

Lively discussion has been underway regarding primary care in South Korea as an alternative medical policy in the face of rising medical costs and health care disparities. However, the lack of research about primary care in South Korea makes it difficult to move policymakers, so it is time to enhance primary care research in South Korea. Primary care research can be defined as research directed toward the better understanding and practice of the primary care function. Primary care research traditionally has included basic research, clinical research, health services research related to primary care, health systems research, and research on primary care training; and each field is complementary. In primary care research, participation of primary care physicians is essential because primary care research is different from other conventional studies of disease prevalence, patient characteristics, diagnostic methods, and the treatment environment. Primary care research findings in other countries cannot be applied to South Korea as the characteristics of the health system and medical practice are different. To enhance the research on primary care in South Korea, financial assistance, promoting the research capacity of primary care physicians, and more attention from primary care physicians to research are needed.
Health Services Research ; Healthcare Disparities ; Humans ; Physicians, Primary Care ; Prevalence ; Primary Health Care ; Republic of Korea

OBJECTIVE: To estimate the status of HIV infection and AIDS incidence using a back-calculation model in Korea. METHODS: Back-calculation is a method for estimating the past infection rate using AIDS incidence data. The method has been useful for obtaining short-term projections of AIDS incidence and estimating previous HIV prevalence. If the density of the incubation periods is known, together with the AIDS incidence, we can estimate historical HIV infections and forecast AIDS incidence in any time period up to time t. In this paper, we estimated the number of HIV infections and AIDS incidence according to the distribution of various incubation periods RESULTS: The cumulative numbers of HIV infection from 1991 to 1996 were 708~1,426 in Weibull distribution and 918~1,980 in Gamma distribution. The projected AIDS incidence in 1997 was 16~25 in Weibull distribution and 13~26 in Gamma distribution. CONCLUSIONS: The estimated cumulative HIV infections from 1991 to 1996 were 1.4~4.0 times more than notified cumulative HIV infections. Additionally, the projected AIDS incidence in 1997 was less than the notified AIDS cases. The reason for this underestimation derives from the very low level of HIV prevalence in Korea. Further research is required for the distribution of the incubation period of HIV infection in Korea, particularly for the effects of combination treatments.
HIV Infections ; HIV* ; Incidence* ; Korea* ; Prevalence

OBJECTIVES: The aims of this study were to know the frequency and the nature of cognitive dysfunction in type 2 diabetics, and to reveal influencing variables on it. METHODS: From eighty type 2 diabetics (42 males and 38 females), demographic and clinical data were obtained by structured interviews. Cognitive functions were measured using the MMSE-K (Korean Version of the Mini-Mental State Examination) and the Korean Version of the Montreal Cognitive Assessment (MoCA-K) tests. Severity of depression was evaluated by the Korean Version of the Hamilton Depression Rating Scale (K-HDRS). RESULTS: 1) Among eighty type 2 diabetics, 13.75% were below 24 on the MMSE-K, while 38.8% were below 22 on the MoCA-K. 2) The total scores and subtest scores of the MoCA-K including visuospatial/executive, attention, language, delayed recall and orientation were significantly lower in type 2 diabetics with cognitive dysfunction (N=31) than those without cognitive dysfunction (N=49) (p < 0.001, respectively). 3) There were significant difference between type 2 diabetics with and those without cognitive dysfunction in age, education, economic status, body mass index, duration of diabetes, total scores of the K-HDRS, the MMSE-K and the MoCA-K (p < 0.05, respectively). 4) The total scores of the MoCA-K had significant correlation with age, education, body mass index, family history of diabetes, duration of diabetes, total scores of the K-HDRS (p < 0.05, respectively). 5) The risks of cognitive dysfunction in type 2 diabetics were significantly influenced by sex, education, fasting plasma glucose and depression. CONCLUSIONS: The cognitive dysfunction in type 2 diabetics seemed to be related to multiple factors. Therefore, more comprehensive biopsychosocial approaches needed for diagnosis and management of type 2 diabetes.
Blood Glucose ; Body Mass Index ; Cognition ; Depression ; Diagnosis ; Education ; Fasting ; Humans ; Male

It has been assumed that tension and anxiety serve to induce or exacerbate tinnitus through increasing muscle tension or alteration in blood flow to the cochlear region. And it is also possible that psychological distress may be a result of tinnitus, or that awareness of tinnitus may be greater during environmental stress. So tinnitus patients need psychologic consideration in their diagnosis and treatment. Purpose of this study is to evaluate the degree and characteristic of the psychologic factors in tinnitus disorder. Cornell Medical Index(CMI), Fukamachi's Discriminative chart and Symptom Check List-90-Revision(SCL-90-R) were examed in tinnitus patients and control group. The results were as follows. 1) According to the Fukamachi's Discriminative Chart using CMI, the tinnitus group showed higher incidence than normal healthy adults group in class III or IV region which is regarded as neurosis. 2) The tinnitus group showed higher score than normal healthy group in all 9 sections of SCL-90-R. 3) The group which has long duration of tinnitus was related to high scores of interpersonal sensitivity, depression, anxiety, and the group which has not history of otologic surgery was related to high scores of depression, phobic anxiety(p<0.01).
Adult ; Anxiety ; Depression ; Diagnosis ; Humans ; Incidence ; Muscle Tonus ; Tinnitus*

Chimerism testing permits early prediction and documentation of successful engraftment, and also facilitates detection of impending graft rejection. In this study, we serially monitored chimerism status by short tandem repeat-based PCR in nucleated cells (NC), T cells and natural killer (NK) cells after myeloablative allogeneic stem cell transplantation (SCT). Four patients with myeloid malignancies showed discrepant chimerism results among those three fractions. Three patients had mixed chimerism (MC) of donor/host T cells at a time point around the onset of chronic graft-versus-host disease (GVHD). In two patients with disease relapse, MC of NK cells preceded a morphological relapse or NK cells showed a higher percentage of patient cells compared to NC. Therefore, our study shows that chimerism analysis in lineage-specific cells might be useful in predicting clinical outcome after allogeneic SCT in certain patients.
Adult ; *Chimerism ; Graft vs Host Disease/*diagnosis/etiology ; Humans ; Killer Cells, Natural/cytology/immunology ; Male ; Microsatellite Repeats/*genetics ; Middle Aged ; Polymerase Chain Reaction ; Predictive Value of Tests ; Stem Cell Transplantation ; T-Lymphocytes/cytology/immunology ; Transplantation, Homologous

BACKGROUND: Tongue cancer comprises 10% of all head and neck cancer, and in spite of progress of therapeutic and diagnostic procedures in oncology, the prognosis of tongue cancer remains poor because of rich lymphatics of the tongue and high propensity of early subclinical lymph node metastasis. MATERIALS AND METHODS: Eighteen cases of tongue cancer specimens were sectioned serially and reviewed to investigate the correlations between macroscopic surface extension diameter and microscopic depth of invasion. And correlations between surface extension, muscular invasion and cervical lymph node metastasis of tongue cancer were studied. Furthermore, safety margin for glossectomy was also studied. RESULTS: The obtained results were as follows: 1) The macroscopic diameter of surface extension and microscopic depth of invasion of tongue cancer were correlated to each other (especially when the macroscopic diameter of surface extension was below 20 mm).2) Surface extension and muscular invasion were correlated independently with cervical lymph node metastasis. However, the 95% confidence index using the Cornfield method was too broad in order to draw a correlation among these three factors. 3) The safety margin was between 2.3mm and 13.5 mm. CONCLUSION: Macroscopic surface extension of tongue cancer serves as a valuable prognostic factor in predicting the depth of muscular invasion. Therefore, the safety resection depth can be estimated by the surface extension. In 12 cases of muscular invasions, relatively high prevalence of cervical lymph node metastasis were found, when compared to that of non-muscular invasive cancer. Therefore, muscular invasion itself is a very useful prognostic factor. But it is difficult to confirm the correlation between muscular invasion and cervical lymph node metastasis because of too broad CI.
Glossectomy ; Head and Neck Neoplasms ; Lymph Nodes ; Neoplasm Metastasis ; Prevalence ; Prognosis* ; Tongue Neoplasms* ; Tongue*

BACKGROUND AND OBJECTIVES: The aim of this study was to compare the effectivenss of 99mTc-MIBI SPECT and CT in evaluating cervical lymph node (LN) metastasis of head and neck cancer. MATERIALS AND METHOD: Histopathologic results of 138 cervical lymph node levels in 26 neck dissected patients were compared with preoperative CT and 99mTc-MIBI SPECT findings about cervical lymph node metastasis. RESULTS: Sensitivity, specificity and predictability of CT and 99mTc-MIBI SPECT were 63.2, 91.6, 87.7% and 52.6, 84.9, 80.4%, respectively. When analyzing CT and 99mTc-MIBI SPECT together, sensitivity and specificity was 78.9, 99.2%, respectively. CONCLUSION: The combined use of 99mTc-MIBI SPECT and CT could increase the accuracy, compared with the single use of either 99mTc-MIBI SPECT or CT, to detect cervical LN metastases.
Head and Neck Neoplasms ; Humans ; Lymph Nodes* ; Neck ; Neoplasm Metastasis* ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon*