BACKGROUND: The high concentration of plasma total homocysteine is recently considered an independent risk factor for atherosclerosis. The purpose of this study was to provide reference ranges for plasma homocysteine levels and to investigate the relationship between plasma homocysteine and cardiovascular risk factors in healthy Korean men. METHODS: Anthropometric parameters, alcohol intake, cigarette use and nutrient intake were determined in 166 healthy men within a wide age range(30-69 yr). Serum levels of lipids, glucose and insulin levels during oral glucose tolerance test(OGTT), plasma amino acid concentrations and levels of antioxidant nutrients and enzymes were also measured. Hyperhomocysteinemia was defined as plasma homocysteine levels above the 90th percentile(> or =15micromol/L) of respective plasma homocysteine distribution in study subjects. Characteristics of hyperhomocysteinemic men(n=16) were compared to normohomocys- teinemic men(n=16) matched for age and body mass index. RESULTS: Plasma total homocysteine values ranged from 2.4 to 38.1micromol/L, a skewed, right-tailed distribution. The homocysteine levels of 25th, 50th and 75th percentile were 7.02, 9.61 and 12.4micromol/L, respectively. The mean concentration of plasma total homocysteine was 10.7micromol/L. Plasma total homocysteine level was positively correlated to body mass index, serum cholesterol and triglyceride levels and alcohol intake, but negatively correlated to serum bata-carotene concentration. In multivariate analysis, serum triglyceride level was the strongest determinant of plasma total homocysteine concentration. There were no significant differences between two groups in waist to hip ratio, alcohol intake, cigarette use, blood pressure and serum levels of glucose and insulin during OGTT. Hyperhomocysteinemic men had significantly higher mean values of serum triglyceride(258mg/dl), total cholesterol(226mg/dl), and LDL-cholesterol(140mg/dl) than normohomocysteinemic men. Hyperhomocysteinemic men showed a decrease in lipid corrected values of serum bata-carotene and alpha-tocopherol and plasma concentrations of serine and taurine, when compared to normohomocysteinemic men. The mean intakes of vitamin B6, folate, vitamin B12 and bata-carotene tended to decline by 25-30% in hyper- homocysteinemic group, when compared to normohomocysteinemic group. CONCLUSION: Our results indicate that healthy Korean men with hyperhomocys- teinemia show signs of hyperlipidemia and decreased antioxidants nutrients and these factors increase risk for coronary artery disease. In addition, hyperhomocysteinemia may affect amino acid metabolism related to homocysteine.
alpha-Tocopherol ; Antioxidants ; Atherosclerosis ; Blood Pressure ; Body Mass Index ; Cholesterol ; Coronary Artery Disease ; Folic Acid ; Glucose ; Glucose Tolerance Test ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Hyperlipidemias ; Insulin ; Male ; Metabolism ; Multivariate Analysis ; Plasma* ; Reference Values ; Risk Factors* ; Serine ; Taurine ; Tobacco Products ; Triglycerides ; Vitamin B 12 ; Vitamin B 6 ; Waist-Hip Ratio

Purpose: To evaluate and introduce the technique of C-arm guided aspiration and an injection of a mixture of corticosteroid and local anesthesia for the treatment of calcific tendinitis of the rectus femoris around the hip joint. Materials and Methods: Between March 2003 and May 2005, C-arm guided aspiration and an injection of a mixture of corticosteroid and local anesthesia were performed on 5 patients and a local excision were performed in 1 patient for the treatment of calcific tendinitis of the rectus femoris. The minimum follow-up period was 6 months. The radiology evaluation revealed the presence and size of the calcification. The clinical evaluation involved checking the level of pain relief, range of motion, recurrence, complications. Results: The hip pain improved immediately after treatment. There were no recurrences or complications. Conclusion: The combined treatment of C-arm guided aspiration and an injection of a mixture of corticosteroid and local anesthesia is an effective method for treating calcific tendinitis of the rectus femoris, which can induce rapid symptom relief without any surgical morbidity.
Anesthesia, Local ; Follow-Up Studies ; Hip Joint* ; Hip* ; Humans ; Quadriceps Muscle* ; Range of Motion, Articular ; Recurrence ; Tendinopathy*

Vibrio parahaemolyticus is a gram-negative halophilic organism commonly associated with outbreaks of acute gastroenteritis which also sometimes causes serious wound infection. It is an uncommon cause of bacteremia. We have experienced a case of bacteremia due to Vibrio parahaemolyticus in a 59-year old man who initially presented with edema and dyspnea. He was diagnosed as liver cirrhosis, gastric cancer, and hepatoma. On hospital day 13, Vibrio parahaemolyticus was isolated from blood culture. The isolate showed typical cultural and biochemical characteristics such as salt tolerance and did not ferment lactose. The isolate was intermediate to ampicillin but susceptible to other agents.
Ampicillin ; Bacteremia* ; Carcinoma, Hepatocellular ; Disease Outbreaks ; Dyspnea ; Edema ; Gastroenteritis ; Humans ; Lactose ; Liver Cirrhosis ; Middle Aged ; Salt-Tolerance ; Stomach Neoplasms ; Vibrio parahaemolyticus* ; Vibrio* ; Wound Infection

A 79-year old male with angina underwent emergent coronary artery bypass graft. After the induction of anesthesia, a pulmonary artery catheter (PAC) was placed via the right subclavian vein. At weaning from cardiopulmonary bypass, the pulmonary artery wave form did not appear on the monitor. We pulled and pushed the PAC repeatedly. However, we could observed no pulmonary artery pressure; the PAC was not pulled out at the 42 cm from the distal tip. Chest X-ray revealed a malposed PAC into the ipsilateral internal jugular vein. No deleterious complications were observed either during the immediate or later postanesthetic period.
Aged ; Anesthesia ; Cardiopulmonary Bypass* ; Catheters* ; Coronary Artery Bypass ; Humans ; Jugular Veins ; Male ; Pulmonary Artery* ; Subclavian Vein ; Thorax ; Transplants ; Weaning*

Tumors of the lung and bronchi containing cartilage were known by a variety of names, chondroma, adenochondroma, chondromatous hamartoma and mixed tumor. This variation in nomenclatures explain the difference of illustration on the nature of these tumor. The concept pulmonary harmatomas are benign neoplasm and not developmental malformations, has gained wide acceptance in recent years. We have experienced four cases of intrapulmonary hamartoma which were all discovered during routine chest film check up for certificate of health and evaluation of other disease. One case is added further detailed histologic examination by electron microscopy. The age at time of the detection were 53 (male), 23 (male), 39 (female), and 56 (female) years old. The mean size is 4.3x3.7x3.4 cm. The locations were three left upper lobes and one right upper lobe. Lobectomy and wedge resecions were done. Cut surface showed promiment lobular structures, papillary configuration and multiple cleft like spaces. Predominant cellular components were cartilage but fat tissue in one of the four cases. Microscopic findings showed abundant hyaline cartilages bearing lobular configuration and overlying pseudostratified ciliated columnar and cuboidal epithelium. Fibromyxoid and undifferentiated cells were seen in myxoid and fatty tissue. Electron microscopic findings revealed stellate, undifferentiated mesenchymal cells bearing collagen formation, stellate smooth muscle and transition areas between undifferentiated mesenchymal cells and mature cartilage. Epithelial components were similar to terminal bronchiole and alveolar epithelium. These findings suggest the concept that intrapulmonary hamartoma represent a histologic specturm of benign mesenchymal neoplasms, which originate in peribronchial connective tissue.
Female ; Male ; Humans ; Hamartoma

No abstract available.

No abstract available.

No abstract available.

Anaphylactic deaths are frequently observed at autopsies. Since death associated with medical practice has become social concern, the identification of anaphylactic shock is an important part of forensic medicine. However, autopsy findings of anaphylactic shock are usually non-specific; therefore, the diagnosis of anaphylactic shock must be inferred from collecting data on the past history of the deceased, circumstances of death, and negative autopsy findings. The analysis of serum mast cell tryptase level is a well-known, useful ancillary test for the diagnosis of anaphylactic shock, but is not widely used in daily practice in Korea. We recently encountered 2 autopsy cases of anaphylactic shock and confirmed that analysis of serum mast cell tryptase level was useful for the diagnosis of anaphylactic shock. In this report, we present these 2 autopsy cases of anaphylactic shock, with literature review of the usefulness and limitations of serum mast cell tryptase analysis.
Anaphylaxis ; Autopsy ; Forensic Medicine ; Korea ; Mast Cells ; Tryptases

BACKGROUND: The erythromycin-resistance rate and phenotype distribution of Streptococcus propenes are quite different by geographical variation and study period. The aim of the present study was to determine the evolution of resistance to erythromycin and the frequency of erythromycin resistance phenotype of S. pyogenes isolated from Wonju Christian Hospital. METHODS: The minimal inhibitory concentrations (MICs) of erythromycin and clindamycin for 94 S. pyogenes isolated from clinical specimens between 1990 to 1998 were investigated. Double disk test of erythromycin (78microgram) and clindamycin (25microgram) were performed for 15 isolates of erythromycin resistant S. pyogenes to evaluate the erythromycin resistance phenotype. RESULTS: The resistance rates of 94 isolates of S. pyogenes were 16%(15/94) to erythromycin and 4%(4/94) to clindamycin. The frequency of erythromycin resistance phenotype in decreasing order were M phenotype (47%), inducible resistance phenotype (40%), and constitutive resistance phenotype (13%). Erythromycin-resistant S. pyogenes did not exist until 1993, but was isolated since 1994, and ranged from 14.0% to 24.0% during the period of 1994-1998. CONCLUSIONS: Our finding documents the emergence of high resistance rates to erythromycin in S. pyogenes at Wonju area since 1994. The M phenotype (47%) and inducible resistance phenotype (40%) account for the majority of erythromycin-resistant S. pyogenes.
Clindamycin ; Erythromycin* ; Gangwon-do ; Phenotype* ; Streptococcus pyogenes* ; Streptococcus*