BACKGROUND/AIMS: For laboratory diagnostics in liver diseases, many enzymes have been used for the assessment of hepatocellular function. Among them, two transaminases, alanine and aspartate aminotransferase, have been regarded as the most sensitive indicators of hepatocellular damage. However, the enhanced enzyme activities of the enzymes do not exactly indicate or represent the cause and progression of diseases in the patients with liver disease. To overcome such limitations, immunological methods have been suggested as one of the alternatives for the replacement or supplement of the conventional enzymatic analysis. METHODS: In the hope of developing a new assay system for measuring the AST concentration rather than its activity, we have developed a new assay using fluorescence labeled anti-AST monoclonal antibodies. Blood was obtained from a normal population of 234 patients and 43 liver disease patients. The linearity, limit of detection, and performance of the new assay system were tested and evaluated. The comparability of assay was examined with an ELISA and biochemical assays. RESULTS: The linearity fell in the range of 0-1 mg/L of AST (R=0.995), and the analytical detection limit was 12 microgram/L of AST. The mean recovery of the control was 102.4 % in a working range. The precision of the intra- and inter-assay in a range of 50-800 microgram/L was CVs < 7% and CVs < 6%, respectively. In the normal population, the mean AST concentration was 35.5 microgram/L. The mean AST concentration in patients with liver disease was 266.5 microgram/L. The new assay system correlated well with an ELISA and biochemical assay for quantification of AST concentration (R=0.92 and 0.88, respectively; N=43). CONCLUSIONS: We have developed a new immunological assay using generated monoclonal antibodies to human cytosolic AST and used them for the development of a fluorescent assay measuring the enzyme mass. Cytosolic AST mass in sera could be measured reproducibly by the immunological method. In conclusion, this study has provided us with a new type of tool for an accurate measurement of the enzyme amount in circulation.
Antibodies, Monoclonal ; Aspartate Aminotransferase, Cytoplasmic/*blood/immunology ; Fluorescent Antibody Technique/*methods ; Humans ; Liver Diseases/diagnosis

We investigated fifteen men and twenty one women, who were diagnosed to have asteroid hyalosis between June, 1997 and November, 1997 at Seoul National University Hospital. After obtaining their medical history a complete eye examination was performed. Specimen was examined by light microscope in one case. Funduscopic examination revealed bilateral involvement in 5 cases. Twenty six patients were diabetic and 12 were hypertensive. There was a significant association with diabetes. Light microscopic exam showed variable sized spherical structures with brown rim. Further decrease in visual acuity due to asteroid hyalosis was not observed in 35 cases in which follow-up exams were possible. In conclusion, asteroid hyalosis rarely caused visual loss and were likely to be monocular and to occur in old age.
Female ; Follow-Up Studies ; Humans ; Male ; Seoul ; Visual Acuity

Neurilemmomas are benign tumors of the nerve sheaths. They are usually painless and are most common in the upper extremities. Pathologically, neurilemmoma is encapsulated and made up of organized element: the Antoni A cells, the Antoni B cells and the Verocay bodies. According to Stout, neurilemmomas never become malignant. Two cases of neurilemmoma of tibial nerve and One case of neurilemmoma of lateral antebrachial cutaneous nerve are presented with a review of the literature. Tumors were enucleated and confirmed by pathological examination.
B-Lymphocytes ; Nerve Sheath Neoplasms ; Neurilemmoma ; Tibial Nerve ; Upper Extremity

OBJECTIVE: Nonstress test(NST) has become an important method of antepartum evaluation of fetal well-being. The fetal heart rate(FHR) testing is used frequently as a nonstress test(NST). However, NST highly depends on whom to interpret the result of FHR testing. Recently, for interpretation of FHR, objective decision methods using softwares have been introduced. In this study, we aim to analyse the correlation between each variable affecting FHR and fetal outcome using objective decision basis with principal component analysis and multiple regression analysis. MATERIALS AND METHODS: The clinical observation was made on 5,314 data from pregnant women who took a NST which had been collected from 1989 to 1997 at Hanyang University Hospital. For collection of data and values of each variable, we used our own FHR interpretation softwares, HYFM-I(DOS version, 1989) and HYFM-II(Window-version, 1998). Then, the principal component analysis is performed to find significant variable and multiple regression analysis using these variables. RESULTS: Each groups were divided and classified as followings ; 1 minute Apgar score-normal, 1 minute Apgar score-abnormal, 5 minute Apgar score-nomal, 5 minutes Apgar score-abnormal; there is significant difference between signal loss and 1 minute Apgar score only. And significant difference was shown between mean baseline FHR, FHR variability-amplitude, FHR variability-MMR, and fetal outcomes(body weight of newborn & Apgar score). The FHR variability-amplitude, FHR variability-MMR, and weight of baby were important values in predict of fetal well-being. CONCLUSIONS: In conclusion, there are close relation in each variable of FHRand fetal outcome. The result of this study would be useful background data in the development of objective and automated FHR analysis software, especially in the computerized FHR analysis system.
Apgar Score ; Female ; Fetal Heart* ; Heart Rate, Fetal* ; Humans ; Infant, Newborn* ; Pregnancy ; Pregnant Women ; Principal Component Analysis

PURPOSE: We proposed a new index for predicting death resulting from hemorrhagic shock, which was calculated by dividing measured lactate concentration by perfusion. METHODS: Using 24 Sprague-Dawley (S-D) rats, we induced uncontrolled hemorrhage and then measured blood lactate concentration and perfusion in addition to vital signs such as heart rate, blood pressure, respiration rate and temperature. Perfusion and lactate concentration were measured by laser Doppler flowmetry and a lactate concentration meter, respectively. We collected the data for 15 min, which consisted of 3 intervals after homeostasis, and thus obtained a new index. RESULTS: The proposed index revealed an earlier death prediction than lactate concentration alone with the same timing as perfusion. The new index showed generally better sensitivity, specificity and accuracy than lactate concentration and perfusion. Using a receiver operating characteristic curve method, the mortality prediction with the proposed index resulted in a sensitivity of 98.0%, specificity of 90.0%, and accuracy of 93.7%. The mortality prediction with the proposed index resulted in a sensitivity of 98.0%, specificity of 90.0% and accuracy of 93.7%. CONCLUSION: This index could provide physicians, in emergency situations, with early and accurate mortality predictions for cases of human hemorrhagic shock.
Animals ; Blood Pressure ; Emergencies ; Heart Rate ; Hemorrhage ; Homeostasis ; Humans ; Lactic Acid ; Laser-Doppler Flowmetry ; Perfusion ; Rats ; Respiratory Rate ; ROC Curve ; Sensitivity and Specificity ; Shock, Hemorrhagic ; Vital Signs

PURPOSE: We proposed a new index for predicting death resulting from hemorrhagic shock, which was calculated by dividing measured lactate concentration by perfusion. METHODS: Using 24 Sprague-Dawley (S-D) rats, we induced uncontrolled hemorrhage and then measured blood lactate concentration and perfusion in addition to vital signs such as heart rate, blood pressure, respiration rate and temperature. Perfusion and lactate concentration were measured by laser Doppler flowmetry and a lactate concentration meter, respectively. We collected the data for 15 min, which consisted of 3 intervals after homeostasis, and thus obtained a new index. RESULTS: The proposed index revealed an earlier death prediction than lactate concentration alone with the same timing as perfusion. The new index showed generally better sensitivity, specificity and accuracy than lactate concentration and perfusion. Using a receiver operating characteristic curve method, the mortality prediction with the proposed index resulted in a sensitivity of 98.0%, specificity of 90.0%, and accuracy of 93.7%. The mortality prediction with the proposed index resulted in a sensitivity of 98.0%, specificity of 90.0% and accuracy of 93.7%. CONCLUSION: This index could provide physicians, in emergency situations, with early and accurate mortality predictions for cases of human hemorrhagic shock.
Animals ; Blood Pressure ; Emergencies ; Heart Rate ; Hemorrhage ; Homeostasis ; Humans ; Lactic Acid ; Laser-Doppler Flowmetry ; Perfusion ; Rats ; Respiratory Rate ; ROC Curve ; Sensitivity and Specificity ; Shock, Hemorrhagic ; Vital Signs

BACKGROUNDS: Ischemic heart diseases has increased by more than 80% in the past 10 years among Korean and the global risk assessment of coronary heart disease(CHD) based on the relative risk factors to the probability of developing CHD became widely used for western populations. In this study we hope to provide information on the distribution and characteristics of the relative risks of CHD using the Framingham risk score. METHODS: This Study involved the subjects who visited a university hospital for health promotion from 1995 to 2000 without CHD. We surveyed medical history of the subjects, and measured their blood pressure, serum glucose, total cholesterol(total C) and HDL cholesterol(HDL C). Risk points from the Framingham chart were given to age, systolic BP, total C, HDL C, smoking, diabetes, and the global risk score was calculated from their sum. We analyzed the global risk scores and each risk points of the high risk groups. RESULTS: For younger and older men in the high risk group, the factors smoking and high blood pressure had the highest score assigned respectively. With younger women total C had the highest score assigned, and with older women diabetes took over but HDL C and high blood pressure still had a higher score. CONCLUSION: For primary prevention of CHD, younger men need active education to quit smoking and for older aggressive blood pressure control is desperately needed. For women, concern about low HDL C is highly needed and after menopause aggressive treatment for diabetes, high blood pressure, low HDL C is needed.
Blood Glucose ; Blood Pressure ; Coronary Disease* ; Education ; Female ; Health Promotion ; Heart ; Hope ; Humans ; Hyperlipidemias ; Hypertension ; Male ; Menopause ; Myocardial Ischemia ; Primary Prevention ; Risk Assessment ; Risk Factors* ; Smoke ; Smoking

Amyloidosis is a group of disorders resulting from the extracellular deposition of amyloid fibrils in tissues and organs. Primary systemic amyloidosis may be myeloma-associated or idiopathic. It involves the kidney, heart, liver, peripheral nerves, autonomic nervous system and skin. We report a case of a 76 year-old woman with primary systemic amyloidosis who suffered from ecchymotic purpura on the periorbital, flexural area with hemorrhagic bulla, and macroglossia for two years. She showed typical symptoms of AL amyloidosis, and while primary systemic amyloidosis was suspected from electrophoresis results, no amyloid was found in the skin, tongue, and bone marrow. Upon her admission due to panperitonitis from diverticulitis, she was diagnosed with primary systemic amyloidosis after amyloid deposition was confirmed in the skin and colon biopsy. She had been treated with bortezomib, but she expired from methicillin-resistant Staphylococcus aureus septic shock.
Amyloid ; Amyloidosis ; Autonomic Nervous System ; Biopsy ; Blister ; Bone Marrow ; Boronic Acids ; Colon ; Diverticulitis ; Electrophoresis ; Female ; Heart ; Humans ; Kidney ; Liver ; Macroglossia ; Methicillin-Resistant Staphylococcus aureus ; Peripheral Nerves ; Plaque, Amyloid ; Purpura ; Pyrazines ; Shock, Septic ; Skin ; Tongue ; Bortezomib

BACKGROUND: Ulnar nerve palsy leads to thumb-web depression, hypothenar flattening, and inter-digital depression in patients with leprosy. To camouflage these deformities, patients used to inject paraffin or silicone oil into the areas of muscle atrophy associated with thumb-web depression and hypothenar flattening. After several years and decades, paraffinomas eventually resulted in extensive inflammatory fibrosis and recalcitrant recurrent ulcers at the injection sites. OBJECTIVE: The aim of this study is to compare the results of different surgical treatments for paraffinomas in patients with leprosy, and to find out the most effective treatment method that has a low recurrence rate. METHODS: Between January 2000 and December 2012, 47 patients with paraffinomas who had visited the Korean Hansen Welfare Association Hospital were enrolled to participate in the study. The number of paraffinomas was 56, and the mean age of the patients was 73 years. A retrospective evaluation of the cosmetic results and recurrence rate was performed. RESULTS: Of the 56 surgically treated paraffinomas, 30 lesions were treated using primary closure, 20 lesions were treated with skin graft, and 6 lesions were treated with skin flap. The cosmetic outcomes, which were assessed using a four-point grading scale, were excellent in 10.7% (6/56), good in 25% (14/56), fair in 38% (21/56), and poor in 28% (15/56) of the patients. There were no significant differences among the three surgical procedures with respect to the cosmetic results. The recurrence rate was 33% (10/31) in the primary closure group, 50% (10/20) in the skin graft group, and 17% (1/6) in the skin flap group. There were no significant differences in the recurrence rate among the three surgical procedures. CONCLUSION: The extensive and aggressive curettage of lesions is very important to reduce recurrence rate. When the older age of the patients is considered in conjunction with the simplicity of the operation and the total operation time, primary closure is considered the treatment of choice both cosmetically and practically.
Congenital Abnormalities ; Curettage ; Depression ; Fibrosis ; Humans ; Leprosy* ; Muscular Atrophy ; Paraffin ; Recurrence ; Retrospective Studies ; Silicone Oils ; Skin ; Transplants ; Ulcer ; Ulnar Neuropathies

We studied intraoperative changes of transurethral resection of the prostate in blood coagulation-fibrinolysis system by thromboelastography (TEG) in 31 patients with benign prostatic hyperplasia. As TEG parameters reaction time (R), clot formation time (K), maximum amplitude (MA), coagulation time (R+K), clot lysis index after 60 minutes (Ly60) were measured. The coagulability was evaluated by R and R+K, the absolute strength of clot by MA, and fibrinolysis by Ly60. Coagulation time (R+K) was shortened in patients with decreased platelet count under 30,000 u/L (p<0.05), irrigating fluid volume over 20,000 ml (p<0.05) and had a tendency of shortening in patient with resection time over 50minutes (p=0.078). MA had a tendency of increasing but significant contributing factor was not detected. The mean value of Ly60 was increased significantly but the change was in normal range. Irrigating fluid volume (r=-0.407, p<0.05) and resection time (r=-0.456, p<0.05) showed negative correlation significantly with the change of R + K. There was no significant correlation between resected prostatic weight and TEG parameters. We concluded that coagulability is increased during TURP suggesting a possible role in postoperative clot retention, but the risk of fibrinolysis is not increased in patients with normal coagulation-fibrinolysis system.
Fibrinolysis ; Humans ; Platelet Count ; Prostate* ; Prostatic Hyperplasia ; Reaction Time ; Reference Values ; Thrombelastography* ; Transurethral Resection of Prostate