Recent studies suggest that apolipoproteins may be better predictor of ischemic heart disease than are plasma lipids, such as total cholesterol and high density lipoprotein cholesterol(HDL-C). To examine this hypothesis, plasma levels of major lipids and major apolipo-proteins were measured and their derivatives were calculated in 30 male patients with ischemic heart disease(16 angina pectoris and 14 old myocardial infarction) and 30 age-matched male healthy controls. Plasma levels of lipids were obtained by conventional methods and apolipoproteins by Rocket immunoelectrophoresis. Levels of HDL-C, HDL2-cholesterol(HDL2-C), and apolipoprotein-AII, and ratios of HDL-C/total cholesterol, HDL2-C/total cholesterol, and apolipoprotein-AI/apolipoprotein-B were lower in the group of patients than in controls. Levels of low density lipoprotein cholesterol(LDL-C) and apolipoprotein-B, and ratios of lDL-C/HDL-C and apolipoprotein-AI/apolipoprotein-AII were higher in the group of patients. There were no statistically significant differences in the levels of total cholesterol and apolipoprotein-AI between the two groups. Stepwise discriminators analysis showed that apolipoprotein-B and apolipoprotein-AII were better discriminators than plasma lipids for identifying those with ischemic heart disease. One could correctly classify 78% of the cases by using the levels of the two apolipoproteins. By using the level of apolipoprotein-B, one could correctly classify 73% of the cases. There were no correlations between the levels of total cholesterol and HDL-C in the controls whereas there were positive correlations between the levels in the group of patients. In conclusion, this study showed that apolipoprotein-B was the best single discriminator for identifying the patients with ischemic heart disease, followed by apolipoprotein-AII.
Angina Pectoris ; Apolipoproteins A* ; Apolipoproteins* ; Cholesterol ; Heart ; Humans ; Immunoelectrophoresis ; Lipoproteins ; Male ; Myocardial Ischemia* ; Plasma* ; Risk Factors*

Hysterosalpingography and Hysteroscopy have been used for the detection of intraute-rine pathology such as polyps, submucous myomas, intrauterine adhesion and endometrial hyperplasia or cancer. Recently the ultrasound has also been utilized for the detection of uterine pathology. Therefore the purpose of this study was to evaluate the diagnostic efficacy of SonoHysterography in detection of intrauterine pathology compared with HSG and Hysteroscopy. 32 patients underwent Sono-Hysterography and Hysteroscopy for the evaluation of the uterine pathology from september 1995 to January 1996. Nine of 32 patients had infertility problem and HSG performed prior to Sono-Hysterography and Hysteroscopy. The results are as follows : 1. The patients' ages ranged from 20 to 50 years(median 37.9). 2. All 9 patients with infertility who had positive HSG findings in uterine cavity showed the intrauterine pathology in Sono-Hysterography as well as Hysteroscopy. The detail findings are as follows :septated uterus(n=2), intrauterine adhesion :IUA(n=3), endometrial polyp(n=3), and IUA combined endmetrial hyperplasia(n=1). 3. Twenty two of 23 patients with abnormal uterine bleeding showed the intrauterne pathology and one patient had negative finding in Sono-Hysterography. However, Hysteroscopy revealed positive intrauterine pathology in 22 patients who had abnormal uterine bleeding. One patients who had positive finding in Sono-Hysterograply showed negative by Hysterography. In contrast, one patient who had negative finding in Sono-Hysterography had positive uterine pathology with polyp in Hysteroscopy. The histologic pathology in all 23 patients reported endometrial polyp(n=12), placental polyp(n=2), submucous myoma(n=1), endometrial hyperplasia(n=5), endometrial cancer(n=1), normal endometrial finding(n=2). 4. Sono-Hysterography, therefore, has a sensitivity and positive predictive value of 96.6%, 93.5% respectively. Our study showed a positive Sono-Hysterography is very predictive of the intrauterine pathology. Sono-Hysterography is safe, quick and minimal invasive procedure. So it is an invaluable technique in the evaluation of uterine cavity.
Endometrial Hyperplasia ; Female ; Humans ; Hysterosalpingography ; Hysteroscopy* ; Infertility ; Myoma ; Pathology* ; Polyps ; Ultrasonography ; Uterine Hemorrhage

Treatment strategies for femoroacetabular impingement (FAI) syndrome have evolved in tandem with increased comprehension of FAI’s impact on hip joint health. Early intervention, including arthroscopic surgery, has gained popularity due to its potential to delay the progression of osteoarthritis. Arthroscopic surgery has demonstrated significant efficacy in treating FAI syndrome, with robust evidence from randomized controlled trials and systematic reviews supporting its use. Despite arthroscopic surgery’s success, complications and reoperations are not uncommon. The incidence ranges from 1% to 31% and 4% to 13%, respectively.Adjunctive biologic treatments, such as bone marrow aspirate concentrates and platelet-rich plasma, have shown promise in chondral lesion management. However, robust evidence supporting their routine use in FAI syndrome is currently lacking. Among conservative treatment methods, intra-articular injections offer diagnostic and therapeutic benefits for FAI patients. While they may provide pain relief and aid in prognosis, their long-term efficacy remains a subject of debate. Comparative studies between conservative and arthroscopic treatments highlight the importance of personalized approaches in managing FAI syndrome. In conclusion, recent advancements in FAI syndrome management have illuminated various treatment modalities. Arthroscopic surgery stands as a pivotal intervention, offering substantial benefits in pain relief, function, and quality of life. However, careful patient selection and postoperative monitoring are crucial for optimizing outcomes. Adjunctive biologics and intra-articular injections show promise but require further investigation. Tailoring treatment to individual patient characteristics remains paramount in optimizing FAI syndrome management.

BACKGROUND: Infections caused by vancomycin-resistant enterococci (VRE) are becoming increasingly prevalent throughout the world. VRE can spread by direct patient-to-patient contact as well as on the hands of personnel and contaminated environmental surfaces. The purpose of this study was to examine the incidence of VRE among total enterococci from clinical specimen and investigate the antimicrobial characteristics and resistance genotypes of isolated VRE. METHODS: A total of 790 enterococcal isolates from patients over a period of 12 months were screened for vancomycin resistance using brain heart infusion agar plates supplemented with 6 g/mL of vancomycin. The incidence of VRE among enterococcal isolates was calculated from microbiology statistics program. Twenty three isolates of VRE were tested for minimal inhibitory concentrations (MIC) of vancomycin, penicillin, and gentamicin and resistance genotypes. RESULTS: In the first half period, the incidence of VRE was 1.9%, and in the second half, the incidence increased to 7.7%. Thirteen strains were found to be highly resistant to vancomycin, penicillin and gentamicin (MIC, >128 g/mL). According to the direct PCR analyses, the frequency of vanB, vanC1, and vanC2 types was 13, 7, and 3 strains, respectively. CONCLUSIONS: Continued vigilance, strict enforcement of infection control, and curtailment of vancomycin use seem to be our best approaches to controlling this increasingly important problem. For this purposes, accurate and timely detection of vancomycin-resistance and periodic investigation for incidence are essential.
Agar ; Brain ; Genotype* ; Gentamicins ; Hand ; Heart ; Humans ; Incidence* ; Infection Control ; Penicillins ; Polymerase Chain Reaction ; Vancomycin ; Vancomycin Resistance

Effect of diltiazem hydrochloride on cardiac performance with particular reference to the antianginal action was studied in 17 patients with ischemic heart disease, including 12 cases of effort angina, by means of clinical and mechanocardiographic evaluations. All patients were kept on the same medications from at least 2 weeks prior to diltiazem administration until the end of the study, and were prescribed no other antianginal drugs except for liberal use of sublingual nitroglycerin. Diltiazem was given 90mg a day in three divided doses for two weeks. Clinical and mechanocardiographic evaluations, including calculations of pressure rate product(PRP), triple product(TP) and tension time index(TTI), were made before and at a weekly interval after diltiazem administration. After the medication, heart rate, blood pressure and the pre-ejection period(PEP) with its ratio to the ejection time tended to decrease, and the decreases in heart rate and the PEP at the end of two weeks were significant. The PRP, TP and TTI were also significantly decreased at the end of the second week, and the decrease in the TTI was significant even a week after the medication. An antianginal effect, which appeared within few days, was excellent to good in over 90 percent of the cases. These facts suggest that diltiazem hydrochloride has no negative inotropic action and its antianginal effecti in its early stage of the drug administration is primarily due to coronary vasodilation and, as the drug is continued, is contributed to possibly by the decrease in the myocardial oxygen consumption as well.
Angina Pectoris* ; Blood Pressure ; Diltiazem* ; Heart Rate ; Humans ; Myocardial Ischemia* ; Nitroglycerin ; Oxygen Consumption ; Vasodilation

BACKGROUND: Asymptomatic vancomycin-resistant enterococci (VRE) colonization precedes infection. VRE-colonized patients serve as silent reservoirs of enterococci that go on to colonize other patients. Rapidly identifying colonized patients is crucial to prevent the spread of VRE. The culture-based method of VRE screening is time-consuming. We evaluated the diagnostic performance of a recently developed multiplex real-time PCR for the detection of VRE. METHODS: We obtained 105 rectal swabs from patients who were being monitored for carriage of VRE. After 24 hour incubation of swabs in enterococcosel broth (EB) supplemented with 6 microg/mL vancomycin, multiplex real-time PCR was performed using the Anyplex(TM) VanR Real-time Detection (VanR) kit (Seegene, Inc., Seoul, Korea). The results of multiplex real-time PCR were compared to those of culture. We evaluated the specificity and detection limits of multiplex real-time PCR using VanR for VRE. RESULTS: A total of 96/105 (91.4%) samples were VRE positive according to multiplex real-time PCR with EB while 85/105 (80.9%) samples were positive in culture. Eleven discordant results (10.4%) (multiplex real-time PCR positive, culture negative) were noted. All non-enterococcal bacteria and vancomycin-susceptible enterococci were negative. The DNA detection limits of VanR were 0.035 pg per reaction (3 microL) for Enterococcus faecium and 0.35 pg for Enterococcus faecalis. CONCLUSION: The application of multiplex real-time PCR after EB incubation allows rapid and sensitive detection in 26-28 hours for VRE screening from rectal swabs. This method could facilitate the timely implementation of contact isolation to prevent the spread of VRE.
Bacteria ; Colon ; DNA ; Enterococcus ; Enterococcus faecium ; Humans ; Limit of Detection ; Mass Screening ; Real-Time Polymerase Chain Reaction ; Sensitivity and Specificity ; Vancomycin

This investigation studied the relationship between Body Mass Index(BMI) and dietary intake, levels of serum lipid, lipoprotein(a) and plasminogen activator inhibitor-1(PAI-1) of 28.449 Korean adults(16.937 men, 11.542 women) from 1995 to 1999. The dietary assessment was conducted using 24-hour dietary records and food frequency questionnaires. During this five year study, the BMI normal-weight group, as a percentage of the annual test population, decreased from 68.0% to 60.2%, while the BMI overweight and obese groups collectively increased from 25.0% to 29.7%. The levels of serum total cholesterol (TC), LDL-cholesterol(LDL-C), Triacylglycerol(TG) and PAI-1 increased as the values of BMI increased, while the levels of HDL-cholesterol(HDL-C) and lipoprotein(a)(men only) appeared to decrease as values of BMI increased. The levels of daily energy intake also increased as values of BMI increased in both men and women. The obese group had significantly higher levels of carbohydrate, protein, fat(men only), and cholesterol intake than those of the normal-weight, underweight, and overweight groups. In men, BMI positively correlated with the levels of macronutrients and cholesterol intake(p<0.001), % energy of protein, fat, and alcohol intake(p<0.001), and the levels of serum TC, LDL-C, TG and PAI-1(p<0.001), while BMI negatively correlated with % energy of carbohydrate intake, and the levels of Lp(a) and HDL-C(p<0.001). In women, BMI negatively correlated with level of cholesterol(p<0.01), fat(p<0.001), alcohol intake(p<0.05),% energy of fat (p<0.001), % energy of alcohol intake and level of and HDL-C(p<0.001). Subjects who had serum TC, LDL-C, HDL-C, and TG levels greater than the standard reference values(TC>240 mg/dl, LDL-C>130 mg/dl, HDL-C>35, TG>200 mg/dl) exhibited a higher intake of the three macronutrients, iron, calcium, meat, milk and fatty foods than those subjects who had serum lipid concentrations less-than-or-equal-to the standard reference values. Overall, there was positive correlation between the high risk factors of vascular disease variables, dietary intake, and BMI. Prevalence of hypertension and high blood sugar were increased as BMI increased, but the prevalence of hypertension is decreased as the year goes by. These findings showed that dietary intake, level of serum lipids and other vascular disease risk factors increased as BIM increased. Therefore, middle or upper class Korean adults who have high BMI should improve their eating habits. This involve reducing alcohol, animal fat, high carbohydrate foods, and overall food intake, and balancing intake in order to lower vascular disease risk factors, including obesity.
Adult* ; Animals ; Blood Glucose ; Body Mass Index* ; Calcium ; Cholesterol ; Diet Records ; Eating ; Energy Intake ; Female ; Humans ; Hypertension ; Iron ; Lipoprotein(a)* ; Male ; Meat ; Milk ; Obesity ; Overweight ; Plasminogen Activator Inhibitor 1* ; Plasminogen Activators ; Prevalence ; Reference Values ; Risk Factors ; Thinness ; Vascular Diseases ; Surveys and Questionnaires

BACKGROUND: To identify the human platelet antigens (HPA) associated with neonatal alloimmune thrombocytopenia (NATP), posttransfusion purpura (PTP), and platelet refractoriness, polymerase chain reaction-sequence specific primer (PCR-SSP) method and immunofluorescent method by flow cytometry were used. The frequencies of the genonotypes of HPA systems by PCR-SSP method and those of phenotypes by flow cytometry were determined. Then both types were compared each other and each types were compared with those of established reports. METHOD: Platelet suspensions were prepared from peripheral blood specimens of 200 blood donors and DNA specimens were extracted from those of 160 donors among them. Phenotypes of 200 specimens and genotypes of 160 ones were tested by flow cytometry and PCR-SSP method, respectively. RESLUTS: Frequencies of penotypes of HPA-1a, -3a, -4a, -4b and NaKa were 100.0%, 88.0, 100.0%, 0.5% and 94.0%, respectively. HPA-5 system could not be identified due to a few antigenic sites of HPA-5 systems. The genotype fequencies are of HPA-2 were a+b- 63.75%, a+b+ 35.00%, a-b+ 1.25%; HPA-3, a+b- 38.12%, a+b+ 48.13%, a-b+ 13.75%; HPA-4, a+b- 100.00%, a+b+ 0.00%, a-b+ 0.00%; HPA-5, a+b- 98.12%, a+b+ 1.88%, a-b+ 0.00%. The frequencies of HPA-4 and -5 were almost same as those of other reports but the frequencies of HPA-2 and -3 were somewhat different from others. Concordant rate between phenotype and genotype of HPA-3a,-4a and -4b were 95.6%, 100% and 99.4%, respectively. CONCLUSION: Phenotyping method by flow cytometry was rapid and objective for identifying HPA systems except HPA-5 system which has a few antigenic sites on platelet membrane. Especially it will be useful method for screening HPA-4b as possible cause of NATP in Koreans. But like other serologic methods, phenotyping by flow cytometry also require the highly qualified antiserum and appropriate amount of platelet. PCR-SSP method was also rapid and simple to test of genotypes of HPA-2~5 systems. Because PCR-SSP method is thought to be one of the most simple and economic genotyping methods to overcome the shortages of serologic methods, it is suggested to be the efficient screening method of HPA systems substituting the serologic methods in the cases which HPA sytems can not be identified by flow cytometry.
Antigens, Human Platelet* ; Blood Donors ; Blood Platelets* ; DNA ; Flow Cytometry* ; Genotype ; Humans ; Mass Screening ; Membranes ; Phenotype ; Purpura ; Suspensions ; Thrombocytopenia, Neonatal Alloimmune ; Tissue Donors

An ABO discrepancy was encountered in a 29-year-old woman with a pregnancy of 36 weeks. The patient's red cell was typed as group O and her serum had only anti-A antibody. Absence of B antigen on patient's RBC was confirmed by adsorption-elution test, B substance was not demonstrated in the saliva and serum. B-transferase activity was not detected in the serum. Patient's serum Ig level was within normal range. The patient's father and son had normal O phenotype and no additional abnormalities were detected among the family members studied.
Adult ; Fathers ; Female ; Humans ; Phenotype ; Pregnancy ; Reference Values ; Saliva

Anhidrotic ectodermal dysplasia is a rare genetic disorder characterized by absence or diminished numbers of structures derived from the ectoderm, and it is reported to be inherited as an x-linked recessive trait. It is recognized clinically by anhidrosis, hypotrichosis, anodontia or reduced numbers of teeth with deformed shape and characteristic facial features. In addition, otolaryngological manifestations include atrophic rhinitis, sensorineural hearing loss, and conductive hearing loss and satyr ear, among others. Early diagnosis of anhidrotic ectodermal dysplasia can prevent fatal hyperpyrexia and appropriate genetic counseling can be followed to make a reasonable future plans for the pediatric patient. A 2-month-old infant was referred with symptoms of intermittent nasal obstruction and crust formation in both nasal cavities. The nasal endoscope demonstrated atrophic changes of nasal mucosa and radiologic study showed an unerupted conical shaped tooth. The diagnosis of anhidrotic ectodermal dysplasia was confirmed with the finger impression test that revealed deficiency of sweat pores. We report a case of anhidrotic ectodermal dysplasia with a review of the literature.
Anodontia ; Diagnosis ; Ear ; Early Diagnosis ; Ectoderm ; Ectodermal Dysplasia* ; Endoscopes ; Fingers ; Genetic Counseling ; Hearing Loss, Conductive ; Hearing Loss, Sensorineural ; Humans ; Hypohidrosis ; Hypotrichosis ; Infant ; Nasal Cavity ; Nasal Mucosa ; Nasal Obstruction ; Rhinitis, Atrophic* ; Sweat ; Tooth