No abstract available.
Humans ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy*

BACKGROUND: Before the introduction of the antinuclear antibody test (ANA), the lupus erythematosus (LE) cell test was a useful diagnostic test for systemic lupus erythematosus(SLE) But, the ANA test has replaced the LE cell test in virtually all laboratories as the current routine test for SLE. However, because the LE cell test is still performed in some laboratories, the authors compared the LE cell test with the ANA test to reevaluate the LE cell test. METHODS: A total of 522 cases were evaluated from Aug. 1990 to Aug. 1994. In these cases, the LE cell test and the ANA test were performed simultaneously, and the results were compared. The authors defined the 'True LE Phenomenon' as only when the LE cell test results agreed with the anti-histone antibody pattern of the ANA test. RESULTS: Of the total 522 cases, 56 cases(10.7%) were SLE. The LE cell test was positive in 22 cases(39.3%) and the ANA test in 56 cases(100%). The LE cell test produced 6(27%) false positive cases and 3 (8.8%) false negative cases. Therefore, the sensitivity of the LE cell test that was verified by the ANA test was only 28.6%. On the other hand, the sensitivity of the ANA test was 100%. In 2 cases, the LE cell results were different in repetitive tests although the ANA results were the same. In 2 other cases, it was impossible to interprete the results of the LE cell test because of severe leukopenia. CONCLUSIONS: The authors concluded that the LE cell test showed markedly low sensitivity and a high false positive and false negative rates for SLE, and that the LE cell test was difficult to perform and interpret accurately due to numerous interfering factors. Therefore, for accurate diagnosis of SLE, the LE cell test must be replaced by more definitive and quantitative immunologic tests in all laboratories such as the ANA test.
Antibodies, Antinuclear ; Diagnosis ; Diagnostic Tests, Routine ; Hand ; Immunologic Tests ; Leukopenia ; Neutrophils*

BACKGROUND: Before the introduction of the antinuclear antibody test (ANA), the lupus erythematosus (LE) cell test was a useful diagnostic test for systemic lupus erythematosus(SLE) But, the ANA test has replaced the LE cell test in virtually all laboratories as the current routine test for SLE. However, because the LE cell test is still performed in some laboratories, the authors compared the LE cell test with the ANA test to reevaluate the LE cell test. METHODS: A total of 522 cases were evaluated from Aug. 1990 to Aug. 1994. In these cases, the LE cell test and the ANA test were performed simultaneously, and the results were compared. The authors defined the 'True LE Phenomenon' as only when the LE cell test results agreed with the anti-histone antibody pattern of the ANA test. RESULTS: Of the total 522 cases, 56 cases(10.7%) were SLE. The LE cell test was positive in 22 cases(39.3%) and the ANA test in 56 cases(100%). The LE cell test produced 6(27%) false positive cases and 3 (8.8%) false negative cases. Therefore, the sensitivity of the LE cell test that was verified by the ANA test was only 28.6%. On the other hand, the sensitivity of the ANA test was 100%. In 2 cases, the LE cell results were different in repetitive tests although the ANA results were the same. In 2 other cases, it was impossible to interprete the results of the LE cell test because of severe leukopenia. CONCLUSIONS: The authors concluded that the LE cell test showed markedly low sensitivity and a high false positive and false negative rates for SLE, and that the LE cell test was difficult to perform and interpret accurately due to numerous interfering factors. Therefore, for accurate diagnosis of SLE, the LE cell test must be replaced by more definitive and quantitative immunologic tests in all laboratories such as the ANA test.
Antibodies, Antinuclear ; Diagnosis ; Diagnostic Tests, Routine ; Hand ; Immunologic Tests ; Leukopenia ; Neutrophils*

No abstract available.
Catheters*

Dermatitis herpetiformis is a chronic, intensely itchy, papulovesicular skin disorder of unknown cause, which is usually symmetrically distributed on extensor surface. Most patients have an associated gluten-sensitive enteropathy which is usually asymptornatic. We report six cases of dermatitis herpetiformis diagnosed by direct immunofluorescence studies. The patients have had characteristic features of dennatitis herpetiformis, such as vesicles, erythernatous papules, urticaria-like plaques, and hypopigmentation or hyperpigmentation, dispersed on the neck, back, and arms. None of the patients had subjective symptoms associated with gluten-sensitive enteropathy. Clinicians should be aware of the clinical features of this disease to avoid possible misdiagnosis, and to provide better therspeutic approaches in time.
Arm ; Celiac Disease ; Dermatitis Herpetiformis* ; Dermatitis* ; Diagnostic Errors ; Fluorescent Antibody Technique, Direct ; Humans ; Hyperpigmentation ; Hypopigmentation ; Neck ; Skin

OBJECTIVES: This study aimed to examine the point prevalence of anxiety, depression and the associated risk factors in hospitalized patients with cancer. METHODS: A total of 114 patients with cancer who admitted to the Cancer Center in St. Mary's Hospital were enrolled for a day. The patients were asked to complete Hospital Anxiety and Depression Scale(HADS). Sociodemographic and cancer related clinical variables were also evaluated. RESULTS: The point prevalence of anxiety and depression was 10.5% and 34.2%, respectively, as assessed with HADS. Logistic regression models revealed that distant metastasis was significantly associated with anxiety in patients with cancer and previous chemotherapy and Low socioeconomic status were significantly associated with depression. CONCLUSIONS: Our results indicate that more than one third of patients with cancer suffer from either anxiety or depression. In addition, previous chemotherapy as well as low socioeconomic status and distant metastasis were associated risk factors of anxiety and depression, respectively. These findings suggest the need for screening and systematized psychosocial intervention for psychological distress in hospitalized patients with cancer.
Anxiety* ; Depression* ; Drug Therapy ; Hospitals, General* ; Humans ; Inpatients* ; Logistic Models ; Mass Screening ; Neoplasm Metastasis ; Prevalence* ; Risk Factors ; Social Class

Until recently, the etiology of schizophrenia was generally attributed to abnormalities in dopaminergic neurotransmission. Specifically, an excess of dopaminergic activity in the mesolimbic system has been postulated to produce the positive symptoms, while decreased dopaminergic activity in the mesocortical system has been suggested to cause negative symptoms. Accordingly, we performed an association study of schizophrenia with TH gene. Three hundred and seventy four biologically unrelated schizophrenic patients meeting DSM-III-R criteria from Kangnam St. Mary's Hospital affiliated with Catholic university of Korea were recruited for our study. The 393 healthy controls were volunteers for DNA library of Kangnam St. Mary's Hospital without personal or family history of psychiatric and neurologic illness. DNA was extracted from peripheral mononuclear cells and polymorphic region was amplified by polymerase chain reaction. TH intron 1 VNTR polymorphism was typed by silver staining. The allele distributions of TH gene were not different between schizophrenics and controls. However, the frequency of allele A was significantly higher in positive group than that of negative group of schizophrenics. These findings suggest that poitive schizophrenia may be associated with allele A of TH gene.
Alleles ; DNA ; Gene Library ; Genetics ; Humans ; Introns* ; Korea ; Polymerase Chain Reaction ; Schizophrenia ; Silver Staining ; Synaptic Transmission ; Tyrosine 3-Monooxygenase* ; Tyrosine* ; Volunteers

We compared all frozen section examination of ovarian tumors during a 5 year period in our institute with permanent section diagnosis from paraffin sections. In this period, 604 ovarian tumors had frozen section examination. Final histologic diagnosis was divided into benign, low malignant potential and malignant. Sensitivity of frozen section diagnosis for malignant was 80 %, low malignant potential 73,1%, and benign 99.8%. Predictive value for malignancy was 98.5%, for low malignant potential 76.6%, and for benign disease 96.2%. Diagnostic problems occurred in huge tumors and low malignat potential mucinous tumors. Analysis of the 32 false negative(miss or under diagnosis) revealed that a sampling error was involved almostly. The cases of discrepancy between frozen section diagnosis and permanent section diagnosis, were 26/34 in mucinous tumors and 33/34 in huge size of tumors(more than 10cm). Although surgeons and pathologist are aware of the limitations of frozen section diagnosis of ovarian tumors, peroperative histologic examination can be worthwhile and prevent under or over treatment of ovarian malignancies.
Diagnosis* ; Frozen Sections* ; Mucins ; Paraffin ; Selection Bias

Four cases of newborn with tension pneumothorax induced by a conventional ventilator were admitted to our nursery from January 1. 1992 to June 30. 1992 and they were managed by high frequency ventilator (Infrasonic Infant Star Ventilator). In contrast, four cases of newborn with tension pneumothorax who were continuously on the conventional ventilator, were included as a control group. They were admitted to our nursery from July 1. 1991 to december 31. 1991 and they were managed by conventional ventilator with conservative treatment. 1) In the control group, who were continuously managed by the conventional ventilator after thoracostomy with water seal drainage, we changed ventilator setting appropriately in control group but they had poor arterial blood gas analysis. The arterial blood gas analysis within 24hr/within 72hr in control group were pH 7.192/7.195, Paco2 72.15/82.25, PaO2 78.92/83.875, HCO3-26.975/27.925 and conventional ventilator care did not show any definite benefit for improvement of arterial blood gas analysis and tension pneumothorax as well. 2) Two cases in control group expired on the 6th day of thoracostomy without any resolution of tension pneumothorax. 3) In contrast, four cases with tension pneumothorax managed by high frequency ventilator were improved. Tension pneumothorax and arterial blood gas analysis to normalize from 6hr of high frequency ventilation and four cases of tension pneumothorax were completely reabsorbed within 4days.
Blood Gas Analysis ; Drainage ; High-Frequency Ventilation* ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn ; Nurseries ; Pneumothorax* ; Thoracostomy ; Ventilators, Mechanical*

BACKGROUND: It has been known that arterial carbon dioxide tension is 4~5 mmHg higher than end-tidal carbon dioxide tension in healthy adults during general anesthesia. But negative arterial to end-tidal PCO2 difference was reported in pregnant patients undergoing cesarean section. The purpose of this study was to elucidate the difference between arterial and end-tidal PCO2 in anesthetized patients with reduced functional residual capacity. METHODS: 90 patients were divided into 3 groups i.e. control group (n=30), obese group (n=20, body weight more than 20% greater than ideal weight), pregnant group (n=40). All patients had no cardiac or respiratory abnormalities and never smoked. Arterial blood gas analysis and measurement of end-tidal PCO2 were done 20 minutes after induction of anesthesia in control and obese group and just before uterine incision and 20 minutes after fetal delivery in pregnant group. RESULTS: There were significant correlations between arterial and end-tidal PCO2 in all groups. The incidences of negative arterial to end-tidal PCO2 difference were 10% in control group, 40% in obese group, 42.5% in pregnant group (p<0.05). CONCLUSION: From this study, it is concluded that patients with reduced functional residual capacity have more incidences of negativity than normal patients in the values of arterial to end-tidal PCO2 difference during general anesthesia. So when the tight control of PaCO2 is required in patients with reduced FRC, we recommend to measure PaCO2 for better anesthetic management.
Adult ; Anesthesia ; Anesthesia, General ; Blood Gas Analysis ; Body Weight ; Carbon Dioxide* ; Carbon* ; Cesarean Section ; Female ; Functional Residual Capacity* ; Humans ; Incidence ; Pregnancy ; Smoke