BACKGROUND: The goal of this study is to assess the clinical utility of cardiac troponin T(cTnT) and creatine kinase MB(CK-MB) activity and to determine optimum decision thresholds by using receiver operating characteristic(ROC) curve for cTnT and CK-MB. METHOD: We evaluated serum cTnT(Elecsys 2010, Boeringer Manheim, Germany) and CK-MB activity(XRC, Johnson & Johnson Clinical Diagnostics, USA) in 15 cases(124 samples) of acute myocardial infarction(AMI) and 64 cases(98 samples) of non-AMI patients from April 1998 to October 1998. RESULTS: CK-MB activity [cut-off value 16 U/L, relative index(CK-MB 100/total CK) 4-25%)] and cTnT(cut-off value 0.1 ng/mL) were detected in serum within 3 hours after onset of chest pain and cTnT was persistent to longer times than CK-MB activity. Sensitivity of cTnT(69.6%) is not statistically different from CK-MB activity(72.9%) within 24 hours of chest pain but more sensitive after 24 hours of symptom. Specificity(87.9%) and negative predictive value(91.2%) of cTnT were superior to that of CK-MB activity within 24 hours of chest pain. ROC curve analysis demonstrated the following decision cutoff, sensitivity, specificity: cTnT 0.13 ng/mL, 76.7%, 100%; CK-MB activity 14 U/L, 84.7% and 71.0%. CONCLUSION: Measurement of cTnT was useful for late admitted AMI and together with CK-MB could improve the detection of myocardial infarction.
Chest Pain ; Creatine Kinase ; Humans ; Myocardial Infarction* ; ROC Curve ; Sensitivity and Specificity ; Troponin T* ; Troponin*

The ICU at Severance Hopital was opened with 7 beds on October 18, 1968 and expanded to 19 beds on February 2, 1981. From 1970-977, We statistically analyzed 3,072 ICU patients. During the period of years from March 1975 to February 1982, We have analyzed clinically 4,348 ICU patients. The Results were as Follows: 1) During the 7 years the total number of patients was 4,383. ln 1981, 1063 patients were admitted to the ICU: this number being almost twice that of in 1980. 2) During the 7 years, the overall mortality was 15.1%, highest in 1976(30.1%) and lowest in 1979(11.5%). It has decreased annually, 12.4% in 1980, 12.3% in 1981. 3) Total admission days in ICU were 18,148 days, the average patient stay in ICU being 4.17 days. The majority of the patients(81.2%) stayed in ICU less than 5 days. The number of patients staying in ICU more than 6 days increased every year from 14.2% in 1975 to 22% in 1981. 4) About 50% of the patients admitted were under the forties-age group. The number under the teens old group was 19%, this group representing the highest number of patients admitted to the ICU. The highest mortality(18.5%) occurred in the 1 to 10 yearold-age group. 5) The number of patients admitted to the department of internal medicine was 1,574 cases, which was the highest among all departments. The mortality rate was highest in the neurosurgery department(41.9%). In 1981, the number of ICU patients in cardiac surgery and pediatrics was increased three time compared with that of 1975. 6) All ICU patients have been divided into two categories, operative and non-operative cases. The operative cases were 2,150, non-operative cases 2,198 cases. Mortality rate was 10% in operative cases, 20% in non-operative cases. 7) Case expired from march 1981 to February 1982: The number of expired parients including those with a poor prognosis was 183 cases. The number of patients that expired under the 10-year-age group was the highest, 78 cases. The cases that expired in internal medicine and pediatrics were 63 and 58 cases respectively. The causes of death were due to damage of central nervous system, cardiovascular system, respiratory system in that order. From the above results, it can be concluded that in spite of an increase in patients, the mortality rate has decreased annually.
Adolescent ; Cardiovascular System ; Cause of Death ; Central Nervous System ; Humans ; Intensive Care Units* ; Critical Care* ; Internal Medicine ; Mortality ; Neurosurgery ; Pediatrics ; Prognosis ; Respiratory System ; Thoracic Surgery

BACKGROUND: Hyperhomocysteinemia is considered as a risk factor for coronary artery disease (CAD). In this study, we investigated the relationship between plasma homocysteine concentration and coronary artery disease. METHODS: We measured plasma homocysteine concentration by fluorescent polarization immunoas-say (IMx, Abbott) in 58 healthy controls (39-72 years) and in 37 patients (42-84 years) who were diagnosed with stable angina (11), unstable angina (14), acute myocardial infarction (8), old myocardial infarction (1) and silent myocardial ischemia (3). RESULTS: The risk of CAD was independently associated with old age, decreased HDL cholesterol and hyperhomocysteinemia (P >or=12.8 nmol/L) and adjusted odds ratios were 2.8, 3.4, and 6.0, respec-tively. The risk for CAD in the upper two homocysteine quartiles (P >or=10.8 nmol/L and 8.1- 10.7 nmol/L) was 11.1 (95% CI, 2.5- 49.4) times and 6.3 (95% CI, 1.4- 27.7) times higher than in the lowest quar-tile (<6.9 nmol/L) (P=0.002 and 0.014, respectively). The mean plasma homocysteine values (M +/- SD) were higher in CAD patients (11.8 +/- 7.4 nmol/L) than in the control group (8.0 +/- 2.4 mol/L) (P=0.0006). In the control group, the mean plasma homocysteine concentration in men was signifi-cantly igher than in women (9.1 vs. 7.2 mol/L, P=0.002). Age and logarithmically transformed plasma homocysteine levels exhibited significant positive correlation in controls (r=0.43, P=0.001), ut no significant correlation in CAD patients (r=-0.024, P=0.9). Plasma homocysteine levels were significantly higher in the elderly, male subjects and smokers in the univariate analysis. CONCLUSIONS: Hyperhomocysteinemia is one of the independent risk factors for CAD.
Aged ; Angina, Stable ; Angina, Unstable ; Cholesterol, HDL ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Male ; Myocardial Infarction ; Myocardial Ischemia ; Odds Ratio ; Plasma ; Risk Factors*

Maple syrup urine disease(MSUD) is an autosomal recessive disorder involving the metabolism of the branched-chain amino acids(BCAA) such as leucine, isoleucine and valine. The disorder is due to a defect in branched-chain alpha-ketoacid dehydrogenase(BCKAD) and the classic form causes rapid progressive and overwhelming illness beginning in the first weeks of life, present with poor feeding, lethargy, change in muscle tone, acidosis, seizures and coma. The goal of therapy in acutely ill patients with MSUD is an immediate reduction in the plasma levels of the BCAAs and branched-chain ketoacids. In this report, we describe an infant with MSUD who was treated by dietary therapy alone. During the therapy, acrodermatitis enteropathica-like syndrome developed with low plasma isoleucine concentration while she was receiving a formula deficient in BCAAs.
Acer* ; Acidosis ; Acrodermatitis* ; Amino Acids, Branched-Chain ; Coma ; Diet Therapy* ; Diet* ; Humans ; Infant ; Isoleucine ; Lethargy ; Leucine ; Maple Syrup Urine Disease* ; Metabolism ; Plasma ; Seizures ; Valine

PURPOSE: The purpose of this study was to explore gender-role identity and cyber delinquency in high school students. METHODS: Data were collected through self-administered questionnaires and analyzed by descriptive statistics, t-test, and ANOVA. The data survey was conducted with 1,208 conveniently selected high school students in Seoul, Gyung-gi and Chung-chung province. RESULTS: The cyber delinquency score was 38.94 and androgyny gender role identity was most common (34.0%). There were significant differences in cyber delinquency by academic year, gender, school record, economic status, educational background of parents, experiences of smoking, drinking, runaway, and gender-role identity. According to gender-role identity, the masculinity group showed highest cyber delinquency and the undifferentiated, androgyny, and femininity groups followed respectively. CONCLUSION: These findings are expected to make a contribution to creation of ideal interventions and to help discover early stage cyber delinquency in high school students as approached by gender role identity.
Adolescent ; Child ; Drinking ; Educational Status ; Femininity ; Gender Identity ; Homeless Youth ; Humans ; Juvenile Delinquency ; Masculinity ; Parents ; Surveys and Questionnaires ; Seoul ; Smoke ; Smoking

PURPOSE: The purpose of this study was to explore gender-role identity and cyber delinquency in high school students. METHODS: Data were collected through self-administered questionnaires and analyzed by descriptive statistics, t-test, and ANOVA. The data survey was conducted with 1,208 conveniently selected high school students in Seoul, Gyung-gi and Chung-chung province. RESULTS: The cyber delinquency score was 38.94 and androgyny gender role identity was most common (34.0%). There were significant differences in cyber delinquency by academic year, gender, school record, economic status, educational background of parents, experiences of smoking, drinking, runaway, and gender-role identity. According to gender-role identity, the masculinity group showed highest cyber delinquency and the undifferentiated, androgyny, and femininity groups followed respectively. CONCLUSION: These findings are expected to make a contribution to creation of ideal interventions and to help discover early stage cyber delinquency in high school students as approached by gender role identity.
Adolescent ; Child ; Drinking ; Educational Status ; Femininity ; Gender Identity ; Homeless Youth ; Humans ; Juvenile Delinquency ; Masculinity ; Parents ; Surveys and Questionnaires ; Seoul ; Smoke ; Smoking

BACKGROUND: There is a clinical need for a reference value based on healthy adults in Korea. The aim of this study was to define IGF-1 concentration in healthy Korean adults and to investigate the factors relative to IGF-1 level. METHODS: By reviewing the medical records of a hospital in Korea, healthy 112 men and 109 women aged over 40 years were studied. We determined the serum IGF-1 levels of both groups according to age, sex, health behaviors, lipid profile, bone mineral density, serum albumin, waist circumference, body mass index, total testosterone, and FSH. RESULTS: IGF-1 had no sexual difference in any age group (258.7+/-84.3 ng/mL for men, 263.7+/-86.8 ng/mL for women), but correlated negatively with age (r=-0.43 and -0.35 for men and women, respectively). The mean decline was 49.6 ng/mL and 43.9 ng/mL per 10 years for men and women, respectively. IGF-1 correlated positively with serum albumin, total cholesterol, and bone mineral density of spine and femur neck. The multiple regression analysis showed that the most powerful factors influencing IGF-1 level was serum albumin (R2; 0.13) followed by age, bone mineral density of femur neck, and total cholesterol. CONCLUSION: We present a reference value for IGF-1 in healthy Korean adults aged over 40 years. The most powerful factor influencing IGF-1 level was serum albumin.
Adult* ; Aging ; Body Mass Index ; Bone Density ; Cholesterol ; Female ; Femur Neck ; Growth Hormone ; Health Behavior ; Humans ; Insulin-Like Growth Factor I* ; Korea ; Male ; Medical Records ; Reference Values ; Serum Albumin ; Spine ; Testosterone ; Waist Circumference

BACKGROUND: Twenty four-hour GH secretion reaches a peak in puberty and declines by 14% every decade in adult life. By age 60, most adults have a total 24-hour secretion rate indistinguishable from those of hypopituitary patients with organic lesions in pituitary gland. We performed this study to know about the predictors of GH secretion after L-dopa stimulation test in adults. METHODS: One hundred and ninety eight patients over the age of 45, who visited the menopausal clinic from Oct. 2001 to May 2002, were studied. We compared the peak GH value after the administration of L-dopa 500 mg by gender and age groups. Also, we compared the GH deficiency group to normal by anthropometric and measured variables. RESULTS: The mean of the stimulated GH peak value and the prevalence rate of growth hormone deficiency were greater in women than in men. GH-AUC after L-dopa stimulation correlated well with all measurements of adiposity. In GH deficiency group, the mean values of measured variables about adiposity were greater than normal in statistical significance. Logistic regression test revealed sex and abdominal obesity contributed significantly to predict GH deficiency after L-dopa stimulation test. The odds ratio of GH deficiency were 3.0 in women compared to men with 2.9 in abdominal obesity. CONCLUSION: Gender and adiposity were the predictors of GH deficiency in adults after L-dopa stimulation test rather than age and IGF-1 values.
Adiposity ; Adolescent ; Adult* ; Aging ; Female ; Growth Hormone* ; Humans ; Insulin-Like Growth Factor I ; Levodopa* ; Logistic Models ; Male ; Obesity, Abdominal ; Odds Ratio ; Pituitary Gland ; Prevalence ; Puberty

No abstract available.
Allografts*

PURPOSE: This study was undertaken to investigate X-ray mammographic findings which correlated with histopathologic classification of breast carcinomas. MATERIALS AND METHODS: In 114 cases (113 patients) weeviewed X-ray mammographic findings of breast carcinoma and their histopathologic classification, and the findings were analysed to define mass, calcification, and spiculation. RESULTS: According to histopathologic classifications of breast carcinomas, infiltrating ductal carcinoma was the most common(78.9%). X-rays mammographyrevealed that irregular mass was found in 43.9% of cases, calcification in 47.4 %, and radiating spiculation in75.4%. Mass with spiculation accounted for 41.2%, and mass with calcification and spiculation for 34.2%. A commonfinding of ductal carcinoma in situ was an ill-defined mass with malignant clustered microcalcification. Infiltrating ductal and infiltrating lobular carcinomas showed irregular masses with spiculation and colloid or medullary carcinomas had well-defined masses. CONCLUSION: Mass with spiculation, and mass with calcification and spiculation were common findings of breast carcinoma. The differences in X-ray mammographic findings among each different histopathologic type of breast carcinoma are helpful for differential diagnosis.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Lobular ; Classification* ; Colloids ; Diagnosis, Differential