BACKGROUND: In this study on fibrinogen/fibrin degradation products (FDPs), we evaluated the performance of a quantitative immunoturbidimetric assay (ITA) using the new Nanopia P-FDP reagent kit (Sekisui Medical Co., Japan) in comparison with a semiquantitative latex agglutination assay (LA) currently performed using the FDP PLASMA kit (Diagnostica Stago SAS, France). METHODS: The quantitative Nanopia P-FDP method using the STA-R EVOLUTION automated coagulation analyzer (Diagnostica Stago SAS) was evaluated with respect to precision, linearity, carryover, and reference interval. The correlations were measured for each of the 145 samples by using the Nanopia P-FDP method and the semiquantitative FDP PLASMA method. RESULTS: The coefficients of variation with regard to precision in low and high control concentrations were 2.97% and 5.77%, respectively. The correlation coefficient of linearity (r) was 0.990 in the measurement range of 2.4-122.8 microg/mL. The level of carryover was 0.83%, while the reference interval range was 0.22-4.32 microg/mL. The results of FDP assay showed an acceptable accord in 115 samples (79%) among the 145 samples by both LA method and ITA method. Seventeen samples (12%) showed relatively lower FDP values in the LA method than those in the ITA method. Thirteen cases (9%) showed relatively higher FDP values in the LA method than those in the ITA method. CONCLUSIONS: The quantitative Nanopia P-FDP method showed good precision, linearity, carryover, reference interval, and an acceptable concordance rate with the semiquantitative FDP PLASMA method. Thus, the Nanopia P-FDP reagent using the STA-R EVOLUTION automated coagulation analyzer can replace the FDP PLASMA reagent for the quantitative analysis of FDPs.
Agglutination ; Blood Coagulation ; Formycins ; Latex ; Phenothiazines ; Plasma ; Ribonucleotides

The high prevalence of migraine. Raynaud's phenomenon, visual field defect and Crohn's disease in variant angina raises the possibility that a common underlying defect of mechanism may partially account for all conditions. These are generalized vascular smooth muscle hypercontractility syndromes. Recently high prevalence of esophageal motility disorders has been noted in patients with coronary artery spasm or microvascular angina, leading to the hypothesis of a generalized abnormality in smooth muscle function1,4,5). We expirienced a case of 55-year-old man with angiographically proven variant angina. Who showed reflux esophagitis, classic migraine and Raynaud's disease.
Coronary Vessels ; Crohn Disease ; Esophageal Motility Disorders ; Esophagitis, Peptic* ; Humans ; Microvascular Angina ; Middle Aged ; Migraine Disorders ; Migraine with Aura* ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Prevalence ; Raynaud Disease* ; Spasm ; Visual Fields

BACKGROUND: The application of gel test to routine immunohematologic works brought on easier interpretation of results and better quality control over conventional tube method. Under the current Korean medical insurance system however, it is very difficult to apply gel test to all routine immunohematologic works because of high cost. We tried to assess its applicability to irregular antibody screening. MATERIALS AND METHODS: Antibody screenings of 2,005 sera from transfusion-scheduled patients were carried out using DiaMedTM LISS/Coombs gel card. Antibody identifications of screen-positive or screen-negative but incompatible cross matched sera were done by conventional tube method firstly, and then by DiaMedTM LISS/Coombs gel test or DiaMedTM NaCl/Enzyme gel test in the cases of negative results for conventional tube method. RESLUTS: Total 34 irregular antibodies (8 warm and 26 cold antibodies) were screened by gel test. For warm antibody screening, the reactivity of LISS/Coombs gel test was much higher than that of conventional tube method, and for cold antibodies, tube method or NaCl/Enzyme gel test revealed better reactivity. CONCLUSION: Antibody screening by LISS/Coombs gel test alone appears to be enough for detecting clinically significant warm antibodies.
Antibodies ; Humans ; Insurance ; Mass Screening* ; Quality Control

A 56-year old female underwent total aortic arch replacement March 1995, because of an expanding chronic Debakey type I aortic dissection. This aortic dissection had an intimal tear at the origin of the right carotid artery. Retrograde and antegrade propagation of dissection resulted in aortic arch blood flow separation and expanding pseudolumen to the abdominal aorta. Sudden anuria (ARF) developed 3 hours later postoperatively and renal doppler ultrasonography and aortography showed diminished blood flow of renal arteries. We performed balloon aortic dilatation but failed. She could be restored good renal flow after intimal flap fenestration resection and thrombectomy of the abdominal aorta. This patient could be discharged in a state of mild CRF after 2 months of ICU care for respiratory and renal failure.
Acute Kidney Injury* ; Anuria ; Aorta, Abdominal ; Aorta, Thoracic* ; Aortography ; Carotid Arteries ; Dilatation ; Female ; Humans ; Middle Aged ; Renal Artery ; Renal Insufficiency ; Thrombectomy ; Ultrasonography, Doppler

From May 1, 1993 to May 31 1995, the authers studied retrospectively 211 patients who underwent cardiovascular operation with cardiopulmonary bypass (CPB). Because we were interested in new development of ARF (prevalence, mortality rate, and main risk factors), we performed a multivariate statistical analysis about data of patients with preoperative serum creatinine values of less than 1.5 mg/dL. Normal renal function before operation (serum creatinine level less than 1.5 mg/dL) was registered in 198 (74%) patients. Of these, 27 (14%) patients showed postoperative renal complication, including 20 (10%) patients classified as renal dysfunction (serum creatinine level between 1.5 and 2.5 mg/dL) and 7 (4%) patients as acute renal failure (serum creatinine level higher than 2.5 mg/dL). The mortality rate was 5.8% in normal patients, 5% in patients with renal dysfunction, and 43% when acute renal failure developed (p=0.036). Indeed, the renal impairment proved to be an independent predictor of mortality (odd ratio 2.52~11.25), along with cardiovascular (odd ratio 4.20) and respiratory (odd ratio 2.18) complications. Multivariate analysis identified the following variables as independent risk factors for postoperative renal impairment : advanced age (odd ratio 1), need for emergency operation (odd ratio 3.78), low-output syndrome (odd ratio 3.66), respiratory complication (odd ratio 1.30), need for deep hypothermic circulatory arrest (odd ratio 1.4). The 13 patients (7%) with preoperative renal failure showed a significantly higher morbidity and mortality rate than those without renal complications before operation. We concluded that the likelihood of severe renal complications is resonably low in the patients undergoing cardiac operation without preexisting renal dysfunction, but associated mortality remains high. A prominant role of hemodynamic factor in the development of postoperative acute renal failure must be recognized during preoperative, intraoperative, and postoperative periods.
Acute Kidney Injury* ; Cardiopulmonary Bypass ; Circulatory Arrest, Deep Hypothermia Induced ; Creatinine ; Emergencies ; Hemodynamics ; Humans ; Mortality ; Multivariate Analysis ; Postoperative Period ; Renal Insufficiency ; Retrospective Studies ; Risk Factors

BACKGROUND: Anatomic correction of transposition of the great arteries by means of the arterial switch operation is now accepted as the therapeutic method of choice. This retrospective study attempts to assess the results of the neonatal arterial switch operation for transposition of the great arteries performed by our newly established institution. MATERIALS AND METHODS: 33 consecutive neonates underwent the arterial switch operation between October 1991 to November 1997. There were 27 neonates with transposition and intact ventricular septum, 3 with ventricular septal defect, and 3 with Taussig-Bing anomaly. The mean age was 10.9+/-7.9 days and mean body weight was 3.29+/-0.44kg. RESULTS: Overall postoperative hospital mortality was 30.3% (10 patients). The mortality has improved with time; 75% (6 patients) among first 8 consecutive patients before 1994, 20% (2 patients) among 10 patients in 1994 and 1995, and 13.3% (2 patients) among 15 patients since 1996. Univariated analysis of risk factors revealed that earlier date of the operations and one of preoperative events were determinants for operative death. There were two late deaths. A mean follow-up of 17.4+/-16.5 months was achieved in all 21 survivors. All were in New York Heart Association functional class I. One patient had mild pulmonary stenosis and two had mild aortic valve regurgitation on their echocardiography. CONCLUSIONS: We concluded that we should continue to perform arterial switch operation for neonates with transposition of the great arteries because the mortality of the operation has been improved and the operative survivors have good functional results with low incidence of late complications.
Aortic Valve ; Arteries ; Body Weight ; Double Outlet Right Ventricle ; Echocardiography ; Follow-Up Studies ; Heart ; Heart Septal Defects, Ventricular ; Hospital Mortality ; Humans ; Incidence ; Infant, Newborn* ; Mortality ; Pulmonary Valve Stenosis ; Retrospective Studies ; Risk Factors ; Survivors ; Transposition of Great Vessels ; Ventricular Septum

PURPOSE: Today, the social requirement of medicine emphasizes the importance of medical professionalism. This forces medical educators to introduce new contents and methods into the curriculum. This study aims to offer ideas for developing the curriculum through clarifying priorities on the basic qualities of medical professionalism and evaluating the current curriculums in medical schools in South Korea. METHODS: In April 2005, 46 respondents majoring in basic medical sciences, clinical medicine, and medical humanities/social sciences completed a structured questionnaire. The questionnaire consisted of 3 categories related to: 1) the basic qualities of medical professionalism/general education courses, 2) the process of developing the qualities of humanities and social sciences in medical education, and 3) the appropriate allocation of credits for each subject to premedical and medical courses. The analysis consisted of frequency, chi-square, and multiple responses using Korean Ed, SPSS 14.0 for Windows. RESULTS: The most important basic quality is basic medical knowledge. The credits for the general education are sufficient but it's contribution is lacking (44.44%). The most lacking element in the general education courses is socio-cultural comprehension (45.65%). The knowledge of humanities and social sciences is very important in developing the basic qualities (56.52%). The important learning experiences related to these is the introspection into human beings (32.16%). Credits for medical humanities classes in premedical and medical course are noticeably insufficient (45.65, 54.35%, respectively). The appropriate program of informal curriculum for fostering the qualities is meeting with various medical specialists (44.44%, 47.83%, respectively). There is almost no difference among the major groups under (p<.05.) CONCLUSION: To assist medical students to be equipped with the basic qualities of medical professionalism, the realm of medical humanities should be made mandatory; and the general education courses need to be reformed, especially in the premedical curriculum. In particular, continuous cooperation between faculties in medicine, liberal arts, and/or social sciences need to exist with the conglomeration of these into fewer medical humanities majors in Korea.
Clinical Medicine ; Comprehension ; Curriculum ; Surveys and Questionnaires ; Education, Medical ; Foster Home Care ; Humanities ; Humans ; Korea ; Learning ; Republic of Korea ; Schools, Medical ; Social Sciences ; Specialization ; Students, Medical

PURPOSE: To compare the mechanism of cell loss and changes in the ventral prostate of young adult Sprague-Dawley rats after treatment with finasteride, a potent 5 alpha-reductase inhibitor, or castration. MATERIALS AND METHODS: Rats were divided into two group: finasteride treated and castrated. Finasteride-treated rats were given 1 mg/kg a day orally. The rats were sacrificed on days 1, 3, 5, 7, 10, 14, and 21. The ventral prostate was weighed and either prepared for histologic examination to detect apoptotic evidence or frozen in liquid nitrogen for the determination of the intraprostatic dihydrotestosterone (DHT) concentration and DNA content. RESULTS: Both finasteride and castration decreased prostate weight and DNA content, the decrease being more pronounced in the castrated group. By 3 days of finasteride treatment, the intraprostatic DHT concentration decreased to a greater extent with no further significant change thereafter, whereas castration gradually decreased the intraprostatic DHT concentration up to day 10, with no further significant decrease thereafter. Apoptotic bodies were typically observed in castrated but not finasteride-treated animals. CONCLUSIONS: Castration caused a more profound involution of rat ventral prostate than did finasteride. The extent of prostatic involution did not correlate with the intraprostatic DHT concentration. We could not find evidence of apoptosis in finasteride-treated animals.
Animals ; Apoptosis ; Castration* ; Cholestenone 5 alpha-Reductase ; Dihydrotestosterone ; DNA ; Finasteride* ; Humans ; Nitrogen ; Prostate* ; Rats* ; Rats, Sprague-Dawley ; Young Adult

Behcet's disease (BD) is a chronic inflammatory disease, involving several organs. It is well known that there are the marked regional differences in the disease expression of BD. In case of the vascular involvement in BD, the frequency rate has been described in 25~30% among the patients from the MiddLe East, whereas it has been noted in 5~15% in our country. In general, BD associated with large vessel lesions is named vasculo-BD. On the other hand, the cardiac involvement in BD has rarely been reported in the literature. Ebstein anomaly is a kind of malformation that is characterized by a downward displacement of the tricuspid valve into the right ventricle. We reported a 54-year-old male patient with vasculo-BD who had inferior vena cava obstruction and Ebstein anomaly. The association of Ebstein anomaly with vasculo-BD is considered to be coincidental. To the best of our knowledge, this is the first case of Ebstein anomaly associated with BD.
Ebstein Anomaly* ; Hand ; Heart Ventricles ; Humans ; Male ; Middle Aged ; Middle East ; Tricuspid Valve ; Vena Cava, Inferior

PURPOSE: This study aimed to establish a large-scale database of patients with gastric cancer to facilitate the development of a national-cancer management system and a comprehensive cancer control policy. MATERIALS AND METHODS: An observational prospective cohort study on gastric cancer was initiated in 2010. A total of 14 cancer centers throughout the country and 152 researchers were involved in this study. Patient enrollment began in January 2011, and data regarding clinicopathological characteristics, life style-related factors, quality of life, as well as diet diaries were collected. RESULTS: In total, 4,963 patients were enrolled until December 2014, and approximately 5% of all Korean patients with gastric cancer annually were included. The mean age was 58.2±11.5 years, and 68.2% were men. The number of patients in each stage was as follows: 3,394 patients (68.4%) were in stage IA/B; 514 patients (10.4%), in stage IIA/B; 469 patients (9.5%), in stage IIIA/B/C; and 127 patients (2.6%), in stage IV. Surgical treatment was performed in 3,958 patients (79.8%), endoscopic resection was performed in 700 patients (14.1%), and 167 patients (3.4%) received palliative chemotherapy. The response rate for the questionnaire on the quality of life was 95%; however, diet diaries were only collected for 27% of patients. CONCLUSIONS: To provide comprehensive information on gastric cancer for patients, physicians, and government officials, a large-scale database of Korean patients with gastric cancer was established. Based on the findings of this cohort study, an effective cancer management system and national cancer control policy could be developed.
Cohort Studies* ; Diet ; Drug Therapy ; Humans ; Korea ; Male ; Occupational Groups ; Prospective Studies* ; Quality of Life ; Stomach Neoplasms*