No abstract available.
Carcinoma, Squamous Cell* ; Female ; Ovary* ; Teratoma*

We aimed to compare the immune response induced by natural infection with 2009 pandemic influenza A/H1N1 (pH1N1) virus and by monovalent pH1N1 vaccination in children and adolescents. This cross-sectional clinical study was conducted at 3 hospitals in Korea from February to May 2010. A total of 266 healthy subjects aged from 6 months to 18 yr were tested for the presence of the antibody against pH1N1 using hemagglutination inhibition (HI) test. Information about pH1N1 vaccination and laboratory-confirmed pH1N1 infection history was obtained. The overall rate of HI titers of > or = 1:40 against pH1N1 was 38.7%, and the geometric mean titer (GMT) was 20.5. Immunogenicity of pH1N1 vaccination only was reflected by a 41.1% of seroprotection rate and a GMT of 22.5. Immunogenicity of natural infection only was reflected by a 61.0% of seroprotection rate and a GMT of 40.0. GMT was significantly higher in the subjects of natural infection group than in the subjects of pH1N1 vaccination group (P < 0.001). The immune responses induced by natural pH1N1 infection exceed those induced by pH1N1 vaccinations.
Adolescent ; Antibodies, Neutralizing/blood ; Antibody Formation ; Child ; Child, Preschool ; Cross-Sectional Studies ; Hemagglutination Inhibition Tests ; Humans ; Infant ; Influenza A Virus, H1N1 Subtype/*immunology/metabolism ; Influenza, Human/epidemiology/*immunology/prevention & control ; Pandemics ; Vaccination

No abstract available.
Bronchial Arteries* ; Hemoptysis*

PURPOSE: To correlate high-resolution CT (HRCT) findings with smoking history and pulmonary function test (PFT) in patients with idiopathic pulmonary fibrosis (IPF) with or without coexisting emphysema. MATERIALS AND METHODS: The study included 24 patients who had undergone HRCT and in whom IPF had been confirmed pathologically (n=7) and clinically (n=17). The patients included 19 men and 5 women aged between from 44 and 78 (mean 59) years. HRCT findings were reviewed by two radiologists and assessed for the presence and extent of emphysema (CT emphysema score ; CES) and honeycombing (CT honeycombing score ; CHS). CES and CHS were retrospectively correlated with smoking status and pulmonary function test. RESULTS: Evidence of emphysema was seen on HRCT in 20 of 24 patients with IPF (83 %). CES was 14.3 and CHS was 18.1 in smokers with IPF, as compared with 1.8 and 6.7 in nonsmokers (p < 0.01). Pulmonary function tests showed lower percent predicted FEV1 (69.3 %), FVC (64.7 %), TLC(73.7 %), and RV (77.3 %), a lower percent predicted diffusing capacity of carbon monoxide (58.2%), and normal FEV1/FVC (99.1%). The pulmonary function test in smokers showed higher TLC and RV than in nonsmokers. Eight of nine patients whose CES was higher than their CHS, as seen on HRCT, were smokers and had a smoking history of 33.1 pack-years. Seven of 15 whose CHS was higher than their CES were smokers and had a smoking history of 16.8 pack-years. In patients with a higher CES than CHS pulmonary function test results showed normal TLC (85 %) and RV (100.7%) ; this contrasted with decreased TLC (72 %) and RV (68 %) in patients whose CHS was higher than their CES. CONCLUSION: Emphysema is a frequently associated finding in patients with IPF, as seen on HRCT, and emphysema is more frequent and extensive in smokers with IPF than non-smokers. HRCT is useful for detecting emphysema in patients with IPF, and the extent of emphysema on HRCT correlates with the results of the pulmonary function test and smoking status.
Carbon Monoxide ; Emphysema* ; Female ; Humans ; Idiopathic Pulmonary Fibrosis* ; Male ; Respiratory Function Tests ; Retrospective Studies ; Smoke ; Smoking

PURPOSE: We wanted to evaluate the effective methods that are appropriate for an endemic area of thyroid disease and to compare the differences of cytologic diagnostic rates with and without using a peculiar smear technique. MATERIALS AND METHODS: We analyzed the incidence rate of insufficient results, complications and the total procedure times of 1,126 thyroid nodules in 776 patients who underwent US-FNAB (ultrasonography-guided fine-needle aspiration biopsy) from January to December 2005. We compared the diagnostic rate between the two groups; the groups' tests were performed with a peculiar smear technique (Group A, n = 313) or with a conventional smear technique (Group B, n = 250). RESULTS: According to the size of the thyroid nodule, the incidence rate of an insufficient result on US-FNAB and the mean total procedure time for 1126 thyroid nodules in 776 patients were measured as 16.9% (52/308) and 208 seconds for nodules under 0.5 cm, 9.8% (30/306) and 160 seconds for nodules between 0.5 cm-1.0 cm, and 6.0% (30/504) and 134 seconds for nodules over 1.0 cm. These 776 patients showed no significant complications, except for mild pain. In Group A, the incidence rate of an insufficient result was calculated as 15.1% (14/93) for the group with nodules under 0.5 cm, 5.3% (5/95) for the group with nodules between 0.5 cm-1.0 cm, 4.8% (6/125) for the group with nodules over 1.0 cm, and 8.0% (25/313) for the total A Group. In Group B, the incidence rate of an insufficient result was measured as 33.3% (15/45) for the group with nodules under 0.5 cm, 28.1% (25/89) for the group with nodules between 0.5 cm-1.0 cm, 21.4% (24/112) for the group with nodules over 1.0 cm, and 25.7% (63/245) for the total B group. There was a statistically significant correlation between the rate of an insufficient result and the peculiar smear technique or the size of the thyroid nodule. CONCLUSION: We consider that US-FNAB is very simple, safe and accurate diagnostic method for thyroid nodules, and US-FNAB with a peculiar smear technique is able to increase the diagnostic rate for thyroid nodules.
Biopsy, Fine-Needle* ; Humans ; Incidence ; Thyroid Diseases ; Thyroid Gland* ; Thyroid Nodule*

Kartagener's syndrome is an inherited condition characterized by triad of chronic paranasal sinusitis, situs inversus, and bronchiectasis. Since 1976, Afzelius found a lack of dynein arm in immotile spermatozoa by electron microscopy, numerous recent studies have focused on the ultrastructural defect in the cilia and reported that the variety type of ultrastructural defect in immotile cilia syndrome. We report a female patient who had the Kartagener's triad with rare multiple ultrastructural defect of cilia in one patient. The electron microscopic examination showed partial dynein arm defect, loss of radial spoke, microtubular transposition, and giant cilia.
Arm ; Bronchiectasis ; Cilia ; Ciliary Motility Disorders ; Dyneins ; Female ; Humans ; Kartagener Syndrome* ; Microscopy, Electron ; Sinusitis ; Situs Inversus ; Spermatozoa

OBJECTIVES: To assess the prevalence of knee osteoarthritis through proper diagnosis in a rural community and to elucidate the relevant factors of this health problem in order to develop educational methods for the prevention of female knee osteoarthritis as well to provide basic data for prospective research. METHODS: Over a period of three months starting from August, 2000, 432 women over the age of 40 and living in a rural area were selected by a multistage cluster sampling method in order to investigate the prevalence of knee osteoarthritis and the related factors. The study utilized interviews and radiological examination. The criteria of knee osteoarthritis used was the American College of Rheumatology classification criteria for osteoarthritis of the knee(1995). RESULTS: The adjusted prevalence of knee osteoarthritis among the subjects was 55.0%, and multiple logistic regression analysis showed that the odds ratio(OR) of knee osteoarthritis among subjects 50-59 years of age and subjects older than 60 years of age as compared to subjects 40-49 years of age were 2.43(95% CI: 1.30-4.70) and 4.40(95% CI: 2.47-7.83), respectively. The OR of knee osteoarthritis among factory workers or farmers as compared to others was 1.79(95% CI: 1.03-3.12). The OR of knee osteoarthritis among subjects who had a family history and subjects who had knee injury or surgical history against those subjects had neither were 2.56(95% CI: 1.42-4.63) and 4.70(95% CI:1.45-15.19), respectively. The OR of knee osteoarthritis among smokers against non smokers was 0.47(95% CI: 0.22-0.97). CONCLUSIONS: Related factors of knee osteoarthritis included age, occupation, family history, smoking, knee injury and history of surgery. In order to prevent knee osteoarthritis in high risked rural woman, education concerning self-care methods and safety guideline must be provided at the work place by the public and private health sectors. Additionally, these women should be continually encouraged to exercise, including jogging and swimming regularly.
Classification ; Diagnosis ; Education ; Female ; Humans ; Jogging ; Knee Injuries ; Knee* ; Logistic Models ; Occupations ; Osteoarthritis ; Osteoarthritis, Knee* ; Prevalence* ; Rheumatology ; Rural Population ; Self Care ; Smoke ; Smoking ; Swimming ; Workplace

BACKGROUND: To the emergency physician, issuing a death certificate is becoming a burden as the DOAs(Deaths on Arrival) have increased in recent years. We analyzed the agreement on the causes of death issued by emergency physicians and attempted to find out whether emergency physicians complied with the guidelines for issuing death certificates. MATERIAL AND METHOD: A survey questionnaire containing twelve pre-selected DOA cases which were supplemented with relevant past medical history and physical examination was used. The cases, with varying causes of death, were chosen from the medical records of DOA patients who presented to the emergency department at Severance Hospital, Yonsei University College of Medicine, from January 1997 to December 2000. The questionnaires were sent to 60 emergency physicians(22 specialists and 38 residents) at 22 university-affiliated teaching hospitals and 2 general hospitals across the nation. They were asked to identify the most probable direct cause of death for each of the 12 cases. The same questionnaire was sent to medical examiners at the National Institute of Scientific Investigation and to a Korean emergency physician at Albert Einstein College of Medicine in New York, USA. We also included an open question about the optimal age for the use of 'senility' as a cause of death. RESULTS: All 60 emergency physicians responded to the survey. The average number of causes of death per case was 9.7(7~14). The range of concordance of causes of death was 23.3% to 66.6%. Out of a total of 720 causes of death given by the emergency physicians, 35(4.9%) failed to adhere to the death certification guidelines. Also, 210 causes of death were not listed in the Korean classification of standard causes of death. Interestingly, the medical examiner answered 'unknown etiology' and the emergency physician in the USA answered 'cardiopulmonary arrest' or 'respiratory arrest' in most cases. Regarding 'senility' as a cause of death, 22 physicians(36.7%) thought the optimal age was over 80 years. CONCLUSION: A significant lack of agreement exists in determining the cause of death for the DOA patients arriving at emergency departments. Therefore, an all-out effort is essential to find ways to improve and resolve this situation. As the death certificate is a legal document and a basis for vital statistics, emergency physician should seek a rational consensus to improve and resolve these inconsistencies.
Cause of Death* ; Certification ; Classification ; Consensus ; Coroners and Medical Examiners ; Death Certificates* ; Emergencies ; Emergency Service, Hospital ; Hospitals, General ; Hospitals, Teaching ; Humans ; Medical Records ; Physical Examination ; Surveys and Questionnaires ; Specialization ; Vital Statistics

No abstract available.
Pregnancy*

Purpose: We compared the changes in the perioperative peripheral lymphocyte subsets and the acute inflammatory reactants (CRP and SAA) to compare the immune responses between a Laparoscopy-assisted distal gastrectomy (LADG) and a conventional open distal gastrectomy (CODG). METHODS: 23 patients, who underwent an operation for early gastric cancer, between Nov. 2003 and Feb. 2004, were enrolled in this study. The total WBC, lymphocytes, peripheral lymphocyte subsets and acute inflammatory reactants (CRP and SAA) were evaluated on the preoperative day, and 2, and 24 hrs and on the 4th postoperative day in 20 of the 23 cases. RESULTS: There were no significant differences in the preoperative total WBC, lymphocyte, peripheral lymphocyte subsets, CRP and SAA between the two groups (P <0.05). The WBC levels were highest 2 hours after surgery, but had decreased at 24 hrs and on the 4th postoperative day in both groups. The numbers of lymphocyte subsets in both groups dropped at 2 hours, but increased gradually during the postoperative days (P >0.05). The postoperative CRP and SAA levels; however, gradually increased compared to the preoperative levels, and were significantly lower in the LADG than the CODG group (CRP: P=0.03 and SAA: P=0.01). Conclusion: No difference was detected in the immune-cell numbers in the gastric cancers between the LADG and CODG groups. The LADG was found to influence the acute inflammatory reaction less than the CODG.
Gastrectomy* ; Humans ; Lymphocyte Subsets ; Lymphocytes ; Stomach Neoplasms*