BACKGROUND: Calcium status is more accurately determined by measuring free calcium, the tightly regulated biologically active form. The concentration of ionized calcium is strongly dependent on different preanalytic factors. In this study the influence of several methodological factors on the concentration of ionized calcium in blood is investigated. METHODS: Authors selected 127 persons of health care management center & comparatively healthy-look, out-patients of our hospital. When serum was needed, blood was anaerobically withdrawn in vacutainers, the serum was separated after standing at room temperature. For the plasma sample blood was anaerobically drawn into the tube with dry sodium heparin 143 IU/10ml blood in the same patient. And then, to avoid CO2 loss, the samples were left unopened and centrifuged anaerobically at 900g for 15 min; the serum and plasma were then pipetted as quickly as possible into 2ml plastic eppendorf-tube, which were completely filled and sealed off immediately and keeping it in refrigeration before testing. For the studies of calcium binding effect by different volume of sodium heparin. blood was collected into two type of tube, each containing 30IU heparin/whole blood ml or 125 IU/ml. Ioniged calcium were measured by ion-selective electrodes. RESULTS: 1. The reference value of ionized calcium in serum and plasma was 4.9+/- 0.19, 4.9+/-0.17 mg/ml(serum versus plasma, p>0.05) respectively. 2. The concentration change of ionized calcium according to heparin volume shows no significant difference until heparin 14.3 IU/blood 1 ml compared with serum. 3. The concentration of ionized calcium of serum and plasma was stable until 4 hours and 4 days after serum and plasma separation. CONCLUSIONS: Above shows that the concentration of ionized calcium have the same reference range on both serum and plasma. But each laboratory should have their own reference range according to heparin volume, ionized calcium in serum and plasma samples kept at -4degrees C remains stable within few days, provided the proposed conditions for storage.
Calcium* ; Delivery of Health Care ; Heparin ; Humans ; Ion-Selective Electrodes ; Outpatients ; Plasma ; Plastics ; Reference Values ; Refrigeration

No abstract available.
Hepatic Encephalopathy*

BACKGROUND: There are many reports showing the efficacy of polymerase chain reaction(PCR) for the diagnosis of Mycobacterium tuberculosis in sputum. but only few reports in extrapulmonary specimens. Because of the difficulty in establishing a diagnosis of tuberculosis in the extrapulmonary specimens there have been considerable interest in the development of a rapid sensitive diagnostic test that might be useful. Therefore we used PCR for detection of M. tuberculosis DNA in extrapulmonary specimens and compared the results of conventional acid-fast stain, culture methods and PCR assay. METHODS: Total of 63 clinical samples(10 cerebrospinal fluids, 12 pleural fluids, 1 pericardial fluid, 3 bone marrow aspirates, 1 ascitic fluid, 25 fine needle aspirates of lymph nodes, 7 urine, 1 stool and 3 tissue biopsies) in Ewha Womans University Tongdaemun hospital were analysed by the PCR. We performed the PCR using a species-specific M. tuberculosis DNA fragment(mtp 40 gene) as primers that was cloned and sequenced at recent and a 396-bp fragment was specifically amplified. We analyzed sensitivity and specificity of AFB culture and PCR for the diagnosis of extrapulomonary tuberculosis. RESULTS: The positivity of AFB smear, culture and PCR were 2(10%), 4(20%), 13(65%) out of total 20 cases diagnosed as clinically active extrapulmonary tuberculosis. respectively. All of 2 smear-positive samples and 2 of 4 culture-positive and smear-negative samples were PCR-positive. And 9 of 14 smear and culture negative specimens also gave detectable DNA products in PCR The specificity of PCR(95.4%) is compared with those of smear and culture(100.0%). CONCLUSIONS: This results suggest that the PCR assay is a sensitive and rapid diagnostic alternative to classical procedures for the diagnosis of extrapulmonary tuberculosis.
Ascitic Fluid ; Bone Marrow ; Cerebrospinal Fluid ; Clone Cells ; Diagnosis* ; Diagnostic Tests, Routine ; DNA ; Female ; Humans ; Lymph Nodes ; Mycobacterium tuberculosis ; Needles ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sputum ; Tuberculosis*

No abstract available.
Thyroid Dysgenesis*

Brodie's abscess is a primary subacute pyogenic osteomyelitis that has a thin wall of fibrous tissue and sclerotic bone. The authors have encountered a case of a Brodie's abscess that was developed in the same place of both tibia at the same time and treated the case with surgery and continuous closed irrigation.
Abscess ; Osteomyelitis ; Tibia

MEN type 1 is characterized primarily by the presence of functioning and nonfunctioning tumors or hyperplasia of the pituitary gland, parathyroid glands, and pancreatic islet cells. Pancreatic islet tumors in MEN type 1 produce different kinds of hormone which were pancreatic polypeptide, gastrin, glucagon, insulin and so on. To date, ten cases had been reported in Korea. We report another case with MEN type 1 having prolatin-secreating pituitary adenoma, parathyroid hyperplasia and insulinoma. A 36-year-old woman was admitted because of long-standing amenorrhea and recently diagnosed osteoporosis. Otherwise, she had been in good health except experiencing one episode of loss of consciousness after skipped meal. The blood chemistries were normal except hypercalcemia and hypophosphatemia. Hormonal studies revealed elevated levels of intact PTH and prolactin and decreased value of estradiol with low LH and FSH. The neck CT revealed 1 cm-sized nodule at posterior portion of right thyroid gland and 99mTc-sestamibi sintigraphy showed a increased uptake in left lower and right lower parathyroid glands. The sella MRI showed 0.7 cm-sized enhanced lesion in the left pituitary gland. The ratio of immunoreactive insulin to glucose was elevated and 3-4 pancreatic masses of variable size were identified by endoscopic ultrasonography and angiography. Subtotal parathyroidectomy and pyrolus-preserving pancreaticoduodenectomy with spleen-preserving distal pancreatectomy was done. Postoperative she had been doing well with normocalcemia and normoglycemia. Transsphenoidal adenonectomy was done 5 months later. Histologic examination of removed tissues revealed a single insulinoma, prathyroid hyperplasia and prolactin-secreating pituitary adenoma.
Adult ; Amenorrhea* ; Angiography ; Endosonography ; Estradiol ; Female ; Gastrins ; Glucagon ; Glucose ; Humans ; Hypercalcemia ; Hyperplasia ; Hypophosphatemia ; Insulin ; Insulinoma ; Islets of Langerhans ; Korea ; Magnetic Resonance Imaging ; Male ; Meals ; Multiple Endocrine Neoplasia Type 1* ; Multiple Endocrine Neoplasia* ; Neck ; Osteoporosis* ; Pancreatectomy ; Pancreatic Polypeptide ; Pancreaticoduodenectomy ; Parathyroid Glands ; Parathyroidectomy ; Pituitary Gland ; Pituitary Neoplasms ; Prolactin ; Technetium Tc 99m Sestamibi ; Thyroid Gland ; Unconsciousness

In order to appreciate the incidence of scabies, the authors conducted an observation of ll,848 cases of scabies in 152,254 outpatients at Chilgok Catholic Skin Clinic from January 1968 to December 1979 and the following results were obtained; The incidence of scabietic patients was 7.78% among total outpatients and the annual frequency increased progressively from 1972 (3.86%), showed maximal incidence in 1975(12. 35%), and thereafter decreased. In sexual distribution, males predominated over female 1.9: 1. In age distribution, 2nd and 3rd decades occupied 64 of total scabietic patients. The monthly distribution of total scabietic patients was highest in December (10.85%) and lowest in August (4.57%) but no seasonal variation was observed. Over half(54.9%) of 5,273 scabietic patients visited within 2 months after their infection. 1,031 cases(10.27%) of 10, 036 scabietic patients revealed the complications such as infection (5.04%), eczematization (3.37%) and nodule (1.86%).
Age Distribution ; Female ; Humans ; Incidence ; Male ; Outpatients ; Scabies* ; Seasons ; Skin

No abstract available.
Facial Asymmetry

Interest in the prevalence of patent foramen ovale(PFO) and its relation to embolic stroke has increased with the sophistication of methods for noninvasive cardiac assessment. The effect of foramen ovale closure on the risk for subsequent strokes is promised. A 22-year old woman was presented with sudden onset of cerebral infarct. She had a patent formen ovale, and right to left shunt during the Valsalva maneuver, which was diagnosed by transesophageal contrast echocardiography. Transcatheter closure of PFO was performed with Rashkind PDA umbrella under the guidance of transesophageal echocardiography. Transcatheter closure of PFO can be accomplised with little morbidity and may reduce the risk of embolic episode.
Echocardiography ; Echocardiography, Transesophageal* ; Female ; Foramen Ovale ; Foramen Ovale, Patent* ; Humans ; Prevalence ; Stroke* ; Valsalva Maneuver ; Young Adult

To establish predictors of prognosis and recurrence of hepatocellular carcinoma (HCC) after curative resection, retrospective analyses of clinical and pathologic factors were done in 85 hepatectomized patients of HCC. The median follow-up duration was 30.5(range: 3-134) months. Two postoperative mortalities and five palliative resections were excluded from analysis of recurrence. The overall 1, 3, 5 year survival rates in 85 patients were 78.6%, 63.6%, 45.6%. The 1, 3, 5 year survival rates in 78 curative resections were 81.8%, 70.2%, 50.3%. The 1, 2, 3 year survival rates of the palliative resections(5 cases) were 60%, 20%, 0%. The 1, 3, 5 year recurrence-free survival rates in the curative resections were 64.4%, 43.2%, 27.5%. Included prognostic variables were age, gender, viral hepatitis, cirrhosis, serum alpha-FP level, ICG-R15, diabetes, preoperativeTACE, tumor size, tumor capsulation, number of tumors, vascular invasion, tumor histologic grading, stage of the chronic hepatitis, and anatomic resection. The significant factors affecting recurrence were number of tumors and vascular invasion.
Carcinoma, Hepatocellular* ; Fibrosis ; Follow-Up Studies ; Hepatectomy ; Hepatitis ; Hepatitis, Chronic ; Humans ; Mortality ; Prognosis ; Recurrence* ; Retrospective Studies ; Survival Rate