BACKGROUND : DHEAS, the major circulating adrenal hormone, has been suggested to have a role in many aging related diseases and perhaps in aging itself. But, there is no epidemiologic data of DHEAS in normal adults in Korea. We studied age changes and sex differences in serum DHEAS & its related factors throughout adulthood. METHODS : We administ structured questionnaires to the study subjects. We measured serum DHEAS levels and several biochemical markers (total cholesterol, triglyceride, HDL-cholesterol, glucose etc) in 1.710 healthy men(857) and women (853), aged 17-76 years. We also measured their height, weight, waist & hip circumference and body fat contents with bioimpedance method. We analyzed various variables relating to serum DHEAS levels by using SPSS. Reference data of serum DHEAS level in normal adults were also suggested. RESULTS : The DHEAS concentration peaked at age group blow age of 30 years in man(260.9 microgram/dL). Then mean values declined steadily in both sexes (r=-0.38, p<0.001 in men and r=-0.46, p<0.001 in women). At age group above 70 years, only 30.9% in men & 30.4% in women, when compared with age group below 30 years, was remained. DHEAS concentration were significantly higher in men than women at all age group except age group above 70 years. Average 1.5 times higher concentration in men than in women (at least 1.28 times at age<30 and max 2.00 times at age 60-64). In men, DHEAS had higher mean value in smokers (218.1 vs 199.1 microgram/dL, p<0.05), drinkers (>or=2 times/week, 219.1 vs 185.3 microgram/dL, p<0.01), android type fat distribution group (waist/hip>0.85, 227.1 vs 197.4 microgram/dL) after adjusting age. DHEAS was positively correlated with body mass index (r=0.12, p<0.01). But in women, drinkers (154.3 vs 131.7 microgram/dL, p<0.05) and regular exercise group (146.1 vs 131.6 microgram/dL, p=0.05) had higher mean DHEAS value. There were no significant association between DHEAS and lipid profile (total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol) & fasting glucose level in both sex. CONCLUSION : Our data suggest that DHEAS levels may influenced by several sociodemographic factors (e.g. smoking, alcohol, exercise etc) and body mass index. DHEAS level was inversely correlated by age in both sex and men had 1.5 times higher DHEAS values than women. We could not find any association between DHEAS level and lipid profile & fasting blood sugar.
Adipose Tissue ; Adult ; Aging ; Biomarkers ; Blood Glucose ; Body Mass Index ; Cholesterol ; Dehydroepiandrosterone Sulfate* ; Dehydroepiandrosterone* ; Fasting ; Female ; Glucose ; Hip ; Humans ; Korea ; Male ; Surveys and Questionnaires ; Sex Characteristics* ; Smoke ; Smoking ; Triglycerides ; Waist-Hip Ratio

No abstract available.
Biometry* ; Rheology* ; Umbilical Arteries*

Choriocarcinoma is a relatively rare malignancy of which characteristic is rapid metastasis to the other organs. It is related to the previous gestation or originated from the teratoma. Choriocarcinoma is mostly originated from the intrauterine chorionic villi, but it is rarely originated from the utreine cervix, fallopian tube, ovary, vagina and pelvic cavity. Primary choriocarcinoma of the fallopian tube is exceedingly rare and it is originated from ectopic tubal pregnancy, tubal migration from the intrauterine pregnancy or intratubal teratoma. 9 Symptoms and signs of the choriocarcinoma originated from the ectopic pregnancy are abdominal pain, vaginal bleeding, palpable adnexal mass, positive pregnancy test and amenorrhea. Thus it is difficult to distinguish choriocarcinoma from ectopic pregnancy on the basis of symptoms before the microscopic diagnosis presented.20 Effective treatment of choriocarcinoma is chemotherapy. Additional operation is possible. B-HCG is a useful measure for the follow up. We experienced a 36-year-old multigravida Korean woman who was diagnosed as the rupture of ectopic pregnancy after left salpingectomy in our hospital and then confirmed primary choriocarcinoma of the fallopian tube without metastasis on microscopic finding. Postoperative chemotherapy was performed with methotrexate. The follow up of disease is still on going at two month intervals and she has remained healthy, We report this case with review of literatures.
Abdominal Pain ; Adult ; Amenorrhea ; Cervix Uteri ; Choriocarcinoma* ; Chorionic Villi ; Diagnosis ; Drug Therapy ; Fallopian Tubes* ; Female ; Follow-Up Studies ; Humans ; Methotrexate ; Neoplasm Metastasis ; Ovary ; Pregnancy ; Pregnancy Tests ; Pregnancy, Ectopic ; Pregnancy, Tubal ; Rupture ; Salpingectomy ; Teratoma ; Uterine Hemorrhage ; Vagina

The purpose of this study was to explore the difference in nutrient intakes between normocholesterolemia and hypercholesterolemia. The subjects were classified as normocholesterolemia and hypercholesterolemia based on The Guideline for Korean Hyperlipidemia. A semiquantitative food frequency questionnaire was used to measure the dietary intakes of the subjects. The results obtained are summarized as follows. Intakes of nutrients such as energy, carbohydrate, protein, fat, minerals, and antioxidant vitamins were not significantly different between the normocholesterolemia group and hypercholesterolemia group. However, antioxidant vitamins and folate intakes in the hypercholesterolemia group tended to be lower than those in the normocholesterolmia group. Intakes of vitamin A, vitamin E, and Ca in normocholesterolemia was much less than the RDA for those nutrients in normocholesterolemia. Cholesterol intake in the hypercholesterolemia group was significantly higher than that in the normochoesterolemia group. However, mean cholesterol intake(240 mg/day) of the hypercholesterolemia group was much less than that of Americans whose cholesterol intake was 400 - 500 me/day. Fatty acid intakes were not significantly different between normocholesterolemia and hypercholesterolemia groups but the hypercholesterolemia group tended to consume omega3 fatty acids less than the normocholesterolemia group. Out data indicate that cholesterol intake is man important determinant of serum cholesterol levels in postmenopausal women. The results of this study provide information that is important in designing appropriate dietary guidelines for hypercholesterolemia in postmenopausal women.
Cholesterol ; Fatty Acids ; Female ; Folic Acid ; Humans ; Hypercholesterolemia* ; Hyperlipidemias ; Minerals ; Nutrition Policy ; Vitamin A ; Vitamin E ; Vitamins ; Surveys and Questionnaires

The purpose of this study was to explore the difference in nutrient intakes between normocholesterolemia and hypercholesterolemia. The subjects were classified as normocholesterolemia and hypercholesterolemia based on The Guideline for Korean Hyperlipidemia. A semiquantitative food frequency questionnaire was used to measure the dietary intakes of the subjects. The results obtained are summarized as follows. Intakes of nutrients such as energy, carbohydrate, protein, fat, minerals, and antioxidant vitamins were not significantly different between the normocholesterolemia group and hypercholesterolemia group. However, antioxidant vitamins and folate intakes in the hypercholesterolemia group tended to be lower than those in the normocholesterolmia group. Intakes of vitamin A, vitamin E, and Ca in normocholesterolemia was much less than the RDA for those nutrients in normocholesterolemia. Cholesterol intake in the hypercholesterolemia group was significantly higher than that in the normochoesterolemia group. However, mean cholesterol intake(240 mg/day) of the hypercholesterolemia group was much less than that of Americans whose cholesterol intake was 400 - 500 me/day. Fatty acid intakes were not significantly different between normocholesterolemia and hypercholesterolemia groups but the hypercholesterolemia group tended to consume omega3 fatty acids less than the normocholesterolemia group. Out data indicate that cholesterol intake is man important determinant of serum cholesterol levels in postmenopausal women. The results of this study provide information that is important in designing appropriate dietary guidelines for hypercholesterolemia in postmenopausal women.
Cholesterol ; Fatty Acids ; Female ; Folic Acid ; Humans ; Hypercholesterolemia* ; Hyperlipidemias ; Minerals ; Nutrition Policy ; Vitamin A ; Vitamin E ; Vitamins ; Surveys and Questionnaires

Neurofibromatosis also referred to as von Recklinghausen`s disease, is an autosomal dominant disease, which is characterized by cutaneous neurofibromas, cafe-au-lait spot, and axillary freckles. Although neruofibromatosis is a congenital disorder, the pulmonary manifestation become evident in adulthood. Approximately 15percent of patients with cutaneous lesions have intrathoracic neurofibromas. In some patients with neurofibromatosis, the lungs are the seat of interstitial fibrosis, leiomyoma, and bullous lesion, meningocele or less commonly lung cancer. The association of neurofibromatosis and lung cancer is rare, A 47-year-old man, who was a heavy smoker, was admitted to our hospital because of hemoptysis. Since cafe-au-lait sopts, diffuse pigmentation and multiple neurofibromatosis were observed on the skin, he was considered to have von Recklinghausen`s disease. Chest X-ray film showd extensive hazy density affecting all of his lung field, and minimal peribronchial infiltratin in his left lower lung field. Chest CT showed that near total consolidative lesions were present of right middle lobe. Also, some patchy infiltration were present in his right lower lobe and some of left lower lobe. Histoathological examination of the percutaneous lung biopsy specimen demonstrated that he had undifferentiated large cell carcinoma. The Authors have experienced a case of neurofibromatosis combined with undifferntiated large cell carcinoma. A brief review of related literature was conducted.
Biopsy ; Blister ; Cafe-au-Lait Spots ; Carcinoma, Large Cell* ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Fibrosis ; Hemoptysis ; Humans ; Leiomyoma ; Lung Neoplasms ; Lung* ; Melanosis ; Meningocele ; Middle Aged ; Neurofibroma ; Neurofibromatoses* ; Pigmentation ; Skin ; Thorax ; Tomography, X-Ray Computed ; X-Ray Film

BACKGROUND: It was reported that Helicobacter pylori causes duodenal ulcer and chronic active gastritis, but is still controversial on the relationship with gastric cancer. H. pylori is still clinically significant despite improvements in microbiologic, pathologic and therapeutic aspects. The purpose of this study is to evaluate the prevalance of H. pylori infection according to age and sex, the risk factors of H. pylori infection and the relationship with upper gastrointestinal symptoms. METHODS: The subjects were 409 people who underwent esophagogastroscopy and CLO test from Feb. to Jun. in 1997 at Health Promotion Center, Pundang CHA General Hospital. Six types of upper gastrointestinal symptoms and demographic characterastics were surveged by questionnaire. The relationship with H. pylori infection according to age, sex, education, smoking,alcohol, coffee, stress and exercise was evaluated. And, the frequencies of H. pylori according to the presence of symptoms and the six different symptoms(indigestion, frequent belching, dyspepsia, nausea/vomiting, distension, anorexia) were anallyzed by Chi-square test. RESULTS: CLO test was positive for 264(64.5%) in total, 156(65.3%) in females. not different significantly in each group. The frequency of CLO test positive was 53.5%(under 30 years old), 64%(thirties), 67.9%(fifties), 48%(over 60years old). H. pylori infection increased slightly as age increased, but deacreased in over sixties. The frequency of H. pylori infection according to sex, education, smoking, alchol, coffee, stress, and exercise was not different significantly. 174(60.2%) of 284 symptomatic subjects(who had more than one symptom) was positive by CLO test and 93(74.4%) of 125 asymptomatic subjects was positive. The frequency of H. pylori infection according to six symptoms was not different significantly. The sensitivity, specificity, false negative rate, false positive rate, positive predictive value and negative predictive value of CLO test to pathologic report were 77.4%, 81.3%, 22.6%, 18.7%, 93.2%, 52% respectively. CONCLUSIONS: The prevalence of H. pylori infection was 64.5% and showed no difference by sex. H. pylori infection infection increased slightly as age increased. Education, smoking, alcohol, coffee, stress, exercise were not considered as risk factors. The relationship of upper gastrointestinal symptoms and H. pylori infection infection was not significant biostatiscally.
Coffee ; Duodenal Ulcer ; Dyspepsia ; Education ; Eructation ; Female ; Gastritis ; Health Promotion ; Helicobacter pylori* ; Helicobacter* ; Hospitals, General ; Humans ; Prevalence* ; Risk Factors* ; Sensitivity and Specificity ; Smoke ; Smoking ; Stomach Neoplasms ; Surveys and Questionnaires

We investigated the adenoviral etiology and seasonal epidemic trends in intussusception and each adenoviral subgroup. Also we confirmed whether we can use the adenovirus data of Acute Infectious Agents Laboratory Surveillance Report (AIALSR) as an epidemic predictor of intussusception. Patients with intussusception (n = 126), < 5 years old, were enrolled and matched by age and sex with controls suffering acute gastroenteritis without intussusception (n = 106), all recruited at 8 centers. All fecal specimens were assayed for adenovirus, including subgroups A, B, C, E, and F, with reverse transcriptase-polymerase chain reaction (RT-PCR). Adenovirus was detected in 53 cases and 13 controls (P < 0.001). Nonenteric adenoviruses (NEAds) were detected in 51 cases and four controls (P < 0.001). We used Spearman's correlation analysis to analyze the incidence of intussusception and adenoviral epidemic trends, and compared them with fecal and respiratory adenoviral epidemic trends in the AIALSR. The trend of intussusception correlated with total NEAds (r = 0.635; P = 0.011), as did the fecal AIALSR adenovirus trends (r = 0.572; P = 0.026). Among the NEAd subgroups, subgroup C was dominant (P < 0.001), but subgroups B (P = 0.007) and E (P = 0.013) were also significant to intussusception. However, only subgroup C showed a significant epidemic correlation (r = 0.776; P = 0.001) with intussusception. Not respiratory but fecal AIALSR adenovirus trends correlated with the incidence of NEAds and intussusception. We suggest the possibility of using fecal AIALSR adenovirus data as an approximate epidemic predictor of intussusception.
Adenoviridae* ; Child ; Gastroenteritis ; Humans ; Incidence ; Intussusception* ; Korea* ; Seasons

Dapsone toxicity is evidenced by varying clinical pictures ranging from deep cyanosis in an otherwise alert normal appearing individual to restlessness, dyspnea, extensive hemolytic anemia, methemoglobinemia, sulfhemoglobinemia and serious central nervous system dysfunction. We experienced a case of acute massive dapsone intoxication in 34 years old man due to voluntary ingestion of 25g of this drug as a suicide attempt. A severe methemoglobinemia developed, accompanied by nausea, vomiting, intense cyanosis, headache, and dyspnea. Subsequently moderate hemolytic anemia observed. The patient recovered completely after intensive treatment with methylene blue, activated charcoal hemoperfusion, oral charcoal ingestion, steroid, and conservative treatment. Methylene blue was given by continuous intravenous infusion in order to avoid overdosage. We herein report a case of the acute hemolytic anemia and severe methemoglobinemia induced by massive dapsone intoxication with a review of the literature.
Adult ; Anemia, Hemolytic* ; Central Nervous System ; Charcoal ; Cyanosis ; Dapsone* ; Dyspnea ; Eating ; Headache ; Hemoperfusion ; Humans ; Infusions, Intravenous ; Methemoglobinemia* ; Methylene Blue ; Nausea ; Psychomotor Agitation ; Suicide ; Sulfhemoglobinemia ; Vomiting

PURPOSE: The purpose of this study is to assess the utility of PTBD spiral CT cholangiography, after infusion of contrast media through a PTBD tube, for evaluation of a biliary lesion after emergency PTBD due to severe jaundice. MATERIALS AND METHODS: Forty patients with emergency PTBD due to extrahepatic biliary obstruction were transferred to our clinic and prospectively studied. The causes of obstruction were 17 extrahepatic cholangiocarcinomas (including three Klatskin's tumors), seven pancreatic head carcinomas, six calculous diseases of the common bile duct, six periampullary lesions, two ampulla of Vater carcinomas, one gall bladder carcinoma with invasion of the common hepatic duct, and one cholangitis. Diagnosis was on the basis of pathologic, radiologic, and clinical findings. Pre-contrast CT scanning was performed. After the infusion of contrast media (iothalamate : normal saline=1:10) through a PTBD tube, spiral CT scans were obtained. After IV infusion of contrast media (Ultravist, 100cc), early- and delayed-phase spiral CT scans were obtained at 45 and 210 seconds, respectively, with an interscan interval of 5mm. 3-D CT cholangiograms were then reconstituted. Spiral CT without infusion of contrast media through a PTBD tube and PTBD spiral CT cholangiography were performed in 14 cases. The level of extrahepatic biliary obstruction was categorized as either upper, middle, or lower third. In 21 surgically confirmed cases, we evaluated the accuracy with which the level and cause of obstruction was determined; levels and causes during surgery and by as seen on PTBD cholaniography were compared. RESULTS: The levels of obstruction diagnosed on PTBD spiral CT cholangiography and on 3-D CT cholangiography corresponded in all cases to the levels during surgery and on PTBD cholangiography [upper third (n=7), middle third (n=12), lower third (n=21)], and the level diagnosed on spiral CT without infusion of contrast media through a PTBD tube corresponded to the level during surgery in ten of 14 cases. The cause of obstruction diagnosed on PTBD spiral CT cholangiography corresponded to pathologic findings in 19 of 21 cases. In 15 cases, 3-D CT cholangiography was diagnostically helpful. CONCLUSION: PTBD spiral CT cholangiography is a useful diagnostic method for determining the level and cause of biliary obstruction.
Ampulla of Vater ; Cholangiocarcinoma ; Cholangiography* ; Cholangitis ; Common Bile Duct ; Contrast Media ; Diagnosis ; Emergencies ; Head ; Hepatic Duct, Common ; Humans ; Jaundice ; Prospective Studies ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Urinary Bladder