A 52-year-old woman with esential mixed cryoglobulinemia (type II ), which was confirmed by cryoglobulin elcct,rophoresis and immunofixation elect,rophoresis, had purpuric skin lesions on the legs. The lesions had a tendency of recurrence for the past 2 years, and moderate degrees of arthralgia and myalgia were accompanied in each time. However, the patient had not been suffered from any internal organ distress caused by the disease proress. Histological examinations of a skin lesions revealed a feature of leukocytoclatic vasculitis, and deposits of IgM, IgG and C; were also recognized. A regimen of small doses of prednisolone was effective for the cutaneous lesions in this patient for 4 months follow-up until this writing. It, seems that the patient has had a mild form of the disease among the clinical spectrum of mixed cryoglobulinemia, with a cryocrit value of 2.4% at the time of her initial visit..
Arthralgia ; Cryoglobulinemia* ; Female ; Follow-Up Studies ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Leg ; Middle Aged ; Myalgia ; Prednisolone ; Recurrence ; Skin ; Vasculitis ; Writing

No abstract available.
Child* ; Humans

S100A6 (calcyclin) is a member of the S100 family and has been originally isolated from the cDNA library of Syrian baby hamster kidney cells. The S100A6 gene expression is reported to remain high throughout the cell cycle following induction by serum or growth factors, suggesting that the gene may be required for cell cycle progression. Nevertheless, the role that S100A6 may play in tumor progression remains unknown. In this study, we have explored the expression patterns of S100A6 gene in human thyroid tissues by northern blot analysis. Using the S100A6 monoclonal antibody, we carried out the immunohistochemical staining to determine the distribution/localization of S100A6 protein within tumor or non-tumorous cells of the thyroid. To modulate the regulation of endogenously expressed S100A6 protein in the intracellular level, overexpressed or anti-sense treated transfectant was constructed by using the eukaryotic expression vector. As a result, immunohistochemistry for S100A6 showed a strong positivity in the malignant tumors of thyroid and a high expression level of S100A6 protein affected cell proliferation in the overexpressed transfectant. These findings suggest that S100A6 may be involved in the tumor pathogenesis and provides another parameter for the differentiation of malignant and benign lesions. A well defined monoclonal antibody against S100A6 protein is now available for the immunohistochemical studies of the various thyroid tissues.
Animals ; Blotting, Northern ; Cell Cycle ; Cell Proliferation ; Cricetinae ; Gene Expression ; Gene Library ; Humans* ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Kidney ; Thyroid Diseases* ; Thyroid Gland*

The ovarian dermoid cyst is the most common ovarian neoplasm in young women and comprises approximately 10-20% of all ovarian tumors. But malignant transformation is an uncommon complication in an ovarian dermoid cyst, usually being reported in about 1.0-1.8% of cases. Most common malignant transformation of ovarian dermoid cyst is squamous cell carcinoma, which represents about 75-80% followed by adenocarcinoma in 6-7%. We report a case of adenocarcinoma arising from ovarian dermoid cyst with a brief review of literatures.
Adenocarcinoma* ; Carcinoma, Squamous Cell ; Dermoid Cyst* ; Female ; Humans ; Ovarian Neoplasms ; Ovary*

In recent years a concern of excessive intakes of vitamins and minerals from various sources is increasing, since there has been a marked increase in production and consumption of vitamin and mineral supplements and fortified foods. The purpose of this study was to assess the maximum exposure of vitamins and minerals from various sources including diet, fortified foods, and health functional foods among Koreans. As a result, the highest exposure group of most vitamins and minerals from diet was adults (30 - 49 years of age) according to 2001 Korean National Nutrition and Health Survey Report. Maximum dietary intakes of vitamin A, B1, B2, C, nicotinamide, calcium, phosphorus and iron were 0.5 - 7 times of the RDA for Koreans, 7th ed. Maximum intakes of vitamins and minerals from fortified foods by adults (20 - 59 years of age) were 8 - 760% of the Korean RDA. In addition, maximum exposure of vitamins and minerals from vitamin.mineral health functional foods by middle aged people was 35 - 140% of the upper limits (UL: DRI for Koreans). As a consequence, maximum combined intakes of vitamin B6, vitamin C, calcium, iron and zinc from the above sources including diet, fortified foods and vitamin.mineral health functional foods were greater than the UL. These results would be applied for determining the safe upper limits of vitamin and mineral of health functional foods.
Adult ; Ascorbic Acid ; Asian Continental Ancestry Group ; Calcium ; Diet ; Food, Fortified ; Functional Food ; Health Surveys ; Humans ; Iron ; Middle Aged ; Minerals* ; Niacinamide ; Phosphorus ; Vitamin A ; Vitamin B 6 ; Vitamins* ; Zinc

The aim of this study was to develop various types of a dish frequency questionnaire (DFQ) for estimating the habitual sodium intake and to evaluate the validity of a 125 item dish frequency questionnaire (DFQ 125) with the DFQ 70, DFQ 36 and DFQ 15. For the DFQ 125, one hundred and twenty five dish items were selected based on the information of sodium content of a one serving size, consumption frequency and dish items that contributed most to the variation of sodium intake. Frequency of consumption was determined through nine categories ranging from more than 3 times a day to almost never to indicate how often the specified amount of each food item was consumed during the past 6 months. The sodium intake estimated with DFQ 125 was 5775.0 +/- 3636.3mg, 12.6% higher than that estimated with a 24 hr urine analysis (5009.7 +/- 1541.9mg) and significant correlation was observed between them (r = 0.3315, p < 0.001). When sodium content in broth leftover was subtracted from the total intake, the actual sodium intakes was decreased to 5309.6 +/- 3076.6mg, which was 3.2% higher than that with a 24-hr urine analysis. Overall, 56% of subjects in the lowest quintile of sodium intake computed with DFQ 125 were also in the lowest of adjacent quintile while categorization into the opposite quintile were 4.9%. DFQ 70 was developed from DFQ 125 by omitting the food items not frequently consumed, selecting the dish items that showed higher sodium content per one portion size and higher consumption frequency. The sodium intake estimated with DFQ 70 (5026.6 +/- 3107.1mg) showed only 0.2% difference from that estimated with a 24-hr urine analysis, significant correlation with it (r = 0.3199, p < 0.001) and higher proportion of subjects to be classified into the same or adjacent quintile. The sodium intake estimated with DFQ 36 or DFQ 15 was also significancy correlated with that estimated with a 24-hr urine analysis (r = 0.3441, p < 0.001; r = 0.321, p < 0.001 respectively) and more. The proportion of subjects was classified into the same or adjacent quintile. However, the actual sodium intake estimated with DFQ 36 or DFQ 15 were 3534.0 +/- 1804.6mg and 2508.0 +/- 1261.5mg, respectively, 31.3% or 51.3% less than that estimated with a 24-hr urine analysis. It seems the DFQ 125 with subtraction of sodium content in broth leftover or DFQ 70 can be used quantitatively to estimate sodium intake of adults. DFQ 36 or DFQ 15 can be used as a screening tool or to assess the changes of sodium intake after nutrition education.
Adult* ; Education ; Humans ; Mass Screening ; Portion Size ; Serving Size ; Sodium*

High tension electrical burns affecting the wrist are likely to produce full thickness necrosis of the skin and to damage deep vital structures beneath the eschar, affecting he local tendons, nerves, vessels, even bones and joints which result in serious dysfunction of the hand. An aggressive approach to the treatment of these severe wounds and adequate wound coverage are essential for the successful result. From October 1997 to February 2000, we had treated 23 electrical wrist injuries in 20 patients with free flaps. Among these, 13 anterolateral thigh flaps, 5 forearm flaps, 2 scapular flaps, 2 parascapular flaps, and 1 medial leg flap were executed. About 2-4 weeks after initial injury, we tried free flaps. Preoperative debridement was not carried out. At the time of surgery, debridement of all nonviable tissue was done, but nerves, tendons, and bones were left in place with minimal or no debridement when they had anatomic continuity, regardless of their appearance of viability. In all cases, successful soft tissue coverage and wound healing were achieved, and we obtained the following conclusions. 1. Flap coverage should be executed before damage of the tendons, nerves, vessels. 2. As long as the free flap survives, the infected tendons, nerves, and denuded bone can be salvaged. 3. For later reconstruction of the wrist, fasciocutaneous flap should be preferred to promise tendon gliding and endure several operative procedures.
Burns* ; Debridement ; Forearm ; Free Tissue Flaps* ; Hand ; Humans ; Joints ; Leg ; Necrosis ; Skin ; Surgical Procedures, Operative ; Tendons ; Thigh ; Wound Healing ; Wounds and Injuries ; Wrist Injuries ; Wrist*

The group A streptococcus is capable of producing exotoxins that have been linked to a toxic shock-like syndrome. Streptococcal toxic shock syndrome is a rapidly progressive associated with injury to multiple organ systems and a 30-60% mortality rate. These cases are very rare in Korea. We present a case of 32-year-old prenant woman who developed streptococcal toxic shock syndrome following intrauterine fetal death. She manifestated hypotension, shock, increased level of creatinine, disseminated intravascular coagulopathy, liver impairment, renal failure, pulmonary edema and adult respiratory distress syndrome. Blood cultures yielded Streptococcus pyogenes. After 17 hours on admission, she died in spite of massive transfusion, antibiotics therapy and ventilatory support. Clinicians should be alert to the importance of early diagnosis and treatment of this lethal infection.
Adult ; Anti-Bacterial Agents ; Creatinine ; Early Diagnosis ; Exotoxins ; Female ; Fetal Death* ; Humans ; Hypotension ; Korea ; Liver ; Mortality ; Pulmonary Edema ; Renal Insufficiency ; Respiratory Distress Syndrome, Adult ; Shock ; Shock, Septic* ; Streptococcus ; Streptococcus pyogenes

PURPOSE: Systematic studies on the relationship between health literacy and health outcomes demonstrate that as health literacy declines, patients engage in fewer preventive health and self-care behaviors and have worse disease-related knowledge. The purpose of this study was to identify effective intervention strategies to improve health outcomes in patients with cardiovascular disease and low literacy skills. METHODS: This study employs the following criteria recommended by Khan Kunz, Keijnen, and Antes (2003) for systematic review: framing question, identifying relevant literature, assessing quality of the literature, summarizing the evidence, and interpreting the finding. A total of 235 articles were reviewed by the research team, and 9 articles met inclusion criteria. Although nine studies were reviewed for their health outcomes, only six studies, which had a positive quality grade evaluation were used to recommend effective intervention strategies. RESULTS: Interventions were categorized into three groups: tailored counseling, self-monitoring, and periodic reminder. The main strategies used to improve health outcomes of low literacy patients included tailored counseling, improved provider-patient interactions, organizing information by patient preference, self-care algorithms, and self-directed learning. Specific strategies included written materials tailored to appropriate reading levels, materials using plain language, emphasizing key points with large font size, and using visual items such as icons or color codes. CONCLUSION: With evidence-driven strategies, health care professionals can use tailored interventions to provide better health education and counseling that meets patient needs and improves health outcomes.
Ants ; Cardiovascular Diseases ; Counseling ; Delivery of Health Care ; Health Education ; Health Literacy ; Humans ; Learning ; Patient Preference ; Self Care