To demonstrate possible influences of general bone density on the mandible, histomorphometric analysis was carried out in mandibles and iliac bones and the correlation of the two bone densities was tested. Comparison of bony density in women and men over 60 years in the mandible was carried out too. Quantitative computed tomography (GCT) was taken in cross-section of mandibles at the same site where histomorphometric analysis was performed to evaluate the reliability of QCT. The analysis included 40 cadavers with no known disease affecting the bones. The subjects consisted of 15 females and 25 males with a mean age of 60.3 years. Spearman correlation analysis and Wilcoxon rank sum test was performed. The results were as follows. 1. There was statistically no correlation between the mandible and iliac bone in the walues of corrected cortical width (CCW), cortical porosity (POR) in cortex, and total bone volume(TBV), mean trabecular plate thickness (MTPT), mean trabecular plate density (MTPD), and mean trabecular plate separation (MTPS) in trabecular bone. 2. Comparison of women and men over 60 years, men had statistically higher bone density than women except for POR of buccal and lingual cortex, and MTPD of alveolar trabeculae in mandible. 3. There was statistically significant correlation between TBV of trabecular bone and CT NO., but not between POR and CT No. In mandible. According to the results above, there was no correlation between mandible and iliac bone density and between mandibular bony density and age. Further studies are required to support the results. A more noninvasive method to be able to measure the bone density of mandible should be developed and it is necessary to accumulate data on the normal values of bone density of mandible according to age and sex. Further study should be carried out about QCT to measure mandibular bony density using QCT.
Bone Density* ; Cadaver ; Female ; Humans ; Male ; Mandible* ; Porosity ; Reference Values

Intrauterine midgut volvulus is an extremely rare and potentially life-threatening disease, requiring prompt surgical intervention after birth. Non-specific prenatal signs of fetal midgut volvulus cause late diagnosis and treatment, resulting very poor outcome. We report a case of preterm newborn with intrauterine midgut volvulus due to malrotation, who survived after immediate postnatal surgical intervention.
Delayed Diagnosis ; Humans ; Infant, Newborn ; Infant, Premature* ; Intestinal Volvulus* ; Parturition

PURPOSE: This study was to evaluate the effects of a short term comprehensive life style modification program on glycemic metabolism, lipid metabolism and body composition in type 2 diabetes mellitus patients. METHOD: A nonequivalent control group with a pre post test was designed. Data collection was done from October 2003 to June, 2004 at a hospital. Glycemic metabolism was measured by a.c., p.c. and HbA1c, and lipid metabolism was measured by cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Body Composition was measured by body weight, body mass index, waist, measurement waist per hip ratio, body fat, muscle weight and abdominal fat tissue(intra abdominal distance). The Experimental group, which was composed of 29 participants, was educated based on a life style modification protocol at a weekly meeting for 12 weeks and carried out exercise, diet along individual parameters and self monitoring, while 24 participants in the control group received only diet education. RESULT: 1.The experimental group showed a significant lower a.c.(t=2.11, p=.04) and HbA1 c(t=2.65, p=.01) compared to those of the control group. 2. The experimental group showed a significant lower LDL than the results of the control group(t=2.42, p=.02). 3. The experimental group showed a significant lower weight(t=3.09, p=.00), BMI(t=3.01, p=.00), body fat(t=2.94, p=.01) and abdominal fat tissue(t=3.05, p=.01) than those of the control group. CONCLUSION: The results provided evidence for the effectiveness of a short term comprehensive life style modification program composed of exercise, diet, support, self efficacy elevation and self monitoring in type 2 diabetes mellitus.
Adult ; Blood Glucose/analysis ; *Body Composition ; Diabetes Mellitus, Type 2/blood/*physiopathology ; Female ; *Health Behavior ; Humans ; Lipids/*blood ; Male ; Middle Aged ; *Patient Education as Topic

OBJECTIVES: Tumor markers have been clinically used to diagnose and monitor the progression of various tumor or to assess their response to therapy. This study focuses on the evaluation of tumor markers in Chronic renal failure patients, compared with normal controls. METHODS: The following 9 kinds of serum tumor markers, such as carcinoembryonic antigen(CEA), squamaus cell carcinoma-related antigen(SCC), CYFRA 21-1, CA(carbohydrate antigen) 125, CA 19-9, alpha-fetoprotein(AFP), prostate specific antigen(PSA), human chorionic gonadotropin(hCG) and CA 72-4 were measured in 56 persons without chronic renal failure(CRF) as controls, in 132 patients with chronic renal failure(56 patients on conservative management, 41 patients on chronic hemodialysis, and 35 patients on CAPD) who did not present any evidences of neoplasia. RESULTS: 1) The mean level of CEA in CRF patients was significantly higher than that of controls(p<0.001), and that of CRF patients on hemodialysis was significantly higher than that of patients on conservative management(p<0.05). 2) The mean level of SCC in CRF patients was significantly higher than that of controls(p<0.001), and the mean levels of SCC did not differ significantly among three groups of CRF patients. 3) The mean level of CYFRA in CI4F patients was significantly higher than that of controls(p<0.001), and that of CRF patients on hemodialysis was significantly higher than those of patients on conservative management and on CAPD respectively (p<0.05). 4) The mean level of CA 125 in CRF patients was significantly higher than that of controls (p<0.001), and that of CRF patients on CAPD was significantly lower than that of controls(p<0.05). 5) Positive percent for CYFRA 21-1 in all CRF patients was 89.7%, and SCC 82.9%, CEA 60.3%, CA 125 48%, CA 19-9 22.4%, PSA 7.9%, CA 72-4 6.1%, hCG 4.7% and AFV 3.2% respectively. CONCLUSION: The present study shows that tumor markers such as CEA, SCC, CYFRA 21-1, CA 19-9 and CA 125 are elevated above reference values in a substantial number of patients according to the reference values commonly used in normal persons, making them unreliable for monitoring malignancies in uremic patients. While the other tumor markers such as AFP, PSA, hCG and CA 72-4 are reliable for the same purpose. These results must be taken into account when serum levels of tumor markers are measured in CRF patients
Chorion ; Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory ; Prostate ; Reference Values ; Renal Dialysis ; Biomarkers, Tumor*

OBJECTIVES: To assess the relationship between ST segment elevation during exercise testing and coronary artery disease. METHODS: Treadmill exercise electrocardiography and coronary angiography were performed in 137 patients with angina with no Q waves. The J point elevation of > 0.03mV(0.3mm) measured from baseline, the elevation of ST segment at 80msec. from J point(ST80) measured larger in lead V1than in aV1, or both the elevation of ST segment at J point and at ST80 developed earlier than or concomitantly with ST depression were considered as abnormal responses. RESULTS: 1) There was no clinical significance of ST elevation in lead aV1. 2) Exercise-induced ST elevation in lead V1occurred in 29 of 137 patients with angina. 3) Abnormal St elevation in V1was detected in 26 of 86 patients with coronary artery disease, for a specificity of 98%. The patients with left anterior descending coronary artery or left main coronary artery stenosis were observed in 3 of 5(60%) patients with single-vessel disease, in 7 of 9(79%) with two-vessel disease, and in 9 of 10(90%) with three-vessel disease. 4) The standard ST depression yielded a specificity of 55% in the patients with isolated or predominant ST depression in inferior leads(II. III, and aVF) and of 81% in the patients with isolated or predominat ST depressin in precordial leads(p<0.001). 5) Abnormal exercise-induced ST elevation in V1was detected in 13 of 39(33%) patients with isolated or predominat ST depression in inferior leads and yielded a specificity of 94% for coronary artery disease. CONCLUSION: Abnormal ST segment elevation in V1may increase the specificity in isolated or predominat ST segment depression in inferior leads and may predict left anterior descending or left main coronary artery disease.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Depression ; Electrocardiography ; Exercise Test* ; Hexamethonium ; Humans ; Sensitivity and Specificity

Bee venom acupuncture have been associated with wide variety of reactions from mild local reaction to fatal systemic reaction. Vascular complications of bee and wasp stings are rare. A 71-year-old man developed pontine and thalamic infarction after honey bee venom acupuncture. Dysarthria and left hemiparesis were noted 3 days later. The brain MRI showed cerebral infarcts in the left pons and thalamus. The presumed mechanisms include vasoconstriction and platelet aggregation secondary to an injection of distinct allergens contained in bee venom acupuncture.
Acupuncture ; Aged ; Allergens ; Bee Venoms ; Bees ; Bites and Stings ; Brain ; Cerebral Infarction ; Dysarthria ; Honey ; Humans ; Infarction ; Paresis ; Platelet Aggregation ; Pons ; Thalamus ; Vasoconstriction ; Venoms ; Wasps

BACKGROUND: Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. METHOD: We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. RESULTS: 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was 14.2 15.5 hour and initial peak expiratory flow rate was 166.7 68.3L/min.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. CONCLUSION: As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.
Adult ; Asthma ; Education ; Emergencies* ; Emergency Service, Hospital* ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Korea ; Male ; Mortality ; Peak Expiratory Flow Rate ; Prognosis ; Referral and Consultation ; Respiratory Tract Infections ; Retrospective Studies ; United Nations

BACKGROUND: The prevalence of Gastro-esophageal reflux(GER) in patients with asthma is estimated to be 50~60% and treatment of GER has been shown to improve asthma symptoms in Western. But GER has been known to be less common in Eastern and GER prevalence rates in asthmatics are not available in Korea. METHOD: We compared the prevalence rate of GER in 42 patients with asthma to that in 20 healthy normal controls and examed the efficacy of new prokinetic drug, cisapride(40mg/day, 8weeks) in patients with GER and asthma. For acid GER to be considered pathological, 24 hour esophageal pH monitoring should reveal values exceeding upper limit of 95 percentile for at least one of 6 parameter of DeMesseter's table. RESULT: The results showed GER was more common in patients with asthma(11/42, 26.2%) than normal controls(3/20, 15%) and asthmatics group showed a significant longer supine time pH<4(%) and total time pH<4(%), and more reflux episodes as compared with normal control group. After 4 asthmatics with GER were treated with cisapride, their asthma symtom scores, FEV1 and composite scores of pH monitoring were improved. CONCLUSION: GER is more common in asthmatics than in normal controls in Korea and prepulsid reduces asthma symptoms in patients with GER and asthma.
Asthma ; Cisapride ; Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration ; Korea ; Prevalence

OBJECTIVE: Autism spectrum disorders (ASDs) are a group of early childhood-onset neurodevelopmental disorders characterized by deficits in social interaction and language skills, and repetitive behaviors. Brain-derived neurotrophic factor (BDNF) plays a critical role in the differentiation of normal neuronal cells during embryonic and postnatal neuronal development through its neurotrophic effects. METHODS: In this study, we performed a family-based association test (FBAT) between single nucleotide polymorphisms (SNPs; rs6265, rs11030101, rs7103411, and rs7103873) or haplotypes in the BDNF gene and affection status or several quantitative traits characterized by ADI-R with151 Korean trios, including a child diagnosed as ASDs. RESULTS: While no significant association was found between SNPs or haplotypes and the ASDs disease status, a quantitative transmission disequilibrium test (QTDT) by using quantitative traits identified associations of the SNPs (rs6265 and rs11030101) with a domain score for "Restricted, Repetitive and Stereotyped patterns of behavior" (C domain), especially at the subdomain scores for "encompassing preoccupation or circumscribed pattern of interest" (C1) (rs6265A allele, dominant model, p-value=0.019; rs11030101 A allele, additive model, p-value=0.015) and "preoccupations with part of objects or non-functional elements of material" (C4) (rs11030101 A allele, additive model, p-value=0.015) within the ADI-R diagnostic algorithm. In addition, significant associations were also identified between the haplotypes and these quantitative traits (C1, p-value=0.016; C4, p-value=0.012). CONCLUSION: We conclude that BDNF gene polymorphisms have a possible role in the pathogenesis of ASDs.
Alleles ; Brain-Derived Neurotrophic Factor* ; Child ; Autism Spectrum Disorder* ; Haplotypes ; Humans ; Interpersonal Relations ; Neurons ; Polymorphism, Single Nucleotide

Parvovirus B19 (PVB19) infection is a rare cause of meningoencephalitis. A 53-year-old previously healthy woman presented with fever, headache, and multiple erythema on the both legs. Cerebrospinal fluid study revealed pleocytosis and elevated opening pressure and protein level. Brain MRI showed multiple, asymmetric, hyperintensity in the brain stem, basal ganglia, white matter, and gray matter. Anti-B19 IgM antibody and PCR for PVB19 were positive in serum. Clinician should consider PVB19 infection in any case of acute febrile illness with erythema and meningoencephalitis.
Basal Ganglia ; Brain ; Brain Stem ; Cerebrospinal Fluid ; Erythema ; Female ; Fever ; Headache ; Humans ; Immunoglobulin M ; Leg ; Leukocytosis ; Magnetic Resonance Imaging ; Meningoencephalitis* ; Middle Aged ; Parvovirus* ; Polymerase Chain Reaction