The angiotensin-converting enzyme (ACE) gene DD homozygote has been suggested to be a significant risk factor for the progression of diabetic nephropathy. We analyzed clinical parameters and ACE genotype distribution between type 2 diabetic patients at the extremes of renal risk, i.e. an end-stage renal failure (ESRF) group (n = 103, group 1) who were on dialysis therapy due to progression of diabetic nephropathy, and a no progression group (n = 88, group 2) who had maintained normal renal function and normoalbuminuria for more than 15 years. There were no significant differences in age, sex, body mass index, HbA1c level, or lipid profiles between the two groups (p > 0.05). Group 1 had a significantly higher prevalence of hypertension [group 1: 82.5% (85/103) vs. group 2: 50.0% (44/88), p < 0.05] and diabetic retinopathy [group 1: 103/103 (100%) vs. group 2: 28/88 (31.8%), p < 0.05] than group 2. Daily urinary albumin excretion was also higher in group 1 than in group 2 [group 1: 2873 +/- 2176 mg/day vs. 12 +/- 7 g/day, p < 0.05]. The frequencies of the DD, ID, and II genotypes of the ACE gene in group 1 and group 2 were 26.2%, 47.6%, and 26.2%, and 7.9%, 57.9%, and 34.2%, respectively. The ACE genotype frequencies between the two groups were significantly different according to a chi-square test with Bonferroni's correction (p = 0.004). The presence of the DD genotype increased the risk of ESRF 4.286-fold compared to the II genotype [odds ratio 4.286, 95% CI 1.60- 11.42, p = 0.005]. The frequency of the D-allele was higher in both male and female patients in group 1 compared to group 2, but reached statistical significance only in males [male, group 1: 50.8% vs. group 2: 35.0%, p = 0.018, female, group 1: 48.8% vs. group 2: 39.5%, p = 0.231]. This study, although limited by sample size, showed that type 2 diabetic ESRF patients more frequently expressed the DD genotype. These findings may substantiate the previously noted relationship between the ACE DD genotype and the progression of diabetic nephropathy in Korean type 2 diabetic patients.
Renal Dialysis ; *Polymorphism, Genetic ; Peptidyl-Dipeptidase A/*genetics/metabolism ; Middle Aged ; Male ; Kidney Failure, Chronic/diagnosis/*genetics ; Humans ; Homozygote ; Gene Frequency ; Female ; Diabetic Nephropathies/diagnosis/*genetics ; Diabetes Mellitus, Type 2/diagnosis/*genetics ; Aged

BACKGROUND: This study was designed to evaluate the effect of monaural headset to the hearing threshold shifts of the female communication workers. METHODS: Hearing threshold shifts of total 642 subjects, selected after excluding workers with history of ear disease, of ototoxic drug administration, and of neuropsychiatric disease, were determined by pure tone audiometric tests. Each worker's personal and work history was taken by the self-administrative questionnaire. In addition, occupational noise exposure levels in the workplace were assessed by noise dosimetry and each worker's noise exposure from the headset was measured by placing the microphone of a noise dosimeter to the external portion of the headset which was coupled by a silicon tube. The hearing threshold shifts were compared between groups of the alternate and the fixed headset user. RESULTS: The results were as follows: 1> The noise levels in the workplace ranged from 62.1 dBA to 63.9 dBA. The mean equivalent sound levels (LEQ) by the headset volume (minimum, middle, and maximum) were 90.8 dBA, 94.6 dBA, and 97.8 dBA, respectively. The maximum sound level (Lmax) of the headset was from 109.1 to 128.6 dBA. 2> The degree of hearing difference of the one side users was higher than that of the alternate users. Comparing the hearing loss of two groups of subjects, hearing loss was statistically significantly higher in the left-ear fixed and in the alternate headset users with more than 15 years than those with less than 15 years of headset taking duration. 3> Based on the hearing loss evaluation criteria by the Korean Ministry of Labor, 25 required follow-up cases (3.89%) and 16 suspected cases (2.49%) out of the 642 subjects were screened. Although statistically not significant, the required follow-up cases were higher among fixed users (4.3%) than those of alternate users (3.7%). CONCLUSION: The results of this study ascertained the possibility of hearing loss due to monaural-headsets among female workers. Thus, it is recommended that an effective hearing conservation program should be provided for the headset-wearing communication workers.
Ear Diseases ; Female* ; Follow-Up Studies ; Hearing Loss ; Hearing* ; Humans ; Noise ; Noise, Occupational ; Silicones ; Surveys and Questionnaires

Pterygium is a proliferative disease. Recent research has reported that stem cells are involved in the pathogenesis of various proliferative diseases, including solid tumors and diabetic proliferate vitreoretinopathy. In previous literature, we hypothesized that adult stem cells originated from bone marrow were involved in the pathogenesis of pterygium. We proved this by immunohistochemical staining with various stem cell markers. The staining showed adult stem cells in the pterygium. c-kit positive cells were observed primarily in the stroma, and some cells were also found in the basal epithelium. AC133 and CD34 positive cells were primarily found in the basal epithelium and were ovoid shaped, similar to the c-kit cells. However, some cells were found in vascular endothelium. STRO-1 positive cells were found mainly in the stroma and were spindle shaped. In recurrent pterygium, cells were more scattered and the expression pattern was denser. Therefore, we suggest a new theory of pterygium pathogenesis. Inflammation caused by environmental factors triggers the abnormal production of some growth factors and cytokines in order to recover from cellular damage. If these healing signals are excessive, limbal basal cells will be changed to abnormally-altered pterygial cells. The excessive wound healing process and remnant altered cells result in recurrence using the same mechanism.
Stem Cells/*physiology ; Pterygium/*etiology ; Proto-Oncogene Proteins c-kit/analysis ; Peptides/analysis ; Middle Aged ; Humans ; Glycoproteins/analysis ; Bone Marrow Cells/*physiology ; Antigens, CD34/analysis ; Antigens, CD/analysis

The effects of intraventricular atropine on the heart rate was investigated in the rabbit. Intraventricular administration of atropine in a dose of 10, 30, 100, or 300 ug produced dose dependant bradycardia. Atropine (100 ug) induced bradycardia was abolished by bilateral vagotomy or intravenous atropine, and inhibited by intravenous propranolol but not by intravenous Regitine. Intraventricular Ecolid or regitine pretreatment diminished the bradycardia induced by intraventricular atropine. From the above results, it is suggested that a central adrenergic mechanism as well as vagal activity plays an important role in the intraventricular atropine-induced bradycardia.
Atropine* ; Bradycardia ; Chlorisondamine ; Heart Rate* ; Heart* ; Phentolamine ; Propranolol ; Vagotomy

OBJECTIVES: The goal of this study is to observe the anatomy around the maxillary sinus ostium and gain an understanding that will help prevent serious complications during middle meatal antrostomies. MATERIALS AND METHODS: Dissection of the maxillary sinuses was carried out in 64 embalmed frozen cadavers, 105 maxillary sinuses. Using a digital ruler, forceps and a malleable probe, we measured the important anatomical relationships around the maxillary sinus ostium and uncinate process, the accessory ostium, and the nasolacrimal duct. RESULTS: 1) The mean width of the uncinate process was 4.9 mm in the mid portion ; 2) A natural ostium of the canal type was observed in 76% of cases ; 3) An accessory ostium was found in 18% of cases and the mean size was 3.17x2.41 mm ; and 4) The mean shortest distance between the nasolacrimal duct and the natural ostium was 4.8 mm. CONCLUSION: Surgeons must keep surgical anatomy in mind to prevent complications when performing endoscopic sinus surgery.
Cadaver* ; Maxillary Sinus* ; Nasolacrimal Duct ; Surgical Instruments

Carcinoma exmixed tumor is a mixed tumor in which a second neoplasm develops from the epithelial component that fulfills the criteria for malignancy. This tumor occurs frequently in the parotid glands. Individuals in whom carcinoma ex mixed tumor have a past history of benign mixed tumor. These lesions contain both a benign mixed tumor as well as a malignant neoplasm. We report a case of carcinoma ex mixed tumor which occurred in the parotid gland. A 67-year-old woman presented with movable right mass. she complained pain and facial paralysis. The clinical presentation, several diagnostic images, and histopathologic findings are presented.
Aged ; Facial Paralysis ; Female ; Humans ; Mixed Tumor, Malignant ; Neoplasms, Second Primary ; Parotid Gland*

A very uncommon tumor, primary intraosseous carcinoma (PIOC), is a carcinoma arising within the jaw. The definite diagnosis of PIOC is often difficult as the lesion must be distinguished from alveolar carcinoma that may invade the bone from the overlying soft tissues or from the tumors that have metastasized to the jaw from a distant site. A case of PIOC arising in the mandible is presented. The clinical, radiologic, and histologic features are described. This rare lesion should be considered in any differential diagnosis of a jaw radiolucency.
Adenocarcinoma, Bronchiolo-Alveolar ; Diagnosis ; Diagnosis, Differential ; Jaw ; Mandible* ; Odontogenic Tumors

Frontal sinusitis can lead to severe and life-threatening disorders. Complications may involve intracranial structures, orbit and adjacent bone and soft tissue structures. Bone wax has been used since the turn of the century as a mechanical aid to hemostasis following surgical procedures. That it may produce a foreign body giant cell reaction in significant proportion of cases is well known. We experienced a woman who had recurrent frontal sinusitis due to bone wax. She was treated by endoscopic frontal sinusotomy with foreign body removal.
Female ; Foreign Bodies ; Frontal Sinus* ; Frontal Sinusitis* ; Giant Cells, Foreign-Body ; Hemostasis ; Humans ; Orbit

To understand the seroepidemiological patterns of haemorrhagic fever with renal syndrome in Korea, a nation-wide survey collaborated with fourteen clinics was carried out from 1994 to 1996. Sera of 4,547 patients with acute febrile episodes were tested by indirect immunofluorescent antibody test and the seroepidemiological analysis including sex, age, seasonal and regional distributions were performed. According to the results obtained in this study, the epidemiological characteristics of haemorrhagic fever with renal syndrome in Korea were summarized as follows: 1. Seropositive rate of hemorrhagic fever with renal syndrome among the patients with acute febrile episodes was 6.4% by the cut-off point of 1:40. 2. Among the seropositives, male outnumbered female and the ratio of males to females was 2.0:1.0. 3. Seventy six % of the seropositive patients were 21-60 years old. 4. The number of seropositive cases increased from October and reached maximum in December and began to decrease gradually from January. 5. The geographical distribution of the seropositives cover most areas including Cheju province in Korea.
Female ; Fever ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Jeju-do ; Korea* ; Male ; Seasons

PURPOSE: To investigate the effect of rhBMP-2 on the healing of bone defect in the low calcium diet rat. MATERIALS AND METHODS: To prepare the experimental model, control group was fed a normal diet and experimental group was fed a low calcium diet for 3 weeks. And then, 4 mm bicortical perforated bone defect wasm made on mandibular body of each rats. Experimental group was subdivided into two groups; experimental group 1 (rats given a low calcium diet before and after bone defect) and experimental group 2 (rats given a low calcium diet before and after bone defect with rhBMP-2 application). At 1, 3, 5 and 7 weeks after bone defect formation, the rats were terminated. The healing of bone defect was assessed by three-dimensional computerized tomography, soft xray radiography, and histopathological examination. RESULTS: The wound healing of the bone defect for control group, experimental group 1, and experimental group 2 showed a increase from 3 weeks after bone defect formation. The experimental group 2 showed a more increase inhealing amount than control group and experimental group 1 from 5 weeks after bone defect formation and the experimental group 2 showed a complete recovery of bone defect at 7 weeks after bone defect formation. CONCLUSION: The healing process of bone defect is accelerated by rhBMP-2 application in the low calcium diet rats.
Animals ; Calcium* ; Diet* ; Models, Theoretical ; Osteoporosis ; Radiography ; Rats* ; Wound Healing