No abstract available.
Pregnancy*

No abstract available.
Child* ; Humans

BACKGROUND: Korea is an endemic area of viral hepatitis B with a rate of 5~10% carrier state. Therefore, hepatitis B vaccination is performed nationwide. But 5~15% of healthy individuals fail to respond adequately to the vaccine and an approved guideline for the nonresponders has not been developed yet. This study is designed to identify risk factors for those who lack anti-HBs after hepatitis B vaccination and to document the results of a double-dose revaccination in such nonresponders to the primary vaccination. METHODS: From Feb. 1996 to Aug, 1997, we assessed 51 healthy subjects(HBs Ag negative, anti-HBs negative, anti-HBc negative and a normal LFT). All subjects were vaccinated with Hepavax- B, 1.0ml, 24 by a rapid schedule(0, 1, and 2 months) and 27 by a standard schedule(0, 1, and 6 months). Anti-HBs titers were evaluated 3 months after the third vaccine and assessed the nonre-sponders (anti-HBs titer<2mIu/ml) and the hyporesponders(2~10mK/ml). All 13 nonresponders were revaccinated with 2ml of Hepavax-B 3 months after the primary vaccination. Anti-HBs titers were evaluated 1 month later. RESULTS: The differences in age(p<0.01) and smoking amount(p<0.05) between the responders and the hypo and the nonresponders were statistically significant. There were more males and higher body mass index in the hypo and the nonresponders but not statistically significant. The seroconversion rate after the double-dose vaccination was 92.3%(12/13) with an average titer of 5K08mlU/ ml(1-132.4mIU/ml). CONCLUSIONS: Increase in age and smoking amount were the risk factors of the nonresponders after the primary vaccination. Most of the hypo and the nonresponders to the primary vaccination responded adequately to the double-dose revaccination.
Body Mass Index ; Carrier State ; Hepatitis B* ; Hepatitis* ; Humans ; Immunization, Secondary* ; Korea ; Male ; Risk Factors* ; Smoke ; Smoking ; Vaccination

BACKGROUND: The prevalence of dementia is estimated to be as high as 11.3% among coummunity-dwelling persons over 65 years of age in Korea. The fear of dementia for both patients and families is growing because of the chronicity and progressiveness of the disease. Though the recognition, evaluation, and management of patients with dementia are important for the care of older pateint, unfortunately, MMSE takes 5 to 10 minutes to administer and is cumbersome to carry for all elderly patients in busy office. The Clock Drawing Test has been known as valid, easily administered and low cost screening procedure for the congnitive impaiment associated with dementia in general geriatric clinic population. In this study, we assessed the usefulness of this measure as a screening test for dementia, on the basis of the correlation between clock drawing and MMSE-K. METHODS: The subjects for this study consisted of 47 elderly who visited to two elderly clubs in Seoul from April 1996 through June 1996 or the outpatient department of Family medicine of the Ehwa Mok-dong hospital. They received the Mini-Mental Status Exam and the Clock Drawing test. Three observers evaluated them by ratings from 10(best) to 1(worst). Inter-rater reliability of scores from the Clock Drawing Test was assessed and Pearson correlation coefficients were used to examine the relationships between scores from the Clock Drawing Test and MMSE-K. RESULTS: Their mean age was 75.4 years with range of 65 to 91 years. There were 34 women and 13 men. Correlations between individual raters was highly significant(y=0.8939, 0.8552, and 0.8698, respectively ; P<0.01). Compared to scores on MMSE-K, rating from clock drawings by each of 3 raters revealed statistically significant correlations(y=0.7164, 0.7398, and 0.6884, respectively ; P<0.01). CONCLUSIONS: The clock drawings can be rated reliably by even untrained observers and performance on this task relates significantly to performance on MMSE-K of severity. We confirmed the usefulness of clock drawings as a simple, easily administered, low cost, and reliable general screening tool for dementia in a general geriatric clinic population.
Aged ; Dementia* ; Female ; Humans ; Korea ; Male ; Mass Screening* ; Outpatients ; Prevalence ; Seoul

BACKGROUND: The studies about that hypertension commonly associated with dyslipidemia and that dyslipidemic hypertension increased mortality compared with hypertension only and dyslipidemia only, suggests an important clinical entity. Therefore, this study aimed to identify prevalence and describe potential insulin resistance of dyslipidemic hypertension, and compare about them with two other groups(dyslipidemia only, hypertension only). METHODS: The data in this study was analyzed from 1,296 persons who had visited Health examination center in Ewha Womans University Mok-dong Hospital from Jan. to April, 1996. Prevalence of dylipidemia, hypertension and dislipidemic hypertension were measured. Average age, and frequency of male, obesity and NIDDM in three groups were measured. Odds ratios of sex, obesity, smoking, and DM according to two age group consisting of persons before and after 50 years were calculated for three groups. RESULTS: Frequency of dyslipidemia only was 27% and of hypertension only was 8%.; conjoint frequency(dyslipidemic hypertension) was 7%, which is 1.5 times greater than expected value(4.7%) if the two diseases were independent. In characteristics for age, sex, obesity and NIDDM, All three groups(dyslipidemic hypertension, dyslipidemia only, hypertension only) w-normal subjects. Dyslipidemic hypertension was more likely to be obese and had a greater frequency of NIDDM than two other group(dyslipidemia only, hypertension only). Odds ratio was contrasted with three groups for sex, smoking, obesity, NIDDM stratified by age to more indentify association with insulin resistance. Sex was associated with male in two groups(dyslipidemia only, dyslipidemic hypertension) of younger group and dyslipudemia only group of older group, but associated with female in hypertension only and dyslipidemic hypertension of older group. Smoking was associated with dyslipidemia only group of younger group. Obesity was associated with increased odds of dyslipidemia only(2.03) and hypertension only(2.02), dyslipidemic hypertension (4.38) in younger group, and dyslipidemic hypertension(2.24) in older group, but associated with decreased odds with dyslipidemia only(0.56). NIDDM was associated with increased odds of dyslipidemia only(2.39) and dyslipidemic hypertension(3.32) in youger group. CONCLUSIONS: Dyslipidemic hypertension is common and more often than would be dictated by chance alone, which is consistent with a distinct syndrome. Dyslipidemia and hypertension were associated with potential insulin resistant states of obesity and DM in this study. So, treatment of dislipidemic hypertension should focus on weight control and exercise, which increase insulin sensitivity.
Diabetes Mellitus, Type 2 ; Dyslipidemias ; Female ; Humans ; Hypertension* ; Insulin ; Insulin Resistance ; Male ; Mortality ; Obesity ; Odds Ratio ; Prevalence* ; Smoke ; Smoking

BACKGROUND: The studies about that hypertension commonly associated with dyslipidemia and that dyslipidemic hypertension increased mortality compared with hypertension only and dyslipidemia only, suggests an important clinical entity. Therefore, this study aimed to identify prevalence and describe potential insulin resistance of dyslipidemic hypertension, and compare about them with two other groups(dyslipidemia only, hypertension only). METHODS: The data in this study was analyzed from 1,296 persons who had visited Health examination center in Ewha Womans University Mok-dong Hospital from Jan. to April, 1996. Prevalence of dylipidemia, hypertension and dislipidemic hypertension were measured. Average age, and frequency of male, obesity and NIDDM in three groups were measured. Odds ratios of sex, obesity, smoking, and DM according to two age group consisting of persons before and after 50 years were calculated for three groups. RESULTS: Frequency of dyslipidemia only was 27% and of hypertension only was 8%.; conjoint frequency(dyslipidemic hypertension) was 7%, which is 1.5 times greater than expected value(4.7%) if the two diseases were independent. In characteristics for age, sex, obesity and NIDDM, All three groups(dyslipidemic hypertension, dyslipidemia only, hypertension only) w-normal subjects. Dyslipidemic hypertension was more likely to be obese and had a greater frequency of NIDDM than two other group(dyslipidemia only, hypertension only). Odds ratio was contrasted with three groups for sex, smoking, obesity, NIDDM stratified by age to more indentify association with insulin resistance. Sex was associated with male in two groups(dyslipidemia only, dyslipidemic hypertension) of younger group and dyslipudemia only group of older group, but associated with female in hypertension only and dyslipidemic hypertension of older group. Smoking was associated with dyslipidemia only group of younger group. Obesity was associated with increased odds of dyslipidemia only(2.03) and hypertension only(2.02), dyslipidemic hypertension (4.38) in younger group, and dyslipidemic hypertension(2.24) in older group, but associated with decreased odds with dyslipidemia only(0.56). NIDDM was associated with increased odds of dyslipidemia only(2.39) and dyslipidemic hypertension(3.32) in youger group. CONCLUSIONS: Dyslipidemic hypertension is common and more often than would be dictated by chance alone, which is consistent with a distinct syndrome. Dyslipidemia and hypertension were associated with potential insulin resistant states of obesity and DM in this study. So, treatment of dislipidemic hypertension should focus on weight control and exercise, which increase insulin sensitivity.
Diabetes Mellitus, Type 2 ; Dyslipidemias ; Female ; Humans ; Hypertension* ; Insulin ; Insulin Resistance ; Male ; Mortality ; Obesity ; Odds Ratio ; Prevalence* ; Smoke ; Smoking

PURPOSE: This study aimed to estimate the effects of a health mentoring program on fasting blood sugar, total cholesterol, triglyceride, physical activity, self care behavior and social support changes among community-dwelling vulnerable elderly individuals with diabetes. METHODS: A non-equivalent control group pre-post-test design was used. Participants were 70 community-dwelling vulnerable elderly individuals with diabetes. They were assigned to the experimental (n=30) or comparative (n=30) or control group (n=28). The experimental group participated in the health mentoring program, while the comparative group participated in health education program, the control group did not participate in any program. Data analyses involved a chi-square test, Fisher's exact test, a generalized linear model, and the Bonferroni correction, using SPSS 23.0. RESULTS: Compared to the control group, the experimental and comparative groups showed a significant decrease in fasting blood sugar, total cholesterol, and triglyceride. Compared to the comparative and control groups, the experimental group showed significant improvement in self care behavior. However, there were no statistical differences in physical activity or social support among the three groups. CONCLUSION: These findings indicate that the health mentoring program is an effective intervention for community-dwelling vulnerable elderly individuals with diabetes. This program can be used as an efficient strategy for diabetes self-management within this population.
Aged* ; Blood Glucose ; Cholesterol ; Diabetes Mellitus ; Fasting ; Health Education ; Humans ; Linear Models ; Mentors* ; Motor Activity ; Self Care ; Statistics as Topic ; Triglycerides ; Vulnerable Populations

Hepatie hilar ductal carcinoma is relatively rare, but the prognosis is known to be poor because an early diagnosis is difficult. Because the majority of patients are already infiltrated into adjacent organ by itself at the diagnosis, the rate of resectability is low. The best method of treatment is curative resection, and the range of tumor invasion is very important. The preoperative diagnosis is difficult because the cholangiography may be normal in cases of superficial invasion. Multifocal lesions within the biliary tract may be identified in as many as 10 percent of patients, Especially, the papillary type has the best prognosis and is associated with multiple tumors within the bile duct. We report a case that percutaneous transhepatic cholangiogram showed normal distal common bile duct, but the hepatic hilar confluence and ampulla of Vater lesion was confirmed as adenocarcinoma.
Adenocarcinoma ; Ampulla of Vater* ; Bile Ducts ; Biliary Tract* ; Carcinoma, Ductal ; Cholangiocarcinoma* ; Cholangiography ; Common Bile Duct ; Diagnosis ; Early Diagnosis ; Humans ; Pancreas* ; Prognosis

No abstract available.
Animals ; Mice* ; Pancreas, Exocrine*

Intracellular accumulation of bile acids in the hepatocytes during cholestasis is thought to be pathogenic in cholestatic liver injury. Due to the detergent-like effect of the hydrophobic bile acids, hepatocellular injury has been attributed to direct membrane damage. However histological findings of cholestatic liver diseases suggest apoptosis can be a mechanism of cell death during cholestatic liver diseases instead of necrosis. To determine the pattern of hepatocellular toxicity induced by bile acid, we incubated primary cultured rat hepatocytes with a hydrophobic bile acid, Glycochenodeoxycholate (GCDC), up to 5 hours. After 5 hours incubation with 400 muM GCDC, lactate dehydrogenase released significantly. Cell viability, quantitated in propidium iodide stained cells concomitant with fluoresceindiacetate was decreased time-and dose-dependently. Most nuclei with condensed chromatin and shrunk cytoplasm were heavily labelled time- and dose-dependently by a positive TUNEL reaction. These findings suggest that both apoptosis and necrosis are involved in hepatocytes injury caused by GCDC.
Animals ; Apoptosis* ; Bile ; Bile Acids and Salts ; Cell Death* ; Cell Survival ; Cholestasis ; Chromatin ; Cytoplasm ; Glycochenodeoxycholic Acid* ; Hepatocytes* ; In Situ Nick-End Labeling ; L-Lactate Dehydrogenase ; Liver ; Liver Diseases ; Membranes ; Necrosis* ; Propidium ; Rats*