BACKGROUND: Familial aggregation of coronary risk factors is well known, which are hypertension, hyperlipidemia, diabetes mellitus, and obesity. However inter-spouse relation of the risk factors has remained controversial. As spouses are not blood-related, any risk factor relation that exist probably may not reflect genetic factors, but the environmental factors to which the couple is exposed. Moreover, the effect of assortative marriage should be considered. This study is designed to identify inter-spouse relation of coronary risk factors and to document the effects of marriage duration to spouse concordance. METHODS: From May 1995 to March. 1999, we enrolled 1,859 couples who had visited the Health Promotion Center at Seoul National University Hospital. We analysed inter-spouse correlation of body mass index, blood pressure, glucose, serum lipid factors, uric acid, smoking, alcohol drinking, and stress known as coronary risk factors. The correlation coefficients were compared according to marriage duration. RESULTS: There was statistically significant spouse concordance for all risk factors with the exception of smoking. The correlation coefficients of blood pressure, total cholesterol, and triglyceride increased with marriage duration but troughed at 30-39 years of marriage. Those of body mass index and glucose peaked at early and late marriage duration. Those of HDL-cholesterol and uric acid was relatively fixed throughout marriage. CONCLUSION: The presence of significant inter-spouse correlation for most of the coronary risk factors reflect the influence of assortative marriage and environmental factors on spouse concordance. If a spouse has many cardiovascular risk factors, partner should be evaluated for risk factors.
Alcohol Drinking ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Diabetes Mellitus ; Family Characteristics ; Glucose ; Health Promotion ; Humans ; Hyperlipidemias ; Hypertension ; Marriage* ; Obesity ; Risk Factors* ; Seoul ; Smoke ; Smoking ; Spouses* ; Triglycerides ; Uric Acid

No abstract available.
Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Early Diagnosis* ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia, Pneumocystis*

No abstract available.
Neoplasm Metastasis*

The leiomyosarcoma is uncommom tumor that consists of 10% of all sarcoma incidence and commonly arise from retroperitomeum or mesentery. But leiomyosarcoma arose from mediastinum is very rare and only incidental case report is present. Mediastial leiomyosarcoma may originate from superior vene cava, pulmonary artery, small vessels of alveoli, esophagus and cardiac muscle. Common symptoms that are related with leimoyosarcoma of mediastinum are cough and dydpnea but dysphagia, chest pain and hemoptysis can be produced. Although long term survival after complete resection of tumor was reported in localized disease, there wes no effective therapy that prolong the survival in patients who had disseminated disease of huge tumor mass. We report the case of posterior mediastinal leiomyosarcoma confirmed by aspiration cytology and immunohistochemical staining, along with a review of literature.
Chest Pain ; Cough ; Deglutition Disorders ; Esophagus ; Hemoptysis ; Humans ; Incidence ; Leiomyosarcoma* ; Mediastinum ; Mesentery ; Myocardium ; Pulmonary Artery ; Sarcoma

The etiology of several motility disorders, including persistent megacolon after definitive surgery for Hirschsprung's disease, meconium ileus which is not associated with cystic fibrosis and idiopathic megacolon, is still unclear. Interstitial cells of Cajal (ICC) are thought to modulate gut motility as gastrointestinal pace maker cells. The aim of this study was to evaluate the role of ICC in the bowel walls of the patients (n=15) who had variable motility disorders. The ICC were identified by immunohistochemical staining using an anti-C-Kit antibody and the results were compared with control specimens (n=2). The control group (G1) showed evenly distributed ICC in their bowel walls. The second group (G2, n=5) who had normal bowel movements after Duhamel procedures and the third group (G3, n=4) who had persistent megacolon after Duhamel procedures showed absent or scarcely distributed ICC in their aganglionic bowels. The ICC were identified by immunohistochemical staining using an anti-C-Kit antibody and the results were compared with control specimens (n=2). The control group (G1) showed evenly distributed ICC in their bowel walls. The second group (G2, n=5) who had normal bowel movements after Duhamel procedures and the third group (G3, n=4) who had persistent megacolon after Duhamel procedures showed absent or scarcely distributed ICC in their aganglionic bowels. Whereas ICC were evenly distributed in the ganglionic bowels of G2, they were not seen or scarecely distributed in the ganglionic bowels of G3. Two patients (G4) who suffered from idiopathic megacolon showed absence or decrease of ICC in spite of presence of ganglion cells in their colons. Four neonates (G5) who underwent ileostomy because of meconium obstruction showed absent or markedly decreased ICC in the colon at the time of ileostomy and the distribution of ICC was changed to a normal pattern at the time of ileostomy closure between 39-104 days of age and their bowelmotility were restored after that. The results suggest that lack of ICC caused reduce motility in the ganglionic colons and it may be responsible for the development of various motility disorders. Delayed maturity of ICC may also play a role in the meconium obstruction of neinates.
Colon ; Cystic Fibrosis ; Ganglion Cysts ; Hirschsprung Disease* ; Humans ; Ileostomy ; Ileus ; Infant, Newborn ; Interstitial Cells of Cajal* ; Meconium ; Megacolon*

BACKGROUND: An association between diabetes and tuberculosis has long ken implied. The severity of diabetes appears to correlate with the degree of tuberculous activity. METHODS: A retrospective chart review of 82 patients with active pulmonary tuberculosis in diabetics(DMTB) and 83 patients with active pulmonary tuberculosis in nondiabetios (Non-DMTB) admitted to the Kyung Hee Medical Center between January 1995 and December 1996 was undertaken. RESULTS: The sex ratio of DMTB was 58 : 24, and that of Non-DMTB was 62 : 21. Male patients predominated in both groups. The highest incidence of DMIB was 6th and 7th decades and that of Non-DMTB was 3rd and 4th decades. In case which the tuberculosis developed after diagnosis of diabetes, the prevalence of pulmonary tuberculosis was the highest in diabetes for 5 -10 years. On chest X-ray findings, the moderate advanced tuberculosis cases were the most common (60.9% in DMTB and 50.6% in Non-DMTB). There was no relation between the degree of tuberculosis activity on chest x-ray(minimal, moderata awl far advanced tuberculosis) and presence of diabetes. The incidence of lower lung field tuberculosis in DMTB was significantly higher than Non-DMTB(p<0.05). The multiple lobe involvement was the predominant chest roentgenograpflc finding in both groups. There was no significant difference of treatment response between DMTB and Non-DMTB. There was no relationship between initial HbA1c and the stverity of pulmonary tuberculosis on chest X-ray. During treatmenu of pulmonary tuberculosis in excellently and well controlled diabetes, the cure rate of pulmonary tuberculosis was sigrificantly higher than the pcorly controlled diabetes and the rate of treatment failure was significantly lower than poorly controlled diabetes. (p<0.05). CONCLUISON: Poor control of blood glucose is related with increased rate of treatment failure in pulmonary tuberculosis with diabetes mellitus. Further investigation will be needed to study the mechanisms of treatment failure in poorly controlled diabetics with pulmonaiy tuberculosis.
Blood Glucose ; Diabetes Mellitus ; Diagnosis ; Humans ; Incidence ; Lung ; Male ; Prevalence ; Retrospective Studies ; Sex Ratio ; Thorax ; Treatment Failure ; Tuberculosis ; Tuberculosis, Pulmonary*

No abstract available.
Cisplatin* ; Humans ; Nausea* ; Vomiting*

BACKGROUND: Korea is a highly prevalent area of isolated anti-HBc with a rate of 15%, but there is neither vaccination nor management guideline agreed. To know the management for Hepatitis B Vaccination for adults with isolated anti-HBc, we investigated immune response to hepatitis B vaccination in adults with isolated anti-HBc. METHODS: The 23 adults with persistent isolated anti-HBc, who visited a health promotion center from Dec. 1998 to Aug. 1999, were vaccinated with Hepavax?-B by the standard schedule (0, 1, 6 month) and anti-HBs titers were measured 1 month after 1st and 3rd vaccinations (1, 7 month). RESULTS: After the 1st vaccination, 18 (78.26%) developed anti-HBs seroconversion. Among them, 4 (17.39%) had titers of 10~49 mIU/ml, 8 (34.78%) 50~99 mIU/ml, and 6 (26.09%) more than 100 mIU/ml. All non-responders after the 1st vaccination remained as such even with 3 doses of complete vaccination. The majority of seroconverted group did not show more anti-HBs response with further vaccination. CONCLUSIONS: Since none of adults with isolated anti-HBc had a primary response, which indicated few false positive results. Therefore they should be excluded on vaccination programs in Korea. To differentiate between immunity and occult infections, a single dose of vaccine with a follow-up anti-HBs test is preferable for adults with isolated anti-HBc. If the test shows a seroconversion it would indicate protective immunity, if not, then occult infection may be suspected.
Adult* ; Appointments and Schedules ; Follow-Up Studies ; Health Promotion ; Hepatitis B Core Antigens* ; Hepatitis B* ; Humans ; Korea ; Vaccination*

PURPOSE: Recently Wilms tumor gene (WT1) transcripts have been detected in leukemia regardless of the disease subtype and the specific DNA markers suggesting that WT1 gene might be a useful panleukemic marker for monitoring minimal residual disease (MRD). This study was performed to investigate the expression of WT1 gene by a quantitative methods and to find the prognostic value of WT1 gene in childhood acute leukemia. METHODS: From the mononuclear cells isolated from bone marrow aspirates and peripheral bloods of 22 childhood acute and chronic leukemia patients, mRNA were extracted for the reverse transcriptase-polymerase chain reactions (RT-PCR). Relative levels of WT1 gene expression was calculated by using the value in K562 cell line to be 1.00 as a positive control. RESULTS: The sensitivity of detection of MRD with WT1 primers was 10 4 and comparable to that of bcr/abl expression in K562 cells and a patient with CML in blast crisis. WT1 gene expression was detected in 17 of 22 (77%) patients; 9/10 of acute lymphoblastic leukemia (ALL), 6/10 acute myelogenous leukemia (AML), 1 acute mixed lineage leukemia (AMLL) and 1 chronic myelogenous leukemia (CML) in blast crisis. In 4 AML patients who received autologous peripheral blood stem cell transplantation (PBSCT), two patients relapsed after reappearance of WT1 gene expression in bone marrow aspirates and the remaining two were in complete remission without expression of WT1 gene. CONCLUSION: These results show that WT1 gene expression is frequently noted in childhood acute leukemia and can be a useful sensitive marker for the detection of MRD comparable to bcr/abl transcripts. WT1 gene can be used as a panleukemic marker for the MRD monitoring for the evaluation of the remission status and in predicting early relapse in children with acute leukemia in the molecular levels. It may also be a useful tool for the detection of leukemic cell contamination in the process of peripheral blood stem cell transplantation.
Blast Crisis ; Bone Marrow ; Cell Line ; Child ; Gene Expression ; Genetic Markers ; Humans ; K562 Cells ; Leukemia* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Neoplasm, Residual ; Peripheral Blood Stem Cell Transplantation ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Recurrence ; RNA, Messenger ; Wilms Tumor

PURPOSE: To determine changes in the degree of pseudomyopia and convergence in patients with spasm of the near reflex. METHODS: In 5 patients with spasm of the near reflex, we checked following: UCVA/BCVA, the degree of pseudomyopia revealed through manifest and cycloplegic refraction tests, pupil size, limitation of EOM, the amount of convergence defined by the alternate prism cover test, and slit lamp and funduscopic exams. RESULTS: Of the 5 patients with spasm of near reflex, 3 had accommodative spasm alone and 2 had accommodative spasm, convergence spasm and miosis. The patients' degrees of pseudomyopia and convergence were -8.0D and 14PD on the average. which disappeared after an average of 10.8 months but recurred in 1 of the 3 patients with accommodative spasm. As for spasm of the near reflex, 1 patient showed improvement in convergence but worsening pseudomyopia during the follow-up period, and another patient showed recurrence. CONCLUSIONS: The most common clinical feature of spasm of the near reflex is accommodative spasm. Patients with accommodative spasm alone showed better prognosis among all patients with spasm of the near reflex in terms of recurrence and the disease course.
Follow-Up Studies ; Humans ; Miosis ; Prognosis ; Pupil ; Recurrence ; Reflex* ; Spasm*