Atrial septal defect is one of the most common congenital heart diseases in adult, of which absolute causes is not confirmed, but explained by multifactorial inheritance. In Korea, there has been no case report of atrial septal defect in identical twins in spite of some reports of atrial septal defect in relatives and twins in other countries. We present a first case of atrial septal defect in identical twins whose mother had no infection or medication history during pregnancy.
Adult ; Heart Diseases ; Heart Septal Defects, Atrial* ; Humans ; Korea ; Mothers ; Multifactorial Inheritance ; Pregnancy ; Twins ; Twins, Monozygotic*

PURPOSE: Prostate specific antigen (PSA) is a test with relatively low specificity used for determination of risk for prostate cancer. PSA velocity (PSAV) has been used as a complimentary test. We investigated the association of PSAV with age and an initial PSA. MATERIALS AND METHODS: We enrolled 989 healthy men with initial PSA of 4.0ng/ml or lower. The PSA levels were measured at intervals of at least 12 months. We analyzed the influence of age and initial PSA on the PSAV. RESULTS: PSAV was directly correlated with age and the initial PSA. The initial PSA was not correlated with the PSAV when adjusted by age (r=0.009, p=0.773); age was correlated with PSAV when adjusted by initial PSA level (r=0.276, p<0.001). The mean PSAV in cases with initial PSA of 2.1-4.0 ng/ml was significantly greater compared to the cases with an initial PSA of 0-2.0 ng/ml (p<0.01). The ratio of the men with a PSAV greater than 0.75 ng/ml/year was significantly higher in cases with an initial PSA of 2.1-4.0 ng/ml (p<0.05). CONCLUSIONS: PSAV is associated with age and an initial PSA level in healthy Korean men. Men with initial PSA of 2.1-4.0 ng/ml had an abnormal PSAV in high proportion, and therefore annual follow up PSA would be useful for the early detection of prostate cancer in these cases.
Follow-Up Studies ; Humans ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Sensitivity and Specificity

No abstract available.
Antibodies, Anticardiolipin* ; Female ; Pregnancy ; Pregnancy Outcome* ; Pregnancy*

No abstract available.
Antibodies* ; Hemorrhagic Fever with Renal Syndrome* ; Humans* ; Immunization*

No abstract available.
Ovarian Neoplasms*

Epinephrine ; Pulmonary Edema

Mobius syndrome is a rare congenital disorder characterlzed by facial diplegia and bilateral abducens palsy, which occasionally combinds with other cranial nerve dysfunction, cardiac anomalies, endocrinopathy. Myopathy, peripheral neuropathy and skeletal abnormalities. We report 2 cases of Mobius syndrome; A 6 year old boy showing delayed development, musculo-skeletal anomaly, hypoglossal dysfunction, carpal tunnel syndrome and mild endocrinologic dysfunction, and a 23 year-old lady with only questionable endocrine dysfunction. MRI scans of brain and brainstem are normal and there is no definite electrophysiological evidence of dysfunctions in brainstem on evoked potential blink reflex study. Mental functions look normal in both cases.
Blinking ; Brain ; Brain Stem ; Carpal Tunnel Syndrome ; Child ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Cranial Nerves ; Evoked Potentials ; Humans ; Magnetic Resonance Imaging ; Male ; Mobius Syndrome* ; Muscular Diseases ; Paralysis ; Peripheral Nervous System Diseases ; Young Adult

OBJECTIVES: The differentiation of tuberculous effusion from the other causes of exudative pleural effusion remained difficult even with aids of biochemical analyses and pleural biopsy. As the pathophysiology of tuberculous pleural effusion is an enhanced cell mediated immunity, Adenosine deaminase(ADA) and various cytokines including Inteferon-γ, tumor necrosis factor alpha(TNF-α) are considered as useful diagnostic tools in differentiating exudative pleural effusion The author would like to demonstrate the diagnostic usefulness of TNF-α in the differentiation of exudative pleural effusion, and compared the discriminating ability of TNF-α with ADA. METHODS: Pleural fluids obtained from 80 patients (tuberculous : 39, malignant : 31, parapneumonic : 10) with exudate pleural effusions were processed for cell counts and biochemical analysis including ADA and TNF-α RESULTS: Tuberculous pleural fluid showed higher levee of ADA and TNF-α, 48.7α 32.7U/L and 184.1±214.2pg/mL than that of non-tuberculous effusion 26.0α41.3U/L and 44.1α114.2pg/mL, respectively (ADA, TNF-α : p<0.05, p<0.01). Receiver operating characteristics(ROC) curves were generated for ADA and TNF-α, and the best cut-off value for adenosine deaminase and TNF-α were considered as 30U/L and 15pg/ml, respectively. Comparing the area under the ROC curves, there was no significant difference between ADA and TNF-α CONCLUSION: For the differential diagnosis of tuberculous pleural effusion from the other causes of exudative pleural effusions, TNF-α as well as ADA was considered as useful diagnostic method. However adding TNF-α to ADA has no further diagnotic benefit than ADA alone.
Adenosine ; Adenosine Deaminase ; Biopsy ; Cell Count ; Cytokines ; Diagnosis, Differential ; Exudates and Transudates ; Humans ; Immunity, Cellular ; Pleural Effusion* ; ROC Curve ; Tuberculosis ; Tumor Necrosis Factor-alpha*

Recently therapeutic efficacy of stomach cancer was greatly improved due to early diagnosis and irnproved diagnostic and therapeutic modalities. Especially in early gastric cancer, 5 year survival rate is near 100%. Recarrence of early gastric cancer after curative surgery is rarely reported. Recently authors experienced one case of recurrent stomach cancer arising from remmnant stomach 14 years after gastrectomy of EGC type I(m), so we reports it here with review of literatures.
Early Diagnosis ; Gastrectomy* ; Stomach Neoplasms* ; Stomach* ; Survival Rate

STUDY OBJECTIVE: determine the level of medical care required for mass gatherings and describe the types of medical problems encountered in a religious mass gathered ceremony. DESIGN: Standard charts and a four-tiered triage system(minor, moderate, urgent, and emergent) were developed before the event. The triage system was applied to each chart retrospectively by a single emergency physician. SETTING: Medical staff(10 physicians,13 nurses,1 pharmacist, and 54 first-aid attendants) were based in 8 advanced life support (ALS) clinics. INTERVENTIONS: First-aid attendants referred patients to the clinics, where nurses conducted initial assessments and referred patients to physicians at the venue. Three ambulances were stationed at the venues. RESULT: 22 trauma patients were developed and 183 medical complaints were encountered. Only 7 urgent medical problems were encountered.
Ambulances ; Emergencies* ; Humans ; Pharmacists ; Retrospective Studies ; Triage