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*

BACKGROUND: Although an oxidants and antioxidants imbalane has been considered in the pathogenesis of chronic obstructive pulmonary disease (COPD), there is a paucity of reports focussing on the smoking-induced changes of oxidants and antioxidants in COPD. METHOD: The concentration of antioxidants (ascorbic acid, uric acid, retinol, and α- &γ-tocopherol) was measured in the serum and induced sputum of 30 healthy controls and 34 stable COPD patients using high performance liquid chromatography (HPLC). The inhibition of lipid peroxidation as an index of antioxidant capacity was measured in the serum by a TBA assay. RESULTS: The serum concentration of ascorbic acid, α-tocopherol, and retinol were significantly lower in the patients with COPD than in healthy controls (484.8±473.3 vs 1497.8±819.2 pmol/L, p<0.001, 48.38±17.34 vs 73.96±26.29 pmol/L, p<0.001, and 9.51±8.33 vs 15.01±5.88 pmol/L, p<0.05, respectively, mean±SD). However, there were little differences in the ascorbic acid and uric acid concentrations in the induced sputum between the COPD patients and the controls. The induced sputum to serum ratio of ascorbic acid was significantly higher in COPD patients compared with healthy control (0.375 vs 0.085, p<0.05). In the normal controls, the serum ascorbic acid concentration was lower in smokers than in nonsmokers (1073±536 vs 1757±845 pmol/L, p<0.05), but the level was still higher than that of the COPD patients (p<0.05). The serum retinol levels were correlated with FEV1 in COPD patients (r=0.58, p<0.05). The products of lipid peroxidation were increased in normal smokers and COPD compared with normal nonsmokers (115.56±19.93 and 120.02±24.56 vs 91.87±20.71 µmol/µmol Pi of liposome, p<0.05). CONCLUSION: Cigarette smoking may induce the depletion of serum antioxidants and this depletion of antioxidants is suggested to play a role in the pathogenesis of COPD.
Antioxidants* ; Ascorbic Acid ; Chromatography, Liquid ; Humans ; Lipid Peroxidation ; Liposomes ; Oxidants ; Pulmonary Disease, Chronic Obstructive* ; Smoking ; Sputum* ; Uric Acid ; Vitamin A

ONJECTIVE: This study was carried out to investigate the epidemiologic characteristics and magnitudes of scrub typhus (tsutsugamushi disease) in Gyeongsangbuk-do, Korea. METHODS: Resources of data collected were epidemiologic surveillance report to public health centers on each disease occurrence. The authors reviewed 344 epidemiologic surveillance reports for cases of scrub typhus developed in Gyeongsangbuk-do, Korea from Jan 1, 1999 to Dec 31, 2001. RESULTS: The scrub typhus cases were 376 during three year period, and the incidence was significantly higher in the county area than in the city area. Incidence of scrub typhus was increasing each year. In 344 epidemiologic surveillance reports, the job of the cases was farmer (67.2%), housewife (4.7%), clerk (3.5%). Two hundred ninety eight cases (86.6%) have experienced outdoor activities before development of the scrub typhus. The outdoor places of exposure were dry field (64.8%), rice field (51.7%), hill (12.8), and grass field (9.7%). The symptoms reported were fever (93.3%), headache (83.7%), chill (69.5%), and rash (54.4%). CONCLUSIONS: Incidence of scrub typhus was increasing in Gyeongsangbuk-do, Korea, this phenomenon may be related to change of climate, the reporting rate of disease and outing activities. Good surveillance and adequate analysis of epidemiologic data is a essential for the prevention of the disease. With this result, high risk population was identified and effective intervention should be done to prevent the disease.
Climate ; Epidemiological Monitoring ; Epidemiology ; Exanthema ; Fever ; Gyeongsangbuk-do* ; Headache ; Incidence ; Korea ; Poaceae ; Public Health ; Scrub Typhus* ; Trombiculidae

OBJECTIVE: To understand the difference of defecation physiology between postpartum and postoperative women. METHODS: Between July 1998 to April 1999, we performed defecogram and pudendal nerve motor latency to 31 women, who were 8 postoperative women, 9 post cesarean-section state women, and 14 normal vaginal delivery-state women. RESULTS: According to the defecogram results, only squeezing angles of the anorectal angle were significantly increased(96.0 vs 72.3, 74.9 degree) in normal vaginal delivery-state women compared to post cesarean-section state and postoperative women, but rest and evacuation angles were not. And to pudendal nerve latency, there were no statistically significant difference. CONCLUSION: We concluded that the pudendal plexus was damaged during labor, therefore its ability to control puborectalis muscle was damaged. So, the anorectal angles of squeezing of postpartum women were significantly increased, compared to those of post cesarean section women or postoperative women.
Cesarean Section ; Defecation* ; Female ; Humans ; Physiology* ; Postpartum Period* ; Pregnancy ; Pudendal Nerve*

OBJECTIVE: The Positive and Negative Affect Schedule (PANAS) was developed as a measure of positive affect (PA) and negative affect (NA). The aim here is to examine the factor structure and concurrent validity of the Korean version of the Positive and Negative Affect Schedule (K-PANAS) in a clinical sample in Korea. METHODS: K-PANAS was administered to a clinical sample in Korea. Internal consistency, test-retest reliability, and confirmatory factor analysis (CFA) were undertaken to examine the factorial structure and reliability of the K-PANAS. RESULTS: The reliability of K-PANAS is satisfactory. CFA showed that several of the models commonly used in Western populations provided an insufficient fit. The modified model provided a more adequate fit to the data. CONCLUSION: The authors demonstrate that the K-PANAS has adequate psychometric properties, and that findings obtained in the West using PANAS were partially replicated.
Appointments and Schedules ; Korea ; Psychometrics

BACKGROUND AND OBJECTIVES: Cardiac troponin T (cTnT) has been used as a very sensitive marker of cardiac injury caused by ischaemia, myocarditis, and cardiomyopathy. After cardiac injury, the fetal cTnT isoform expression in the heart and serum cTnT increases. To investigate the increased levels of serum cTnT, and the expression of fetal cTnT isoform in the heart, that can predict myocardial injury, we measured serum cTnT levels and the fetal cTnT isoform expression at various time points during the early phase of myocardial toxicity induced by adriamycin (ADR) in rat. MATERIALS AND METHODS: Male Sprague-Dawley rats were injected, intraperitoneally, with ADR (5 mg/kg) twice a week for 2 weeks. Control rats were injected with saline. Serum cTnT levels were measured by ELISA. The ratio of fetal/adult (F/A) cTnT isoform expression (%) was semi-quantified by RT-PCR using total RNA from frozen hearts. RESULTS: Serum cTnT levels did not increase by 1 week after ADR injection, but increased significantly after 2 weeks. The ratio of F/A cTnT in the heart significantly increased from day 1, peaked at 1 week and persisted until the end of 2 week. CONCLUSION: The expression of the fetal cTnT isoform occurred from 1 day after ADR injection when the serum cTnT levels were still normal. Although the serum cTnT level is a very sensitive, and an early marker, of cardiac damages, the fetal cTnT isoform expression in the endomyocardial biopsy specimen may be a more sensitive and an earlier marker in the ADR-induced myocardial damage.
Animals ; Biopsy ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Doxorubicin ; Enzyme-Linked Immunosorbent Assay ; Heart ; Humans ; Male ; Myocarditis ; Rats* ; Rats, Sprague-Dawley ; RNA ; Troponin T* ; Troponin*

PURPOSE: The clinical significance of preoperative serum levels of CEA and CA19-9, levels of CEA and CA19-9 in peritoneal washing fluid and free cancer cells in peritoneal washing fluid in gastric cancer patients were evaluated in this study. MATERIALS AND METHODS: Serum and peritoneal levels of CEA and CA19-9 and peritoneal washing cytology in 115 patients with gastric cancer were analyzed with respect to the prognostic factors using univariate and multivariate analysis. RESULTS: Positive rate of serum CEA and CA19-9 was 16.5%, 13.0%. And that of peritoneal washing CEA, CA19-9 and cytology was 15.7%, 7.8% and 9.6%. A univariate analysis showed that tumor markets in serum and peritoneal washing fluid and peritoneal washing cytology had significant correlations with the progression of the tumors, and patients with positive serum or peritoneal tumor markers had poorer survival after operation than did the patients with negative tumor markers. But in a multivariate analysis showed that only peritoneal CA19-9 was an independent risk factor. And combination of these five markers provided rnore predictable prognostic informations in a multivariate analysis. CONCLUSION: Combination of serum or peritoneal levels of CEA, CA19-9 and washing cytology appeared to be a useful marker for managing gastric cancer patients.
Humans ; Multivariate Analysis ; Risk Factors ; Stomach Neoplasms ; Biomarkers, Tumor

The stereotactic radiosurgery for arteriovenous malformation (AVM) began in the early 1970s. Nowadays, by 2000 world-wide, more than 27,500 patients have undergone Gamma Knife radiosurgery for cerebrovascular disease (CVD). New concepts, consisting of obliteration rate, postradiosurgical hemorrhagic risk, dose selection for treatment, and radiosurgery for pediatric AVM, medium-to-large sized AVM, cavernous malformation, venous angioma, so on, have been established. Gamma Knife radiosurgery has been considered as an effective management stratege with relatively few side effects for AVM. However, recently delayed radiation-induced complications were reported in 3.2 to 12.5% in range. Therefore, the long-term follow-up is thought to be mandatory even after treatment goal, complete obliteration, is confirmed.
Arteriovenous Malformations ; Follow-Up Studies ; Hemangioma ; Humans ; Patient Selection ; Radiosurgery*

BACKGROUND: The amount of interference due to hemolysis, bilirubin, and lipemia can be measured on the AU5800 autoanalyzer (Beckman Coulter, USA) by spectrophotometry. This is reported as semi-quantitative indices, specifically H-index, I-index, and L-index, respectively. In this study, we evaluated the impact of interference using chemistry assays and established the concentration of interfering substances and HIL-index above which analytically significant interference exists, according to CLSI guidelines C56-A and EP7-A2. METHODS: Pooled sera including different concentrations of analytes were prepared and mixed with hemoglobin, bilirubin, or Intralipid. These samples were then tested for 35 clinical chemistry analytes by AU5800 and the bias based on interferent concentrations was computed. The interferent concentration above which significant interference exists was calculated from the 50% within-subject biological variation (desirable analytic goal), and the corresponding index was assigned. RESULTS: Among 35 items evaluated, interference was detected for 12 analytes by hemoglobin, 7 analytes by bilirubin, and 12 analytes by Intralipid. We proposed HIL-index₁ and HIL-index₂ for each analyte according to 2 different medical decision levels. HIL-index₁ and HIL-index₂ were considered more reasonable criteria than the HIL-index from the manufacturer's technical document (HIL-index(TD)). This is because HIL-index(TD) was empirically set to 5% or 10%, and had a wide tolerance range, which was not sufficient to reflect the presence of interference, compared to HIL-index₁ and HIL-index₂. CONCLUSIONS: We have demonstrated hemoglobin, bilirubin, and Intralipid interferences according to CLSI guidelines using the desirable analytic goal. Our results provide applicable information for Beckman Coulter automated chemistry analyzers.
Bias (Epidemiology) ; Bilirubin ; Chemistry ; Chemistry, Clinical ; Hemolysis* ; Hyperlipidemias* ; Jaundice* ; Spectrophotometry

Clonorchiasis is known to be closely related with the development of recurrent pyogenic cholangitis and carcinoma of the bile ducts. In order to ascertain the cholangiographic signs for recurrent pyogenic cholangitis or carcinoma of the bile ducts arising in patients with clonorchiasis. we reviewed cholangiograms in 42 patients with proven clonorchiasis. The population consisted of 29 patients with clonorchiasis alone, six patients with clonorchiasis and recurrent pyogenic cholangitis, and seven patients with clonorchiasis and carcinoma of the bile ducts. Cholangiographic abnormalities in 29 patients with clonorchiasis alone, six patients with clonorchiasis and recurrent pyogenic cholangitis, and seven patients with clonorchiasis and carcinoma of the bile ducts. Cholangiographic abnormalities in 29 patients with clonorchiasis alone were intrahepatic multiple, oval, or elliptic filling defects measuring 2-10 mm in size, representing adult flukes (n=24). The peripheral bile duct were obstructed (n=18), and the margins were ragged (n=20) and hazy (n=12) the intrahepatic bile ducts were dilated diffusely (n=27), and the dilated peripheral small tributaries gave the impression of "too many ducts appearance" (n=7) and dilatation was mid (n=17) In six patients with clonorchiasis and recurrent pyogenic cholangitis, there were filling defects of stones, and the extrahepatic ducts and larger intrahepatic ducts were predominantly dilated. In seven patients with clonorchiasis and cholangiocarcinoma all the biliary tree proximal to the tumor was markedly and diffusely dilated In the latter two groups, filling defects of flukes and associated findings were less prominent, but there was disproportionately severe dilatation of too many intrahepatic ducts. In patients with recurrent pyogenic cholangitis or cholangiocarcinoma, clonorchiasis should be considered as a underlying cause when cholangiogram shows "disproportionately" severe dilatation of too many intrahepatic ducts. intrahepatic ducts.
Adult ; Bile Ducts ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholangiocarcinoma ; Cholangitis ; Clonorchiasis* ; Dilatation ; Humans ; Trematoda