We investigated the adenoviral etiology and seasonal epidemic trends in intussusception and each adenoviral subgroup. Also we confirmed whether we can use the adenovirus data of Acute Infectious Agents Laboratory Surveillance Report (AIALSR) as an epidemic predictor of intussusception. Patients with intussusception (n = 126), < 5 years old, were enrolled and matched by age and sex with controls suffering acute gastroenteritis without intussusception (n = 106), all recruited at 8 centers. All fecal specimens were assayed for adenovirus, including subgroups A, B, C, E, and F, with reverse transcriptase-polymerase chain reaction (RT-PCR). Adenovirus was detected in 53 cases and 13 controls (P < 0.001). Nonenteric adenoviruses (NEAds) were detected in 51 cases and four controls (P < 0.001). We used Spearman's correlation analysis to analyze the incidence of intussusception and adenoviral epidemic trends, and compared them with fecal and respiratory adenoviral epidemic trends in the AIALSR. The trend of intussusception correlated with total NEAds (r = 0.635; P = 0.011), as did the fecal AIALSR adenovirus trends (r = 0.572; P = 0.026). Among the NEAd subgroups, subgroup C was dominant (P < 0.001), but subgroups B (P = 0.007) and E (P = 0.013) were also significant to intussusception. However, only subgroup C showed a significant epidemic correlation (r = 0.776; P = 0.001) with intussusception. Not respiratory but fecal AIALSR adenovirus trends correlated with the incidence of NEAds and intussusception. We suggest the possibility of using fecal AIALSR adenovirus data as an approximate epidemic predictor of intussusception.
Adenoviridae* ; Child ; Gastroenteritis ; Humans ; Incidence ; Intussusception* ; Korea* ; Seasons

BACKGROUND: In the present study, we aimed to compare clinical and radiographic outcomes between hook plate fixation and coracoclavicular (CC) ligament reconstruction for the treatment of acute unstable acromioclavicular (AC) joint dislocation. METHODS: Forty-two patients who underwent surgery for an unstable acute dislocation of the AC joint were included. We divided them into two groups according to the treatment modality: internal fixation with a hook plate (group I, 24 cases) or CC ligament reconstruction (group II, 18 cases). We evaluated the clinical outcomes using a visual analog scale (VAS) for pain and Constant-Murley score, and assessed the radiographic outcomes based on the reduction and loss of CC distance on preoperative, postoperative, and final follow-up plain radiographs. RESULTS: The mean VAS scores at the final follow-up were 1.6 +/- 1.5 and 1.3 +/- 1.3 in groups I and II, respectively, which were not significantly different. The mean Constant-Murley scores were 90.2 +/- 9.9 and 89.2 +/- 3.5 in groups I and II, respectively, which were also not significantly different. The AC joints were well reduced in both groups, whereas CC distance improved from a mean of 215.7% +/- 50.9% preoperatively to 106.1% +/- 10.2% at the final follow-up in group I, and from 239.9% +/- 59.2% preoperatively to 133.6% +/- 36.7% at the final follow-up in group II. The improvement in group I was significantly superior to that in group II (p < 0.001). Furthermore, subluxation was not observed in any case in group I, but was noted in six cases (33%) in group II. Erosions of the acromion undersurface were observed in 9 cases in group I. CONCLUSIONS: In cases of acute unstable AC joint dislocation, hook plate fixation and CC ligament reconstruction yield comparable satisfactory clinical outcomes. However, radiographic outcomes based on the maintenance of reduction indicate that hook plate fixation is a better treatment option.
Acromioclavicular Joint/injuries/radiography/*surgery ; Acute Disease ; Adult ; Arthroscopy ; Bone Plates ; Dislocations/radiography/*surgery ; Female ; Humans ; Ligaments, Articular/surgery ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

There have been reports that hyperammonemia and amino acid disturbance can cause loss of consciousness in patients with multiple myelomas and normal liver function. We experienced a case of a 71-years-old female patient with amyloidosis, who had shown disturbance of consciousness. At that time, the serum ammonia level was elevated; serum amino acids disturbance was also noted. In particular, the decrease in branched-chain amino acids and increase in aromatic amino acids results in a low Fisher ratio. The Fisher ratio, the ratio of branched-chain to aromatic amino acids, has been suggested as an important indicator of consciousness disturbance. We report, for the first time in Korea, a case of amyloidosis, with mental disturbance due to serum amino acid disturbance.
Amino Acids ; Amino Acids, Aromatic ; Amino Acids, Branched-Chain ; Ammonia ; Amyloidosis* ; Consciousness ; Female ; Humans ; Hyperammonemia* ; Korea ; Liver ; Multiple Myeloma ; Unconsciousness

Fenoverine is a non-atropine like spasmolytic drug that inhibits calcium channel currents in the smooth muscle. It has been occassionally reported that fenoverine can cause rhabdomyolysis under the certain conditions such as hepatic dysfunction, concomitant use of HMG-CoA reductase, mitochondrial myopathy, lipid storage myopathy or malignant hyperthermia. However, there is no report of fenoverine-induced rhabdomyolysis in type 2 diabetic nephropathy patient. So we describe here a case of fenoverine-induced rhabdomyolysis in type 2 diabetic patient. A 70-year-old man had both lower legs and shoulder pain for 5 days prior to hospital admission. He was a type 2 diabetic patient and had been managed for diabetic nephropathy. He had been consumed common doses of fenoverine for 20 days due to abdominal pain and diarrhea. Results of investigations showed evidence of rhabdomyolysis. Fenoverine therapy was stopped after admission and he was treated supportive care, his condition was recovered. In this case, renal function impairment may have been a predisposing factor for fenoverine-induced rhabdomyolysis. The incidence of muscular complications of fenoverine therapy could be reduced by avoidance of prescription of the drug in patients with diabetic nephropathy.
Abdominal Pain ; Aged ; Calcium Channels ; Causality ; Diabetic Nephropathies* ; Diarrhea ; Humans ; Incidence ; Leg ; Malignant Hyperthermia ; Mitochondrial Myopathies ; Muscle, Smooth ; Muscular Diseases ; Oxidoreductases ; Prescriptions ; Rhabdomyolysis* ; Shoulder Pain

Choriocarcinoma is a relatively rare malignancy of which characteristic is rapid metastasis to the other organs. It is related to the previous gestation or originated from the teratoma. Choriocarcinoma is mostly originated from the intrauterine chorionic villi, but it is rarely originated from the utreine cervix, fallopian tube, ovary, vagina and pelvic cavity. Primary choriocarcinoma of the fallopian tube is exceedingly rare and it is originated from ectopic tubal pregnancy, tubal migration from the intrauterine pregnancy or intratubal teratoma. 9 Symptoms and signs of the choriocarcinoma originated from the ectopic pregnancy are abdominal pain, vaginal bleeding, palpable adnexal mass, positive pregnancy test and amenorrhea. Thus it is difficult to distinguish choriocarcinoma from ectopic pregnancy on the basis of symptoms before the microscopic diagnosis presented.20 Effective treatment of choriocarcinoma is chemotherapy. Additional operation is possible. B-HCG is a useful measure for the follow up. We experienced a 36-year-old multigravida Korean woman who was diagnosed as the rupture of ectopic pregnancy after left salpingectomy in our hospital and then confirmed primary choriocarcinoma of the fallopian tube without metastasis on microscopic finding. Postoperative chemotherapy was performed with methotrexate. The follow up of disease is still on going at two month intervals and she has remained healthy, We report this case with review of literatures.
Abdominal Pain ; Adult ; Amenorrhea ; Cervix Uteri ; Choriocarcinoma* ; Chorionic Villi ; Diagnosis ; Drug Therapy ; Fallopian Tubes* ; Female ; Follow-Up Studies ; Humans ; Methotrexate ; Neoplasm Metastasis ; Ovary ; Pregnancy ; Pregnancy Tests ; Pregnancy, Ectopic ; Pregnancy, Tubal ; Rupture ; Salpingectomy ; Teratoma ; Uterine Hemorrhage ; Vagina

OBJECTIVES: To evaluate the clinical manifestations and perinatal outcomes of pregnancies complicated with gestational impaired glucose tolerance (GIGT) and gestational diabetes mellitus (GDM). METHODS: We performed 50gm oral glucose tolerance test (OGTT) for GIGT and GDM screening in 4,367 pregnant women at 24-28 weeks of gestation. In 1,010 women with plasma glucose level over 130mg/dl, 753 women underwent 100gm OGTTs at 28-32 weeks of gestation. According to the NDDG criteria, 113 cases with GIGT (single positive level of OGTT ; group 2), 125 cases with GDM (group 3), and 515 cases with control (group 1) were identified among the 753 cases. Retrospective review of outcome of these patients was performed. ANOVA and chi-square test were used to determine the statistical significance. RESULTS: The incidence of GIGT and GDM was 2.7%, 3.0%. The prepregnant body mass index (21.4+/- 3.0kg/m2, 21.3+/-2.8kg/m2, 23.2+/-4.1kg/m2), overweight of BMI over 26 (7.4%, 4.4%, 14.4%) and obesity of BMI over 30 (1.2%, 0.0%, 8.0%) was significantly higher in group 3 than group 1 (p<0.05). We defined poor maternal outcome as those suffering from any one of birth canal injury, hydramnios or oligohydramnios, preeclampsia, cesarean delivery due to cephalopelvic disproportion, dystocia, fetal distress. Group 3 showed most highest poor maternal outcome (22.3%, 28.3%, 39.2%, p<0.05). And we defined poor neonatal outcome as those suffering from any one of hyperbilirubinemia, hypoglycemia, congenital anomaly, admission to neonatal intensive care unit due to respiratory distress syndrome. Group 2 and group 3 showed poor neonatal outcome than group 1 (6.2%, 13.3%, 21.6%, p<0.05). CONCLUSION: Pregnancies complicated with GDM showed poor maternal and neonatal outcome, and GIGT experienced no adverse maternal outcomes but showed poor neonatal outcomes compared to normal pregnancy, and showed less correlation with obesity than GDM. Further study of pathophysiology and proper management of GIGT will be mandatory.
Blood Glucose ; Body Mass Index ; Cephalopelvic Disproportion ; Diabetes, Gestational* ; Dystocia ; Female ; Fetal Distress ; Glucose Tolerance Test ; Glucose* ; Humans ; Hyperbilirubinemia ; Hypoglycemia ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Mass Screening ; Obesity ; Oligohydramnios ; Overweight ; Parturition ; Polyhydramnios ; Pre-Eclampsia ; Pregnancy* ; Pregnant Women ; Retrospective Studies

OBJECTIVE: Survivin is a novel inhibitor of apoptosis. Suppression of apoptosis is important for carcinogenesis and tumor growth. The purpose of this study was to investigate whether survivin is expressed in the tissues of normal uterine cervix, cervical intraepithelial neoplasia grade III (CIN III) and squamous cell carsinoma of the uterine cervix, as a first step for evaluation of the clinical significance of survivin in uterine cervical cancer. METHODS: We investigated the expression of survivin in the tissues of 11 cases of normal uterine cervix and 14 cases of CIN III and 20 cases of uterine cervical cancer, using Immunohistochemistry at department of obstetrics and gynecology of Ajou university hospital from Jan. 2000 to Jan. 2001 and then compared with the results of three groups. RESULTS: The expression of survivin is increased significantly in cases of CIN III and uterine cervical cancer compared with controls. (p<0.05, One way ANOVA test) CONCLUSION: This study shows survivin could play an important role in the carcinogenesis mechanism of uterine cervix. And further study will be followed to evaluate the clinical relationship of survivin in uterine cervical cancer and whether to act a prognostic factor or not.
Apoptosis ; Carcinogenesis ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Female ; Gynecology ; Immunohistochemistry ; Obstetrics ; Uterine Cervical Neoplasms

The purpose of this study was to explore the difference in nutrient intakes between normocholesterolemia and hypercholesterolemia. The subjects were classified as normocholesterolemia and hypercholesterolemia based on The Guideline for Korean Hyperlipidemia. A semiquantitative food frequency questionnaire was used to measure the dietary intakes of the subjects. The results obtained are summarized as follows. Intakes of nutrients such as energy, carbohydrate, protein, fat, minerals, and antioxidant vitamins were not significantly different between the normocholesterolemia group and hypercholesterolemia group. However, antioxidant vitamins and folate intakes in the hypercholesterolemia group tended to be lower than those in the normocholesterolmia group. Intakes of vitamin A, vitamin E, and Ca in normocholesterolemia was much less than the RDA for those nutrients in normocholesterolemia. Cholesterol intake in the hypercholesterolemia group was significantly higher than that in the normochoesterolemia group. However, mean cholesterol intake(240 mg/day) of the hypercholesterolemia group was much less than that of Americans whose cholesterol intake was 400 - 500 me/day. Fatty acid intakes were not significantly different between normocholesterolemia and hypercholesterolemia groups but the hypercholesterolemia group tended to consume omega3 fatty acids less than the normocholesterolemia group. Out data indicate that cholesterol intake is man important determinant of serum cholesterol levels in postmenopausal women. The results of this study provide information that is important in designing appropriate dietary guidelines for hypercholesterolemia in postmenopausal women.
Cholesterol ; Fatty Acids ; Female ; Folic Acid ; Humans ; Hypercholesterolemia* ; Hyperlipidemias ; Minerals ; Nutrition Policy ; Vitamin A ; Vitamin E ; Vitamins ; Surveys and Questionnaires

The purpose of this study was to explore the difference in nutrient intakes between normocholesterolemia and hypercholesterolemia. The subjects were classified as normocholesterolemia and hypercholesterolemia based on The Guideline for Korean Hyperlipidemia. A semiquantitative food frequency questionnaire was used to measure the dietary intakes of the subjects. The results obtained are summarized as follows. Intakes of nutrients such as energy, carbohydrate, protein, fat, minerals, and antioxidant vitamins were not significantly different between the normocholesterolemia group and hypercholesterolemia group. However, antioxidant vitamins and folate intakes in the hypercholesterolemia group tended to be lower than those in the normocholesterolmia group. Intakes of vitamin A, vitamin E, and Ca in normocholesterolemia was much less than the RDA for those nutrients in normocholesterolemia. Cholesterol intake in the hypercholesterolemia group was significantly higher than that in the normochoesterolemia group. However, mean cholesterol intake(240 mg/day) of the hypercholesterolemia group was much less than that of Americans whose cholesterol intake was 400 - 500 me/day. Fatty acid intakes were not significantly different between normocholesterolemia and hypercholesterolemia groups but the hypercholesterolemia group tended to consume omega3 fatty acids less than the normocholesterolemia group. Out data indicate that cholesterol intake is man important determinant of serum cholesterol levels in postmenopausal women. The results of this study provide information that is important in designing appropriate dietary guidelines for hypercholesterolemia in postmenopausal women.
Cholesterol ; Fatty Acids ; Female ; Folic Acid ; Humans ; Hypercholesterolemia* ; Hyperlipidemias ; Minerals ; Nutrition Policy ; Vitamin A ; Vitamin E ; Vitamins ; Surveys and Questionnaires

BACKGROUND: It was reported that Helicobacter pylori causes duodenal ulcer and chronic active gastritis, but is still controversial on the relationship with gastric cancer. H. pylori is still clinically significant despite improvements in microbiologic, pathologic and therapeutic aspects. The purpose of this study is to evaluate the prevalance of H. pylori infection according to age and sex, the risk factors of H. pylori infection and the relationship with upper gastrointestinal symptoms. METHODS: The subjects were 409 people who underwent esophagogastroscopy and CLO test from Feb. to Jun. in 1997 at Health Promotion Center, Pundang CHA General Hospital. Six types of upper gastrointestinal symptoms and demographic characterastics were surveged by questionnaire. The relationship with H. pylori infection according to age, sex, education, smoking,alcohol, coffee, stress and exercise was evaluated. And, the frequencies of H. pylori according to the presence of symptoms and the six different symptoms(indigestion, frequent belching, dyspepsia, nausea/vomiting, distension, anorexia) were anallyzed by Chi-square test. RESULTS: CLO test was positive for 264(64.5%) in total, 156(65.3%) in females. not different significantly in each group. The frequency of CLO test positive was 53.5%(under 30 years old), 64%(thirties), 67.9%(fifties), 48%(over 60years old). H. pylori infection increased slightly as age increased, but deacreased in over sixties. The frequency of H. pylori infection according to sex, education, smoking, alchol, coffee, stress, and exercise was not different significantly. 174(60.2%) of 284 symptomatic subjects(who had more than one symptom) was positive by CLO test and 93(74.4%) of 125 asymptomatic subjects was positive. The frequency of H. pylori infection according to six symptoms was not different significantly. The sensitivity, specificity, false negative rate, false positive rate, positive predictive value and negative predictive value of CLO test to pathologic report were 77.4%, 81.3%, 22.6%, 18.7%, 93.2%, 52% respectively. CONCLUSIONS: The prevalence of H. pylori infection was 64.5% and showed no difference by sex. H. pylori infection infection increased slightly as age increased. Education, smoking, alcohol, coffee, stress, exercise were not considered as risk factors. The relationship of upper gastrointestinal symptoms and H. pylori infection infection was not significant biostatiscally.
Coffee ; Duodenal Ulcer ; Dyspepsia ; Education ; Eructation ; Female ; Gastritis ; Health Promotion ; Helicobacter pylori* ; Helicobacter* ; Hospitals, General ; Humans ; Prevalence* ; Risk Factors* ; Sensitivity and Specificity ; Smoke ; Smoking ; Stomach Neoplasms ; Surveys and Questionnaires