Stones in the common duct occur in 10% to 15% of patients with cholelithiasis. In our case, coexistent cholelithiasis and choledocholithiasis were diagnosed by endoscopic retrograde cholangiopancreatography. The stone basket was easily introduced into the gallbladder and common bile duct, then fortunately removed stones. However, endoscopic retrograde cholelithiasis removal is known to be difficult because of the anatomical approach. We herein present a rare case of cholelithiasis successfully treated by retrograde endoscopic removal.
Cholangiopancreatography, Endoscopic Retrograde* ; Choledocholithiasis ; Cholelithiasis* ; Common Bile Duct ; Gallbladder ; Humans

OBJECTIVE: To know the genotypic distributions of Angiotensinogen, Thermolabile Methylenetetrahydrofolate Reductase (MTHFR) and Factor V Gene Variants, suggested as risk factors of preeclampsia, among Korean Women. METHODS: 113 preeclampsia patients and 70 normotensive pregnancy controls were evaluated. DNA was extracted from peripheral leukocytes, then PCR and restriction by appropriate enzymes were done to identify the single nucleotide polymorphism. The genotypic distributions of preeclampsia and the control group were compared. RESULTS: Nineteen of 113 women with preeclampsia (17%) and 14 of 72 with nulliparous preeclampsia (19%) were heterozygous for the angiotensinogen T704C mutation, and 94 of 113 women with preeclampsia (83%) and 58 of 72 women with nulliparous preeclampsia (81%) were homozygous. While 7/70 (10%) were heterozygous, and 59/70 (84%) were homozygous for the T704C mutation among the control subjects. The frequency of the MTHFR T677 allele was 36% in the preeclamptic group and 38% in the control group, and TT homozygosity was found in 26 preeclamptic women (23%) and in 13 controls (19%). No women were homozygous or heterozygous for the factor V Leiden mutation. CONCLUSION: Angiotensinogen T704C mutation is associated with preeclampsia in the Korean population. There was no association between the thermolabile variant of MTHFR and risk of preeclampsia in our study population. We observed no factor V Leiden mutation. We also suggested that a person with angiotensinogen T704C mutation plus MTHFR C677T variant does not have more of an increased risk for preeclampsia than with angiotensinogen T704C mutation only.
Alleles ; Angiotensinogen* ; DNA ; Factor V* ; Female ; Humans ; Leukocytes ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Pre-Eclampsia* ; Pregnancy ; Risk Factors*

STATEMETN OF PROBLEM: In-Ceram system is one of the all-ceramic crowns that can be used in anterior 3 unit fixed partial dentures and posterior single crowns. The alumina core used in In-Ceram system is manufactured using slip-casting technique. The slip-casting technique is difficult and technique sensitive. To improve this problem, tape-casting method was introduced into dentistry. There were no studies to examine the effect of margin design on the margin fit-ness of all-ceramic crowns fabricated from alumina tape. PURPOSE: The purpose of this study was to compare the marginal fitness of glass infiltrated alu-mina core fabricated from aqueous-based alumina tape according to different margin types (90 .,110 ., 135 .shoulder margin). MATERIAL AND METHOD: Three upper central resin incisors were prepared with 90 ., 110 .and 135 .shoulder margins for all-ceramic crowns, respectively. The resin teeth were duplicated and master die and special plaster die were made as usual. After alumina cores were fabri-cated from aqueous-based alumina tape, cores were cemented to each 15 epoxy dies replicated from three resin teeth with resin cement. These cemented cores were embedded in epoxy resin. Specimens were cut mesiodistally and buccolingually. Marginal gap and discrepancy were measured under microscope. RESULTS: The marginal gap and discrepancy of 90.marginal angle was 75.1 mu m, 86.6 mu m, 110 .marginal angle was 41.5 mu m, 50.7 mu m and 135 .marginal angle was 51.7 mu m, 54.2 mu m, respectively. The smallest value was seen in 110 (angle, which was statistically significant com-pared to that of 90 .angle (p<0.05). CONCLUSION: Marginal fitness of alumina cores made of alumina tape with 110 .shoulder mar-gin was best and others were clinically acceptable.
Aluminum Oxide* ; Crowns ; Dentistry ; Denture, Partial, Fixed ; Glass* ; Incisor ; Resin Cements ; Shoulder ; Tooth

OBJECTIVE: The age-associated changes of mtDNA include nucleotide deletion, point mutations, as well as modifications. Age associated alterations of mtDNA occur in several different species; however, their physiological relevance remains unclear. The function of human ovary changes dramatically around the menopausal period. However, the mechanism of menopause and ovarian aging is not well understood. Thus, to study the regulatory mechanism of ovarian dysfunction by aging, the accumulation of mtDNA deletions in human ovaries from pre-menopausal and menopausal women was analyzed and compared with mtDNA deletions in myoma and myometriums of the same subjects. METHOD: Total DNA was extracted from these tissues, an part of mtDNA were amplified by polymerase chain reaction. The detailed locations of each of the deleted mtDNA regions were identified by sequencing. RESULT: Four types of mtDNA deletions were identified: a 4977 bp deletion, a 3805 bp deletion, a 7150 bp deletion, and a 5777 bp deletion. In ovaries, the occurrence of a 4977 bp deletion of mtDNA in menopausal women was significantly higher than that in pre-menopausal women, i.e., 62.5% of that in menopausal women and 20.0% of that in pre-menopausal women. In menopausal women, the occurrence of all of those four mtDNA deletions identified in this study in ovaries was higher than that in myomas and myometriums. CONCLUSION: A 4977 bp deletion of mtDNA between the ATPase 8 and ND5 genes in ovaries can be related to ovarian aging, especially during menopause. A 4977 bp deletion in ovaries of menopausal women can be a usuful marker of natural ovarian aging and may have a relationship to dysfunction of the ovarian aging. Three other mtDNA deletions identified in this study, a 3809 bp deletion, 7150 bp deletion, and 5777 bp deletion, was newly reported. A 5777bp deletion was found in a large amount in Korean women and further studies about this racial specificity will be needed.
Adenosine Triphosphatases ; Aging ; Animals ; DNA ; DNA, Mitochondrial* ; Female ; Humans* ; Menopause ; Mice ; Myoma ; Myometrium ; Ovary* ; Point Mutation ; Polymerase Chain Reaction ; Sensitivity and Specificity

Metastatic foci to the breast resulting from extramammary malignant neoplasm are rare and multiple myeloma involved the breast are extremely rare. A 53 year old woman with a history of multiple myeloma, diagnosed 4 years previously, was admitted with a lump in her right breast. A multiple course of chemotherapy was administered. Examination revealed a palpable mass in the upper outer quadrant of the right breast. The firm and mobile mass measured 3X2 cm. There was no palpable axillary lymphadenopathy. Two echo-poor solid masses were present on breast ultrasound and there was evidence of neovascularization on color Doppler. A mammogram revealed a circumscribed spheroid shadow without evidence of microcalcification, spiculation or any other signs of desmoplastic response. A core biopsy revealed immature plasma cell infiltration showing kappa light chain restriction, consistent with multiple myeloma involving the breast. Another case of breast metastasis of multiple myeloma origin is described and a review of the literature is discussed.
Biopsy ; Breast* ; Drug Therapy ; Female ; Humans ; Lymphatic Diseases ; Middle Aged ; Multiple Myeloma* ; Neoplasm Metastasis ; Plasma Cells ; Ultrasonography

BACKGROUND AND OBJECTIVE: Buckwheat is considered one of the most important food allergens in Korea. Although a very small amount is ingested or inhaled, it can cause serious allergic reactions. However, the major allergens of buckwheat still remain to be elucidated. The aim of our study was to identify and characterize the major allergen of buckwheat seed. MATERIAL AND METHOD: Dialysis membrane with a cut-off MW 1kD was used for the preparation of crude buckwheat seed allergen extract. SDS-PAGE under reducing conditions and IgE immunoblotting were performed using sera from 15 buckwheat sensitive subjects. Isoelectric focusing and lectin blotting assay were done. RESULT: Western blot analysis showed more than 15 IgE-reactive buckwheat proteins. Among them, a 24kD protein was shown to be the most frequently bound to sera from allergic subjects (54%). Isoelectric point of 24kD protein was around 5.9. In lectin blotting assay, 24kD protein did not bind to Con A nor five other lectins. CONCLUSION: A 24kD protein was the most frequently recognized allergenic component in buckwheat seed. Isoelectric point was around 5.9. Glycosylation was not detected in 24kD of buckwheat protein.
Allergens ; Blotting, Western ; Dialysis ; Electrophoresis, Polyacrylamide Gel ; Fagopyrum* ; Glycosylation ; Hypersensitivity ; Immunoblotting ; Immunoglobulin E ; Isoelectric Focusing ; Isoelectric Point ; Korea ; Lectins ; Membranes

PURPOSE: The prognosis of stage IV stomach cancer patients is very poor and the effectiveness of radical surgery including extended lymphadenectomy and combined resection in these patients is still controversial. The purposes of this retrospective study were to identify the prognostic factors and to evaluate the effectiveness of extended lymphadenectomy and combined resection in stage IV stomach cancer paients. MATERIALS AND METHODS: Of 585 patients who were operated for stomach cancer at the NMC from Jan. 1987 to Oct. 1993, 154 patients of stage IV stomach cancer (121 patients who had distant metastasis and 33 patients who had not) were identified. We analyzed data of these 154 patients to find the characteristic clinicopathological features, the prognostic factors and the proper extent of surgical treatment. RESULTS: Comparing with stage I, II and III groups, larger tumor size, higher proportions of Borrmann type IV and undifferentiated carcinoma and higher rates of lymph node metastasis and combined resection were noticed in stage IV stomach cancer group. In combined resection, pancreas tail was mainly resected due to tumor invasion but spleen was mainly resected for the completeness of lymph node dissection. In multivariate analyses, peritoneal metastasis and postoperative residual tumor were independent prognostic factors. The overall 5-year survival rate was 14.6%. Stage IV stomach cancer patients without distant metastasis had better 5-year survival rate than that of those who had distant metastasis (34.3% vs 7.9%, p=0.00001). CONCLUSIONS: Radical procedures including extended lymphadenectomy and combined resection of the invaded organs should be considered in the stage IV stomach cancer patients without distant metastasis.
Carcinoma ; Humans ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm, Residual ; Pancreas ; Prognosis ; Retrospective Studies ; Spleen ; Stomach Neoplasms* ; Stomach* ; Survival Rate

PURPOSE: Cockroaches have been reported one of the major causes of allergic disease such as bronchial asthma and allergic rhinitis. About 10% of children and 20% of adult respiratory allergy patients have positive results of allergy skin tests to cockroach allergen. This finding suggests that cockroach is also important allergen in Korea. Among 4,000 species, German cockroach seems predominant species in the Korean peninsula. Identification and charactrerization of the major allergen is the first step in German cockroach allergen research. But, there have been controversies. It may depends upon different identifying methods. The aim of our study was to identify the major allergen in German cockroach using Westernblot. METHODS: Crude German cockroach allergen extracts with or without protease inhibitor cocktail mixture were prepared, and protein patterns of these two extracts were compared using SDS-PAGE and Coommssie stain. Sera from 32 atopic asthmatic patients with positive allergy skin test against cockroach allergen were used for IgE immunoblot. RESULTS: Coomassie stain after SDS-PAGE demonstrated some discordance between the differently prepared crude allergen extracts. In comparison with the allergen extract which abolished endogenous protease activity, the untreated extract revealed new 32, 55 and 78 kD protein bands and 41 kD protein band was disappeared. About 60% of sera with positive allergy skin test revealed IgE binding bands in Westernblot. Among them, 10, 21, 25, 36 and 52 kD protein band might seemed important German cockroach allergen. CONCLUSION: Finding above may suggest that endogenous protease could denature allergenic proteins in the process of crude cockroach allergen extract. The 10, 21, 25, 36, and 52 kD might be the important allergens in German cockroach.
Adult ; Allergens ; Asthma ; Blattellidae* ; Child ; Cockroaches ; Electrophoresis, Polyacrylamide Gel ; Humans ; Hypersensitivity ; Immunoglobulin E ; Korea ; Protease Inhibitors ; Rhinitis ; Skin Tests

This study was designed retrospectively to evaluate Ranson's criteria and APACHE II scores as a predictor of mortality in patients with acute pancreatitis. Acute pancreatitis is a common disorder. From mild disease to multiorgan failure, it is a disorder that has numerous causes, an obscure pathogenesis. An accurate history and through physical examination will often raise clinical suspicion of acute pancreatitis in the differential diagnosis of a patient with acute abdominal pain. The retrospective analysis by chart review of 86 cases of acute pancreatitis who visited emergency department of Dongsan hospital from Jan to Dec 1996. The results were as follows. The majority of the patients with acute pancreatitis presented with chief complaints of abdominal pain. The male patient outnumbered female by the ratio of 2.9:1. The highest incidence of age group was between 40 and 50. The majority of our patients had past histories of either chronic alcoholic or gallbladder problems e.g.. the number being 53 cases(61.6%) and 31 cases(36%) respectively. Among 7 patients who had changes in consciousness, 5 were expired. Of those expired, 3 patients had less than 90 mmHg of systolic blood pressure. The overall mortality rate was 10.5%(9 cases). It has been known that acute pancreatitis would be the results of traumatic and non-traumatic causes. The exact mechanism of its pathophysiolgy has not been known yet, but it has been well known that the majority of patients who in forties and fifties had history of alcoholic abuse, the rest being mainly gallbladder problem and, some other diseases implicated too. The relationship of acute pancreatitis with familiar Ranson's criteria was such that 3 patients of the Ranson's out of 9 death were noted to have more than 3 of the criteria, but another 3 had less than 3. Among the 60 patients in whom the required physiologic variables were available out of total 86 patients studied, 9 were expired and 51 survived, average APACHE II scores for the survival and the expired being 6.92+/-3.99 & 18.11+/-5.68 respectively (P<0.05). We concluded that the APACHE II score could be used to better than Ranson's criteria to predict hospital mortality in patients with acute pancreatitis.
Abdominal Pain ; Alcoholics ; APACHE ; Blood Pressure ; Consciousness ; Diagnosis, Differential ; Emergency Service, Hospital ; Female ; Gallbladder ; Hospital Mortality ; Humans ; Incidence ; Male ; Mortality ; Pancreatitis* ; Physical Examination ; Retrospective Studies

No abstract available.
Adult* ; Child* ; Humans ; Infant* ; Respiratory Distress Syndrome, Adult*