BACKGROUND/AIMS: Apolipoprotein E (ApoE) plays an important role in regulating lipid and lipoprotein metabolism, and ApoE genotypes are known to affect plasma lipoprotein concentrations. We investigated whether ApoE genotype determines the disease outcome in hepatitis B virus (HBV)-infected individuals, and verified the association between ApoE genotype and the occurrence of hepatocellular carcinoma (HCC) in patients with chronic liver diseases of various etiologies. METHODS: This hospital-based, case-controlled study enrolled 156 subjects (47 healthy controls, 50 HBV-related liver cirrhosis patients, and 59 HCC patients). ApoE genotypes were determined using PCR-based ApoE genotyping kits. The biological significance of ApoE genotype was verified by measuring serum ApoE levels using an ELISA kits. RESULTS: The epsilon3 allele was the most common allele, with allele frequencies among the entire cohort of 5.8%, 84.3%, and 9.9% for the epsilon2, epsilon3, and epsilon4 alleles, respectively. Significantly more of those patients carrying the epsilon3/3 genotype had developed liver cirrhosis compared to the control subjects. Being an ApoE4 carrier was associated with a lower probability of developing liver cirrhosis. The allele frequencies and genotype distribution of ApoE did not differ significantly between the liver cirrhosis and HCC patients. The serum level of ApoE was significantly higher in patients with liver cirrhosis than in the healthy controls, but did not differ significantly with the ApoE genotype. CONCLUSIONS: The ApoE epsilon3/3 genotype frequency was higher in patients with HBV-associated liver cirrhosis than in the controls.
Adult ; Aged ; Aged, 80 and over ; Alleles ; Apolipoproteins E/*genetics/metabolism ; Carcinoma, Hepatocellular/*metabolism/pathology ; Case-Control Studies ; Child ; Chronic Disease ; Cohort Studies ; Female ; Gene Frequency ; Genotype ; Hepatitis B/complications/metabolism/virology ; Hepatitis B virus/*physiology ; Humans ; Liver Cirrhosis/etiology/*metabolism ; Liver Neoplasms/*metabolism/pathology ; Male ; Middle Aged ; Young Adult

There are several reported possible complications of acupuncture including hepatitis, pneumothorax, and cardiac tamponades, but the development of empyema is unusual. All the previously described cases of empyemas were due to acupuncture needles being inadvertently left in the thoracic cavities. We describe a thirty seven years old female patient who developed empyema after multiple acupuncture sessions whose disease course was unique because the empyema developed without an acupuncture needle being left in the thoracic cavity. This case demonstrates that an acupuncture needle being left in the thoracic cavity is not necessary for the development of empyema after acupuncture sessions as previously described.
Acupuncture ; Cardiac Tamponade ; Empyema ; Female ; Hepatitis ; Humans ; Needles ; Pneumothorax ; Thoracic Cavity

Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi and manifested with fever, skin rash, myalgia, and hepatitis etc. Most of patients improve with antibiotics such as doxycycline. The spectrum of the clinical severity ranges from mild to severe with fatal complication such as meningoencephalitis, pneumonitis, myocarditis. We report a case of a 72-year-old man with scrub typhus complicating subdural hematoma.
Aged ; Anti-Bacterial Agents ; Doxycycline ; Exanthema ; Fever ; Hematoma, Subdural* ; Hepatitis ; Humans ; Meningoencephalitis ; Myalgia ; Myocarditis ; Orientia tsutsugamushi ; Pneumonia ; Scrub Typhus*

Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi and manifested with fever, skin rash, myalgia, and hepatitis etc. Most of patients improve with antibiotics such as doxycycline. The spectrum of the clinical severity ranges from mild to severe with fatal complication such as meningoencephalitis, pneumonitis, myocarditis. We report a case of a 72-year-old man with scrub typhus complicating subdural hematoma.
Aged ; Anti-Bacterial Agents ; Doxycycline ; Exanthema ; Fever ; Hematoma, Subdural* ; Hepatitis ; Humans ; Meningoencephalitis ; Myalgia ; Myocarditis ; Orientia tsutsugamushi ; Pneumonia ; Scrub Typhus*

BACKGROUND: In the measurement of bronchodilator reversibility, the forced expiratory volume in one second(FEV(1)) and the forced vital capacity(FVC) are commonly used parameters and recommended criteria for the reversibility requiring an increase of more than 200ml and 12% above the baseline, respectively. However, aged patients do not often meet the criteria of an increase in volume(>200ml) even though the medical history of that patient is adequate for asthma. This study investigated the role of the forced expiratory volume in six seconds(FEV(6)) in the bronchodilator reversibility test in elderly patients. METHODS: A total of 236 patients more than 65 years of age with a FEV(1)/FVC ratio<80% were enrolled in this study. The bronchodilator revesibility tests were examined. With the setting FEV(1) as the baseline, the patients were divided into three groups; Group I: FEV(1)> or = 80% of the predicted value, Group II: 60% Aged ; Asthma ; Forced Expiratory Volume ; Humans

BACKGROUND: As the number of malaria patients has increased in Korea, the number of blood donors who are diagnosed as malaria after donation has also increased. And during 1997~2001, ten cases of transfusion-transmitted malaria were reported. We investigated the transfusion safety of blood that was donated by malaria patients before diagnosis. METHODS: For a total of 2,552 malaria patients diagnosed in 2001, blood donation history of past one year before diagnosis was inquired at the beginning of 2002. Then we inquired informations about recipients of the hospitals through the regional Red Cross blood centers. we also inquired development of malaria after transfusion for the recipients in the August of 2002. Malaria antibody test results of donated blood were also analyzed to determine the status of immunity of donors in Seoul, Gyeonggi and Gangwon area. RESULTS: Among 2,552 malaria patients, 162 (6.3%) patients had donated within one year before diagnosis and they were all man. Their blood was processed into 292 units of blood components and supplied to 90 hospitals, where it was transfused 286 patients. Among these 286 patients, no one was diagnosed as malaria until time of database retrieving. Among 162 malaria patient, enzyme immunoassay malaria antibody test results of 107 (66.0%) patients were available, and all were negative. CONCLUSION: No one has developed malaria among the recipients transfused with blood that was donated by malaria patients before diagnosis. Therefore, the infectivity of blood donated before malaria diagnosis is thought to be very low. As antibody to malaria was not produced in some of malaria patients before diagnosis, this finding could be useful for the study of immunology of malaria infection.
Allergy and Immunology ; Blood Donors ; Diagnosis* ; Gangwon-do ; Gyeonggi-do ; Humans ; Immunoenzyme Techniques ; Korea ; Malaria* ; Red Cross ; Seoul ; Tissue Donors

BACKGROUND: In Korean Red Cross, recombinant immunoblot assay (RIBA) has been used for the confirmatory test of HCV positive units since 1995. To certify the HCV infection in blood donors who showed the 'indeterminate result on the RIBA test, this study was performed. METHODS: Three enzyme immunoassay (EIA) kits (LG HCD 3.0, DONG-A HCV 3.0, and ORTHO HCV 3.0)and RNA detection method were employed to evaluate infection state of 135 samples of the 'indeterminate in the RIBA test. RESULTS: The 52.6% of the samples showed the same test results with three EIA kits. Fifteen samples (11.1%) were HCV RNA positive with RT-PCR-hybridization technique. Among 15 samples of HCV RNA positive, 13 (86.7%), 13 (86.7%), and 14(93.3%) of samples were positive in LG HCD 3.0, Ortho HCV 3.0 and Dong-A HCV 3.0 EIA, respectively. In the analysis of RIBA band reaction, HCV RNA positivity were correlated with core14, core518, and 897 antigen. However, among 64 samples which react with core antigen only, five samples (7.8%) were HCV RNA positive. CONCLUSION: Based on the results of the present study, it is recommend that the HCV RNA test be used as a method of confirmatory test in order to notify exact HCV positivity status to blood donor who showed indeterminate RIBA result.
Blood Donors* ; Humans ; Immunoenzyme Techniques ; Red Cross ; RNA ; Tissue Donors*

BACKGROUND: Serologic test for syphilis(STS) is an old traditional donor screening test for preventing transfusion-transmitted syphilis. By conducting STS, history taking for donors and refrigeration of blood, transfusion associated syphilis is very rare at present. This study evaluated the usefulness of the STS as a surrogate marker for preventing the transfusion of human immunodeficiency virus(HIV) via the transfusion of infectious window-period blood in Korean blood donors. METHODS: Demographic and laboratory information on blood donations made between January 1997 and December 1998 in 16 Korean Red Cross Blood Centers was analyzed. STS positive rate of 239 HIV-infected people and blood donors in 1999 were investigated. RESULTS: Of 4,808,297 donations over 2-year period, 3,956 (0.08%) were positive in STS and 40 (0.0008%) were anti-HIV confirmed positive. Of those, two were simultaneously positive for STS and anti-HIV. Among donations, Anti-HIV positive donations were 64 times more likely to be STS positive(odds ratio=63.9) and positive predictive value (PPV) of STS for anti-HIV was 0.05%. Fourteen of 239 HIV-infected people were STS positive. CONCLUSION: STS positivity was higher in anti-HIV positive donors, but the PPV of STS for anti-HIV was low. STS as a donor screening test is considered as a poor marker for preventing post-screening HIV infections and the usefulness of STS must be evaluated in its own value.
Biomarkers* ; Blood Donors* ; Donor Selection ; HIV Infections ; HIV* ; Humans* ; Red Cross ; Refrigeration ; Serologic Tests* ; Syphilis* ; Tissue Donors

PURPOSE: Acute promyelocytic leukemia (APL) is a distinct subtype of acute myelogenous leukemia characterized by the morphology of blast cells (M3 in FAB classification), the t (15;17) translocation, and a coagulopathy combining disseminated intravascular coagulation and fibrinolysis. It has been considered to have better response to combination chemo- therapy of an anthracycline and cytosine arabinoside and a higher cure rate than other subtypes because of recent approach of differentiating leukemic blasts by all-transretinoic acid (ATRA). The role of stem cell transplantation in APL has to be determined in comparison with that of consolidation chemotherapy. MATERIALS AND METHODS: We compared the leukemia-free survival and overall survival between APL patients receiving the consolidation chemotherapy and those undergoing the allogeneic or autologous stem cell transplantation following the high-dose anticancer therapy. Of the 65 patients achieving the first complete remission from 1992 to 1997, 33 patients were treated with 3 courses of consolidation chemotherapies and 32 with the stem cell transplantation. RESULTS: With a median follow-up of 22 months (8-60), the actuarial leukemia-free survival at 3 years was significantly higher in transplantation group than in chematherapy group (73.8% versus 33.5%; P=0.0087), and the probability of leukemic relapse was considerably lower in transplantation group than in chemotherapy group (6.3% versus 57.5%; P=0.001). The treatment-related mortalities of the groups were 0% in chemotherapy group and 14.3% in transplantation group. The main cause of deaths was relapse in the consolidation chemotherapy group. CONCLUSION: These data demonstrate that the stem cell transplantation results in better leukemia-free survival than the consolidation chemotherapy for patients with APL in the first complete remission because of lower risk of relapse.
Bone Marrow Transplantation* ; Bone Marrow* ; Cause of Death ; Consolidation Chemotherapy* ; Cytarabine ; Disseminated Intravascular Coagulation ; Drug Therapy ; Fibrinolysis ; Follow-Up Studies ; Humans ; Leukemia, Myeloid, Acute ; Leukemia, Promyelocytic, Acute* ; Mortality ; Recurrence ; Stem Cell Transplantation

PURPOSE: We investigated the difference of glucose metabolism of medial and lateral temporal lobes of patients with temporal lobe epilepsy (TLE) utilizing quantitative comparison of regional metabolic activities using asymmetric index. MATERIALS AND METHODS: We studied 19 pathologically proven mesial TLE and 25 lateral TLE patients. Lateral TLE patients were either normal on magnetic resonance imaging (cryptogenic: n=14) or had structural lesions (lesional: n=11). Asymmetric index (ASI) was calculated as [(ipsilateral-contralateral)/(ipsilateral+ contralateral)]x200. RESULTS: ASI of medial and lateral lobes of mesial TLE was decreased (-16.4+/-8.3 and -12.7+/-5.5, respectively). In cryptogenic lateral TLE, ASI of lateral temporal lobe was decreased (-11.8+/-4.7), whereas that of medial temporal lobe was not decreased (-4.6+/-6.3). ASI of medial lobe of lesional lateral TLE was -7.3+/-9.1, which was significantly different from that of mesial TLE (p<0.05). Patients with lesional lateral TLE had evident metabolic defects or decrease (ASI: -22+/-10.5) in lateral temporal lobe. While we could not find the difference of metabolic activity in lateral temporal lobes between cryptogenic lateral TLE and mesial TLE patients, the difference of metabolic activity was significant in medial temporal lobes which was revealed by ASI quantitation. CONCLUSION: Asymmetric decrease of metabolic activity in both medial and lateral temporal lobes indicates medial temporal epilepsy. Symmetry of metabolic activity in medial temporal lobe combined with asymmetry of that in lateral temporal lobe may give hints that the epileptogenic zone is lateral.
Epilepsy ; Epilepsy, Temporal Lobe* ; Glucose* ; Humans ; Magnetic Resonance Imaging ; Metabolism* ; Temporal Lobe*