BACKGROUND: Directly measured low density lipoprotein cholesterol (DLDLC) has been reported to be more accurate than calculated low density lipoprotein cholesterol (CLDLC) using the Friedewald equation. However, some limitations of DLDLC have been reported. In this study, we evaluated differences between CLDLC and DLDLC measured using HiSens reagents. METHODS: Data were collected from 582 persons undergoing routine physical examinations at a general hospital. LDLC measurements were made directly or estimated using the Friedewald formula, and were classified according to the National Cholesterol Education Program's Adult Treatment Panel III guidelines. The relationship between these differences and other clinically relevant factors, such as triglyceride (TG) levels, were examined using multiple logistic regression analysis. RESULTS: The DLDLC and CLDLC were strongly correlated according to simple linear regression analysis (r=0.917, P<0.001) but the mean difference between measurements was -11.0+/-15.3 (-62 to 90.5) mg/dL (P<0.001). For more than 10 mg/dL of their absolute differences, the DLDLC was typically lower than the CLDLC. The highest discrepancies in LDLC measurements occurred when LDLC was more than 160 mg/dL and less than 190 mg/dL. Differences in LDLC measurements were prone to striking negative and positive biases dependent on CLDLC and TG concentrations, respectively (all r>0.5). CONCLUSION: Unlike other studies, DLDLC was significantly lower than CLDLC and the large differences in LDLC concentrations were not dependent on TG concentration. Our work suggests that verification of DLDLC accuracy is needed and differences in LDLC measurements should be accounted for in making clinical decisions.
Adult ; Bias (Epidemiology) ; Cholesterol ; Cholesterol, LDL* ; Education ; Hospitals, General ; Humans ; Indicators and Reagents* ; Linear Models ; Logistic Models ; Physical Examination ; Strikes, Employee ; Triglycerides

OBJECTIVES: The aim of the study was to develop a North Korean version of the Composite International Diagnostic Interview (NK-CIDI) and to evaluate the reliability and validity of NK-CIDI. METHODS: Subjects were 100 North Korean defectors, aged 18 to 65, who were recruited in a center for defectors in the National Medical Center or who were on an education curriculum in the defector settlement support center. NK-CIDI was developed based on the Korean version of CIDI considering the sociocultural background of North Korea. Inter-rater reliability, test/retest reliability, and validity of NK-CIDI were evaluated and kappa value was calculated. RESULTS: Different vocabularies and awkward expressions were adjusted, and additional explanations were supplemented for difficult phases. The target for development of NK-CIDI was early defectors who entered South Korea less than 3 months ago. Inter-rater reliability (n=30, kappa value 0.35-1.00), test/retest reliability (n=30, kappa value 0-0.86), and diagnostic validity (n=100, kappa value -0.02-0.42) were evaluated. CONCLUSION: Compared to the general population, defectors experience more psychiatric issues, and a standardized tool for diagnosis is needed. In this study, NK-CIDI was developed and the results suggest that reliability is acceptable but validity needs further verification. NK-CIDI could be utilized in future epidemiologic studies.
Curriculum ; Democratic People's Republic of Korea ; Diagnosis ; Education ; Epidemiology ; Korea ; Mental Disorders ; Reproducibility of Results ; Vocabulary

Imaging mass spectrometry (IMS) is currently receiving large attention from the mass spectrometric community, although its use is not yet well known in the clinic. As matrix-assisted laser desorption/ionization time-of-flight (MALDI)-IMS can show the biomolecular changes in cells as well as tissues, it can be an ideal tool for biomedical diagnostics as well as the molecular diagnosis of clinical specimens, especially aimed at the prompt detection of premalignant lesions much earlier before overt mass formation, or for obtaining histologic clues from endoscopic biopsy. Besides its use for pathologic diagnosis, MALDI-IMS is also a powerful tool for the detection and localization of drugs, proteins, and lipids in tissue. Measurement of parameters that define and control the implications, challenges, and opportunities associated with the application of IMS to biomedical tissue studies might be feasible through a deep understanding of mass spectrometry. In this focused review series, new insights into the molecular processes relevant to IMS as well as other field applications are introduced.
Biopsy ; Chemoprevention ; Diagnosis ; Mass Spectrometry* ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Biomarkers

BACKGROUND/AIMS: In a previous issue published in Gut and Liver, we found that erosive changes in the esophagogastroduodenal mucosa were strongly correlated with increased levels of volatile sulfur-containing compounds (VSC), suggesting that halitosis could be a symptom reflecting the erosive status of the upper gut mucosa. Together with other studies showing a possible association between halitosis and gastroesophageal reflux disease (GERD), under the premise that halitosis could be one of extraesophageal manifestations of erosive GERD (ERD), we investigated the significance of Halimeter ppb levels on ERD compared to non-erosive gastroesophageal reflux disease (NERD). METHODS: Subjects were assigned to the NERD group if there was no evidence of esophageal erosive changes on endoscopy, despite reflux symptoms, and to the ERD group if they had GERD A, B, C, or D (according to the Los Angeles classification). The VSC levels were measured in all patients with either a Halimeter (before endoscopy) or by gas chromatography of the gastric juices aspirated during endoscopy. RESULTS: The VSC level differed significantly between the NERD and ERD groups (p<0.0001), suggesting that this can be used to discriminate between NERD and ERD. However, the VSC level did not differ significantly with the severity of GERD. Even though hiatal hernia and a body mass index of >24 kg/m2 was significantly associated with ERD, there was no correlation with Halimeter ppb levels. Minimal-change lesions exhibited the highest VSC levels, signifying that minimal change lesions can be classified as ERD based on our finding that halimeter ppb levels were descrimitive of erosive change. CONCLUSIONS: Erosive changes in the esophageal mucosa were strongly associated with VSC levels, supporting the hypothesis that halitosis can be a potential biomarker for the discrimination between ERD and NERD, reflecting the presence of erosive change in the lower esophagogastric junction.
Body Mass Index ; Chromatography, Gas ; Discrimination (Psychology) ; Endoscopy ; Esophagogastric Junction ; Gastric Juice ; Gastroesophageal Reflux ; Halitosis ; Hernia, Hiatal ; Humans ; Liver ; Los Angeles ; Mucous Membrane

BACKGROUND: Recent studies have shown that Mohs micrographic surgery (MMS) decreased the recurrent rate of tumors and conserved the normal, unaffected tissue. Therefore, MMS is accepted as the first choice treatment modality for cutaneous malignant tumors. OBJECTIVE: The purpose of this study was to review the use of MMS and reconstruction of cutaneous malignant tumors over the past 10 years. METHOD: We retrospectively evaluated 104 patients who had been diagnosed with cutaneous malignant tumors between January 1994 and December 2003, and had been treated with MMS and tumor reconstruction. RESULTS: There were 54 males and 50 females. The mean age was 62. Basal cell carcinoma was the most common skin tumor, and the most common anatomical site was the face. Mean number of stages of MMS were 1.91, and the mean size of the final defect after MMS was 19.46x25.4 mm. A local flap was most commonly used to repair the surgical defects (59%). Recurrent cases totalled 2 out of 104 over the 4-60 months of follow up. CONCLUSION: MMS and proper reconstruction are a reliable and effective method for the treatment of cutaneous malignant tumors and offers the lowest functional and cosmetic morbidity in skin cancer treatment.
Carcinoma, Basal Cell ; Female ; Follow-Up Studies ; Humans ; Male ; Mohs Surgery* ; Retrospective Studies ; Skin ; Skin Neoplasms

Frontal fibrosing alopecia is considered to be a clinical variant of lichen planopilaris. This condition is characterized by progressive frontal hairline recession associated with scarring. Frontal fibrosing alopecia has become an increasingly recognized distinct clinical entity in recent years. We report a typical case of frontal fibrosing alopecia and review the pertinent literature.
Alopecia* ; Cicatrix ; Lichens

Osteoma cutis is a rare disorder characterized by compact bone formation in the dermis and subcutaneous tissue. It is classified in primary and secondary forms according to the presence or absence of previous cutaneous lesions. Multiple miliary osteomas of the face is a form of primary miliary osteoma cutis that generally occurs in middle-aged and older women. We report a typical case of multiple miliary osteomas of the face in a 63-year-old woman.
Dermis ; Female ; Humans ; Middle Aged ; Osteogenesis ; Osteoma* ; Subcutaneous Tissue

Intravascular papillary endothelial hyperplasia(IPEH) is a solitary slowly enlarging, often tender, blue to red elevated nodule. The predilection sites include the head and neck region, and the extremities, especially the fingers. Histologically, IPEH is characterized by the well-circumscribed intravascular papillary structures, which are formed by fibrous cores that are lined by endothelial cells. We report a case of intravascular papillary endothelial hyperplasia developed on the unusual site of lip.
Endothelial Cells ; Extremities ; Fingers ; Head ; Hyperplasia* ; Lip* ; Neck

Systemic PUVA therapy can produce various acute reactions and potential long-term damage including benign and malignant skin tumors. Obviously the risk is related to DNA damage, but PUVA-induced down-regulation of immune responses may play an additional role. Keratoacanthoma is etiologically related to sunlight and immunosuppression. PUVA keratoses are raised warty papules with a broad base and a diameter of several millimeters to 1 centimeter, and they are associated with an increased risk of nonmelanoma skin cancer. We report a case of solitary keratoacanthoma and multiple PUVA keratoses all developing in vitiliginous areas in a patient receiving long-term, high-dose PUVA therapy for generalized vitiligo. A 57-year-old Korean female, who had undergone intermittent systemic PUVA therapy for 11 years, noted multiple asymptomatic, yellowish, hyperkeratotic papules on the dorsa of hands and feet 1 year previously, and a bean-sized raised painful nodule filled with keratin plug on the dorsum of right hand 1 month previously. Skin biopsy confirmed the diagnoses of PUVA keratoses and keratoacanthoma, respectively. PCR-SSCP analysis revealed no mutation of p53 tumor suppressor gene in this case.
Biopsy ; Diagnosis ; DNA Damage ; Down-Regulation ; Female ; Ficusin* ; Foot ; Genes, Tumor Suppressor ; Hand ; Humans ; Immunosuppression ; Keratoacanthoma* ; Keratosis* ; Middle Aged ; Photochemotherapy* ; PUVA Therapy ; Skin ; Skin Neoplasms ; Sunlight ; Vitiligo*

No Abstract Available.
Humans ; Renal Dialysis*