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Backgrounds: The electroencephalogram (EEG) abnormalities in Alzheimer's disease (AD) have been widely reported, and medial temporal lobe atrophy (MTLA) is one of the hallmarks in early stage of AD. We aimed to assess the relationship between EEG abnormalities and MTLA and its clinical validity. Materials and Methods: A total of 18 patients with AD were recruited (the mean age: 77.83 years). Baseline EEGs were analyzed with quantitative spectral analysis. MTLA was assessed by a T1-axial visual rating scale (VRS). Results: In relative power spectrum analysis according to the right MTLA severity, the power of theta waves in C4, T4, F4, F8, and T5 increased significantly and the power of beta waves in T6, C4, T4, F8, T5, P3, T3, and F7 decreased significantly in severe atrophy group. In relative power spectrum analysis according to the left MTLA severity, the power of theta waves in T3 increased significantly and that of beta waves in P4, T6, C4, F4, F8, T5, P3, C3, T3, F3, and F7 decreased significantly in severe atrophy group. Conclusion: The severe MTLA group, regardless of laterality, showed more severe quantitative EEG alterations. These results suggest that quantitative EEG abnormalities are correlated with the MTLA, which may play an important role in AD process. [ABSTRACT FROM AUTHOR]

During a survey of marine fungi from the waters surrounding Jeju Island, Korea, several Penicillium strains were isolated from seawater and marine sponges. Based on morphological characteristics and phylogenetic analyses of the internal transcribed spacer and RNA polymerase subunit II, four strains were identified as Penicillium antarcticum, a fungus that, to the best of our knowledge, had not been previously reported in Korea. Here, we provide detailed descriptions of the morphological characteristics and extracellular enzyme activities of the four strains. [ABSTRACT FROM AUTHOR]

Background: Concern regarding the health-related quality of life (HRQOL) of long-term survivors of thyroid cancer has risen due to the rapid increase in the incidence of thyroid cancer, which generally has an excellent prognosis. The aim of this study was to evaluate the status of HRQOL in disease-free survivors of differentiated thyroid carcinoma (DTC) and to evaluate the important determinants of HRQOL., Methods: This was a cross-sectional study in which we interviewed consecutive disease-free survivors of DTC. Three different validated questionnaires ("EORTC QLQ-C30" for various functional domains, the "brief fatigue inventory (BFI)" and the "hospital anxiety and depression scale" (HADS)) were used. Data from a large, population based survey of 1,000 people were used as a control., Results: The response rate for the questionnaires was 78.9% (316/401). Disease-free survivors of DTC showed a decreased HRQOL in all five functional domains (physical, role, cognitive, emotional, and social) on the EORTC QLQ-C30 compared with controls (P < 0.01). BFI and HADS-anxiety scores also showed greater distress in disease-free survivors of DTC than in controls (P < 0.05). A multiple regression analysis for the determinants of HRQOL showed that the HADS-anxiety, HADS-depression, and BFI scores were the most significant components of decreased HRQOL., Conclusions: Although disease-free survivors of DTC are expected to have disease-specific survival comparable to the general population, they experience a significantly decreased HRQOL. Anxiety, depression, and fatigue were the major determinants of the decreased HRQOL. Supportive psychological care should be integrated into the management of long-term survivors of DTC.

We studied 65 adult patients without a history of diabetes who were diagnosed with diabetic ketoacidosis. Ketosis-prone type 2 diabetes was common (42%) among this group of Korean patients with new-onset diabetes presenting with diabetic ketoacidosis. These patients were younger, showed a greater defect in insulin secretion.

Background: Elevated pretreatment alanine aminotransferase (ALT) over two times the upper limit of normal reference range has been accepted as a marker for predicting HBeAg loss and an indicator for initiating antiviral therapy. Recently, several opinions argued that in patients aged over 40 years, the treatment should be started if they have elevated serum hepatitis B virus (HBV) DNA without elevated ALT. However, initiating treatment in these patients might be argued against by the concept that the rate of HBeAg loss depends on the pretreatment ALT., Aim: This study was conducted to investigate the usefulness of pretreatment ALT in predicting HBeAg loss in patients aged over 40 years under lamivudine treatment., Methods: We retrospectively analyzed 820 HBeAg-positive patients treated with lamivudine. The patients with hepatocellular carcinoma at or after initiating the lamivudine treatment and patients with evident liver cirrhosis were excluded. Three hundred fifty-five patients met the criteria and were divided into two groups: 40 years of age (Group 2)., Results: Analysis using the Kaplan-Meier method and the log rank test showed that the cumulative rate of HBeAg loss was not different in the two groups. Multivariate modelling indicated that an elevated pretreatment ALT level was a predictor of HBeAg loss in Group 1 (P<0.05), whereas it failed to act as a predictor in Group 2., Conclusion: Antiviral therapy might not need to be deferred until the ALT level increases in order to enhance the chance of HbeAg loss in HBV DNA-(+) patients aged over 40 years.

An epidemiologic study was performed to determine the genetic variability of rotaviruses in Seoul, South Korea. In 3,174 stool specimens from children with acute diarrhea at five referral hospitals, 571 (18%) possessed the antigen of group A rotavirus detectable by ELISA--10.8% in 2004 and 28.1% in 2005. VP7 genotyping revealed that the G3 type was found in 25.6% of all typed isolates, G4 in 23.8%, G2 in 21.6%, and G1 in 17.6%. VP4 genotyping showed that the P[8] type was detected in 66.7%, P[6] in 15.6%, P[4] in 13.0%, and P[9] in 0.2%. Because the variant P[8] type could not be amplified initially by conventional P typing primers (1T-1), PCR were performed using newly designed 1T-1S primer, which revealed that 307 specimens were the variant P[8] type. Uncommon combinations such as G4P[6] and G2P[8] were also found with relatively high prevalence, 14.6% and 12.8%, respectively. Variant P[8] types were associated with an outbreak of rotavirus in 2005.

A randomized controlled trial has started in both Japan and Korea to evaluate the role of gastrectomy in the management of incurable advanced gastric cancer (AGC). Patients with AGC diagnosed as having a single non-curable factor are randomized to gastrectomy plus chemotherapy or chemotherapy alone. Surgeons at 33 specialized centers in Japan and at 15 high-volume hospitals in Korea will recruit 330 patients. Primary end-point is overall survival, and secondary end-points are progression-free survival and adverse events associated with either gastrectomy or chemotherapy.

A common and important problem in patients with chronic hepatitis B is the progression of liver fibrosis. Matrix metalloproteinases (MMPs) play an important role in the progression of liver fibrosis. Our aim of this study was to examine the association of MMP-3 polymorphism with liver cirrhosis in Korean patients with chronic hepatitis B. Genomic DNA was extracted from 127 patients with chronic hepatitis B (CHB), 92 patients with hepatitis B virus (HBV)-related liver cirrhosis (HBV-LC), and 146 healthy subjects. MMP-3 polymorphism was determined by polymerase-chain reaction-based assays, and the association with the progression of liver cirrhosis was investigated. With regard to MMP-3 polymorphism, there was no statistical difference in genotype distributions among the three groups. However, the peripheral platelet count of the 5A carriers was significantly lower than that of the 6A homozygotes in the HBV-LV group (85.0 +/- 36.9 vs. 109.8 +/- 47.0 x 10(9)/l; P = 0.02). With MMP-3 promoter polymorphism (rs3025058), a lower peripheral blood platelet count, which was related to advanced liver cirrhosis, was observed in 5A carriers. Therefore, more studies of MMP-3 gene polymorphism with larger populations should be conducted to further understand its role in the progression of liver cirrhosis.

The idea that human bocavirus (hBoV) infection possibly plays a role in gastroenteritis has been suggested because of the frequent manifestation of gastrointestinal symptoms. The purpose of this study was to investigate the prevalence of hBoV in children with gastroenteritis. We studied the etiologic agents in 962 children hospitalized with gastroenteritis. Viral etiologic agents were detected by enzyme-linked immunosorbent assay or reverse-transcriptase polymerase chain reaction. A viral agent was found in 44.4% of the study population: rotavirus, norovirus, adenovirus, and astrovirus were detected in 25.7%, 13.7%, 3.0%, and 1.1% of the study population, respectively; hBoV was detected in 0.8%, which suggests that it might play a minor role in gastroenteritis.

This study investigated the effects of the herd, cow parity, the insemination protocol and season on the incidence of pregnancy loss (PL) in dairy herds. Furthermore, we determined the downstream effects of PL on reproductive performance and its economic impact. The overall incidence rate of PL was 6.9% in 1,001 pregnant cows and its incidence peaked (p < 0.01) during the second trimester of gestation. GLIMMIX analysis revealed that cow parity was the important risk factor for the PL. The odds ratio showed that the likelihood of PL in cows with parities of 1 or 2 was decreased by 0.6 or 0.5 fold compared to the cows with a parity of 3 or higher. Following PL, the mean rate of endometritis was 23.2% and endometritis was more common (p < 0.05) when PL occurred during the third trimester than during the first and second trimesters. The mean culling rate was 46.4% and this did not differ with the period of PL. The overall mean intervals from PL to the first service and conception were 63.4 and 101.8 days, respectively. The mean interval from PL to first service was longer (p < 0.01) for cows with PL during the third trimester than for the cows with PL during the first and second trimesters. The economic loss resulting from each PL was estimated at approximately $2,333, and this was largely due to an extended calving interval and increased culling. These results suggest that cow parity affects the incidence of PL, which extends calving interval and causes severe economic loss of dairy herds.

The purpose of this study was to explore factors that influence academic achievement for dental students during their first semester of graduate-entry programs. Nine variables were considered, including students' age, gender, undergraduate grade point averages (UGPAs), Dental Education Eligibility Test (DEET) scores, oral exam, and interview selection scores. DEET is a standardized aptitude test developed for graduate-entry dental programs in Korea. The test consists of four separate sections: reading comprehension, scientific reasoning parts I and II, and perceptual ability. GPA scores were obtained as a measure of academic achievement from ninety students at the graduate-entry dental program at Seoul National University, Korea. Path analysis was used to test the hypothetical model of causal influence. The most significant predictors with direct influence on achievement were scores from both scientific reasoning parts I and II, undergraduate GPAs, and gender. Age, scores from the other subjects in DEET (reading comprehension and perceptual ability), and oral exam scores were found to bear no relation to the students' achievement.

Using three reference strains of Brachyspira hyodysenteriae (B204, B234, B169), one B. pilosicoli (P43/6/78), one B. murdochii (56-150), one B. intermedia (PWS/A), one B. innocens (B256) and ten Korean isolates, PCR-RFLP analysis of DNA encoding 23S rRNA was performed to establish a rapid and accurate method for characterizing porcine intestinal spirochetes. Consequently, B. hyodysenteriae and B. pilosicoli revealed different restriction patterns; however, the other three species shared the same pattern. These findings are not consistent with a prior report. Differences in 23S rRNA gene sequences, between two B. murdochii strains, 56-150 and 155-20, were observed. These results indicate that 23S rRNA PCR-RFLP could be used as an identification method for pathogenic Brachyspira spp. (B. hyodysenteriae and B. pilosicoli) as well as an epidemiological tool for characterizing spirochetes isolated from swine.

Aim: Recently, germ-line mutation in the base excision repair gene MYH has been identified to cause a novel autosomal recessive form of familial adenomatous polyposis (FAP). Interestingly, a striking evidence for MYH mutations within different ethnic groups has been demonstrated. In this study, we screened 30 patients with multiple adenomatous polyps for MYH mutations to assess its prevalence and ethnic specificity in Korea., Methods: Thirty patients (21 men and 9 women; mean age 62.3 years) with multiple adenomatous polyps were examined for MYH mutations. The mean number of adenomas per patient was 10.0. Sixteen exonic regions and their intronic sequences were amplified by PCR and subjected to SSCP and DNA sequencing analyses., Results: None of the patients was identified to carry any truncating or sequence alterations in MYH. Our screening for the mutational regions, which were recognized from Caucasian patients or affected Indian families, also failed to detect sequence substitutions., Conclusion: Mutation in MYH may be rarely involved in the pathogenesis of multiple sporadic colorectal adenomas in Korean population, although a large-scale analysis will be required to clarify the presence of specific MYH variants in a subset of patients and their role in the predisposition of multiple colorectal adenomas in Korean population.

This study was done to characterize diversity in 10 Brachyspira hyodysenteriae isolates in Korea. The isolates were compared with 14 well-characterized non-Korean strains of various Brachyspira species. All Korean isolates showed strong beta haemolysis and had blunt cell ends with 7-14 periplasmic flagella. They produced indole, and did not ferment fructose. They were alpha-glucosidase positive and alpha-galatosidase negative using the APIZYM kit. Using polyclonal antisera raised in rabbits against recognized serotypes, all isolates showed a strong reaction to B. hyodysenteriae antisera E, A and B. Using multilocus enzyme electrophoresis (MLEE) with 15 enzymes and 5 buffer systems, the Korean and non-Korean isolates were divided into 22 electrophoretic types (ETs) and 5 divisions (A, B, C, D and E). Division A corresponded to B. hyodysenteriae, B to B. innocens, C to B. intermedia, D to B. murdochii and E to B. pilosicoli. The 10 Korean isolates of B. hyodysenteriae were relatively diverse, being divided into 9 ETs within MLEE division A. They were all distinct from the non-Korean strains.

Background: In Korea, it is customary to prescribe iron and folic acid supplements to pregnant women after the 20th wk of gestation; however, little evidence exists to support this practice., Objective: The objective was to determine the effects of time of initiation and dose of prenatal iron and folic acid supplementation on the iron and folate nutriture of Korean women during pregnancy., Design: A total of 131 pregnant women were placed into 1 of 5 experimental groups, either the control group or 1 of 4 supplemented groups. The supplemented groups varied by time of initiation, which was either during the first trimester or at week 20 of gestation, and by dose of iron and folic acid supplements provided, which consisted of either 30 mg Fe plus 175 microg folic acid or 60 mg Fe plus 350 microg folic acid. All supplemented groups continued supplementation until delivery., Results: Improvements in iron and folate nutriture were highly dependent on when the supplement program was initiated, but both supplement doses were equally effective. In contrast, the influence of folic acid supplementation on maternal folate status was not as pronounced as was the influence of iron supplementation on iron status., Conclusion: In pregnant Korean women, initiating iron and folic acid supplementation earlier during pregnancy may prevent the deterioration of iron and folate nutriture more than does increasing supplement doses in later stages of pregnancy.

The aim of this study was to carry out a serological and molecular survey for the presence of Dirofilaria immitis infection in stray cats using an ELISA kit and PCR assay. One hundred and fifty-five stray cats (77 females and 78 males) in Gyunggi province in South Korea, were used in this study. Four (2.6%) tested with the ELISA kit showed a positive reaction, and all positive samples by the ELISA kit showed a positive reaction by PCR analysis. No significant difference was observed between the male (2.6%) and female (2.6%) cat groups by ELISA kit. The positive rates for dirofilariosis were 2.8% in the 4-6-year-old group, and 18.2% in the > 6-year-old group by ELISA kit. With regard to the age element, older cats showed a higher prevalence of D. immitis infection in this study. A statistical analysis revealed that significant difference was observed in > 6-year-old group (p < 0.01). In conclusion, D. immitis infection in stray cats was present in Gyunggi province, although its incidence was low. Therefore, heartworm treatment and/or prophylaxis for stray cats captured are required in this area.

Objective: Development of a Semantic Web technology based system for the formalization of the gross description., Method: A system is developed using the Java-2 platform. It is based on a light-weight version of the Galen top level ontology. Web technologies like XML, SAX en DOM have been used., Result: Three system components have been developed to support the semantic, the object and the syntax layers of the PathOnt architecture., Conclusion: The PathOnt approach provides a tool for the communication among clinicians and technicians involved in pathology examinations. This tool also provides a foundation for linking the specimen-specific data with the controlled medical ontology so that the stored information can be used in different circumstances.

Background: The presence of antibody to the hepatitis B core antigen (anti-HBc) IgG in serum usually means a past infection of the hepatitis B virus (HBV). The clinical characteristics of patients with hepatocellular carcinoma (HCC), who have only a marker for past HBV infection, were investigated., Methods: A total of 565 HCC patients were classified according to their markers for HBV and the hepatitis C virus (HCV). The clinical features and the survival rate of hepatitis B surface antigen (HBsAg)(-)/anti-HBc(+) patients were compared to those of HBsAg(+) patients., Results: Four hundred and three patients were positive for HBsAg (B group, 71.3%), 64 were positive for anti-HCV (11.3%), and 90 were negative for both HBsAg and anti-HCV (N group, 15.9%). In the N group, 71 were positive for anti-HBc (PB group, 12.6% of total patients). The clinical characteristics of the PB group were different from those of the B group: age at diagnosis (60.6 +/- 9.6 vs 53.3 +/- 10.6 years, P < 0.001), habitual drinking (59.2% vs 23.6%, P < 0.001), family history of liver disease (9.9% vs 38.9%, P < 0.005), detection with periodic screening (28.2% vs 50.4%, P < 0.001), and elevated alpha-fetoprotein (53.5% vs 76.2%, P < 0.001). In both the PB group and the B group, liver cirrhosis was accompanied by a similar high prevalence (74.6% vs 89.1%). However, there was no significant difference in the cumulative survival rate., Conclusions: The prevalence of HBsAg(-)/anti-HBc(+) HCC is not rare or more common than that of anti-HCV(+) HCC in Korea, a high HBV endemic area. Although some differences in clinical characteristics may imply a different pathogenesis, chronic HBV infection or habitual drinking may be major contributing factors in the development of HCC in these patients.

Interleukin-1B and IL-1 receptor antagonist gene polymorphisms are associated with an increased risk of gastric cancer (GC) in Caucasian populations. However, recent studies could not find any association between IL-1B-511T polymorphism and the risk of GC in Asians. We tested for an association between IL-1 loci polymorphisms with increased gastric mucosal levels of IL-1beta and an increased risk of developing GC in a Korean population. Polymorphisms of IL-1A-889, IL-1B-31, IL-1B-511 and IL-1RN were genotyped in 434 controls and 234 patients with GC. Mucosal IL-1beta cytokine was measured using an ELISA. The frequencies of IL-1A, IL-1B-511, IL-1B-31 and IL-1RN were not statistically different between controls and all patients with GC. After subclassification of GC, only patients with intestinal-type GC showed a higher frequency of IL-1B-31T homozygotes (OR = 2.2; 95% CI = 1.1-4.3) compared with controls. Risk was also significantly increased in these patients for IL-1B-31T homozygotes compared with patients with diffuse-type GC (OR = 3.4; 95% CI = 1.5-7.7). As in Caucasian populations, linkage disequilibrium between IL-1B-31 and IL-1B-511 was nearly complete, but the pattern of haplotype related to the risk of GC (IL-1B-31T/IL-1B-511C) was opposite (IL-1B-511T/IL-1B-31C). Mucosal IL-1beta levels in H. pylori-infected GC patients were higher in patients homozygous for IL-1B-31T compared with IL-1B-31C/T and IL-1B-31C/C. Thus, the combined effects of H. pylori infection and IL-1B-31T/IL-1B-511C polymorphisms with enhanced mucosal IL-1beta production contributed to the development of intestinal-type GC in this Korean population., ((c) 2004 Wiley-Liss, Inc.)

Background/aims: There has been a shift of the etiologies of chronic liver disease in the 1990s. Therefore, we studied clinical characteristics of hepatocellular carcinoma (HCC) in the 90s., Methods: Medical records of 806 patients diagnosed as having primary HCC were reviewed. Etiology, clinical and laboratory characteristics were evaluated according to the time of diagnosis (the early period, 1992-1995; the late period, 1996-2000)., Results: The mean age was 55.7 years and male to female ratio was 4.6:1. The proportion of the symptomatic patients at the time of diagnosis was decreased from 67.4% of the early period to 41.3% of the late period. On the other hand, that of the patients detected by a periodic check-up was increased up to 58.7% in the late period from 32.6% in the early period (p<0.01). The majority of the patients accompanied cirrhosis (73.3%) and the main cause of HCC was HBV (78.6%) with no changes in the etiologic distribution according to the periods. The proportion of the candidates for surgical resection was significantly increased to 12.4% in the late period compared with 7.1% in the early period., Conclusions: Although the proportion of HCC which can be treated curatively has increased in the later half of the 1990s, its absolute number is still small. More meticulous periodic examination may be required in high risk patients.

Background: It had been believed that over 75% of cases of esophageal carcinoma were squamous cell carcinoma (SCC). However, recently, in Western countries, the incidence of SCC has decreased, while the rate of adenocarcinoma has increased dramatically, accounting for almost 50% of esophageal carcinomas. With this change, concern over Barrett's esophagus (BE) has increased. Traditionally, it was believed that BE affected Asians less frequently. However, accelerated westernization has changed the lifestyle of Asians dramatically, and this raises the question that the prevalence might be changed in Asians living in Asia. Lacking reports on the prevalence of BE in the Korean population, we examined the data from endoscopic examinations performed at five referral hospitals in Seoul, Korea, to estimate the period prevalence of BE., Methods: One thousand five hundred and fifty-three patients who presented themselves to five referral hospitals due to various gastrointestinal symptoms prospectively underwent upper gastrointestinal endoscopic examinations and were enrolled in the study. Two biopsy specimens were taken from any parts of pink mucosa 3 cm or more above the squamocolumnar junction., Results: BE was detected in 5 of the 1553 patients who underwent upper gastrointestinal endoscopic examinations, and the approximate period prevalence of BE in Korean patients in the five referral hospitals was 3.2 per 1000. Of the 5 patients, two were men and three women with a mean age of 65 +/- 11.8 (mean +/- SD) years. All these patients had a body mass index (BMI) of less than 25 and were not obese. Regurgitation was described by 2 (40%) patients with BE, and heartburn was complained of by 4 (80%) patients. Of the 5 patients with BE, 3 (60%) patients had esophagitis, 2 (40%) patients had hiatal hernia, and none of the patients had Helicobacter pylori infection. The gross type of BE consisted of type I (spike) in 2 (40%) patients, type II (circumferential type II) in 1 (20%) patient, type III (circumferential type III) in 1 (20%) patient, and mixed type in 1 (20%) patient. Specialized intestinal metaplasia was found in all 5 patients., Conclusions: The period prevalence of BE among the patients of five referral hospitals was 3.2 per 1000, and it seems that the prevalence of BE in Korean urban area is lower than that in Western countries.

A positive family history is an increased risk factor for gastric cancer within family members, and one of the possible causes of this is the intrafamilial clustering of Helicobacter pylori infection. Our study examined the prevalence of H. pylori infection, serum antibodies to CagA and VacA and atrophic gastritis and/or intestinal metaplasia in the offspring or siblings of gastric cancer patients. A total of 726 subjects included 300 relatives of 300 separate gastric cancer patients and 426 controls. All subjects underwent upper gastrointestinal endoscopic examination with a rapid urease test. Blood samples were obtained to test for the presence of serum antibodies to the CagA and VacA proteins of H. pylori. The prevalence of H. pylori infection was higher in relatives of cancer patients (75.3%) than in controls (60.1%), and the adjusted odds ratio was 2.1 (95% CI 1.5-2.9). When either siblings or 2 or more family members were gastric cancer patients, the prevalence of H. pylori infection was much higher compared to the prevalence in controls. There was no specific relationship between CagA and VacA, and H. pylori infection. Atrophic gastritis and/or intestinal metaplasia were more frequently found in H. pylori-infected relatives of cancer patients (26.1%) than in H. pylori-infected controls (12.9%). These results strongly support a role for H. pylori infection in familial aggregation of gastric cancer. The prophylactic eradication of H. pylori infection in the offspring or siblings of gastric cancer patients may be clinically beneficial., (Copyright 2002 Wiley-Liss, Inc.)