An elevated serum lipoprotein(a) level is an independent risk factor for atherosclerotic diseases, and the lipoprotein(a) level is correlated to preclinical atherosclerosis. To evaluate the association between lipoprotein(a) and aortic selerosis, mitral sclerosis, and abdominal aorta thickness, we measured the aortic valve thickness, mitral valve thickness and abdominal aorta thickness. Also, we assessed the relationship between the aortic valve sclerosis, mitral valve sclerosis, abdominal aorta thickness and other coronary risk factors.

We measured serum lipoprotein(a) in 116 patients(52 men, 64 women) with mean age of 58.7±13.9 years. Aortic valve thickness was assessed by parasternal long and short axis two dimensional echocardiography, mitral valve thickness was measured by apical 4 chamber view. The abdominal aorta thickness was measured by the subcostal view.

The level of lipoprotein(a) was significantly correlated with the aortic valve thickness, but not with the miral valve thickness and the abdominal aorta thickness. lipoprotein(a) level was higher in smoking patients(p<0.05), and not related to other ariables such as blood pressure, age, total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein. Coronary angiography was performed in 18 paitents, and there was a tendency of the coronary artery disease with high level of the lipoprotein(a)(p<0.005). There was no significant difference in the thickness of aortic valve in terms of sex, blood pressure, total cholesterol, high density lipoprotein, triglyceride or blodo sugar.

We conclude that increased serum levels of lipoprotein(a) are closely related to aortic valve sclerosis and may be a risk factor for coronary artery disease.

Helicobacter(H.) pylori is a major etiological factor in chronic gastritis, peptic ulcer and gastric adenocarcinoma. The mode and route of transmission of H. pylori are still uncertain, but there is a strong evidence for person-to-person transmission via the oro-oral or gastro-oral route or via the fecal-oral route. Persons involved in patient care are likely to be at higher risk of H. pylori infection than the general population if H. pylori is transmitted from person-to-person. However, detailed studies about the occupational risk in hospital workers are scarce, especially in Korea which is a high prevalent area of H. pylori infection. The purpose of this study was to determine whether different groups of hospital workers are at increased risk of acquiring H. pylori.

The staff members were assigned to four groups : 1) medical staff(n=39), 2) nursing staff(n=267), 3) medical technicians and pharmacists(n=48), 4) nonmedical staff(n=163). Serum antibodies for H. pylori were measured by ELISA GAP IgG Helicobacter pylori kit(Bio-Rad Lab, USA)(cut-off value ; 15 U/mL).

The overall seropositivity was 70.4%(364/517). The seroprevalence of H. pylori was 64% in group I, 69.7% in group II, 66.7% in group III, and 74.2% in group IV(not significant). Seroprevalence increased by a little with age, but it was not statistically significant. There was no difference of seroprevalence between men(75%) and women(68.6%).

It was thought that the prevalence of H. pylori infection in Korean hospital workers is high and since there was no difference of seropositivity between medical and non-medical staffs, occupational exposure to patients does not increase the rate of infection with H. pylori.

In order to evaluate clinical significance of MR signal change within vertebral body marrow, we investigated the relationship between signal change of marrow and duration of low back pain, hight of disc, segmental hypermobility, disc degeneration and degree of disc herniation.

We reviewed retrospectively simple radiograph, flexion-extension dynamic radiograph and MR images of the lumber spines(L3-S1) of 100 patients, who underwent discectomy at Ewha Womans University Mokdong Hospital from September 1993 to October 1996.

1) There were Modic type 2 changes in 36 patients of 100 patients(36%) and in 52 segments of 300 segments(17.3%). 2) Average was older in the group with signal change in marrow than in that without signal change. 3) Signal change of vertebral body marrow was not significantly related to duration of low back pain. 4) Decreased disc heght was more frequently found in segments with signal change in marrow than in those without signal chagne. 5) Modic type 2 changes was not related to lumbar segmental hypermobility. 6) Degeneration of disc was more frequently found in segments with signal change in marrow than in those without signal change. 7) Signal change of vertebral body marrow was not directly related to degree of disc herniation.

Signal change of vertebral body marrow in MRI was significantly related to age, disc height and degree of disc degeneration, and it suggests that the marrow change can be induced by response of vertebral body to the changed mechanical environment, which is due to long-standing disc degeneration.

Head and neck squamous cell carcinoma(HNSCC) has been associated with host immunosuppression, including depressed T-lymphocyte and natural killer cell function. This immunosuppression has been shown to be most pronounced in the locoregional environment of the tumor and appears to be mediated by soluble suppressor factor prostaglandinE₂(PGE₂). PGE₂ is a product of cell membrane phospholipid metabolism that is known to have potent immunoregulatory activity including inhibition of natural killer cell activity and antibody dependent cell mediated cytotoxicity(ADCC).

In our experiment, we have established an ADCC assay with IgGl cMAB SF-25, 323A/3 using human squamous cell carcinoma of the head and neck cell line(PCI-50) as target. The measurement of cytotoxicity was determined by measuring the release of ⁵¹Chromium from the target cells after 4 hour incubation.

PGE₂ inhibited antibody dependant cell mediated cytotoxicity.

It thus implies that the production of prostaglandins by tumor cells may constitute a means by which the tumor cells subvert the effect of a cellular immune response that is directed against them and arming of NK cells with chimeric antibody could be considered in developing means for treatment of human SCCHN in adjuvant setting.

This study was performed to compare postoperative results of thyroplasty typeI and arytenoid adduction, which were recent phonosurgical procedures for the management of unilateral vocal cord paralysis.

Twenty-two cases of unilateral vocal cord paralysis with several etiologies were managed with thyroplasty typeI and/or arytenoid adduction. The subjective and MPT(maximum phonation time) improvements after those procedures were compared statistically.

The cause of paralysis were idiopathic(7 cases), thoracic lesion(6 cases) thyroidectomy(3 cases), neck mass excision(3 cases), neck trauma(2 cases) and diphtheria(case). The left side(15 cases) was paralyzed more frequently than the right(7 cases). There were significant increase(p=0.006) in MPT from 4 seconds preoperatively to 6 seconds postoperatively in thyrolasty cases, and also significant increase(p=0.014) from 5 seconds to 10.5 seconds in arytenoid adduction cases. Better result were observed in subjective improvement and MPT(p=0.0011) with arytenoid adduction. There was no significant complication.

Both arytenoid adduction and thyroplasty were effective and safe phonosurgical procedures for unilateral vocal cord paralysis. Better results were observed in arytenoid add-uction cases.

This study was performed to investigate the clinical manifestations and laboratory findings, and to see whether the severity of atopic dermatitis(AD) implies a relationship to the clinical and laboratory findings.

Our study was designed by analyzing outpatients with AD via physical examination, questionnaires and laboratory investigations such as prick test to house dust mites, bacterial cultures, total IgE, IgA, IgG, IgG₄, IgM, and peripheral eosinophil count.

1) Xerosis, ear fissuring and hyperlinear palms were related to the severity of AD(p<0.05). 2) Sweating, foods and aeroallrgen were related to the severity of AD(p<0.05). 3) The presence of family history of AD differed significantly(p<0.05) between the severe group(57.9%) & the mild group(26.3%). 4) The positivity of the prick test to Dermatophagoides pteronyssinus and D.farinae was found in 90.0% of respiratory group and in 30.0% of AD only(p<0.05%). 5) Serum IgE level was higher in the severe group(938.3±601.8 IU/mL) than the mild group(526.7±352.1IU/mL)(p<0.05). 6) Serum IgE level in AD patients with respiratory disease(1025.8±713.2IU/mL) was higher than AD only(403.3±273.4IU/mL)(p<0.05). 7) Peripheral eosinophil counts were higher in the severe group(509.9±389.4/mm³) than the mild group(340.5±219.4/mm³)(p<0.05).

The factors related to severity of AD were xerosis, ear fissuring, hyperlinear palms, sweating, food, aeroallergen, serum IgE and peripheral eosinophil count. The AD patients with respiratory allergic disease had higher IgE levels and higher positive rates of prick test with house dust mite.

Preoxygenation is recommended in order to prevent hypoxemia with hypoventilation or apnea during induction of anesthesia. The purpose of this study was to determine the duration of preoxygenation required to achieve an end-tidal oxygen fraction(FE'O₂) of 0.9 in children and adults.

In 24 healthy children and adults breathing 100% oxygen, end tidal oxygen and carbon dioxide concentration have been measured at 15 seconds interval from the start of liter per minute. The gas sampling line of the Capnomac II(Datex, Helsinki, Finland) was placed in the nasal cavity.

The study showed that all children attained an FE'O₂ of 0.9 within 75s of preoxygenation, but adults had not reached an FE'O₂ of 0.9 within 180s.

More oxygen wash-in would be expected in children. We suggested that at least 3 min of preoxygenation should be performed before intravenous induction of anesthesia in children.

Gastric polyp is histologically very diverse and its classification is still unsettled. The purpose of the article is to classify the endoscopically diagnosed polypoid lesions and to evaluate their malignant potential.

A retrospective study was done on 142 cases of endoscopically diagnosed gastric polypoid lesions from September 1993 to May 1996. We investigated their clinical findings, histopathology, and nuclear gradings of PCNA by immunohistochemistry.

1) The mean age is 57.9 and sex ratio os 0.8:1

2) The most prevalent location is antrum(57.7%).

3) Morphologically, Yamada type II is the most frequent(35.9%).

4) Histologically, lesions are classified as true polyps and reactive lesions. True polyps are subclassified as hyperplastic polyp(61.2%), adenomatous polyp(19.4%), mixed adenomatous and hyperplastic polyp(10.2%), fundic gland polyp(2.0%), and adenocarcinoma(7.1%). Reactive lesions are subclassified as chronic superficial gastritis(68.2%), mucosal hyperplasia(15.9%), edema of lamina propria(9.1%), xanthoma(4.5%), and ectopic pancreas(2.3%).

5) Atypical changes is accompanied in 12 cases(20%) of hyperplastic polyps.

6) Adenocarcinoma arising from adenomatous polyp is noted in 6 cases. In hyperplastic polyp one case is combined with adenocarcinoma.

7) Among the true polyps single lesions are 127 cases(89.4%), and multiple lesions, 15 cases(10.6%)

8) Immunohistochemical staining for proliferating cell nuclear antigen(PCNA) reveals that hyperplastic polyps show focal positive rection in the area of pit and fundus, and adenomatous polyps show diffuse positive reaction. Dysplastic foci in both adenomatous and hyperplastic polyps shows diffuse positive reaction of PCNA.

Endoscopically diagnosed polypoid lesions show variable histologic findings ranging from chronic superficial gastritis to adenocarcinoma. They are mainly subclassified as histologically true polyps and reactive lesions. Some of true polyps have atypical changes of varing dgree in not only adenomatous polyps but also hyperplastic polyps.