Evaluating the Use of Distilled Water for Washing Sodium Hydroxide in Mycobacterial Culture / 대한임상미생물학회지

Background@#Respiratory specimens subjected to mycobacterial detection were initially pretreated with N-acetyl-L-cysteine-sodium hydroxide (NALC-NaOH) to remove the mucus and normal flora. Next, they were washed and neutralized with phosphate-buffered solution (PBS).The effectiveness of distilled water (DW) compared to PBS as a washing neutralizer during identification of mycobacteria was evaluated in this study. @*Methods@#We analyzed the results of mycobacterial test conducted at a general hospital in Gwangju from October 2016 to September 2018. PBS and DW were used as a respiratory sample washing agent for one year each. @*Results@#The positive culture rate for the culture of mycobacteria was 12.7% (1,843/14,532) and 14.7% (2,095/14,291), when PBS and DW were used, respectively. The recovery rate of the mycobacteria growth indicator tubes (MGIT) and the separation rates of Mycobacterium tuberculosis complex and nontuberculous mycobacteria (NTM) showed no significant change.However, in 2% Ogawa medium, as the NTM culture increased from 47.4% (399/841) to 56.1% (630/1,122), the recovery rate increased from 45.6% (841/1,843) to 53.6% (1,122/2,095). The MGIT contamination rate decreased from 6.5% to 4.1%. @*Conclusion@#DW as a washing agent for NALC-NaOH increased the recovery rate of Ogawa media and reduced the contamination rate of MGIT. Therefore, use of DW instead of PBS as a washing neutralizer during identification of mycobacteria might be useful.

Evaluating the Use of Distilled Water for Washing Sodium Hydroxide in Mycobacterial Culture / 대한임상미생물학회지

Background@#Respiratory specimens subjected to mycobacterial detection were initially pretreated with N-acetyl-L-cysteine-sodium hydroxide (NALC-NaOH) to remove the mucus and normal flora. Next, they were washed and neutralized with phosphate-buffered solution (PBS).The effectiveness of distilled water (DW) compared to PBS as a washing neutralizer during identification of mycobacteria was evaluated in this study. @*Methods@#We analyzed the results of mycobacterial test conducted at a general hospital in Gwangju from October 2016 to September 2018. PBS and DW were used as a respiratory sample washing agent for one year each. @*Results@#The positive culture rate for the culture of mycobacteria was 12.7% (1,843/14,532) and 14.7% (2,095/14,291), when PBS and DW were used, respectively. The recovery rate of the mycobacteria growth indicator tubes (MGIT) and the separation rates of Mycobacterium tuberculosis complex and nontuberculous mycobacteria (NTM) showed no significant change.However, in 2% Ogawa medium, as the NTM culture increased from 47.4% (399/841) to 56.1% (630/1,122), the recovery rate increased from 45.6% (841/1,843) to 53.6% (1,122/2,095). The MGIT contamination rate decreased from 6.5% to 4.1%. @*Conclusion@#DW as a washing agent for NALC-NaOH increased the recovery rate of Ogawa media and reduced the contamination rate of MGIT. Therefore, use of DW instead of PBS as a washing neutralizer during identification of mycobacteria might be useful.

Milk Intake Patterns with Lactose and Milk Fat in Korean Male Adults / 대한지역사회영양학회지

OBJECTIVES: This study examined the milk intake patterns with lactose and milk fat in Korean male adults using the following variables: milk intake level, awareness of lactose, and milk fat, health problems, and necessity of milk intake. In addition, the factors affecting milk intake were analyzed by multiple regression analysis. METHODS: The subjects were 532 males aged 20 years or older among the nationwide milk purchasing group. The subjects were 223 (41.9%) in the 20–29 year age group, 188 (35.3%) in the 30–49 year age group and 121(22.7%) in the over 50 year age group. The survey was conducted using ANOVA and multiple comparative analysis to examine the differences in age and multiple regression analysis was performed to investigate the factors affecting the intake of milk. RESULTS: The intake of milk in the subjects was 538.14 ± 494.23 ml per week. There were statistically significant differences in the subjects' age according to processed milk, low fat, nonfat milk, cheese, and ice cream. The perception of milk and lactose and milk fat was recognized as a good food for skeletal health when milk was consumed. Among the milk nutrients, lactose was highly recognized at the age of 20–29, and milk fat was recognized in those over 50 years. In addition to lactose and milk fat, calcium was the most highly recognized among the milk nutrients. Health problems associated with milk were skeletal health, obesity, and lactose intolerance. The perception of lactose intolerance was related to lactose intolerance and fatness, and the dietary behavior was unaffected. CONCLUSIONS: This study examined the milk intake patterns of adult Korean males. Many variables were found to be related to the intake of milk. In this study, the milk intake was high when there was no problem with the perception and dietary behaviors of milk nutrition (lactose and milk fat). This study focused on lactose and milk fat, which are major nutrients in milk, and it is a new perspective study among milk-related research.

Milk Intake Patterns with Lactose and Milk Fat in Korean Male Adults / 대한지역사회영양학회지

OBJECTIVES: This study examined the milk intake patterns with lactose and milk fat in Korean male adults using the following variables: milk intake level, awareness of lactose, and milk fat, health problems, and necessity of milk intake. In addition, the factors affecting milk intake were analyzed by multiple regression analysis. METHODS: The subjects were 532 males aged 20 years or older among the nationwide milk purchasing group. The subjects were 223 (41.9%) in the 20–29 year age group, 188 (35.3%) in the 30–49 year age group and 121(22.7%) in the over 50 year age group. The survey was conducted using ANOVA and multiple comparative analysis to examine the differences in age and multiple regression analysis was performed to investigate the factors affecting the intake of milk. RESULTS: The intake of milk in the subjects was 538.14 ± 494.23 ml per week. There were statistically significant differences in the subjects' age according to processed milk, low fat, nonfat milk, cheese, and ice cream. The perception of milk and lactose and milk fat was recognized as a good food for skeletal health when milk was consumed. Among the milk nutrients, lactose was highly recognized at the age of 20–29, and milk fat was recognized in those over 50 years. In addition to lactose and milk fat, calcium was the most highly recognized among the milk nutrients. Health problems associated with milk were skeletal health, obesity, and lactose intolerance. The perception of lactose intolerance was related to lactose intolerance and fatness, and the dietary behavior was unaffected. CONCLUSIONS: This study examined the milk intake patterns of adult Korean males. Many variables were found to be related to the intake of milk. In this study, the milk intake was high when there was no problem with the perception and dietary behaviors of milk nutrition (lactose and milk fat). This study focused on lactose and milk fat, which are major nutrients in milk, and it is a new perspective study among milk-related research.

Fatty Acid Content in Perilla Cultivars and Commercial Oils Determined by GC Analysis

The content analysis of fatty acids in Perilla cultivars and commercial oils is conducted through gas chromatography with a flame ionization detector. Results show that Perilla cultivars, such as Deulsaem and Daesil, contain high amounts of α-linolenic acid (262.22 and 261.97 mg/g, respectively). Among commercial oils, Perilla oil contains a higher amount of α-linolenic acid (515.20 mg/g). Accordingly, α-linolenic acid is a major fatty acid of Perilla cultivars and oil. Therefore, Perilla cultivars could be used as a food supplement for nutritional and pharmaceutical purposes.

Dietary Behavior of Marriage Migrant Women according to Their Nationality in Multicultural Families / 대한지역사회영양학회지

OBJECTIVES: Nowadays, the multicultural families make up significant portion of Korean population and communities. Successful re-settling in a new country can be difficult, particularly when there are disparities in dietary behavior compared to home country. The objective of the study was to investigate the dietary behavior of marriage migrant women according to their nationality in multicultural families. METHODS: The primary research was conducted targeting 94 marriage migrant women who came from China (40.4%), Vietnam (26.6%), and other countries except for Japan (33.0%). We investigated their dietary behavior, such as eating attitude and food choice behavior for Korea acculturation. We also studied dietary behavior among 14 selected subjects who had high level of integration and assimilation acculturation patterns by administering the Focus Group Interview (FGI). RESULTS: The multicultural families had more integration acculturation patterns, which could have been influenced by their nationality. Vietnamese origin has the highest cultural adaptation as marginalization pattern. The common types of Korea acculturation were integration (3.03 +/- 1.08), separation (3.10 +/- 0.59), marginalization (3.10 +/- 0.58), followed by assimilation (2.84 +/- 0.51). There were significant differences in the four types of acculturation by marriage immigrant women's country of origin (p<0.05). According to dietary behavior, 'eliminating hunger' was the most important value in a meal. Chinese marriage migrant women, who had higher level of food intake attitude significantly, also considered 'being healthy' an important value. Regarding food choice behavior, Vietnamese had lowest frequency of homeland food intake. Most of marriage immigrant women were satisfied with the Korean food, and need for education was very high with interest for cooking, good nutrition, and managing their children's dietary life. CONCLUSIONS: Coping with a change in dietary behavior is one of the biggest transitional difficulties, and family members may need support to find their familiar food items and to continue their cultural food choice behavior in the local areas. Further researches with quantitative and qualitative analysis are needed to understand the effect of dietary behavior for acculturation in multicultural families.

Diagnostic accuracy of urine dipstick for proteinuria in older outpatients

BACKGROUND: The urine dipstick is widely used as an initial screening tool for the evaluation of proteinuria; however, its diagnostic accuracy has not yet been sufficiently evaluated. Therefore, we evaluated its diagnostic accuracy using spot urine albumin/creatinine ratio (ACR) and total protein/creatinine ratio (PCR) in proteinuria. METHODS: Using PCR > or = 0.2g/g or > or = 0.5g/g and ACR > or = 300mg/g or > or = 30mg/g as the reference standard, we calculated the diagnostic accuracy profile: sensitivity, specificity, positive and negative predictive value, and the area under the curve (AUC) of the receiver operating characteristic curve. RESULTS: PCR and ACR were available for 10,348 and 3,873 instances of dipstick testing. The proportions with PCR > or = 0.2g/g, > or = 0.5g/g and ACR > or = 300mg/g, > or = 30mg/g were 38.2%, 24.6% and 8.9%, 31.7%, respectively. The AUCs for PCR > or = 0.2g/g, > or = 0.5g/g, and ACR > or = 300mg/g were 0.935 (trace: closest to ideal point), 0.968 (1+), and 0.983 (1+), respectively. Both sensitivity and specificity were > 80% except for PCR > or = 0.5g/g with trace cutoff. For the reference standard of ACR > or = 30mg/g, the AUC was 0.797 (trace) and the sensitivity was 63.5%. CONCLUSION: Urine dipstick test can be used for screening in older outpatients with ACR > or = 300mg/g or PCR as the reference standard for proteinuria. However, we cannot recommend the test as a screening tool with ACR > or = 30mg/g as the reference owing to its low sensitivity.

Left Ventricular Myxoma Leading to Left Ventricular Outflow Tract Obstruction / 대한내과학회지

Cardiac myxoma is the most common primary cardiac tumor, but ventricular myxoma accounts for only 5% of the cases. We report a case of a 62-year-old woman with a left ventricular myxoma emerging from the ventricular side of the mitral valve that led to left ventricular outflow tract obstruction. The patient complained of chest discomfort and dyspnea. A mobile intracardiac mass was seen on echocardiography. The mass was excised and confirmed to be a myxoma by histopathological examination. She was discharged from the hospital without complications and remains asymptomatic.

Acute Severe Hyponatremia with Seizure Following Polyethylene Glycol-Based Bowel Preparation for Colonoscopy / 고신대학교의과대학학술지

4 liters of polyethylene glycol (PEG) solution is commonly used to evacuate the colon before colonoscopy. This substance, however, is known to cause electrolyte abnormalities such as hyponatremia. Seizures caused by hyponatremia associated with bowel preparation have only rarely been reported. We report the case that a 75-year-old woman with no prior history of seizures was developed severe hyponatremia (112 mEq/L) with generalized tonic-clonic seizure and mental change after ingestion of 4L of PEG solution. Past medical history was notable for thiazide diuretics. Her symptoms are improved during intravenous administration of hypertonic saline for the correction of hyponatremia. Patients with impaired ability to excrete free water those with renal insufficiency, hypothyroidism, mineralocorticoid deficiency, liver cirrhosis, or heart failure as well as those taking drugs which including thiazide diuretics, NASIDs, and ACE inhibitors have risk of hyponatremia following bowel preparation for colonoscopy. We conclude that physicians should check patient's condition and electrolyte abnormalities before colonoscopy procedures.

A Case of Infective Endocarditis Occurred during Treatment for Infectious Spondylitis Accompanied by Peptostreptococcus Anaerobius Bacteremia / 고신대학교의과대학학술지

It is necessary to distinguish between pyogenic and tuberculous spondylitis of infectious spondylitis, if it is pyogenic spondylitis, antimicrobial therapy should be directed against an identified microorganism and clinical assessment should be done at 4 weeks. But if microorganism is a anaerobic bacteria, especially Peptostreptococcus anaerobius, combination antibiotic therapy should be considered bacause it may be a component of mixed infections as a passenger and have abilities to induce abscesses, other bacterial growth as a synergy effect. In addition, echocardiography may be necessary because pyogenic spondylitis is associated with infective endocarditis about 12%. We report a 64-year-old man who was treated for infectious spondylitis accompanied by Peptostreptococcus anaerobius bacteremia, but had to undergo heart surgery because an attack of infective endocarditis with systemic embolism during hospitalization.

Clinical Significance of Subjective Foamy Urine / 전남의대학술지

Foamy urine is widely regarded as a sign of proteinuria. However, there is no objective definition of foamy urine and there are no reports on the proportion of involved patients who have overt proteinuria or microalbuminuria. We performed this study to investigate this proportion and to identify possible risk factors for these two conditions. We reviewed all new outpatients from 1 November 2011 to 30 April 2012 and identified patients complaining of foamy urine. Their demographic data and medical records were examined. In particular, we tabulated the patients' spot urinary protein to creatinine ratio, spot urinary microalbumin to creatinine ratio (ACR), blood urea nitrogen (BUN), and serum levels of creatinine (Cr), uric acid, calcium, phosphate, and glucose. In addition, we calculated estimated glomerular filtration rates (eGFRs) by using the CKD-EPI equation. We also performed risk factor analysis with the Chi-squared test and by logistic regression. Seventy-two patients (6.3% of total new outpatients) complained of foamy urine; of these, there were 59 males with a median age of 65.5 years (range, 36-87 years). Of the 72 patients, 16 (22.2%) had overt proteinuria. We found that diabetes, poor renal function (high Cr, BUN, low eGFR), increased serum phosphate, and increased serum glucose were associated with overt proteinuria. Multiple logistic regression analysis showed that serum Cr and serum phosphate were associated with overt proteinuria. The ACR was available for 38 patients, and in this subgroup, 12 (31.6%) showed microalbuminuria or overt proteinuria. In this subgroup, a high serum Cr was the only statistically significant risk factor. Among patients who complained of foamy urine, approximately 20% had overt proteinuria, and increased serum Cr and phosphate were statistically significant risk factors.

Clinical Significance of Subjective Foamy Urine / 전남의대학술지

Foamy urine is widely regarded as a sign of proteinuria. However, there is no objective definition of foamy urine and there are no reports on the proportion of involved patients who have overt proteinuria or microalbuminuria. We performed this study to investigate this proportion and to identify possible risk factors for these two conditions. We reviewed all new outpatients from 1 November 2011 to 30 April 2012 and identified patients complaining of foamy urine. Their demographic data and medical records were examined. In particular, we tabulated the patients' spot urinary protein to creatinine ratio, spot urinary microalbumin to creatinine ratio (ACR), blood urea nitrogen (BUN), and serum levels of creatinine (Cr), uric acid, calcium, phosphate, and glucose. In addition, we calculated estimated glomerular filtration rates (eGFRs) by using the CKD-EPI equation. We also performed risk factor analysis with the Chi-squared test and by logistic regression. Seventy-two patients (6.3% of total new outpatients) complained of foamy urine; of these, there were 59 males with a median age of 65.5 years (range, 36-87 years). Of the 72 patients, 16 (22.2%) had overt proteinuria. We found that diabetes, poor renal function (high Cr, BUN, low eGFR), increased serum phosphate, and increased serum glucose were associated with overt proteinuria. Multiple logistic regression analysis showed that serum Cr and serum phosphate were associated with overt proteinuria. The ACR was available for 38 patients, and in this subgroup, 12 (31.6%) showed microalbuminuria or overt proteinuria. In this subgroup, a high serum Cr was the only statistically significant risk factor. Among patients who complained of foamy urine, approximately 20% had overt proteinuria, and increased serum Cr and phosphate were statistically significant risk factors.

Distal Renal Tubular Acidosis with Nephrocalcinosis in a Patient with Primary Sjogren's Syndrome

Renal involvement is not uncommon in primary Sjogren's syndrome; however, it is clinically insignificant in most cases. Distal renal tubular acidosis accounts particularly for the majority. While the underlying distal renal tubular acidosis is an important cause of nephrocalcinosis and urolithiasis, nephrocalcinosis is rarely a presenting feature of primary Sjogren's syndrome. We report a 65-year-old woman who was diagnosed with distal renal tubular acidosis accompanied by primary Sjogren's syndrome, according to nephrocalcinosis, which was incidentally identified by an abdominal ultrasonography during a medical examination.

Rates of Early Surgery and Associated Risk Factors in Crohn's Disease / 대한소화기학회지

BACKGROUND/AIMS: The individual course of Crohn's disease is diverse, and some patients may require bowel resection. The aims of this study were to determine the early surgery rate of Crohn's disease and to identify risk factors associated with early surgery in Korea. METHODS: Ninety six patients with Crohn's disease (68 men; median age at the time of diagnosis: 25 years), who had been followed up more than a year, were retrospectively analyzed. Early surgery was defined as a bowel operation for Crohn's disease or its complications occurring within 3 years from diagnosis. Early surgery rate and risk factors for early surgery were identified. RESULTS: Fifteen patients (15.6%) underwent early surgery. The cumulative surgery rate was 8.6% after 6 months, 11.9% after 12 months, 14.1% after 18 months, and 16.7% after 24 to 36 months. Multivariate analysis revealed penetrating or stricturing behavior to be an independent risk factor for early surgery (p<0.001, Exp (B)=2.97 CI 1.39-6.37). CONCLUSIONS: The cumulative early surgery rate in Korean patients seems to be lower than Western patients. Penetrating or stricturing behavior is significantly associated with early surgery, requiring early aggressive medical treatments.

Effects of Recombinant Human Growth Hormone Treatment in Elderly Patients Undergoing Surgery for Hip Fracture / 대한정형외과연구학회지

PURPOSE: To investigate whether early recombinant human growth hormone (hGH) treatment in elderly patients undergoing surgery for hip fracture improves biochemical and functional recovery. MATERIALS AND METHODS: From September 2007 to December 2008, a total of 25 patients older than 60 years who underwent a gamma nailing surgery for an accidental hip fracture were randomized to be treated with either hGH (Declage(R), 3mg/week) (Group I: 15 patients) or placebo (Group II: 10 patients) at a postoperative 1, 2, 3 weeks, starting within 24 hour after the hip fracture. Mean age was 73.5 years. 6 cases were male and 19 cases were female. Serum IGF-I was measured by radioimmunoassay. Subjective and objective parameters were analyzed such as the mean mid-thigh circumference, change of weight, hand grip strength, functional recovery by Modified Barthel Index of activities of daily living (ADL). RESULTS: There were significant differences in the mean serum IGF-I, mid-thigh circumference, hand grip strength, Modified Barthel Index of activities of daily living between two groups. There were no significant differences in the change of weight. There were three nausea symptom after hGH injection, but no any general adverse effect. CONCLUSION: Early recombinant human growth hormone (hGH) treatment in elderly patients undergoing surgery for hip fracture showed clinical safety and good biochemical and functional recovery.

The Effects of Smoking Cessation through a Smoking Cessation Counselling Program on Expiratory CO Concentration, BMI, Blood Pressure, Liver Function, and Lipid Metabolism in Smoking Cessation Successes

PURPOSE: This study was performed in order to examine the effects of an smoking cessation counselling program for smoking cessation success. METHOD: Among a total of 468 persons who had ceased from smoking for 6-months and had visited the smoking cessation clinic of a public health center from January 2nd to December 31th in 2006, 61 in all who had a negative reaction in the urine nicotine check were selected for this study. Collected data were expiratory CO concentration, BMI, blood pressure, liver function, and lipid metabolism. These data were analyzed by descriptive statistics, repeated measured ANOVA and paired t-test with the SPSS/PC(Version 12.0) program. RESULT: There were significant changes in expiratory CO concentration, SBP, DBP, AST, ALT, and TG, but not in BMI, gamma-GTP, TC, HDL-C, and LDL-C. CONCLUSION: This study showed that smoking cessation through a smoking cessation counselling program has partially positive effects for smoking cessation success. The results of this study show that the smoking cessation counselling program at the smoking cessation clinic of a public health center should be continued for smoking cessation success.

Factors Influencing on Quality of Sleep among Patients at Surgical Intensive Care Units / 성인간호학회지

PURPOSE: This study was conducted to evaluate quality of sleep and to assess the factors that influence quality of sleep in surgical ICU. METHODS: The subject of the study were consisted 109 adult patients who admitted to surgical ICU. The data were collected from May 20 to December 10, 2007 by structured questionnaires. The data were analyzed with descriptive analysis, paired t-test, Pearson correlation coefficient and stepwise multiple regression. RESULTS: The score of quality of sleep was 4.57 point. The main sleep disturbance factors related to quality of sleep in surgical ICU inpatient were sleep time, machinery alarm and noise(adjusted R2=33.2). CONCLUSION: Based on the finding of this study, it is needed to develop a nursing intervention program that including to promote quality of sleep and to decrease machinery alarm and noise in surgical ICU.

Evaluation of Sysmex UF-100 Urine Flow Cytometer in Predicting the Outcome of Urine Cultures / 대한임상미생물학회지

BACKGROUND: Urine culture is still the standard laboratory procedure for definitive diagnosis of urinary tract infection. The author investigated the feasibility of eliminating the costs and time expended in examination of negative urine cultures by combining the Sysmex UF-100 (Toa Medical Electronics, Kobe, Japan) urine flow cytometer and urine strips to predict the outcome of urine cultures. METHODS: Seven hundred eighty one specimens were obtained from 661 males and 120 females (mean age, 66 years; range, 4~93 years). Urine cultures were performed with 10,000 colony forming units (CFU)/mL as the positive criterion. Each sample was analyzed by Clinitek Atlas (Bayer Co., Elkhart, IN, USA) using N-multistix SG urine strips, followed by identification and quantification of the formed elements on the Sysmex UF-100. RESULTS: Of the 781 urine specimens examined, 402 (51.5%) yielded positive cultures. The diagnostic performance of the UF-100 results for bacteria or WBC vs the urine strip results for leukocyte esterase or nitrite in comparison with the urine culture results were as follows: sensitivity 0.88 vs 0.80, specificity 0.77 vs 0.77, positive predictive value 0.80 vs 0.78, and negative predictive value 0.85 vs 0.79. The highest sensitivity (0.91) and the lowest false negative (0.05) were obtained when any one of the four tests was positive. CONCLUSION: The use of Sysmex UF-100 flow cytometer and urine strip results, seperately or in combination, does not accurately predict the outcome of urine cultures.

Factors Associated with Success of Smoking Cessation during 6 Months / 간호학회지

PURPOSE: This study was to identify which factors are likely to influence the effectiveness of smoking cessation on adults who smoke in Metropolitan Incheon. METHOD: Data from 9,083 smokers, who visited a smoking cessation clinic of a public health center from Jan. to Oct. 2005, were provided by the Korean Health Research Society. Among 9,083 smokers, 1,495 people were selected for follow up care at 6 months in order to analyze the differences between two groups one is a successful group and the other is a failure group. RESULTS: The successful group included 639 people and the failure group 856 people. In the demographic profiles such as sex, age and motive registration, there was a significant difference between the two groups. In the view of smoking pattern and factors such as the expiratory CO level, the age of starting to smoke, the duration of smoking, alcohol, and dependence on alcohol use and nicotine, there were significant differences between the two groups. The smoking cessation method, results of uni variate analysis, the total number of visits to the smoking cessation clinics, and the use of nicotine gum or a patch(stage 1, stage 2) were significantly different in the two groups. CONCLUSION: The results of multi variate analysis have shown that the factors associated with the success for smoking cessation is the total number of visits to the smoking cessation clinic, and the dependence on alcohol.

Hyperhomocysteinemia as a Risk Factor for Cerebral Infarction / 대한진단검사의학회지

BACKGROUND: Homocysteine (Hcy) is known to increase the risk of cerebrovascular disease. I investigated this association in cerebral infarction (CI) and established reference intervals for serum total Hcy concentrations among individuals aged 40 or over in Korea. METHODS: I measured Hcy concentrations in the sera from 93 healthy controls (male 74, female 19) and 742 patients with CI (male 616, female 126) by a fluorescent polarization immuno assay technique using Axsym system (Abbott Laboratories, IL, USA). RESULTS: In CI group, the following parameters were significantly higher (P or =60 years), hypertension, DM, hyperhomocysteinemia, high creatinine, and in the highest Hcy quartile (> or =15.1 micromol/L) compared to the lowest Hcy quartile (<9.6 micromol/L) with the crude odds ratios of 2.1, 4.3, 10.5, 7.4, 3.0, and 6.6, respectively; in multivariate analysis, the risk of CI was independently associated with hypertension, DM, hyperhomocysteinemia and adjusted odds ratios were 3.6, 5.3, and 7.1, respectively. In CI group, Hcy exhibits negative correlations (P<0.001) with folate (r=-0.356) and vitamin B12 (r=-0.256). CONCLUSIONS: Hyperhomocysteinemia may represent an independent risk factor for cerebrovascular disease.