Essential thrombocytosis (ET) is a myeloproliferative disorder characterized by an anomalous increase in platelet production. Many patients with ET are asymptomatic. Few studies have reported ET-associated thromboembolism in large vessels such as the aorta. We report a patient with ET who presented with peripheral embolism from an abdominal aortic thrombus and developed acute limb ischemia. The patient underwent aortic replacement successfully. The patient’s platelet count was controlled with hydroxyurea, and no recurrence was noted over 2 years of follow-up.
Aorta ; Aorta, Abdominal* ; Blood Platelets ; Embolism ; Extremities ; Follow-Up Studies ; Humans ; Hydroxyurea ; Ischemia ; Myeloproliferative Disorders ; Platelet Count ; Recurrence ; Thrombocythemia, Essential ; Thrombocytosis ; Thromboembolism* ; Thrombosis

Thoracoabdominal aortic aneurysm accompanied by Leriche syndrome is an extremely rare combination of aortic diseases, the surgical management of which has not been described to date. We report the successful treatment of one such case through open surgical repair of the thoracoabdominal aorta.
Aorta ; Aortic Aneurysm, Thoracic* ; Aortic Diseases ; Arterial Occlusive Diseases ; Blood Coagulation Disorders ; Leriche Syndrome* ; Thrombosis

Forty eight cases of spontaneous thalamic hemorrhage diagnosed by brain CT scan, were analyzed clinically. The age incidence was highest in the 6th decade. We have classified the thalamic hemorrhage by location of hematoma and arterial blood supply. The anteromedial types were 12 cases(25%) and the posterolateral types were 14 cases(29%), the superomedial types were 10cases(21%), the posteromedial types were 5cases(10%), the globe types were 7cases(15%). The sites of hemorrhage were highest in the thalamogeniculate artery territories. In the aspect of clinical symptoms, ocular signs were more common in the posteromedial and the globe type. Motor weakness and sensory symptoms were developed in the all types, almostly. Speech involvements were developed in 14% of Lt.side thalamic hemorrhages. Mental symptoms(confusion, disorientation) appeared in the large amount of hemorrhage exclusively. The mortality rate was 10.4%. Prognosis was correlated with the extent of involvement and the amount of hematoma, not the location.
Arteries ; Brain ; Hematoma ; Hemorrhage* ; Incidence ; Mortality ; Prognosis ; Thalamus ; Tomography, X-Ray Computed

The formation of aortic thrombi is an extremely rare complication of acute pancreatitis. Here we report a case of acute pancreatitis complicated by a paraesophageal pseudocyst, necrotizing mediastinitis, and the formation of multiple thrombi in the ascending aorta. The patient was successfully treated by surgical therapy, which included extensive debridement of the mediastinum and removal of the aortic thrombi under cardiopulmonary bypass. Although esophageal resection was not carried out concomitantly, the lesions were resolved and the patient remained free of complications over 2 years of follow-up care.
Aorta ; Cardiopulmonary Bypass ; Debridement ; Esophageal Diseases ; Follow-Up Studies ; Humans ; Mediastinitis* ; Mediastinum ; Pancreatitis* ; Pancreatitis, Acute Necrotizing ; Thrombosis

In this study, We evaluated the safety and efficacy of mycophenolate mofetil (MMF) for the prevention of acute rejection episodes when given in combination with cyclosporine and corticosteroids during the postoperative period in living donor kidney transplantation. 212 patients were enrolled; 106 patients received triple therapy with azathioprine (control group) and another 106 patients received triple regimen with MMF 2 g/day (study group). There was two subgroup in the study group. Of the study group, one subgroup was 90 patients treated MMF after acute rejection episode or an increase in serum creatinine level above 2.0 mg/dl (MMF conversion) and another group was 16 patients with primary MMF therapy. We made no demographic difference between study and control groups with patient selection for reducing bias. There was no statistical differences in serum creatinine level between two groups at 2 years after transplantation. There were 12 (13.3%), 3 (18.8%) acute rejection episodes in the MMF conversion and primary MMF therapy groups and 36 (33.7%) in the control group with statistic difference (p=0.01). 5 patients (5.6%) in the MMF-treated group lost their graft versus 16 patiens (15%) in the AZA-treated group. The 2-year graft survival rate was 97.4% in the study group and 83.9% in the control group. There was signficant difference in 2-year graft survival (p=0.003). The adverse effects of MMF were opportunistic infection, leukopenia, abdominal pain and diarrhea. MMF in combination with cyclosporine and prednisone was superior to a standard immunosuppressive regimen including azathioprine. Taken together, the data indicated that MMF will be a valuable addition to the list of immunosuppressants available for the prevention and treatment of acute renal rejection after renal transplantation. Its final place in clinical transplantation will be determined by further analysis of future, randomized-prospective studies, and by broadening experience with this important addition to the immunosuppressive regimen.
Abdominal Pain ; Adrenal Cortex Hormones ; Azathioprine ; Bias (Epidemiology) ; Creatinine ; Cyclosporine ; Diarrhea ; Graft Survival ; Humans ; Immunosuppressive Agents ; Kidney Transplantation* ; Leukopenia ; Living Donors ; Opportunistic Infections ; Patient Selection ; Postoperative Period ; Prednisone ; Transplants*

Two strains of non-O group 1 Vibrio cholerae (non-0:1V. cholerae) were isolated from blood of a woman who had undergone a gastrectomy and from peritoneal fluid of a man with an impaired liver function. Microbiology laboratories in countries where raw fish and shellfish are frequently consumed should consider the possibility of non-0:1 V. cholerae when they identify vibrios from extraintestinal sources.
Adult ; Cholera/complications* ; Female ; Human ; Male ; Middle Age ; Peritonitis/etiology* ; Septicemia/etiology* ; Vibrio cholerae/isolation & purification

Combined double chambered right ventricle(DCRV) and discrete subaortic stenosis(DSAS) is a rare entity on which only 12 cases have been reported in the literature. We presented a case of combined DCRV and DSAS in an 18 year old girl. She had type II(thin membranous type) DSAS and the peak systolic prssure gradient between aorta and left ventricle was 38 mmHg. Aberrant muscle bundle was found on the right ventriculography and the pressure gradient in the right ventricle was 35 mmHg. She also had aortic regurgitation, persistent left sided superior vena cava and extracardiac malformations such as kyphoscoliosis and congenital cloacal anomaly.
Adolescent ; Aorta ; Aortic Valve Insufficiency ; Discrete Subaortic Stenosis* ; Female ; Heart Ventricles* ; Humans ; Vena Cava, Superior

This study intends to examine the polymorphism of 5 STR loci inX-chromosome (GATA172D05, HPRTB, DXS8377, DXS101, HumARA) and to evaluate usefulness of them in forensic identification. 100 unrelated Korean men and women were selected. DNA was extracted from these sample and PCR was performed to amplify it. And using automated DNA sequencer and computer program, the genotype and allele frequency of them were investigated and analyzed. The following results were obtained: 1. The genetic analysis of 5 STR loci inX-chromosome was performed with quadruplex PCR for GATA172D05, HPRTB, DXS8377, HumARA and monoplex PCR for DXS101. 2. Polymorphism information content of 5 loci is higher than 0.5, the high information content is observed. The heterozygosity is higher in DXS8377, DXS101, HumARA than others. 3. The power of discrimination is revealed high in all 5 loci in women, but in men DXS8377 and HumARA is higher than others. 4. The mean exclusion chance is revealed high in DXS8377 and HumARA which have more alleles than others in trio case and motherless case. 5. The difference of allele frequency is observed with other population group in DXS8377, DXS101, HumARA of Korean population group. Based on the results of this study, the allele frequency and population data of 5 STR loci inX-chromosome may be useful in forensic investigation.
Alleles ; Discrimination (Psychology) ; DNA ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Polymerase Chain Reaction ; Population Groups

BACKGROUND: The purpose of this study is to evaluate the patients' general perception about the analgesics and the effects of the preoperative education about analgesics and patient-controlled analgesia (PCA). METHODS: One hundred patients scheduled for elective gastrectomy were randomly allocated into two groups. In control group (n = 50), patients were given conventional preanesthetic visit with questionnaire survey on PCA one day before operation. In study group (n = 50), patients were sufficiently explained about postoperative analgesia and PCA by anesthesiologist and given precise explanation sheet about PCA. Total amounts of drug used in PCA as well as rescue analgesics, the pain scores, and side effects were compared. RESULTS: 62.2% of patients had much information from various sources that analgesics effects positively in the recovery phase, but actually 73.7% of patients considered that analgesics do not seem to have any influence on the recovery after operation. There was no difference between the amounts of total PCA used, rescue analgesics, and the pain scores. However, the educated patients complained less dizziness at postoperative days (POD) one. Also, the number of patients excluded from study due to the PCA discontinuation secondary to related side effects was less in educated patients (P = 0.025). CONCLUSIONS: Preoperative education about analgesics and PCA failed to demonstrate significant decrease in the amount of analgesics and of pain scores. However, it lowered the incidence of PCA discontinuation due to side effects.
Analgesia ; Analgesia, Patient-Controlled* ; Analgesics* ; Dizziness ; Education* ; Gastrectomy ; Humans ; Incidence ; Passive Cutaneous Anaphylaxis ; Postoperative Care

Incontinentia pigmenti (IP) is an uncommon genodermatosis that usually occurs in female infants. It is characterized by ectodermal, mesodermal, neurological, ocular, and dental manifestations. The aim of this study was to clarify clinical symptoms, accompanying diseases, and complications of IP. Forty cases of IP have been reviewed by their medical records, laboratory data, clinical photographs, and telephone survey. Male-to-female ratio was 1 to 19 and their onsets were mostly in utero. They were usually diagnosed during the neonatal period owing to their early expression of skin manifestation. Central nervous system anomalies were found in 46.7%. Ocular disorders and dental defects were detected in 66.7% and 72.7% respectively. The most commonly diagnosed anomalies were hypodontia, retinopathy, and seizure. For better understanding of IP, long term and close cooperation between dermatologists, pediatricians, neuroscientists, genentic counselors, and even dentists is crucial.
Stomatognathic Diseases/complications ; Skin Diseases/complications ; Male ; Magnetic Resonance Imaging/methods ; Korea ; Infant, Newborn ; Infant ; Incontinentia Pigmenti/*diagnosis/pathology ; Humans ; Female ; Eye Diseases/complications ; Eosinophilia/complications ; Child, Preschool ; Child ; Central Nervous System Diseases/complications