BACKGROUNDS: With the recent elucidation of genetic basis of Rh blood group, it is now available the molecular genotyping methods for Rh blood typing. These can be used when serological typing is difficult. This study was conducted to investigate the usefulness of Rh genotyping method for Koreans. METHODS: Genotyping for Rh C/c and E/e was performed in peripheral blood DNA samples from 34 blood donors by polymerase chain reaction using sequence-specific primers (PCR-SSP). The PCR determined genotypes were compared with serologically determined phenotypes. RESULTS: The Rh C/c and E/e genotyping results of 34 blood donors were full concordance with the results of their serologic phenotyping. CONCLUSIONS: Rh genotyping method on the basis of Rh genetic model can be applied to Koreans. This genotyping method would be useful tool in prenatal Rh typing of fetus at risk of hemolytic disease and when serotyping is not available for example massive transfusion. (Korean J Blood Transfusion 10(1): 21-26, 1999)
Blood Donors ; Blood Grouping and Crossmatching ; Blood Transfusion ; DNA ; Fetus ; Genotype ; Humans ; Models, Genetic ; Phenotype ; Polymerase Chain Reaction* ; Serotyping

Injuries to the extensor mechanism include a wide range of injuries from minor one to massive defect. And the methods of treatment must be individualized according to the anatomical site, extent and chronicity of injuries. The extensor mechanism is a triangular thin sheet like structure, the function of which cannot be explained completely by the Tubiana's church-steeple like diagram. Authors think that the extensor mechanism should be repaired or reconstructed as a triangular sheet. The tension of the repaired or reconstructed tendon was estimated as good when the neutral extensions were obtained in all the MP, PIP and DIP joints after the completion of sutures. Also authors think that stable sutures are mandatory for the early rehabilitation postopoeratively. Seventy-five patients have been treated by the authors from 1982 to 1994. According to zonal classification, forty-two patients were injured in Zone I. 5 in Zone II, 21 in Zone III, 5 in Zone IV and 2 patients were unclassified due to massive defects of the extensor mechanism. Mostly bony mallet injuries were treated by open reduction and K-wire fixation. Acute tendinous mallet injuries were treated by conservative splinting and old injuries were treated by anatomical plication of the terminal extensor tendon. Old buttonhole deformities were generally treated by the central tendon plication. Massive defects were managed by skin coverage and reconstruction of the extensor mechanism by using a tendon graft which was tailored like a triangular thin sheet. With author's treatment principles, excellent or good results were obtained in about 87%. Consequently, authors emphasize that an anatomical repair or reconstruction is a keystone in the treatment of injuries to the extensor mechanism.
Classification ; Congenital Abnormalities ; Fingers ; Fluconazole ; Humans ; Joints ; Rehabilitation ; Skin ; Splints ; Sutures ; Tendons ; Transplants

The surgical outcome of excimer laser photorefractive keratectomy(PRK) depends on the accuracy of ablation and the smoothness of the surface ablated. The purpose of this study was to investigate the clinical usefulness of a new eyeball fixation device(EK fixation device). First, the PRK was done on the cornea of New Zealand white rabbit (-8 D, 5.5 mm). The surface with the device was smoother compared to that without. Second, The PRK (-4 D, 6 mm)was done on the surface of the contact lens over the cornea of human volunteers. The ablation surface with the device was smoother than that without(0.20+/-0.04 micrometer vs. 0.34 +/-0.14 micrometer, p=0.028). The epithelial healing experiment in New Zealand white rabbit after myopic PRK (-8 D, 5.5 mm)showed more rapid wound healing in the fixation group (66.49+/-0.03 micrometer/hr vs 47.93+/-1.80 micrometer/hr, p=0.0001). In conclusion, the EK fixation device during the PRK procedures creates a smoother ablation surface and enhances corneal epithelial healing, thus may be a useful clinical device.
Cornea ; Healthy Volunteers ; Lasers, Excimer ; New Zealand ; Wound Healing

A 51-year-old male with sustained fever was diagnosed with military tuberculosis and tuberculous aortitis complicated with pseudoaneurysm formation at the proximal descending aorta. A follow-up computed tomography evaluation showed an increased size of the pseudoaneurysm in this area, suggestive of a contained rupture. Consequently, the patient underwent emergency excision and replacement of the aorta using a left heart bypass. The patient was discharged without postoperative complications on post-operative day 12. During the one-year follow-up period, the patient was free of any complications or recurrence of tuberculosis. We report a case of pseudoaneurysm of the descending aorta that was successfully surgically repaired.
Aneurysm, False ; Aorta ; Aorta, Thoracic ; Aortitis ; Emergencies ; Fever ; Follow-Up Studies ; Heart Bypass, Left ; Humans ; Male ; Middle Aged ; Military Personnel ; Postoperative Complications ; Recurrence ; Rupture ; Tuberculosis

BACKGROUND: Prenatal determination of a blood antigen of a fetus at risk for hemolytic disease of the newborn makes the obstetrician facilitate to take timely procedures such as intra-uterine transfusion or plasma exchange. However, determining the phenotype of a fetal antigen is of limited use because fetal RBCs must be obtained by periumbilical blood sampling which entails considerably greater adverse outcomes than an amniocentesis does. METHODS: Genotypes of Rh, MN and Kell systems using 14 amniotic fluid samples were compared with phenotypes of cord blood. The incidence of maternal blood contamination in 8 amniotic fluid samples which were obtained during mid-trimester was estimated by amplification of variable number of tandem repeat(VNTR) D1S80. The detection sensitivity of each technique was evaluated by artificially mixed samples. RESULTS: All the 14 paired samples of amniotic fluid and cord blood showed identical results between the genotype of amniocyte and the phenotype of cord blood. Of 8 paired samples of amniotic fluid and maternal blood, D1S80 VNTRs of fetuses were evidently amplified and there were no evidence of maternal blood contamination. The detection sensitivity of Rh(E) and Rh(c) genotyping was 0.5% by ethidium bromide staining, while D1S80 VNTR was 10%. Heterozygosity of D1S80 VNTR was 94%. CONCLUSIONS: Genotypes of Rh, MN and Kell systems could be prenatally determined by this technique. Since the heterozygosity of D1S80 VNTR is high up to 94% in Koreans, D1S80 VNTR could be effectively used in determining the maternal blood contamination of amniotic fluid. The prenatal determination of fetal red cell antigen genotypes by this technique will be helpful for the management of sensitized pregnancies at risk for HDN.
Amniocentesis ; Amniotic Fluid* ; Blood Group Antigens* ; DNA* ; Ethidium ; Female ; Fetal Blood ; Fetus ; Genotype ; Humans ; Incidence ; Infant, Newborn ; Phenotype ; Plasma Exchange ; Pregnancy

BACKGROUNDS: With the recent elucidation of genetic basis of Rh blood group, it is now available the molecular genotyping methods for Rh blood typing. These can be used when serological typing is difficult. This study was conducted to investigate the usefulness of Rh genotyping method for Koreans. METHODS: Genotyping for Rh C/c and E/e was performed in peripheral blood DNA samples from 34 blood donors by polymerase chain reaction using sequence-specific primers (PCR-SSP). The PCR determined genotypes were compared with serologically determined phenotypes. RESULTS: The Rh C/c and E/e genotyping results of 34 blood donors were full concordance with the results of their serologic phenotyping. CONCLUSIONS: Rh genotyping method on the basis of Rh genetic model can be applied to Koreans. This genotyping method would be useful tool in prenatal Rh typing of fetus at risk of hemolytic disease and when serotyping is not available for example massive transfusion.
Blood Donors ; Blood Grouping and Crossmatching ; DNA ; Fetus ; Genotype ; Humans ; Models, Genetic ; Phenotype ; Polymerase Chain Reaction* ; Serotyping

Exercise testing with Thallium imaging is widely used for the noninvasive evaluation of patients suspected of having coronary artery disease. However, many patients referred for stress testing connot exercise adequately for either physical or psychological reasons, and as a result may have nondiagnostic or suboptimal test results. Intravenous dipyridamole in conjunction with Thallium imaging is as effective alternative method without exercise. But, myocardial imaging using the standard scintillation camera technique(planner view) is hampered by superposition of proximal & distal cardial walls and by the segmental nature of myocardial ischemia. For this reason, Single Photon Emission Computed Tomography(SPECT) reslut in high specificity & sensitivity rates for the detection of coronar artery disease compared with conventional technique. So we performed dipyridamole Th-201 myocardial scintigraphy on 25 subjects who have suspicious angina or myocardial infarction instead of exercise Th-201 myocardial scintigraphy, and compared SPECT view with conventional plannar view. The results obtained are as follows : 1) T1-201 scintigraphic findings in 17 patients with suspicious angina were as follows ; redistribution defect was seen in 4 cases in plannar view and 13 cases in SPECT view. 2) T1-201 scintigraphic findings in 8 patients with myocardial infarction were as follows ; in planner view, perfusion defect was seen in all cases and 1 cases of them, redistribution defect was accompained, and in SPECT view, perfusion defect was seen in all cases and 6 cases of them, redistribution defect was accompained. 3) During dipyridamole infusion, the mean systolic & diatolic pressure decreased from 133+/-22.7/86+/-13.5 to 121+/-23.9/78+/-13.1mmHg and the heart rate increased from 68+/-12.4 to 84+/-12.4beats/min. 4) Adverse effects of dipyridamole were noted in 14(56%) of the subjects, but in 12 of these, the symptoms were mild in severity and subsided spontanously. To summarize, Dipyridamole-201 myocardial imaging is a useful and test for coronary artery disease, and the new tomographic technique, SPECT view, is more useful than the conventional plannar view.
Arteries ; Coronary Artery Disease ; Dipyridamole* ; Exercise Test ; Gamma Cameras ; Heart Rate ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Sensitivity and Specificity ; Thallium* ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Perfusion scans are accurate predictors of postoperative lung function. There are few previous studies aimed at predicting the postoperative exercise capacity using the perfusion scanning and those that did reported contradictory results. METHOD: We prospectively studied the preoperative spirometric, exercise tests and perfusion scans from in 49 consecutive patients who were admitted to Inha University Hospital with surgically resectable lung cancer from Jan. 1998 to Jun. 1999 29 patients who had any condition affecting the lung function and exercise capacity, or refused a surgical resection or a follow-up study were excluded. Spirometric and exercise tests were performed 6 months after operation in 20 patients. RESULTS: The predicted postoperative FEV1, FVC and TLC correlated well with the following corresponding postoperative values : γs and p value, 0.809 and 0.000 for the FEV1 ; 0.895 and 0.000 for the FVC ; 0.741 and 0.006 for the TLC, respectively. The measured postoperative exercise values were slightly higher than the postoperative exercise values predicted, VO(2max) and Wr(max), were as 112% of VO(2max) predicted and 119% of WR(max) predicted. The change in FEV1, FVC and TLC had a weak correlation with the change in VO(2max) and WR(max). CONCLUSION: The perfusion scan was a useful tool for predicting the postoperative exercise capacity. However, they had a tendency to underestimate the exercise capacity, especially in the patients who had a pneumonectomy. A weak correlation between the change in lung function and exercise capacity was obseved.
Exercise Test ; Follow-Up Studies ; Humans ; Lung ; Lung Neoplasms ; Perfusion* ; Pneumonectomy ; Prospective Studies

BACKGROUND: The purpose of this study is to investigate the positive rates of screening tests for inherited metabolic disorders, set cutoff values, and report the actual status of internal quality controls in LabGenomics Clinical Laboratories by using LC-MS/MS system. METHODS: We use Agilent 1260 Infinity HPLC System (Agilent Technologies, USA) for liquid chromatography, and API 2000 (AB Sciex, Canada) for MS/MS system. We set up screening tests for 55 diseases, which include metabolic disorders of 25 amino acids, 16 organic acids, and 14 fatty acids. RESULTS: We determined the analyte cutoff values as 99.9 or 0.1 percentiles in 15,000 newborn samples. The total number of samples tested from January 2012 to September 2014 was 119,948; of these, 6,681 were repeated. Of the repeated samples, 713 were presumed to be positive in the screening tests. Repeat screening with newly obtained dried blood spot specimens was recommended for these 713 samples and 600 specimens were obtained. Thus, the recall rate was 0.5% (600/119,948) for all samples and 84.2% (600/713) for the samples presumed to be positive in the screening tests. About 70 samples, that is, 0.06% of the total samples and 11.7% of the "reobtained" samples, again tested positive; we recommended confirmatory tests for these samples. CONCLUSIONS: We have presented data on the status of neonatal screening tests for inherited metabolic disorders using LC-MS/MS, including positive rates and recall rates of screening tests, set up cutoff values and reported the actual status of internal quality controls in a clinical laboratory in Korea.
Amino Acids ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Fatty Acids ; Humans ; Infant, Newborn ; Korea* ; Mass Screening ; Neonatal Screening* ; Quality Control ; Tandem Mass Spectrometry*

BACKGROUND: Vasoconstricting drugs such as dopamine, phenylephrine (PE) and epinephrine constrict normoxic lung vessels preferentially, thereby disproportionately increasing normoxic lung pulmonary vascular resistance (PVR) and inhibit hypoxic pulmonary vasoconstriction (HPV). In this study, we evaluated the effect of PE on HPV and arterial oxygenation. METHODS: This study was performed on 21 patients undergoing thoracotomy. After induction of anesthesia, Swan-Ganz catheter was inserted. After one lung ventilation was started, systolic blood pressure (SBP) of the patient was reduced to 100 mmHg using inhalation anesthetic agent and then the blood pressure was raised up to 140 mmHg by PE infusion. Hemodynamic variables were measured and arterial blood gas was analyzed at the start of one lung ventilation (control), SBP of 100 mmHg and SBP of 140 mmHg. RESULTS: The mean dose of PE infused was 5.9 +/- 3.8 microgram/kg. Infusion of PE did not increase pulmonary vascular resistant index (PVRI) significantly and did not reduce arterial PO2. There was no statistically significant difference in intrapulmonary shunt fraction (Qs/Qt) between the time of low and high blood pressures. CONCLUSION: Pulmonary vasomotor changes induced by PE are minimal and so should not affect the distribution of blood flow during one lung ventilation. On the basis of this result, PE appears to a reasonable vasoconstrictor to be used in patients undergoing thoracotomy.
Anesthesia ; Blood Pressure ; Catheters ; Dopamine ; Epinephrine ; Hemodynamics ; Humans ; Hypertension ; Inhalation ; Lung ; One-Lung Ventilation* ; Oxygen* ; Phenylephrine* ; Thoracotomy ; Vascular Resistance ; Vasoconstriction*