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*

We report two cases of toxic methemoglobinemia caused by an inert ingredient in pesticide product after intentional ingestion of pesticide. First, 51-year-old male visited to the emergency department (ED) after the ingestion of pesticide in a suicide attempt. Initial methemoglobin (MetHb) level was 25.6%. We did not know the cause of methemoglobinemia at that time. Second, 56-year-old female visited to the ED after the ingestion of the same pesticide in a suicide attempt. MetHb level after 30 minutes was 16.1%. The patients were treated with methylene blue. We contacted to the Korean Rural Development Administration and estimated that magnesium nitrate was more likely to cause methemoglobinemia. This report highlights the importance of considering the possibility of methemoglobinemia caused by inert ingredient in pesticide and early antidotal therapy.
Eating* ; Emergency Service, Hospital ; Female ; Humans ; Magnesium ; Male ; Methemoglobin ; Methemoglobinemia* ; Methylene Blue ; Middle Aged ; Pesticides ; Social Planning ; Suicide

PURPOSE: Perianal lesions are common in Crohn disease, but their clinical course is unpredictable. Nevertheless, predicting the clinical course after surgery for perianal Crohn disease (PCD) is important because repeated operations may decrease patient's quality of life. The aim of this study was to predict the risk of reoperation in patients with PCD. METHODS: From September 1994 to February 2010, 377 patients with PCD were recruited in twelve major tertiary university-affiliated hospitals and two specialized colorectal hospitals in Korea. Data on the patient's demographics, clinical features, and surgical outcomes were analyzed. RESULTS: Among 377 patients, 227 patients were ultimately included in the study. Among the 227 patients, 64 patients underwent at least one reoperation. The median period of reoperation following the first perianal surgery was 94 months. Overall 3-year, 5-year, and 10-year cumulative rates of reoperation-free individuals were 68.8%, 61.2%, and 50.5%, respectively. In multivariate analysis (Cox-regression hazard model), reoperation was significantly correlated with an age of onset less than 20 years (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.07-3.48; P = 0.03), history of abdominal surgery (HR, 1.99; 95% CI, 1.08-3.64; P = 0.03), and the type of surgery. Among types of surgery, fistulotomy or fistulectomy was associated with a decreased incidence of reoperation in comparison with incision and drainage (HR, 0.19; 95% CI, 0.09-0.42; P < 0.001). CONCLUSION: Young age of onset and a history of abdominal surgery were associated with a high risk of reoperation for PCD, and the risk of reoperation were relatively low in fistulotomy or fistulectomy procedures.
Age of Onset ; Crohn Disease ; Demography ; Drainage ; Humans ; Incidence ; Inflammatory Bowel Diseases* ; Korea ; Multivariate Analysis ; Quality of Life ; Recurrence ; Reoperation* ; Risk Factors*

To find out the different cognition of the members of medical school about the importance of graduate outcomes such as 'clinical performance, communication, supporting patients, professionalism, problem solving and research, self-development', a survey applied with self-report method was conducted with 110 faculties, 132 students (71 premedical 2nd graders and 61 medical 2nd graders), and 30 parents about graduate outcomes and sub-outcome competences. Parents usually thought highly of the importance of graduate outcomes, while medical second graders comparatively regarded them as less important. Among graduate outcomes, 'clinical performance' was definitely considered the most important and was followed by 'communication'. As for 'self-development', parents and premedical 2nd graders regarded it as important, while faculty and medical 2nd graders had lower awareness about its importance. As to the suboutcome competences, faculty generally had lower awareness about their importance compared to students and parents.
Cognition ; Humans ; Methods ; Parents* ; Problem Solving ; Professionalism ; Schools, Medical*