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

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: 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

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: To investigate the effect of human joint fluid media on the survival and proliferation of bone marrow derived precusor cell, and to provide the basic data of the intraarticular injection with scaffold-free progenitor cell in advanced degenerative osteoarthritis (OA). MATERIALS AND METHODS: We obtained the joint fluid and bone marrow from 15 patients who had total knee arthroplasty due to degenerative OA, and isolated the mesenchymal progenitor cells (MPCs) from bone marrow by washing and ten times subculture. We devided the control and experiment groups according to the addition of joint fluid at various ratios (1/100, 1/10, 1, 10, 100, 1000 microliter), and statistically analyzed the numbers of mesenchymal progenitor cell proliferated according to the culture period. RESULTS: The experiments using joint fluid without centrifuge showed the increase of MPCs as the culture poriod was extended and was independent to the existence of fetal bovine serum, the dose dependent pattern in the increase of MPCs in proportion to the dose of joint fluid, and statistically significant increase MPCs in 10, 100, 1000 microliter of serum contained groups, 1000 microliter of serum-free groups (p=0.039, p=0.017, p=0.077, p=0.004). The experiments using joint fluid with centrifuge showed the increase of MPCs as the culture period was extended and was independent of fetal bovine serum, and the dose dependent pattern in the increase of MPCs in proportion to the dose of joint fluid, and statistically significant increase MPCs in 1000 microliter of both serum contained and serum-free groups (p=0.006, p=0.024). CONCLUSION: MSCs not only can survive, but also proliferate in human joint fluid. The rate of proliferaton is increased faster by the adding of joint fluid than only using common media in cell culture. And the experiment shows the dose dependent pattern in the increase of MPCs in proportion to the dose of joint fluid.
Arthroplasty ; Bone Marrow ; Cell Culture Techniques ; Humans* ; Injections, Intra-Articular ; Joints* ; Knee ; Mesenchymal Stromal Cells ; Osteoarthritis ; Stem Cells*

OBJECTIVES: To investigate the relationship of neurochemical changes of brain in SCHE patients and the level of cognitive function, the authors measured hydrogen containing neurochemicals in two brain regions using 1H MRS, and compared those changes with the level of cognitive performances such as attention, visual analysis, or fine motor function. METHODS: A total of patients with liver cirrohosis were defined as SCHE, for they performed poorly(out of 1 SD of normative data) in more than one neuropsychological tests conventionally used(digit symbol and block design tests in KWIS, trail making test A and B). They were further evaluated in attentional ability and efficacy of visual analysis using Cognitrone subtest in Vienna Neurocognitive Test battery. Fine motor coordination were also measured by Grooved Pegboard test. Patients and 20 normal controls underwent proton MRS study. Proton containing neurochemicals, such as myoinositol(mI), N-acetyl-L-aspartate(NAA), creatine(Cr), choline(Cho) were measured from 2*2*2cm3 voxel of basal ganglia and parietal white matter using 1.5 tesla clinical MRI/MRS system. The ratios of above metabolites to Cr were analyzed. RESULTS: 1) Patients with SCHE showed reductions in Cho/Cr and mI/Cr in both basal ganglia and parietal white matter compared to normal subjects. 2) Performance of Grooved Pegboard test were negatively correlated with mI level of basal ganglia and with Cho level of parietal white matter(r=-0.59, p<.05). 3) Mean time of correct responses in Cognitrone test showed negative correlation with NAA level of parietal white matter(r=-0.55, p<.05). CONCLUSION: Certain neurocognitive disturbances in SCHE patients seemed to be related with neurochemical changes in basal ganglia or parietal white matter. To further elucidate the relationship of focal biochemical changes and neurocognitive deficits in SCHE patients, however, follow-up study according to the illness stage must be performed. Studies on other disorders showing similar cognitive deficit patterns would be helpful.
Basal Ganglia ; Brain ; Hepatic Encephalopathy* ; Humans ; Hydrogen ; Liver ; Neuropsychological Tests ; Protons* ; Rabeprazole ; Trail Making Test