BACKGROUND: Fibrin-related markers (FRM) such as fibrin monomer (FM) and D-dimer (DD) are considered useful biological markers for the diagnosis of disseminated intravascular coagulation (DIC). However, no studies on the diagnostic performance of different FRMs have been published in Korea. The aim of this study was to evaluate the diagnostic performance of FM for DIC in comparison with DD. METHODS: The reference limit of FM was determined based on plasma sample data obtained from 210 control individuals. To evaluate diagnostic performance, FM data from the plasma samples of 139 patients with DIC-associated diseases were obtained for DIC scoring. FM was measured by immunoturbidimetry using STA-LIATEST FM (Diagnostica Stago, France). Patients were classified according to the DIC score as non-DIC, non-overt DIC, or overt DIC. ROC curve analyses were performed. RESULTS: The reference limit in the control individuals was determined to be 7.80 microg/mL. Patients with DIC-associated diseases were categorized as non-DIC (N=43), non-overt DIC (N=80), and overt DIC (N=16). ROC curve analyses showed that the diagnostic performance of FM was comparable to DD in both non-overt DIC and overt DIC (P=0.596 and 0.553, respectively). In addition, FM had higher sensitivity, specificity, positive predictive value, and negative predictive value than DD for differentiating overt DIC from non-DIC. CONCLUSIONS: This study demonstrated that the diagnostic performance of FM for DIC was comparable to DD. FM might be more sensitive and more specific than DD in the diagnosis of overt DIC, but not non-overt DIC.
Area Under Curve ; Biological Markers/blood ; Disseminated Intravascular Coagulation/blood/*diagnosis ; Fibrin Fibrinogen Degradation Products/*analysis/immunology/standards ; Humans ; Immunoassay/*methods/standards ; Nephelometry and Turbidimetry/*methods/standards ; ROC Curve ; Reagent Kits, Diagnostic ; Reference Values

BACKGROUND: Fibrin-related markers (FRM) such as fibrin monomer (FM) and D-dimer (DD) are considered useful biological markers for the diagnosis of disseminated intravascular coagulation (DIC). However, no studies on the diagnostic performance of different FRMs have been published in Korea. The aim of this study was to evaluate the diagnostic performance of FM for DIC in comparison with DD. METHODS: The reference limit of FM was determined based on plasma sample data obtained from 210 control individuals. To evaluate diagnostic performance, FM data from the plasma samples of 139 patients with DIC-associated diseases were obtained for DIC scoring. FM was measured by immunoturbidimetry using STA-LIATEST FM (Diagnostica Stago, France). Patients were classified according to the DIC score as non-DIC, non-overt DIC, or overt DIC. ROC curve analyses were performed. RESULTS: The reference limit in the control individuals was determined to be 7.80 microg/mL. Patients with DIC-associated diseases were categorized as non-DIC (N=43), non-overt DIC (N=80), and overt DIC (N=16). ROC curve analyses showed that the diagnostic performance of FM was comparable to DD in both non-overt DIC and overt DIC (P=0.596 and 0.553, respectively). In addition, FM had higher sensitivity, specificity, positive predictive value, and negative predictive value than DD for differentiating overt DIC from non-DIC. CONCLUSIONS: This study demonstrated that the diagnostic performance of FM for DIC was comparable to DD. FM might be more sensitive and more specific than DD in the diagnosis of overt DIC, but not non-overt DIC.
Area Under Curve ; Biological Markers/blood ; Disseminated Intravascular Coagulation/blood/*diagnosis ; Fibrin Fibrinogen Degradation Products/*analysis/immunology/standards ; Humans ; Immunoassay/*methods/standards ; Nephelometry and Turbidimetry/*methods/standards ; ROC Curve ; Reagent Kits, Diagnostic ; Reference Values

A 49 years old male patient suffering from liver cirrhosis and diabetes mellitus was admitted with complaints of chest pain and hematemesis. Three years ago, the patient received a transfusion of unknown blood components, presumed platelet concentrates. During the pretransfusion testing, we found irregular antibodies with the antibody-screening test and identified the antibody as anti-Xga. An antiglobulin test was done as a part of a cross-match and all compatible units of packed red cells were transfused. No transfusion reaction was observed.
Antibodies ; Blood Group Incompatibility ; Blood Platelets ; Chest Pain ; Coombs Test ; Diabetes Mellitus ; Hematemesis ; Humans ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Male ; Middle Aged

Bisphosphonate is notable for the treatment of osteoporosis in the world. But recently if Bisphosphonate is taken for a long time, it causes an insufficiency fracture by suppression of bone turn-over and it is reported rarely on femur neck. Here we report a case of insufficiency fracture on ipsilateral femur neck in woman treated with long term Bisphosphonate therapy.
Female ; Femur ; Femur Neck ; Fractures, Stress ; Humans ; Osteoporosis

Compared with acromioclavicular dislocation, dislocation of the clavicle at its sternal end is uncommon and accounts for 3% of all injuries to the shoulder girdle. Furthermore, the posterior dislocation of the sternoclavicular joint is relatively a rare injury compared to the other types of sternoclavicular dislocation. We report this case since we have experience with similar cases of traumatic posterior dislocation at the sternoclavicular joint, which were successfully treated with x-ray guided reduction.
Clavicle ; Dislocations ; Shoulder ; Sternoclavicular Joint

PURPOSE: Microsurgery is an essential technique in plastic and reconstructive surgery. However, microsurgical suturing and handling of the instrument are difficult for beginners, and who requires a steep learning curve. Therefore, methods for improving the technical skill are needed. The authors describe the value of a small stereoscopic microscope as a training tool. MATERIALS AND METHODS: A small stereoscopic microscope was used to help improve the microsurgical skill. Monofilament 10-0 Nylon and a surgical rubber globe were used as a suture material and education material, respectively RESULT: Stereoscopic view of the operation field was obtained and basic microsurgical suture was possible. CONCLUSION: The stereoscopic microscope is an effective training tool for beginners of microsurgery with benefits in cost and usefulness in small place.
Handling (Psychology) ; Hypogonadism ; Learning Curve ; Microsurgery ; Mitochondrial Diseases ; Nylons ; Ophthalmoplegia ; Plastics ; Rubber ; Sutures

BACKGROUND AND OBJECTIVES: The polysomnography is essential for diagnosis of obstructive sleep apnea-hypopnea (OSAH) and provides important objective information. But, in fact, there are some difficulties for comprehensive interpretation of multiple indices from the polysomnogram. This study was designed to find out which polysomnogram indices were significant to respiratory distress indices (RDI) and apnea index (AI) on statistical correlation and which other indices should be considered together for proper management plan apart from RDI and AI (respiratory index). SUBJECTS AND METHOD: We evaluated 40 patients whose RDI were over 5 as the result of overnight polysomnography before any management from February 2003 to September 2003 at Eulji medical center. By multiple linear regression analysis, we studied the relationship of RDI and AI as dependent variables to ST, O2 desaturation events (O2DE), lowest O2 saturation (LoO2), slow wave sleep portion (S3&S4), arousal index (ArI), body-mass index (BMI) and age. We also studied the relationship of ST as an dependent variable to O2DE, LoO2, S3&S4, ArI, BMI, and age. RESULTS: 1) There were significant correlations between RDI and O2DE, ArI as was true between AI and O2DE, ArI (p<0.05). And there was no significant difference in the degree of the correlation between RDI and AI. 2) Other variables such as ST, LoO2, S3&S4, BMI and age were not significant. 3) ST had no significant correlation with respiratory index and any other variables (p<0.05). CONCLUSION: Because the respiratory index may not the entire physical status during sleep for OSAH patients, multiple indices (such as LoO2, BMI, ST, S3&S4, age) should be considered together apart from the respiratory index for proper management plan.
Apnea ; Arousal ; Diagnosis ; Humans ; Linear Models ; Polysomnography* ; Sleep Apnea, Obstructive

Authors measured the length of the auricle of both sides, and the length of face to know the medicolegal significance of them in 265 medicolegal autopsy cases. The data were analyzed by anthropometric study method to gain the ear-face height index (auricular length x 100/facial length). The results were as follows: 1. The relationship between the ear-face height indices of the length of life is statistically significant (r=0.34; p<0.001). 2. The relationship between the ear-face height indices of the length of life is higher than in females than males (males: r=0.28, females: r=0.51). 3. In the natural deaths and homicide cases, the relationship between the ear-face height indices of the length of life is higher than the accidental deaths and suicide cases, however, the natural death cases only show statistically significant relationship between the ear-face height indices of the length of life (p<0.05).
Anthropometry ; Autopsy* ; Ear* ; Female ; Homicide ; Humans ; Longevity ; Male ; Suicide

OBJECTIVE: Cancer stem cells (CSCs) represent a subpopulation of undifferentiated tumorigenic cells thought to be responsible for tumor initiation, maintenance, drug resistance, and metastasis. The role of CSCs in drug resistance and relapse of cancers could significantly affect outcomes of ovarian cancer patient. Therefore, therapies that target CSCs could be a promising approach for ovarian cancer treatment. The antibiotic salinomycin has recently been shown to deplete CSCs. In this study, we evaluated the effect of salinomycin on ovarian cancer stem cells (OCSCs), both alone and in combination with paclitaxel (PTX). METHODS: The CD44⁺CD117⁺CSCs were obtained from the ascitic fluid of patients with epithelial ovarian cancer by using an immune magnetic-activated cell sorting system. OCSCs were treated with PTX and salinomycin either singly or in combination. Cell viability and apoptosis assays were performed and spheroid-forming ability was measured. The expression of sex determining region Y-box 2 (SOX2) and octamer-binding transcription factor 3/4 (OCT3/4) mRNA was determined using reverse transcription polymerase chain reaction, and protein expression was observed using western blot analysis. RESULTS: Treatment with salinomycin alone reduced the stemness marker expression and spheroid-forming ability of OCSCs. Treatment with PTX alone did not decrease the viability of OCSCs. Treatment with a combination of salinomycin decreased the viability of OCSCs and promoted cell apoptosis. The enhancement of combination treatment was achieved through the apoptosis as determined by annexin V/propidium iodide (PI) staining, caspase-3 activity, and DNA fragmentation assay. CONCLUSION: Based on our findings, combining salinomycin with other anti-cancer therapeutic agents holds promise as an ovarian cancer treatment approach that can target OCSCs.
Apoptosis* ; Ascitic Fluid ; Blotting, Western ; Caspase 3 ; Cell Survival ; DNA Fragmentation ; Drug Resistance ; Humans* ; Neoplasm Metastasis ; Neoplastic Stem Cells ; Ovarian Neoplasms* ; Paclitaxel ; Polymerase Chain Reaction ; Recurrence ; Reverse Transcription ; RNA, Messenger ; Stem Cells* ; Transcription Factors

Amyloidosis is a heterogeneous group of diseases in which misfolding of extracellular proteins is the pathogenic factor. Light chain amyloidosis (AL) is the most common form of amyloidosis, and the causative proteins in AL are the immunoglobulin light chains produced by clonal plasma cells. Hemorrhagic events, ranging from mild subcutaneous hemorrhage to life-threatening bleeding, account for a significant proportion of morbidities and mortality in AL patients. Deficiency of factor X from deposition into amyloid fibrils has been reported to be the most common acquired factor deficiency in AL. We herein report 2 patients with acquired factor X deficiency in AL. A 55-yr-old woman with AL had a prolonged prothrombin time (PT) and an activated partial thromboplastin time (aPTT) of 2.51 International Normalized Ratio (INR) and 75.1 sec, respectively, which were corrected on mixing with normal plasma. Factor X activity was markedly decreased at 5%. The other patient was a 67-yr-old man with AL with a PT of 1.63 INR and an aPTT of 50.3 sec, which were corrected on mixing with normal plasma. Factor X activity was decreased at 17%. Neither of the patients had apparent hemorrhagic manifestations. Identification of acquired factor deficiency and timely coagulation tests are needed in the diagnostic workup and management in AL.
Aged ; Amyloidosis/*complications ; Factor X/*metabolism ; Factor X Deficiency/*diagnosis/etiology/therapy ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Immunoglobulin Light Chains/*metabolism ; Male ; Middle Aged ; Republic of Korea ; Transplantation, Autologous