BACKGROUND: Heparin salts induce negative proportional bias according to anticoagulant concentration for analysis of ionized calcium (iCa) However, D-phenylalanyl -L-prolyl- L-arginine chloromethyl ketone (PPACK), a selective thrombin inhibitor, do not bind to ionized calcium. Therefore, we evaluated PPACK as an alternative anticoagulant to lithium heparin (Li-Hep) for analysis of ira, blood gases and electrolytes. METHODS: The concentration of iCa in whole blood anticoagulated with heparin was compared with that in serum of patients admitted to Chungbuk National University Hospital (n=27). The blood gases, electrolytes and iCa according to each anticoagulant concentration (Ll-Hep or PFACK) were analyzed. The concentrations of anticoagulated whole blood (Li-Hep; 50 kIU/L, PPACK ; 75 mumol/L) were compared with those of nonanticoagulated whole blood for blood gases, electrolytes and iCa (n=17), RESULTS: The results were as follows; whole blood anticoagulated with Li-Hep demonstrated -0.28+/-0.15 mmol/L (26.6%) bias for ira compared with serum. No bias according to each anticoagulated concentrations were observed in analysis of blood gases, potassium and chloride. Negative proportional bias for iCa and sodium in serum anticoagulated with Li-HeP was observed. In comparison, no bias for ira and sodium was observed with PPACK. No bias was observed in analysis of blood gas or electrolytes with each anticoagulated whole blood except for sodium and chloride that had clinically nonsignificant bias. Whole blood anticoagulated with Li-Hep demonstrated a consistent -0.08+/-0.02 mmol/L (6.3%) bias for ira compared with nonanticoagulated whole blood. In comparison, no bias was observed with PPACK-anticoagulated whole blood for iCa. CONCLUSIONS: We concluded that PPACK is an ideal anticoagulant without bias for analysis of iCa, blood gases and electrolytes.
Arginine ; Bias (Epidemiology) ; Calcium* ; Chungcheongbuk-do ; Electrolytes* ; Gases ; Heparin* ; Humans ; Lithium ; Potassium ; Salts* ; Sodium ; Thrombin

The authors analysed bone marrow findings of sixteen cases of culture proven typhoid fever to reveal the pathologic changes according to the disease stage. The most frequent finding was chronic granulomatous inflammation (eight cases). Infection (bacteria) associated hemophagocytic syndrome (four cases), reactive marrow (two cases), and non specific findings (two cases) were also encountered. Granulocytic hyperplasia with hemophagocytosis appeared at the early stage and was followed by infection (bacteria) associated hemophagocytosis and granuloma in proliferative stage. In lysis (late) stage, granulomatous inflammation was noted. However, resolution of granulomatous inflammation was not distinct. Some nuclear debris and phagocytosis were remarkable in well-formed granulomas. Thrombocytopenia was the most remarkable peripheral blood finding at the time of biopsy. Anemia, leukopenia, and pancytopenia were also observed in descending order.
Adult ; Bone Marrow/microbiology/*pathology ; Female ; Humans ; Male ; Middle Aged ; Salmonella typhi/isolation & purification ; Thrombocytopenia/pathology ; Typhoid Fever/microbiology/*pathology

Lipiodol, lipid soluble contrast media, was applied to 59 patients, who was clinically suspected to havehepatic tumor, in the department of Diagnotic Radiology, Seoul National University Hospital. The results of theclinical use of Lipiodol were as follows: 1. The clinical diagnosis was hepatocellular carcinoma(HCC) in 50 cases,cavernous hemangioma in 4 cases, metastasis in one case and others in 4 cases. 2. After hepatic arteriography,Lipiodol only was injected in 28 cases, mixture of Lipiodol and Mitomycin was injected in 22 cases andtranscatheter arterial embolization was performed additionally after injection of Lipiodol and Mitomycin in 9cases. 3. Among the 50 cases of HCC, Lipiodol was accumulated in the lesion in 49 cases. However, similaraccumulation of Lipiodol occured in a metastatic cancer and cavernous hemangiomas. 4. Plain radiographic patternsof Lipiodol accumulation could be divided into fine granular type, nodular type and linear or branching type. Thelinear or branching pattern disappeared in follow-up radiography after one week. 5. As minor complication afterLipiodol Injection. GOY &GPT were transiently elevated in 30 cases and normalized in a week. Abdominal pain andfever developed but subsided in a week too. 6. When an appropriate lipid-soluble chemotherapeutic agent orradioisotope is applied to this phenomenon in which Lipiodol is selectively accumulated in hepatic tumor, thediagnostic and therapeutic values will be more enhanced.
Abdominal Pain ; Angiography ; Contrast Media ; Diagnosis ; Ethiodized Oil ; Follow-Up Studies ; Hemangioma ; Hemangioma, Cavernous ; Humans ; Mitomycin ; Neoplasm Metastasis ; Radiography ; Seoul

BACKGROUND: The HBV-PCR assay seems to be potentially valuable diagnostic tool for the evaluation of variable serologic status. However, the selection of the primer for HBV-PCR test may be very important because they can influence the HBV-PCR positivity. METHODS: We compared the results of primer HBV1/2 including famous 1896 and 1899 mutation sites with those of primer PHBV1/2 at precore/core region. HBV-PCR was tested in 87 HBsAg-positive patients using two sets of primers. The results were evaluated according to the primers and also compared the results with the clinical diagnosis and the alanine aminotransferase (ALT) level. RESULTS: The positive rate of PHBV primer was higher than HBV primer including mutation sites (nucleotide 1896 and 1899) in HBeAg-negative patients. According to the clinical diagnosis, the sensitivity of PHBV primer was higher than that of HBV primer in chronic hepatitis patients. There was no significant correlation between ALT level and HBV-PCR results. CONCLUSIONS: It is important that the selection of primer in HBV-PCR is important, because the primer including mutation sites may result in false negative results. PHBV primer used in this study could be useful for the detection of HBV-DNA by HBV-PCR.
Alanine Transaminase ; Diagnosis ; Hepatitis, Chronic ; Humans ; Polymerase Chain Reaction*

No abstract available.
Lung*

We encountered a case of neonatal altoimmune thrombocytopenia(NAIT) due to anti-HLA-B7+B60+B61. Bilateral cephal hematoma and umbilical hematoma were noted at the time of birth. Purpura developed at the third day. Platelet count was 110,000 at birth and decreased to 66,000/micro liter at the day 4. Prothrombin time and partial prothrombin time were within normal limit. The mother's platelet count was 220,000/micro liter and she had no history of abnormal bleeding. Platelet antibody tests empolying mixed passive hemagglutination and immunofluorescence revealed that the mother's serum was reactive against the platelets from the father and the neonate, but was not reactive with her own platelets. Platelets from eight volunteer group 0 donors were tested with the mother's serum; seven were reactive and one was negative. The positive reactions were lost after chloroquine treatment of platelets. Antigen capture ELISA(ACE) and modified antigen capture ELISA employing monoclonal antibodies against platelet glycoproteins In, IIa, IIb, and IIIa were negative. Mother's serum was tested for lymphocytotoxicity against 49 donor ]ymphocytes and the specificity was found to be anti-HLA-B7+B60+B61. At the 9th day, one unit of platelet concentrate from the mother was transfused and the platelet count of the neonate rose up to 340,000/micro liter. The neonate was discharged at the day of sixteenth and the platelet count remained high thereafter.
Antibodies, Monoclonal ; Blood Platelets ; Chloroquine ; Enzyme-Linked Immunosorbent Assay ; Fathers ; Fluorescent Antibody Technique ; Hemagglutination ; Hematoma ; Hemorrhage ; Humans ; Infant, Newborn ; Mothers ; Parturition ; Platelet Count ; Platelet Membrane Glycoproteins ; Prothrombin Time ; Purpura ; Sensitivity and Specificity ; Thrombocytopenia* ; Tissue Donors ; Volunteers

Cis-AB (A2B3) is a rare genotype resulting from the inheritance of both A and B genes on one chromosome. Among possible genotypes of cis-AB, in individuals with O/cis AB and A1/cis-AB, the B antigen is usually weakly expressed. Study on a blood sample from a 13-year-old Korean girl showed a discrepancy between red blood cell and serum typing. The blood type was identified as AweakB on the red cell test, while weak anti-B was detected in the serum. Cis-AB (A2B3) was suspected, however, known blood types of her father and mother were A and O, respectively. In the repeated test, the propositus was typed as group A2B3. Her mother was typed as normal group O. Her father was typed as group A1 in cell typing, but in his serum, anti-B was very weakly detected. In the saliva test and adsorption and elution studies of the father, B substance was not detected. Finally, ABO genotyping was performed and ABO genotypes of the patient, mother and father were cisAB/O, O/O and cisAB/A1, respectively. This was the first reported case of A1/cisAB with phenotype A1. ABO genotyping technique will resolve problems encountered in association with unusual phenotype expression of cis-AB trait.
Adolescent ; Adsorption ; Child* ; Erythrocytes ; Fathers* ; Female ; Genotype ; Genotyping Techniques ; Humans ; Mothers* ; Phenotype* ; Saliva ; Wills

BACKGROUND: Both left ventricular hypertrophy (LVH) and microalbuminuria (MA) are well described markers or surrogate for cardiovascular outcome. Many factors are known to be related to the two markers which are encountered together in some patients. But the epidemiological backgrounds for the two markers are not clearly demonstrated so far. METHODS: Measurements of echocardiographic left ventricular mass index (LVMI) and MA were introduced to the population survey in Yangpyeong County, Korea in 2005 and 2006 for 1,767 among 2,028 subjects. The criteria for MA were 17-250 mg/g of albumin creatinine ratio (ACR) in male and 25-355 mg/g in female. 1,636 data were analyzed. RESULTS: Age was 60.9 +/- 10.4 years and the proportion of female was 59.4% (972). Body mass index (BMI) was 24.7 +/- 3.21 kg/m2 and blood pressure were 124.1 +/- 17.3 mm Hg/80.0 +/- 10.5 mm Hg. LVMI was 45.3 +/- 11.6 g/m2.7 and ACR was 23.9 +/- 150.9 mg/g. Prevalence of LVH and MA were 23.5% and 12.2%, respectively. In male/female, odds ratios for MA were 1.035 (range, 1.010-1.061)/1.01 (range, 0.988-1.032) for age, 0.962 (range, 0.882-1.049)/0.941 (range, 0.881-1.006) for BMI, 1.754 (range, 1.097-2.804)/2.158 (range, 1.413-3.298) for hypertension (HTN), 4.87 (range, 2.883-8.226)/2.154 (range, 1.311-3.539) for diabetes, 1.005 (range, 0.999-1.012)/1.007 (range, 1.002-1.012) for cholesterol, and 1.011 (range, 0.987-1.035)/1.011 (range, 0.994-1.029) for LVH. CONCLUSIONS: In a population level, even if diabetes was strongest factor for MA, HTN is also independent factor for MA in both genders.
Albuminuria ; Blood Pressure ; Body Mass Index ; Cholesterol ; Creatinine ; Female ; Humans ; Hypertension ; Hypertrophy ; Hypertrophy, Left Ventricular ; Korea ; Male ; Obesity ; Odds Ratio ; Prevalence ; Republic of Korea

Epidermolysis bullosa (EB) is a rare genetic disease that is known for continuous skin blistering caused by minor trauma. The skin blisters and bullae that develop often cause skin defects. There is no definitive treatment for EB, only symptomatic relief. We report our experience with cultured allogenic keratinocyte grafting in a newborn patient with EB simplex who had unhealed raw surfaces and was not a skin grafting candidate. The skin lesions of the patient were covered with cultured allogenic keratinocyte grafts and re-epithelialized quickly with no scarring. Allogenic keratinocyte grafting reduced pain and produced noticeable improvements in the unhealed wounds. We think that allogenic keratinocyte grafting can play an important role in the management of patients with EB simplex.
Blister ; Cicatrix ; Epidermolysis Bullosa ; Epidermolysis Bullosa Simplex ; Humans ; Infant, Newborn ; Keratinocytes ; Methylmethacrylates ; Polystyrenes ; Skin ; Skin Transplantation ; Transplants

BACKGROUND: Several investigators have linked the interleukin-4(IL-4) gene nearby markers located on chromosome 5 to atopy and demonstrated that the T allele of a polymorphism in the IL-4 gene promoter region -590C/T is associated with elevated levels of total serum IgE. IL-4 receptor alpha gene has been also reported to be involved in the development of atopy. Recently, the R allele of a polymorphism in the IL-4 receptor alpha gene (IL4R*A) has been reported to be associated with atopy. OBJECTIVE: The purpose of our study is to investigate the association of IL-4 promoter gene C-590T polymorphism and receptor alpha gene (-1902) IL4R*A polymorphism with atopic dermatitis in Korea. MATERIAL AND METHODS: Seventy one Korean patients with atopic dermatitis and one hundred and sixty six normal subjects participated in this study with the analysis of polymorphism of IL-4 promoter (-590C/T) gene and IL-4 receptor alpha(-1902) gene by using PCR-SSCP. RESULTS: The frequency of IL-4 promoter (-590) genotypes (T/T, T/C, C/C), genes (T, C), alleles (T, C) did not show any significant difference between atopic dermatitis patients and normal controls (p>0.05). There were weak associations in the frequency of IL-4 receptor alpha(-1902) genotypes (IL4R*G/IL4R*G) and genes (IL4R*A) in patients of atopic dermatitis and normal controls (p=0.05). But, the frequency of IL-4 receptor alpha(-1902) genotypes (IL4R*A/IL4R*G, IL4R*A/IL4R*A), genes (IL4R*G), alleles (IL4R*A, IL4R*G) did not show any significant difference between atopic dermatitis patients and normal controls (p>0.05). CONCLUSION: These data show that IL-4 promoter polymorphism (-590C/T) and IL-4 receptor alpha polymorphism (-1902) IL4R*A are not associated with atopic dermatitis in Korean. It is suggested that the difference between our results and previous reports means racial difference, cooperation of -590C/T or IL4R*A polymorphism with the other gene, and the existence of another polymorphism.