A giant abdominal aortic aneurysm (AAA) renders surgical treatment much more difficult by deforming the proximal infrarenal aortic neck (shortened length and disturbed angulation), by altering the iliac arteries (marked tortuosity and aneurysmal dilatation), and by displacing abdominal organs. Because the retroperitoneal rupture of giant AAA makes the mesentery more elongated and deformed, compromising its blood flow and thus increasing the risk of mesenteric ischemia such as colon ischemia. We describe here the surgical repair of a large infrarenal AAA with a ruptured huge left common iliac artery aneurysm of 13.5 cm in diameter, accompanied by colostomy due to colon ischemia which occurred during the operation. We discuss the pathophysiology and preventive strategy of colon ischemia during ruptured giant AAA repair.
Aneurysm* ; Aneurysm, Ruptured ; Aortic Aneurysm, Abdominal ; Colitis, Ischemic ; Colon* ; Colostomy ; Iliac Artery ; Ischemia* ; Mesentery ; Neck ; Rupture

PURPOSE: Our study aims to evaluate to evaluate clinical outcomes after cephalic vein transposition (CVT) to the axilla in patients with brachiocephalic arteriovenous fistula (BC-AVF) and cephalic arch stenosis (CAS). MATERIALS AND METHODS: Hospital records of 13 patients (median age, 61 years; males, 54%) who received CVT to the proximal basilic/axillary vein due to either dysfunction (n=2) or thrombosis (n=11) between January 2010 and February 2014 were retrospectively reviewed. RESULTS: Operation was performed under local anesthesia in all cases. There was no technical failure. Concomitant inflow procedure (banding or aneurysmorrhaphy) was performed in 5 patients (38%). During follow-up (1 to 50 months, median 17 months), 3 patients died with functioning AVF and one was successfully transplanted. Two patients suffered from recurrent symptomatic stenosis of AVF and received percutaneous balloon angioplasty. Another 2 patients experienced AVF occlusion treated with interposition graft and manual fragmentation. Overall primary, assisted primary, and secondary patency rates were 77.5%, 92.3%, and 100% at 6 months and 66.1%, 92.3%, and 100% at 1 year, respectively. CONCLUSION: Although most patients presented with BC-AVF occlusion, technical success and access patency rates after CVT were favorable compared with historical data for interventional treatment. CVT should be considered as an appropriate option in selected patients with CAS.
Anesthesia, Local ; Angioplasty, Balloon ; Arteriovenous Fistula* ; Axilla ; Constriction, Pathologic* ; Follow-Up Studies ; Hospital Records ; Humans ; Male ; Renal Dialysis ; Retrospective Studies ; Thrombosis ; Transplants ; Veins*

The identification of the DNA structure as a doublestranded helix consisting of two nucleotide chain molecules was a milestone in modern molecular biology. The DNA chip technology is based on reverse hybridization that follows the principle of complementary binding of doublestranded DNA. DNA chip can be described as the deposition of defined nucleic acid sequences, probes, on a solid substrate to form a regular array of elements that are available for hybridization to complementary nucleic acids, targets. DNA chips based on cDNA clones, oligonucleotides and genomic clones have been developed for gene expression studies, genetic variation analysis and genomic changes associated with diseases including cancers and genetic diseases. DNA chips for gene expression profiling can be used for functional analysis in human cells and animal models, diseaserelated gene studies, assessment of gene therapy, assessment of genetically modified food, and research for drug discovery. DNA chips for genetic variation detection can beused for the detection of mutations or chromosomal abnormalities in cancers, drug resistances in cancer cells or pathogenic microbes, histocompatibility analysis for transplantation, individual identification for forensic medicine, and detection and discrimination of pathogenic microbes. The DNA chip will be generalized as a useful tool in clinical diagnostics in the near future. Labona chip and informatics will facilitate the development of a variety of DNA chips for diagnostic purposes.
Chromosome Aberrations ; Clone Cells ; Discrimination (Psychology) ; DNA* ; DNA, Complementary ; Drug Discovery ; Food, Genetically Modified ; Forensic Medicine ; Gene Expression ; Gene Expression Profiling ; Genetic Therapy ; Genetic Variation ; Histocompatibility ; Humans ; Informatics ; Models, Animal ; Molecular Biology ; Nucleic Acids ; Oligonucleotide Array Sequence Analysis* ; Oligonucleotides

Leiomyosarcoma (LMS) is a soft tissue sarcoma that originates from smooth muscle cells. It is commonly found in the uterus but can occur throughout the body, including the retroperitoneal space, abdominal cavity, and any vascular structure. Although there are many case reports of uterine or vascular LMS metastasizing to the heart, cardiac metastasis from nonvisceral lesions has only been reported in two cases. Herein we report a rare case of a patient presenting metastatic LMS from the left flank in the right ventricle observed with echocardiography and enhanced computed tomography.

Objective: : The optic nerve sheath diameter (ONSD)/eyeball transverse diameter (ETD) ratio is a more reliable marker of intracranial pressure than the ONSD alone. We aimed to investigate the predictive value of the ONSD/ETD ratio (OER) for neurological outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods: : Adult patients with aSAH who visited the emergency department of a tertiary hospital connected to a South Korean university between January 2015 and December 2021 were included. Data on patient characteristics and brain computed tomography scan findings, including the ONSD and ETD, were collected using a predefined protocol. According to the neurological outcome at hospital discharge, the patients were divided into the unfavorable neurological outcome (UNO; cerebral performance category [CPC] score 3–5) and the favorable neurological outcome (FNO; CPC score 1–2) groups. The primary outcome was the association between the OER and neurological outcomes in patients with aSAH. Results: : A total of 171 patients were included in the study, of whom 118 patients (69%) had UNO. Neither the ONSD (p=0.075) nor ETD (p=0.403) showed significant differences between the two groups. However, the OER was significantly higher in the UNO group in the univariate analysis (p=0.045). The area under the receiver operating characteristic curve of the OER for predicting UNO was 0.603 (p=0.031). There was no independent relationship between the OER and UNO in the multivariate logistic regression analysis (adjusted odds ratio, 0.010; p=0.576). Conclusion : The OER was significantly higher in patients with UNO than in those with FNO, and the OER was more reliable than the ONSD alone. However, the OER had limited utility in predicting UNO in patients with aSAH.

Tumors of the clivus and metastases to the clivus are very rare. Metastasis involving the clivus has previously been described in only two case reports. In skull metastasis, the breast and prostate are the most common primary foci, while metastasis from gastric carcinoma is extremely rare. A review of the English literature revealed only one published case of clivus metastases from gastric adenocarcinoma. There is no literature thoroughly explaining the differential diagnosis between chordoma and metastasis. Here we report a rare case of metastasis to the clivus from a gastric adenocarcinoma in a 42-year-old female patient with sudden blurry vision, presenting as bilateral cranial nerve VI palsy.
Abducens Nerve Diseases* ; Adenocarcinoma* ; Adult ; Breast ; Chordoma ; Cranial Fossa, Posterior* ; Diagnosis, Differential ; Female ; Humans ; Neoplasm Metastasis* ; Prostate ; Skull ; Skull Base

BACKGROUND: Oligonucleotide chip technology has proven to be a very useful tool in the rapid diagnosis of infectious disease. Rifampin resistance is considered as a useful marker of multidrug-resistance in tuberculosis. Mutations in the rpoB gene coding β subunit of RNA polymerase represent the main mechanism of rifampin resistance. The purpose of this study was to develop a diagnosis kit using oligonucleotide chip for the rapid and accurate detection of rifampin-resistance in Mycobacterium tuberculosis. METHOD: Tle sequence specific probes for mutations in the rpoB gene were designed and spotted onto the glass slide, oligonucleotide chip. 38 clinical isolates of Mycobacterium were tested. A part of rpoB was amplified, labelled, and hybridized on the oligonucleotide chip with probes. Results were analyzed with a laser scanner. Direct sequencing was done to verify the results. RESULT: The low-density oligonucleotide chip designed to determine the specific mutations in the rpoB gene of M. tuberculosis accurately detected rifampin resistance associated with mutations in 28 clinical isolates. Mutations at codons 531, 526, and 513 were confirmed by direct sequencing analysis. CONCLUSION: Mutant detection using oligonucleotide chip technology is a reliable and useful diagnostic tool for the detection of multidrug-resistance in M. tuberculosis.
Clinical Coding ; Codon ; Communicable Diseases ; Diagnosis ; DNA-Directed RNA Polymerases ; Glass ; Mycobacterium ; Mycobacterium tuberculosis ; Rifampin ; Tuberculosis*

Purpose: The purpose of this study was to develop a theory on the gambling addiction process in adults who experienced domestic violence in childhood. Methods: Data were collected from 20 adults from May 1st to August 30th, 2020. Data were analyzed using grounded theory methodology as suggested by Strauss and Corbin. Results: The core category of this study was revealed to be ‘becoming addicted to gambling to avoid the physical and emotional pain caused by childhood domestic violence and be rewarded’. The core phenomenon was ‘struggle from pain’, which was derived from casual and contextual conditions: ‘ruthless physical violence’, ‘intolerable psychological pain’, and ‘bystand of violence’, ‘family addiction problem’. ‘parental immoral attitude’, The action and interaction strategies were ‘making money by any means’, and ‘gambling to forget the pain’. The intervening conditions affecting them were ‘a distorted view of money’, ‘resignation to helpless’, and ‘avoiding emotional distress’. The phases abbreviated through the produced process were the trauma phase, the avoidance phase, and the addiction phase. Conclusion Adults became addicted to gambling as a manifestation of distorted compensation mentality in an attempt to avoid the physical and emotional trauma of domestic violence in childhood.

Purpose: The purpose of this study was to develop a theory on the gambling addiction process in adults who experienced domestic violence in childhood. Methods: Data were collected from 20 adults from May 1st to August 30th, 2020. Data were analyzed using grounded theory methodology as suggested by Strauss and Corbin. Results: The core category of this study was revealed to be ‘becoming addicted to gambling to avoid the physical and emotional pain caused by childhood domestic violence and be rewarded’. The core phenomenon was ‘struggle from pain’, which was derived from casual and contextual conditions: ‘ruthless physical violence’, ‘intolerable psychological pain’, and ‘bystand of violence’, ‘family addiction problem’. ‘parental immoral attitude’, The action and interaction strategies were ‘making money by any means’, and ‘gambling to forget the pain’. The intervening conditions affecting them were ‘a distorted view of money’, ‘resignation to helpless’, and ‘avoiding emotional distress’. The phases abbreviated through the produced process were the trauma phase, the avoidance phase, and the addiction phase. Conclusion Adults became addicted to gambling as a manifestation of distorted compensation mentality in an attempt to avoid the physical and emotional trauma of domestic violence in childhood.

BACKGROUND: Variable-number tandem repeat (VNTR) typing is a promising method to discriminate the Mycobacterium tuberculosis isolates in molecular epidemiology. The purpose of this study is to determine the optimal VNTR combinations for discriminating isolated M. tuberculosis strains in Korea. METHODS: A total of 317 clinical isolates collected throughout Korea were genotyped by using the IS6110 restriction fragment length polymorphism (RFLP), and then analysed for the number of VNTR copies from 32 VNTR loci. RESULTS: The results of discriminatory power according to diverse combinations were as follows: 25 clusters in 83 strains were yielded from the internationally standardized 15 VNTR loci (Hunter-Gaston discriminatory index [HGDI], 0.9958), 25 clusters in 65 strains by using IS6110 RFLP (HGDI, 0.9977), 14 clusters in 32 strains in 12 hyper-variable VNTR loci (HGDI, 0.9995), 6 clusters in 13 strains in 32 VNTR loci (HDGI, 0.9998), and 7 clusters in 14 strains of both the 12 hyper-variable VNTR and IS6110 RFLP (HDGI, 0.9999). CONCLUSION: The combination of 12 hyper-variable VNTR typing can be an effective tool for genotyping Korean M. tuberculosis isolates where the Beijing strains are predominant.
Discrimination (Psychology)* ; Korea* ; Methods ; Minisatellite Repeats ; Molecular Epidemiology ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymorphism, Restriction Fragment Length ; Tandem Repeat Sequences ; Tuberculosis