No abstract available.
Retreatment* ; Treatment Failure*

The type-specific PCR and the sequence analysis of 56 kDa gene of Orientia tsutsugamushi infected in field rodents specimens have shown intratypic genetic heterogeneity in genotype Karp. In sequence comparison, this genetic heterogeneity was mainly due to insertion or deletion of a repeated unit in variable domain I (VDI) region. These results suggested that genetic duplication or deletion of the specific sequence rnight be involved in intratypic genetic heterogeneity of Orientia tsutsugamushi.
Genetic Heterogeneity* ; Genotype* ; Orientia tsutsugamushi* ; Polymerase Chain Reaction ; Rodentia ; Sequence Analysis

The authors developed a computer program for use in report printing as well as data storage and retrieval for the gastrointestinal endoscopy service. This program used IBM PC XT and was written in dBASE III plus language. We applied the automatic SNOMED coding method, which is one of the most efficient and accurate method of computerization of medical data. The working sheet which contained the results of previous endoscopic studies could be printed during registration. The dBASE word processor enabled issuing of the formal report of endoscopic result, and the data storage was carried out during the typewriting of the report. Two kinds of data files were stored in the hard disk; the temporary file contained full informations and the permanent file contained patients identification data and SNOMED code. Searching of a specific case was performed by chart number, patients name, date of study, or SNOMED code within a second. All the cases were arranged by SNOMED codes of procedure, topography and morphology codes. Every new data was copied to the diskette automatically. with which data could be restored in case of hard disk failure. The main advantages of this program in comparison to the large main frame computer system are low price, flexibility and easy accessibility. Based on our experience (including surgical pathology department, radiology, clinical pathology), we assume that this program may fit every endoscopy room where there are less than 20,000 cases per year.
Information Storage and Retrieval ; Clinical Coding* ; Computer Systems ; Endoscopy ; Endoscopy, Gastrointestinal* ; Humans ; Information Storage and Retrieval* ; Pathology, Surgical ; Pliability ; Systematized Nomenclature of Medicine

No abstract available.
Diagnosis* ; Gynecology* ; Laparoscopy*

No abstract available.
Female ; Humans ; Ovary*

BACKGROUND: The angiotensin-converting enzyme(ACE) plays an important role in cardiovascular disease by production of angiotensin and degradation of bradykinin. Cloning of ACE gene revealed an insertion/deletion(I/D) polymorphism according to the presence/absence of a 287 base pair fragment in the 16th intron of ACE gene, and the ACE polymophism was associated with ACE activity. The genotype DD was identified as a risk factor for myocardial infarction in several studies. We analyzed the ACE I/D polymorphism in 62 patients with myocardial infarction and 67 normal subjects. METHODS: Genomic DNA from peripheral blood was amplified by polymerase chain reaction and characterized by three ACE genotypes; two insertion alleles(genotype II), two deletion alleles(genotype DD) and heterogenous alleles(genotype ID). ACE activity was determined by spectrophotometric method utilizing the synthetic substrate. RESULTS: There was no significant difference in ACE polymorphism between patients and normal subjects. But, the frequency of genotype DD was significantly increased in the low-risk group of patients compared with the high-risk group. The multi-vessel disease was more strongly associated with genotype DD, but there was no statistical significance. The ACE activity was strongly associated with ACE polymorphism with the activity being highest in genotype DD. There was no significant difference between patients and control subjects of the same genotype. CONCLUSION: There was no significant difference in ACE polymorphism between patients and normal subjects. The frequencies for genotype II, ID, DD were 0.328, 0.537, 0.134, respectively in normal subjects. There was high frequency of genotype II compared with Caucasians. A deletion polymorphism(genotype DD) may increase the risk for myocardial infarction in lowrisk group, and the serum ACE activity was correlated with three genotypes.
Angiotensins ; Base Pairing ; Bradykinin ; Cardiovascular Diseases ; Clone Cells ; Cloning, Organism ; DNA ; Genotype ; Humans ; Introns ; Myocardial Infarction* ; Polymerase Chain Reaction ; Risk Factors

We report here on a case of priapism that was associated with the use of tadalafil. A 41 year-old-man visited our urology outpatient department with a relapsed erection he'd experienced for 3 days. He had no contributing factors for the priapism. He had taken tadalafil, which was prescribed at a local medical center 3 days previously. After the development of priapism, he first visited the emergency department of other hospital. Aspiration was done and then the priapism was resolved. Yet the priapism recurred 2 days later, andaspiration and other bedside management failed to resolve it. After his arrival to our department, weimmediately performed a caverno-glandular shunt with 18-gauge needle and we observed bright reddish- color blood. An intracorporal ephedrine injection and saline irrigation were then done. After that, the patient gradually experienced detumescence. The priapism did not recur during the 2 days of the hospitalization period. At the outpatient follow-up of 3 months later, patient almost recovered to his full erectile function and he had normal sexual activity.
Carbolines ; Emergencies ; Ephedrine ; Follow-Up Studies ; Hospitalization ; Humans ; Needles ; Outpatients ; Priapism ; Sexual Behavior ; Urology ; Tadalafil

PURPOSE: The prevalence of developmental delay is 5-10% of the total pediatric population and early diagnosis and proper intervention are essential but a challenge for clinicians. We performed this study for several purposes. First is to know the distribution & characteristics of developmental disorders in Korea. Second is to identify all possible causes of these disorders through a multidisciplinary diagnostic approach, and thus to find out the clinical variables that are helpful in finding the etiology. And finally to develop a useful protocol that eliminates the cost of unnecessary tests and raises the diagnostic rate of the cause. METHODS: 518 patients(M 349, F 169) were studied who visited Ilsan Hospital Developmental Disorder Clinic(DDC) for the evaluation of developmental delay from April 2001 to Jan 2005. RESULTS: The mean age was 51.5+/-32.9 months, ranging from 2 months to 16.0 years of age with a majority of the preschool children(<6 yr)(79.3%). Phenomenological diagnosis consisted of 133 cases of mental retardation, 122 cases of autistic disorders, 101 cases of delayed language disorders, 27 cases of cerebral palsies, and 91 cases labeled as simple developmental delay requiring follow up due to age less than 2 years of age. Etiologic diagnosis was obtained in 119 cases(22.9%) out the 518 cases of developmental delays. 37 cases of chromosomal anomalies, 23 cases of Periventricular leukomalacia and hypoxic ischemic encephalopathy, 21 cases of syndromes, 7 cases of malformation of cortical development, 4 cases of myopathies, 4 cases of neuropathies, and 4 cases of cerebral infarctions were found. Among the clinical variables, low birth weight, facial dysmorphism, hypotonia, focal neurologic signs, and abnormalities in MRI, chromosome, EEG and EMG studies contributed to the yields of etiologic diagnosis significantly. CONCLUSION: Possible etiology was determined in about 23% of the subjects. The most important part of the assessment for the identification of etiology is thorough history taking, physical and neurologic examination. Neuroimaging study is useful in case of micro or macrocephaly, focal neurologic signs. Genetic studies increasingly produce a yield, when there is family history of inherited disorder and there are dysmorphic features. Routine metabolic screening test has limited utility. Development of a useful screening protocol adequate for Korean situation is required.
Cerebral Infarction ; Diagnosis ; Early Diagnosis ; Electroencephalography ; Follow-Up Studies ; Humans ; Hypoxia-Ischemia, Brain ; Infant, Low Birth Weight ; Infant, Newborn ; Intellectual Disability ; Korea ; Language Disorders ; Leukomalacia, Periventricular ; Macrocephaly ; Magnetic Resonance Imaging ; Mass Screening ; Muscle Hypotonia ; Muscular Diseases ; Neuroimaging ; Neurologic Examination ; Neurologic Manifestations ; Paralysis ; Prevalence

PURPOSE: To investigate the relationship of refraction, geometry of the posterior corneal surface and the residual corneal thickness after excimer laser photorefractive keratectomy. METHODS: Thirty eyes of 15 patients were treated with Star S2 Smooth Scan (VISX, U.S.A.) and followed up for 3 months. The refractive, anteroposterior changes in the posterior corneal surface and residual corneal thickness were measured using slit-scanning topography, Orbscan IIR (Orbtek, Bausch & Lomb) at 1 week preoperatively, and 1 and 3 months postoperatively. RESULTS: Mean forward shift of the posterior cornea surface was 8.83+/-1.34 micrometer, 11.53+/-4.23 micrometer and 14.70+/-3.50 micrometer at 1 week, 1 month, and 3 months respectively. Mean spherical equivalence of posterior cornea was = -7.01+/-0.31 D preoperatively; it changed to -7.17+/-0.47 D, -7.22+/-0.21 D and -7.17+/-0.6 D at 1 week, 1 month and 3 months. The degree of forward shift of posterior corneal surface is correlated with the posterior corneal refractive changes (r=-0.808, P< 0.01). The forward shift of the posterior corneal surface is correlated with the residual corneal thickness (r=-0.483, P< 0.01). CONCLUSIONS: Photorefractive keratectomy significantly influenced the forward shift of the cornea, which is correlated with the residual corneal thickness.
Cornea ; Humans ; Lasers, Excimer ; Photorefractive Keratectomy*

PURPOSE: To assess the the accuracy and variability in pachymetry measurements obtained by Orbscan and ultrasonic pachymeter in laser in situ keratomileusis (LASIK). METHODS: Thirty two eyes of 16 patients before LASIK were measured by ultrasonic pachymeter and Orbscan. Thirty eyes of 16 patients that had LASIK were measured by ultrasonic pachymeter and Orbscan postoperatively. The theoretical residual corneal thickness was compared to measurements by both instruments in eyes that had LASIK procedures. RESULTS: The ultrasound pachymeter measurements (543.8+/-24.2 micrometer) were thicker than the Orbscan pachymetry measurements, (541.2+/-24.9 micrometer) by mean of 2.7+/-7.4 micrometer (SD), preoperatively. But this is not statistically significant (p>0.05). Postoperatively, the ultrsound measurements were consistent with theoretical residual corneal thickness, 461.8+/-37.4 micrometer versus 467.9+/-30.71 micrometer (p=0.064), while Orbscan measurements were statistically less than the theoretical residual corneal thickness, 433.2+/-48.75 micrometer versus 464.32+/-33.4 micrometer (p<0.001). CONCLUSIONS: In LASIK eyes, the ultrasonic pachymetry was a more accurate measurement of corneal pachymetry than Orbscan topography system.
Corneal Pachymetry ; Humans ; Keratomileusis, Laser In Situ* ; Ultrasonics* ; Ultrasonography