Holoprosencephaly is a rare and complex malformation affecting the cleavage of the developing forebrain and is usually associated with defects of the mid Face. We have experienced a case of holoprosencephaly, diagnosed prenatally by ultrasound examination at 31 weeks of pregnancy in a 31-year-old primigravida woman. This case is characterized by holoprosencephaly, cleft palate, cleft lip, left renal aplasia and right renal hypertrophy. The chromosomal study showed a deletion of the long arm of chromosome 7, 46, XX, del(7)(q32), We report with a terminal deletion of chromosome 7q associated with atypical clinical picture and holoprosencephaly.
Adult ; Arm ; Chromosomes, Human, Pair 7 ; Cleft Lip ; Cleft Palate ; Female ; Holoprosencephaly* ; Humans ; Hypertrophy ; Pregnancy ; Prosencephalon ; Ultrasonography

To minimize the period of brain ischemia and the potential for neurologic damage during aortic arch replacement, we used the arch-first technique. First case was a 28-year-old female with extensive aneurysm involving ascending, arch and descending thoracic aorta. Exposure was obtained via a bilateral via a bilateral thoracotomy (clamshell incision) in the anterior 4th right and 3rd left intercostal space with oblique sternotomy. To prepare for arch perfusion, the side-arm graft(10mm) was anastomosed to the aortic graft, opposite the site of the planned anastomosis to the arch vessels. After completing the arch anastomosis under total circulatory arrest(37min) and retrograde cerebral perfusion(12min), aortic graft was clamped on either side and the arch was perfused via side-arm graft for 36min. When distal aortic anastomosis was finished, distal clamp of aortic graft was released and arch vessels were perfused via common femoral artery, and the proximal aortic anastomosis was accomplished. The patient was discharged with no event. Second case was a 48-year-old male with extensive aneurysm involving ascending, arch, and aortic regurgitaiton(grade III/IV). This case was also done using the clamshell incision. Aortic valve replacement was done by valved-conduit(Vascutek 30mm), both coronary artery anastomosis using Cabrol's procedure. Last operation procedure was the same as the 1st case.
Adult ; Aneurysm* ; Aorta, Thoracic* ; Aortic Valve ; Brain Ischemia ; Coronary Vessels ; Female ; Femoral Artery ; Humans ; Male ; Middle Aged ; Perfusion ; Sternotomy ; Thoracotomy ; Transplants

No abstract available.
Cytogenetics* ; Gestational Age*

OBJECTIVE: The Childhood Trauma Questionnaire (CTQ) is perhaps the most widely used and well-studied retrospective measure of childhood abuse or neglect. This study tested the initial reliability and validity of a Korean translation of the Childhood Trauma Questionnaire (CTQ-K) among non-psychotic psychiatric outpatients. METHODS: The CTQ-K was administered to a total of 163 non-psychotic psychiatric outpatients at a university-affiliated training hospital. Internal consistency, four-week test-retest reliability, and validity were calculated. A portion of the participants (n=65) also completed the Trauma Assessment Questionnaire (TAQ), the Impact of Events Scale-Revised, and the Dissociative Experiences Scale-Taxon. RESULTS: Four-week test-retest reliability was high (r=0.87) and internal consistency was good (Cronbach's alpha=0.88). Each type of childhood trauma was significantly correlated with the corresponding subscale of the TAQ, thus confirming its concurrent validity. In addition, the CTQ-K total score was positively related to post-traumatic symptoms and pathological dissociation, demonstrating the convergent validity of the scale. The CTQ-K was also negatively correlated with the competence and safety subscale of the TAQ, confirming discriminant validity. Additionally, we confirmed the factorial validity by identifying a five-factor structure that explained 64% of the total variance. CONCLUSION: Our study indicates that the CTQ-K is a measure of psychometric soundness that can be used to assess childhood abuse or neglect in Korean patients. It also supports the cross-cultural equivalence of the scale.
Child ; Child Abuse ; Dissociative Disorders ; Humans ; Mental Competency ; Outpatients ; Psychometrics ; Surveys and Questionnaires ; Reproducibility of Results ; Retrospective Studies

OBJECTIVE: To compare the scar formation and hand function between moist exposed burn ointment (MEBO) treatment and conventional skin graft in full thickness hand burns. METHOD: Prospective comparative study was done between MEBO treatment group and conventional skin graft group. Full thickness burn wound scars on dorsal hand were compared. Scars were assessed with the Vancouver scar scale and other objective measurement tools such as pigmentation, erythema, pliability, transepideramal water loss, thickness and perfusion. Hand function was evaluated by the Jebsen hand function test and Michigan Hand Function Questionnaire. RESULTS: Vancouver Scar scale showed significantly better scores in the MEBO group than in the conventional skin graft group. Scar thickness and transepidermal water loss were greater in the MEBO treatment group whereas pigmentation value was greater in the conventional skin graft group. There was no significant difference in the hand function between the two groups. CONCLUSION: MEBO application could be an alternative treatment to conventional skin graft treatment in full thickness hand burn wounds. In the future, more studies are yet to come how MEBO treatment may affect the skin condition of the burn injuries.
Burns* ; Cicatrix* ; Erythema ; Hand* ; Michigan ; Perfusion ; Pigmentation ; Pliability ; Prospective Studies ; Surveys and Questionnaires ; Skin* ; Transplants* ; Wounds and Injuries

No abstract available.

OBJECTIVE: Preterm delivery (PTD) is the leading cause of perinatal mortality and morbidity. However, its etiology and pathogenesis remain unknown in most cases. Recently, some research put forth the hypothesis that PTD results, at least in part, from a genetic predisposition. This study was undertaken to elucidate whether polymorphisms of cytochrome 450 (CYP) 1A1 and 1A2 are associated with PTD caused by preterm premature rupture of membrane (PPROM) in Korean pregnant women. METHODS: From August 2002 to October 2003, in the affiliated hospitals in the Catholic University of Korea, we have collected the samples from the 264 women who delivered after 37 weeks and from 26 women who delivered following spontaneously ruptured membranes before 37 weeks. RESULTS: There was no significant difference in the genotype frequency as well as in the allelic frequency of CYP1A1*m2 in PPROM group compared with the control group (54% vs. 66%, P=0.224; 0.29 vs. 0.40, P=0.111, respectively). The genotype frequency of CYP1A2*C was significantly higher in PPROM group than in the control group (69% vs. 49%, P=0.047). However, the allelic frequency of CYP1A2*C was not significantly higher in PPROM group than in the control group (0.4 vs. 0.275, P=0.45). CONCLUSION: These results suggest that CYP1A2*C may be, at least in part, associated with PPROM.
Cytochrome P-450 CYP1A1* ; Cytochrome P-450 CYP1A2* ; Cytochromes ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Korea ; Membranes* ; Perinatal Mortality ; Pregnant Women ; Rupture*

No abstract available.

BACKGROUND: Recently, patients' demands for emergency medicine are increasing, and most of prehospital medical care, including basic life support, cardiopulmonary resuscitation and triage, are provided by paramedics or emergency medical technicians. Evaluation of the adequacy of prehospital management and triage has become important for improving the quality and the effectiveness of the emergency medical system. METHODS: The 202 patients who were transferred by ambulance with paramedics, nurses, or emergency medical technicians to the Emergency Department in Gil Medical Center from July 1, 1999, to September 31, 1999, were enrolled. This study was conducted prospectively by using the emergency physician's log and newly devised protocols recorded by paramedics or nurses. RESULTS: 1) Male to female ratio was 1:0.8, and the peak age of the patients were the 4th(18.8%) and 6th decade(15.3%). 2) Of the 202 patients, 84 patients were transferred for trauma and 118 for medical problems. The mean transfer time was 6+/-1.73 minutes. 3) The validities of prehospital triage and decisions using the trauma severity measure and the disease severity measure, were 33.3% in trauma patients and 57.6% in medical patients. 4) The results for the adequacy rate in prehospital management analyzed by using the rate of necessity of treatment, performance of treatment, and adequate treatment were as follows: oxygen supply, 38.1/41.6/93.8; wound dressing, 19.3/71.8/92.9; immobilization of the cervical spine, 15.8/56.3/92.9; application of a spinal board, 12.9/42.3/72.7; application of a splint, 9.9/50.0/60.0; manual maintenance of an airway, 9.9/55.0/63.6; and CPR, 4.5/66.7/0.5) Kind of ALS(Advanced Life Support) were not conducted(peripheral IV, EKG, intubation medical administration, defibrillation, pacing). The rates of necessity of treatment were as follows: peripheral IV, 40.6%; ECG monitoring, 23.3%; endotracheal intubation, 8.9%; medical administration, 8.9%; defibrillation, 3.5%; and pacing, 1.5%. CONCLUSION: The adequacy of prehospital triage and decisions using trauma and disease severity measures was relatively low. To improve the adequacy of BLS(Basic Life Support) and to increase the performance of ALS(Advanced Life Support), we must create challenges to develop new protocols and to supplement new equipment.
Allied Health Personnel ; Ambulances ; Bandages ; Cardiopulmonary Resuscitation ; Electrocardiography ; Emergencies ; Emergency Medical Technicians ; Emergency Medicine ; Emergency Service, Hospital ; Female ; Humans ; Immobilization ; Intubation ; Intubation, Intratracheal ; Male ; Oxygen ; Prospective Studies ; Spine ; Splints ; Triage* ; Wounds and Injuries

The reconstruction of soft tissue defects on the leg remains a difficult challenge for plastic surgeons. If the defect is large and complicated by bone or joint defects, and excellent result can be obtained with free tissue transfer. In cases with no bony problem, no severe osteomyelitis and small medium-sized defects local flap is more acceptable than free tissue transfer because of its simple onestage and reliable operation. Fasciocutaneous turnover flaps revolve around the lack of criteria for safely designing these random pattern flaps as well as the risk of donorsite problems. Vertically-based deep fascia turnover flaps nourished by the subfascial plexus within deep fascia were used successfully for reconstruction of the leg in 5 patients. A vertically-based deep fascia turnover flap consists of deep fascia of the leg and its subfascial and epifascial plexus. As musculofascial, septofascial and periosteofascial branches these contribute to a richly anastomosing vascular network within deep fascia. Unlike adipofascial turnover flaps, the transversely-oriented deep fascia turnover flap keeps its subcutaneous layer with its intact vascular plexus so that the overlying skin is adequately perfused, even in patients with sizable flaps or extremely thin skin. Between March 1998 and February 1999, five cases underwent this procedure to reconstruct soft tissue defect on the leg. The advantages of this method are fast, safelyelevated preservation of the superficial vascular plexus, thus preserving the shape of the leg minimizing donor site scar and hypertrophy.
Cicatrix ; Fascia* ; Humans ; Hypertrophy ; Joints ; Leg* ; Osteomyelitis ; Skin ; Tissue Donors