BACKGROUND: The students who had traveled in Jeju island developed symptoms of diarrhea at a girls' high school in Busan, June 2000. The goals of this study are to investigate the pattern of shigellosis and to compare drug resistance to S. sonnei with recent studies by reference reports. METHODS: Through epidemiological investigation and stool test of new patients, 993 students were registered from Jun.12 to 17, 2000 in a girls' high school, Busan. 2nd grade students(N=355) who had traveled in Jeju island described a questionnaire of the source of infection. Clinical and bacteriological studies were carried out on 6 cases of patients with S. sonnei. RESULTS: Among total 993 students, 79 patients were considered to have diarrhea. But 54 patients of 2nd grade students developed symptoms of diarrhea(14.7%) and the analysis of associative symptoms showed that it contained abdominal pain(72.2%), headache(61.6%), tenesmus(57.4%). 43 students of 2nd grade students who had traveled in Jeju ate chinese foods. Of them, 40 students showed diarrhea(93.0%) confirmed shigellosis(6 students), probable shigellosis(34 students). S. sonnei was isolated from 6 patients(14.0%). The attack rate of diarrhea was 20.7 times more in the group eating chinese foods than in the group not eating chinese foods(p<0.001). After the 2nd grade students ate chinese foods in Jeju, diarrhea attack day distribution was first day(23.2%), second day(39.7%), and third day(16.3%). The result of drug resistance test to S. sonnei(ampicillin, amoxicillin/clavulanic acid, tetracycline, sulfamethoxazole trimethoprim, and streptomycin) was 100%. CONCLUSION: The 2nd grade patients with shigellosis ate chinese foods in a restaurant, Jeju. The pattern of antibiotic resistance to S. sonnei was different from that of several previous cases of shigellosis in Busan.
Asian Continental Ancestry Group ; Busan* ; Diarrhea ; Drug Resistance ; Drug Resistance, Microbial ; Dysentery, Bacillary ; Eating ; Epidemiologic Studies* ; Humans ; Restaurants ; Shigella sonnei* ; Shigella* ; Sulfamethoxazole ; Tetracycline ; Trimethoprim ; Surveys and Questionnaires

PURPOSE: Reported incidence of urinary incontinence after a radical prostatectomy (RP) varies between studies. This may be due not only to the definition of incontinence applied, but also how the information is acquired. We investigated the differences in perception of post robot-assisted laparoscopic RP (RALP) urinary incontinence acquired through doctor interviews and patient-reported questionnaires. MATERIALS AND METHODS: Of 238 consecutive men who underwent RALP by a single surgeon between July 2005 and February 2008, we evaluated 66 men using the International Consultation on Incontinence Questionnaire (ICIQ) at various time points after surgery. Each patient's ICIQ results were considered to be the patient's perceptions of urinary incontinence. The physician at the same time directly interviewed the patients about the number of pads used and considered complete continence to be equivalent to the use of no pads or safety liners. RESULTS: Of the 66 patients, the physician reported that 34 (51.5%) had obtained complete continence. However, analysis of the questionnaires of these 34 patients revealed that only 5 (14.7%) patients reported that they never leaked during the past 4 weeks. Most patients (11 patients, 32.4%) who did not use any pad did in fact reported leakage of a small or moderate amount of urine about once a day. CONCLUSION: Our results indicate that there are discrepancies in the perception of urinary incontinence between doctor and patient after RALP. Non-use of pads is not equivalent to obtaining complete urinary continence. Therefore, the number of pads used is not a good measure to determine the status of complete urinary continence.
Aged ; Aged, 80 and over ; Biopsy ; Humans ; Laparoscopy/methods ; Male ; Middle Aged ; Perception ; Physician-Patient Relations ; Prostatectomy/*adverse effects/methods ; Questionnaires ; Robotics ; Treatment Outcome ; Urinary Incontinence/*etiology

The laparoscopic pancreaticoduodenectomy (LPD), introduced by Gagner and Pomp in 1994, is typically done in high-volume centers due to its technical demands. Our methods aim to provide effective traction, enabling efficient surgery despite limited staffing. A retrospective analysis of 29 patients undergoing LPD by a single surgeon between September 2021 and December 2022 showed promising outcomes: median intraoperative bleeding of 425 mL, operation time of 505 minutes, and postoperative hospital stay of 10 days. With only one case requiring open conversion, our external retraction techniques demonstrate efficacy in overcoming challenges associated with manpower constraints, highlighting potential utility for surgeons in similar settings. We share LPD external retraction techniques and outcomes.

No abstract available.
Phenylketonurias*

Phenylketonuria is metabolic disorder that results from a deficiency of the hepatic phenylalanine hydroxylase. But among patients with hyperphenylalaninemia, the defect resides in one of the enzymes necessary for production or recycling of tetrahydrobiopterin (BH4). The reduction of BH4 affects not only phenylalanine metabolism but also formation of the tyrosine related neurotransmitter, dopamin and tryptophan related neurotransmitter, serotonin. Administration of L-dopa and 5-hydroxytriptophan seems to be the most effective treatment and may prevent irreversible neurologic damage if started early in life in hyperphenylalaninemia due to deficiency of cofactor BH4. Therefore, all patients with PKU and hyperphenylalaninemia should be tested for BH4 deficiency as early as passible. So we measured reduced forms of biopterin in urines of 19 phenylketonuria patients by Funkushima and Nixon method and 13 of PKU patients measured dihydropterin reductase (DHPR) in white blood cells by modified Narisawa method. We could not find abnormal pterin patterns of cofactor BH4 and normal value of DHPR. All Korean 19 PKU children were classic PKU. A missense mutation has been identified in the phenylalanine hydroxylase (PAH) gene of 16 Koran PKU patients. 5 mutations (IVS4, Y204 C, R243Q, Y356 X, R413 P) have been identified. The frequency of these mutations was found to be 50% of PKU alleles. The IVS4 mutation had a high frequency in Korea and southern China, due to the result of the founder effect and genetic drift. the R413 P mutation, which may have originated in the regions surrounding the Baikal, expanded to northen China and Japan. We were not able to find Caucasian mutations in Korean ptiets. PKU mutations occured after racial divergence between Caucasian and Mongoloids. We observed that PKU patients with Y 204 C and R413 P mutations showed mild mild clinical phenotype but IVS4 mutation had severe mental retardation. the establishment of genotype will therefore aid in the prediction of clinical phenotypes in patients with this disease. So, pterin and DHPR measurement and DNA analsis will be useful for prognosis and proper treatment of PKU patients.
Alleles ; Biopterin ; Child ; China ; DNA* ; Founder Effect ; Genetic Drift ; Genotype ; Humans ; Intellectual Disability ; Japan ; Korea ; Leukocytes ; Levodopa ; Metabolism ; Mutation, Missense ; Neurotransmitter Agents ; Oxidoreductases ; Phenotype ; Phenylalanine ; Phenylalanine Hydroxylase ; Phenylketonurias ; Prognosis ; Recycling ; Reference Values ; Serotonin ; Tryptophan ; Tyrosine

BACKGROUND: The goals of this study are to evaluate the propensity to depression in Korean internet users associated with internet using environment and attempt to aid proper management of internet users in the field of family practice. METHODS: A group of 1,674 subjects who replied to internet research were selected from March 26 to 28, 1999. Making use of CES-D-K for Korean internet users, we investigated the propensity to depression. At the same time, general characteristics, internet using environmental characteristics were investigated and their relationship was assssed. RESULTS: The CES-D-K score was 16.19. The CES-D-K score was significantly higher in females, in younger age and low education level group(P<0.001). There was no significance between CES-D-K score and region. In internet using environmental characteristics, the CES-D-K score was significantly higher in low velocity users, long internet using time per day group (P<0.001). There was no significance between CES-D-K score and internet using year. CONCLUSION: There was a significant correlation between internet using velocity, internet using time per day and the propensity to depression. Therefore, family physician should think about the correlation of the propensity to depression and internet using environment, if internet users have symptoms of depression.
Depression* ; Education ; Family Practice ; Female ; Humans ; Internet* ; Physicians, Family

Partial Trisomy of 3p (Trisomy of 3p2, dup (3) (p23-->pter)) is a characteristic syndrome of chromosomal duplication of distal part of 3p, but breakpoints seem to vary in location. This syndrome shows multiple congenital anomalies with severe mental retardation, characteristic craniofacial change and absence of other gross external abnormalities. The craniofacial dysmorphism includes frontal bossing and temporal indentation, square face, marked hypertelorism, thick and short nose, full lips and a large mouth with downturned corners. Congenital heart defect, most frequently ASD and VSD, are found in most patients. In the majority of patients, the 3p2 duplication is the unbalanced product of a parental autosomal translocation involving 3p2 and another chromosome. We report a case of female baby who has facial dysmorphism, ASD and hyptonia and was found to have 3p2 duplidation (46XX-9, +der(9)t (3:9)(p23:p24)) by chromosomal analysis. Also we found her father was a carrier of blanced translocation of 3p2 and chromosome 9p (46XY, t(3:9)(p23:p24)).
Chromosome Duplication ; Fathers ; Female ; Heart Defects, Congenital ; Humans ; Hypertelorism ; Intellectual Disability ; Lip ; Mouth ; Nose ; Parents ; Trisomy*

No abstract available.
Endothelial Cells

Calciphylaxis has been described as a rare condition in patients with end-stage renal disease and secondary hyperparathyroidism. Selye et al. first coined the term calciphylaxis to describe soft-tissue calcification and cutaneous necrosis. The common manifestation include painful digital necrosis and medial calcification of small and medium sized vessels. Calciphylaxis is a clinical diagnosis and is characterized by painful, violaceous, mottled skin lesions. Radiographic studies reveal calcification of median and small vessels under the knee but vascular calcification is not specific for calciphylaxis. Histolopathologic findings show a markedly reduced lumen, secondary to the fibrin deposition and inflammation in and around the outer media with an outer ring of calcification which leads to progressive ischemic tissue necrosis. Kidney transplantation and parathyroidectomy is recommened but it is controversial. We present the case of a 64-years-old man with chronic renal failure as well as painful ischemic necrosis on the lower extremity. The pertinets literature is reviewed.
Calciphylaxis ; Diagnosis ; Fibrin ; Humans ; Hyperparathyroidism, Secondary ; Inflammation ; Kidney Failure, Chronic* ; Kidney Transplantation ; Knee ; Lower Extremity ; Necrosis ; Numismatics ; Parathyroidectomy ; Skin ; Vascular Calcification

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare malignancy-related complication causing severe pulmonary hypertension, right heart failure, and death. PTTM is characterized by diffuse fibrocellular intimal proliferation and multiple thrombi formation in the pulmonary arteries and arterioles, which result from invasion of the pulmonary blood vessels by tumor cells. Establishing the diagnosis of PTTM is very difficult and few cases are diagnosed ante mortem. We report the case of a 48-year-old woman diagnosed with PTTM before death who developed breast cancer and presented with persistent dyspnea on exertion.
Ants ; Arterioles ; Blood Vessels ; Breast ; Breast Neoplasms ; Dyspnea ; Female ; Heart Failure ; Humans ; Hypertension, Pulmonary ; Middle Aged ; Pulmonary Artery ; Thrombotic Microangiopathies