OBJECTIVE: In Korea, control activities against the endemic malaria due to Plasmodium vivax had been done in 1960s. It is now widely accepted in Republic of Korea that indigenous malaria stopped its endemicity in the mid-1970s. But a vivax malaria case without history of being abroad was recognized in 1993. In addition to this case, 20 cases of indigenous malaria were detected in 1994. And they were progressively increased to about 80 cases in 19%. We report these recently developed cases. METHODS: In a 7-month period between June and December 1995, high fever patient were examined. Patients having a narcotic drug injection or those who had blood transfusion were excluded. Laboratory studies including blood cell count, peripheral blood smear and abdominal sonogaphy were taken. RESULTS: Over 3-month period from July through September 19%, 26 cases of new indigenous malaria were diagnosed. In a blood smear, plasmodium vivax was diagnosed. CONCLUSION: The twentysix new indigenous malaria cases occured. Because all the detected patients had no history of visiting endemic countries, they were not imported cases. Vivax malaria in the present patients can be contracted by infected mosquitos which came across the militarized zone (DMZ). Officially speaking, DMZ is a 4 km wide between the north and south borders, Hut the width is much narrower in many parts. However, we do not have any information on the malaria situation in the north Korea. In order to evaluate a significance of the recent indigenous malario occurrence, a surveillance system should be operated in these areas.
Blood Cell Count ; Blood Transfusion ; Culicidae ; Democratic People's Republic of Korea ; Fever ; Humans ; Korea ; Malaria* ; Malaria, Vivax ; Plasmodium vivax ; Republic of Korea

Anti-HLA antibody related neonatal thrombocytopenia is an uncommon disorder caused by platelet antigen incompatibility between mother and fetus in Korea. Mothers who lack the specific platelet antigen produce the IgG against the platelet antigen which the fetus inherits from the father. These IgG antibodies are then transported across the placenta into the fetal circulation where they lead to the destruction of fetal platelets. We report a case of neonatal alloimmune thrombocytopenia related with anti-HLA antibody in second baby of dizygotic twin who had petechia on trunk and platelet count 43,000/mm. Initially, mother and twin showed the positives in antiplatelet antibodies. In microlym- phocytotoxic test at 6 months of age, anti-HLA antibodies was negative in twins but anti-HLA A2, A24 was positive in their mother. The patient was treated with intravenous immunoglobulin and clinically improved and her platelet count was norrnalized.
Antibodies ; Blood Platelets ; Fathers ; Fetus ; Humans ; Immunoglobulin G ; Immunoglobulins ; Infant, Newborn ; Korea ; Mothers ; Placenta ; Platelet Count ; Thrombocytopenia, Neonatal Alloimmune ; Twins ; Twins, Dizygotic

Propionic acidemia is an autosomal-recessive inborn error of branched-chain amino acid metabolism. It is caused by deficient activity of propionyl-coenzyme A carboxylase and is characterized by a spectrum of clinical and biochemical findings. It usually manifests in the neonatal period or early infancy. Since Childs et al first described the propionic acidemia of infants in 1961, it has rarely been reported. There have been no previous report of this organic acidemia in Korea. We present a case of propionic acidemia in a 4-day old male, who had poor feeding, dehydration, and hyperammonemia and died at 12 days of age. Diagnosis was established by gas chromatography and mass spectrometry, and this case is the first reported propionic acidemia in literature in Korea. A review of the related literature was included.
Child ; Chromatography, Gas ; Dehydration ; Diagnosis ; Diethylpropion* ; Humans ; Hyperammonemia ; Infant ; Korea ; Male ; Mass Spectrometry ; Metabolism ; Methylmalonyl-CoA Decarboxylase ; Propionic Acidemia*

BACKGROUND: Many patients received transfusion in emergency department because of blood loss. There are few studies on massive transfusion for non-traumatic patients. This study investigated mortality and risk factor for non-traumatic bleeding patients who received transfusion. METHODS: Non-trauma patients who received transfusion at the emergency department for 3 years from March 2009 to February 2011 were enrolled. The patients who are younger than 15 years, trauma patients, and transfused FFP or platelet alone are excluded. Medical records was investigated retrospectively. We investigated predictive factors for MT on non-trauma patients and predictive factors for mortality on MT patients. RESULTS: Among 1655 non-trauma patients, 150 patients (9.24%) received MT. The age of MT group was younger than that of non-MT group and systolic bloor pressure, diastolic blood pressure, mean arterial pressure were significantly lower. Base excess, pH, lactate levels were significantly different between MT and non-MT group. Intensive care unit length of stay was longer, mortality of 24 hours was higher and survival discharge was lower than non-MT group. Mortality rate of MT group was 20.7% which was significantly higher than non-MT group's 9.3%. FFP:RBC ratio was higher in MT group than non-MT group. Among the MT group, non-survival group used higher FFP:RBC ratio product than survival group. On multivariate analysis, sBP, MAP, lactate, pH, BE were significant as predictors of MT. CONCLUSION: For non-trauma patients in emergency department, if sBP, MAP, lactate, pH, BE are abnormal, massive transfusion could be expected. Like trauma patients, basic scoring system that can predict MT would be necessary and useful.
Arterial Pressure ; Blood Platelets ; Blood Pressure ; Blood Transfusion* ; Emergencies* ; Hemorrhage ; Humans ; Hydrogen-Ion Concentration ; Intensive Care Units ; Lactic Acid ; Length of Stay ; Medical Records ; Mortality ; Multivariate Analysis ; Retrospective Studies ; Risk Factors

BACKGROUND: In-line intravenous filters have been used in intravenous administration sets of fluid to retain bacteria and bacterial endotoxin. We evaluated the effects of intravenous filters on Staphylococcus epidermidis, Pseudomonas aeruginosa, Candida and bacterial endotoxin retention. METHODS: S. epidermidis, C. albicans, P. aeruginosa and endotoxin were injected into each 10 bags of amino acid solution. After incubation for 24 and 72 hours, aspirates of 0.1 mL from 30 bags, with filtration and without filtration, were inoculated into culture media. The effluent from bags containing endotoxin was tested by limulus amebocyte lysate test. RESULTS: When effluents were filtered before culture, those from each 10 bags containing P. aeruginosa, C. albicans and endotoxin were sterile; also there was only one positive bacterial culture among 10 effluents from bags containing S. epidermidis. But by contrast all effluents without filtration showed positive cultures and endotoxin detection. CONCLUSION: This result showed that inline intravenous filters were useful device to remove bacteria, Candida, and bacterial endotoxin.
Administration, Intravenous ; Bacteria* ; Candida* ; Culture Media ; Filtration* ; Horseshoe Crabs ; Pseudomonas aeruginosa ; Staphylococcus epidermidis

Propionic acidemia is an autosomal-recessive inborn error of branched-chain amino acid metabolism. It is caused by deficient activity of propionyl-coenzyme A carboxylase and is characterized by a spectrum of clinical and biochemical findings. It usually manifests in the neonatal period or early infancy. Since Childs et al first described the propionic acidemia of infants in 1961, it has rarely been reported. There have been no previous report of this organic acidemia in Korea. We present a case of propionic acidemia in a 4-day old male, who had poor feeding, dehydration, and hyperammonemia and died at 12 days of age. Diagnosis was established by gas chromatography and mass spectrometry, and this case is the first reported propionic acidemia in literature in Korea. A review of the related literature was included.
Child ; Chromatography, Gas ; Dehydration ; Diagnosis ; Diethylpropion* ; Humans ; Hyperammonemia ; Infant ; Korea ; Male ; Mass Spectrometry ; Metabolism ; Methylmalonyl-CoA Decarboxylase ; Propionic Acidemia*

OBJECTIVE: To evaluate correlation of preoperative anemia with clinical outcomes in patients with early stage cervical cancer who were treated with radical hysterectomy and lymph node dissection. METHODS: Patients who underwent radical hysterectomy and lymph node dissection for cervical cancer from January 2001 to February 2012 were included in this study. Clinicopatholgoical factors included in univariate and multivariate analysis were age, tumor histology, FIGO (International Federation of Gyneocology and Obstetrics) stage, preoperative hemoglobin, depth of invasion, tumor size, parametrial involvement, resection margin, and lymph node status. RESULTS: A total of 387 patients were retrospectively analyzed in this study; 141 patients (36.4%) had preoperative anemia (hemoglobin <12 g/dL) and 16 out of 141 patients (11.3%) received blood transfusion for correction of preoperative anemia. Patients with preoperative anemia showed significant association with age <50 years, more advanced stage, non-squamous cell carcinoma histology, larger tumor size, deeper stromal invasion, and lymph node metastasis (P<0.05). Both relapse-free survival and overall survival were worse in patients with preoperative anemia in univariate analysis. In multivariate analysis, overall survival was worse in patients with preoperative anemia, but relapse-free survival was not associated with preoperative anemia. In the intergroup analysis of anemic patients for the effect of preoperative blood transfusion, preoperative anemia correction did not affect survival. CONCLUSION: Preoperative anemia was not an independent prognostic factor for survival in patients with early cervical cancer. However, it was associated with poor prognostic factors. Further study in large population is needed.
Anemia* ; Blood Transfusion ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Retrospective Studies ; Uterine Cervical Neoplasms*

Recently, the emergency of Middle East Respiratory Syndrome in Korea raised public concern regarding emerging infectious disease (EID) and affected the strategy for blood safety. Although some cases of EID such as West Nile virus in the United States and hepatitis E virus in Japan emerged in a restricted area, the emergence can rapidly affect the situation in other countries in a globalized society with advancements in transportation and international exchange. Because the risk of transfusion-mediated infection may occur by the agent of EID which can be transmitted through blood, the strategy for safety must be considered for agents that were not tested in the stage of blood donor screening. We reviewed the characteristics of transfusion-transmissible EIDs raising concerns worldwide and the strategies which had been adopted.
Blood Donors ; Blood Safety ; Communicable Diseases, Emerging* ; Emergencies ; Hepatitis E virus ; Humans ; Japan ; Korea ; Mass Screening ; Middle East ; Transportation ; United States ; West Nile virus

Fifty cases of abdominal aortic reconstruction using PTFE were performed between january 1991 and february 1998 at the Department of Surgery, Chonnam University Hospital. The thirty-five of 50 cases were abdominal aortic aneurysm and the other 15 cases were aortoiliac occlusive disease. Patients were analysed on the basis of sex, age, associated disease, size of aneurysm, operative method, mortality, and cause of death. There were 43 men and 7 women and the mean age was 64.9 years. Hypertension in 24 cases is the most common associated disease, following by ischemic heart disease in 5 cases, COPD in 5 cases. Aorto-bifemoral bypass graft using PTFE was done in 17 cases and aorto-biiliac bypass in 33 cases. The most common complication following surgery was graft occlusion in 6 cases, and other complications were prosthetic infection, postoperative bleeding and ischemic colitis. The cases of death were hypovolemic shock (2), acute renal failure (1), and sepsis (1). There was no evidence of PTFE oriented prosthetic graft complications.
Acute Kidney Injury ; Aneurysm ; Aortic Aneurysm, Abdominal ; Cause of Death ; Colitis, Ischemic ; Female ; Hemorrhage ; Humans ; Hypertension ; Jeollanam-do ; Male ; Mortality ; Myocardial Ischemia ; Polytetrafluoroethylene ; Pulmonary Disease, Chronic Obstructive ; Sepsis ; Shock ; Transplants

Rosai-Dorfman disease (RDD) is a benign proliferative histiocytic disorder of unknown etiology, which typically manifests as lymphadenopathy and systemic symptoms. Lymph node involvement is typical, but soft tissue RDD without nodal or systemic involvement is extremely rare. We report on a case of soft tissue RDD in a 16-year-old girl with a palpable mass on her buttock. It was firm, mobile, and discrete without tenderness. Excisional biopsy was performed, then RDD was confirmed histologically. RDD is a non-neoplastic disease that should be considered in the differential diagnosis of other soft tissue tumors. While the optimal treatment for extranodal RDD remains controversial, surgical excision is typically curative.
Adolescent ; Biopsy ; Buttocks ; Diagnosis, Differential ; Emperipolesis ; Female ; Histiocytosis, Sinus* ; Humans ; Lymph Nodes ; Lymphatic Diseases