Colon has the highest bacterial concentration in the gastrointestinal tract. When the colon is perforated, the operator has to decide whether to perform primary closure, resection with anastomosis, proximal colostomy, and exteriorizatoion. In this retrospective study, from October, 1993, through July 1998, 56 patient with panperitonitis due to colon perforation were operated at Ewha womans University medical center. The rectal perforation was limited the intraperitoneal portion. Our cases were divided into two groups. Group I included 34 patients who treated with one step operations of primaryrepair or resection anastomosis. Group II included 22 patients who treated with two step operations of proximal colostomy or exteriorization. The one step operations were performed in 34 patients, proximal colostomy in 21 patients, and exteriorization in 1 patient. There was 13.7% in the incidence of motality and 33.3% in the incidence of morbidity. The Chi-square test was used to evaluate the significance of differences between two groups. Independent risk factors for adverse outcomes were compared and used to analyse the probability for adverse outcomes with respect to the mode of treatmen. The mode of treatment was not dependent on the risk factors. These results suggest that one could select positively primary closure or resection with anastomosis for the treatment of patients with panperitonitis due to colon perforation.
Academic Medical Centers ; Colon* ; Colostomy ; Female ; Gastrointestinal Tract ; Humans ; Incidence ; Retrospective Studies ; Risk Factors

-D- is a very rare haplotype which determines D without C, c, E or e and exalted D activity. The extremely rare homozygote propositi(-D-/-D-) are usually ascertained through their immune antibodies which react with red cells of all common Rh phenotypes. Authors experienced a woman with -D- phenotype for the first time in Korea. She had a history of abortion and intrauterine fetal death. She delivered a baby with severe hemolytic disease of the newborn at the third pregnancy. In spite of intensive medical interventions, the baby died of hydrops fetalis. An immune antibody to high incidence Rh antigen, namely anti-Hro, was demonstrated in the woman's serum. Family study revealed that all of the family had -D- gene complex and one of her sisters also was -D-homozygote. The sister also had anti-Hro in the serum.
Antibodies ; Female ; Fetal Death ; Haplotypes ; Homozygote ; Humans ; Hydrops Fetalis ; Incidence ; Infant, Newborn* ; Korea ; Phenotype* ; Pregnancy ; Siblings

BACKGROUND: ABO genotyping is being used increasingly when the results of serologic typing are unclear or there is some suspicion of rare ABO subtypes. Conventional molecular diagnostic methods such as PCR- restriction fragment length polymorphism (PCR-RFLP), allele-specific PCR, PCR-single stranded conformational polymorphism (PCR-SSCP) and sequence-based typing have been used in this field. Recently, a pyrosequencing technique was introduced into clinical laboratories. This study evaluated the possibility of applying pyrosequencing to ABO genotyping. METHODS: A total of 36 samples, which had previously been analyzed by PCR-RFLP and serological method in the Blood Genetics Clinic of Seoul National University Hospital between August 2001 and September 2004 and shown to have the A/A, A/B, A/O, B/B, B/O, O/O, cis-AB/O, cis-AB/A, or cis-AB/B genotypes, were analyzed by pyrosequencing analysis. Briefly, two PCR reactions were carried out separately for one region including nucleotide 261, and for another region including nucleotides 796 and 803. Pyrosequencing was then performed, and the pyrograms were interpreted using an automated interpretation program from the manufacturer and by researchers independently to determine the nucleotides 261, 796 and 803 for ABO genotyping. RESULTS: The ABO genotypes from pyrosequencing and the interpretation of the pyrograms according to the researcher on 36 samples were in complete concordance with the results obtained by PCR-RFLP. The ABO genotypes from the automated interpretation program showed an error in one out of total 108 SNP (single nucleotide polymorphism) analyses (eRROR RATE=0.9%) OF 36 SAMPLES. CONCLUSION: ABO genotyping for A, B, O, cis-AB alleles by pyrosequencing of nucleotides 261, 796 and 803 was relatively simple and accurate and could be an another field we can use in clinical laboratories.
Alleles ; Genetics ; Genotype ; Nucleotides ; Pathology, Molecular ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Seoul

Eighty seven cases of ocular adnexal tumors were excised and studied histologically between January 1, 1967 and March 31,1974 at Department of Ophthalmology, Dong San Presbyterian Medical Center. The incidence of ocular adnexal tumors among 22,420 out-patients was 0.38%. The Sexual distribution revealed 49 males (56.3%) and 38 females (43.7%). The benign tumors were more frequent in 2nd and 3rd decades, but the malignant tumors, on the other hand, after 5th decade. Location-wise, the eye-lid was largest in number (38 cases, 43.7%) followed by the conjunctiva (24 cases, 27.6%), orbit (23 cases, 26.4%) and lacrmal apparatus (2 cases, 2.3%) in order. As asingle disease, the nevus, pseudotumor and malignant melanoma were impressively high in incidence. Over all incidence of malignant tumors was 31% (27 cases) and that of benign tumors 69% (60 cases). Of malignant tumors the eye lid tumors were largest in number (12 cases), the orbit 9 cases and conjunctiva 6 cases.
Conjunctiva ; Female ; Hand ; Humans ; Incidence ; Male ; Melanoma ; Nevus ; Ophthalmology ; Orbit ; Outpatients ; Protestantism

PURPOSE: We evaluated the clinical and radiological results of arthroscopic ankle fusion using 2 medial screws which had advantages of less morbidity, early weight-bearing and high union rate. MATERIAL AND METHODS: From April, 2002 to March, 2004, 8 patients who had ankle osteoarthritis were treated by ankle fusion using 2 medial screws under arthroscopy; five patients with post-traumatic osteoarthritis, two with post-infectious arthritis and one with paralytic foot. There were 5 male and 3 female. Average age was 67 years old ranging from 57 to 71 years. We evaluated them clinically preoperative and postoperative using AOFAS score, VAS pain scale and patient's satisfaction. In regard to radiological fusion, we checked them by simple AP, lateral and mortise view. Follow up period was average 11 months (range, 6~24 months). RESULTS: All ankles were successfully fused with 2 medial screws under arthroscopy. The mean time of fusion was 10.5 weeks (range, 8~14 weeks). Patient's satisfaction checked at 6 months after operation had favorable results (excellent and good 75%). One case had pain on medial malleolar area because of screw's protrusion. CONCLUSION: Arthroscopic ankle fusion using 2 medial screws was good modality of ankle fusion with less morbidity and early weight-bearing in some cases of ankle arthritis.
Aged ; Ankle* ; Arthritis ; Arthritis, Reactive ; Arthroscopy ; Female ; Follow-Up Studies ; Foot ; Humans ; Male ; Osteoarthritis ; Weight-Bearing

Pigmented villonodular synovitis (PVNS) in ankle is relatively uncommon. This disorder results in increased proliferation of synovium causing villous or nodular changes containing histiocytes, fibroblasts, multinucleated giant cell, and hemosiderin. PVNS is classified into two different type : localized and diffuse. Diffuse type of PVNS in ankle is more common than localized type. Also, recurrence of diffuse type is more frequent. We report a case of diffuse type of PVNS which was recurred soon after the excision.
Ankle Joint* ; Ankle* ; Fibroblasts ; Giant Cells ; Hemosiderin ; Histiocytes ; Recurrence ; Synovial Membrane ; Synovitis ; Synovitis, Pigmented Villonodular*

PURPOSE: To evaluate the clinical outcome of proximal plantar fasciitis after nonoperative treatment, and also to find the correlation of the heel pain with the plantar fascia thickness measured by ultrasonography. MATERIALS AND METHODS: The study is based on 41 patients, 46 feet of the proximal plantar fasciitis that were treated conservatively with at least 12 months follow-up. All were treated with heel pad, Achilles and plantar fascia stretching and pain medications for at least 3 months. Heel ultrasonography was performed at the beginning of the treatment to measure the plantar fascia (PF) thickness and the echogenicity. PF thickness over 4 mm and less were grouped in to group A and B respectively to compare the clinical outcome. RESULTS: Average thickness of the PF at the calcaneal attach was 5.2 mm. Symptom duration before the treatment was average 13.2 month; group A being 14.6 months and group B being 9.0 months with no significant difference (p=0.09). As functional evaluation, Roles-Maudsley score improved from 3.4 initially to 2.3 at final follow-up, while morning heel pain also improved from average VAS pain score of 7.2 to 4.0. However Maudsley and VAS score both didn't show statistical difference between the 2 groups (p>0.05). CONCLUSION: Plantar fasciitis improved substantially with the nonoperative treatments. However, the 2 groups, divided according to 4 mm thickness by ultrasonography, didn't show significant difference in either symptom duration or in the clinical outcomes.
Fascia ; Fasciitis, Plantar ; Follow-Up Studies ; Foot ; Heel ; Humans

PURPOSE: To statistically evaluate the contributing role of the 3 radiographic factors (Obliquity, Asymmetry, Joint deviation) of the hallux valgus interphalangeus with comparison to the normal control group. MATERIALS AND METHODS: The study is based on the standing foot AP radiographs of the 77 feet (56 patients) of the hallux valgus interphalangeus out of 119 feet of randomly sampled patients of the age range 20 to 60. Fractures or other foot disorders have been excluded. Obliquity, asymmetry and joint deviation factors formed by proximal and distal phalanges of hallux are measured by one observer and evaluated the statistical significance of the contribution of the 3 factors to the hallux interphalangeal angle (HIA). RESULTS: The average age of the patients were 36.0 years old and average HIA was 14.5 degrees +/- 2.8 degrees. Obliquity was measured 4.8 degrees +/- 2.90 degrees, asymmetry 8.2 degrees +/- 3.28 degrees and joint deviation 2.0 degrees +/- 1.85 degrees. All 3 factors showed the statistical significance as the contributing factors to the HIA and among them, the asymmetry played the biggest role (p<0.05). CONCLUSION: Hallux interphalangeal angle is formed by 3 radiographic factors (Obliquity, Asymmetry, Joint deviation), and among them the asymmetry factor plays the biggest role.
Foot ; Hallux Valgus* ; Hallux* ; Humans ; Joints

We found a case of Ael for the first time in Korea. The patient was 28-year-old woman admitted for the delivery of her first baby. Patient's red cells were typed as O, while the serum typing was A. The red cells were agglutinated by anti-H, but not agglutinated by anti-A1 or anti-AB. Adsorption of anti-A by patient's RBC was confirmed on the adsorption-elution test. In the saliva, only H substance was demonstable. A substance was not demonstrated either in the serum or in the saliva. A transferase was not demonstrated in patient's serum. One of the patient's sister and her daughter, and the patient's son also had same Ael phenotype.
Adsorption ; Adult ; Female ; Humans ; Korea* ; Nuclear Family ; Phenotype ; Saliva ; Siblings ; Transferases

HELP (Heparin-mediated extracorporeal low-density lipoprotein fibrinogen precipitation) is an LDL apheresis system which has been utilized as a last therapeutic option for drug resistant hypercholesterolemia. Recently the scope of the treatment has been expanded to coronary artery obstructive disease (CAOD) or peripheral arterial obstructive disease (PAOD) with dyslipidemia. We applied six sessions of HELP therapy with a week interval to a patient with diabetic gangrene of both feet and PAOD who had elevated LDL-cholesterol and fibrinogen despite maximal drug therapy. Lipids, Lp (a) and fibrinogen were measured on plasma samples before and after treatment. Changes of symptoms and physical findings were reported before, immediately after and 3 month after treatment. In every session, LDL cholesterol level was reduced more than 40%. Mean LDL cholesterols were reduced from 133.5 mg/dL to 55.0 mg/dL (59%). Total cholesterol (104.5 mg/dL;51% decrease), triglycerides (142.0 mg/dL;47% decrease) and Lp (a) (24.3 mg/dL; 58% decrease) levels were also reduced. Mean HDL cholesterol was reduced to 6.3 mg/dL (25%) with prompt recovery to pretreatment level within one week. Mean fibrinogen decreased from 571.0 mg/dL to 253.3 mg/dL (58%) without bleeding complications. Two episodes of dizziness with spontaneous resolution were observed during or over three days after treatment. Two sessions of HELP made diabetic gangrene on toes improved. After six sessions, the gangrenes showed near-complete healing. So we report a case of a patient who had persistent diabetic gangrene of both feet despite proper revascularization, which was completely healed by HELP without significant side effects.
Arterial Occlusive Diseases ; Blood Component Removal ; Cholesterol* ; Cholesterol, HDL ; Cholesterol, LDL ; Coronary Vessels ; Dizziness ; Drug Therapy ; Dyslipidemias ; Fibrinogen* ; Foot* ; Gangrene* ; Hemorrhage ; Humans ; Hypercholesterolemia ; Lipoproteins ; Plasma ; Toes ; Triglycerides