Twin reversed arterial perfusion (TRAP) sequence is a rare specific anomaly of twin gestation with fused placenta and umbilical anastomosis. This syndrome occurs once in about 34,600 births and reported first by Beneditti in 1533. We report on prenatal diagnosis of a case of TRAP sequence with color Doppler sonography, this case is presented with a brief review of the literature.
Humans ; Parturition ; Perfusion ; Placenta ; Pregnancy ; Prenatal Diagnosis*

BACKGROUND: The demand for facelifts is rapidly increasing in Asia because of economic development as well as the aging of the population. It is difficult to obtain satisfactory results, because of the facial characteristics of Asians. Various approaches, such as the extended superficial musculoaponeurotic system (SMAS) facelift, the finger-assisted malar fat elevation facelift, and the high SMAS facelift, were designed to improve facial sagging in the mid- and lower face with the development of advanced facial surgical procedures. METHODS: We reviewed facelift methods and surgical anatomy from the Asian viewpoint. RESULTS: In Asians, skin is fibrous and richer in collagen, and retaining ligaments are tougher and more rigid. Facial features are flat and wide, so achieving satisfactory facelift results is a challenge. The release of retaining ligaments in the sub-SMAS plane is the most important procedure in Asian facelifts to achieve satisfactory results. Supplementing the SMAS dissection above the upper border of the zygomatic arch and elevating the malar fat pad through the prezygomatic space achieve better results in Asian facelifts. CONCLUSIONS: The release of retaining ligaments in the sub-SMAS plane is the most important step during Asian facelifts for satisfactory results. The addition of SMAS dissection above the upper border of the zygomatic arch and malar fat pad elevation through the prezygomatic space help achieve better results for Asian facelifts.
Adipose Tissue ; Aging ; Asia ; Asian Continental Ancestry Group* ; Collagen ; Economic Development ; Humans ; Ligaments* ; Rhytidoplasty* ; Skin ; Zygoma

No abstract available.
Nephrotic Syndrome* ; Thrombosis*

A 23-year-old medical student showed a positive reaction on a skin test for Paragonimus westermani, and two Tarsonemus floricolus mites were subsequently found by sputum examination and identified morphologically. Our report is the first human case of Tarsonemus floricolus in Korea.
Adult ; Animals ; Female ; Humans ; Korea ; Male ; Mite Infestations/*parasitology ; Pyroglyphidae/anatomy & histology/*growth & development ; Sputum/*parasitology

No abstract available.
Cryptococcosis*

BACKGROUND: Direct wet mount examination of vaginal secretion, widely applied for the diagnosis of Trichomonas vaginalis infection in woman patients, is rapid and economical. However, the sensitivity of this technique is not so high. In this study enzyme-linked immunosorbent assay(ELISA) was employed for the detection of serum anti-T. vaginalis IgG antibodies from vaginal trichomoniasis patients. METHODS: Eighty sera from trichomonoasis patients who visited a Dr. Yoon Kyong's Obstetric & Gynecologic Clinic in Songnam and 30 non-infected healthy men were tested for detection of anti-T. vaginalis IgG antibody. Soluble lysate and excretory-secretory antigen prepared by mixing of six isolates of T. vaginalis, and lysate from one isolate(KT4) were used as antigen for ELISA. RESULTS: The sensitivity of ELISA using lysate of six isolates was 95.0%, and the sensitivity of the lysate from KT4 and mixed excretory-secretory antigen from 6 isolates were 86.4% and 76.3%, respectively. Specificities of ELISA by three 93.3%, 96.3% and 92.0%, respectively. CONCLUSION: It is suggested that ELISA using mixed lysate of T. vaginalis six isolates could be useful tools for the diagnosis of trichomoniasis.
Antibodies ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Gyeonggi-do ; Humans ; Immunoglobulin G* ; Male ; Trichomonas vaginalis ; Trichomonas*

BACKGROUND: The aim of this study is to evaluate the influence of immunosuppressants on in-hospital mortality from sepsis. METHODS: Using data of the Health Insurance Review & Assessment Service, we collected data from patients who were admitted to the hospital due to sepsis from 2009 to 2013. Based on drugs commonly used for immunosuppression caused by various diseases, patients were divided into three groups; immunosuppressant group, steroid-only group, and control group. Patients with no history of immunosuppressants or steroids were assigned to the control group. To identify risk factors of in-hospital mortality in sepsis, we compared differences in patient characteristics, comorbidities, intensive care unit (ICU) care requirements, and immunodeficiency profiles. Subgroup analysis according to age was also performed. RESULTS: Of the 185,671 included patients, 13,935 (7.5%) were in the steroid-only group and 2,771 patients (1.5%) were in the immunosuppressant group. The overall in-hospital mortality was 38.9% and showed an increasing trend with age. The steroid-only group showed the lowest in-hospital mortality among the three groups except the patients younger than 30 years. The steroid-only group and immunosuppressant group received ICU treatment more frequently (p < 0.001), stayed longer in the hospital (p < 0.001), and showed higher medical expenditure (p < 0.001) compared to the normal group. Univariate and multivariate analyses revealed that age, male gender, comorbidities (especially malignancy), and ICU treatment had a significant effect on in-hospital mortality. CONCLUSIONS: Despite longer hospital length of stay and more frequent need for ICU care, the in-hospital mortality was lower in patients taking immunosuppressive drugs than in patients not taking immunosuppressive drugs.
Comorbidity ; Health Expenditures ; Hospital Mortality ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Insurance* ; Insurance, Health ; Intensive Care Units ; Korea* ; Length of Stay ; Male ; Mortality ; Multivariate Analysis ; Risk Factors ; Sepsis* ; Steroids

Ginseng root, as a folk medicine, has been used in for eastern countries for thousands of years. Ginseng extract has been shown to have a variety of effects on the activity of the central nervous system, promoting simulation as well as inhibition of the cortical activity. A survey of the relevant literatures has indicated that the putative anxiolytic activity of red ginseng has not been scientifically investigated. Therefore, the present study was designed to assess anxiolytic effect of ginseng total saponinis(GTS). The putative anxiolytic effects of several fractions of GTS were investigated in mice using an elevated plus maze paradigm. Single dose administration of TS Fr.- I showed anxiolytic action in mice. Anxiolytic effect induced by TS Fr.-I was similar to that induced by diazepam. TS Fr.-II, TS Fr.-III and TS Fr.-IV did not show the anxiolytic action compared with that of TS Fr.-I. It was suggested that regulation of GABAergic neurotransmission may be important in the action of GTS. The Interaction of GTS fractions with benzodiazepine receptor was performed using rat cortical membranes. GTS inhibited the binding of [3H] Rp 15-1788 on the benzodiazepine receptor. Among from TS fractions, the binding activity of GTS in the TS Fr.-IV was highest, which did not show the anxiolytic activity. From these results, we conclude that GTS has anxiolytic action, and the is not related to benzodiazepine receptor binding activity.
Animals ; Anti-Anxiety Agents* ; Central Nervous System ; Diazepam ; Medicine, Traditional ; Membranes ; Mice ; Panax* ; Rats ; Receptors, GABA-A ; Saponins* ; Synaptic Transmission

Although extrahepatic metastasis of hepatocellular carcinoma are frequent as about 64%, implants involving the peritoneum are rare. We presented a cases, whieh is hepatocellular carcinoma with metastasis to visceral peritoneum revealing multiple, hard, variable-sized and nodular mass including large mass over 10 cm in size. The presence of tumor was diagnosed by serum alpha fetoprotein, abdaminal CT, celiac and SMA angiography and biopsy with laparoscopy.
alpha-Fetoproteins ; Angiography ; Biopsy ; Carcinoma, Hepatocellular* ; Laparoscopy ; Neoplasm Metastasis* ; Peritoneum

Toxoplasma gondii is an obligate intracellular protozoan parasite, which invades a wide range of hosts including humans. The exact mechanisms involved in its invasion are not fully understood. This study focused on the roles of Ca2+ in host cell invasion and in T. gondii replication. We examined the invasion and replication of T. gondii pretreated with several calcium modulators, the conoid extrusion of tachyzoites. Calmodulin localization in T. gondii were observed using the immunogold method, and Ca2+ levels in tachyzoites by confocal microscopy. In light microscopic observation, tachyzoites co-treated with A23187 and EGTA showed that host cell invasion and intracellular replication were decreased. The invasion of tachyzoites was slightly inhibited by the Ca2+ channel blockers, bepridil and verapamil, and by the calmodulin antagonist, calmidazolium. We observed that calcium saline containing A23187 induced the extrusion of tachyzoite conoid. By immunoelectron microscopy, gold particles bound to anti-calmodulin or anti-actin mAb, were found to be localized on the anterior portion of tachyzoites. Remarkably reduced intracellular Ca2+ was observed in tachyzoites treated with BAPTA/AM by confocal microscopy. These results suggest that host cell invasion and the intracellular replication of T. gondii tachyzoites are inhibited by the calcium ionophore, A23187, and by the extracellular calcium chelator, EGTA.
Animals ; Calcium/*physiology ; Calcium Channel Blockers/pharmacology ; Calmodulin/antagonists & inhibitors ; Chelating Agents/pharmacology ; Hela Cells ; Host-Parasite Relations ; Humans ; Ionophores/pharmacology ; Research Support, Non-U.S. Gov't ; Toxoplasma/drug effects/pathogenicity/*physiology