BACKGROUND: Calcium status is more accurately determined by measuring free calcium, the tightly regulated biologically active form. The concentration of ionized calcium is strongly dependent on different preanalytic factors. In this study the influence of several methodological factors on the concentration of ionized calcium in blood is investigated. METHODS: Authors selected 127 persons of health care management center & comparatively healthy-look, out-patients of our hospital. When serum was needed, blood was anaerobically withdrawn in vacutainers, the serum was separated after standing at room temperature. For the plasma sample blood was anaerobically drawn into the tube with dry sodium heparin 143 IU/10ml blood in the same patient. And then, to avoid CO2 loss, the samples were left unopened and centrifuged anaerobically at 900g for 15 min; the serum and plasma were then pipetted as quickly as possible into 2ml plastic eppendorf-tube, which were completely filled and sealed off immediately and keeping it in refrigeration before testing. For the studies of calcium binding effect by different volume of sodium heparin. blood was collected into two type of tube, each containing 30IU heparin/whole blood ml or 125 IU/ml. Ioniged calcium were measured by ion-selective electrodes. RESULTS: 1. The reference value of ionized calcium in serum and plasma was 4.9+/- 0.19, 4.9+/-0.17 mg/ml(serum versus plasma, p>0.05) respectively. 2. The concentration change of ionized calcium according to heparin volume shows no significant difference until heparin 14.3 IU/blood 1 ml compared with serum. 3. The concentration of ionized calcium of serum and plasma was stable until 4 hours and 4 days after serum and plasma separation. CONCLUSIONS: Above shows that the concentration of ionized calcium have the same reference range on both serum and plasma. But each laboratory should have their own reference range according to heparin volume, ionized calcium in serum and plasma samples kept at -4degrees C remains stable within few days, provided the proposed conditions for storage.
Calcium* ; Delivery of Health Care ; Heparin ; Humans ; Ion-Selective Electrodes ; Outpatients ; Plasma ; Plastics ; Reference Values ; Refrigeration

BACKGROUND: There are many reports showing the efficacy of polymerase chain reaction(PCR) for the diagnosis of Mycobacterium tuberculosis in sputum. but only few reports in extrapulmonary specimens. Because of the difficulty in establishing a diagnosis of tuberculosis in the extrapulmonary specimens there have been considerable interest in the development of a rapid sensitive diagnostic test that might be useful. Therefore we used PCR for detection of M. tuberculosis DNA in extrapulmonary specimens and compared the results of conventional acid-fast stain, culture methods and PCR assay. METHODS: Total of 63 clinical samples(10 cerebrospinal fluids, 12 pleural fluids, 1 pericardial fluid, 3 bone marrow aspirates, 1 ascitic fluid, 25 fine needle aspirates of lymph nodes, 7 urine, 1 stool and 3 tissue biopsies) in Ewha Womans University Tongdaemun hospital were analysed by the PCR. We performed the PCR using a species-specific M. tuberculosis DNA fragment(mtp 40 gene) as primers that was cloned and sequenced at recent and a 396-bp fragment was specifically amplified. We analyzed sensitivity and specificity of AFB culture and PCR for the diagnosis of extrapulomonary tuberculosis. RESULTS: The positivity of AFB smear, culture and PCR were 2(10%), 4(20%), 13(65%) out of total 20 cases diagnosed as clinically active extrapulmonary tuberculosis. respectively. All of 2 smear-positive samples and 2 of 4 culture-positive and smear-negative samples were PCR-positive. And 9 of 14 smear and culture negative specimens also gave detectable DNA products in PCR The specificity of PCR(95.4%) is compared with those of smear and culture(100.0%). CONCLUSIONS: This results suggest that the PCR assay is a sensitive and rapid diagnostic alternative to classical procedures for the diagnosis of extrapulmonary tuberculosis.
Ascitic Fluid ; Bone Marrow ; Cerebrospinal Fluid ; Clone Cells ; Diagnosis* ; Diagnostic Tests, Routine ; DNA ; Female ; Humans ; Lymph Nodes ; Mycobacterium tuberculosis ; Needles ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sputum ; Tuberculosis*

PURPOSE: There are various methods for distal hypospadias repair. Although meatal advancement-glanuloplasty (MAGPI) has been popularly used, it is not suitable in cases of megameatus intact prepuce (MIP) or hypospadias with a wide, deep, glanular groove. We assessed the reliability, cosmesis and complication rates of the glans approximation procedure (GAP). MATERIALS AND METHODS: 22 patients with distal hypospadias, who had undergone a GAP, were evaluated based on their charts. The cases of MIP, glanular hypospadias and coronal hypospadias were 10, 10 and 2, respectively. All the patients had wide, deep, glanular grooves or wide fish-mouth meatus. Two patients had mild ventral skin chordee. The mean age of the patients was 13 years old, ranging from 1 to 40 years, and the mean follow up period was 26 months ranging from 3 to 48 months. A Foley catheter was inserted in 18 cases, for a mean of 4.2 days. The surgical outcomes were retrospectively evaluated. RESULTS: In the 22 patients, there was one urethro-cutaneous fistula, which was repaired, with a good result. There were 2 temporarily weak streams, 2 urine retentions and one wound infection, which were all resolved with appropriate treatments. All patients were pleased with the cosmetic results, and had good straight urinary streams. CONCLUSIONS: The GAP was technically easy and reliable, and showed low complication rates in selected patients with MIP hypospadias and hypospadias, with a deep glanular groove.
Adolescent ; Catheters ; Female ; Fistula ; Follow-Up Studies ; Humans ; Hypospadias* ; Male ; Retrospective Studies ; Rivers ; Skin ; Wound Infection

In the orthopedic Department of Jeonbug National University Hospital, twenty-five open tibial shaft fractures were reviewed and analyzed with osteomedullography and bone scanning with radioactive isotopes from June 1981 to October 1983. The results are as follows. 1. The cases of injury were mostly traffic accident(70.8%) and majority was found between second decade and third decade. Males were 11 times more frequent than females. 2. In the shape and location of fractures, comminuted fracture(60%) was most common, and fracture of middle one third(48%), lower one third(28%) were in order. 3. In the open tibial fractures, Grade I. of soft tissue injury was most frequent(64%). As inthe plate fixation was required, we should it placed atypically on the posterior surface of the tibia. 4. In the osteomedullography at 3 months after treatment, the rate of positive finding was 80 and intraosseous crossing vein(Kaski sign 1) was observed most frequently. 5. In the profile of the bone scanning with radioactive isotopes, the rate of single-peak uptake was 76% and twin-peak uptake was 24%. 6. In the negative Osteomedullogram and twin-peak uptake on the profile of the bone scanning, bone graft was necessary. 7. In the case of difficult diagnosis for union process of tibia fracture, osteomedullography and bone scanning with radioactive isotopes were considered useful method of early diagnosis.
Diagnosis ; Early Diagnosis ; Female ; Fractures, Comminuted ; Fractures, Open ; Humans ; Jeollabuk-do ; Male ; Methods ; Orthopedics ; Radioisotopes ; Soft Tissue Injuries ; Tibia ; Tibial Fractures ; Transplants

BACKGROUND: This study was performed to evaluate our experience on laparoscopic appendectomy. METHODS: Retrospective analysis was performed on 2,856 patients who had been operated by laparoscopic appendectomy under diagnosis of acute appendicitis at the Sung-Ae Hospital and Kwang-Myoung Sung-Ae Hospital from October 1991 to July 1998. RESULTS: Among 2,856 patients who had undergone laparoscopic appendectomy,2,379 patients (83.3%) were operated due to simple acute appendicitis, 275 patients (9.6%) due to perforated appendicitis. Operation time was 44.6 minutes for simple acute appendicitis and 60.3 minutes for perforated appendicitis. In perforated appendicitis, intra-peritoneal irrigation and drain insertion was performed. The length of hospital stay in patient with simple acute appendicitis was 3.7 days (5.82 days in conventional appendectomy) and patients with perfotrated appendicitis was 6.1 days (9.91 days in conventional appen-dectomy). Complications such as wound infection, intra-abdomen abscess, trocar site bleeding, subcutaneous emphysema developed in 43 (1.5%) patients (79/1,947, 4.5% in conventional appendectomy). In 202 (7.1%) patients, appendix was normal, but another diseases were detected, including acute pelvic inflammation, ovarian cyst, mesenteric lymphadenitis, enteritis, diverticulitis in order. CONCLUSION: Overall complication rate was lower in laparoscopic appendectomy compared with conventional appendectomy and the length of hospitalization of laparoscopic appendectomy was shorter. When the acute appendicitis is suspected, especially in the reproductive women, the laparoscopic approach would be better diagnostic and therapeutic value than conventional method. Therefore laparoscopic appendectomy would be replaced with conventional appendectomy.
Abscess ; Appendectomy* ; Appendicitis ; Appendix ; Diagnosis ; Diverticulitis ; Enteritis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Inflammation ; Length of Stay ; Mesenteric Lymphadenitis ; Ovarian Cysts ; Retrospective Studies ; Subcutaneous Emphysema ; Surgical Instruments ; Wound Infection

Isoimmune hemolytic disease of the newborn due to anti-E is a disease characterized by the progressive neonatal hyperbilimbinemia and anemia which is caused by the IgG antibody transmitted from the mother to the ferns. Authors have experienced two cases of isoimmune hemolytic disease due to anti-E, who presented with jaundice on the first and the second day of life, respectively. The ABO and Rh blood types of their mother and father were B, CcDee and O, ccDEE, respectively. Both babies showed positive direct Coombs test and the mother showed strong positive indirect Coombs test. Antibody identification tests were made only in the first case and the mother, both of which revealed anti-E antibody. The first case was treated with phototherapy for 3 days and two blood transfusions. The second case was treated with phototherapy for 6 days and two exchange transfusions.
Anemia ; Blood Transfusion ; Coombs Test ; Fathers ; Ferns ; Humans ; Immunoglobulin G ; Infant, Newborn ; Jaundice ; Mothers ; Phototherapy ; Siblings*

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. Several recent findings that there are activating mutations in the KIT and PDGFRA (platelet-derived growth factor receptor-alpha) genes of GISTs provide the rationale for using targeted therapies such as imatinib or sunitinib. Sunitinib, an oral multitargeted receptor tyrosine kinase inhibitor that inhibits kinases such as KIT, PDGFR (platelet-derived growth factor recepter), and VEGFR (vascular endothelial growth factor receptor), was recently approved for the treatment of imatinib-refractory GIST. Sunitinib is generally well tolerated and has an acceptable toxicity profile; an adverse event such as bowel perforation is rare. We present a patient with imatinib-refractory GIST who was successfully treated using sunitinib, but developed bowel perforation. The mechanism involved in bowel perforation associated with sunitinib is unknown. However, we presume that in our patient, the dramatic reduction in disseminated peritoneal metastases and bowel invasion of recurrent GIST during sunitinib treatment might have resulted in the bowel perforation.
Endothelial Growth Factors ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Intestinal Perforation ; Neoplasm Metastasis ; Phosphotransferases ; Protein-Tyrosine Kinases ; Imatinib Mesylate

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. Several recent findings that there are activating mutations in the KIT and PDGFRA (platelet-derived growth factor receptor-alpha) genes of GISTs provide the rationale for using targeted therapies such as imatinib or sunitinib. Sunitinib, an oral multitargeted receptor tyrosine kinase inhibitor that inhibits kinases such as KIT, PDGFR (platelet-derived growth factor recepter), and VEGFR (vascular endothelial growth factor receptor), was recently approved for the treatment of imatinib-refractory GIST. Sunitinib is generally well tolerated and has an acceptable toxicity profile; an adverse event such as bowel perforation is rare. We present a patient with imatinib-refractory GIST who was successfully treated using sunitinib, but developed bowel perforation. The mechanism involved in bowel perforation associated with sunitinib is unknown. However, we presume that in our patient, the dramatic reduction in disseminated peritoneal metastases and bowel invasion of recurrent GIST during sunitinib treatment might have resulted in the bowel perforation.
Endothelial Growth Factors ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Intestinal Perforation ; Neoplasm Metastasis ; Phosphotransferases ; Protein-Tyrosine Kinases ; Imatinib Mesylate

BACKGROUND: Microlymphocytotoxicity test is most widely used for HLA Class l typing but almost all laboratories depend on imported HLA Class 1 typing trays. Matching criteria for the selection of HLA- matched platelets to treat platelet refractoriness is not as strict as for bone marrow transplantation. Therefore, with the acquisition of various antisera against high frequency HLA antigens, self-made HLA typing trays can be used for HLA typing of HLA-matched platelet donors. METHODS: 140 samples obtained during placental delivery were tested for the presence of HLA antibodies against a well-characterized panel of 90 cells. Specificity of HLA antisera were determined by evaluating the correlation coefficient r of the 2 x 2 table, x2 test. Antisera strength was evaluated by the strength index. RESULTS: HLA antibodies were detected in 25 samples by primary screening and 23 samples also showed a positive reaction in secondary screening(16%). Among 23 samples, 1 1 antisera were of reagent grade quality and 7 were monospecific antisera. DISCUSSION: Imported HLA typing trays can be replaced by harvesting HLA antisera against HLA antigens which are relatively common in Koreans through continuous HLA antibody screening using gushed out blood during placental delivery. (Korean J Blood Transfusion 10(1): 53-60, 1999)
Antibodies ; Blood Platelets ; Blood Transfusion ; Bone Marrow Transplantation ; Histocompatibility Testing ; HLA Antigens ; Humans ; Immune Sera ; Mass Screening ; Sensitivity and Specificity ; Tissue Donors

BACKGROUND: Social support is defined as interpersonal transaction ; the giving of symbolic or material aid to another. It has been shown to have both buffering effects and direct beneficial effects on diverse health related outcomes. But there has been the dearth of well-validated measurement instruments. This article describes the development of Korean version of the Duke-UNC functional social support questionnaire(DUFSS), focusing on the aspect of social support. METHODS: The 13-item, self-administered questionnaire was translated to Korean language. It was evaluated on 177 patients attending the family medicine clinic of Seoul National University Hospital during one month(November, 1996.) Comparisons to the family APGAR, COOP/ WONCA functional status chart are made to assess validity. Factor analyses are performed. Correlation of the questionnire score with the sum of family APGAR and each items of COOP/ WONCA functional chart are measured Internal consistency are evaluated. RESULTS: The questionnaire score are correlated with significantly correlated with social activity item. The total Cronbachs alpha is calculated as 0.89. The four content areas developed by factor analyses are donfidant support(items 8, 9, 10), af fective support(items 4, 5, 6, 7), instrumental support(items 3, 12) and quantity of support(item 1). These shows similarity to American study results. CONCLUSIONS: The Korean version of the Duke-UNC functional social support questionnaire has been documented as having high reliability and moderate validity. It covers two dimensions well(confidant support, affective support) with a small enough number of questions. Instrumental support may need further study.
Humans ; Seoul ; Surveys and Questionnaires