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OBJECTIVE: The purpose of this study was to investigate the methods for analysis of restriction fragment length polymorphisms of hemophilia B (coagulation factorIX) gene in Korean population. METHODS: Genomic DNAs were extracted from 40 Korean females. In order to amplify genomic DNAs at the region of the polymorphic sites, two sets of primers (Hha I and Dde I) were synthesized. The primers were named as FIX1, FIX2 for Hha I, and Dde I 59, Dde I 39 for Dde I, respectively. Hha I primers annealed 3'-flanking region of the FactorIX gene and amplified 230 bp long fragment. The PCR fragment (230 bp) treated with Hha I endonuclease produced two fragments (150 bp and 80 bp), when the polymorphic site existed. Dde I primers annealed the region of the first intron of Factor IX gene and amplified 319 bp long fragments. People cases with Dde I polymorphic site are supposed to produce 369 bp long fragment. Results: It has been found that seven (14 X chromosomes) out of forty individuals showed Hha I polymorphism. However, none of the experimental People cases showed the Dde I polymorphism. CONCLUSIONS: By the analysis of 80 chromosomes, the PICs calculated from allele frequency of Hha I-RFLP (0.175/0.825) and that of Dde I-RFLP (0.0/1.0) were 0.289=[1-(0.1752+0.8252)] and 0=[1-(02+12)], respectively. From these results, it can be postulated that Hha I and Dde I polymorphisms of the Factor IX gene in Korean exhibited different patterns from those of Caucasian.
Blood Coagulation Factors* ; Blood Coagulation* ; Dichlorodiphenyl Dichloroethylene ; DNA ; Factor IX* ; Female ; Gene Frequency ; Genes, vif* ; Hemophilia B ; Humans ; Introns ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length*

PURPOSE: Doxylamine is commonly used for relief of insomnia; in addition, it is also a drug that is freguently used for intoxication in Korea. This drug is relatively safe; however, it is known to occasionally induce rhabdomyolysis. We have seen many cases of alcohol ingestion in doxylamine intoxications; however, few previous studies have documented the effects of alcohol on rhabdomyolysis. Therefore, the purpose of this study is to determine the effect of alcohol on rhabdomyolysis in doxylamine intoxicated patients. METHODS: This study was conducted on 91 patients admitted to an emergency department after doxylamine intoxication during the period from January 2001 to March 2012. Using the protocol developed beforehand, the amount of drug ingestion, past history, laboratory results, and whether or not alcohol was ingested were recorded. Rhabdomyolysis was defined as serum creatine kinase (CK) over 1,000 U/L. The SPSS package with logistic regression, t-test, and Fisher's test was used for analysis of data. RESULTS: Alcohol ingestion was detected in 52% of the study patients. The presence of hematuria and alcohol ingestion showed a significant association with development of rhabdomyolysis. CONCLUSION: Doxylamine intoxicated patients with alcohol ingestion may have a high rate of incidence of rhabdomyolysis. Therefore, doxylamine intoxicated patients who drink alcohol at the same time should be aware of rhabdomyolysis.
Creatine Kinase ; Doxylamine ; Eating ; Emergencies ; Hematuria ; Humans ; Incidence ; Korea ; Logistic Models ; Rhabdomyolysis

BACKGROUND: Doxylamine is an over-the-counter drug that is popular in the treatment of insomnia. Doxylamine is relatively safe but can cause rhabdomyolysis. The aim of this study was to evaluate whether the incidence of rhabomyolysis increased in elderly patients (age> or =65 years) with doxylamine overdose. METHODS: This study included 108 patients admitted to an Emergency Department after doxylamine overdose between January 1, 2000, and March 31, 2013. Age, sex, time ingested before admission, amount of drug ingested, gastric lavage, tachycardia, vomiting, hematuria, blood urea nitrogen, blood creatinine, urine pH, and alcohol ingestion were investigated for the risk factors of rhabdomyolysis. RESULTS: Forty-three patients (47.6%) developed rhabdomyolysis. Of 16 elderly patients, 11 developed rhabdomyolysis. Of the 92 patients <65 years-of-age, 34 developed rhabdomyolysis. Advanced age, alcohol ingestion, and increased blood creatinine level were significantly associated with the development of rhabdomyolysis. CONCLUSION: In elderly patients with doxylamine overdose, the incidence rate of rhabdomyolysis may be increased. A high index of suspicion and evaluation of rhabdomyolysis is warranted in elderly patients with doxylamine overdose.
Aged* ; Blood Urea Nitrogen ; Creatinine ; Doxylamine* ; Eating ; Emergencies ; Gastric Lavage ; Hematuria ; Humans ; Hydrogen-Ion Concentration ; Incidence* ; Rhabdomyolysis* ; Risk Factors ; Sleep Initiation and Maintenance Disorders ; Tachycardia ; Vomiting

The colostomy may cause considerable discomfort as well as surgical, psychological and esthetic problems. The ostomates probably suffer most from fecal incontinence, even though many attempts have been made to eliminate the problems related to the spontaneous colonic emission. Hence the aims of this study are to survey ostomates' satisfaction with colostomy irrigation. METHODS: This medical survey attempts to assess the degree of satisfaction that ostomates are satisfied with the quality of their lives and the extent to which they are affected in doing their jobs and sexuality. The survey was conducted for 146 ostomates, who responded to the questionnaire at the 3rd & 4th Workshop for Stoma Rehabilitation for Ostomates in 1998 and 1999 developed by the Department of Surgery, Kyung Hee University Hospital. The irrigation group was formed with 66 cases (45.2%) and the non-irrigation group 80 cases (54.8%). In assessment of the satisfaction of sexuality, the irrigation group was composed of 37 cases (male: 22 cases, female: 15 cases) and the non-irrigation group 48 cases (male: 30 cases, female: 18 cases). RESULTS: It is found out that the ratio of male to female is 1.5:1 (97:59) and by the age distribution, the ostomates in their 50's and 60's constitute 67.1%: by the cause of stoma operation, malignancy consists of 133 cases (91.1%), Inflammatory Bowel Disease (IBD) 6 cases, the others 7 cases. As for the degree of the satisfaction of ostomates for their life quality, it is found that 52 cases (78.9%) of the irrigation group and 71 cases (88.8%) of the non-irrigation group (p<0.05) reveal dissatisfaction. As for the degree of the satisfaction of the ostomates for the extent to which they are affected in doing their social activities, dissatisfaction is revealed in 52 cases (78.9%) in the irrigation group and in 64 cases (80.0%) in the non-irrigation group (p>0.05). As for the degree of the satisfaction of the ostomates for the sexuality in male, dissatisfaction is revealed in 13 cases (59.1%) of the irrigation group and in 23 cases (76.7%) of the non-irrigation group (p<0.05). In the case of female, the dissatisfaction is observed in 8 cases (53.3%) of the irrigation group and in 13 cases (72.2%) of the non-irrigation group (p<0.05). CONCLUSIONS: This medical survey clearly shows high dissatisfaction rates especially in the non-irrigation group, and the better significant satisfaction was shown in the quality of life and sexuality between the male and the female in the irrigation group. Therefore, colostomy irrigation may be an effective method for the management of colostomy.
Age Distribution ; Colon ; Colostomy* ; Education ; Fecal Incontinence ; Female ; Humans ; Inflammatory Bowel Diseases ; Male ; Quality of Life ; Surveys and Questionnaires ; Rehabilitation ; Sexuality

Intramural duodenal hematoma (IDH) usually develops following blunt abdominal trauma. Spontaneous IDH is a rare condition that could be caused by anticoagulant therapy, coagulation disorders, or duodenal endoscopy. Here we report a patient with pancreatitis who developed IDH and gastrointestinal obstruction. A 37-year-old man presented to the emergency department with a six-hour history of persistent localized pain over the epigastric area that radiated to his back and was associated with vomiting. A computed tomography scan with multiplanar reformation revealed pancreatitis and collapse of the duodenal loop that was deviated upward by a hematoma. Pancreatitis-induced IDH was diagnosed and conservative treatment was initiated. On the fourth day of his hospital stay, the patient developed unbearable abdominal pain associated with symptoms of small bowel obstruction. During laparotomy, the hematoma was evacuated and gastrojejunostomy was performed to relieve the duodenal obstruction. Pancreatitis-induced IDH is a rare condition causing gastrointestinal obstruction and should be differentiated from other conditions that result in retroperitoneal hematoma.
Abdominal Pain ; Adult ; Duodenal Obstruction ; Duodenum ; Emergencies ; Endoscopy ; Gastric Bypass ; Hematoma ; Humans ; Intestinal Obstruction ; Laparotomy ; Length of Stay ; Pancreas ; Pancreatitis ; Vomiting

The posttraumatic complications of jaw fractures related to jaw function and facial deformity include nonunion, malunion, malocclusion, temporomandibular joint dysfunction and facial asymmetry. This report presents cases referred to our department for revision of malunion and malocclusion following inadequate reduction of jaw fractures. Three patients with posttraumatic malocclusions caused by malunion were treated with a LeFort I osteotomy in one case and re-fracture in two cases. All of the patients exhibited stable results without further complications (e.g., malunion or malocclusion). Accurate preoperative diagnosis and proper anatomical reduction of the fracture segments are essential to preventing post-surgical malunion and malocclusion.
Congenital Abnormalities ; Diagnosis ; Facial Asymmetry ; Humans ; Jaw ; Jaw Fractures ; Malocclusion* ; Osteotomy ; Temporomandibular Joint

OBJECTIVES: Recently, comparison of drug responses on gene expression has been a major approach to identifying the functional similarity of drugs. Previous studies have mostly focused on a single feature, the expression differences of individual genes. We provide a more robust and accurate method to compare the functional similarity of drugs by diversifying the features of comparison in gene expression and considering the sample dependent variations. METHODS: For differentially expressed gene measurement, we modified the conventional t-test to normalize variations in diverse experimental conditions of individual samples. To extract significant differentially co-expressed gene modules, we searched maximal cliques among the co-expressed gene network. Finally, we calculated a combined similarity score by averaging the two scaled scores from the above two measurements. RESULTS: This method shows significant performance improvement in comparison to other approaches in the test with Connectivity Map data. In the test to find the drugs based on their own expression profiles with leave-one-out cross validation, the proposed method showed an area under the curve (AUC) score of 0.99, which is much higher than scores obtained with previous methods, ranging from 0.71 to 0.93. In the drug networks, we could find well clustered drugs having the same target proteins and novel relations among drugs implying the possibility of drug repurposing. CONCLUSIONS: Inclusion of the features of a co-expressed module provides more implications to infer drug action. We propose that this method be used to find collaborative cellular mechanisms associated with drug action and to simply identify drugs having similar responses.
Biomarkers, Pharmacological ; Drug Repositioning ; Gene Expression Regulation ; Gene Expression* ; Gene Regulatory Networks ; Methods ; Transcriptome*

Methamphetamine (MA) is an extremely addictive central nervous system stimulant. MA abuse has increased during the past three decades in Korea because it is cheap relatively and easily produced. Acute toxicity can occur via nasal insufflation, intravenous administration and ingestion of liquid formulations. The clinical manifestations include hypertension, tachycardia, hyperthermia, an altered mentality and seizure. Severe complications can occur such as pulmonary edema, rhabdomyolysis, disseminated intravascular coagulation and multiple organ dysfunction syndrome. This case report describes a previously healthy 40-year-old woman who presented to an emergency department with complaints of hyperthermia, an altered mentality and vomiting. This patient was diagnosed as acute MA intoxication by urine toxicology screening, and she showed a variety of clinical manifestations and complications. Physicians should suspect MA intoxication if a patient shows an unknown fever, an altered mentality and hypertension, and they should carefully manage these patients in the ICU.
Administration, Intravenous ; Adult ; Central Nervous System ; Disseminated Intravascular Coagulation ; Eating ; Emergencies ; Female ; Fever ; Humans ; Hypertension ; Insufflation ; Korea ; Mass Screening ; Methamphetamine ; Multiple Organ Failure ; Pulmonary Edema ; Quadriplegia ; Rhabdomyolysis ; Seizures ; Tachycardia ; Toxicology ; Vomiting

Delayed splenic rupture is a rare complication of blunt abdominal trauma in which the time interval from injury to splenic rupture is > 48 hours. The diagnosis can be challenging if the history of trauma is remote, or initially missed, because symptoms may present subtly and without classic historical associations. We report a case of delayed rupture of the spleen from remote, minor trauma that required an emergency splenectomy.
Abdominal Injuries ; Emergencies ; Rupture ; Spleen ; Splenectomy ; Splenic Rupture