BACKGROUND: Vibrio vulnificus(V. vulnificus) is a pathogenic, marine, halophilic, Gram negative bacillus which causes fulminant infection in humans through skin wounds. or the ingestion of raw seafoods or Most cases are reported sporadically in summer in the south-western coastal area of Korea. OBJECTIVE: We studied the distribution of V. vulnificus in sea water, fishes, shellfish and sea mud from May to October in 1996 and the relationship between regional distribution and environmental factors. METHODS: We collected the sea water, sea mud, fishes and seafoods from May to October in Kunsan, Daechun, Moochangpo, Puan, Youngkwang and cultured it in Thiosulfate-Citrate-Bile salt-Sucrose(TCBS) agar, Cellobiose-Polymyxin B-Colistin(CPC) agar, and Sodium dodecyl sulfate- Polymyxin B-Sucrose(SPS) agar. At the same time we investigated environmental factors such as temperature, pH, salinity, turbidity, dissolved oxygen(DO), NO3 of sea water. RESULTS: Twelve strains(2.17%) of V. vulnificus were isolated from a total of 552 specimens. The V. vulnificas isolation rate from sea mud was higher than in sea water and shellfish. Areas where V. vulnipcus was isolated were Kunsan and Daechun. It was isolated during June, July and August. The Isolation rate was higher with CPC agar than TCBS, SPS agar. When V.vulnificus was isolated at Kunsan, the environmental factors of sea water noted were as follows: temperature, 25.3C; turbidity, 121Formazine turbidity units; salinity, 12.2%; DO, 7.3mg/L; pH, 7.37 and NO3, 1.18mg/L. CONCLUSION: CPC agar is the best medium of the three above used for the isolation of V. vulnificus from environmental samples. V. vulnificus was highly isolated in the Kunsan area because of the high water temperature and turbidity, low salinity and weak alkali state of the sea water in comparision with other areas. We suggest that high temperature and turbidity, low salinity and weak alkalinity of sea water are very important environmental factors for the growth of V. vulnificus.
Agar ; Alkalies ; Bacillus ; Eating ; Fishes ; Humans ; Hydrogen-Ion Concentration ; Jeollabuk-do ; Korea* ; Polymyxins ; Salinity ; Seafood ; Seawater* ; Shellfish ; Skin ; Sodium ; Vibrio vulnificus* ; Vibrio* ; Water ; Wounds and Injuries

No abstract available.

Atypical cutaneous fibrous histiocytoma (ACFH) is not well known and only a small number of cases have been reported. Characteristically, ACFH is found on the trunk and limbs of middle-aged women. Although considerable cellular atypia may be present, it occurs focally, the remainder of the tumor representing more classical cutaneous fibrous histiocytoma. A 37-year-old woman presented with a solitary brownish firm nodule on her right forearm. No other abnormalities were found in her personal or family history. Clinically, the tumor simulated a benign fibrous histiocytoma. Histologic examination revealed a poorly delineated intradermal tumor with the usual appearance of benign cutaneous fibrous histiocytoma, but a variable pro-portion of cells in the tumor were scattered atypical cells or bizarre multinucleated giant cells. We report upon a rare case of ACFH.
Adult ; Extremities ; Female ; Forearm ; Giant Cells ; Histiocytoma, Benign Fibrous* ; Humans

PURPOSE: To assess the outcome of tunneled central venous catheter placement via the right internal jugular vein. MATERIALS AND METHODS: Between June 2001 and May 2002, 670 consecutive Hickman catheters were placed in 654 patients via the right internal jugular vein. The procedural complications arising and follow-up data obtained from May to July 2002 were evaluated. RESULTS: The technical success rate for catheter placement was 99.9% (669/670). Procedural complications were limited to eight cases (1.2%), including three pneumothoraces, one early migration of the catheter, one clinically unimportant air embolism, one catheter injury, one catheter kinking and one primary malpositioning in the azygos vein. Catheter dwelling time ranged from 1 to 407 (mean 107.1) days. During the follow-up period, 416 catheters were removed for various reasons: treatment had ended (n=334), patients declined treatment or their drug regimen was changed (n=16), late complications arose (n=53), or other circumstances intervened (n=13). Late complications included 44 cases of catheter-related infection (6.6%), five of catheter migration (0.7%), two of catheter occlusion (0.3%), one of thrombophlebitis (0.15%), and one of catheter-related right atrial thrombosis (0.15%). Only one instance of symptomatic venous thrombosis or stenosis was noted , namely the one case of thrombophlebitis. CONCLUSION: Because the incidence of subsequent symptomatic venous thrombosis or stenosis is lower, the preferred route for tunneled central venous catheter placement is the right internal jugular vein.
Azygos Vein ; Catheter-Related Infections ; Catheters* ; Central Venous Catheters ; Constriction, Pathologic ; Embolism, Air ; Follow-Up Studies ; Humans ; Incidence ; Jugular Veins* ; Thrombophlebitis ; Thrombosis ; Venous Thrombosis

OBJECTIVE: The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. MATERIALS AND METHODS: Eleven consecutive patients (age range, 2–79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated. Technical success, treatment efficacy (defined as disappearance of jejunal varix on follow-up CT), and clinical success were analyzed. Primary stent patency rate was plotted using the Kaplan-Meier method. RESULTS: All patients underwent hepatobiliary-pancreatic cancer surgery except two children with liver transplantation for biliary atresia. Portal occlusion was caused by benign postoperative change (n = 6) and local tumor recurrence (n = 5). Variceal bleeding occurred at 27 months (4 to 72 months) and portal stenting was performed at 37 months (4 to 121 months), on average, postoperatively. Technical success, treatment efficacy, and clinical success rates were 90.9, 100, and 81.8%, respectively. The primary patency rate of portal stent was 88.9% during the mean follow-up period of 9 months. Neither procedure-related complication nor mortality occurred. CONCLUSION: Interventional portal stenting is an effective treatment for delayed jejunal variceal bleeding due to portal occlusion after hepatobiliary-pancreatic surgery.
Biliary Atresia ; Child ; Esophageal and Gastric Varices ; Follow-Up Studies ; Hemorrhage* ; Humans ; Liver Transplantation ; Male ; Methods ; Mortality ; Portal Vein* ; Recurrence ; Stents* ; Treatment Outcome ; Varicose Veins*

OBJECTIVE: 1) To evaluate the mid-term efficacy and safety of a permanent nitinol inferior vena cava (IVC) filter; 2) to evaluate filter effectiveness, filter stability and caval occlusion. MATERIALS AND METHODS: A prospective evaluation of the TrapEase IVC filter was performed on 42 patients (eight men, 34 women) ranging in age from 22 to 78 years (mean age 66 years). All patients were ill with a high risk of pulmonary embolism (PE). Indications for filter placement were: 1) deep vein thrombosis with recurrent thromboembolism; 2) and/or free-floating thrombus with contraindication to anticoagulation; and 3) complications in achieving adequate anticoagulation. Follow-up evaluations (mean: 15.4 months, range: 2 to 28 months) were performed at 6- and 12-month intervals after the procedure and included clinical histories, chart reviews, plain film, Doppler ultrasounds, and contrasted abdominal CT scans. RESULTS: In follow-up evaluations, the data analysis revealed no cases of symptomatic PE. There were no cases of filter migration, insertion site thrombosis, filter fracture, or vessel wall perforation. During the study, there was one case of filter thrombosis; early symptomatic thrombosis that was successfully treated in the hospital. Of the 42 subjects, eight died. These deaths were not related to the filter device or the implantation procedure, but to the underlying disease. CONCLUSION: This study demonstrates that the TrapEase permanent IVC filter is a safe and an effective device with low complication rates and is best used in patients with thromboembolic disease with a high risk of PE.
Adult ; Aged ; *Alloys ; Equipment Design ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Embolism/*prevention & control ; Safety ; Thromboembolism/complications ; Treatment Outcome ; *Vena Cava Filters ; Vena Cava, Inferior ; Venous Thrombosis/*complications

OBJECTIVE: To present our experience with subintimal angioplasty (SA) for treatment of chronic lower limb ischemia (CLLI) and to assess its effectiveness and durability. MATERIALS AND METHODS: From April 2003 through June 2005, we treated 40 limbs in 36 patients with CLLI by SA. Balloons with or without secondary stent placement appropriate in size to the occluded arteries were used for SA of all lesions, except for iliac lesions where primary stent placement was done. The patients were followed for 1-23 months by clinical examination and color Doppler ultrasound and/or CT angiography. Technical results and outcomes were retrospectively evaluated. The presence of a steep learning curve for performance of SA was also evaluated. Primary and secondary patencies were determined using Kaplan-Meier analysis. RESULTS: Technical success was achieved in 32 (80%) of 40 limbs. There was no statistical difference between technical success rates of 75% (18/24) during the first year and 88% (14/16) thereafter. There were four complications (10%) in 40 procedures; two arterial perforations, one pseudoaneurysm at the puncture site, and one delayed hematoma at the SA site. Excluding initial technical failures, the primary patency rates at six and 12 months were 68% and 55%, respectively. Secondary patency rates at six and 12 months were 73% and 59%, respectively. CONCLUSION: Subintimal angioplasty can be accomplished with a high technical success rate. It should be attempted in patients with CLLI as an alternative to more extended surgery, or when surgical treatment is not recommended due to comorbidity or an unfavorable disease pattern.
Tunica Intima/pathology ; Stents ; Middle Aged ; Male ; Leg/*blood supply ; Ischemia/epidemiology/*surgery ; Intermittent Claudication/surgery ; Humans ; Female ; Feasibility Studies ; Constriction, Pathologic ; Comorbidity ; Chronic Disease ; Angioplasty, Balloon/*methods ; Aged, 80 and over ; Aged

OBJECTIVE: To report our initial experience on the technical feasibility and safety for hemostasis of a new pneumatic compression device in patients undergoing femoral arteriotomy. MATERIALS AND METHODS: This study included 40 consecutive patients in whom hemostasis after transfemoral catheterization was readered by using a pneumatic compression device consisting of an inflatable bulb-containing main body and four pieces of supplementary tape. Medical records were retrospectively reviewed for outcomes and complications of hemostasis. Technical success was defined as achieving immediate hemostasis 10 minutes after applying the device over the arteriotomy sites, and clinical success was defined as the ability to ambulate after 4 hours of bed rest without any complications. RESULTS: Technical and clinical success was achieved in 38 (95%) and 37 (93%) patients, respectively. In two patients, hemostasis was achieved after conversion to manual compression. One patient required sand bag placement after removal of the device to control minimal oozing of blood. No patients had late complications. CONCLUSION: The new pneumatic compression device provides effective and safe hemostasis after transfemoral catheterization in selected patient populations.
Carcinoma, Hepatocellular/therapy ; Chemoembolization, Therapeutic/methods ; Feasibility Studies ; Female ; Femoral Artery/*surgery ; Hemostatic Techniques/*instrumentation ; Humans ; Liver Neoplasms/therapy ; Male ; Middle Aged ; *Punctures ; Retrospective Studies ; Treatment Outcome

The distribution of glycogen, polysaccharide, mucopolysaccharide, lipid and nucleic acid has been studied in Echinorhynchus gadi(Acanthocephala). The results were summarized as follows: Glycogen and polysaccharide was demonstrated by Bauer PAS reaction technique and was found in fertilization membrane in ovum, central nuclear mass in acanthor and lemnisci, hypodermis in cystacanth. Mucopolysaccharide was demonstrated by Mowry alcian blue staining technique and was found in outer membrane, fibrillar coat, fertilization membrane and inner membrane in acanthocephalan ova. Lipid was demonstrated by Smith Nile blue stain and Lison Sudan black B staining technique and was found roughly parallel to that of polysaccharide. Nucleic acid was demonstrated by Rosenbeck Feulgen reaction, Taft methylgreen-pyronin stain and Diengdoh acridine orange staining technique and found in central nuclear mass in acanthor, also, was found in lemnisci, proboscis and hypodermis in cystacanth.
parasitology-Acanthocephala ; histochemistry ; Echinorhynchus gadi ; glycogen ; mucopolysaccharide ; lipid ; nucleic acid

Congenital hypohidrotic ectodermal dysplasia is a rare genodermatosis. It is characterized by hypohidrosis hypotrichosis, dental hypoplasia and characterstic facial features, which reflect a wide constellation of developmental defec of tissue from the ectoderm. We have encountered three cases of congenital hypohidrotic ectodermal dysplasia in a 28-year-old female, her new-born baby, and a 10-month-old boy with a family history. All of the three patients had hypohidrosis, hypotrichosis, defective dentition, and characterstic facial features, which were characterstic features of this disorder. In addition, they showed dry skin, sparse and thin hairs. Histopathologic findings of previous cases revealed no eccrine gland structure in the dermis with routine and immunohistochemical stainning such cytokeratin and filaggrin. We report three typical cases of hypohidrotic ectodermal dysplasia with the review of literature.
Adult ; Dentition ; Dermis ; Eccrine Glands ; Ectoderm ; Ectodermal Dysplasia 1, Anhidrotic* ; Female ; Hair ; Humans ; Hypohidrosis ; Hypotrichosis ; Infant ; Keratins ; Male ; Skin