BACKGROUND: Major vascular injuries can jeopardize a patient's life or imperil limb survival. We performed this study to establish an optimal management plan for vascular injuries. MATERIAL AND METHOD: We retrospectively reviewed 26 cases of vascular injury that were treated at Pusan National University Hospital from May, 1999 to September, 2004. The age and sex distribution, the locations and causes of vascular injury, the diagnostic tools, the degree of injuries, clinical manifestations, the treatment modality and complications were reviewed. RESULT:The mean age was 39.5 years (range: 12~86) and the male to female ratio was 22:4. The injuries were in 6 descending thoracic aortas, 4 femoral arteries, 4 popliteal veins and so on. The causes of injury were iatrogenic in 8 cases, traffic accident in 7, stab injury in 6 and industrial accident in 5. The most commonly used diagnostic tools were CT and angiography. The degrees of arterial injury were pseudoaneurysm in 10 cases, partial severance in 5, complete severance in 3 and thrombosis in 3. The degrees of venous injury were partial severance in 6 cases, complete severance in 2 and arteriovenous fistula in 2. The clinical manifestations were absence of pulse in 8 cases, coldness in 7, chest pain in 6, swelling in 5, bleeding in 5 and so on. The most frequently used type of revascularization was graft interposition in 11 cases. Two arteriovenous fistulae were repaired by endovascular procedure. There was one case of mortality due to multi-organ failure after hemorrhagic shock. There were three major amputations, and two of them were due to delayed diagnosis and treatment. CONCLUSION: A system for the early diagnosis and treatment is essential for improving limb salvage and patient mortality. As a consequence of the widespread application of endovascular procedures, the incidence of iatrogenic injuries has recently increased. Educating physicians is important for the prevention of iatrogenic injury. Easy communication and cooperation for earlier involvement of a vascular surgeon is also an important factor.
Accidents, Occupational ; Accidents, Traffic ; Amputation ; Aneurysm, False ; Angiography ; Aorta, Thoracic ; Arteriovenous Fistula ; Busan ; Chest Pain ; Delayed Diagnosis ; Early Diagnosis ; Endovascular Procedures ; Extremities ; Female ; Femoral Artery ; Hemorrhage ; Humans ; Incidence ; Limb Salvage ; Male ; Mortality ; Popliteal Vein ; Retrospective Studies ; Sex Distribution ; Shock, Hemorrhagic ; Thrombosis ; Transplants ; Vascular System Injuries*

Background/Aims: Scrub typhus infection has been known to complicate cardiovascular diseases mainly attributing to high mortality. Genetic susceptibility loci for complicating cardiac diseases such as atrial fibrillation, heart failure, and ischemic heart disease identified by genomic study have been limited in scrub typhus infection. Therefore, we investigated the genetic novel variants predicting complicating cardiac diseases in patients with confirmed scrub typhus infection using whole genome sequencing. Methods: We performed a prospective study for eight consecutive patients with scrub typhus infection. During follow-up, six cases were clinically diagnosed with complicating cardiac diseases and two controls without complicating cardiac diseases. The whole genomes of the all patients were sequenced, and the individual sequence variants were compared between accordcase and control patients. Variant genotypes were compared and identified as a single nucleotide polymorphism (SNP) of the different genotype distributions between six cases and two controls. Results: The GG genotype in SNP (rs4977397) of solute carrier 24 family member 2 (SLC24A2) gene and non-TT genotype in SNP (rs2676750) of adenosine deaminase, RNA specific, B2 (ADARB2) gene were distinctively found in the case patients with complicated cardiac disease, compared with control patents in the scrub typhus infection. Conclusions We suggest that the SNPs of SLC24A2 and ADARB2 might be genetic surrogate markers for complicating cardiac diseases in the scrub typhus infection. Our study show that early detection based on individual sequence variants might be feasible to predict complicating cardiac diseases in patients with scrub typhus infection, if further studies with more participants confirm these findings.

The isolation of fetal cells from maternal circulation has the potential to allow relativelyself prenatal diagosis for all pregnant women. The present technology, however, has notreached the accuracy required for clinical diagnosis because of maternal cell contaminationSo we published a new method for enrichment of nRBC in a fetal cell isolation(1996).In this study, attempted to FISH analysis of nRBC which was isolated by our ownmethods. We evaluated the efficiency of FISH.As the results, we have successfully used FISH on enriched nRBC.We were able to identified 2 abnormal fetus which were confirmed by conventionalcytogenentic study as Down syndrome(Fig.1) and Klinefeltre syndrome(Fig.2). And thesensitivity and specificity for FISH was 86%(49/57) and 92.3%(36/39), respectively.According to our results, fetal cell analysis by FISH can be reliable used for prenatalaneuploidy diagnosis. However, the problems of enrichment of the fetal cell and FISH probeor condition should be over come before analyze.
Aneuploidy ; Diagnosis ; Erythroblasts* ; Female ; Fetus ; Fluorescence* ; Humans ; Pregnant Women ; Sensitivity and Specificity

Adult worms of Parvatrema spp. (Digenea: Gymnophallidae) were found in the intestines of 2 species of migratory birds, i.e., a great knot, Calidris tenuirostris, and 2 Mongolian plovers, Charadrius mongolus, in the coastal area of Gunsan-si, Jeollabuk-do in October 2009. The recovered Parvatrema worms were 79 in total number and composed of 2 species. The worms from a great knot were 289 micrometer in length with the oral and ventral sucker ratio of 2 : 1. They had a single vitellarium, and their intrauterine eggs were 25.0 x 17.5 micrometer in size. These findings were compatible with P. duboisi (Dollfus, 1923) Bartoli, 1974 (syn. P. timondavidi Bartoli, 1963). The worms recovered from the Mongolian plovers were smaller in length than P. duboisi and had 2 vitellaria. The oral and ventral sucker ratio was 2.5 : 1, and the eggs were 17.5 x 8.8 micrometer in size. These worms were assigned to be P. homoeotecnum James, 1964. This is the first report on the natural final hosts of Parvatrema spp. in Korea.
*Animal Migration ; Animals ; Bird Diseases/*parasitology ; Charadriiformes/*parasitology/physiology ; Trematoda/anatomy & histology/*isolation & purification ; Trematode Infections/parasitology/*veterinary

Macroglossia can create dental and skeletal instability after orthodontic treatment or orthognathic surgery for mandibular prognathism. In relevant literature, partial glossectomy is suggested for a good post-treatment prognosis. Most of the published partial glossectomy cases are two-staged surgery, because of concern about postoperative airway obstruction. As orthognathic surgical techniques and fixation method develop, however, concerns about postoperative airway obstruction have lessened. In this case, mandibular setback surgery and partial glossectomy were performed simultaneously, leading to stable recovery without any postoperative respiratory problems. After surgical technique to preserve the tongue tip, we achieved good outcomes without postoperative side effects of lingual hypoesthesia, pronunciation disorder and dyskinesia. We report this case with a literature review.
Airway Obstruction ; Dyskinesias ; Glossectomy* ; Hypesthesia ; Macroglossia ; Orthognathic Surgery* ; Prognathism* ; Prognosis ; Tongue

No abstract available.
Brain Neoplasms* ; Brain* ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Free Tissue Flaps*

Regardless of an appropriate radiation therapy administered to a patient with a brain tumor, clinical and radiological evidence of progression may still develop because of a recurrence of the tumor and/or radiation necrosis, or even rarely, a radiation induced neoplasm. The evaluation of tumor recurrence and radiation-induced necrosis presents a diagnostic challenge. A thirty eight year old woman was treated for a focal motor seizure on the right side of her face.with a fractionated external beam radiotherapy under the impression of cystic astrocytoma in the left frontoparietal region. After 6 months, she developed a headache, nausea and vomiting, dysphagia, and secondary generalized seizure. A follow-up brain MRI showed a high signal mass lesion in a T2 weighted image and a fluorodeoxyglucose PET revealed hypometabolism in the left frontoparietal lobe, suggesting radionecrosis. It was confirmed as radionecrosis with an expanding edema by open biopsy. We report a cerebral radiation necrosis mimicking recurrent brain tumor.
Astrocytoma ; Biopsy ; Brain ; Brain Neoplasms* ; Deglutition Disorders ; Edema ; Female ; Follow-Up Studies ; Headache ; Humans ; Magnetic Resonance Imaging ; Nausea ; Necrosis* ; Radiotherapy ; Recurrence ; Seizures ; Vomiting

Our earlier studies found a significant correlation between the activities of ranitidine N-oxidation catalyzed by hepatic flavin-containing monooxygenase (FMO) and the presence of mutations in exon 4 (E158K) and exon 7 (E308G) of the FMO3 gene in Korean volunteers. However, caffeine N-1 demethylation (which is also partially catalyzed by FMO) was not significantly correlated with these FMO3 mutations. In this study, we examined another common mutation (V257M) in exon 6 of FMO3 gene. The V257M variant, which is caused by a point mutation (G769A), was commonly observed (13.21% allele frequency) in our subjects (n=159). This point mutation causes a substitution of Val257 to Met257, with transformation of the secondary structure. The presence of this mutant allele correlated significantly with a reduction in caffeine N-1-demethylating activity, but was not correlated with the activity of N-oxidation of ranitidine. In a family study, the low FMO activity observed in a person heterozygous for a nonsense mutation in exon 4 (G148X) and heterozygous for missense mutation in exon 6 (V257M) of FMO3 was attributed to the mutations. Our results suggest that various point mutations in the coding regions of FMO3 may influence FMO3 activity according to the probe substrates of varying chemical structure that correlate with each mutation on the FMO3 gene.
Alleles ; Caffeine ; Clinical Coding ; Codon, Nonsense ; Exons ; Genotype ; Humans* ; Mutation, Missense ; Phenotype ; Point Mutation ; Ranitidine ; Substrate Specificity* ; Volunteers

The authors note that on pages 167 (Fig. 2A), 168 (Fig. 3A), and 169 (Fig. 4A), the figure label “RPF-001” should instead appear as “PRF-001.”