The very rare D--/D-- phenotype lacks C, c, E, e antigens with strong expression of the D antigen. A 31-year-old woman delivered her second baby, 3.6 kg girl at 38+4 weeks' gestation through repeat-Cesarean section. Her parents were not consanguineous. She had one artificial abortion, one Cesarean section with red blood cell transfusion and two spontaneous abortions. Her red cells were typed as O, D+C-c-E-e- and did not react with anti-Hr(o) (Rh 17). Her serum reacted with all of the screening cells and identification panel cells with strength of (++)~(+++). The baby was mildly jaundiced 12 hours after delivery. At 1 day after delivery, total bilirubin was 17.7 mg/dL, and direct and indirect antiglobulin tests were both positive. Phototherapy was immediately given for the baby but jaundice and anemia were worsened. Twenty six milliliter of the mother's whole blood was given twice to the baby after plasma depletion and leukocyte reduction. The baby showed improvement of jaundice and anemia, and discharged at hospital day 14. As far as we know, this is the third reported case of hemolytic disease of the newborn occurred in the D--/D-- mother with anti-Hr(o) in Korea, and the first case that was neither fatal nor treated with intensive medical care.
Abortion, Spontaneous ; Adult ; Anemia ; Bilirubin ; Cesarean Section ; Coombs Test ; Erythrocyte Transfusion ; Female ; Hepatitis B e Antigens ; Humans ; Infant, Newborn* ; Jaundice ; Korea ; Leukocytes ; Mass Screening ; Mothers ; Parents ; Phenotype* ; Phototherapy ; Plasma ; Pregnancy

BACKGROUND: We evaluated whether the unilateral spinal anesthesia using a 26-gauge Quincke needle provides more adequate or hemodynamically stable spinal anesthesia than the conventional spinal anesthesia in orthopedic patients. METHODS: Fifty-eight ASA 1 or 2 patients aged from 18 to 65 years undergoing unilateral lower limb surgery were included. All patients were placed in the lateral position with the side to be operated on dependent and received a 8 mg 0.5% hyperbaric bupivacaine through a 26-gauge Quincke spinal needle for 80 seconds. Local anesthetic was injected with the needle orifice turned toward the dependent side, then the immediate supine position (conventional group, n = 34), or the lateral position (unilateral group, n = 24) was maintained for 15 minutes. Hemodynamic variables, as well as loss of cold, pinprick sensation and motor block on both sides were recorded. RESULTS: All the 23 patients in the unilateral group had adequate spinal anesthesia, whereas 6 out of 34 patients of the conventional group (17.6%) had inadequate to failed spinal anesthesia (P < 0.05). There were significant differences in the degree of motor block on the dependent side of lower extremities between the two groups. Motor block of grade 0 to 1 on the dependent side were 23.5% and 0% in the conventional and unilateral group, respectively (P < 0.05). Unilateral sympathetic or sensory block were not observed in the unilateral group. No differences in blood pressure, heart rate changes were observed between the two groups. CONCLUSIONS: The present study does demonstrate clinically relevant advantages of a lateral position for 15 minutes, either in terms of adequacy of spinal anesthesia or differential motor block using a 26-gauge Quincke spinal needle in orthopedic patients.
Anesthesia, Spinal* ; Blood Pressure ; Bupivacaine ; Heart Rate ; Hemodynamics ; Humans ; Lower Extremity ; Needles* ; Orthopedics ; Sensation ; Supine Position

Paraffinoma induces many unexpected complications such as tissue necrosis, granuloma formation, hypersensitivity, embolism and even carcinoma. The treatment modality is known to be primary repair, flap surgery, skin graft, radiotherapy and high frequency current treatment after the excision of the lesion. Although these methods can remove the paraffinoma and resurface penile shaft, various complications such as skin tension after surgery, hypertrophic scars, difficulty of erection, and deficiency of bulkiness are frequently occurred. Groin flap is the proper method for the patients who want simultaneously soft tissue reconstruction and augmentation of penis. A 32 year-old male patient who visited our clinic had firm mass, abscess, skin necrosis, and dyspareunia after the injection of paraffin into penis 3 months ago. Reconstruction was executed using right side of the groin flap after the radical resection of the whole tissues ruined by infections and infiltration of paraffin. The penile bulkiness, erectile function and duration of erection was all satisfactory. The follow-up period was 7 months after the surgery and no specific complication was developed. Groin flap is the satisfactory method to enhance penile bulkiness as well as resurface the lesion.
Abscess ; Adult ; Cicatrix, Hypertrophic ; Dermatologic Surgical Procedures ; Dyspareunia ; Embolism ; Female ; Follow-Up Studies ; Granuloma ; Groin* ; Humans ; Hypersensitivity ; Male ; Necrosis ; Paraffin ; Penis ; Radiotherapy ; Skin ; Transplants

Cis-AB (A2B3) is a rare genotype resulting from the inheritance of both A and B genes on one chromosome. Among possible genotypes of cis-AB, in individuals with O/cis AB and A1/cis-AB, the B antigen is usually weakly expressed. Study on a blood sample from a 13-year-old Korean girl showed a discrepancy between red blood cell and serum typing. The blood type was identified as AweakB on the red cell test, while weak anti-B was detected in the serum. Cis-AB (A2B3) was suspected, however, known blood types of her father and mother were A and O, respectively. In the repeated test, the propositus was typed as group A2B3. Her mother was typed as normal group O. Her father was typed as group A1 in cell typing, but in his serum, anti-B was very weakly detected. In the saliva test and adsorption and elution studies of the father, B substance was not detected. Finally, ABO genotyping was performed and ABO genotypes of the patient, mother and father were cisAB/O, O/O and cisAB/A1, respectively. This was the first reported case of A1/cisAB with phenotype A1. ABO genotyping technique will resolve problems encountered in association with unusual phenotype expression of cis-AB trait.
Adolescent ; Adsorption ; Child* ; Erythrocytes ; Fathers* ; Female ; Genotype ; Genotyping Techniques ; Humans ; Mothers* ; Phenotype* ; Saliva ; Wills

Capsaicin is the principal pungent component of Capsicum fruits. Biological effect of capsaicin is various and complicated. This study was undertaken to define the effect of topical application of capsaicin on flap survival in rat. Fourty Sprague Dawley rats were divided into four groups. With ten rats in each group, group A was only flap elevation group, as the control, group B was applied 0.025% capsaicin ointment for 7 days after skin flap elevation, group C was applied 0.075% capsaicin ointment for 7 days after skin flap elevation, group D was elevated two skin flap and one flap was control, the other flap was applied 0.075% capsaicin ointment for 7 days. Group A demonstrate 46.2+ 2.5% flap survival rate. Group B demonstrate 48.8+/-7.8% of flap survival rate, group C demonstrate 53.3+/-7.0% of flap survival rate. Control flap on group D demonstrate 43.5+/-3.5% of flap survival rate, 0.075% capsaicin applied flap demonstrate 52.9+/-7.2% of flap survival rate. Compared to the control group, increase in survival rate in group B was not statistically significant. The mean flap survival rate in group C was significantly increased than control group (p < 0.05). Compared to the control flap in group D, 0.075% capsaicin applied flap showed significantly higher flap survival rate. Based upon this data, local application of 0.075% capsaicin ointment demonstrate significantly increased value of survival area and survival rate on skin flap in rat (p < 0.05). And further studies may be needed for the evaluation of correct action mechanisms of capsaicin.
Animals ; Capsaicin* ; Capsicum ; Fruit ; Rats ; Rats, Sprague-Dawley ; Skin ; Survival Rate

From an aesthetic surgical point of view, rhinoplasty is one of most important field. The nose of asian is characterized by thin and weak nasal septal cartilage, wide and small alar cartilage, bulbous nasal tip due to excessive fibrous tissue and thick skin. Conventional rhinoplasty is not enough to get a satisfactory result. In order to produce optimal nasal shape, it is extremely important to augment the tip along with nasal dorsum in most of the patients. From March of 1997 to June of 1999, total 162 patient underwent open rhinoplasty with various nasal implants. Surgical approach was done through the transcolumella incision and alar rim incision. The nasal dorsum was augmented with silicone implant, and columella shape was controlled by 0.85-mm thickness porous high-density polyethylene sheet(Medpor). Porous high-density polyethylene sheet was 4mm width and was placed between the medial crura. The nasal tip was corrected by Polytetrafluoroethylene(Gore-Tex) implant. Reverse pyramidal shaped onlay graft of Polytetrafluoroethylene(Gore-Tex"") implant was not palpable on nasal tip skin. We obtained harmonious nasal shape and high patient satisfaction. There was two infection and one exposure of Polytetra- fluoroethylene(Gore-Tex) implant, but there was no other major complications. We believe that this method is stable, reliable, predictable, valuable technique for rhinoplasty, but we think that further follow up and study are needed.
Asian Continental Ancestry Group ; Cartilage ; Follow-Up Studies ; Humans ; Inlays ; Nose ; Patient Satisfaction ; Polyethylene ; Polytetrafluoroethylene ; Rhinoplasty* ; Silicones ; Skin ; Transplants

Many people want to receive facial rejuvenation with surgical treatment, but the post operative result is not always satisfying following classic soft tissue surgery. The reasons for dissatisfaction are many. We were particularly interested in the skeletal disharmony which is frequent in orientals. Since many orientals have flat and quadrangular facial contours, they often don't obtain the harmony of the facial skeleton and soft tissue despite successful surgery. So, to correct facial contour, mandibular angle contouring can be performed at the time of face lift. Seven patients had mandibular angle resection performed during facial rhytidectomy from October of 1996 to October of 1998 at Kangbuk Samsung Hospital, and they were followed from 4 months to 24 months. At the time of face lift, we tried the retromandibular approach for mandibular angle resection when it was indicated, instead of the intraoral approach which does not leave a noticeable scar and does not have the risk of facial nerve injury. Because of a restricted operative field, the intraoral approach has the disadvantages of a long operation time and a high risk of complications. The retromandibular approach with rhytidectomy incision showed neither noticeable scar nor developed a facial nerve injury. In conclusion, we found that mandibular angle contouring by retromandibular approach is easy and the result is more normal with a shorter recovery time. There were no complications and aesthetic results were quite satisfactory.
Cicatrix ; Facial Nerve Injuries ; Humans ; Rejuvenation ; Rhytidoplasty* ; Skeleton

BACKGROUND: A and B transferase are glycosyltransferase that transfer N-acetylgalactosamine and D-galactose to H antigen, respectively and lead to the expression of A and B phenotypes in ABO blood group system. Reduced or no activities of serum A and B transferase were observed in some A and B subgroup individuals. Determining the activities of serum A and B transferase can be useful in discriminating rare A and B subgroups. MATERIALS AND METHODS: ABO typing, saliva test, adsorption elution test and serum transferase assay were performed on samples from 12 individuals showing ABO discrepancy or weakened cell typing reactions which were referred to the Seoul National University Hospital to confirm their ABO blood types. Serum transferase activity was assayed by determining the ability of serum to convert group O RBCs into A or B cells. RESULTS: Determination of serum ABO transferase activity was useful in the identification of Ael (3 cases), B3 (2 cases), Bm (1 case), Am (1 case), Bx (1 case), O with weakened anti-A or anti-B (3 cases), and A without anti-B due to hypogammaglobulinemia (1 case). CONCLUSION: Determining serum A and B glycosyltransferase activity was proven to be a simple and useful tool for the classification of several ABO subgroups.
ABO Blood-Group System ; Adsorption ; Agammaglobulinemia ; B-Lymphocytes ; Classification* ; Galactose ; Phenotype ; Saliva ; Seoul ; Transferases

BACKGROUND: A and B transferase are glycosyltransferase that transfer N-acetylgalactosamine and D- galactose to H antigen, respectively and lead to the expression of A and B phenotypes in ABO blood group system. Reduced or no activities of serum A and B transferase were observed in some A and B subgroup individuals. Determining the activities of serum A and B transferase can be useful in discriminating rare A and B subgroups. MATERIALS AND METHODS: ABO typing, saliva test, adsorption elution test and serum transferase assay were performed on samples from 12 individuals showing ABO discrepancy or weakened cell typing reactions which were referred to the Seoul National University Hospital to confirm their ABO blood types. Serum transferase activity was assayed by determining the ability of serum to convert group 0 RBCs into A or B cells. RESULTS: Determination of serum ABO transferase activity was useful in the identification of Ael (3 cases), B. (2 cases), Bm (1 case), Am (1 case), Bx (1 case), 0 with weakened anti-A or anti-B (3 cases), and A without anti-B due to hypogammaglobulinemia (1 case). CONCLUSION: Determining serum A and B glycosyltransferase activity was proven to be a simple and useful tool for the classification of several ABO subgroups.(Korean J Blood Transfusion 10(1): 27-33, 1999)
ABO Blood-Group System ; Adsorption ; Agammaglobulinemia ; B-Lymphocytes ; Blood Transfusion ; Classification* ; Galactose ; Phenotype ; Saliva ; Seoul ; Transferases

BACKGROUND: Onychomycosis, especially toenail onychomycosis has become one of the common fungal infection and has historically been regarded as a cosmetic rather than medical problem by many patients, even by physicians. Recently, however, there are several reports that this is a refractory disease which may cause a deleterious effect on patients' quality of life (QOL). OBJECTIVE: The purpose of this study was to investigate the impact of toenail onychomycosis on QOL in Korea and to assess the changes of QOL after treatment. METHODS: Total 1004 patients with toenail onychomycosis which was confirmed by clinical findings and KOH preparation were enrolled at 47 dermatologic centers in Korea, and interviewed with standardized QOL questionnaire before and after systemic antifungal treatment. Responses to the questionnaire were scored by f-point scale (0~4) and averaged, and were analyzed for 5 dimensions of emotional impact, social impact, symptom and functional impact, patients' views concerning treatment, and relationship with doctor. RESULTS: 1. Before and after treatment, the most serious impact was emotional dimension showing 1.90 and 1.30 in average score (AS), and social (AS: 1.14 and 0.83) and symptom and functional impact (AS: 1.05 and 0.92) was also affected. 2. In female rather than male, statistically more significant impact on patients' QOL was observed in all dimensions. 3. After treatment, 3 of 5 dimensions were improved significantly - emotional dimension (AS: from 1.90 to 1.30), social dimension (AS: from 1.14 to 0.83), patients' view concerning treatment(AS: from 1.34 to 1.02) 4. The degree of patients' satisfaction at the therapeutic effect was very high - 62.4% (immediately after. treatment) and 65.8% (9 months after initiation of treatment) of patients answered excellent or good. CONCLUSION: This study confirms that toenail onychomycosis has significant Impact on the overall QOL of patients. Also the effect of antifungal therapy on patients' QOL were satisfactory. Therefore, both doctor and patient should pay more attention to the treatment of onychomycosis.
Female ; Humans ; Korea* ; Male ; Nails* ; Onychomycosis* ; Quality of Life* ; Social Change ; Surveys and Questionnaires