In a study of the fungal diversity on Ulleung Island in Korea, three novel strains of Penicillium were isolated. Different sites on Ulleung Island were selected for collecting endophytic fungi, and three endophytic fungal strains showed unique morphological characteristics. DNA sequence of the internal transcribed spacer, β-tubulin, calmodulin, and RNA polymerase II second largest subunit regions of the strains were analyzed and they showed unique taxonomic position from the other species of Penicillium section Sclerotiora. The new strains were named Penicillium ulleungdoense sp. nov. As the novel endophytic Penicillium taxa were discovered in a unique environment, the data could be meaningful for understanding the geographical distribution of Ascomycetes on Ulleung Island.

OBJECTIVE: Protocols for posterior circulation ischemic stroke have not been established by randomized clinical trials. Mechanical endovascular thrombectomy (MET) devices are evolving, and many of these devices already developed or in development are suitable for posterior circulation MET. MATERIALS AND METHODS: We investigated the medical records of patients who underwent MET for posterior circulation ischemic stroke from January 2012 to August 2016. Fifteen patients were included. MET was performed in patients with or without injected intravenous tissue plasminogen activator. MET was considered in patients with a National Institute of Health Stroke Scale score of 4 or more, older than 18 years, with definite occlusion of the basilar artery or posterior cerebral artery (PCA), and who arrived at the hospital within 24 hours from onset. RESULTS: The direct catheter aspiration technique was used in five cases, and the stent retrieval technique was used in seven cases. The stent retrieval technique with the direct aspiration technique was used in three cases. Recanalization failed in two cases. Basilar occlusion without PCA involvement is the only effective factor of successful recanalization (p = 0.03). Successful recanalization (p = 0.005) and the presence of a posterior communicating artery (p = 0.005) affected the good outcome at discharge. CONCLUSION: An early diagnosis and active MET may improve the patient outcome. MET may help recanalization and good flow restoration and the potential for a good outcome.
Arteries ; Basilar Artery ; Catheters ; Early Diagnosis ; Humans ; Medical Records ; Passive Cutaneous Anaphylaxis ; Posterior Cerebral Artery* ; Stents ; Stroke ; Thrombectomy* ; Tissue Plasminogen Activator

OBJECTIVE: Immediate contralateral epidural hematoma (EDH) and traumatic intracerebral hematoma (T-ICH) after craniectomy for traumatic subdural hematoma (SDH) are rare but devastating post-operative complications. Their clinical features and outcomes are not well studied. In this report, we present the clinical features and outcomes of immediate contralateral acute hematoma cases requiring a second operation. METHODS: This study includes 10 cases of immediate contralateral EDH and T-ICH following bilateral craniectomy for the evacuation of traumatic SDH and contralateral hematoma between 2004 and 2015. Their medical records and radiographic findings were reviewed and analyzed retrospectively. RESULTS: Ten of the 528 patients (1.89%) who underwent craniectomy for the evacuation of traumatic SDH developed post-operative EDH (n=5), T-ICH (n=5). The trauma was caused by a fall in 5 patients and by a traffic accident in 5 patients. The patients who suffered trauma due to pedestrian accidents died. Seven patients had a low admission Glasgow Coma Scale (GCS; GCS≤8) score in the preoperative state (average admission GCS, 7.7; average discharge GCS, 3.4; and average discharge Glasgow Outcome Scale, 2.0). Severe intra-operative brain swelling was noted in all patients, while skull fracture was observed in 8. Multiple associated injuries and medication for heart disease were characteristic of patients who died. CONCLUSION: The prognosis of delayed contralateral hematoma was very poor. Multiple associated injuries, past medical history and traffic accidents, especially pedestrians were seemed to be associated with higher mortality rates. Finally, contralateral skull fractures can indicate high risk of delayed contralateral acute intracranial hematoma.
Accidents, Traffic ; Brain Edema ; Decompression* ; Decompressive Craniectomy ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Heart Diseases ; Hematoma* ; Hematoma, Subdural ; Hematoma, Subdural, Acute* ; Humans ; Medical Records ; Mortality ; Pedestrians ; Prognosis ; Retrospective Studies ; Skull Fractures

The major problems of revision surgery for recurrent lumbar disc herniation (LDH) include limited visualization due to adhesion of scar tissue, restricted handling of neural structures in insufficient visual field, and consequent higher risk of a dura tear and nerve root injury. Therefore, clear differentiation of neural structures from scar tissue and adhesiolysis performed while preserving stability of the remnant facet joint would lower the risk of complications and unnecessary fusion surgery. Biportal endoscopic spine surgery has several merits including sufficient magnification with panoramic view under very high illumination and free handling of instruments normally impossible in open spine surgery. It is supposed to be a highly recommendable alternative technique that is safer and less destructive than the other surgical options for recurrent LDH.
Adult ; Diskectomy/*methods ; Endoscopy/*methods ; Humans ; Intervertebral Disc Displacement/*surgery ; Lumbar Vertebrae/surgery ; Lumbosacral Region/*surgery ; Male ; Minimally Invasive Surgical Procedures/*methods ; Patient Positioning

PURPOSE: The aim of this study was to analyze the outcomes of immediate primary repair (IPR) compared with delayed repair (DR) after initial suprapubic cystostomy. MATERIALS AND METHODS: We reviewed the records of 60 patients with bulbous urethral disruption after blunt trauma from February 2001 to March 2011. Seventeen patients who presented in an acute injury state underwent IPR; 43 patients underwent DR after the initial suprapubic cystostomy. None of the patients had undergone previous urethral manipulation. We compared the outcomes, including stricture, impotence, and incontinence, between the two management approaches. We also measured the time to spontaneous voiding, the duration of suprapubic diversion, and the number of days spent in the hospital. RESULTS: The median follow-up was 20.5 months (range, 13 to 59 months; mean, 23.3 months). Among 17 patients in the IPR group, strictures developed in 2 patients (11.7%), and among 53 patients in the DR group, strictures developed in 8 patients (18.6%, p=0.709). The incidences of impotence and incontinence were similar in both groups (17.6% and 0% in the IPR group vs. 27.9% and 4.6% in the DR group, p=0.520 and 1.000, respectively). The time to spontaneous voiding and the duration of suprapubic diversion were significantly shorter in the IPR group (average 27.3 and 33.4 days, respectively) than in the DR group (average 191.6 and 198.1 days, respectively; p<0.001 and <0.001). CONCLUSIONS: IPR may provide comparable outcomes to DR and allow for shorter times to spontaneous voiding and reduce the duration of suprapubic diversion.
Constriction, Pathologic ; Cystostomy ; Erectile Dysfunction ; Follow-Up Studies ; Humans ; Incidence ; Male ; Urethra ; Urethral Stricture ; Urologic Surgical Procedures

Castleman's disease is a rare disorder and thought to occur as a result of chronic antigenic stimulation due to an unknown infectious or inflammatory etiology. It has a heterogenous course: the symptoms persist in some cases for many years and have a progressive fatal course in others. Renal dysfunction in the form of nephrotic syndrome is quite a rare occurrence. Secondary amyloidosis due to Castleman's disease has also been reported in a few case reports. A 46-year-old female who had asymptomatic abdominal lymphadenopathy was diagnosed with Castleman's disease-plasma cell type in our hospital in 2006. Three years after diagnosis, she developed chronic diarrhea, weight loss, anemia and nephrotic range proteinuria. The etiology of symptom was found to be secondary amyloidosis based on renal and gastrointestinal biopsies. She was discharged with steroid therapy. Unfortunately, she had a progressive fatal course. One month after the treatment, she developed thrombocytopenia and died due to cerebral hemorrhage.
Amyloidosis ; Anemia ; Biopsy ; Diarrhea ; Female ; Giant Lymph Node Hyperplasia ; Humans ; Kidney ; Lymphatic Diseases ; Middle Aged ; Nephrotic Syndrome ; Plasma Cells ; Proteinuria ; Thrombocytopenia ; Weight Loss

Since oxidative stresses are involved in gastroenteritis and diarrhea, we investigated antioxidative and antidiarrheal activities of persimmon flesh extract (PFE) and persimmon calyx extract (PCE) in vitro and in vivo, respectively. PCE significantly scavenged 1,1-diphenyl-2-picrylhydrazyl hydrate and 2,2'-azinobis (3-ethylbenzthiazoline-6-sulfonic acid) from 500 microg/mL, although PFE was ineffective. In addition, PFE and PCE exhibited strong nitric oxide-scavenging effects from 1 microg/mL, in which PCE was superior to ascorbic acid (50 microM). Furthermore, PFE and PCE significantly inhibited FeCl3-induced lipid peroxidation as well as Cu2+/H2O2-induced protein oxidation from 10 microg/mL. In vivo charcoal-propulsion assay, in contrast to a negligible effect of PFE, treatment with PCE (160-500 mg/kg) markedly inhibited intestinal motility. The results indicate that extracts of persimmon, especially PCE, possess antioxidative, antiinflammatory and antidiarrheal activities. Therefore, it is suggested that persimmon extracts could be used for the relief of gastroenteritis and diarrhea.
Ascorbic Acid ; Biphenyl Compounds ; Diarrhea ; Diospyros ; Gastroenteritis ; Gastrointestinal Motility ; Lipid Peroxidation ; Oxidative Stress ; Picrates

Various venous approaches are available for chemoport insertion. The subclavian vein and jugular vein are commonly used. The cephalic vein has several advantages for chemoport insertion. The authors introduce chemoport insertion using cephalic vein. Operation methods were as follows: patient was placed in supine position. Under local anesthesia, the incision was made in the infraclavicular portion, dissection was performed along the deltopectoral groove and the cephalic vein was identified and isolated. Dissection was performed between the subcutaneous fat layer and the muscle layer to make space for chemoport placement. The cephalic vein was incised and the catheter was introduced to the cephalic vein directly and examined by fluoroscopy. Chemoport insertion using cephalic vein is a useful method of chemoport insertion.
Anesthesia, Local ; Catheters ; Fluoroscopy ; Humans ; Jugular Veins ; Muscles ; Subclavian Vein ; Subcutaneous Fat ; Supine Position ; Veins

A 34 year-old excavator driver was found dead at stone quarry in Cheongwon, North Chungcheong Province, with a severely burnt mobile phone in his shirt pocket and with his chest bruised and ribs fractured. An emergency physician examined him and said that high pressure from an explosion damaged his lungs and heart, leading to his death. So, a number of Korean and foreign newspapers reported that phone battery explosion killed the man. Autopsy showed that the deceased had fractures all over the chest and lacerations of the heart and the lungs. The damages seemed too extensive to be caused by a single mobile phone explosion. Lithium-ion polymer batteries used in mobile phones can catch fire by external forces but they hardly explode like a bomb. We recommended police to reinvestigate the scene and co-worker. So, police reinvestigated the accident scene and the co-worker. The co-worker told police that he hit the deceased while reversing his drill rig at a stone quarry. The incident reminds of us that our postmortem investigation system must be revised.
Autopsy ; Bombs ; Cellular Phone ; Emergencies ; Explosions ; Fires ; Heart ; Humans ; Lacerations ; Lung ; Mandrillus ; Periodicals ; Police ; Polymers ; Ribs ; Thorax

BACKGROUND/AIMS: Recently, living donor liver transplantation (LDLT) has been frequently performed in Korea because of the limited availability of a cadaveric donor (CD). We evaluated the clinical features of patients with biliary complications after liver transplantation and we compared the incidence of biliary complications according to the type of donor and the anastomotic type of the biliary tract. METHODS: Between May 1996 and July 2004, 300 patients (CDLT 102/LDLT 198) underwent liver transplantation at Samsung Medical Center. The patients who experienced biliary complications during the follow-up period were enrolled to the study and we retrospectively reviewed their cases. RESULTS: Sixty-seven cases (23%) of biliary complications were noticed in 53 patients (18%). The complications consisted of 20 cases (7%) of bile leakage, 38 cases (13%) of biliary strictures, 7 cases (2%) of biliary stones, and 2 cases (1%) of biliary stenosis due to other cause. There was no significant difference on the incidence of complications between CDLT (15/102; 14.7%) and LDLT (38/198; 19.2%) (p=0.42). In addition, there was no significant difference between choledocho-choledochostomy (43/237; 18.1%) and hepatico-jejunostomy (10/ 63; 15.9%)(p=0.85) CONCLUSIONS: The incidence rate of biliary complication after liver transplantation was 23%, and there was no difference according to the type of donor and the anastomotic type of biliary tract.
Adult* ; Bile ; Biliary Tract ; Cadaver ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Liver Transplantation* ; Liver* ; Living Donors ; Retrospective Studies ; Tissue Donors