Virus Isolation from the First Patient with SARS-CoV-2 in Korea

Novel coronavirus (SARS-CoV-2) is found to cause a large outbreak started from Wuhan since December 2019 in China and SARS-CoV-2 infections have been reported with epidemiological linkage to China in 25 countries until now. We isolated SARS-CoV-2 from the oropharyngeal sample obtained from the patient with the first laboratory-confirmed SARS-CoV-2 infection in Korea. Cytopathic effects of SARS-CoV-2 in the Vero cell cultures were confluent 3 days after the first blind passage of the sample. Coronavirus was confirmed with spherical particle having a fringe reminiscent of crown on transmission electron microscopy. Phylogenetic analyses of whole genome sequences showed that it clustered with other SARS-CoV-2 reported from Wuhan.

Virus Isolation from the First Patient with SARS-CoV-2 in Korea

Novel coronavirus (SARS-CoV-2) is found to cause a large outbreak started from Wuhan since December 2019 in China and SARS-CoV-2 infections have been reported with epidemiological linkage to China in 25 countries until now. We isolated SARS-CoV-2 from the oropharyngeal sample obtained from the patient with the first laboratory-confirmed SARS-CoV-2 infection in Korea. Cytopathic effects of SARS-CoV-2 in the Vero cell cultures were confluent 3 days after the first blind passage of the sample. Coronavirus was confirmed with spherical particle having a fringe reminiscent of crown on transmission electron microscopy. Phylogenetic analyses of whole genome sequences showed that it clustered with other SARS-CoV-2 reported from Wuhan.

Virus Isolation from the First Patient with SARS-CoV-2 in Korea

Novel coronavirus (SARS-CoV-2) is found to cause a large outbreak started from Wuhan since December 2019 in China and SARS-CoV-2 infections have been reported with epidemiological linkage to China in 25 countries until now. We isolated SARS-CoV-2 from the oropharyngeal sample obtained from the patient with the first laboratory-confirmed SARS-CoV-2 infection in Korea. Cytopathic effects of SARS-CoV-2 in the Vero cell cultures were confluent 3 days after the first blind passage of the sample. Coronavirus was confirmed with spherical particle having a fringe reminiscent of crown on transmission electron microscopy. Phylogenetic analyses of whole genome sequences showed that it clustered with other SARS-CoV-2 reported from Wuhan.

Weight analysis of mastectomy specimens and abdominal flaps used for breast reconstruction in Koreans

BACKGROUND: Slim patients or those with large breasts may be ineligible for breast reconstruction with an abdominal flap, as the volume of the flap may be insufficient. This study aimed to establish that abdominal tissue–based breast reconstruction can be well suited for Korean patients, despite their thin body habitus. METHODS: A total of 252 patients who underwent postmastectomy breast reconstruction with an abdominal flap from October 2006 to May 2013 were retrospectively reviewed. The patients' age and body mass index were analyzed, and a correlation analysis was performed between the weight of the mastectomy specimen and that of the initial abdominal flap. RESULTS: The average weights of the mastectomy specimen and initial abdominal flap were 451.03 g and 644.95 g, respectively. The ratio of the weight of the mastectomy specimen to that of the initial flap was 0.71±0.23. There was a strong positive linear relationship between the weight of the mastectomy specimen and that of the initial flap (Pearson correlation coefficient, 0.728). Thirty nulliparous patients had a final-to-initial flap weight ratio of 0.66±0.11. The 25 patients who underwent a contralateral procedure had a ratio of 0.96±0.30. The adjusted ratio of the final flap weight to the initial flap weight was 0.66±0.12. CONCLUSIONS: Breast weight had a strong positive relationship with abdominal flap weight in Koreans. Abdominal flaps provided sufficient soft tissue for breast reconstruction in most Korean patients, including nulliparous patients. However, when the mastectomy weight is estimated to be >700 g, a contralateral reduction procedure may be considered.

Outcomes of Take-Back Operations in Breast Reconstruction with Free Lower Abdominal Flaps

BACKGROUND: Microvascular complications after free-flap breast reconstructions are potentially devastating problems that can increase patient morbidity and lead to flap loss. To date, no comprehensive study has examined the rates of salvage and the methods of microvascular revision in breast reconstruction. We reviewed the treatment of microvascular complications of free-flap breast reconstruction procedures over a seven-year period. METHODS: A retrospective review of all patients who underwent microvascular breast reconstruction at our institution between April 2006 and December 2013 was conducted. Based on their surgical records, all patients who required emergency re-exploration were identified, the rate of flap salvage was determined, the factors associated with flap salvage were evaluated, and the causes and methods of revision were reviewed. RESULTS: During the review period, 605 breast reconstruction procedures with a free lower abdominal flap were performed. Seventeen of these flaps were compromised by microvascular complications, and three flaps were lost. The overall salvage rate was 82.35%. No significant differences between the salvaged group and the failed group were observed with regard to age, BMI, axillary dissection, number of anastomotic arteries and veins, recipient vessel types, or use of the superficial inferior epigastric vein in the revision operation. Successful salvage of the flap was associated with a shorter time period between recognizing the signs of flap compromise and the take-back operation. CONCLUSIONS: The salvage rate of compromised lower abdominal flaps was high enough to warrant attempting re-exploration. Immediate intervention after the onset of flap compromise signs is as important as vigilant postoperative monitoring.

Is Obstructive Sleep Apnea a Risk Factor of Subclinical White Matter Damages?

BACKGROUND: Obstructive sleep apnea (OSA) has been reported to increase risk of ischemic stroke. This study was performed to investigate the prevalence and relationship of subclinical white matter damages (SD) in patients with OSA. METHODS: All subjects (n = 54) had brain MRI and nocturnal polysomnogram (PSG). SD are defined by nonsymptomatic lacunar infarcts > 3 mm or periventricular white matter changes (PVWC). We analyzed the difference between OSA patients with and without SD (SD and non-SD groups), and also with and without PVWC. Using apnea-hypopnea index (AHI), we classified OSA into mild (515). RESULTS: SD group (n = 31) showed significantly increased apnea-hypopnea index (AHI), apnea index (AI) and oxygen desaturation index (ODI) compared to non-SD (n = 23). Among the 37 patients without lacunar infarctions, 14 showed PVWC while the other 23 did not have any lesions. Compared to non-SD group, SD group showed increased AHI and ODI, and decreased lowest SaO2 (p < 0.05). Similarly, AHI and ODI were higher and the lowest SaO2 was lower in patients with PVWC than without PVWC (p < 0.05). Moderate to severe OSA group showed more frequent subclinical or periventricular white matter changes than mild group (p < 0.05). CONCLUSIONS: Severity of OSA showed a positive correlation with the occurrence of subclinical white matter damages. OSA may cause subclinical white matter damages.

Association between Elevated Homocysteine Concentration and Alzheimer's Disease, Vascular Dementia, and Mild Cognitive Impairment

BACKGROUND: Alzheimer's disease (AD) and vascular dementia (VaD) are the common causes of dementia. Mild cognitive impairment (MCI) refers to the clinical condition between normal aging and dementia. Recent studies have appraised the possibility that homocysteine might play a role in the pathogeneses not only of VaD but also of AD. The purpose of this study was to investigate the relations of AD, VaD and MCI with homocysteine. METHODS: The study population consisted of 712 consecutive subjects, 629 of whom were eligible for analyses. The plasma total homocysteine was measured in 409 non-demented elderly control subjects, 102 MCI, and 118 demented patients with a clin-ical diagnosis of AD (n=68) or VaD (n=50). RESULTS: Homocysteine was significantly increased in patients with AD (13.9+/-4.1 ?mol/L; p<0.001), VaD (13.6+/-5.8 ?mol/L; p<0.01), and MCI (13.3+/-5.6 ?mol/L; p<0.001) as compared to controls (11.3+/-4.6 ?mol/L). Subjects in the highest homocysteine tertile had significantly higher adjusted odds ratio (AORs) for AD (AOR, 7.42; 95%CI, 3.01-18.30), VaD (AOR, 3.50; 95%CI, 1.51-8.11), and MCI (AOR, 2.40; 95%CI, 1.24-4.63). Only in the subjects with AD, the AOR was significantly higher in the middle homocysteine tertile than in the lowest tertile (AOR, 2.60; 95%CI, 1.11-6.11). In addition, homocysteine was correlated with folate, vitamin B12, age, depression, and MMSE scores, but not with schooling years. CONCLUSIONS: In this study, significantly elevated homocysteine levels were found in patients with AD, VaD, and MCI. These findings suggest that hyperhomocysteinemia might be a risk factor for cognitive decline in the elderly.

Association between MTHFR C677T Polymorphism and Ischemic Stroke

BACKGROUND: Hyperhomocysteinemia is an independent risk factor for ischemic stroke. Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism has been known to result in reduced MTHFR enzyme activity, and induced hyperhomocysteinemia. Recently, a significant association with ischemic stroke was identified for the homozygous T allele of the MTHFR polymorphism by meta-analysis. This current study was undertaken to determine whether MTHFR C677T polymorphism was associated with ischemic stroke in the Korean population. METHODS: We enrolled 1292 patients with ischemic stroke and 457 healthy individuals and measured their fasting plasma homocysteine levels and analyzed the C677T polymorphisms in the MTHFR gene. RESULTS: The prevalence of the homozygous mutation was significantly higher in ischemic stroke patients (23.9%) than in controls (13.8%; por=11.80 micro mol/L), moderate (8.80 to 11.79 micro mol/L), and low (<8.80 micro mol/L) groups, the AOR was significantly greater in subjects with the high group compared with the low group (AOR, 3.61; 95%CI, 2.63 to 4.95). The AOR and 95% confidence intervals was 1.74 (1.27 to 2.37) for the TT genotype in patients with ischemic stroke compared to controls. CONCLUSIONS: We found that the MTHFR C677T polymorphism is an independent risk factor for ischemic stroke in Koreans, and our findings may have the predictive value of ischemic stroke by analyzing genetic defects.

Diagnosis of Neuropathies for CMT1A and HNPP Using the Microsatellite Multiplex PCR System

BACKGROUND: Tandem duplication of chromosome 17p11.2-p12 including peripheral myelin protein 22 (PMP22) gene is the most frequent cause of Charcot-Marie-Tooth 1A (CMT1A). Patients carrying one extra copy of PMP22 develop CMT1A, whereas the deletion of the 17p11.2-p12 region causes hereditary neuropathy with the liability to pressure palsies (HNPP). In the present study, we established the genotyping methods of 6 microsatellite markers (D17S921, D17S9B, D17S9A, D17S4A, D17S918 and D17S122) within the 17p11.2-p12 regions by the hexaplex PCR for the genetic diagnosis of CMT1A duplication and HNPP deletion. METHODS: We established polymorphic behavior and genotyping methods of 6 microsatellite markers (D17S921, D17S9B, D17S9A, D17S4A, D17S918 and D17S122) within the duplication region. The 6 markers were amplified by hexaplex PCR reaction and analyzed by an automatic sequencing analyzer and genotyper program. RESULTS: The genotype distributions of all markers were not significantly deviated from the Hardy-Weinberg equilibrium (P>or=0.05). When comparing the control group and CMT1A, HNPP patients group by the distribution of allele, there is no significant difference in the 5 locus except in the 1 locus (D17S921) among HNPP patients. The specificity was more than 99.9%. The sensitivity of each CMT1 and HNPP was 56.3% (40/71 pedigrees) and 72.1% (31/43 HNPP pedigrees), respectively. CONCLUSIONS: The error rate for the system may be less than 0.001. According to this study, it is possible to have rapid and exact genetic diagnosis of both CMT1A and HNPP, which may be helpful for the development of personalized therapy according to genetic defects.