Standardized Sweat Chloride Analysis for the Diagnosis of Cystic Fibrosis in Korea / 대한진단검사의학회지

BACKGROUND: Cystic fibrosis is a chronic progressive autosomal recessive disorder caused by the CFTR gene mutations. It is quite common in Caucasians, but very rare in Asians. Sweat chloride test is known to be a screening test for the cystic fibrosis due to the fact that electrolyte levels in sweat are elevated in patients. In this study, sweat chloride levels in Korean population were measured and analyzed by using standardized pilocarpine iontophoresis sweat chloride test. METHODS: The sweat chloride test was performed in 47 patients referred to Yondong Severance Hospital from August, 2001 to April, 2007 and 41 healthy volunteers. The sweat chloride tests were conducted according to the CLSI C34-A2 guideline using pilocarpine iontophoresis method, and the chloride concentrations in sweat were measured by mercurimetric titration. RESULTS: Four patients showed sweat chloride concentrations higher than 60 mmol/L. Reference interval was calculated as 1.4-44.5 mmol/L by analysis of the results of healthy volunteers (n=41). Four patients who exhibited high sweat chloride levels, had characteristic clinical features of cystic fibrosis and their diagnoses were confirmed either by repeated sweat chloride test or genetic analysis. CONCLUSIONS: Standardized sweat chloride test can be utilized as a useful diagnostic tool for cystic fibrosis in Koreans. In cases of sweat chloride levels higher than 40 mmol/L, the test should be repeated for the possible diagnosis of cystic fibrosis. All the confirmed Korean cases of cystic fibrosis showed sweat chloride level above 60 mmol/L.

Aesthetic Breast Surgery in Korean

Breast surgery is fully justified only in aesthetic perspectives. Although there are largely two areas in breast surgery, reconstruction and aesthetic, they frequently overlap each other. A reconstructed breast, therefore, should be aesthetically as natural as possible and similar to the contralateral one, even if this means reproducing some little defects. The authors present our experience of recent 6 years in breast reconstruction with an aesthetic eye and an artistic touch, and illustrate personal tips and technical adjustments: use of anatomical prostheses, autologous tissue transfer, axillary fold and nipple-areola complex reconstruction, including augmentation mammaplasty(implant, fat injection) and reduction mammaplasty. In 6 years, 178 cases of breast surgery were performed. Breast reconstruction(post-mastectomy, post burn deformity, congenital deformity etc) was 106 cases. There were 83 TRAM free flap cases, 10 Latissimus dorsi free flap cases. 7 cases using tissue expander and breast implant and 6 were fat graft cases. Number of breast augmentation was 35(25 submuscular, 10 subglandular). Breast reduction procedure was performed in 37 cases(13 periareolar, 8 vertical, 14 inferior pyramidal and 2 free nipple graft technique). The factors characterizing aesthetic results are profiles of breast(projection, inframammary fold location, superficial evenness, and ptosis), symmetry, axillary fold, areola, and nipple. In every procedure, we take account above factors, and results were satisfactory both surgically and aesthetically.