Down syndrome is the most common autosomal chromosomal abnormality characterized by mental and growth retardation, and by various typical features including prominent epicanthal fold, oblique palpebral fissure, flat nasal bridge, short and broad hand, wide toe interspace, etc. The overall incidence has been shown to be 1:800 deliveries, increasing with advancing maternal age. However, twin cases are extremely rare, and thus far only 500 cases were reported worldwide. We have recently observed 10-day-old male monozygotic twins with Down syndrome, born to a mother of 30 years of age with one normal child. Both have VSD confirmed by 2D-echocardiography, in addition to various typical features. Cytogenetic examination revealed that both have karyotypes of 47, XY, +21. This is the first report in Korea as the authors are aware of.
Child ; Chromosome Aberrations ; Cytogenetics ; Down Syndrome ; Hand ; Humans ; Incidence ; Incontinentia Pigmenti* ; Karyotype ; Korea ; Male ; Maternal Age ; Mothers ; Toes ; Twins, Monozygotic

This study was conducted to investigate the prevalence rate of low back pain during past one year and its risk factors. The data were collected form 1,384 manafacturing factory workers from March 1, 1992 to August 30, 1992. The results obtained were as follows: 1. The one year prevalence rate of low back pain by manufacturing company was 38.4% in textile manufacturing, 35.2% in concrete reenforcement, 31.0% in cigarette and 26.1% in metal part(P<0.01). 2. In textile manufacturing, age groups with high prevalence rate of low back pain were 30's (36.8%) and 40's (36.4%) (P<0.05), and the one year prevalence rates of low back pain by marital state were 34.9% in married workers and 28.5% in unmarried(P=0.0511). 3. The one year prevelence rates of low back pain by job part are 35.0% in labor workers and 26.1% in clerical(P<0.05), and by work hour per day it was 34.9% in 9 or more and 28.9% in 8 or less (P<0.05). 4. The highest group of low back pain by work posture was 43.5% in 'lifting and transfering materials', and it by fitness of chair was 56.0% in uncomfortable one, and by height of working board was 33.6% in low working one. 5. In logistic regression analysis, significant determinants with low back pain were marital state (P<0.05), work hour per day(P<0.05), height of working board(P<0.01), and work posture(P<0.01).
Humans ; Logistic Models ; Low Back Pain* ; Posture ; Prevalence ; Risk Factors* ; Textiles ; Tobacco Products

No abstract available.
Bandages*

Non-Hodgkin's lymphoma rarely originates from bone, and even more infrequently from a vertebral body. Lymphoblastic lymphoma is a rare type of non-Hodgkin's lymphoma, and results from an abnormality in adaptive immune cells. A 27-year-old man presented with a two-month history of night sweats, weight loss, and severe back pain. Radiological studies demonstrated an osteolytic lesion compressing the subarachnoid space at the T11 level. Posterolateral fusion with decompression was performed and a pathologic examination confirmed lymphoblastic lymphoma of the B-cell precursor type. To our knowledge, this is the first report of solitary lymphoblastic lymphoma from B-cell precursors in of the thoracic spine. Herein, we discuss the presenting symptoms and the management of this rare case of lymphoblastic lymphoma.
B-Lymphocytes ; Back Pain ; Decompression ; Lymphoma, Non-Hodgkin ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Spine ; Subarachnoid Space ; Sweat ; Weight Loss

Conventional medical therapies have not been very successful in treating adults with refractory septic shock. The effects of direct hemoperfusion using polymyxin B and veno-arterial extracorporeal membrane oxygenation (ECMO) for refractory septic shock remain uncertain. A 66-year-old man was admitted to the emergency department and suffered from sepsis-induced hemodynamic collapse. For hemodynamic improvement, we performed direct hemoperfusion using polymyxin B. Computed tomography scan of this patient revealed emphysematous pyelonephritis (EPN), for which he underwent emergent nephrectomy with veno-arterial ECMO support. To the best of our knowledge, this is the first report of successful treatment of EPN with refractory septic shock using polymyxin B hemoperfusion and nephrectomy under the support of ECMO.
Adult ; Aged ; Emergency Service, Hospital ; Endotoxins ; Extracorporeal Membrane Oxygenation* ; Hemodynamics ; Hemoperfusion ; Humans ; Nephrectomy* ; Polymyxin B ; Pyelonephritis ; Shock, Septic*

PURPOSE: The aim of this study was to confirm if Laser-treated implants were soaked in 0.9% NaCl solution for 2 weeks could increase the surface hydrophilicity, and the Remoal Torque of each implant that inserted in rabbit tibia for initial healing period of 10 days. MATERIALS AND METHODS: Twenty machined titanium surface screws were produced with a diameter 3 mm, length 8 mm. Ten screws had their surface treated with a laser only (laser treated group), and the other 10 were soaked in saline for 2 weeks after surface treatment with a laser (laser treated + saline soaked group). Implants were inserted in rabbit tibia (ten adult New Zealand white rabbits), and the RTQ of each implant was measured after 10 days. The wettability among implants was compared by measuring the contact angle. Surface composition and surface topography were analyzed. RESULTS: After 10 days, the laser treat + soaking group implants had a significantly higher mean RTQ than the laser treated implants (P = .002, < .05). There were no significant morphological differences between groups, and no remarkable differences were found between the two groups in the SEM analysis. CONCLUSION: Saline soaking implants is expected to produce excellent RTQ and surface analysis results.
Adult ; Humans ; Hydrophobic and Hydrophilic Interactions ; New Zealand ; Tibia ; Titanium ; Torque ; Wettability

PURPOSE: The purpose of this study was to compare the removal torques of a chemically modified SLActive implant and a blasted, laser-treated (BLT) implant, which were soaked in saline for 2 weeks after their surface modifications. The removal torques of the two implants were measured 4 weeks after their implantation into the bone defect area in rabbit tibias with concentrated growth factor (CGF) application. MATERIALS AND METHODS: To make artificial bone defects in the cortical layers of both tibias, an 8-mm diameter trephine bur was used. Then, prepared CGF was applied to the bony defect of the left tibia, and the bony defect of the right tibia was left unfilled. Four weeks later, the surgical sites of 16 rabbits were re-exposed. For 8 rabbits, the SLActive implants (Straumann, Switzerland) were inserted in the left tibia, and the BLT implants (CSM implant, Daegu, Korea) were inserted in the right tibia. For other rabbits, the BLT implants were inserted in the left tibia, and the SLActive implants were inserted in the right. Four weeks afger the insertion, torque removal was measured from 4 rabbits exterminated via CO2 inhalation. RESULTS: No significant difference was observed between removal torques of the BLT implant and the SLActive implant (P>.05). CONCLUSION: It was found that BLT surface modification exhibited excellent osseointegration. In addition, CGF application did not affect the insertion and removal torque of the implants.
Daegu ; Inhalation ; Osseointegration ; Rabbits ; Tibia* ; Titanium* ; Torque*

In 17 myotonic cases (16 of myotonic muscular dystrophy and 1 of congenital myotonia), 13 cases showed significant decremental responses on RNS study. The decremental responses had the tendency of more prominence on faster stimulating rate, and in the proximal limb muscles. This result suggests that the RNS test is useful but not specific for the disorder of neuromuscular junction.
Extremities ; Humans ; Muscles ; Muscular Dystrophies ; Neuromuscular Junction

BACKGROUND/AIMS: Superficial esophageal squamous cell carcinoma (SESCC) is being increasingly detected during screening endoscopy. Endoscopic submucosal dissection (ESD) allows for en bloc and histologically complete resection of lesions. This study assessed the technical feasibility and long-term outcomes of ESD for SESCCs. METHODS: Between January 2005 and August 2012, 27 patients with 28 SESCCs underwent ESD at Pusan National University Hospital. The en bloc and pathologically complete resection rates, complication (perforation and bleeding) rate, incidence of esophageal stricture after ESD, and overall and disease-specific survival rates were evaluated. RESULTS: The en bloc and pathologically complete resection rates were 93% and 83%, respectively. No significant bleeding occurred, and perforation with mediastinal emphysema was observed in two patients (7%). Post-ESD stricture occurred in two patients (7%) who had mucosal defects involving more than three-fourths of the esophageal circumference. During a mean follow-up of 23 months, local tumor recurrence was seen in two of four lesions with pathologically incomplete resection; one was treated by re-ESD, and the other was treated by surgical esophagectomy. The 5-year overall and disease-specific survival rates were 84% and 100%, respectively. CONCLUSIONS: ESD seems to be a feasible, effective curative treatment for SESCCs. All patients should be closely followed after ESD.
Aged ; Carcinoma in Situ/pathology/*surgery ; Carcinoma, Squamous Cell/pathology/*surgery ; Cohort Studies ; Disease-Free Survival ; Dissection ; Esophageal Neoplasms/pathology/*surgery ; Esophageal Perforation ; Esophageal Stenosis ; Esophagoscopy ; Female ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Mucous Membrane/pathology/*surgery ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local/*pathology ; Operative Time ; *Postoperative Complications ; Postoperative Hemorrhage ; Retrospective Studies ; Treatment Outcome ; Tumor Burden

OBJECTIVES: The causes of benign esophageal stricture were postoperative, corrosive, peptic and after esophageal sclerotheraphy, etc. The patients mainly suffered from dysphagia and insufficient nutrition. Recently, balloon and bougie dilatation were introduced to these patients. This study was performed to evaluate the effectiveness and safety of both procedures in different types of strictures METHODS: 32 patients who presented dysphagia enrolled from March 1996 to August 1997 who visited Pusan National University Hospital. Balloon dilatation was performed on 22 patients and bougie on 10 patients. RESULTS: 1) The causes of stricture were postoperative (18 cases), corrosive (10 cases), hypertensive LES (2 cases), peptic (1 case) and web (1 case). 2) Overall cure rate was 59% in bougie dilatation and 40% in balloon dilatation 3) The cure rate of postopertive stricture was 59% which is significantly higher than that of corrosive stricture (27%), and cure rate of hypertensive LES, peptic stricture and web was 100%. 4) The cure rate of corrosive stricture was significantly higher on bougie dilatation than balloon dilatation. 5) The cure rate of postoperative stricture was similiar between balloon and bougie dilatation 6) The length of stricture was inversly affected on cure rate of both dilatation procedures. 7) Overall complication was 5.6% and similiar between balloon and bougie dilatation. CONCLUSIONS: These results suggested that bougie dilatation was recommended on corrosive stricture and balloon dilatation on postopertive stricture
Busan ; Constriction, Pathologic ; Deglutition Disorders ; Dilatation* ; Esophageal Stenosis* ; Humans