Abnormal offsprings from balanced translocation carriers usually inherit only one of the translocated products and are therefore partially trisomic for one chromosome and partially monosomic for another. Partial trisomy 1q usually demonstrates fetal growth restriction and anomalies of head, face, urogenital tract, heart, finger and toes with a wide range of characteristics and severities. It has been reported in a few individuals in the world and this is the first report of partial trisomy 1q in Korea. We present the case of recurrent partial trisomy 1q in maternal balanced translocation which was prenatally diagnosed by amniocentesis with fluorescence in situ hybridization(FISH) based on abnormal ultrasonographic findings and poor obstetric history.
Amniocentesis ; Fetal Development ; Fingers ; Fluorescence ; Head ; Heart ; Korea ; Prenatal Diagnosis ; Toes ; Trisomy*

INTRODUCTION: Identifying menton (Me) on posteroanterior cephalograms and three-dimensional (3D) cone-beam computed tomography (CBCT) images is difficult, because the midpoint of the symphyseal area is not identifiable after the mandibular symphysis fuses at an early age. The aim of this study was to evaluate the reliability of the identification of the genial tubercle (GT) in patients with mandibular asymmetry and to compare it with that of the traditional landmark, Me. METHODS: The samples comprised 20 CBCT images of adults with mandibular asymmetry. Two examiners performed the identifications and measurements. Me and GT were marked, and the anteroposterior, vertical, and transverse distances to the three reference planes were measured on 3D-reconstructed CBCT images. The intra- and inter-examiner reliability of landmark identification of Me and GT were assessed using the intraclass correlation coefficient (ICC) and Bland-Altman plots. RESULTS: The Me and GT landmarks showed excellent reliability (ICC ≥ 0.993) three-dimensionally. In the transverse evaluation, the ICC values of the GT (range, 0.997–0.999) tended to be slightly higher than those of Me (range, 0.993–0.996). In the Bland-Altman plots for the two separate assessments, Me showed a maximum error of 1.76 mm in the transverse direction, whereas the GT showed a maximum error of 0.96 mm in the 95% limit. CONCLUSIONS: Our results suggest that both Me and GT are clinically reliable and equally useful landmarks for the evaluation of mandibular asymmetry on CBCT images.
Adult ; Cone-Beam Computed Tomography ; Diagnosis* ; Humans ; Prospective Studies*

Immunoglobulin G4 (IgG4)-related disease (IgG4RD) is a relatively recently recognized entity that is histopathologically characterized by an extensive infiltration of lymphocytes and IgG4-positive plasma cells with dense fibrosis. IgG4RD is now known to affect any organ system, and a few cases of gastrointestinal lesions have also been reported. However, solitary IgG4RD of the stomach is still very rare. Furthermore, as it can mimic malignant conditions, it is important to recognize this disease to avoid unnecessary surgery. Herein, we present a case of IgG4RD presenting as an isolated subepithelial mass in the stomach.
Fibrosis ; Granuloma, Plasma Cell* ; Immunoglobulins* ; Lymphocytes ; Plasma Cells ; Stomach* ; Unnecessary Procedures

BACKGROUND: The development of new drugs or alternative therapies effective against methicillin-resistant Staphylococcus aureus (MRSA) is of great importance, and various natural anti-MRSA products are good candidates for combination therapies. We evaluated the antibacterial activities of a Phellinus baumii ethyl acetate extract (PBEAE) and its synergistic effects with beta-lactams against MRSA. METHODS: The broth microdilution method was used to determine the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of the PBEAE. The PBEAE synergistic effects were determined by evaluating the MICs of anti-staphylococcal antibiotic mixtures, with or without PBEAE. Anti-MRSA synergistic bactericidal effects of the PBEAE and beta-lactams were assessed by time-killing assay. An ELISA was used to determine the effect of the PBEAE on penicillin binding protein (PBP)2a production. RESULTS: The MICs and MBCs of PBEAE against MRSA were 256-512 and 1,024-2,048 microg/mL, respectively. The PBEAE significantly reduced MICs of all beta-lactams tested, including oxacillin, cefazolin, cefepime, and penicillin. However, the PBEAE had little or no effect on the activity of non-beta-lactams. Time-killing assays showed that the synergistic effects of two beta-lactams (oxacillin and cefazolin) with the PBEAE were bactericidal in nature (Deltalog10 colony forming unit/mL at 24 hr: 2.34-2.87 and 2.10-3.04, respectively). The PBEAE induced a dose-dependent decrease in PBP2a production by MRSA, suggesting that the inhibition of PBP2a production was a major synergistic mechanism between the beta-lactams and the PBEAE. CONCLUSIONS: PBEAE can enhance the efficacy of beta-lactams for combined therapy in patients infected with MRSA.
Acetates/chemistry ; Agaricales/*chemistry/metabolism ; Anti-Infective Agents/chemistry/*pharmacology ; Drug Synergism ; Enzyme-Linked Immunosorbent Assay ; Methicillin-Resistant Staphylococcus aureus/*drug effects/metabolism ; Microbial Sensitivity Tests ; Penicillin-Binding Proteins/analysis/metabolism ; Plant Extracts/chemistry/*pharmacology ; beta-Lactams/*pharmacology

PURPOSE: The well-known prognostic factors for breast cancer, such as axillary lymph node status, do not always account for the exact outcome. The developinent of other accurate prognostic factors would help in assessing high risk for the disease recurrence and death. Recently, there are reports that peritumoral lymphatic vessel invasion is a good prognostic factor to solid tumors in animal studies and clinical trials. This study was performed to estimate the significance of peritumoral lymphatic vessel invasion (PLVI) as a prognostic factor in breast cancer. Also, PLVI was compared with established clinicopathological prognostic factors and hormone receptors. MATERIALS AND METHODS: A group of patient was selected from the Department of Surgery, College of Medicine, Hallym University, which consists of 43 out of 96 patients who received curative operation from 1985 to 1993. Peritumoral lymphatic vessel invasion by tumor cells on H&E stain was considered PLVI positive. We classified 43 breast-cancer patients into 32 with negative PLVI and ll with positive PLVL. We estimated the correlation between the PLVI and other established prognostic factors. We also calculated survivals based on PLVI. RESULTS: The 4-year disease-free survival rate was 61.8+/-8.7%, and the 4-year overall survival rate was 73.0+/-8.0%. The receptor status of estrogen and of progesterone had significant impacts on survival (ER: p=0.0001, PR: p=0.0001). Also, metastasis status of lymph node had significant impacts on overall survival (p=0.0148). We found a significant correlation between PLVI and tumor size (p=0.004), estrogen receptor (p=0.002), progesterone receptor (p=0.006), but could not find any significant corelation between PLVI and menopausal status, histologic grade, nuclear grade, lymph node metastasis. PLVI status was corelated with disease free survival rate (p=0.01) and overall survival rate (p=0.01). CONCLUSION: The determination of PLVI in breast cancer tissue may be useful as a prognostic factor, but it is necessary to investigate the PLVI in a large number of patients before this conclusion can be stated with certainty.
Animals ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Estrogens ; Humans ; Lymph Nodes ; Lymphatic Vessels ; Neoplasm Metastasis ; Progesterone ; Receptors, Progesterone ; Recurrence ; Survival Rate

BACKGROUND: The aim of this study was to estimate the minimum effective volume (MEV) of 1.5% mepivacaine for ultrasound-guided supraclavicular block by placing the needle near the lower trunk of brachial plexus and multiple injections. METHODS: Thirty patients undergoing forearm and hand surgery received ultrasound-guided supraclavicular block with 1.5% mepivacaine. The initial volume of local anesthetic injected was 24 ml, and local anesthetic volume for the next patient was determined by the response of the previous patient. The next patient received a 3 ml higher volume in the case of the failure of the previous case. If the previous block was successful, the next volume was 3 ml lower. MEV was estimated by the Dixon and Massey up and down method. MEV in 95, 90, and 50% of patients (MEV95, MEV90, and MEV50) were calculated using probit transformation and logistic regression. RESULTS: MEV95 of 1.5% mepivacaine was 17 ml (95% confidence interval [CI], 13-42 ml), MEV90 was 15 ml (95% CI, 12-34 ml), and MEV50 was 9 ml (95% CI, 4-12 ml). Twelve patients had a failed block. Three patients received general anesthesia. Nine patients could undergo surgery with sedation only. Only one patient showed hemi-diaphragmatic paresis. CONCLUSIONS: MEV95 was 17 ml, MEV90 was 15 ml, and MEV50 was 9 ml. However, needle location near the lower trunk of brachial plexus and multiple injections should be performed.
Anesthesia, General ; Brachial Plexus ; Forearm ; Hand ; Humans ; Mepivacaine ; Needles

BACKGROUND/AIMS: Determining the depth of tumor invasion and the presence of regional lymph node metastasis is important in deciding therapeutic strategies. We aimed to evaluate the diagnostic accuracy of EUS in detecting the depth of tumor invasion and regional lymph node metastasis. MATERIALS AND METHODS: A total of 141 consecutive patients underwent preoperative evaluation using EUS, CT, and PET CT from November 2005 to June 2009 in Pusan National University Hospital. We reviewed the patients' medical records and compared EUS and pathologic findings. RESULTS: A total of 59 patients were included in the final analysis. The overall accuracy of EUS in predicting the correct T stage was 79.7% (95% CI, 66.8~88.6%). EUS accurately predicted T stage in 93.2% (95% CI, 82.7~97.8%) of T1 tumors, 79.7% (95% CI, 66.8~88.6%) of T2 tumors, and 86.4% (95% CI, 74.5~93.6%) of T3 tumors. Overall, EUS accurately predicted N stage in 83.1% of cases. EUS correctly predicted N stage in 91.4% of N0 tumors and 70.8% of N1 tumors. CONCLUSIONS: Overall accuracy of EUS for the T and N staging of esophageal cancer was high. Thus, EUS is a useful diagnostic modality in determining the initial stage of esophageal cancer.
Busan ; Diagnosis ; Endosonography* ; Esophageal Neoplasms* ; Humans ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis

Here we report a patient who suffered an acute infarction of the contralateral postcentral cerebral cortex and subsequently developed unilateral partial epilepsy with negative myoclonus. The findings of brain magnetic resonance imaging, polygraphic recordings of the postcentral somatosensory area, and response to anticonvulsant treatment support the presence of a cause-and-effect relationship, thereby providing evidence for a pathophysiological substrate for epileptic negative myoclonus.
Brain ; Cerebral Cortex* ; Cerebral Infarction* ; Epilepsies, Partial ; Humans ; Infarction ; Magnetic Resonance Imaging ; Myoclonus*

PURPOSE: The purpose of this study is to report clinical and radiographic results over a period of two 2 years after cementless total hip arthroplasty (THA) with fourth generation ceramic-on-ceramic articulation. MATERIALS AND METHODS: We studied 22 patients, 23 cases which were followed up for two years among 25 patients, 26 patients who underwent cementless THA with the fourth generation ceramic between April 2009 and December 2009. The average age of the patients was 55.9 years old(22 to 72 years old), and the average follow-up duration was 28 months(24 to 32 months). A clinical evaluation was performed using the Harris hip score (HHS), and radiologic evaluation was based on acetabular cups and osteolysis of the femoral stems, instability, distance, angle, and so on. RESULTS: HHS showed an increase, from 54 for before-surgical treatment, to 91 at the last follow-up. Inguinal pain was observed in one case, and femoral pain was observed in two cases. Stable fixation was achieved in all cases, and no instability, osteolysis, or movement of acetabular cups and femoral stems was observed. CONCLUSION: Clinical and radiological short-term results for use ofthe fourth generation ceramic-on-ceramic cementless THA have favorable so far. Further follow-up study should be performed for evaluation of the long-term results.
Arthroplasty ; Ceramics ; Follow-Up Studies ; Hip ; Humans ; Osteolysis ; Tacrine

PURPOSE: To determine the metal plate that has almost the same volume and weight as the conventional plate, but has improved properties by changing the shape using finite element analysis. MATERIALS AND METHODS: The bone is assumed to be of 100 mm length, 20 mm outer diameter and 12 mm inner diameter, respectively. There is a fracture line that is perpendicular to the major axis of the bone at the center. The two pieces of bone are joined together using a metallic plate that is made of titanium. Six holes are located, with an interval of 12 mm. We suppose that screws of 2 mm diameter and 25 mm length are inserted in six holes. The metallic plates are of 5 shapes (A, B, C, D and E) in total. Shape A is the standard or nominal type. Shape B and C are thicker at the center of the plate, respectively. Shape D and E are wider at the center. Six types of load are applied to each of those plates: tension, compression, anterior flexion, posterior flexion, lateral flexion and torsion. We compared stress, deformation, maximal stress and maximal deformation, according to the six types of load. RESULTS: Our deliberate investigation using finite element analysis showed that increasing the thickness or width at the center of metallic plates lowered the maximum stress and deformation. In particular, maximal stress and deformation could be reduced by 33.5% and 38.6%, respectively, in the anterior bending situation. Compression showed lower stress and deformation in type C or D, but the absolute quantity was much smaller than others, for example 0.01-0.001 times. CONCLUSION: As for the internal bone fixation plates with the same volume, the wider or thicker in the middle the plate become, the less deformation and yielding it bears.
Axis, Cervical Vertebra ; Bone Plates ; Finite Element Analysis ; Fracture Fixation ; Stress, Mechanical ; Titanium ; Ursidae