PURPOSE: We performed invasive thermometry to verify the elevation of local temperature in the liver during hyperthermia. MATERIALS AND METHODS: Three 40-kg pigs were used for the experiments. Under general anesthesia with ultrasonography guidance, two glass fiber-optic sensors were placed in the liver, and one was placed in the peritoneal cavity in front of the liver. Another sensor was placed on the skin surface to assess superficial cooling. Six sessions of hyperthermia were delivered using the Celsius TCS electro-hyperthermia system. The energy delivered was increased from 240 kJ to 507 kJ during the 60-minute sessions. The inter-session cooling periods were at least 30 minutes. The temperature was recorded every 5 minutes by the four sensors during hyperthermia, and the increased temperatures recorded during the consecutive sessions were analyzed. RESULTS: As the animals were anesthetized, the baseline temperature at the start of each session decreased by 1.3degrees C to 2.8degrees C (median, 2.1degrees C). The mean increases in temperature measured by the intrahepatic sensors were 2.42degrees C (95% confidence interval [CI], 1.70-3.13) and 2.67degrees C (95% CI, 2.05-3.28) during the fifth and sixth sessions, respectively. The corresponding values for the intraperitoneal sensor were 2.10degrees C (95% CI, 0.71-3.49) and 2.87degrees C (1.13-4.43), respectively. Conversely, the skin temperature was not increased but rather decreased according to application of the cooling system. CONCLUSION: We observed mean 2.67degrees C and 2.87degrees C increases in temperature at the liver and peritoneal cavity, respectively, during hyperthermia. In vivo real-time thermometry is useful for directly measuring internal temperature during hyperthermia.
Anesthesia, General ; Animals ; Fever* ; Glass ; Liver* ; Peritoneal Cavity ; Skin ; Skin Temperature ; Swine ; Thermometry ; Ultrasonography

Goltz syndrome(focal dermal hypoplasia) is a rare disorder characterized by ectodermal and mesodermal dysplasia described in 1962 by Goltz. In Korea, one case of Goltz syndrome was reported in 1994. The inheritance mode is mostly X-linked dominant. Skin abnormality is the most common manifestation including hypoplasia of the dermis. Skeletal involvement such as syndactyly, polydactyly, scoliosis, kyphosis and spina bifida occulta may be present, also ocular and dental abnormalities are reported. Radiologic findings are the osteopathy and striation of the long bone. We experienced a case of Goltz syndrome in a 9-year old female who was presented with right side hypotrophy, focal dermal hypoplasia, ocular(anidria, microcornea), dental(oligodontia, amelogenesis) and skeletal(syndactyly) abnormalities. Skin biopsy was performed and showed decreased expression of type I collagen gene with Northern blotting.
Biopsy ; Blotting, Northern ; Child ; Collagen Type I ; Dermis ; Ectoderm ; Female ; Focal Dermal Hypoplasia* ; Humans ; Korea ; Kyphosis ; Mesoderm ; Polydactyly ; Scoliosis ; Skin ; Skin Abnormalities ; Spina Bifida Occulta ; Syndactyly ; Wills

OBJECTIVE: To compare the clinical severity of congenital muscular torticollis (CMT) based on the method of child birth. METHOD: Children diagnosed with CMT and who were < 6-years-of-age at the time of their first visit at the Center for Torticollis, Ajou Medical Center, were included in this study. The medical records were retrospectively reviewed with reference to the method of child birth and the clinical severity of CMT. The clinical severity of CMT was determined either by whether stretching exercises were needed for the children <6-month-of-age or whether surgical release was required for the children > or =6-months-of-age at the time of the first visit. RESULTS: One hundred seventy eight subjects with CMT were enrolled. There was no significant difference in the rate of surgical release according to the method of child birth. For 132 patients <6-month-of-age there was also no significant difference in the rate of stretching exercises. CONCLUSION: There was no significant difference in the clinical severity of CMT based on the method of child birth. This finding suggests that prenatal factors alone could be a cause of CMT and that the clinical severity of CMT in children delivered by Cesarean section is not different when compared with the severity of CMT in children born through vaginal delivery.
Cesarean Section ; Child ; Exercise ; Female ; Humans ; Medical Records ; Parturition ; Pregnancy ; Retrospective Studies ; Torticollis

A male infant was diagnosed with obstetric brachial plexus injury, congenital muscular torticollis and cleft palate 17 days after birth. His mother presented with gestational diabetes and premature rupture of membranes. Although it is possible that these three disorders arose independently, it is very likely that all three have the same etiologic cause, and we propose that a possible mechanism for this concurrence is related to maternal gestational diabetes. Maternal hyperglycemia mostly affects fetal structures deriving from the neural crest, including the palatine bone, and may have caused the cleft palate observed in this case. Gestational diabetes is also associated with increased frequency of large for gestational age infants and, by extension, with increased risk of birth injuries such as obstetric brachial plexus injury or congenital muscular torticollis associated with large for gestational age infants. Since the children of mothers with gestational diabetes are at increased risk for congenital defects such as cleft palate as well as being large for gestational age, precautions indicated for each respective disorder must be taken during prenatal testing and during birth. However, further studies of more cases are required to evaluate whether the concurrence of obstetric brachial plexus injury, congenital muscular torticollis and cleft palate in this case are complications specifically associated with gestational diabetes or just a simple coincidence.
Birth Injuries ; Brachial Plexus ; Child ; Cleft Palate ; Congenital Abnormalities ; Diabetes, Gestational ; Female ; Fetus ; Gestational Age ; Humans ; Hyperglycemia ; Infant ; Male ; Membranes ; Mothers ; Neural Crest ; Palate, Hard ; Parturition ; Pregnancy ; Rupture ; Torticollis

Objective: Putaminal iron deposition is an important feature that helps differentiate multiple system atrophy with predominant parkinsonism (MSA-p) from Parkinson’s disease (PD). Most previous studies used visual inspection or quantitative methods with manual manipulation to perform this differentiation. We investigated the value of a new semiautomated diagnostic algorithm using 3T-MR susceptibility-weighted imaging for MSA-p. Methods: This study included 26 MSA-p, 68 PD, and 41 normal control (NC) subjects. The algorithm was developed in 2 steps: 1) determine the image containing the remarkable putaminal margin and 2) calculate the phase-shift values, which reflect the iron concentration. The next step was to identify the best differentiating conditions among several combinations. The highest phaseshift value of each subject was used to assess the most effective diagnostic set. Results: The raw phase-shift values were present along the lateral margin of the putamen in each group. It demonstrates an anterior- to-posterior gradient that was identified most frequently in MSA-p. The average of anterior 5 phase shift values were used for normalization. The highest area under the receiver operating characteristic curve (0.874, 80.8% sensitivity, and 86.7% specificity) of MSA-p versus PD was obtained under the combination of 3 or 4 vertical pixels and one dominant side when the normalization methods were applied. In the subanalysis for the MSA-p patients with a longer disease duration, the performance of the algorithm improved. Conclusion This algorithm detected the putaminal lateral margin well, provided insight into the iron distribution of the putaminal rim of MSA-p, and demonstrated good performance in differentiating MSA-p from PD.

Alcohol dependence is a serious disorder that can be related with a number of potential health-related and social consequences. Cortical thickness measurements would provide important information on the cortical structural alterations in patients with alcohol dependence. Twenty-one patients with alcohol dependence and 22 healthy comparison subjects have been recruited and underwent high-resolution brain magnetic resonance (MR) imaging and clinical assessments. T1-weighted MR images were analyzed using the cortical thickness analysis program. Significantly thinner cortical thickness in patients with alcohol dependence than healthy comparison subjects was noted in the left superior frontal cortical region, correcting for multiple comparisons and adjusting with age and hemispheric average cortical thickness. There was a significant association between thickness in the cluster of the left superior frontal cortex and the duration of alcohol use. The prefrontal cortical region may particularly be vulnerable to chronic alcohol exposure. It is also possible that the pre-existing deficit in this region may have rendered individuals more susceptible to alcohol dependence.
Alcoholism ; Brain ; Cerebral Cortex ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging

The aim of this update of Korean clinical practice guidelines for stroke is to provide timely evidence-based recommendations on the antiplatelet therapy in secondary prevention of stroke. Evidence-based recommendations are included for the use of antiplatelet agents for noncardioembolic stroke. Changes in the guidelines necessitated by new evidence will be continuously reflected in the new guideline.
Aspirin ; Platelet Aggregation Inhibitors ; Secondary Prevention ; Stroke ; Ticlopidine

PURPOSE: This study was undertaken to determine risk factors that influence the severity of injury in motor cycle accidents. METHODS: Hospital trauma registry data of all patients treated for motor cycle injuries at Wonju Christian Hospital from July 2008 to December 2009 were analyzed. Analyses included injury site, injury mechanism, alcohol intake, status of self protection, underlying diseases, weather at the time of injury, time of injury, and injury severity (injury severity score=ISS, revised trauma score=RTS). The risk factors between patients whose injuries were severe (ISS> or =16) and non-severe were compared. RESULTS: The records of 344 patients (mean age 44.3+/-22.2 years, 306 males and 38 females) were analyzed. The rate of protection was higher in 293 non-severely injured patients (ISS=5.1+/-3.9) than in the 51 severely-injured patients (ISS=21.9+/-5.9) (49.8% vs 31.4% p=0.015). The rate of alcohol ingestion was lower in non-severely injured patients (22.5%) than in the severely-injured patients (37.3%), (p=0.024). But there were no significant differences in age, gender, injury site, and underlying diseases in both groups. The most common cause of death was brain injury. CONCLUSION: Risk factors influencing the severity of motor cycle-related injury were protection (helmet) rate and alcohol ingestion.
Brain ; Cause of Death ; Eating ; Humans ; Male ; Risk Factors ; Weather

OBJECTIVE: (1) To present the magnetic resonance imaging (MRI) findings of congenital muscular torticollis (CMT) of subjects who underwent surgical release and subjects who showed a good prognosis with stretching exercises and (2) to correlate the MRI findings with the histopathologic findings of CMT for subjects who underwent surgical release in order to examine the hypothesis that the MRI findings of CMT can be used as a determinant to perform surgical release of CMT. METHOD: The neck MRI findings of 33 subjects who underwent surgical release for CMT were compared with those of 18 subjects who were successfully managed only with conservative management. The MRI findings were correlated with the histopathologic sections of the CMT mass. RESULTS: All 33 subjects (100%) who underwent surgical release showed one or more low signal intensities within the involved sternocleidomastoid muscle (SCM) on the T1- and T2-weighted images of neck MRI. The eighteen non-surgical candidates showed only enlargement of the SCM without low signal intensity within the SCM. The histopathologic findings showed interstitial fibrosis and/or the presence of aberrant tendon-like excessive dense connective tissue that was either well-arranged or disorganized. CONCLUSION: The histopathologic findings and MRI findings showed good correlation in terms of the amount of fibrosis and aberrant dense connective tissue within the SCM. If multiple or large low signal intensities within the SCM are noted, we think that surgical release should be considered.
Connective Tissue ; Exercise ; Fibrosis ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Muscles ; Neck ; Prognosis ; Torticollis

BACKGROUND: This study was to investigate the effect of biomechanical stimulation on osteoblast differentiation of human periosteal-derived stem cell using the newly developed bioreactor. METHODS: Human periosteal-derived stem cells were harvested from the mandible during the extraction of an impacted third molar. Using the new bioreactor, 4% cyclic equibiaxial tension force (0.5 Hz) was applied for 2 and 8 h on the stem cells and cultured for 3, 7, and 14 days on the osteogenic medium. Biochemical changes of the osteoblasts after the biomechanical stimulation were investigated. No treatment group was referred to as control group. RESULTS: Alkaline phosphatase (ALP) activity and ALP messenger RNA (mRNA) expression level were higher in the strain group than those in the control group. The osteocalcin and osteonectin mRNA expressions were higher in the strain group compared to those in the control group on days 7 and 14. The vascular endothelial growth factor (VEGF) mRNA expression was higher in the strain group in comparison to that in the control group. Concentration of alizarin red S corresponding to calcium content was higher in the strain group than in the control group. CONCLUSIONS: The study suggests that cyclic tension force could influence the osteoblast differentiation of periosteal-derived stem cells under optimal stimulation condition and the force could be applicable for tissue engineering.
Alkaline Phosphatase ; Bioreactors ; Calcium ; Humans* ; Jaw* ; Mandible ; Molar, Third ; Osteoblasts* ; Osteocalcin ; Osteonectin ; RNA, Messenger ; Stem Cells* ; Tissue Engineering ; Vascular Endothelial Growth Factor A