No abstract available.
Animals ; Rats*

The C749G(Pro250Arg) mutation in the gene for fibroblast growth factor receptor 3 (FGFR3) has been found in patients with various types of craniosynostosis. In this study, the blood of 9 Korean children with non-syndromic craniosynostosis were collected and mutation analyses were performed to screen whether this Pro250Arg mutation is also prevalent in Korean population. The genomic DNA samples were analysed by PCR amplification to amplify exon 7 and flanking intron sequence of FGFR3 (341 bp). Restriction digests were analysed by gel electrophoresis. There were no heterozygous for Pro250Arg mutation. No mutations in restriction enzyme digestion were confirmed by direct DNA sequencing. In this study, only 9 patients with simple craniosynostosis were subjected to mutation detection. Therefore, it is necessary to study a large number of patients in order to understand the proportion of non-syndromic craniosynostosis attributalbe to FGFR3 mutation. The epidemiologic study of this disease should be also combined in addition.
Child ; Craniosynostoses* ; Digestion ; DNA ; Electrophoresis ; Exons ; Fibroblast Growth Factors* ; Fibroblasts* ; Humans ; Introns ; Polymerase Chain Reaction ; Receptor, Fibroblast Growth Factor, Type 3* ; Receptors, Fibroblast Growth Factor* ; Sequence Analysis, DNA

The C749G(Pro250Arg) mutation in the gene for fibroblast growth factor receptor 3 (FGFR3) has been found in patients with various types of craniosynostosis. In this study, the blood of 9 Korean children with non-syndromic craniosynostosis were collected and mutation analyses were performed to screen whether this Pro250Arg mutation is also prevalent in Korean population. The genomic DNA samples were analysed by PCR amplification to amplify exon 7 and flanking intron sequence of FGFR3 (341 bp). Restriction digests were analysed by gel electrophoresis. There were no heterozygous for Pro250Arg mutation. No mutations in restriction enzyme digestion were confirmed by direct DNA sequencing. In this study, only 9 patients with simple craniosynostosis were subjected to mutation detection. Therefore, it is necessary to study a large number of patients in order to understand the proportion of non-syndromic craniosynostosis attributalbe to FGFR3 mutation. The epidemiologic study of this disease should be also combined in addition.
Child ; Craniosynostoses* ; Digestion ; DNA ; Electrophoresis ; Exons ; Fibroblast Growth Factors* ; Fibroblasts* ; Humans ; Introns ; Polymerase Chain Reaction ; Receptor, Fibroblast Growth Factor, Type 3* ; Receptors, Fibroblast Growth Factor* ; Sequence Analysis, DNA

PURPOSE: Pedicled transverse rectus abdominis myocutaneous(TRAM) flap has been a gold standard for breast reconstruction and one of surgical techniques preferred by many surgeons. The authors examined the course of deep epigastric artery focusing on distance from margins of rectus abdominis to pedicle and location of choke vessels to get minimal muscles during pedicled TRAM flap operation. METHODS: Eleven rectus abdominis muscle from nine cadavers were used in this study. Rectus abdominis was separated from the cadavers, deep inferior and superior epigastric artery were isolated and then 8 anatomical landmarks in medial and lateral margins of rectus abdominis were designated. Distance to a pedicle meeting first horizontally was measured and vertical location from umbilicus to choke vessel was determined. In addition, 32 rectus abdominis images of 16 women(average age: 37.2 years old) from 64 channel abdomen dynamic computerized tomography were also examined with the same anatomical landmarks with those of cadavers. RESULTS: Average distance from four landmarks on lateral margin of rectus abdominis to pedicle was 1.9-3.4cm and 1.8-3.8 cm on medial margin. Choke vessel was located between middle and inferior tendinous intersection in all cases and average distance between two tendinous intersection was 6.7-7.0cm on medial margin and 6.2cm on lateral margin. Location of inferior tendinous intersection was on umbilicus or superior of it in all cases and its average distance from umbilicus was 1.8-5.6cm on medial margin and 2.7-6.2cm on lateral margin. CONCLUSION: Distance from medial and lateral margins of rectus abdominis muscle to pedicle was the shortest in inferior tendinous intersection and that was averagely 1.8cm on medial margin and 1.9cm in average on lateral margin. All choke vessels were located between middle and inferior tendinous intersection.
Abdomen ; Cadaver ; Epigastric Arteries ; Female ; Glycosaminoglycans ; Mammaplasty ; Muscles ; Rectus Abdominis ; Umbilicus

A 29-year-old woman had 1-month history of back pain radiating into lower extremities, motor weakness, and sensory abnormalities in both lower extremities. Contrast-enhanced spinal magnetic resonance imaging (MRI) revealed a homogeneously enhancing mass at the T12∼L1 and several intradural enhancing nodular lesions at L2∼S1. Tumor resection surgery was performed and following histological examination showed that the tumor satisfied the diagnostic criteria for atypical choroid plexus papilloma (CPP). To find primary tumor sites, contrast-enhanced brain MRI, whole spine MRI, and PET-CT were carried out and additional lesions were detected at the fourth ventricle, right cerebellum, and upper thoracic spinal cord. This is a very rare case of metastatic atypical CPP that involves brain, upper thoracic spinal cord, and cauda equina with initial manifestation of radicular symptoms without clinical signs of primary brain lesion.

A 29-year-old woman had 1-month history of back pain radiating into lower extremities, motor weakness, and sensory abnormalities in both lower extremities. Contrast-enhanced spinal magnetic resonance imaging (MRI) revealed a homogeneously enhancing mass at the T12∼L1 and several intradural enhancing nodular lesions at L2∼S1. Tumor resection surgery was performed and following histological examination showed that the tumor satisfied the diagnostic criteria for atypical choroid plexus papilloma (CPP). To find primary tumor sites, contrast-enhanced brain MRI, whole spine MRI, and PET-CT were carried out and additional lesions were detected at the fourth ventricle, right cerebellum, and upper thoracic spinal cord. This is a very rare case of metastatic atypical CPP that involves brain, upper thoracic spinal cord, and cauda equina with initial manifestation of radicular symptoms without clinical signs of primary brain lesion.

Takayasu's arteritis (TA) is a chronic inflammatory vascular disease that mainly affects large vessels. Central nervous system involvement occurs in about 20% of cases with rare involvement of intracranial vessel, and its typical manifestation is cerebral ischemia or stroke. Reversible cerebral vasoconstriction syndrome (RCVS) is a group of disorders with prolonged, but reversible vasoconstriction of the cerebral arteries with acute-onset, severe, recurrent headaches with or without neurologic signs or symptoms. We report a case of TA in a 17-year old girl who presented with secondary RCVS. She complained of thunderclap headache, seizure and acute stroke. 3-dimensional computed tomography scan and magnetic resonance angiography of head revealed irregular thickening of aortic wall and its main branches with multifocal narrowing of intracranial basilar artery, which improved after oral nimodipine intake. This case highlights RCVS as an unusual manifestation of TA and demonstrates the diagnosis, treatment and response to therapy of RCVS in TA, which resolved after treatment with calcium channel blocker.
Basilar Artery ; Brain Ischemia ; Calcium Channels ; Central Nervous System ; Cerebral Arteries ; Glycosaminoglycans ; Head ; Headache ; Headache Disorders, Primary ; Humans ; Magnetic Resonance Angiography ; Neurologic Manifestations ; Nimodipine ; Seizures ; Stroke ; Takayasu Arteritis ; Vascular Diseases ; Vasoconstriction

PURPOSE: In this study, we aimed to measure the effects of emergency department (ED) expansion at a tertiary hospital on overall ED length of stay (LOS). METHODS: This study was a before and after study using data from a tertiary medical center in Seoul, a large metropolis. We used electronic medical records and administrative databases obtained from the ED. The control period (before expansion) was defined as from January 1 to April 31, 2016. The study period (after expansion) was defined as from May 1 to August 31, 2016. The number of ED beds increased from 42 to 74 after the expansion. After adjusting individual characteristics and institutional characteristics, multivariate regression analysis was carried out to evaluate the effects of expansion on overall ED LOS. RESULTS: A total of 45,632 patients visited the emergency medical center: 20,592 patients before and 25,040 after the expansion. Although the absolute number of patients increased, the portion of medical patients, portion of non-referral patients, and ambulatory patients decreased during the study period (all p<0.001). Average visit number increased from 170.2 (standard deviation [SD], 27.3) to 203.6 (SD, 21.3) (p<0.001). The overall ED LOS increased from 332.2 (SD, 473.4) to 391.0 minutes (SD, 649.5). After adjusting for potential confounders, we found that ED expansion was associated with an increase in ED LOS by 75.8 minutes (95% confidence interval, 63.5 to 88.2). CONCLUSION: We found that the ED expansion was associated with a significant increase in ED LOS.
Crowding ; Electronic Health Records ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Hospital Administration ; Humans ; Length of Stay* ; Overall ; Seoul ; Tertiary Care Centers*

A 61-year-old woman came to the hospital with dyspnea and pleural effusion on chest radiography. She underwent repeated thoracentesis, transbronchial lung biopsy, bronchoalveolar lavage, and thoracoscopic pleural biopsy with talc pleurodesis, but diagnosis of her was uncertain. Positron emission tomography showed multiple lymphadenopathies, so she underwent endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal lymph nodes. Here, we report a case of malignant pleural mesothelioma that was eventually diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration. This is an unusual and first case in Korea.
Biopsy ; Bronchoalveolar Lavage ; Bronchoscopy ; Dyspnea ; Female ; Humans ; Korea ; Lung ; Lymph Nodes ; Mesothelioma ; Needles ; Pleural Effusion ; Pleurodesis ; Porphyrins ; Positron-Emission Tomography ; Talc ; Thorax

OBJECTIVES: The aim of this study was to investigate various factors associated with the willingness to visit psychiatric clinics among the general adult population in Bucheon city, South Korea. METHODS: One thousand seventy-five adults completed a self-questionnaire assessing their willingness to visit psychiatric clinics, family history of mental illnesses, frequency of contact with the mentally ill, stigma and discrimination toward the mentally ill, and the Community Attitude toward the Mentally Ill (CAMI). Logistic regression analyses were performed to identify variables associated with the willingness to visit psychiatric clinics. RESULTS: Study results showed that being single was associated with reduced willingness to visit psychiatric clinics. Subjects who had more frequent contact with mentally ill patients were more willing to visit psychiatric clinics. Concerning the CAMI scale, higher scores in authoritarianism and lower scores in benevolence subscales were associated with greater willingness to visit psychiatric clinic. Subjects who strongly admitted the existence of the stigma, and discrimination, toward mentally ill patients were more willing to visit psychiatric clinics. CONCLUSION: Enhanced understanding of the factors associated with the willingness to visit psychiatric clinics would be helpful in reducing barriers to mental health services utilization in the community.
Adult* ; Ambulatory Care ; Authoritarianism ; Beneficence ; Discrimination (Psychology) ; Gyeonggi-do* ; Humans ; Korea ; Logistic Models ; Mental Health ; Mental Health Services ; Mentally Ill Persons