No abstract available.
Femoral Nerve* ; Humans ; Ossification, Heterotopic*

BACKGROUND & PURPOSE: The ocular torsion (OT) and tilt of the subjective visual vertical (SVV) are sensitive brainstem signs and helps us to localize lesion. We calibrated the degree of OT, SVV tilt and head tilt to investigate their characteristics and temporal profiles in patients with brainstem lesion. METHODS: We selected 15 patients with acute brainstem stroke. We took serial fundus photographs and body pictures in upright position at various times after the stroke. We also determined the deviations of patient's SVV. The data measurement for this investigation ranged from day 2 to day 47. RESULTS: Eight of ten patients with lateral medullay infarction showed ipsiversive tilt of SVV and OT. Among four patients with pontine infarction, one showed ipsiversive tilt and three contraversive. One patient with midbrain hemorrhage showed cotraversive tilt. The resolution of OT and the tilt of SVV in medullary lesions occurred over the periods ranging from 7 days to more than 47 days and was slower in patients with upper brainstem lesion than lower brainstem lesion. The directions of head tilt in our patients, especially with medullary lesions, were rather different from the previous reports. CONCLUSION: The vestibular dysfunction by the brainstem lesions disturbs the eye and head stabilization and also distorts the perception of the subjective vertical in space. The direction of OT and the tilt of SVV is ipsiversive in lower brainstem lesion and contraversive in upper brainstem lesion. But head tilt is contraversive in most lower brainstem lesion as well as upper brainstem lesion. Large-grouped study for the direction of head tilt is thought to be needed. These signs are compensated in the course of clinical recovery.
Brain Stem Infarctions* ; Brain Stem* ; Head* ; Hemorrhage ; Humans ; Infarction ; Mesencephalon ; Stroke

Skip lesion is not uncommon feature in osteosarcoma and considered to be importantly associated with poor prognosis factor, and thus, should be excised with the main mass. The accurate pre-operative evaluation of the intramedullary extent of osteosarcoma is essential, because it determines the level of bone resection. Among the reliable detection methods, bone scan has a drawback of high rate of false negative results and regional MRI has a difficulty to cover the whole involved lesions without clinical suspicion. The authors report a case of osteosarcoma of the distal femur with a proximal skip lesion that was not detected by either regional MR imaging or by bone scan, but which was visualized by FDG-PET/CT.
Complement System Proteins ; Femur ; Neoplasm Metastasis ; Osteosarcoma ; Prognosis

PURPOSE: The aim of this study was to evaluate the normal values of regional cerebral blood flow (rCBF) and cerebrovascular reserve (CVR) in normal children to aged volunteers using Tc-99m HMPAO. MATERIALS AND METHODS: Thirty four right-handed normal volunteers (20 males, 14 females, mean age 40.3+/-24.9 years, range 4 to 82 years) were underwent rest/acetazolamide (ACZ) brain SPECT using Tc-99m HMPAO and the sequential injection and subtraction method. rCBF was estimated on the basis of a semiquantitative approach by means of right/left ratio, region/cerebellum and region to whole brain ratios in frontal, parietal, temporal, and occipital lobes, basal ganglia, thalami, and cerebellum. CVR was measured by means of % perfusion increase calculated as % mean count change compared to rest rCBF in each regions. RESULTS: Mean values of right to left ratios range from 1.004 to 1.018. rCBF was highest in cerebellum and lowest in basal ganglia and thalami. Frontal and temporal rCBF decreased while occipital and thalamic rCBF increased according to age. No sexual difference of rCBF was noted. Mean CVR was 29.9+/-12.9%. Mean CVR significantly increased to late teens, and declined thereafter. After 6th decade, CVR in both frontal lobes, left parietal lobe and right basal ganglia decreased significantly with advancing age. There was no sexual difference of CVR. CONCLUSION:: Quantitative assessment of CVR was possible by ACZ Tc-99m HMPAO brain SPECT. It revealed that rCBF and CVR changed according to age in normal Korean volunteers. There was no sexual difference.
Acetazolamide ; Adolescent ; Basal Ganglia ; Brain* ; Cerebellum ; Child ; Female ; Frontal Lobe ; Healthy Volunteers ; Humans ; Male ; Occipital Lobe ; Parietal Lobe ; Perfusion ; Rabeprazole ; Reference Values ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon* ; Volunteers

The incidence of recurrence and anal stricture after surgical hemorrhoidectomy were reported in about 5% and 2.5~13%, respectively Generally, complete and adequate surgery for hemorrhoids was not infrequently neglected because the treatment of hemorrhoids was based on symptoms rather than pathogenesis. This study was performed to analyze the clinical features of recurrent hemorrhoids and to assess the adequate surgical management for the prevention of recurrence. From June 1989 to December 1997, we reviewed 222 (10.6%) recurrent hemorrhoids of surgically treated at Asan Medical Center. Median follow-up period was 38 months (range, 4 months~8 years 9 months). The most common symptom was prolapse (37%). Previous treatment for hemorrhoids was surgical hemouhoidectorny in 99 cases (45%) and sclerotherapy in 111 cases (50%). The most common location and associated complication of recurrent hemorrhoids were sites of major piles (83%) and anal stricture (37%), respectively. Anal stricture was more prevalent in patients with previous sclerotherapy (P<0.05). In respect to the numbers of combined surgical procedures, one procedure was more frequently performed in the non-complicated recurrent hemorrhoids group (P<0.05) whereas over four in the complicated group (P<0.05). Internal sphincterotomy and anoplasty were frequently needed in the complicated recurrent hemorrhoids (P<0.05). Mean hospital stay and healing time were 5 days (range, 2~26 days) and 21 days (range, 6~180 days), respectively. We had excellent or satisfactory results in 175 of 197 patients (89%). Conclusively, multiple combined surgical procedures in accordance with individual status might be useful in treating the recurrent hemorrhoids. An adequate and complete surgical procedure must be applied during the initial operation of hemorrhoids, especially on major piles.
Chungcheongnam-do ; Constriction, Pathologic ; Follow-Up Studies ; Hemorrhoidectomy ; Hemorrhoids* ; Humans ; Incidence ; Length of Stay ; Prolapse ; Recurrence ; Sclerotherapy

PURPOSE: This study evaluated the influence of growth factors on muscle regeneration when the bone is distracted, relative to the distraction rate. MATERIALS AND METHODS: The influence of bone distraction on the tibialis anterior and soleus muscles of 6-month-old Sprague-Dawley rats was evaluated. IGF-I, PDGF, and bFGF expression were used as growth markers. The rats were divided into two groups containing six rats each. In each group, the right tibia was distracted and the left tibia was used as the control. The distraction rates were 0.35 and 0.7 mm/day in the respective groups. RESULTS: For the tibialis anterior, the level of IGF-I expression in the group distracted at 0.35 mm/day was significantly higher (p<0.001) but significantly lower (p<0.01) in the group distracted at 0.7 mm/day than in the control. In contrast, there was no significant change in the soleus muscle (p>0.05). In the tibialis anterior, PDGF expression was higher in the group distracted at 0.7 mm/day but this increase was not significant (p=0.145). In the soleus, the expression level was lower in the group distracted at 0.7 mm/day but the difference was not significant (p>0.05). bFGF was not expressed in the tibialis anterior or soleus. CONCLUSION: Bone distraction promotes the release of growth factors but the amount of growth factor released in mature muscle decreases in proportion to the distraction rate. bFGF is not related to myoblast proliferation and differentiation. Moreover, the amount of muscle growth decreases with increasing rate of muscle distraction.
Animals ; Humans ; Infant ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins* ; Muscle, Skeletal ; Muscles ; Myoblasts ; Osteogenesis, Distraction* ; Rats ; Rats, Sprague-Dawley ; Regeneration* ; Tibia

A three-year-old girl presented with a right-sided limp and mild fever. Laboratory findings were normal, except for an elevated erythrocyte sedimentation rate (ESR) of 30 mm/h and a C-reactive protein (CRP) level of 1.5 mg/dl. Magnetic resonance imaging showed a periosteal reaction in the distal posteromedial femur with contour bulging and extension of the reaction to the adjacent vastus muscles. Under a working diagnosis of acute suppurative osteomyelitis, she was initially treated with antibiotics and anti-inflammatory agents for one week. However, this did not result in resolution of her problems or normalization of the ESR and CRP. Biopsies of periosteum and muscle revealed Burkitt lymphoma expressing Bcl-6(+). In a child, limping can be the first clinical sign of hematogenous malignancy. In a limping child, if the general clinical course does not show improvement, and empirical treatment is ineffective, a comprehensive evaluation is necessary, including biopsies or bone marrow aspiration.
Anti-Bacterial Agents ; Anti-Inflammatory Agents ; Biopsy ; Blood Sedimentation ; Bone Marrow ; Burkitt Lymphoma* ; C-Reactive Protein ; Child ; Diagnosis ; Female* ; Femur ; Fever ; Hip ; Humans ; Magnetic Resonance Imaging ; Muscles ; Osteomyelitis ; Periosteum

OBJECTIVES: This study aims to identify dietary factors related to metabolic syndrome in middle aged Korean men who were participants in the Fourth Korea National Health and Nutrition Examination Survey(KNHANES IV) in 2007. METHODS: The study targeted 361 of the 709 men aged between 40 and 64 years for a final analysis; the other 348 surveys had incomplete data which did not allow for the determination of metabolic syndrome. The definition of metabolic syndrome was based on the National Cholesterol Education Program Adult Treatment Panel III(NCEP ATP III). RESULTS: There were significant differences in the metabolic syndrome of middle-aged men according to age, smoking pack-years, and number of resturant meals per week. Dietary factors such as vitamins, riboflavin, natrium, carbohydrate, protein and lipid intakes were not significant. CONCLUSIONS: It was verified that metabolic syndrome in middle-aged men is related to age, smoking pack-years and number of resturant meals per week. Dietary factors were not significantly related. However, further detailed studies in this area are needed.
Adenosine Triphosphate ; Adult ; Aged ; Cholesterol ; Humans ; Korea ; Male ; Meals ; Middle Aged ; Multiple Endocrine Neoplasia Type 1 ; Riboflavin ; Smoke ; Smoking ; Vitamins

Purpose: To provide a wider choice of treatment opportunities for patients with neuroendocrine tumor (NET) in Korea, we have conducted a phase 1, open-label, single-arm, dose-escalation study of SNU-KB-01, a no-carrier added (NCA) 177Lu-labeled DOTATATE. Materials and Methods: Seven patients with inoperable, progressive, metastatic, or locally advanced, somatostatin receptor-positive NET with Ki67 index ≤ 20% were enrolled according to the rolling six design. The study consisted of two cohorts to receive 4 cycles of SNU-KB-01 every 8 weeks for the first dose of 5.55 GBq (n=3) and 7.40 GBq (n=4). We assessed the incidence of dose-limiting toxicity (DLT) and adverse event, absorbed dose of kidneys and bone marrow, and objective tumor response. Results: Seven patients completed 4 cycles (21.3-30.1 GBq total dose) of SNU-KB-01. The mean absorbed doses to kidneys and bone marrow were 0.500 mGy/MBq and 0.053 mGy/MBq, respectively, and the total body effective dose was 0.115 mSv/MBq. No DLT was observed and the maximum tolerated dose was 7.40 GBq/cycle. Grade 3 thrombocytopenia occurred in one patient, but no other grade 3 or 4 major hematologic or renal toxicity was observed. The best objective response to SNU-KB-01 was partial response. Overall response rate was 42.9% and disease control rate was 85.7%. Conclusion Treatment with 4 cycles of SNU-KB-01 was well tolerated and resulted in control of disease in most of the patients. Our results indicate SNU-KB-01, an NCA 177Lu-labeled DOTATATE, as a potentially safe and efficacious treatment option for NET patients in Korea.

PURPOSE: Coronary artery diseases (CADs) are the leading causes of death in the world. Recent studies have reported that differentially expressed microRNAs (miRNAs) are associated with prognosis or major adverse cardiac events (MACEs) in CAD patients. In a previous meta-analysis, the authors made serious mistakes that we aimed to correct through an updated systematic review and meta-analysis of the prognostic value of altered miRNAs in patients with CADs. MATERIALS AND METHODS: We performed a systematic search of MEDLINE (from inception to May 2017) and EMBASE (from inception to May 2017) for English-language publications. Studies of CADs with results on miRNAs that reported survival data or MACEs were included. Data were extracted from each publication independently by two reviewers. RESULTS: After reviewing 515 articles, a total eight studies were included in this study. We measured pooled hazard ratios (HRs) and 95% confidence intervals (CIs) of miRNA 133a with a fixed-effect model (pooled HR, 2.35; 95% CI, 1.56–3.55). High expression of miRNA 133a, 208b, 126, 197, 223, and 122-5p were associated with high mortality. Additionally, high levels of miRNA 208b, 499-5p, 134, 328, and 34a were related with MACEs. CONCLUSION: The present study confirmed that miRNA 133a, which was associated with high mortality in CAD patients, holds prognostic value in CAD. More importantly, this study corrected issues raised against a prior meta-analysis and provides accurate information.
Cause of Death ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; MicroRNAs* ; Mortality ; Prognosis ; Publications