Corpus callsoum (CC) is the largest commissural fiber connecting the cerebral hemispheres. The gender difference in the size or the shape of CC is a long standing dispute. Some reported that adult female CC had more bulbous splenium and larger area considering brain size, but others failed to replicate this findings. There is no definite consensus on sexual dimorphism of CC yet, although extensive studies on sexual dimorphism has been expected to provide a clue to explain sociopsychological differences between male and female. This variable results are attributed to limited number of subjects, measured parameters, and method of measurement. We have employed comprehensive analytic parameters with large subjects to understand gender differences on CC of healthy Korean adults. We have analyzed the magnetic resonance image (MRI) in adults free from neurological disorders. The subjects were composed of 108 young people (3rd decade; male : 51, female : 57). Total area, its 5 sub-areas, linear parameters including height, length, and width and five specific angles of the CC were measured on the midsagittal MR images with NIH Image program (R) (Ver 1.6). The gender differences were observed in the area of splenium and length in the group. The male CC have larger splenium and longer length than female. The angle between neural axis and base of corpus callosum in female was significantly larger than that of male. This study reports not only gender difference of adult CC, but Korean adult standard morphometric data of CC research. These results might serve a useful basic data for various research in the fields of neuroanatomy, neuroradiology, and neuropsychiatry.
Adult* ; Axis, Cervical Vertebra ; Brain ; Cerebrum ; Consensus ; Corpus Callosum* ; Dissent and Disputes ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Nervous System Diseases ; Neuroanatomy ; Neuropsychiatry

Pleomorphic xanthoastrocytoma (PXA) has been considered as a low grade tumor of adolescents and young adults. Although this tumor often shows cystic component, the hemorrhage within the cyst is extremely rare. The authors report a rare case of cystic PXA with a hemorrhage within the cyst and the mural nodule in the left frontal lobe. A 64-year-old male presented with a week history of the right side hemiparesis. After gross total resection of the tumor, the patient was fully recovered from neurological deficit. It is suggested that this typically benign tumor could be presented with hemorrhage, causing a rapid neurological deterioration. Prompt surgical intervention, especially total removal of the tumor can provide an excellent functional recovery.
Adolescent ; Frontal Lobe ; Hemorrhage* ; Humans ; Male ; Middle Aged ; Paresis ; Young Adult

Craniovertebral junction (CVJ) tuberculosis is a rare disease, potentially causing severe instability and neurological deficits. The authors present a case of CVJ tuberculosis with atlantoaxial dislocation and retropharyngeal abscess in a 28-year-old man with neck pain and quadriparesis. Radiological evaluations showed a widespread extradural lesion around the clivus, C1, and C2. Two stage operations with transoral decompression and posterior occipitocervical fusion were performed. The pathological findings confirmed the diagnosis of tuberculosis. Treatment options in CVJ tuberculosis are controversial without well-defined guidelines. But radical operation (anterior decompression and posterior fusion and fixation) is necessary in patient with neurological deficit due to cord compression, extensive bone destruction, and instability or dislocation. The diagnosis and treatment options are discussed.
Adult ; Cranial Fossa, Posterior ; Decompression ; Diagnosis ; Dislocations* ; Humans ; Neck Pain ; Quadriplegia ; Rare Diseases ; Retropharyngeal Abscess ; Tuberculosis*

PURPOSE: Radionuclide cisternography may be helpful in understanding pathophysiology of postural headache and low CSF pressure in patients with spontaneous intracranial hypotension. The purpose of this study was to characterize radionuclide cisternographic findings of spontaneous intracranial hypotension. MATERIALS AND METHODS: The study population consists of 15 patients with spontaneous intracranial hypotension. Diagnosis was based on their clinical symptoms and results of lumbar puncture. All patients underwent radionuclide cisternography following injection of 111 to 222 MBq of Tc-99m DTPA into the lumbar subarachnoid space. Sequential images were obtained between 1/2 hour and 24 hour after the injection of Tc-99m DTPA. Radioactivity of the bladder, soft tissue uptake, migration of radionuclide in the subarachnoid space, and extradural leakage of radionuclide were evaluated according to the scan time. RESULTS: Radionuclide cisternogram showed delayed migration of radionuclide into the cerebral convexity (14/15), increased soft tissue uptake (11/15), and early visualization of bladder activity at 30 min (6/10) and 2 hr (13/13). Cisternography also demonstrated leakage site of CSF in 4 cases and 2 of these were depicted at 30 min. Epidural blood patch was done in 11 patients and headache was improved in all cases. CONCLUSION: The characterstic findings of spontaneous intracranial hypotension were delayed migration of radionuclide and early visualization of the soft tissue and bladder activity. These scintigraphic findings suggest that CSF leakage rather than increased CSF absorption or decreased production may be the main pathophysiology of spontaneous intracranial hypotension. Early and multiple imaging including the bladder and soft tissue is required to observe the entire dynamics of radionuclide migration.
Absorption ; Blood Patch, Epidural ; Diagnosis ; Headache ; Humans ; Intracranial Hypotension* ; Pentetic Acid ; Radioactivity ; Spinal Puncture ; Subarachnoid Space ; Urinary Bladder

The technique of computer-assisted continuous infusion (CACI) has revolutionised the administration of drugs by intravenous infusion. A stable blood concentration is achieved rapidly with CACI, allowing the anesthesiologist to monitor therapeutic effect and titrate drug concentrations accordingly. Propofol and opioids can be administered by CACI for the induction and maintenance of anesthesia in adult patients. Also, the ability to maintain a constant blood concentration of drugs is also extremely important for studying the pharmacodynamic interactions of drugs, and research in the area has increased with advent of CACI. We experienced a case of total intravenous anesthesia which was totally conducted by CACI, using a Master TCI for propofol and Stelpump program for fentanyl infusion.
Adult ; Analgesics, Opioid ; Anesthesia ; Anesthesia, Intravenous* ; Fentanyl ; Humans ; Infusions, Intravenous ; Propofol

We analysed the 49 probands of autosomal dominant polycystic kidney disease (ADPKD) in Korea to elucidate clinical and genetic characteristics. 1) Family history of renal disease or ADPKD was taken from 44% of probands; hypertension 88%, cerebrovascular attack 64%, end stage renal disease 16%. 2) From the family screening with renal ultrasonography, we have confirmed dominant trait in 24 families. We found 2 families which have suspicious new mutations. 3) We performed linkage analysis of 15 families. The PKD-1 to non PKD-1 ratio was 13 : 2. 4) The male to femal ratio was 17 : 32 and age at diagnosis was 41 (24-65)years (mean (range)) in male, 45 (26-68) years in female. 5) The factors leading to the diagnosis of ADPKD were flank pain (23%), incidental finding (17%), palpable abdominal mass (11%), headache (9%) and gross hematuria (9%) 3) Hypertension (80%), azotemia (43%), flank pain (42%), renal calcification (42%), gross hematuria (33%) and cyst hemorrhage (25%) were renal complications. There were 2 renal cell carcinoma cases. 4)Liver cyst (82%) was the most common extrarenal manifestations. There were colonic diverticulosis (13%), cerebral artery aneurysm (7%), adrenal cyst (4%) and pancreatic cyst (2%). Results of our study revealed the clinical and genetic characteristics of ADPKD in Korea. We found only 44% of family history of renal disease, variable initial manifestations, variable renal and extrarenal complications. And we also found the similar percentage of PKD-2 (13%) to that (5-15%) of western countries, but it is necessary to study with more patients and families.
Aneurysm ; Azotemia ; Carcinoma, Renal Cell ; Cerebral Arteries ; Diagnosis ; Diverticulosis, Colonic ; Female ; Flank Pain ; Headache ; Hematuria ; Hemorrhage ; Humans ; Hypertension ; Incidental Findings ; Kidney Failure, Chronic ; Korea* ; Male ; Mass Screening ; Pancreatic Cyst ; Polycystic Kidney, Autosomal Dominant* ; Ultrasonography

Rib seriation has not been used to identify individual human skeletal remains in Koreans. Accurate rib seriation is important for determining rib number and for establishing an individual's age at death. The aim of this study was to use a previously published quantitative method to correctly predict rib sequencing in Koreans. We used complete rib sets of 54 individuals and measured three variables: AFTAL (articular facet of the tubercle-toangle length), HAFL (head-to-articular facet length), and SCTCH (superior costo-transverse crest height). AFTAL and SCTCH were more useful than HAFL for predicting rib seriation, and AFTAL produced the simplest equation for determining sex. In the ranking, the cumulative percentage of AFTAL was 79% with an error of 0, and the range of seriation error was +/-4. Compared to other studies using European measures, AFTAL showed greater accuracy of rib seriation in this study of Korean ribs. In fact, both AFTAL and AFTAL with SCTCH accurately predicted rib 4 in 94% of cases. AFTAL was the most accurate, and use of both SCTCH and AFTAL yielded better results than either alone. Thus, the high accuracy and predictive ability showed that this method is useful for measuring rib seriation in Koreans.
Humans ; Ribs

BACKGROUND: Because moving means can be easily shiftable according to their crude data, we made a selective expected ranges to calculate the moving means. Bull's mean (exponential factor, P=0.50) and Exponentially Adjusted Moving Mean (EAMM, P=0.66) were assessed. we studied to determine appropriately expected range and exponential factor. METHODS: We made the target values from RBC indices being measured with H-2 hematology autoanalyzer from 800 patients and the expected range from red cell indices data of additional 600 patients. Both moving means using this expected ranges were calculated. The % difference of Bull's mean and EAMM was compared and total mean of (deltaBull's mean/deltaBatch mean) and (deltaEAMM/deltaBatch mean) was compared. RESULTS: The target values were MCV: 90.6 fL, MCH: 29.8 pg. MCHC: 32.8 g/dL. The expected ranges were within +/-6% of their target values. Among the 20 batches obtained from expected range, there were no above +/-3% difference of red cell indices in both moving means. The comparison between % difference of Bull's mean and that of EAMM showed no difference. Total mean of (deltaEAMM/deltaBatch mean) was higher than that of (deltaBull's mean/deltaBatch mean). CONCLUSIONS: The % difference results of Bull's mean and EAMM were basically similiar within the expected range but EAMM method was more sensitive than Bull's mean method under the aspect of specimen effects, so EAMM was more detectable than Bull's mean on the quality control of red cell indices.
Erythrocyte Indices* ; Hematology ; Humans ; Quality Control

Insulin-like growth factor binding proteins (IGFBPs) are major regulators of insulin-like growth factor bioavailability and activity in metabolic signaling. Seven IGFBP family isoforms have been identified. Recent studies have shown that IGFBPs play a pivotal role in metabolic signaling and disease, including the pathogenesis of obesity, diabetes, and cancer. Although many studies have documented the various roles played by IGFBPs, transcriptional regulation of IGFBPs is not well understood. In this review, we focus on the regulatory mechanisms of IGFBP gene expression, and we summarize the findings of transcription factor activity in the IGFBP promoter region.
Biological Availability ; Gene Expression ; Humans ; Insulin-Like Growth Factor Binding Protein 2* ; Insulin-Like Growth Factor Binding Proteins ; Liver ; Metabolic Diseases ; Obesity ; Promoter Regions, Genetic ; Protein Isoforms ; Transcription Factors

PURPOSE: We evaluated the efficiency of low contact stress(LCS) system in total knee arthroplasty by analyzing clinical and radiological results. MATERIALS AND METHODS: Out of 128 cases who underwent total knee arthroplasty with meniscal bearing type LCS system, eighty one cases who were followed up for more than two years were analysed. Average follow-up period was 32,6 months(24 months-48 months). The diagnoses were six cases of degenerative arthritis, eighteen cases of rheumatoid arthritis, and two cases of avascular necrosis. Clinical analysis were performed by American Knee Society Knee Score and Hospital for Special Surgery(HSS) knee score and radiographic analysis were performed by the Knee Society Roentgenographic Evaluation and Scoring System. RESULTS: Average preoperative flexion contracture was improved from 13.4 degrees preoperatively to 1.2 degrees at final follow-up and average arc of motion was changed from 107 degrees preopeatively to 108 degrees at final follow-up without significant improvement. American Knee Society Knee Score was improved from average 55.2 preoperatively to 88.5 at final follow-up. HSS knee score also showed improvement from average 58.2 to 86.5. Tibio-femoral angle was improved from 6.3 degrees of varus preoperatively to 5.1 degrees of valgus at final follow-up. Radiolucent lines was seen most commonly at zone 1 in anteroposterior radiograph of tibia and in zone 1 in lateral radiograph of femur. Complications such as superficial wound infection, stiffness, and meniscal bearing fracture were seen in four cases. CONCLUSION: Total knee arthroplasty using LCS system showed satisfactory improvement in flexion contracture, deformity correction. Clinical and radiographic result.
Arthritis, Rheumatoid ; Arthroplasty* ; Congenital Abnormalities ; Contracture ; Diagnosis ; Femur ; Follow-Up Studies ; Knee* ; Necrosis ; Osteoarthritis ; Tibia ; Wound Infection