We report an autopsy of a male fetus that showed multiple congenital anomalies that could best be designated as Meckel-Gruber syndrome. The fetus was born dead at the gestational age of 38 weeks. His parents denied any history of congenital malformation. And the parity of the mother was 0-0-0-0, but she had the past history of receiving herb medication for common cold. The congenital anomalies found in this case consited of occipital meningoencephalocele, midline cleft palate, bifid epiglottis, hepatic fibrosis, choledochal cyst, bilateral polycystic kidneys, postaxial polydactyly of both hands and feet, aplasia of the left testis, secundum type atrial septal defect and patent ductus arterious. This malformation syndrome is rare and lethal. The prenatal diagnosis should be made by ultrasound study or analysis of the amniotic fluid for alpha-feto protein during intrauterine period. The kidneys showed Potter type III cystic change and there was a characteristic hepatic fibrosis.
Male ; Humans

A retrospective comparative study of MRI and CT in 24 patients with diffuse axonal injury (DIA) was undertaken. Three-quaters of the lesions were non-hemorrhagic, and the sites of involvement were lobar white matter (96%), corpus callosum (70%), and rostral brainstem (42%), in descending order. MRI was singnificantly more sensitive than CT in detecting DAI lesions. The average number of DAI lesions was higher with increasing clinical stage of the injury. MRI is more valuable than CT for staging the full magnitude of the injury and in predicting the neurologic prognosis of DAI lesions.
Axons* ; Brain Stem ; Brain* ; Corpus Callosum ; Diffuse Axonal Injury ; Humans ; Magnetic Resonance Imaging* ; Prognosis ; Retrospective Studies ; White Matter

PURPOSE: Un-healing and centrally located defect on back area, it is sometimes a challenge for the reconstructive surgeon. Although skin grafts are considered as the first choice for reconstruction of large skin defect on the back region, it is not always helpful but vascularized flaps provide a superior functional and aesthetic outcome. The present study was designed to investigate the clinical anatomy of the lumbar artery perforator flap to reconstruct back ulcer. MATERIALS AND METHODS: Clinical anatomy study was undertaken using computed tomographic angiographic analysis. We identified the courses of lumbar arteries and its perforators, measured pedicle length by layers. The location of the perforator vessel was charted against anatomical landmarks. RESULTS: The pedicle lengths of the third and fourth lumbar artery perforator reached a mean of 27.8 mm and 37.1 mm respectively from superficial fascia to deep fascia. The fourth perforator was more laterally located than the third perforator and less than 1 cm above the iliac crest. A case in which the fourth lumbar artery perforator was used as flap pedicle is described. CONCLUSION: For the reconstruction of central defect on the back area, the lumbar artery perforator flap coverage may be a good alternative option. Computed tomographic angiography can easily identify the course and location of lumbar artery perforators and can be helpful to elevate the flap successfully.
Angiography* ; Arteries* ; Fascia ; Perforator Flap* ; Skin ; Subcutaneous Tissue ; Transplants ; Ulcer* ; Wound Closure Techniques

PURPOSE: A survey was performed to identify the level of mouthguard use, awareness, wearability issues and attitude toward mouthguard among elite Korean Taewondo athletes. MATERIALS AND METHODS: Survey questionnaires were given to 152 athletes participating in the Korea National Taekwondo team selection event for the 2010 Guangzhou Asian Games. Questionnaires consisted of three sections, mouthguard awareness, reasons for not wearing mouthguard and the last section to test the level of acceptance on current mouthguard and when the identified problems were resolved. For analyzing difference among response, chi2 test was used and significant level (alpha) was set up as 0.05. RESULTS: Responses in each of items showed significant difference (P<.001). Majority of response regarding each question: Majority of respondents believed that mouthguard were effective in preventing injuries (36.4%) but the result suggested that the provision of information on mouthguard to athletes was inadequate (44.0%) and the result showed that respondents were not greatly interested or concerned in relation to the mandatory mouthguard rule (31.6%). Although the responses on the level of comfort and wearability of mouthguard were negative (34.8%), athletes were positively willing to wear mouthguard if the problems rectified (51.2%). CONCLUSION: Considering the high level of willingness to wear mouthguard if the problems rectified, it is thought that together with efforts in providing more mouthguard information, the work of sports dentistry to research and improve mouthguard will be invaluable in promoting mouthguard to more athletes.
Asian Continental Ancestry Group ; Athletes ; Dentistry ; Humans ; Korea ; Martial Arts ; Mouth Protectors ; Sports ; Surveys and Questionnaires

For the last 20 years, several different techniques of fat injections have been developed. However, a standard technique of fat grafts has not yet been adopted for all practitioners. The purpose of this study was to evaluate the safety and long-term results of fat grafts using the modified Colman's technique. A total of 234 patients who underwent fat injections were retrospectively reviewed. The results were evaluated by patient satisfaction and photographs. The patient satisfaction was assessed using visual analogous scale(VAS), and photographs were evaluated by medical professionals. The fat was harvested using tumescent liposuction with a two hole Coleman harvesting cannula, and centrifuged at 3000rpm for 3 minutes. The refined fatty tissue was then transferred into a 1-ml syringe, and injected subcutaneously using 17-gauge cannula. The amount of fat tissue placed with each withdrawal of a cannula was 0.3~0.5mL. This technique showed good results with long-lasting volume consistency and few complications. The average value of VAS scored by patients was 8.7, and that by surgeons was 8.5, showing statistically no significant difference between the values evaluated by patients and surgeons. Author's fat injection procedure is a good choice for the correction of cosmetic defects and facial rejuvenation.
Adipose Tissue ; Catheters ; Cosmetics ; Follow-Up Studies ; Humans ; Lipectomy ; Patient Satisfaction ; Rejuvenation ; Retrospective Studies ; Syringes ; Transplants

Epithelial-myoepithelial carcinoma of intercalated duct(origin) is a recently described tumor characterized by its typical biphasic pattern of central duct like cell and peripheral clear cell. We described a case of epithelial-myoepithelial carcinoma in a 10-year-old boy. Microscopically, the tumor showed typical biphasic pattern, diffuse proliferation of clear cells and linining epithelial cells of tubular structures. Immunohistochemically, the clear cell showed positive reaction to S-100 protein, and the epithelial cells expressed cytokeratin indicating myoepithelial and epithelial differentiation respectively. Biphasic differentiation of the tumor cells could be also proved by electronmicroscopic study.

OBJECTIVES: In this study, we examined the relationship between attachment style, alexithymia, marital satisfaction, and depressive symptoms in married couples. METHODS: We administered the Korean version of Experiences in Close Relationships questionnaire-Revised (K-ECR-R), Korean version of the 20-item Toronto Alexithymia Scale (TAS-20K), Revised-Dyadic Adjustment Scale (R-DAS), Korean version of the Beck Depression Inventory (K-BDI), and to 105 men and 115 women in the community. The data was analyzed with correlation analysis between related variables, and the regression analysis method of Baron and Kenny (1986) was used. RESULTS: The current study assumes that alexithymia mediates between attachment style and marital satisfaction, and these factors influence depressive symptoms. The results were as follows : 1) alexithymia mediated perfectly between attachment anxiety style and marital satisfaction and 2) alexithymia, and marital satisfaction had significant influences on depressive symptoms. Attachment avoidance style was excluded for dissatisfaction with the assumption of the regression analysis method of Baron and Kenny (1986). CONCLUSION: These results suggest that attachment style, alexithymia, and marital satisfaction seem to be important factors in depressive symptoms among married people. These results suggest that different interventions according to attachment style may helpful for the enhancement of marital satisfaction and the reduction of the depressive symptoms of married couples.
Affective Symptoms ; Anxiety ; Depression ; Family Characteristics ; Female ; Humans ; Male

PURPOSE: To measure the size of normal corpus callosum in each portion using objective and reproducible method with MRI and evaluation of morphological change of corpus callosum by grade of hydrocephalus. MATERIALS AND METHODS: Midsagittal Tl-weighted MR imaging of the corpus callosum was investigated in 41 volunteers of normal Korean adults and 19 patients with hydrocephalus. Corpus callosum was measured for the anteroposterior length(A), height(B), and the thickness of genu(C), body (D), splenium(E), and the narrowest portion of body(F). And the analysis of morphology and signal intensity of the corpus callosum were also evaluated. Hydrocephalus was graded as mild, moderate, and severe, and comparision of thickness with normal corpus callosum in each portion was done. RESULTS: The mean length and height were 72.3mm, 28.6mm in male, and 70.7ram, 28.9mm in female. And the mean dimention for C, D, E, and F were 13.1 ram, 8ram, 13.2mm, 5.2ram in male, and 12.8mm, 7.5ram, 12.3 ram, 5mm in female. The morphology of normal corpus callosum was "hook" shaped on midline sagittal Tl-weighted image. Narrowing at posterior third portion of body were present on 30 cases(73.2%) and even in thickness of the body in 11 cases(26.8%). The signal intensity of the corpus callosum on midsagittal Tl-weighted spin echo image of normal cases was homogeneous hyperintense as compared with cerebral gray matter. In hydrocephalus, A and B were increased and other portions were decreased in thickhess. Genu and the narrowest portion of body showed significant difference of thickness according to the grade of hydrocephalus. CONCLUSION: The mean dimention of all portion of corpus callosum were larger in male than female except for callosal height but not significant statistically with the exception of splenium. Hydrocephalus lead to morphological change of the corpus callosum. Among the portion of corpus callosum, genu and the narrowest portion of the body were thought to be the most sensitive indicators of degree in hydrocephalus.
Adult* ; Corpus Callosum* ; Female ; Humans ; Hydrocephalus* ; Magnetic Resonance Imaging* ; Male ; Volunteers

Twenty-two children(4 months to 17 years old)with a clincial diagnosis of complex partial seizure(CPS) were examined with a 0.5T MRI scanner using spin-echo sequences. Eleven patients showed abnormal brain MRI findings; two had focal lesions with corresponding seizure foci on the EEG, one arising from temporal lobe(Hippocampal Formation atrophy) and the other from the frontal lobe. Nine patients showed diffuse lesions with inconsistent seizure foci on EEG. The remaining 11 patients were normal on bran MRI; two of them had normal EEG findings and the others either focal or diffuse abnormalities on EEG.
Brain* ; Child* ; Diagnosis ; Electroencephalography ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging* ; Seizures*

BACKGROUND: We can usually see the yawning at induction of anesthesia, however, it has not been studied as such an indicator of anesthesia. The yawning is one means of changing arousal level, and a sign or marker that such a change is occurring, although its functions are not well understood. The purpose of the present study was to evaluate the yawning whether it could be used as an indicator of induction of anesthesia, using its property as a marker of changed arousal level. METHODS: In 60 adult patients, group 1 was done propofol target controlled infusion (TCI) with Stelpump software, while group 2 was done thiopental TCI similarly. Clinical indicators of induction of anesthesia were measured as follows: loss of verbal control (LOV), loss of eyelash reflex (LOE), the yawning. In addition, the occurrence of apnea (OOA) were measured, too. We assessed the hypnosis levels of indicators of induction of anesthesia including the yawning and demonstrate their effect site concentrations and elapsed time. Furthermore, we compared the incidences of yawning and apnea between both groups. RESULTS: Clinical indicators of induction occurred in the order of LOV > LOE > the yawning >> OOA in both groups. With respect to BIS, the yawning showed the lowest BIS and the highest effect site concentrations except OOA in both groups. The incidence of the yawning in group 2 was higher than in group 1 (about 82 vs 63%). On the contrary, the incidence of apnea in group 1 was higher than in group 2 (about 79 vs 53%). CONCLUSIONS: As far as the yawning could be shown, we could observe, it approximated most closely to their clinical impression of the 'true' induction in terms of the hypnosis level and its effect site concentration.
Adult ; Anesthesia* ; Apnea ; Arousal ; Humans ; Hypnosis ; Incidence ; Propofol ; Reflex ; Thiopental ; Yawning*