OBJECTIVE : To analyze the methylenetetrahydrofolate reductase (MTHFR) mutation in recurrent spontaneous abortion associated with hyperhomocysteinemia. MATERIAL AND METHOD: The blood Sample of habitual aborter with high fasting homocysteine level was tested by PCR-RFLP method. RESULTS: The patient was found to be a homozygosity for MTHFR gene mutation that was confirmed by the finding which is consistent with the mutation at the nucleotide 677 C to T, Corresponding to Ala to Val. CONCLUSIONS: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. Therefore, the MTHFR mutation should be examined in the workup of recurrent spontaneous abortion showing hyperhomocysteinemia.
Abortion, Spontaneous* ; Fasting ; Female ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Pregnancy

PURPOSE: Gastrointestinal stromal tumors (GIST) are a heterogenous group of mesenchymal neoplasms of the gastrointestinal tract. This study was performed to determine the clinical characteristics and prognostic factors of GIST. METHODS: We studied 24 cases of GIST collected over a 9 year period. This retrospective review analyzed the clinical presentation, pathologic examination, and long-term follow-up of patients with GIST. The clinicopathological features were evaluated to identify the predictors of survival. RESULTS: The most common clinical presentation was pain or discomfort (37.5%). GISTs were found to be typically present in older individuals and be most common in the stomach (41.7%). All patients underwent surgical resection with curative intent. The follow-up period ranged from 3 to 110 months. Recurrence occurred in 11 (45.8%) of 24 patients. According to multivariate analysis, survival was inversely correlated with size (P=0.032) and the number of mitoses (P=0.030). Patients younger than 50 had an independent value for prognostic prediction (P=0.058). CONCLUSION: Tumor size, mitotic index and patient's age can be used as prognostic factors for GIST according to the results of our study. But, better pathological and immunohistochemical methods are still required to improve GIST prognosis.
Follow-Up Studies ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Mitosis ; Mitotic Index ; Multivariate Analysis ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach

The calcar femorale is a specific anatomic entity which is often confused with the medial trabecular system or posteromedial cortex of the neck of the femur. The clinical significance of its architecture is evident when one considers the great number of operative procerdures performed in the upper end of the femur. This study deals with 45 cases of the Korean Dry femur(male: 27, female: 12, useless: 6) and two pairs of the femur from the cadavers. The authors observed the three dimensional structure of the calcar femorale and studied the relation between anteversion and calcar femorale. The results obtained were as follows: 1. The calcar femorale was a vertical plate of the thickened bone that lay deep to the lesser trochanter. The length in the vertical axis of the calcar femorale was 44.82±3.59mm. The calcar femorale was thickest medially where it joins the medial trabecular system of the femoral neck (maximal thickness: 2.65±0.65, width: 8.90±1.82mm). 2. The calcar femorale lay in one plane, which inclined 30.02±7.80 degree to the discondylar axis of the femur. By using this inclination of the calcar plane, it could be best visualized with about 60° external rotation of femur in a simple X-ray. 3. The angle between the calcar plane and the diacondylar axis was proportionate to the anteversion of the femoral neck. Correlation coefficient(r=0.80) was calculated. The regression line of y (anteversion) on x(calcar angle) was y=0.75X−8.53(slope). With this proportion, the angle of the femoral anteversion could be determined. 4. Microscopic features of the calcar femorale was revealed in the scanning electron microscopic studies. The medial side of the calcar was a cortical extension and it became thinner posterolaterally and than it was composed of fused or thickened trabeculae.
Cadaver ; Female ; Femur Neck ; Femur ; Humans ; Neck

Intramural hematoma(IMH) and penetrating aortic ulcer have been increasingly recognized as causes of acute aortic pathology in addition to aortic dissection. The presence of the intimal tear and a flap traversing the aortic lumen is considered to be a most reliable differential point of aortic dissection and IMH. Transesophageal echocardiography(TEE) has become a valuable modality for the diagnosis, prognosis and management of acute aortic syndrome with the unique advantages of portability and the ability to obtain high-resolution real time images. Endovascular Stent-graft placement over the primary entry tear may be an alternative to open surgery because it can close the intimal tear, which leads to thrombosis of the false lumen, excluding flow through the intimal tear and redirecting aortic flow exclusively into the true lumen. We report 88 year-old male with aortic dissection in descending thoracic aorta, successfully treated with endovascular Stent-graft implantation, which was mimicking intramural hematoma by its appearance and subclinical intimal tear diagnosed exclusively by TEE against other imaging studies.
Aged, 80 and over ; Aorta, Thoracic* ; Diagnosis ; Hematoma* ; Humans ; Male ; Pathology ; Prognosis ; Thrombosis ; Ulcer

OBJECTIVE: The purpose of this retrospective study was to report the outcome of the endovascular treatment of eight patients with eight saccular posterior inferior cerebellar artery (PICA) aneurysms. MATERIALS AND METHODS: Over the last seven years (1999-2006), eight consecutive patients with saccular PICA aneurysms were treated by endovascular methods. Five of the aneurysms were presented with subarachnoid hemorrhaging, whereas three were discovered incidentally. Four of the aneurysms (3 ruptured and 1 incidental) were treated by intrasaccular coiling, whereas the remaining four (1 ruptured and 3 incidental) were treated by vertebral artery (VA) occlusion. RESULTS: Of the four aneurysms treated by intrasaccular coiling, three were completely packed with coils and one was partially packed. In three of four patients who underwent vertebral artery occlusions, follow-up digital subtraction angiographies demonstrated thrombosed aneurysms and PICA. No procedure-related morbidity occurred and no re-bleed was encountered during a follow-up examination (mean; 31 months). CONCLUSION: As a result of this study, we found that the endovascular management of saccular PICA aneurysms should be considered as safe and effective.
Adult ; Aged ; Aneurysm, Ruptured/radiography/*therapy ; Cerebellum/blood supply/*radiography ; Cerebral Angiography ; Embolization, Therapeutic/*methods ; Female ; Humans ; Incidental Findings ; Intracranial Aneurysm/radiography/*therapy ; Male ; Middle Aged ; Retrospective Studies ; Subarachnoid Hemorrhage/radiography/*therapy ; Treatment Outcome

Pulmonary embolism is the impaction of material into branches of the pulmonary arterial bed. It usually occurs in patients with primary hypercoagulable states or secondary hypercoagulable states like cancer, preganancy, and estrogen replacement therapy. We report a case of a pulmonary embolism in a patient with positive lupus anticoagulant who received estrogen replacement therapy. The patient was referred due to suddenly developed shortness of breath and echogenic mass densities in the right atrium on 2 dimensional echocardiography. The patient was markedly improved with intravenous urokinase and subsequent oral anticoagulant therapy. Related articles are also reviewed.
Dyspnea ; Echocardiography ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Heart Atria ; Humans ; Lupus Coagulation Inhibitor* ; Pulmonary Embolism* ; Urokinase-Type Plasminogen Activator

PURPOSE: This study examined the mediating effect of school nurses' self efficacy, which is one of the significant cognitive factors influencing cultural sensitivity, on the mutual relationships between multicultural attitude and cultural sensitivity in Korean elementary schools. METHODS: A cross-sectional descriptive survey design was used. Participants were 157 school nurses in elementary schools located in Gyeonggi-do, South Korea. The survey instruments included Teacher Multicultural Attitude Survey, Teacher Efficacy Scale, and Multicultural Sensitivity Scale. Data were analyzed using three regression equations to test the mediation model. RESULTS: The mean score of the school nurses' cultural sensitivity was relatively low. A positive correlation among multicultural attitude, self efficacy, and cultural sensitivity was noted. Self efficacy of school nurses showed a significant mediating effect on the relationships between multicultural attitude and cultural sensitivity. CONCLUSIONS: Given the meaningful influence of positive multicultural attitude on cultural sensitivity and significant mediator effect of self efficacy as a school nurse between the two variables, the strategies to cultivate a positive multicultural attitude and enhance school nurses' self efficacy in their unique role should be considered in a training program. School nurses' health care services will benefit from the improvement of cultural sensitivity toward young children from multicultural families.
Adult ; *Attitude of Health Personnel ; Cross-Sectional Studies ; *Cultural Diversity ; Humans ; Middle Aged ; Nursing Staff, Hospital/*psychology ; Republic of Korea ; *Self Efficacy ; Surveys and Questionnaires

Seventy four patients with soft tissue sarcomas treated by postoperative radiotherapy in the Department of Therapeutic Radiology, Seoul National University Hospital between August 1979 and September 1990 were analyzed. The follow-up period ranged from 3 to 145 months with a median of 51 months. Liposarcoma and malignant fibrous histiocytoma(MFH) constituted 54% of the cases and the histologic grades of tumors are as follows: grad I, 23 case; grade II, 17 cases; grad III, 24 cases; unknown grade , 10 cases. The patients were treated by marginal(17 cases), wide(55 cases) or compartmental(2 cases) excision followed by postoperative radiotherapy. The total radiation doses were 4200-8820 cGy(median 6000cGy), 180-200n cGy daily, 5 times per week. Of 74 patients, 35 utimately failed. The local control was 62.2% at 5 years and cumulative rik of distant metastasis was 22.3% at 5 years. The overall survival and disease free survival were 72.3% and 53.3% at 5 years, respectively. Survival after appearance of metastasis was 15.1% at 3 yeaers. Patients with liposarcoma experienced better local control that those with other histologic type and tumor grade and surgical resection margin significantly correlated with local recurrence, distant metastasis and overall survival on univeriate analysis. In conclusion, re-excision is needed for patients with positive surgical resection margin to improve local control and further therapeutic measures using effective chemotherapy should be explored in the hope of improving overall survival.
Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Hope ; Humans ; Liposarcoma ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy* ; Recurrence ; Sarcoma* ; Seoul

Unilateral localized hyperhidrosis over scalp and face is an extremely rare disease that usually has undetermined origin. We report a case of idiopathic unilateral localized hyperhidrosis over left scalp and face. A 55-year-old female patient with unilateral hyperhidrosis that is localized in the left side of scalp and face visited our dermatology clinic. She had increased sweating in left face and scalp, recurring in summer for 3 years. She complained of the exacerbation by thermal and gustatory stimuli and exercise. The starch iodine test and digital infrared thermal imaging test revealed a marked increase in sweat gland activity on the affected areas as compared to the contralateral normal sites.
Dermatology ; Female ; Humans ; Hyperhidrosis* ; Iodine ; Middle Aged ; Rare Diseases ; Scalp* ; Starch ; Sweat ; Sweat Glands ; Sweating

The purpose of this study was to investigate the ideal clinical torque(In the SWA rectangular wire, the torque by the angle between the plane part and twisted part to move the tooth) of the orthodontic rectangular wire which produce the proper labiolingual movement of the single tooth during finishing stage of the orthodontic treatment. The clinical torque is the sum of the play and the active torque which generates the moment at the bracket. The play is calculated by the formula and the active torque is calculated by the computer aided three-dimensional finite element method. The finite element model was consist of the three brackets which formed a row and 3 kinds of orthodontic rectangular wire(stainless steel, TMA, NiTi) which inserted in brackets. Both sides of the model were twisted and the moment generated in the center bracket was calculated. The sizes of seven wires which were used commonly were .016" X .022", .017" X .022", .017" X .025", .018" X .025", .019" X .025", .020" X .025", .021" X .025". In 018" bracket, 016" X .022", .017" X .022", .017" X .025" wires were inserted and in 022" bracket, all the sizes of wires except .016" X .022" were inserted and tested. The following conclusions could be drawn from this study. 1. The moments generated on the same size of the wires by the same active torque were equal regardless of the bracket slot size. 2. The moments were increased with the size of the wires. The moment generated on the .021" X .025" wire was about 1.75 times as large as that on the .016" X .022" wire regardless of the material. 3. The moments were increased in the order of the NiTi, TMA, stainless steel. The moment of the TMA wire was 0.35 times as small as that of the stainless steel wire and the moment of the NiTi was 0.16 times as small as that of the stainless steel wire. 4. The moment was decreased as the interbracket distance was increased. 5. To get a desired moment with the specific size and material of the wire on the specific bracket slot, the formula and the results were displayed.
Finite Element Analysis* ; Stainless Steel ; Steel ; Tooth ; Torque*