STUDY DESIGN: This is a retrospective review of 10 consecutive patients with spinal cord injury without radiographic evidence of abnormalities (SCIWORA) and 17 spinal cord injury patients without radiographic evidence of trauma (SCIWORET). OBJECTIVES: We wanted to assess the MRI and clinical findings, the prognosis and effect of anterior decompression of the spinal cord in SCIWORET patients. SUMMARY OF THE LITERATURE REVIEW: SCIWORET is not uncommon among middle-age and elderly people. It is less reported in adults as compared with children. There are no studies on the method for the treatment or the effectiveness of anterior decompression of the spinal cord. MATERIALS AND METHODS: From February 1994 to December 2005, this study included 27 patients who had cervical spinal cord injury without radiographic evidence of trauma on the plain roentgenography and MRI. Ten patients had no spinal cord compression (SCIWORA patients, group 1) and 17 had their spinal cord compressed from the anterior (SCIWORET patients, group 2), We conservatively treated the group 1 patients and 10 of the group 2 patients, and anterior decompression and fusion were done for 7 of the group 2 patients. Neurological evaluation was performed initial and at last follow up using an ASIA motor score and the Frankel grade. RESULTS: The patients who had spinal cord edema on MRI had a better prognosis than those who had contusion (p=0.06). There is no statistical difference between the two groups for the neurologic changes at the initial period and the last follow up period (p=0.06, 0.61). Decompression of the spinal cord anteriorly was not effective for the neurologic recovery (p=0.25) and the involved segments were not related to the neurologic changes (p=0.34, 0.25). CONCLUSIONS: It was presumed that patients with edema of the spinal cord had a better prognosis than those with contusion of the spinal cord. There was no difference between the SCIWORA and SCIWORET groups for the neurologic changes and anterior decompression was not effective for the recovery of neurologic symptoms. This study was limited by its retrospective nature and the small number of patients, so a multi-center study is needed.
Adult ; Aged ; Asia ; Child ; Contusions ; Decompression ; Edema ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Neurologic Manifestations ; Prognosis ; Retrospective Studies ; Spinal Cord ; Spinal Cord Compression ; Spinal Cord Injuries

Human leucine-rich alpha-2-glycoprotein 1 (LRG1 ) was first identified as a trace protein in human serum. The primary sequence of LRG1 includes repeated leucine residues and putative membrane-binding domains. But, there is no published information on the genetic variation of this gene. In this study, LRG1 was identified as one of several upregulated genes in RA patients. We examined the expression levels of LRG1 between an RA patient and a healthy control by RT-PCR and validated that LRG1 was highly expressed in RA patients compared with controls. We identified the possible variation sites and single nucleotide polymorphisms (SNPs) in the human LRG1 gene by direct sequencing and analyzed the association of genotype and allele frequencies between RA patients and a control group without RA. We further investigated the relationship between these polymorphisms and the level of RF or anti-CCP in RA patients. We identified a total of three SNPs (g.-678A> G, g.-404C>T and g.1427T>C) and two variation sites (g.-1198delA and g.-893delA) in the LRG1 gene. Our results suggest that polymorphisms of the LRG1 gene are not associated with the susceptibility of RA in the Korean population.
Arthritis, Rheumatoid ; Gene Frequency ; Genetic Variation ; Genotype ; Humans ; Leucine ; Polymorphism, Single Nucleotide

Recently the changes in medical informatics enabled us to use medical information whenever we want and wherever we are. However, there are few information supporting systems on the web in occupational health field. So we have tried to make an occupational health information system (OHIS) based on the Internet and to provide occupational information to occupational health personnel. There were two steps for developing OHIS. First, we analyzed user's needs and existing information systems and then developed contents of our OHIS. Second, we constructed web server under the environment of Windows user, using operating system of windows NT 4.0 and web browsers of Netscape Navigator. Many users in worksites wanted information through the Internet. The contents of OHS which they wanted were information related to health education of workers, health counselling, news, and so on. The contents of OHIS which we forwarded were occupational health service, information about organization of occupational health, book references and journals, link-sites related to occupational health. In the future, this Interned-based OHIS will be an useful site offering a lot of information to occupational health personnel.
Health Education ; Health Information Systems* ; Information Systems ; Internet* ; Medical Informatics ; Occupational Health ; Occupational Health Services ; Occupations* ; Web Browser ; Workplace

To select candidate genes, we attempted to comparative analysis of protein levels between rheumatoid arthritis (RA) patients and healthy controls by two-dimensional electrophoresis (2-DE) and matrix-assisted laser desorption ionization mass spectrometry (MALDI-TOF-MS). We identified 17 proteins that showed up- or down-regulated spots in RA patients. We found that coactosin-like1 (COTL1) were highly expressed in RA patients compared with healthy controls. We performed a case-control study to determine whether the COTL1 gene polymorphisms were associated with RA and systemic lupus erythematosus (SLE). The genotype frequency of c.-1124G>T and the allelic frequency of c.484G>A in RA patients, and the genotype frequency of c.484G>A in SLE patients were significantly different from healthy controls (P = 0.009, 0.027, and 0.025, respectively). We also investigated the correlation with the levels of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibody in RA patients, and anti-nuclear antibodies (ANA) in SLE patients. The c.484G>A polymorphism in RA patients has significant association with the levels of anti-CCP antibody (P = 0.03). Our findings demonstrated that c.-1124G>T and c.484G>A polymorphisms of the COTL1 gene might be associated with the genetic susceptibility of autoimmune disorders.
Arthritis, Rheumatoid/*genetics/immunology/metabolism ; Autoimmune Diseases/genetics/immunology ; Case-Control Studies ; Electrophoresis, Gel, Two-Dimensional ; Genotype ; Humans ; Lupus Erythematosus, Systemic/genetics/immunology ; Microfilament Proteins/*genetics/metabolism ; Polymorphism, Genetic/*genetics ; Proteome/genetics ; Proteomics/*methods ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

To select candidate genes, we attempted to comparative analysis of protein levels between rheumatoid arthritis (RA) patients and healthy controls by two-dimensional electrophoresis (2-DE) and matrix-assisted laser desorption ionization mass spectrometry (MALDI-TOF-MS). We identified 17 proteins that showed up- or down-regulated spots in RA patients. We found that coactosin-like1 (COTL1) were highly expressed in RA patients compared with healthy controls. We performed a case-control study to determine whether the COTL1 gene polymorphisms were associated with RA and systemic lupus erythematosus (SLE). The genotype frequency of c.-1124G>T and the allelic frequency of c.484G>A in RA patients, and the genotype frequency of c.484G>A in SLE patients were significantly different from healthy controls (P = 0.009, 0.027, and 0.025, respectively). We also investigated the correlation with the levels of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibody in RA patients, and anti-nuclear antibodies (ANA) in SLE patients. The c.484G>A polymorphism in RA patients has significant association with the levels of anti-CCP antibody (P = 0.03). Our findings demonstrated that c.-1124G>T and c.484G>A polymorphisms of the COTL1 gene might be associated with the genetic susceptibility of autoimmune disorders.
Arthritis, Rheumatoid/*genetics/immunology/metabolism ; Autoimmune Diseases/genetics/immunology ; Case-Control Studies ; Electrophoresis, Gel, Two-Dimensional ; Genotype ; Humans ; Lupus Erythematosus, Systemic/genetics/immunology ; Microfilament Proteins/*genetics/metabolism ; Polymorphism, Genetic/*genetics ; Proteome/genetics ; Proteomics/*methods ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

BACKGROUND: The polymorphisms, C677T and A1298C in the methylenetetrahydrofolate reductase (MTHFR) gene express a decreased enzyme activity. These polymorphic variants are known to decrease the risk of some malignancies. We examined whether the polymorphisms in MTHFR gene play a role in childhood acute lymphoblastic leukemia (ALL). METHODS: Peripheral blood or bone marrow samples were collected from 99 ALL patients aged <16 years and 105 age and sex matched controls. We performed PCR-restriction fragment length polymorphism with HinF1 for C677T and MboII A1298C. RESULTS: The frequencies of 677CC, 677CT, and 677TT genotypes were 43.4%, 46.5% and 10.1% in patients and 39.0%, 45.7%, and 15.2% in controls. The 677TT variants seemed to decrease the risk for ALL than the 677CC genotype, but the difference was not statistically significant (OR=0.60, 95% CI=0.2-1.5). The frequencies of 1298AA, 1298AC, and 1298CC genotype were 66.7%, 26.3% and 7.1% in patients and 60.0%, 38.1% and 1.9% in controls. The 1298CC genotype seemed to increase the risk for ALL than 1298AA, but without statistical significance (OR=3.34, 95% CI=0.7- 18.1). These findings were more evident in the patient groups with hyperploid and translocation than those with normal karyotypes. CONCLUSIONS: In our series, MTHFR C677T and A1298C polymorphism did not show a statistically significant protective effect for the childhood ALL.
Bone Marrow ; Genotype ; Humans ; Karyotype ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

OBJECTIVE: To evaluate the efficacy of botulinum toxin type A in the treatment of spasticitc and dystonic upper limbs in a group of cerebral palsy children METHOD: Eighteen children with cerebral palsy who did not have fixed contractures in the wrist and hand were enrolled (mean age 9.0 years; range 6~15). Measurements were obtained before and at 1 and 3 months after botulinum toxin A injections. Assessments included spasticity (modified Ashworth scale), range of motion of thumb and functional assessments including Melbourne assessment of unilateral upper limb function and Jebsen Taylor hand function test. Hand and forearm muscles were injected with 1~3 u/kg botulinum toxin. RESULTS: Spasticity measured by modified Ashworth scale decreased by 1 month and diminished spasticity continued for 3 months. Range of motion of thumb increased by 1 and 3 months. In Jebsen hand function test, patients showed functional improvements in item 6 (lifting light weight object) and item 7 (lifting heavy object). Melbourne assessment of unilateral upper limb function scores improved from a mean value of 92 at baseline to a mean value of 101 at 1 month and a mean value of 105 at 3 months. CONCLUSION: Botulinum toxin A would be helpful in some selected cerebral palsy patients with upper limb dysfunction. But further research including randomized controlled study is needed on the use of botulinum toxin A to improve function.
Botulinum Toxins* ; Botulinum Toxins, Type A ; Cerebral Palsy* ; Child* ; Contracture ; Forearm ; Hand ; Humans ; Muscle Spasticity ; Muscles ; Range of Motion, Articular ; Thumb ; Upper Extremity* ; Wrist

Although the genetic component in the etiology of rheumatoid arthritis (RA) has been consistently suggested, many novel genetic loci remain to uncover. To identify RA risk loci, we performed a genome-wide association study (GWAS) with 100 RA cases and 600 controls using Affymetrix SNP array 5.0. The candidate risk locus (APOM gene) was re-sequenced to discover novel promoter and coding variants in a group of the subjects. Replication was performed with the independent case-control set comprising of 578 RAs and 711 controls. Through GWAS, we identified a novel SNP associated with RA at the APOM gene in the MHC class III region on 6p21.33 (rs805297, odds ratio (OR) = 2.28, P = 5.20 x 10(-7)). Three more polymorphisms were identified at the promoter region of the APOM by the re-sequencing. For the replication, we genotyped the four SNP loci in the independent case-control set. The association of rs805297 identified by GWAS was successfully replicated (OR = 1.40, P = 6.65 x 10(-5)). The association became more significant in the combined analysis of discovery and replication sets (OR = 1.56, P = 2.73 +/- 10(-10)). The individuals with the rs805297 risk allele (A) at the promoter region showed a significantly lower level of APOM expression compared with those with the protective allele (C) homozygote. In the logistic regressions by the phenotype status, the homozygote risk genotype (A/A) consistently showed higher ORs than the heterozygote one (A/C) for the phenotype-positive RAs. These results indicate that APOM promoter polymorphisms are significantly associated with the susceptibility to RA.
Apolipoproteins/*genetics ; Arthritis, Rheumatoid/*genetics ; Case-Control Studies ; DNA/genetics ; Female ; *Genetic Predisposition to Disease ; Genome-Wide Association Study ; Genotype ; Heterozygote ; Homozygote ; Humans ; Lipocalins/*genetics ; Luciferases/metabolism ; Male ; Middle Aged ; Polymorphism, Single Nucleotide/*genetics ; Promoter Regions, Genetic/*genetics ; Real-Time Polymerase Chain Reaction ; Risk Factors

With rapid population aging, the socioeconomic burden caused by dementia care is snowballing. Although a few community-based studies of Alzheimer's disease (AD) have been performed in Korea, there has never been a nationwide hospital-based study thereof. We aimed to identify the demographics and clinical characteristics of mild-to-moderate AD patients from the Clinical Research Center for Dementia of Korea (CREDOS) registry. A total of 1,786 patients were consecutively included from September 2005 to June 2010. Each patient underwent comprehensive neurological examination, interview for caregivers, laboratory investigations, neuropsychological tests, and brain MRI. The mean age was 74.0 yr and the female percentage 67.0%. The mean period of education was 7.1 yr and the frequency of early-onset AD (< 65 yr old) was 18.8%. Among the vascular risk factors, hypertension (48.9%) and diabetes mellitus (22.3%) were the most frequent. The mean score of the Korean version of Mini-Mental State Examination (K-MMSE) was 19.2 and the mean sum of box scores of Clinical Dementia Rating (CDR-SB) 5.1. Based on the well-structured, nationwide, and hospital-based registry, this study provides the unique clinical characteristics of AD and emphasizes the importance of vascular factors in AD in Korea.
Aged ; Aged, 80 and over ; Alzheimer Disease/complications/*diagnosis ; Brain/radionuclide imaging ; Caregivers ; Dementia/diagnosis ; Demography ; Diabetes Mellitus, Type 2/etiology ; Female ; Hospitals ; Humans ; Hypertension/etiology ; Interviews as Topic ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Questionnaires ; *Registries ; Republic of Korea ; Risk Factors

The aim of this study was to observe the effects of prophylactic palivizumab on hospitalization secondary to respiratory syncytial virus (RSV) infection (RSVhospitalization) in former very low birth weight infants (VLBWI) with bronchopulmonary dysplasia (BPD). This study also sought to identify the risk factors of RSVhospitalizationin this particular infant population. A prospective observational study was conducted between September 2007 and April 2008 in seven Korean hospitals. Children with a history of very low birth weight, a diagnosis of BPD and who were <2 yr old at the onset of the RSV season were included in this study. Palivizumab injections were administered monthly for a maximum of five months during the RSV season. RSVhospitalization rates were reviewed, and RSVhospitalization rates between subgroups were categorized by gestational age, birth weight, and duration of ventilator care. A total of 90 subjects completed the follow-up interviews. The mean gestational age at birth was 26.1+/-1.7 weeks, and the mean birth weight was 889.4+/-222.2 g. The incidence of RSVhospitalization in the study population was 8.9% (8/90), and the mean hospital stay was 11.0+/-5.5 days, including one death. There were no statistically significant differences in the patients' demographic characteristics or risk factors for RSV hospitalization. When subgroup analyses were conducted, there were still no statistically significant differences. The administration of palivizumab prophylaxis during the entire RSV season is important in VLBWI with BPD, regardless of their gestational age and birth weight, or previous ventilator dependency.
Antibiotic Prophylaxis/*methods ; Antiviral Agents/*therapeutic use ; Birth Weight ; Bronchopulmonary Dysplasia/*complications ; Female ; Gestational Age ; Hospitalization/statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; *Infant, Very Low Birth Weight ; Length of Stay ; Male ; Palivizumab/*therapeutic use ; Prospective Studies ; Respiratory Syncytial Virus Infections/drug therapy/*epidemiology/prevention & control ; Respiratory Syncytial Viruses/drug effects ; Risk ; Risk Factors