No abstract available.
Sturge-Weber Syndrome*

The aim of this study was to compare widely used quantitative sensory tests to evaluate the diabetic neuropathy(DN). We tested plantar sensation of 40 patients with diabetes mellitus(Group I: 20 with neuropathic symtom, Group II: 20 without symptom) using Semmes-Weinstein monofilament(touch sensation), Biothesiometer(vibration sensation) and EMG. This result was also compared with that of the control group. Eighty percent of Group I and thirty percent of Group II had abnormal EMG findings. Group I had decreased vibration and touch sensation. Comparison of vibration perception threshold(Biothesiometer) with touch pressure sensation(Semmes-Weinstein monofilament) showed that the test with Biothesiometer was relatively accurate, however it was complicated, time consuming and that the test with monofilament was simple and easily performed in the field even though it was relatively crude. 5.07 monofilament could be very effective in the eearly detection of diabetic neumpathy. In conclusion, we recommend 5.07 monofilament as a screening method of diabetic neuropathy and biothesiometer as its follow-up method.
Diabetic Neuropathies ; Follow-Up Studies ; Humans ; Mass Screening ; Methods ; Peripheral Nervous System Diseases ; Sensation ; Vibration

No abstract available.

Background: Korea National Health Insurance Service (NHIS) is operated as a social insurance system in which people pay a portion of their monthly income as insurance premiums and receive benefits when they experience illness or injury. Since 2005, the national health insurance remained surplus accumulating cumulative reserves each year. However, as of 2018, NHIS revenue recorded 62.11 trillion won and spending of 62.29 trillion won. The deterioration of NHIS finances is expected to accelerate with the aging population, income growth, new medical technology development, and enhanced security policies. Methods: To examine the financial health and sustainability of NHIS, we estimated the future revenue and spending until 2030 using the data from Korea Health Insurance Review and Assessment Service statistical yearbook. 2004–2018 average percentage change in NHIS revenue and spending was calculated. We estimated the future NHIS financial status using two methods. In the first method, we calculated the revenue and spending of the future NHIS by applying the 2004–2018 average percentage change to the subsequent years consecutively. In the second method, we estimated the future NHIS financial status after adjusting for the predicted demographic changes such as the aging population and declining birth rate in South Korea. Results: The estimates from this study suggest that the NHIS’s cumulative reserves will run out by 2024. Conclusion In terms of spending on current health insurance, there should be a search for ways of more efficient spending and funding options.

PURPOSE: The aim of this study was to compare the color stability, water sorption and cytotoxicity of thermoplastic acrylic resin for the non-metal clasp dentures to those of thermoplastic polyamide and conventional heat-polymerized denture base resins. MATERIALS AND METHODS: Three types of denture base resin, which are conventional heat-polymerized acrylic resin (Paladent 20), thermoplastic polyamide resin (Bio Tone), thermoplastic acrylic resin (Acrytone) were used as materials for this study. One hundred five specimens were fabricated. For the color stability test, specimens were immersed in the coffee and green tee for 1 and 8 weeks. Color change was measured by spectrometer. Water sorption was tested after 1 and 8 weeks immersion in the water. For the test of cytotoxicity, cell viability assay was measured and cell attachment was analyzed by FE-SEM. RESULTS: All types of denture base resin showed color changes after 1 and 8 weeks immersion. However, there was no significant difference between denture base resins. All specimens showed significant color changes in the coffee than green tee. In water sorption test, thermoplastic acrylic resin showed lower values than conventional heat-polymerized acrylic resin and thermoplastic polyamide resin. Three types of denture base showed low cytotoxicity in cell viability assay. Thermoplastic acrylic resin showed the similar cell attachment but more stable attachment than conventional heat-polymerized acrylic resin. CONCLUSION: Thermoplastic acrylic resin for the non-metal clasp denture showed acceptable color stability, water sorption and cytotoxicity. To verify the long stability in the mouth, additional in vitro studies are needed.
Cell Survival ; Coffee ; Denture Bases ; Dentures* ; Immersion ; Mouth ; Nylons ; Water*

PURPOSE: To evaluate the clinical characteristics of intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures and assess the surgical outcomes of a novel, closed intramedullary nailing surgical approach designed to minimize fixation failure. MATERIALS AND METHODS: Between May 2013 and April 2017, 31 patients with intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures treated with closed intramedullary nailing or long proximal femoral nail antirotation (PFNA) were enrolled in this study. Preoperative data included age, sex, injury severity score, body mass index, location of shaft fracture, injury mechanism, accompanying traumatic injury, walking ability before injury, and surgical timing. Perioperative outcomes, including follow-up period, types of intramedullary nails, number of blocking screws used, operation time, and blood loss were assessed. Radiologic outcomes, including union rate, time from surgery to union, and femoral shortening, and clinical outcomes, including hip flexion, walking ability, and Harris hip score were also evaluated. RESULTS: A total of 29 unions (93.5%) were achieved. The time to union was 16.8 months (range, 11–25 months) for hip fractures (15.7 weeks for intertrochanteric fractures and 21.7 weeks for subtrochanteric fractures) and 22.8 months for femoral shaft fractures. There were no significant differences in surgical outcomes between the two groups except for type of intramedullary nail. CONCLUSION: Closed intramedullary nailing in the treatment of intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures may be a good surgical option. However, fixation of femoral shaft fractures might not be sufficient depending on the implant design.
Body Mass Index ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip ; Hip Fractures ; Humans ; Injury Severity Score ; Walking

PURPOSE: To investigate the different types of anatomical connection between the lacrimal sac and the canaliculi using digital subtraction dacryocystography (DCG) in Koreans. METHODS: The authors of the present study performed digital subtraction DCG in Korean patients who presented with epiphora from January 2010 until December 2010. The 248 patients (496 eyes) who achieved a satisfactory DCG image were classified as follows: 1) type I: visible common canaliculus (CC), 2) type II: no visible CC and the canaliculi entering the sac at the point where they meet on the sac wall (common opening), 3) type III: no visible CC and common opening, and each canaliculus entering the sac from different points. RESULTS: Out of a total of 496 eyes, CC was observed in 449 eyes (type I: 90.5%). In 41 eyes (8.3%), the CC was absent (type II), but the upper and lower canaliculi joined at the wall of the lacrimal sac. In 6 eyes (1.2%), the upper and lower canaliculi entered the sac separately (type III). Eighteen patients (7.3%) showed different types of lacrimal drainage system between the 2 eyes. CONCLUSIONS: The CC may not exist in all patients, and the type of anatomical connection between the lacrimal sac and the canaliculi may be different between the eyes in the same individuals. Although such patients comprise a minority, anatomical knowledge of the lacrimal drainage system could be helpful to assess and manage patients with lacrimal drainage disorder.
Drainage ; Eye ; Humans ; Lacrimal Apparatus Diseases

Recently xenotransplantation has been thought as a final solution for the controi of donor organ shortage in allograft. In order to be a ciinicai entity, xenotransplantation has many obstacles such as hyperacute rejection and delayed xenogratt rejection as a potent immunologic reaction, zoonosis and ethical problems. We already reported the eariy immunoiogic events occuring soon after xenograft in animal model, in which natural antibody and complement have a crucial roie in rejection response. As a further step for the prolongation of graft survival, we used anticomplement agent (cobra venom factor, CVF) in the same model. Graft survival in discordant (guinea pig-to-rat) xenogratt was extended from 30.6 minutes to 2 days following singie injection of CVF, which showed similar pattern of rejection with the concordant xenogratt in terms of time of rejection response after grafting. In this setting antibody response in the blood did not show any difference between that of pre CVF and post CVF, even though IgM response was more pronounced than IgG. The complement activity in the blood showed marked suppression following CVF injection. Intragraft complement gene (C3 mRNA) expression in CVF injected discordant showed delayed response in a similar pattern like that of concordant xenograft. Interestingly enough intragraft anticomplement gene expression showed the simiiar pattern of response with the complement. From these results we can conclude that anticomplement agent (CVF) extended the graft survival in discordant xenograft upto the level of concordant xenograft by shifting the complement activation response from that of discordant to concordant xenograft.
Rats ; Animals

BACKGROUND: JC virus (JCV) is a polyomavirus that commonly infects humans and can cause progressive multifocal leukoencephalopathy in immunocompromised patients. Recently, many reports have documented detection of JCV in gastrointestinal tract cancers. We investigated the presence of JCV in gastric adenocarcinoma, adenoma, and non-neoplastic gastric mucosa. METHODS: We selected paraffin-embedded tissue from endoscopic mucosal resections performed from January 2007 to September 2008. DNA was extracted from the paraffin-embedded specimens of 30 adenocarcinomas, 20 adenomas of the stomach, and 20 non-neoplastic gastric mucosa. Polymerase chain reaction amplifications were performed using gene-specific primers to detect the JCV gene sequences, and immunohistochemical staining was performed to detect the T-antigen (T-Ag) protein. RESULTS: The T-Ag sequence was detected in nine of 30 gastric cancers (30%), two of 20 adenomas (10%), and eight of 20 non-neoplastic gastric mucosa specimens (40%). T-Ag protein expression was found in five of 30 gastric cancers (16.7%) and one of 20 non-neoplastic gastric mucosa specimens (5%), whereas no expression was observed in any of the adenomas. CONCLUSIONS: Although we could not detect a correlation between JCV and gastric cancer, we demonstrated the presence of JCV T-Ag expression in human gastric cancers. These findings suggest a possible role for JCV in gastric carcinogenesis.
Adenocarcinoma ; Adenoma ; Antigens, Viral, Tumor ; DNA ; Gastric Mucosa ; Gastrointestinal Neoplasms ; Humans ; Immunocompromised Host ; JC Virus ; Leukoencephalopathy, Progressive Multifocal ; Polymerase Chain Reaction ; Polyomavirus ; Stomach ; Stomach Neoplasms

Unmet healthcare is an important indicator to measure accessibility of healthcare services. To examine the latest status of unmet healthcare needs in South Korea, four different data which is composed of nationally representative sample of South Korean population were used; the Korea National Health and Nutrition Examination Survey (KNHANES, 2007–2020), the Community Health Survey (CHS, 2008–2020), the Korea Health Panel Survey (KHP, 2011–2018), and the Korean Welfare Panel Study (KOWEPS, 2006– 2020). The proportion of individuals reporting unmet healthcare needs were 6.4% (KNHANES), 5.4% (CHS), and 12.2% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.9%, -9.1%, and -5.5%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.0% (KNHANES), 0.4% (CHS), 2.2% (KHP), and 0.4% (KOWEPS). The APC was -11.3%, -17.0%, -12.2%, and -21.2%, respectively. Overall, the low-income and the elderly population reported a higher rate of unmet health care needs. Although the overall experience rate of unmet medical care due to cost decreased over the past decade, the disparity between the lowest and highest income groups still remained in 2020. Disparity between income levels and age groups is a challenge to address in healthcare system, and these results suggest the need for adequate health coverage for the low-income and the elderly populations.