There have been many radiographic studies on age estimation that evaluate reduction in size of dental pulp cavity with secondary dentin formation. The Paewinsky method reported high accuracy in estimating ages by measuring the width of the pulp cavity in panoramic radiographs. The aim of this study was to evaluate the application of the Paewinsky method to digital periapical radiographs. This study was conducted on 103 cases that reported to the Section of Human Identification of the National Forensic Service. The age was calculated by applying the Paewinsky method that measures the root and pulp canal width at three points in a tooth. The estimation results were compared with those calculated by the Johanson method. When the Paewinsky models were applied to digital periapical radiographs, the errors were significantly greater as compared to the original study. The errors of the maxillary second premolar and mandibular lateral incisor were greater than those of the maxillary central incisor, lateral incisor, mandibular canine, and first premolar. Furthermore, errors of the age estimation models in level C were greater than those in levels A and B. This study could be a reference for the application of the Paewinsky method to digital periapical radiographs.
Age Determination by Teeth ; Bicuspid ; Dental Pulp Cavity ; Dentin, Secondary ; Forensic Anthropology ; Incisor ; Methods ; Radiography, Dental ; Tooth

There have been many radiographic studies on age estimation that evaluate reduction in size of dental pulp cavity with secondary dentin formation. The Paewinsky method reported high accuracy in estimating ages by measuring the width of the pulp cavity in panoramic radiographs. The aim of this study was to evaluate the application of the Paewinsky method to digital periapical radiographs. This study was conducted on 103 cases that reported to the Section of Human Identification of the National Forensic Service. The age was calculated by applying the Paewinsky method that measures the root and pulp canal width at three points in a tooth. The estimation results were compared with those calculated by the Johanson method. When the Paewinsky models were applied to digital periapical radiographs, the errors were significantly greater as compared to the original study. The errors of the maxillary second premolar and mandibular lateral incisor were greater than those of the maxillary central incisor, lateral incisor, mandibular canine, and first premolar. Furthermore, errors of the age estimation models in level C were greater than those in levels A and B. This study could be a reference for the application of the Paewinsky method to digital periapical radiographs.

OBJECTIVE: To investigate the effect of environmental enrichment on the cognitive and motor development in the experimental hypoxia-ischemic encephalopathy neonatal rat model. METHOD: Hypoxic-ischemic encephalopathy models were made in neonatal Sprague-Dawley rats at 3 days of age by ligating the unilateral carotid artery followed by inhalation of 8% oxygen and raised in the enriched environment (n=10), treadmill exercise (n=8) and non-stimulation (n=10) from the 3rd to 8th weeks of age. Neurobehavioral and histopathological changes were compared. RESULTS: The neurobehavioral tests of the rats with hypoxic-ischemic encephalopathy showed prolonged latencies of achievement for cliff avoidance and negative geotaxis (p<0.05). Persisting abnormality into adult life of limb placing improved in exercise and enriched environment groups and spatial learning and memory in a water maze recovered in the rats with enriched environment (p<0.05). The density of dendritic spine increased in the hippocampus with enriched environment (p<0.05). CONCLUSION: The present study supports the possibilities of the positive effects after the enriched environment in the developing brain with hypoxic injury.
Achievement ; Adult ; Animals ; Brain ; Carotid Arteries ; Cognition ; Dendritic Spines ; Extremities ; Hippocampus ; Humans ; Hypoxia-Ischemia, Brain ; Infant, Newborn ; Inhalation ; Learning ; Locomotion ; Memory ; Oxygen ; Rats ; Rats, Sprague-Dawley

OBJECTIVE: To evaluate the effects of high frequency repetitive transcranial magnetic stimulation (rTMS) of the affected hemisphere on the motor recovery and spasticity in chronic post-stroke hemiplegic patients. METHOD: Thirteen chronic stroke hemiplegic patients were randomized to receive real and sham rTMS. rTMS was carried out 10 times at a frequency of 10 Hz with 10 s stimulation followed by 50 s rest, totalling 1,000 stimulations to the affected primary motor cortex using an intensity of 100% of resting motor threshold of unaffected hemisphere. Median nerve H-reflex, modified Ashworth scale (MAS) at elbow and wrist, and manual function test (MFT) were measured at baseline and after 2 weeks of treatment. RESULTS: High frequency rTMS resulted in increased H-reflex latency and decreased H-reflex amplitude and H/M ratio. Also MAS decreased and MFT score increased after 2 weeks of treatment. CONCLUSION: High frequency rTMS in the affected motor cortex might facilitate motor recovery and reduce spasticity in chronic stroke patients.
Elbow ; H-Reflex ; Humans ; Median Nerve ; Motor Cortex ; Muscle Spasticity ; Salicylamides ; Stroke ; Transcranial Magnetic Stimulation ; Wrist

BACKGROUND: Primary aldosteronism describes a group of disorders characterized by long-standing aldosterone excess, with suppressed renin activity, resulting in hypertension and hypokalemia. The protean clinical and biochemical characteristics of this syndrome have important implications regarding its pathophysiology and responsiveness to treatment. METHODS: The cases of 12 primary aldosteronisms, diagnosed at Hanyang University Hospital between 1996 and 1999, were reviewed. RESULTS: The 12 cases were composed of 9 aldosterone-producing adenoma, 2 adrenal hyperplasia and a case of idiopathic hyperaldosteronism. There were 9 women and 3 men. The mean age was 46 yrs (range, 23 to 64 yrs). At the initial visit, the mean blood pressure was 160+/-26/104+/-14 mmHg, and one case of idiopathic hyperplasia had normal blood pressure. The mean serum K+ level was 2.6+/-0.5 mEq/L (range, 1.5 to 3.5 mEq/L). The mean plasma renin activity and plasma aldosterone concentration were 0.4+/-0.4 ng/ml/hr (range, 0.2 to 1.6 ng/ml/hr) and 407.5+/-199.8 pg/mL (range, 225 to 800 pg/mL), respectively. Different steps of diagnostic modalities were applied for the preoperative differential diagnosis. All patients, with the exception of the one with idiopathic hyperaldosteronism, were managed by a unilateral laparoscopic adrenalectomy, as they were all diagnosed under the impression of adrenal adenomas. Ultimately, 9 cases were proven to have adrenal adenomas. One hypertensive case, with hypokalemia, had adrenal hyperplasia, and the case with normotension was found to have adrenal nodular hyperplasia from the pathology. The size of the tumors ranged from 1.4 to 2.4 cm in diameter. Among the 11 cases that underwent an adrenalectomy, the blood pressures in 6 cases normalized after the operation, while the other 5, including the one with unilateral hyperplasia, were still in need of antihypertensives for the control of elevated blood pressures, even after the operation. The other case of idiopathic hyperaldosteronism was managed by the prescription of spironolactone. CONCLUSION: From these, it can be suggested that the clinical diversity of the syndrome, especially in the pathophysiology and response to operation, awaits the development of a better preoperative lateralization procedure
Adenoma ; Adrenalectomy ; Aldosterone ; Antihypertensive Agents ; Blood Pressure ; Diagnosis, Differential ; Female ; Humans ; Hyperaldosteronism* ; Hyperplasia ; Hypertension ; Hypokalemia ; Male ; Pathology ; Plasma ; Prescriptions ; Renin ; Spironolactone

OBJECTIVES: It has been known that children reved symptoms of Posttraumatic Stress Disorder (PTSD) after experiencing traumas similar to adults. But there are a few studies regarding the psychopathologies of PTSD in preschool children. Considering more active brain and psychological development in preschool children, it is expected that trauma of preschool children causes more serious psychopathologies than those of children with older ages or adults. This study aims to investigate psychopathologies of 9 preschool children experiencing a single, severe trauma, specifically in the respect of PTSD diagnosis. METHODS: Nine preschool children, 3-5 years old, experiencing physical injuries caused by attack from a psychotic patient during lunch time at kindergarten, were evaluated for clinical diagnoses through semi-structured interviews using Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) and Research Diagnostic Criteria (RDC for Kiddies) of PTSD for preschool children. RESULTS: Five (56% by DSM-IV) and Six (67%, by RDC) out of 9 children were diagnosed as to have PTSD. Among those children with PTSD, four (44%) showed Separation Anxiety Disorder (SAD) and one (17%) showed Major Depressive disorder (MDD) as comorbid diagnoses. On subclinical level, two of 9 children (22%) suffered from separation anxiety, seven (78%) from aggressive behaviors, and two (22%) from depressive mood. Sleep disturbances (89%) and reexperiencing of trauma (89%) were the most prominent symptoms of PTSD in preschool children. CONCLUSION: While preschool children showed profiles of PTSD symptoms similar to those of adults, it was critical to use more developmentally sensitive diagnostic tools for a better detection of psychopathologies. Young children experiencing severe trauma showed other comorbid psychopathologies along with PTSD. For proper diagnosis and intervention, it is important to make an accurate clinical diagnosis based on developmentally appropriate diagnostic process and tools.
Adult ; Anxiety, Separation ; Brain ; Child ; Child, Preschool* ; Depressive Disorder, Major ; Diagnosis ; Humans ; Lunch ; Mood Disorders ; Schizophrenia ; Stress Disorders, Post-Traumatic

Some circulating cancer cells in the blood play a central role in the metastatic process and may have a major influence on patient progress. Their numbers can be very small and techniques for their detection need to be both sensitive and specific. Polymerase chain reaction (PCR) has been successfully used to detect small numbers of tumor cells in cancer. We used a reverse transcriptase-polymerase chain reaction (RT-PCR) to detect circulating breast cancer cells in venous blood samples before operations and assessed cytokeratin-19 (CK-19) and cytokeratin-20 (CK-20) as target mRNA markers in the blood of healthy donors (n=6) and breast cancer patients (n=30) with American Joint Committee on Cancer stages 0 to IIIa. CK-19 mRNA was expressed in all blood samples of healthy donors and patients. But CK-20 was the only mRNA marker not detected in the blood from healthy donors. Seven of 30 (23%) venous blood isolates of breast cancer patients yielded a CK-20 mRNA with positive results. There was no correlating CK-20 mRNA expression with stage and axillary lymph node status. In conclusion, CK-19 showed no diagnostic value as a mRNA marker in the detection of circulating cancer cells by RT-PCR assay because this was expressed in the blood of healthy donors. CK-20 mRNA was an useful marker to detect circulating cancer cells in breast cancers.
Breast Neoplasms/pathology* ; Breast Neoplasms/genetics* ; DNA Primers ; Female ; Gene Expression Regulation, Neoplastic ; Genetic Markers ; Human ; Intermediate Filament Proteins/genetics ; Keratin/genetics ; Neoplasm Circulating Cells* ; RNA, Messenger/analysis ; RNA, Neoplasm/analysis* ; Reverse Transcriptase Polymerase Chain Reaction/methods* ; Sensitivity and Specificity ; beta 2-Microglobulin/genetics

BACKGROUND: Though K-ras mutation and aberrant p53 have been considered the event of the oncogenesis of pancreatic adenocarcinoma, it is controversial that these have been attributed to difference of survival in pancreatic adenocarcinoma. We investigated for presence of a K-ras mutation, K-ras expression and p53 expression in carcinogenesis of pancreatic adenocarcinoma. Also their correlation with tumor grade, stage and survival was investigated. METHODS: We examined 48 patients surgically resected, formalin-fixed and paraffin-embedded pancreatic adenocarcinoma. By using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), we detected K-ras mutation at codon 12. An aberrant K-ras and p53 expression was stained using an immunohistochemical staining (IHC) method. RESULTS: Thirty-one of 48 cases (64.6%) showed K-ras mutation. K-ras expression was showed in 68.8% (33/48). p53 expression was showed in 47.9% (23/48). There was no correlation between a presence of K-ras mutation or K-ras expression and tumor grade, lymph node metastasis, clinical stage or survival rate. A positive correlation between p53 expression and clinical stage was found (p<0.05). The patients with p53 expression had shorter survival than the patients without p53 expression (p>0.05). CONCLUSION: Mutation of the K-ras gene and aberrant p53 might play an important role in pancreatic carcinogenesis. But mutation of K-ras gene and K-ras expression is not considered to relate to progression of pancreatic carcinoma. It is suggested that p53 expression seems to be associated with a progression of pancreatic carcinoma.
Adenocarcinoma ; Carcinogenesis ; Codon ; Genes, ras ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Pancreatic Neoplasms* ; Prognosis ; Survival Rate

BACKGROUND: Although abnormalities of p53 gene and their relation to clinicopathologic parameters have been identified in some human malignancies, there is little published data on their prevalence and clinical significance in ampullary adenocarcinoma (AAC). The aim of this study is to determine the prevalence of p53 abnormalities in AAC and to evaluate their relation to clinicopathologic features. METHOD:35 formaline-fixed paraffin-embedded tissues of AAC were examined for detection of p53 abnormalities by both single-strand conformation polymorphism (SSCP) analysis of polymerase chain reaction- amplified DNA fragments corresponding to exons 5-8 and immunohistochemistry (IHC) using monoclonal antibody to p53 protein (Novocastra, DO7), and the association between the p53 abnormalities and clinicopathologic parameters was analyzed. RESULT: In 22.9% of AAC, p53 gene muation was demonstrated by SSCP analysis, mainly at PCR-amplified exon 8 and exon 7. The p53 protein overexpression by IHC was 48.6% of AAC. Six SSCP and IHC-positive (17.2%) cases and 16 normal (45.7%) cases showed concordant results between the methods, although 13 cases (37.1%) showed discordance, including 11 IHC-positive (31.4%) and 2 SSCP-positive (5.7%) cases. Overall, the prevalence of p53 abnormalities was 54.3%. No significant associations between the p53 abnormalities and clinicopathological parameters such as clinical manifestations, histologic differentiation, and tumor stage were observed. CONCLUSION: The p53 abnormalities detected in 55% of AAC are not associated with prognostic factor, suggesting that abnormal p53 gene may play a role in the development of AAC, but not in its invasiveness.
Adenocarcinoma* ; DNA ; Exons ; Genes, p53* ; Humans ; Immunohistochemistry ; Polymorphism, Single-Stranded Conformational ; Prevalence*

OBJECTIVES: This study was carried out to survey the prevalence of Helicobacter pylori infection and the incidence of vacuolating toxin producing H. pylori. A further aim of this study was to evaluate the quantitative assay for cell vacuolation on the basis of the rapid uptake of neutral red dye by vaculoes of the cells. METHODS: We studied the gastric biopsy specimens of patients with 154 cases of gastritis, 74 cases of gastric ulcer, and 167 cases of gastric cancer and in 44 cases of healthy persons. One of the biopsy specimen was placed into a CLOtest plate for rapid urease test and the other one of the biopsy spcimen was inoculated on Brain Heart Infusion blood agar for culture. The culture supernatant of isolated H. pylori was serially diluted with BHI broth. After 24 hour incubation of cultured RK-13 cells treated with the culture supernatant of H. pylori, cytoplasmic vacuolation of the cells were observed microscopically. RESULTS: The positivity of urease test and the rate of isolation of H. pylori from urease positive gastric biopsy materials were 34.1% and 93.3% in healthy person, 55.8% and 70.9% in gastritis, 60.8% and 71.1% in gastric ulcer, and 56.3% and 96.8% in gastric cancer. The isolation rate of H. pylori from patients between 20 and 39 years old was 16.8%, for patients between 40 and 59 years old it was 51.9%, and for patients above 60 years old it was 31.2%. The isolation rate of the vacuolating toxin producing H. pylori from gastric biopsy specimens was 66.7% in a healthy person, 76.6% in gastritis, 79.4% in gastric ulcer, and 80% in gastric cancer. CONCLUSIONS: The isolation rate of H. pylori from the patients with gastric diseases is higher than the rate of H. pylori from healthy persons, but the isolation rate of the vacuolating toxin producing H. pylori is not different between the patients with gastric diseases and healthy persons. The titers of vacuolating toxin produced by some H. pylori isolated from the patients with gastric diseases are higher than those from healthy persons.
Adult ; Agar ; Biopsy ; Brain ; Cytoplasm ; Gastritis ; Heart ; Helicobacter pylori* ; Helicobacter* ; Humans ; Incidence* ; Middle Aged ; Neutral Red ; Prevalence ; Stomach Diseases* ; Stomach Neoplasms ; Stomach Ulcer ; Urease