Thirty eight cases of moyamoa disease, 21 children, 17 adults were encountered during a 16-year period at Yonsei University Medical Center. Clinical manifestations, together with computed tomography (CT) and angiographic findings were analyzed with a review of the literature. The mean age was 6.3 +/- 3.5 years in children and 36.8 +/- 9.9 years in adults. The majority of attacks occurred in spring in both adults and children. The most common chief complaint on admission was hemiparesis followed by convulsion in children, while in adults, loss of consciousness was most common followed by headache. Of transient neurologic deficits, hemiplegia was most common in children, while cranial nerve involvement was common in adults. Hemiplegia, also was the most common permanent neurologic manifestation in children, while hemiparesis and intellectual deterioration were the most common in adults. Of the children, 90.6% showed infarction on CT, while 88.2% of adults had hemorrhage. Bilateral occlusion of the carotid arteries was the most common site of lesions in both adults and children on cerebral angiogaphy.
Adolescent ; Adult ; Age Factors ; Central Nervous System Diseases/physiopathology ; Child ; Child, Preschool ; Cranial Nerves/pathology ; Female ; Human ; Korea/epidemiology ; Male ; Middle Age ; Moyamoya Disease/*epidemiology/physiopathology/radiography ; Retrospective Studies ; Seasons ; Tomography, X-Ray Computed

PURPOSE: The objective of the present study was to determine whether fermentation can increase the protective effects of blueberry liquid in a high-fat diet-induced obese mice model. METHODS: Male C57BL/6J mice were fed a high-fat diet (HD, 60% fat, w/w,), HD supplemented with 10 ml/kg BW/day of blueberry liquid (BHD, blueberry high-fat diet), or HD supplemented with 10 ml/kg BW/day of fermented blueberry liquid (FBHD, fermented blueberry high-fat diet) for 10 weeks. RESULTS: There were significant decreases in the body, epididymal adipose tissue, and liver weights of blueberry-fed groups compared to HD, whereas there were no significant differences in food intake among the groups. Furthermore, blueberry liquid groups, especially fermented blueberry liquid, significantly attenuated the contents of hepatic triglycerides and total cholesterol induced by HD. Serum LDL-cholesterol was significantly lower in the BHD and FBHD-fed groups, whereas FBHD significantly increased the serum HDL-cholesterol level compared to the control. Concentrations of aspartate transaminase, alanine transaminase, and leptins in serum were also reduced by blueberry liquid supplementation. The mRNA expression of hepatic acetyl CoA carboxylase was significantly reduced in both the BHD and FBHD groups compared to HD. Furthermore, FBHD altered the mRNA expression level of hepatic lipolysis genes. CONCLUSION: In conclusion, these results suggest that blueberry, especially fermented blueberry liquid, may improve obesity-related abnormalities.
Acetyl-CoA Carboxylase ; Adipose Tissue ; Alanine Transaminase ; Animals ; Aspartate Aminotransferases ; Blueberry Plant* ; Cholesterol ; Diet, High-Fat ; Eating ; Fermentation ; Humans ; Leptin ; Lipolysis ; Liver ; Male ; Mice* ; Mice, Obese ; RNA, Messenger ; Triglycerides ; Weights and Measures

We report the clinical and pathological features, including the immunohistochemical and electron microscopic findings, of a case of hypercalcemic type, large cell variant, ovarian small cell carcinoma. A 44-year-old woman complained of abdominal pain and dysmenorrhea. A mass on the left ovary was detected by computer tomographic scan. A total hysterectomy with bilateral salpingo-oophorectomy was done. Histologically, the tumor was predominantly composed of large cells with abundant eosinophilic cytoplasm and prominent nucleoli. Mucin-containing cells and myxoid stroma were also present. Typical follicle-like spaces with lined by small, closely packed epithelial cells with scanty cytoplasm were occasionally seen. No dense core granules were identified on electron microscopic examination.
Abdominal Pain ; Adult ; Carcinoma, Small Cell* ; Cytoplasm ; Dysmenorrhea ; Eosinophils ; Epithelial Cells ; Female ; Humans ; Hypercalcemia ; Hysterectomy ; Ovary*

OBJECTIVE: To determine whether polymorphisms of the Vitamin D receptor (VDR)gene,known to be associated with osteoporosis and/or osteoarthritis (OA) in Caucasians,might also relate to the risk of OA and osteoporosis in Korean postmenopausal women METHODS: A population of 130 postmenopausal women,including 76 healthy controls and 54 knee OA patients,were studied using anteroposterior radiographs of the knee,which were graded for OA according to the Kellgren classification system.The VDR genotype was determined by using polymerase chain reaction and by digestion with the three restriction enzymes Taq I,Bsm I,and Apa I.Femoral neck bone mineral density (BMD)was assessed in all participants by dual energy X-ray absorptiometry . RESULTS: VDR genotype frequency distributions in Koreans were much different from Caucasian's both in the OA group and the control group.Especially, "t t", "B B" and "A A" genotype were very rare,prominently differentiating from Caucasians.But within Koreans,no significant differences in VDR genotype frequencies were observed between OA cases and controls.VDR genotype was not significantly associated with the radiographic grades of OA.And there were no significant relationships of VDR genotype with BMD scores in each group. CONCLUSION: In Korean postmenoposal women,the VDR gene polymorphisms do not significantly contribute to an increased prevalence of knee OA or to differences in BMD.VDR genotype analysis would not be helpful for assessing the risk of knee OA in Koreans because :(1)there is no correlation of VDR genotypes with the radiographic severity of OA ;and (2)there is a more skewed distribution of VDR genotypes in Korean population compared to the Caucasian's .
Absorptiometry, Photon ; Bone Density ; Classification ; Digestion ; Female ; Genotype ; Humans ; Knee* ; Neck ; Osteoarthritis* ; Osteoporosis ; Polymerase Chain Reaction ; Prevalence ; Receptors, Calcitriol

PURPOSE: Bell's palsy is defined as an idiopathic facial nerve paralysis of sudden onset. In spite of intensive clinical and experimental investigation, there is still uncertainty in the incidence, etiology, and preferred mode of treatment in children.The objective of this study was to analyze clinical outcome and prognosis of children with Bell' palsy. METHODS: We analyzed 61 cases of Bell's palsy diagnosed at the Department of Wonkwang University Hospital from January 1998 to July 2006. The inclusion criteria were any children with acute isolated unilateral lower motor neuron type of facial nerve palsy. The clinical findings and investigations were reviewed including age, sex, affected site, seasonal incidence and result of steroid treatment. Chi-square and Fisher's exact test was used to compare clinical outcome between duration of complete recovery and age. RESULTS: There was no difference in incidence according to sex or age. Incidence was higher in summer and winter. There was no difference in complete recovery rate and duration between steroid treated group and control group. In the group of children younger than 6 years, duration of complete recovery was shorter than older children. CONCLUSION: We found increasing the incidence of Bell's palsy in summer and winter. Children younger than 6 years had shorter duration in complete recovery.
Bell Palsy* ; Child* ; Facial Nerve ; Humans ; Incidence* ; Motor Neurons ; Paralysis ; Prognosis* ; Seasons ; Uncertainty

BACKGROUND: The serum total cholesterol is supposed to be increased as dietary pattern is Westernized recently in our country. We studied the longitudinal change of serum total cholesterol levels in normal Korean adult male workers and analyzed the influence of age, weight, blood pressure, fasting blood sugar, lifestyle (exercise, smoking, alcohol drinking habits) on change of serum total cholesterol levels. METHODS: The 6279 healthy adult male workers were studied during recent 10 Years (1992 and 2002). Those who suffered from hypertension, diabetes mellitus, ischemic heart disease, nephropathy, thyroid disease were excluded. Those who took antilipidemic drugs were also excluded. Blood sampling for serum total cholesterol and sugar was done after overnight fasting for more than 12 hours. Data on lifestyle were obtained using self administered questionnaires. RESULT: The serum total cholesterol levels had increased by 23.2 +/- 23.60 mg/dL (2.32 mg/dL per year) between 1992 and 2002 surveys. The increment of serum total cholesterol levels was most prominent in twenties (3.30 mg/dL per year) during 10 years and less prominent in thirties (2.80 mg/dL per year), forties (2.19 mg/dL per year) and fifties (1.55 mg/dL per year). The change of body mass index (BMI) was most significantly correlated with that of serum total cholesterol level (r=0.290, p=0.0001) (r2=0.084, p=0.0001). The change of serum total cholesterol levels was also significantly correlated with age, diastolic blood pressure change, fasting blood sugar change, exercise and smoking habits. However, it was not significantly correlated with the alcohol drinking habits among influencing variables. CONCLUSION: The serum total cholesterol levels were increased by 23.2 +/- 23.60 mg/dL (2.32 mg/dL per year) during recent 10 years. The increment of serum total cholesterol levels was most prominent in younger age group. The change of serum total cholesterol levels was most significantly correlated with that of body mass index (BMI) among influencing variables.
Adult* ; Aging ; Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol* ; Diabetes Mellitus ; Fasting ; Follow-Up Studies* ; Gyeongsangbuk-do* ; Humans ; Hypertension ; Life Style ; Longitudinal Studies ; Male* ; Myocardial Ischemia ; Smoke ; Smoking ; Thyroid Diseases ; Surveys and Questionnaires

OBJECTIVES: The posttraumatic stress disorder (PTSD) checklist (PCL) is currently the most popular self-report scale employed in screening PTSD. This study was conducted 1) to test the reliability and validity of PCL in veterans of the Vietnam War and 2) to compare the results when using a conventional paper survey and mobile app survey. METHODS: Participants included 186 Korean veterans of the Vietnam War. Mini Mental Status Examination, PTSD module of Structured Clinical Interview for DSM-IV (SCID), and Life Event Checklist were administered. PCL was administered in either written format or mobile app. Diagnostic validity of the PCL was compared using the PTSD module of SCID. Other psychometric properties of PCL were also calculated. RESULTS: PCL results using different methods, paper and mobile app, showed no significant difference in each item and total score. Cronbach's coefficient of PCL was 0.95, optimal cut-off 49.5, sensitivity 91.7%, and specificity 93.5%. CONCLUSION: PCL showed excellent internal reliability, sensitivity, specificity, and validity. There was no statistically significant difference between survey methods. These results suggest that PCL is a reliable self-report scale in veterans. In addition, PCL with mobile app can be helpful in screening PTSD.
Aged* ; Checklist* ; Surveys and Questionnaires ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Mass Screening ; Mobile Applications* ; Psychometrics ; Reproducibility of Results ; Sensitivity and Specificity ; Stress Disorders, Post-Traumatic* ; Veterans* ; Vietnam*

OBJECTIVE: The purpose of this study was to review the incidence, clinicopathological feature, treatment, outcome in the series of childhood and adolescence with ovarian mass PATIENTS AND METHODS: Retrospective reviews of the medical recordings for 116 patients with ovarian mass under the age of twenty years old who were admitted, operated and confirmed with histopatholgical study at the department of obstetric and gynecology, Gachon medical school, Inchon, Korea for 8 years from Jan. 1993 till Dec. 2000. RESULTS: Of 116 the patients who underwent surgical treatment, the incidence of malignant ovarian tumors was 15 cases(12.9%). If ovarian neoplasm alone are considered, the rate of malignancy increases to 17.6%. The frequency of ovarian malignancies correlated inversely with patient age. In the 0-10 age group ,40% had malignancies, as compared with 20.3% in the 11-15 age group and 15.3% in the 16-20 age group. On histopathological classification, the tumors originated from germ cell tumors were 55.2%, epithelial cell tumors were 40%, and sex-cord stromal tumors were 4.7%. According to FIGO classification of malignant ovarian tumor, stage I(80%) was most common, followed stage IV(13.3%), stage II(6.6%) and III(0%). 13 of the 15 malignant ovarian tumors, unilateral salpingoophorectomy was done in an attempt for reproductive organ conservation; 2 cases of stage IV disease were treated with hystrectomy, bilateral salpingoophorectomy and omentectomy. On follow up, only two ovarian malignancy stage IV died within 3 months and another is well. CONCLUSION: The frequency with which ovarian meoplasms malignancy in the under 20 age group is 17.6%. Because of their malignant potential in young girl, prompt evaluation and treatment is imperative.
Adolescent* ; Classification ; Epithelial Cells ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Incheon ; Incidence ; Korea ; Medical Records ; Neoplasms, Germ Cell and Embryonal ; Ovarian Neoplasms ; Retrospective Studies ; Schools, Medical

Annual proficiency surveys were performed in March, June and September 2014 by clinical microbiology division of The Korean Association of Quality Assurance for Clinical Laboratory. Parasitology part has been newly incorporated in this survey. For each trial, three sets which were composed of different combinations of five bacteria and yeast were distributed for gram stain, culture, identification, and antimicrobial susceptibility tests of general bacteriology and five fixed sputum smear on slides were distributed for acid fast bacilli stain. Two advanced bacteriology survey materials for culture and identification of anaerobic bacteria and mold were distributed to the voluntary participants in every trial and five mycobacterial culture and identification specimens, five anti-tuberculosis susceptibility testing specimens, and two Mycobacterium tuberculosis strains for rapid detection of rifampin and isoniazid resistance were distributed to the voluntary participants in March and June trials. Five virtual microscopic slides for stool parasite examination were open for the registered participants in June trial. A total of 340 laboratories were enrolled and 330 (97.0%), 331 (97.4%), and 331 (97.4%) returned the results on trial I, II, and III, respectively. For bacterial identification, the percent acceptable identification of Burkholderia cepacia, Klebsiella pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumoniae, Streptococcus agalactiae, Plesiomonas shigelloides, and Enterococcus faecalis were greater than 95%. Group C and group D Salmonella species challenged as the different sets of M1422 resulted in the acceptable rate lower than 95% because nine participants reported the identification of different sets. Surveillance cultures for methicillin-resistant S. aureus and vancomycin-resistant enterococci were correctly determined by 89.6% and 69.0% of the respondents, respectively. Correct identification to species level of Candida albicans, Candida auris, Candida glabrata, and Candida parapsilosis were 86.1%, 1.6%, 48.1%, and 83.8%. Vancomycin disk diffusion test in S. aureus, missing oxacillin screen or penicillin susceptibility test in S. pneumoniae and lack of reliable methods of quinolone resistance detection in Salmonella species caused unacceptable results in antimicrobial susceptibility testing. Advanced bacteriology trials revealed low performance in species identification of mold. Mycobacterial culture, identification and susceptibility test performance was kept in excellence. The performance of identification of stool parasites was acceptable >90% for detection of helminth eggs and amebic cysts but 28.6% false positive responses resulted from negative specimens. In conclusion, species-level identification of fungi of both candida species and mold were challenging to clinical microbiology laboratories. Vancomycin disk diffusion method for S. aureus and lack of proper penicillin susceptibility test for S. pneumoniae were still common cause of inaccurate results. Virtual microscopic survey has been successfully introduced in parasitology.
Bacteria ; Bacteria, Anaerobic ; Bacteriology ; Burkholderia cepacia ; Candida ; Candida albicans ; Candida glabrata ; Surveys and Questionnaires ; Diffusion ; Eggs ; Enterococcus faecalis ; Fungi ; Helminths ; Isoniazid ; Klebsiella pneumoniae ; Korea* ; Methicillin Resistance ; Mycobacterium tuberculosis ; Ovum ; Oxacillin ; Parasites ; Parasitology ; Penicillins ; Plesiomonas ; Pneumonia ; Pseudomonas aeruginosa ; Rifampin ; Salmonella ; Sputum ; Staphylococcus aureus ; Streptococcus agalactiae ; Streptococcus pneumoniae ; Streptococcus pyogenes ; Vancomycin ; Yeasts

PURPOSE: As diagnostic tools for Hirschsprung's disease (HD), barium enema and rectal biopsy have radiation exposure and invasiveness respectively; however anorectal manometry does not have these disadvantages. We therefore performed this study to evaluate the diagnostic efficacy of anorectal manometry. METHODS: We reviewed medical records of infants with one or two symptoms of vomiting, abdominal distension, chronic diarrhea or constipation who had a anorectal manometry followed by barium enema and/or biopsy from July 1995 to May 2002. We evaluated the sensitivity, specificity and predictive value of anorectal manometry and barium enema for diagnosis of HD. We also measured sphincter length, median value of balloon volume at which rectoanal inhibitory reflex (RAIR) occurred. RESULTS: All 61 patients received anorectal manometry, 33 of 61 received barium enema. 18 of 61 were diagnosed as HD according to histology and 43 of 61 were evaluated as a control. The sensitivity, specificity, positive predictive value, negative predictive value of anorectal manometry and barium enema for diagnosis of HD were 1.00, 0.91, 0.82, 1.00 and 0.93, 0.67, 0.70, 0.92 respectively. The mean value of sphincter length in control was 1.68+/-0.67 cm and correlated with age, weight and significantly longitudinal length. The median value of balloon volume at which RAIR occurred was 10 mL and did not correlated with age, weight and longitudinal length. CONCLUSION: This study suggests that anorectal manometry is an excellent initial screening test for Hirschsprung's disease because of its safety and accuracy.
Barium ; Biopsy ; Constipation ; Diagnosis* ; Diarrhea ; Enema ; Hirschsprung Disease* ; Humans ; Infant ; Manometry* ; Mass Screening ; Medical Records ; Reflex ; Sensitivity and Specificity ; Vomiting