Reconstructing the impact of infectious disease on past populations is one of the main fields in paleopathological studies. The initial phase of paleopathology was descriptive, focusing on the identification and presence of disease in the past. However, currently paleopathological studies are moving toward probing questions about the larger picture of origin and transmission of disease agents. In this study, paleopathological studies of major infectious disease (i.e., tubuerculosis, treponemal disease and leprosy) were reviewed through osteoarcheological work published in American Journal of Physical Anthropology, International Journal of Osteoarchaeology, Journal of Archaeological Science and International Journal of Paleopathology from 1981 to 2017. A basic objective of this research was to examine many types of research in paleopathology and to characterize research trend in this field. As paleopathological studies becomes more abundant, the approaches to infectious disease have been increasingly specialized and interdisciplinary from 1980. Also, methodology used in paleopathology continues to evolve through the holistic approaches of molecular analysis, radiology and histopathology. Ultimately, this study reinforces the importance for retention of large-scale skeletal collections for paleopathological study in population perspective. In the near future, Korean paleopathology can contribute in the reconstructions of the history of disease and its effect on past human populations.
Anthropology, Physical ; Communicable Diseases* ; Humans ; Leprosy ; Paleopathology ; Syphilis ; Tuberculosis

A 39 years old woman was admitted to the hospital because of recurrent hemoptysis. On a bronchoscopic inspection, nodular shaped mass-like lesions were found on the orifice of right middle and lower lobar bronchus and a biopsy was performed. This was immediately followed by massive bleeding into the airways. The bleeding could not be controlled by nonsurgical treatment. Immediately she underwent a right middle and lower bilobectomy in order to control of bleeding. Biopsy revealed the bleeding to have been caused by a biopsy injury of an abnormal artery that had run superficially in the bronchial mucosa.
Adult ; Arteries ; Biopsy* ; Bronchi ; Bronchial Arteries* ; Bronchoscopy ; Female ; Hemoptysis ; Hemorrhage* ; Humans ; Mucous Membrane

Although complex fractionated electrogram (CFE) is known to be a target for catheter ablation of fibrillation, its physiological meaning in fibrillation wave-dynamics remains to be clarified. We evaluated the spatiotemporal relationships among the parameters of fibrillation wave-dynamics by simulation modeling. We generated maps of CFE-cycle length (CFE-CL), local dominant frequency (LDF), wave break (WB), and phase singularity (PS) of fibrillation in 2-dimensional homogeneous bidomain cardiac modeling (1,000 x 1,000 cells ten Tusscher model). We compared spatiotemporal correlations by dichotomizing each maps into 10 x 10 lattice zones. In spatial distribution, WB and PS showed excellent correlation (R = 0.963, P < 0.001). CFE-CL had weak correlations with WB (R = 0.288, P < 0.001), PS (R = 0.313, P < 0.001), and LDF (R = -0.411, P < 0.001). However, LDF did not show correlation with PS or WB. PSs were mostly distributed at the periphery of low CFE-CL area. Virtual ablation (5% of critical mass) of CFE-CL < 100 ms terminated fibrillation at 14.3 sec, and high LDF ablation (5% of critical mass) changed fibrillation to organized tachycardia, respectively. In homogeneous 2D fibrillation modeling, CFE-CL was weakly correlated with WB, PS, and LDF, spatiotemporally. PSs are mostly positioned at the periphery of low CFE-CL areas, and virtual ablation targeting low CFE-CL regions terminated fibrillation successfully.
Algorithms ; Atrial Fibrillation/*physiopathology ; Body Surface Potential Mapping ; Catheter Ablation ; *Electrocardiography ; Electrodes ; Heart Atria/physiopathology ; Humans ; *Models, Biological

PURPOSE: This study aims to investigate the effects of smoking on the development of placenta-associated syndromes, including preeclampsia, abruptio placentae, and placenta previa, which share the common pathophysiology of vascular compromise of the placenta. METHODS: A total of 966,629 pregnancies identified from the Korean National Insurance Claims Database and the National Health Information Database were analyzed from 2010 to 2014. The adjusted odds ratio and attributable risk of smoking for the development of placenta-associated syndromes, such as preeclampsia, placenta previa, and abruptio placentae, were analyzed. Maternal age, alcohol consumption, exercise habit, and economic status were controlled as confounding variables. A binary logistic regression model was used, and simple and multiple logistic regression analyses were performed. RESULTS: Among 966,629 pregnancies, 11.86% of women were ever smokers. Ever smokers had a higher risk of developing placenta previa (adjusted odds ratio, 1.23; 95% confidence interval [CI], 1.18–1.29; adjusted attributable risk, 18.70%). The adjusted odds ratio of developing placenta-associated syndromes in ever smokers compared to nonsmokers over the age of 35 years with a low economic status was 1.32 (95% CI, 1.18–1.47), with an adjusted attributable risk of 23.95%. CONCLUSION: The risk of developing placenta-associated syndromes, such as preeclampsia, placenta previa, and abruptio placentae, is high in ever smokers. Pregnant ever smokers who are >35 years and belong to the lower one-third of the economic division require special care to prevent the development of placenta-associated syndromes.
Abruptio Placentae ; Alcohol Drinking ; Confounding Factors (Epidemiology) ; Female ; Humans ; Insurance ; Korea ; Logistic Models ; Maternal Age ; Odds Ratio ; Placenta ; Placenta Previa ; Pre-Eclampsia ; Pregnancy ; Smoke ; Smoking

A 39 years old woman was admitted to the hospital because of recurrent hemoptysis. On a bronchoscopic inspection, nodular shaped mass-like lesions were found on the orifice of right middle and lower lobar bronchus and a biopsy was performed. This was immediately followed by massive bleeding into the airways. The bleeding could not be controlled by nonsurgical treatment. Immediately she underwent a right middle and lower bilobectomy in order to control of bleeding. Biopsy revealed the bleeding to have been caused by a biopsy injury of an abnormal artery that had run superficially in the bronchial mucosa.
Adult ; Arteries ; Biopsy* ; Bronchi ; Bronchial Arteries* ; Bronchoscopy ; Female ; Hemoptysis ; Hemorrhage* ; Humans ; Mucous Membrane

PURPOSE: Acute coronary lesions commonly trigger out-of-hospital cardiac arrest (OHCA). However, the prevalence of coronary artery disease (CAD) in Asian patients with OHCA and whether electrocardiogram (ECG) and other findings might predict acute myocardial infarction (AMI) have not been fully elucidated. MATERIALS AND METHODS: Of 284 consecutive resuscitated OHCA patients seen between January 2006 and July 2013, we enrolled 135 patients who had undergone coronary evaluation. ECGs, echocardiography, and biomarkers were compared between patients with or without CAD. RESULTS: We included 135 consecutive patients aged 54 years (interquartile range 45-65) with sustained return of spontaneous circulation after OHCA between 2006 and 2012. Sixty six (45%) patients had CAD. The initial rhythm was shockable and non-shockable in 110 (81%) and 25 (19%) patients, respectively. ST-segment elevation predicted CAD with 42% sensitivity, 87% specificity, and 65% accuracy. ST elevation and/or regional wall motion abnormality (RWMA) showed 68% sensitivity, 52% specificity, and 70% accuracy in the prediction of CAD. Finally, a combination of ST elevation and/or RWMA and/or troponin T elevation predicted CAD with 94% sensitivity, 17% specificity, and 55% accuracy. CONCLUSION: In patients with OHCA without obvious non-cardiac causes, selection for coronary angiogram based on the combined criterion could detect 94% of CADs. However, compared with ECG only criteria, the combined criterion failed to improve diagnostic accuracy with a lower specificity.
Aged ; Biomarkers/*blood ; Case-Control Studies ; Coronary Angiography ; Coronary Artery Disease/blood/*diagnosis/epidemiology ; Echocardiography/*methods ; Electrocardiography/*methods ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/blood/*diagnosis/epidemiology ; Out-of-Hospital Cardiac Arrest/*diagnosis ; Sensitivity and Specificity ; Troponin T

PURPOSE: To compare vascular displacement in the macula after surgical closure of idiopathic macular hole (MH) after single-layered inverted internal limiting membrane (ILM) flap technique and conventional ILM removal. METHODS: This retrospective study included patients who underwent either vitrectomy and ILM removal only or vitrectomy with single-layered inverted ILM flap for idiopathic MH larger than 400 µm from 2012 to 2015. A customized program compared the positions of the retinal vessels in the macula between preoperative and postoperative photographs. En face images of 6 × 6 mm optical coherence tomography volume scans were registered to calculate the scale. Retinal vessel displacement was measured as a vector value by comparing its location in 16 sectors of a grid partitioned into eight sectors in two rings (inner, 2 to 4 mm; outer, 4 to 6 mm). The distance and angle of displacement were calculated as an average vector and were compared between the two groups for whole sectors, inner ring, outer ring, and for each sector. RESULTS: Twenty patients were included in the ILM flap group and 22 in the ILM removal group. There were no statistical differences between the groups for baseline characteristics. The average displacement in the ILM flap group and the ILM removal group was 56.6 µm at −3.4° and 64.9 µm at −2.7°, respectively, for the whole sectors (p = 0.900), 76.1 µm at −1.1° and 87.3 µm at −0.9° for the inner ring (p = 0.980), and 37.4 µm at −8.2° and 42.7 µm at −6.3° for the outer ring (p = 0.314). There was no statistical difference in the displacement of each of the sectors. CONCLUSIONS: Postoperative topographic changes showed no significant differences between the ILM flap and the ILM removal group for idiopathic MH. The single-layered ILM flap technique did not appear to cause additional displacement of the retinal vessels in the macula.
Humans ; Membranes* ; Retinal Perforations* ; Retinal Vessels ; Retrospective Studies ; Tomography, Optical Coherence ; Vitrectomy

PURPOSE: To investigate the change in axial length (AL) in highly myopic adults using partial coherence interferometry, and to identify the factors associated with the increase in AL. METHODS: Medical records of highly myopic adults (≥ −6 diopters [D] or AL ≥ 26.0 mm) were retrospectively reviewed. The AL of each patient was measured using partial coherence interferometry at least three times over 2 years, and the yearly change in AL was calculated. Associations between age, AL, choroidal thickness, and the rate of AL change were evaluated using multiple regression analysis. RESULTS: In total, 24 patients (4 males, 20 females) and 44 eyes were included in this study. The mean age was 54.9 ± 10.4 years, the initial AL was 29.335 ± 2.006 mm, the choroidal thickness was 72.7 ± 41.80 µm, the average spherical equivalent was −11.86 ± 3.85 D (−5.1~−22.0 D), and the mean follow-up period was 2.2 ± 0.5 years. A significant increase in AL of ≥0.05 mm was observed in 38 eyes (86.4%) at 2 years. The mean AL was significantly increased, to 29.409 ± 2.007 mm (p < 0.001), at 1 year and to 29.476 ± 2.028 mm (p < 0.001) at 2 years. The average rate of AL change was 0.071 ± 0.049 mm (−0.01~0.19 mm) per year. None of the included factors showed an association with the rate of AL change in multiple regression analysis. CONCLUSIONS: In this study, an increase in AL in highly myopic adults was more frequent than in previous reports using A-scan. Periodic measurements are therefore recommended for the early detection of complications.
Adult ; Choroid ; Follow-Up Studies ; Humans ; Interferometry ; Male ; Medical Records ; Retrospective Studies

PURPOSE: The present study investigated associations between dopamine transporter (DAT) availability and α-synuclein levels in cerebrospinal fluid, as well as synuclein gene (SNCA) transcripts, and the effect of single nucleotide polymorphism of SNCA on DAT availability in healthy subjects. MATERIALS AND METHODS: The study population comprised healthy controls who underwent 123I-FP-CIT single-photon emission computed tomography screening. Five SNCA probes were used to target the boundaries of exon 3 and exon 4 (SNCA-E3E4), transcripts with a long 3′UTR region (SNCA-3UTR-1, SNCA-3UTR-2), transcripts that skip exon 5 (SNCA-E4E6), and the rare short transcript isoforms that comprise exons 1–4 (SNCA-007). RESULTS: In total, 123 healthy subjects (male 75, female 48) were included in this study. DAT availability in the caudate nucleus (p=0.0661) and putamen (p=0.0739) tended to differ according to rs3910105 genotype. In post-hoc analysis, DAT availability in the putamen was lower in subjects of TT genotype than those of CC/CT (p=0.0317). DAT availability in the caudate nucleus also showed a trend similar to that in the putamen (p=0.0597). Subjects of CT genotype with rs3910105 showed negative correlations with DAT availability in the putamen with SNCA-E3E4 (p=0.037, rho=−0.277), and SNCA-E4E6 (p=0.042, rho=−0.270), but not those of CC/TT genotypes. CONCLUSION: This is the first study to investigate the association of rs3910105 in SNCA with DAT availability. rs3910105 had an effect on DAT availability, and the correlation between DAT availability and SNCA transcripts were significant in CT genotypes of rs3910105.
Biomarkers ; Caudate Nucleus ; Cerebrospinal Fluid ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Exons ; Female ; Genotype ; Healthy Volunteers* ; Humans ; Mass Screening ; Polymorphism, Single Nucleotide ; Protein Isoforms ; Putamen ; Synucleins* ; Tomography, Emission-Computed

Background: Cardiac resynchronization therapy (CRT) is an effective treatment option for patients with heart failure (HF) and left ventricular (LV) dyssynchrony. However, the problem of some patients not responding to CRT remains unresolved. This study aimed to propose a novel in silico method for CRT simulation. Methods: Three-dimensional heart geometry was constructed from computed tomography images. The finite ele‑ ment method was used to elucidate the electric wave propagation in the heart. The electric excitation and mechani‑ cal contraction were coupled with vascular hemodynamics by the lumped parameter model. The model parameters for three-dimensional (3D) heart and vascular mechanics were estimated by matching computed variables with measured physiological parameters. CRT effects were simulated in a patient with HF and left bundle branch block (LBBB). LV end-diastolic (LVEDV) and end-systolic volumes (LVESV), LV ejection fraction (LVEF), and CRT responsiveness measured from the in silico simulation model were compared with those from clinical observation. A CRT responder was defined as absolute increase in LVEF ≥ 5% or relative increase in LVEF ≥ 15%. Results: A 68-year-old female with nonischemic HF and LBBB was retrospectively included. The in silico CRT simu‑ lation modeling revealed that changes in LVEDV, LVESV, and LVEF by CRT were from 174 to 173 mL, 116 to 104 mL, and 33 to 40%, respectively. Absolute and relative ΔLVEF were 7% and 18%, respectively, signifying a CRT responder.In clinical observation, echocardiography showed that changes in LVEDV, LVESV, and LVEF by CRT were from 162 to 119 mL, 114 to 69 mL, and 29 to 42%, respectively. Absolute and relative ΔLVESV were 13% and 31%, respectively, also signifying a CRT responder. CRT responsiveness from the in silico CRT simulation model was concordant with that in the clinical observation. Conclusion This in silico CRT simulation method is a feasible technique to screen for CRT non-responders in patients with HF and LBBB.