OBJECTIVE: To evaluate the epidemiologic change of patients with spinal cord injury who were admitted to a Rehabilitation Hospital, Yonsei University College of Medicine, during 1987-1996 and 2004-2008. METHODS: Medical records of 629 patients with spinal cord injury admitted to the Rehabilitation Hospital, Yonsei University College of Medicine, from 2004 to 2008 were collected and reviewed retrospectively. RESULTS: The male-to-female ratio decreased to 2.86:1, the mean age at injury increased, nontraumatic etiology increased, traffic accident remained to be the most common in traumatic spinal cord injury, and falling increased significantly. Tumor was the most common etiology in nontraumatic spinal cord injury, tetraplegia and incomplete injuries occurred more than paraplegia and complete injuries, indwelling catheter was the most common voiding method, and the duration of hospitalization decreased. CONCLUSION: Many trends changed in epidemiology of spinal cord injury.
Accidents, Traffic ; Catheters, Indwelling ; Hospitalization ; Humans ; Medical Records ; Paraplegia ; Quadriplegia ; Spinal Cord ; Spinal Cord Injuries

PURPOSE: We encountered a rare case of optic neuritis that developed in a sphenoid sinusitis. This case has not been reported at any of the Korean Ophthalmological Society meetings. CASE SUMMARY: A 12-year-old boy with swollen optic disc was diagnosed with optic neuritis secondary to sphenoid sinusitis, through orbit MRI (magnetic resonance imaging) and paranasal sinus CT (computed tomography). We observed the recovery of visual acuity and the improvement of papilledema after treatment. In the initial examination, the BCVA (best-corrected visual acuity) of the right eye was only hand movement. Papilledema was detected by ophthalmoscopy. Orbit MRI and paranasal sinus CT were then performed, which revealed that sphenoid sinusitis had invaded the right optic nerve. Treatment included the use of antibiotics, systemic steroid therapy, and endoscopic sinus surgery. One month after treatment, the BCVA of the right eye was 1.0 and the papilla of right eye had a normal ophthalmoscopic finding. CONCLUSIONS: Sphenoid sinusitis can be a cause of optic neuritis. The treatment of optic neuritis caused by paranasal sinusitis must include antibiotics use or endoscopic sinus surgery to remove the sinus inflammation as well as high dose steroid therapy.
Anti-Bacterial Agents ; Child ; Hand ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Male ; Ophthalmoscopy ; Optic Nerve ; Optic Neuritis* ; Orbit ; Papilledema ; Sinusitis ; Sphenoid Sinus* ; Sphenoid Sinusitis* ; Visual Acuity

In the adult mammalian brain, neural-lineage cells are continuously generated in the subventricular zone (SVZ) and dentate gyrus of the hippocampus. These cells in vivo arising from the adult SVZ may be regulated by environmental enrichment (EE). EE is a method of raising animals in a huge cage containing novel objects, running wheels and social interaction with a complex combination of physical, cognitive, and social stimulations. EE can affect neural plasticity via overexpression of growth factors such as brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1), fibroblast growth factor-2 (FGF-2), and synaptic activity-regulating genes. EE also have advanced effects on brain functions including the enhancement of motor and cognitive functions in normal and pathological states. Additionally, behavioral changes by EE are related with molecular changes including neurogenesis, gliogenesis, angiogenesis, axonal sprouting, and dendritic branching in the adult brain. In this review, we focus on brain plasticity and neurorestoration associated with molecular changes of neurotrophic growth factors such as BDNF, VEGF, IGF-1, FGF-2 and synaptic activity-regulating genes that occurs in interaction to EE.
Adult ; Animals ; Axons ; Brain* ; Brain-Derived Neurotrophic Factor ; Dentate Gyrus ; Fibroblast Growth Factor 2 ; Hippocampus ; Humans ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins ; Interpersonal Relations ; Neurogenesis ; Plastics* ; Running ; Vascular Endothelial Growth Factor A

Background: Preeclampsia (PE) is known to arise from insufficient trophoblast invasion as uterine spiral arteries lack remodeling. A significant reduction in placental perfusion induces an ischemic placental microenvironment due to reduced oxygen delivery to the placenta and fetus, leading to oxidative stress. Mitochondria are involved in the regulation of cellular metabolism and the production of reactive oxygen species (ROS). NME/NM23 nuceloside diphosphate kinase 4 (NME4) gene is known to have the ability to supply nucleotide triphosphate and deoxynucleotide triphosphate for replication and transcription of mitochondria. Our study aimed to investigate changes in NME4 expression in PE using trophoblast stem-like cells (TSLCs) from induced pluripotent stem cells (iPSCs) as a model of early pregnancy and peripheral blood mononuclear cells (PBMNCs) as a model of late preterm pregnancy. Methods: Transcriptome analysis using TSLCs was performed to identify the candidate gene associated with the possible pathophysiology of PE. Then, the expression of NME4 associated with mitochondrial function, p53 associated with cell death, and thioredoxin (TRX) linked to ROS were investigated through qRT-PCR, western blotting and deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate (dUTP) nick end labelling (TUNEL) assay. Results: In patients with PE, NME4 was significantly downregulated in TSLCs but upregulated in PBMNCs. p53 was shown to be upregulated in TSLCs and PBMNCs of PE. In addition, western blot analysis confirmed that TRX expression had the tendency to increase in TSLCs of PE. Similarly, TUNEL analysis confirmed that the dead cells were higher in PE than in normal pregnancy. Conclusion Our study showed that the expression of the NME4 differed between models of early and late preterm pregnancy of PE, and suggests that this expression pattern may be a potential biomarker for early diagnosis of PE.

Severe adenovirus pneumonia that causes acute respiratory failure can occur in infants, children, and immunocompromised patients. However, severe adenovirus pneumonia is rare in adults with a normal immune system. Adenovirus pneumonia may progress to acute respiratory failure in a few hours or a few days, and its clinical course cannot be predicted. In addition, the mortality rate is very high (range, 50% to 66%). However, the optimal treatment of adenovirus pneumonia has not been established. Herein, we report the successful treatment of acute respiratory failure due to adenovirus pneumonia with extracorporeal membrane oxygenation.
Adenoviridae* ; Adult ; Child ; Extracorporeal Membrane Oxygenation* ; Humans ; Immune System ; Immunocompromised Host ; Infant ; Mortality ; Pneumonia* ; Respiratory Distress Syndrome, Adult ; Respiratory Insufficiency

Two important endocrine emergencies, thyroid crisis and diabetic ketoacidosis (DKA), are uncommon when presented together, but pose serious complications. Without appropriate management, they may result in high mortality. Although several cases of simultaneous presentation of thyroid crisis and DKA have been reported, it is a clinically unusual situation and remains a diagnostic and management challenge in clinical practice. We report rare case with simultaneous presentation of thyroid crisis and DKA without previous warning symptoms. A 23-year-old-woman was brought to the emergency department presenting with acute abdominal pain for one day. She was healthy and there was no personal history of diabetes or thyroid disease. Through careful physical examination and laboratory tests, the patient was diagnosed with thyroid crisis combined with DKA. Concomitance of these two endocrine emergencies led to sudden cardiac arrest, but she was successfully resuscitated. This emphasizes the importance of early recognition and prompt management when the two diseases are presented concomitantly.
Abdominal Pain ; Death, Sudden, Cardiac ; Diabetic Ketoacidosis ; Emergencies ; Heart Arrest ; Humans ; Physical Examination ; Thyroid Crisis ; Thyroid Diseases ; Thyroid Gland

Acardiac twin is a rare anomaly that occurs 1% in monochorionic twins and 1 in 35,000 pregnancies overall. Acardiac twin, also known as twin-reversed arterial perfusion (TRAP) sequence, involves a "pump" or donor twin perfusing a recipient or "acardiac" twin through vascular (usually arterial-arterial and venous-venous) anastomoses. Perinatal mortality rate for the pump twin has been reported to be 50~75%, mainly as a result of polyhydramnios, preterm labor, and congestive heart failure. Therefore, occlusion of the circulation to the acardiac twin has been recommended to improve perinatal outcome of the pump twin. Radiofrequency ablation of the acardiac twin effectively protects the pump twin from high-output cardiac failure and death. We report our experience in the treatment of patients with TRAP sequence using radio frequency ablation to stop perfusion to the acardiac twin.
Female ; Fetus ; Heart Failure ; Humans ; Obstetric Labor, Premature ; Perfusion ; Perinatal Mortality ; Polyhydramnios ; Pregnancy ; Pregnancy, Twin ; Tissue Donors ; Umbilical Cord

Cell therapeutic agents for treating degenerative brain diseases using neural stem cells are actively being developed. However, few systems have been developed to monitor in real time whether the transplanted neural stem cells are actually differentiated into neurons. Therefore, it is necessary to develop a technology capable of specifically monitoring neuronal differentiation in vivo. In this study, we established a system that expresses cell membrane-targeting red fluorescent protein under control of the Synapsin promoter in order to specifically monitor differentiation from neural stem cells into neurons. In order to overcome the weak expression level of the tissue-specific promoter system, the partial 5′ UTR sequence of Creb was added for efficient expression of the cell surface-specific antigen. This system was able to track functional neuronal differentiation of neural stem cells transplanted in vivo, which will help improve stem cell therapies.
Antigens, Surface* ; Brain Diseases ; Neural Stem Cells ; Neurons* ; Stem Cells

PURPOSE: p21-activated kinases (PAKs) are involved in cytoskeletal reorganization, gene transcription, cell proliferation and survival, and oncogenic transformation. Therefore, we hypothesized that PAK expression levels could predict the sensitivity of pancreatic cancer cells to gemcitabine treatment, and PAKs could be therapeutic targets. MATERIALS AND METHODS: Cell viability inhibition by gemcitabine was evaluated in human pancreatic cancer cell lines (Capan-1, Capan-2, MIA PaCa-2, PANC-1, Aspc-1, SNU-213, and SNU-410). Protein expression and mRNA of molecules was detected by immunoblot analysis and reverse transcription polymerase chain reaction. To define the function of PAK4, PAK4 was controlled using PAK4 siRNA. RESULTS: Capan-2, PANC-1, and SNU-410 cells were resistant to gemcitabine treatment. Immunoblot analysis of signaling molecules reported to indicate gemcitabine sensitivity showed higher expression of PAK4 and lower expression of human equilibrative nucleoside transporter 1 (hENT1), a well-known predictive marker for gemcitabine activity, in the resistant cell lines. Knockdown of PAK4 using siRNA induced the upregulation of hENT1. In resistant cell lines (Capan-2, PANC-1, and SNU-410), knockdown of PAK4 by siRNA resulted in restoration of sensitivity to gemcitabine. CONCLUSION: PAK4 could be a predictive marker of gemcitabine sensitivity and a potential therapeutic target to increase gemcitabine sensitivity in pancreatic cancer.
Cell Line* ; Cell Proliferation ; Cell Survival ; Equilibrative Nucleoside Transporter 1 ; Humans ; p21-Activated Kinases ; Pancreatic Neoplasms* ; Phosphotransferases* ; Polymerase Chain Reaction ; Reverse Transcription ; RNA, Messenger ; RNA, Small Interfering ; Up-Regulation

OBJECTIVES: There are only a limited number of studies on instruments assessing fatigue in university students, although fatigue exerts negative influences on their health and academic performances and fatigue-related complaints are more frequently reported in young adults than middle-aged adults. The aim of this study was to validate the 9-item Fatigue Severity Scale (FSS) among university students including both undergraduate and graduate students in South Korea. METHODS: A total of 176 university students completed a battery of self-report questionnaires, including the FSS, the Brief Fatigue Inventory (BFI), the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI), the Medical Outcomes Study Short Form 36 version 2 (MOS-SF36v2), and the Inclusion of Community in the Self Scale (ICS). The data were collected from February of 2012 to June of 2012. The reliability, convergent validity, divergent validity, and exploratory factor analyses were conducted to assess psychometric properties of the FSS. RESULTS: The mean FSS score was 3.20 (standard deviation = 1.43). The FSS demonstrated an excellent internal consistency (Cronbach's alpha = 0.93) and item-total correlations ranged from 0.56 to 0.90. Correlations of the FSS with the BFI (r = 0.71, p < 0.01), BDI-II (r = 0.54, p < 0.01), BAI (r = 0.46, p < 0.01), MOS-SF36v2 physical component summary (r = -0.28, p < 0.01), MOS-SF36v2 mental component summary (r = -0.55, p < 0.01), and ICS (Spearman's rho = -0.07, p = 0.33) showed acceptable convergent and divergent validity. Exploratory factor analysis defined one underlying factor (eigenvalue = 5.67) that explained 93.50% of the total variance. CONCLUSIONS: To the best of our knowledge, this is the first study to investigate reliability and validity of the FSS in university students. The FSS exhibits good psychometric properties for evaluation of fatigue among university students in South Korea. Since the FSS is easy to administer, score, and interpret, it could be a useful tool in research and practice for assessing fatigue among university students.
Adult ; Anxiety ; Depression ; Fatigue ; Humans ; Psychometrics ; Reproducibility of Results ; Republic of Korea ; Young Adult ; Surveys and Questionnaires