Carpometacarpal dislocations occur in less thsn 1% of osseous hand injuries. Sine Dec. 1987, two cases of multiple carpometacarpal dislocations were treated at Hanyang University Hospital. All of these were successfully treated by closed reduction and percutaneous pinning with K-wires. Follow-up periods were 6 months and 5 months respectively. All patients were asymptomstic, but one patient had occasional discomfort and diminished grip strength.
Carpometacarpal Joints ; Dislocations ; Follow-Up Studies ; Hand Injuries ; Hand Strength ; Humans

There is an increasing interest in the epidemiology of children's fractures particullary to the patterns of children's fractures but there is a few available articles about them. We reviewed 398 children under the 15 years of age who were affected by fractures during 4 years and analysed the patterns of children's fractures concerning with the sex, age, seasons of a year, etiology, fracture sites and the types of fractures. The results were as follows : 1. Boys were affected about 2.5 times than girls. Fractures were predominant in between 5 and 9 years of age group. 2. The three highest monthly incidences of the fractures were showed in July, September and October. 3. The major causes of fractures were fall from a height or slipdown, pedestrian traffic accidents and sports injury in decreasing orders. 4. The traffic accidents were occured frequently in children of five to seven year old, and it is occured predominantly in June, July and August(37.8%). 5. The frequent sites of children's fractures were humerus(33.5%), tibia(21.0%), forearm (17.3%) and femur(13.6%). 6. The sports injuries were affected evenly in all age groups except below 3 years old children and the frequent causes were bicycling, exercising on the horizontal bar, Korean wrestling and during football game in decreasing orders.
Accidents, Traffic ; Athletic Injuries ; Bicycling ; Child ; Clinical Study ; Epidemiology ; Female ; Football ; Forearm ; Humans ; Incidence ; Seasons ; Wrestling

The diagnosis of painful hips of the children are very difficult in their early stage of diseases. Transient synovitis, Legg-Calve-Perthes' diseas juvenile rheumatoid arthritis and pyogenic hip are very similar in clinical manifestation and plane radiology. But the treatment methods and prognoses are very different, so it is very important to make an accurate diagnosis and differential diagnosis as early as possible. In the above mentioned diseases hip joint effusion is one of common manifestations, so we studied the hip joint effusion by ultrasonography in 49 children with painful hips and also we studied both hips of healthy children to determine the criteria of the normal hip joint. And the results are summerized as follows: l. Ultrasonography was very good method for detection of hip joint effusion. 2. In healthy children, the average bone-to-capsule distance was 2.95mm. 3. In children patients with unilateral painful hip, the average bone-to-capsule distance was 2.96mm, so it was very similar to that of healthy children. 4. The difference more than 2mm between both hips was abnormal. 5. In 49 children with painful hips, over all positive rate was 63.3%.
Arthritis, Juvenile ; Child ; Diagnosis ; Diagnosis, Differential ; Hip Joint ; Hip ; Humans ; Methods ; Prognosis ; Synovitis ; Ultrasonography

Recent cohort studies have relied on exposure prediction models to estimate individual-level air pollution concentrations because individual air pollution measurements are not available for cohort locations. For such prediction models, geographic variables related to pollution sources are important inputs. We demonstrated the computation process of geographic variables mostly recorded in 2010 at regulatory air pollution monitoring sites in South Korea. On the basis of previous studies, we finalized a list of 313 geographic variables related to air pollution sources in eight categories including traffic, demographic characteristics, land use, transportation facilities, physical geography, emissions, vegetation, and altitude. We then obtained data from different sources such as the Statistics Geographic Information Service and Korean Transport Database. After integrating all available data to a single database by matching coordinate systems and converting non-spatial data to spatial data, we computed geographic variables at 294 regulatory monitoring sites in South Korea. The data integration and variable computation were performed by using ArcGIS version 10.2 (ESRI Inc., Redlands, CA, USA). For traffic, we computed the distances to the nearest roads and the sums of road lengths within different sizes of circular buffers. In addition, we calculated the numbers of residents, households, housing buildings, companies, and employees within the buffers. The percentages of areas for different types of land use compared to total areas were calculated within the buffers. For transportation facilities and physical geography, we computed the distances to the closest public transportation depots and the boundary lines. The vegetation index and altitude were estimated at a given location by using satellite data. The summary statistics of geographic variables in Seoul across monitoring sites showed different patterns between urban background and urban roadside sites. This study provided practical knowledge on the computation process of geographic variables in South Korea, which will improve air pollution prediction models and contribute to subsequent health analyses.
Air Pollution* ; Altitude ; Buffers ; Cohort Studies ; Family Characteristics ; Geographic Information Systems ; Geography ; Housing ; Information Services ; Korea* ; Seoul ; Transportation

Recent cohort studies have relied on exposure prediction models to estimate individual-level air pollution concentrations because individual air pollution measurements are not available for cohort locations. For such prediction models, geographic variables related to pollution sources are important inputs. We demonstrated the computation process of geographic variables mostly recorded in 2010 at regulatory air pollution monitoring sites in South Korea. On the basis of previous studies, we finalized a list of 313 geographic variables related to air pollution sources in eight categories including traffic, demographic characteristics, land use, transportation facilities, physical geography, emissions, vegetation, and altitude. We then obtained data from different sources such as the Statistics Geographic Information Service and Korean Transport Database. After integrating all available data to a single database by matching coordinate systems and converting non-spatial data to spatial data, we computed geographic variables at 294 regulatory monitoring sites in South Korea. The data integration and variable computation were performed by using ArcGIS version 10.2 (ESRI Inc., Redlands, CA, USA). For traffic, we computed the distances to the nearest roads and the sums of road lengths within different sizes of circular buffers. In addition, we calculated the numbers of residents, households, housing buildings, companies, and employees within the buffers. The percentages of areas for different types of land use compared to total areas were calculated within the buffers. For transportation facilities and physical geography, we computed the distances to the closest public transportation depots and the boundary lines. The vegetation index and altitude were estimated at a given location by using satellite data. The summary statistics of geographic variables in Seoul across monitoring sites showed different patterns between urban background and urban roadside sites. This study provided practical knowledge on the computation process of geographic variables in South Korea, which will improve air pollution prediction models and contribute to subsequent health analyses.
Air Pollution* ; Altitude ; Buffers ; Cohort Studies ; Family Characteristics ; Geographic Information Systems ; Geography ; Housing ; Information Services ; Korea* ; Seoul ; Transportation

BACKGROUND AND OBJECTIVES: The Deiters' cell is one of the supporting cells in the organ of Corti and is known to possibly regulate the signal transduction pathway in the organ of Corti. The signal transduction process can be modulated by ATP and acetylcholine, the so-called neurotransmitters, in Deiters' cells. Intracellular Ca2+ concentration can be also increased by these neurotransmitters and the control mechanism on the organ of Corti is highly suggested in Deiters' cells. Potassium ion (K+) is known to be important both in hair cells and supporting cells. Through K+ channel, the membrane potential may be controlled and the signal transduction pathway can be regulated. Furthermore, the motility of outer hair cell and the signal transduction from the apical stereocilia are considered to be regulated by this channel. The aim of this study is to record the K+ current in the isolated Deiters' cells from guinea pig cochlea. MATERIALS AND METHODS: Deiters' cells were isolated from the organ of Corti of guinea pig by using collagenase and a pipet. A whole cell patch clamp was performed under the inverted microscope and the current was measured with List-7 amplifier and pClamp 8.0.2 software. RESULTS: The resting membrane potential was -15.02+/-2.66 mV (n=6). When the cell membrane was hyperpolarized into -110 mV from the -40 mV holding potential, the peak current was -227+/-39.9 pA (n=15). After having depolarized to the maximum, (50 mV), the peak current was 7123+/-737 pA, and the reversal potentials of different external K+ concentration changed in the K+-dependent manner. About 80% of this current was inhibited by TEA. When K+ was substituted by Cs+, the peak current was 1788+/-231 pA at 50 mV step pulse. Activation curve of this outward current showed two different Vh (half activation voltage) and K (slope factor). CONCLUSION: Outward rectifying K+ channels exist in Deiters' cells and they can be inhibited by TEA and permeable to Cs+. More than two types of K+ current can exist and they may play a role in the recovery of membrane potential after depolarization,
Acetylcholine ; Adenosine Triphosphate ; Animals ; Cell Membrane ; Cochlea* ; Collagenases ; Guinea Pigs* ; Guinea* ; Hair ; Labyrinth Supporting Cells ; Membrane Potentials ; Neurotransmitter Agents ; Organ of Corti ; Patch-Clamp Techniques ; Potassium ; Potassium Channels ; Signal Transduction ; Stereocilia ; Tea

Background and Objectives: The directed differentiation of pluripotent stem cells into motor neurons is critical for the development of disease modelling and therapeutics to intervene degenerative motor neuron diseases. Cell surface receptor Cdo functions as a coreceptor for Sonic hedgehog (Shh) with Boc and Gas1 in the patterning of ventral spinal cord neurons including motor neurons. However, the discrete function of Cdo is not fully understood. Methods: and Results: In this study, we examined the role of Cdo in motor neuron generation by utilizing in vitro differentiation of Cdo＋/＋ and Cdo−/− embryonic stem cells (ESCs). In response to Shh, Cdo−/− ESCs exhibited impaired expression of motor neuron specification markers while dorsal interneuron specification markers were significantly increased, compared to Cdo＋/＋ ESCs. Reactivation of Shh signalling pathway with Smoothened (Smo) agonist (SAG) restored motor neuron specification in Cdo−/− ESCs. In addition, electrophysiological analysis revealed the immature electrical features of Cdo−/− ESCs-derived neurons which was restored by SAG. Conclusions Taken together, these data suggest that Cdo as a Shh coreceptor is required for the induction of motor neuron generation by fully activating Shh signalling pathway and provide additional insights into the biology of motor neuron development.

Insulin autoimmune syndrome is characterized by spontaneous hypoglycemia, high concentrations of serum immunoreactive insulin, and the presence of autoantibodies to insulin without previous insulin injection. A 71-year-old woman with diabetes, who had been treated with oral hypoglycemic agents, suffered from frequent hypoglycemia. High insulin levels and the presence of insulin autoantibodies were shown, so insulin autoimmune syndrome was diagnosed. Drugs containing sulfhydryl groups play an important role in the pathogenesis of insulin autoimmune syndrome. Alpha-lipoic acid, which contains a sulfhydryl group, was administered before the onset of hypoglycemia. The patient's human leukocyte antigen (HLA) type was HLA-Cw4 and DRB1*0406. There is a strong correlation between HLA-DRB1*0406 and insulin autoimmune syndrome. The patient was treated with prednisolone and has not had a hypoglycemic attack since. We report a case of insulin autoimmune syndrome, possibly associated with alpha-lipoic acid.
Aged ; Autoantibodies ; Female ; HLA-C Antigens ; HLA-DRB1 Chains ; Humans ; Hypoglycemia ; Hypoglycemic Agents ; Insulin ; Leukocytes ; Prednisolone ; Thioctic Acid

We report our experience with a case of performing laparoscopy-assisted total gastrectomy along with pancreas-preserving splenectomy for treating early gastric cancer. Laparoscopy-assisted total gastrectomy was planned for a 62-year-old male patient with a double early gastric cancer located in the upper and lower third of the stomach. Five trocars were placed and we used a harmonic scalpel to dissect the greater curvature. Enlarged splenic hilar lymph node was encountered and they were proved to be metastasis by frozen section biopsy. We then performed total gastrectomy with pancreas-preserving splenectomy for the purpose of completely dissecting the lymph nodes along the splenic artery and splenic hilum. We created a 4 cm sized longitudinal mini-laparotomy below the xiphoid process to remove the specimen, and anastomosis was done via the Roux-en-Y method. The patient was discharged on the 9th postoperative days after an uneventful recovery. Our experience shows that laparoscopy-assisted total gastrectomy with pancreas-preserving splenectomy is a relatively safe procedure for treating upper third early gastric cancer with metastatic splenic hilar lymph nodes.
Biopsy ; Frozen Sections ; Gastrectomy* ; Humans ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Splenectomy* ; Splenic Artery ; Stomach ; Stomach Neoplasms* ; Surgical Instruments

BACKGROUND/AIMS: We compared the efficacy and safety of the second-generation everolimus-eluting stent (EES) and the third generation biolimus-eluting stent (BES) in patients with acute myocardial infarction (AMI). METHODS: We analyzed 629 consecutive patients (mean age 65.1 +/- 11.2 years, 426 males) with AMI undergoing percutaneous coronary intervention from February 2008 to April 2012. They were divided into two groups according to stent type (EES group, n = 426; BES group, n = 203). The primary end-point was 2-year major adverse cardiac events (MACEs), defined as the composite of all-cause death, myocardial infarction, target vessel revascularization, non-target vessel revascularization and target lesion revascularization. The secondary end-point was 2-year target lesion failure (TLF). RESULTS: There were no significant differences in baseline characteristics, except that the patients with EES had a significantly higher prevalence of diabetes mellitus (34.7 vs. 22.7%, p = 0.002) and were older (67.1 +/- 11.3 vs. 64 +/- 12.9 years, p = 0.039) compared with the patients with BES. After propensity score matching, 2-year clinical outcomes showed no differences in composite MACEs or TLF between the two groups. Multivariate Cox regression analysis showed that stent type was not a predictor of 2-year mortality or MACEs. However, older age (hazard ratio [HR] 1.037, 95% confidence interval [CI] 1.014-1.060, p = 0.001), diabetes mellitus (HR 2.247, 95% CI 1.426-3.539, p = 0.001) and a left ventricular ejection fraction < or = 45% (HR 3.007, 95% CI 1.978-4.573, p = 0.001) were independent predictors for 2-year MACEs in patients undergoing EES or BES. CONCLUSIONS: Patients with BES had similar clinical 2-year outcomes compared with EES patients with AMI.
Diabetes Mellitus ; Humans ; Mortality ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Prevalence ; Prognosis ; Propensity Score ; Stents* ; Stroke Volume