The term Down's syndrome is preferred to mongolism. The most constant characteristic of disease is mental retardation. The incidence of Down's syndrome is about 1/600 in the general population, being roughly the same in various parts of world and in all races. The patient's mother's age at the same time of conception as well as the nature of chromosomalmalformation are in genetic counseling. We reported a case of Down's syndrome in 5 year old female who was bone in 38 year old mother, and she was noted epicanthus, nystagmus, esotropia, Brush-field spots. Other systemic manifestation-, Simian crease, short extrimites, inward curved 5th finger, Sandal gap foot, congenital heart disease, prominent abdomen-, was also noted.
Adult ; Child, Preschool ; Continental Population Groups ; Down Syndrome* ; Esotropia ; Female ; Fertilization ; Fingers ; Foot ; Genetic Counseling ; Heart Defects, Congenital ; Humans ; Incidence ; Intellectual Disability ; Mothers

This study was conducted to compare the date on knowledge, attitude and motivation toward blood donation between donors and non-donors. The study population included 622 donors and 322 non-donors who visited the mobile blood donation car of Taegu Red Cross Blood Center and participated the group appointed blood donation campaign managed by the center from March 1 to March 31, 1989. The donors and non-donors were questioned above mentioned items with a formulated questionnaire. Among the general characteristics of the subjects in the study, male predominance (84.1% in donors and 73.6% in non-donors) in young age group (16-24 years) was the outstanding feature. As a medium of information about blood donation, “television” was playing a dominant role (donors; 75.2%, non-donors; 78.9%), while “magazine” played more important roles among donors. Of the donors, 70.6% and of the non-donors, 58.1 replied that they had ever been induced to donate blood (p<0.01). Major inducers were friend and personnel of mobile blood donation vehicle. On the measuring of knowledge level, the average rates of correct answer was higher in donors (62.6%) than in non-donors (54.1%) (p<0.01). Higher the education level was presented, higher the knowledge level (p<0.05). There have been noticeable difference between donors and non-donors in blood replying the questionnaire set to measure their attitude toward blood donation, especially in the items such as “impression toward blood”, “selection of transfusion blood source” and “view on the situation of blood shortage.” The major motivation toward blood donation of the groups were “possible future need” and “altruism or humanitarian interest”. The major reasons for not donation blood in both groups were “fear of the needle” and “dread to visit to mobile car or center”.
Blood Donors* ; Daegu ; Education ; Friends ; Humans ; Male ; Motivation* ; Red Cross ; Tissue Donors

Background: More comprehensive healthcare services should be provided to patients with complex chronic diseases to better manage their complex care needs. This study examined the effectiveness of comprehensive primary care in patients with complex chronic diseases. Methods: We obtained 2002–2019 data from the National Health Insurance Sample Cohort Database. Participants were individuals aged ≥ 30 years with at least two of the following diseases: hypertension, diabetes mellitus, and hyperlipidemia. Doctors’ offices were classified into specialized, functional, and gray-zone based on patient composition and major diagnostic categories. The Cox proportional hazard model was used to examine the association between office type and hospital admission due to all-causes, severe cardiovascular or cerebrovascular diseases (CVDs), hypertension, diabetes mellitus, or hyperlipidemia. Results: The mean patient age was 60.3 years; 55.8% were females. Among the 24,906 patients, 12.8%, 38.3%, and 49.0% visited specialized, functional, and gray-zone offices, respectively. Patients visiting functional offices had a lower risk of all-cause admission (hazard ratio [HR], 0.935; 95% confidence interval [CI], 0.895–0.976) and CVD-related admission (HR, 0.908; 95% CI, 0.844–0.977) than those visiting specialized offices.However, the admission risks for hypertension, diabetes mellitus, and hyperlipidemia were not significantly different among office types. Conclusion This study provides evidence of the effectiveness of primary care in functional doctors’ offices for patients with complex chronic diseases beyond a single chronic disease and suggests the need for policies to strengthen functional offices providing comprehensive care.

Background: Health-adjusted life expectancy (HALE) is an indicator of the average lifespan in good health. Through this study, we aimed to identify regional disparities in the gap between HALE and life expectancy, considering the trends that have changed over time in Korea. Methods: We employed a group-based multi-trajectory modeling approach to capture trends in the gap between HALE and life expectancy at the regional level from 2008 to 2019. HALE was calculated using incidence-based “years lived with disability.” This methodology was also employed in the Korean National Burden of Disease Study. Results: Based on five different information criteria, the most fitted number of trajectory groups was seven, with at least 11 regions in each group. Among the seven groups, one had an exceptionally large gap between HALE and life expectancy compared to that of the others.This group was assigned to 17 regions, of which six were metropolitan cities. Conclusion Based on the results of this study, we identified regions in which health levels have deteriorated over time, particularly within specific areas of metropolitan cities. These findings can be used to design comprehensive policy interventions for community health promotion and urban regeneration projects in the future.

Rhizomelic chondrodysplasia punctata(RCDP) is a rare autosomal recessive disorder clinically characterized by symmetrical shortening of the proximal limbs, contractures of joints, a typical dysmorphic face, cataracts, and itchyosis. Patients with RCDP can be subdivided into three subgroups based on biochemical analysis and complementation studies. RCDP type I results from mutations in the PEX7 gene encoding the peroxisomal targeting signal type II(PST2) receptors and presents with both a defect in plasmalogen biosynthesis and phytanic acid oxidation. RCDP type II is deficient in the activity of dihydroxyacetonephosphate acyltransferase(DHAP-AT). RCDP type III is deficient in alkyl-dihydroxyacetonephosphate synthase(alkyl-DHAP). We report a case of RCDP type I which was confirmed with biochemical study, fibroblast culture, and gene study.
Cataract ; Chondrodysplasia Punctata, Rhizomelic* ; Complement System Proteins ; Contracture ; Extremities ; Fibroblasts ; Humans ; Joints ; Phytanic Acid

OBJECTIVE: The present study was performed to investigate whether apoptosis occur in human embryos by annexin staining and detect the expression of Fas, Fas-ligand (FasL), Bax, and Bcl-2 in human fragmented embryos derived from IVF-ET by immunofluorescence and Western blot analysis. MATERIALS AND METHODS: Using annexin staining, immunofluorescence and Western blot analysis on normal and fragmented embryos, we were able to detect apoptotsis and apoptotic gene products in fragmented embryos. RESULTS: Phosphatidylserine (PS) translocation, the marker for apoptosis, were detected frequently in fragmented embryos. Bcl-2 and Bax protein were detected in both fragmented and non-fragmented embryos. When fragmented embryos compared to normal embryos, immunofluorescent intensity of Bcl-2 tended to be lower in fragmented embryos. Bax gene expression increased in the fragmented embryos compared to the normal embryos. This result supports a model in which the molar ratio of Bcl-2 to Bax determines whether apoptosis induced or inhibited in human embryo. Fas was highly expressed in human preimplantation embryos but not FasL. It suggests that embryo may undergo apoptosis by binding with FasL produced by follicular or immune cells. CONCLUSION: The over expression of Bax and Fas will trigger apoptosis to lead embryo fragmentation and change embryo to be nonviable.
Apoptosis* ; bcl-2-Associated X Protein ; Blastocyst ; Blotting, Western ; Embryonic Structures* ; Fluorescent Antibody Technique ; Gene Expression ; Humans* ; Molar

PURPOSE: To describe the two-phase spiral CT findings of acute cholecystitis. MATERIALS AND METHODS: CTscans of nine patients with surgically-proven acute cholecystitis were retrospectively reviewed for wallthickening, enhancement pattern of the wall, attenuation of the liver adjacent to the gallbladder, gallstones,gallbladder distention, gas collection within the gallbladder, pericholecystic fluid and infiltration ofpericholecystic fat. RESULT: In all cases, wall thickening of the gallbladder was seen, though this was moredistinct on delayed images, Using high-low-high attenuation, one layer was seen in five cases, nd three layers infour. On arterial images, eight cases showed transient focal increased attenuation of the liver adjacent to thegall bladder;four of these showed curvilinear attenuation and four showed subsegmental attenuation. One caseshowed curvilinear decreased attenuation between increased attenuation of the liver and the gallbladder, andduring surgery, severe adhesion between the liver and gallbladder was confirmed. Additional CT findings wereinfiltration of pericholecystic fat (n=9), gallstones (n=7), gallbladder distension (n=6), pericholecystic fluid(n=3), and gas collection within the gallbladder (n=2). CONCLUSION: In patients with acute cholecystisis,two-phase spiral CT revealed wall thickening in one or three layers ; on delayed images this was more distint. Inmany cases, arterial images showed transient focal increased attenuation of the liver adjacent to the gallbladder.
Cholecystitis, Acute* ; Gallbladder ; Gallstones ; Humans ; Liver ; Retrospective Studies ; Tomography, Spiral Computed*

Objectives: Regional disparities in cardiovascular care in Korea have led to uneven patient outcomes. Despite the growing need for and access to procedures, few studies have linked regional service availability to mortality rates. This study analyzed regional variation in the utilization of major cardiovascular procedures and their associations with short-term mortality to provide better evidence regarding the relationship between healthcare resource distribution and patient survival. Methods: A cross-sectional study was conducted using nationwide claims data for patients who underwent coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), stent insertion, or aortic aneurysm resection in 2022. Regional variation was assessed by the relevance index (RI). The associations between the regional RI and 30-day mortality were analyzed. Results: The RI was lowest for aortic aneurysm resection (mean, 26.2; standard deviation, 26.1), indicating the most uneven regional distribution among the surgical procedures. Patients undergoing this procedure in regions with higher RIs showed significantly lower 30-day mortality (adjusted odds ratio [aOR], 0.73; 95% confidence interval, 0.55 to 0.96; p=0.026) versus those with lower RIs. This suggests that cardiovascular surgery regional availability, as measured by RI, has an impact on mortality rates for certain complex surgical procedures. The RI was not associated with significant mortality differences for more widely available procedures like CABG (aOR, 0.96), PCI (aOR, 1.00), or stent insertion (aOR, 0.91). Conclusions Significant regional variation and underutilization of cardiovascular surgery were found, with reduced access linked to worse mortality for complex procedures. Disparities should be addressed through collaboration among hospitals and policy efforts to improve outcomes.

Rhabdomyolysis is a syndrome characterized by muscle necrosis and release of intracellular muscle constituents into the circulation. Rhabdomylosis can be precipitated by different causes, such as trauma, extraordinary physical exer- tion, metabolic disorder, drugs, toxins, infection, or endocrinopathy. Salmonellosis is another rare cause of rhabdomyolysis. We report a 62-year-old male who developed severe diarrhea and vomitting, one day after boiled pork & raw octopus ingestion. The diagnosis of rhabdomyolysis was established primarily by the elevated serum CPK and myoglobin level. There were no other traumatic, metabolic, toxic, or enzymatic causes for the rhabdomyolysis. Stool cultures received at the first day of hospitalization yielded Salmonella Group C. Salmonella sp. is suggested to cause muscle damage by direct bacterial invasion as well as by decreasing the oxidative and glycolytic enzyme activity of skeletal muscles and by activating lysosomal enzymes. We wish to draw attention to these serious complication of salmonella gastroenteritis, and to institute of prompt measures for preventing the development of ATN. We report a case of acute renal failure associated with rhabdomyolysis and gastroenteritis caused by salmonella Group C with review of literatures.
Acute Kidney Injury* ; Diagnosis ; Diarrhea ; Eating ; Gastroenteritis* ; Hospitalization ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; Myoglobin ; Necrosis ; Octopodiformes ; Rhabdomyolysis* ; Salmonella Infections ; Salmonella*

BACKGROUND/AIMS: Recent studies suggest possibility of continuous and prolonged liver ischemia exceeding one hour. We compared mortality rates, liver function, serum Interleukin-6(IL-6) concentration and liver cell necrosis after continuous and intermittent hepatic ischemia in rats. METHODS: Sixty rats were divided into 6 groups to compare 7 day mortality rate. Continuous and intermittent left hepatic inflow occlusion was performed for a total period of 45, 60 and 90 minutes. In a separate study, following 90 minutes continuous or intermittent ischemia, systemic blood was sampled at 0 minute, 6 hours and 24 hours after final clamp release for measurement of SGOT, SGPT and IL-6. Pathologic examination was performed 24 hours or 7 days after reperfusion accordingly. RESULTS: There were no differences in the mortality rates within seven days. There were no differences in the level of SGOT, SGPT and IL-6 between each experimental group. In a pathologic examination, similar liver cell necrosis was found in each group until 24 hours of reperfusion. However, at 7 days after reperfusion, significantly higher grade of hepatic necrosis was noted in the group having continuous ischemia compared with intermittent ischemia of 90 minutes(p<0.05). CONCLUSION: Continuous ischemia is associated with significant risk in the aspect of pathologic study, although it did not affect short term mortality rates.
Alanine Transaminase ; Animals ; Aspartate Aminotransferases ; Interleukin-6 ; Ischemia ; Liver ; Mortality ; Necrosis ; Rats* ; Reperfusion ; Reperfusion Injury*