Intramedullary spinal cord metastases (ISCM) account for only 3.4% of symptomatic metastases to the spinal cord. The survival of patients with ISCM is characteristically short, often no longer than 2 months, due to a rapid neurologic deterioration and the presence of widespread metastases, including metastases to the brain. We report two cases of ISCM arising from primary sphenoid sinus carcinoma and primary lung cancer along with a review of the literature. The case of ISCM from the primary sphenoid sinus is the third case of secondary syringomyelia due to ISCM in the world literature, and ISCM from the primary lung cancer is the first case reported in Korea. One case showed a slow progression of symptoms and a longer survival (26 months after the radiotherapy to the spine), and the other showed a rapid deterioration of symptoms with a shorter survival. More effective palliation can be achieved if the disease is diagnosed at an early stage when the neurologic deficits are still reversible.
Brain ; Humans ; Korea ; Lung Neoplasms ; Neoplasm Metastasis* ; Neurologic Manifestations ; Radiotherapy ; Sphenoid Sinus ; Spinal Cord* ; Syringomyelia

No abstract available.
Carcinoma, Squamous Cell* ; Female ; Ovary* ; Teratoma*

No abstract available.
Humans ; Infant, Newborn*

No abstract available.
Obesity, Morbid* ; Polycystic Ovary Syndrome*

A rostro-caudal topography of the oculomotor nerve fascicles is relatively well known in animal but not in human. We experienced two cases of midbrain infarctions presenting with isolated oculomotor nerve palsies. The MRI of the patient who had monocular elevation palsy with ptosis revealed a lesion in the middle to lower midbrain, whereas that of the other who had monocular depression and adduction palsy with pupillary mydriasis showed a discrete lesion in the upper to middle midbrain. We present the rostro-caudal arrangement of the oculomotor fascicles within midbrain based on MRI findings.
Animals ; Depression ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Mesencephalon* ; Mydriasis ; Oculomotor Nerve ; Oculomotor Nerve Diseases ; Paralysis

BACKGROUND: Recent DNA polymorphism analysis using numerous DNA markers has been used to determine the parental origin of the extra chromosome 21 in Down syndrome. In this study we used seven dinucleotide repeat polymorphisms on chromosome 21 to characterize a case of rea(21q21q) and to know whether it is consistent with an isochromosome or a true Robertsonian translocation. METHODS: Cytogenetic investigation was done by conventional G banding DNA was extracted from whole blood of a proband and her parents and was amplified by PCR using seven sets of (GT)n repeat dinucleotide markers located on the long arm of chromosome 21 After electrophoresis of the PCR product in polyacrylamide gel and silver staining the parental origin and number of DNA copy were determined by visual comparison of the band intensities within and between individuals. RESULTS: Conventional cytogenetics showed that the proband had a 46.XX.re(21q21q) chromosome pattern. Parental chromosome studies were normal, therefore, the rearrangement was a de novo event. All seven DNA markers showed one or two alleles, demonstrating rea(21q21q) to be an isochromosome. For D21S215 and D21S156 markers both parents were heterozygous and the proband inherited one copy of paternal allele and two copies of maternal allele which both parents did not share. This finding was consistent with a maternally derided isochromosome. CONCLUSION: Use of dinucleotide repeat DNA polymorphisms after PCR amplification will be very useful to detect the parental origin of additional chromosome 21 or rearrangement of chromosome 21 in Down syndrome. Besides employing siltier staining of a PCR product we will be able to avoid using of radioisotopes and apply to clinical laboratory diagnosis.
Alleles ; Arm ; Chromosomes, Human, Pair 21 ; Clinical Laboratory Techniques ; Cytogenetics ; Dinucleotide Repeats* ; DNA ; Down Syndrome ; Electrophoresis ; Genetic Markers ; Humans ; Isochromosomes ; Parents ; Polymerase Chain Reaction ; Radioisotopes ; Silver Staining

OBJECTIVE: The aim of this study was to conduct three-dimensional finite element analysis of individual tooth displacement and stress distribution when a posterior retraction force of 200 g was applied at different positions of the retraction hook on the transpalatal arch (TPA) of a molar, and over different lengths of the lever arm on the maxillary anterior teeth in lingual orthodontics. METHODS: A three-dimensional finite element model, including the entire upper dentition, periodontal ligaments, and alveolar bones, was constructed on the basis of a sample (Nissan Dental Product, Kyoto, Japan) survey of Asian adults. Individual movement of the incisal edge and root apex was estimated along the x-, y-, and z-coordinates to analyze tooth displacement and von Mises stress distribution. RESULTS: When the length of the lever arm was 15 mm and 20 mm, the incisal edge and root apex of the anterior teeth was displaced lingually, with a maximum lingual displacement at the lever arm length of 20 mm. When the posterior retraction hook was on the root apex, the molars showed distal displacement. When the length of the lever arm was 20 mm, anterior extrusion was reduced and the crown of the canine displaced toward the buccal side, in which case, the retraction hook was on the edge, rather than at the center, of the TPA. CONCLUSIONS: The results of the analysis showed that when 6 anterior teeth were retracted posteriorly, lateral displacement of the canine and lingual displacement of the incisal edge and root apex of the anterior teeth occur without the extrusion of the anterior segment when the length of the lever arm is longer, and the posterior retraction hook is in the midpalatal area.
Adult ; Arm ; Asian Continental Ancestry Group ; Crowns ; Dentition ; Displacement (Psychology) ; Finite Element Analysis ; Humans ; Mechanics ; Molar ; Periodontal Ligament ; Tooth

Operative reduction is not essential for mild to moderate spondylolisthesis, but some authors agree that reduction of spondylolisthesis is beneficial for widening of intervertebral canal and consequently for decompression of neural tissue even though the degree of slippage is grade I or II. In our institute, we sometimes reduced the slippage for these reasons. But at follow up study we would find redisplacement and the degree of it seemed to be associated with the kind of instruments. So we analyzed redisplacement rate according to the kind of instruments in 59 cases of spondylolisthesis that were followed more than one year. The conclusions were as follow; 1. There was no significant correlation between reduction and redisplacement rate with pathologic type, lesion site, age,iscectomy and clinical result at least in grade I or II spondylolisthesis (P>0.05). 2. The pedicle screw system was more useful in reduction and its maintenance than the Luque ring system (P<0.001). 3. Redisplacement was occurred mainly within 2 months after operation, 4. The cause of redisplacement after reduction seems to be associated with mechanical insecurity before consolidation of the grafted bone takes place.
Decompression ; Follow-Up Studies ; Spondylolisthesis* ; Transplants

PURPOSE: The purpose of this study was to evaluate the effects of three different oral care treatments on the oral state of patients with intubation in intensive care units. METHODS: The research design was a nonequivalent control group design with repeated measures. The patients were assigned a normal saline, chlorhexidine or toothbrushing group. Each group received its own oral care treatment for 5 minutes, twice a day and for 8 days. The oral assessment guide, hygiene performance index and pathogenic microorganisms. Data were collected from patients before the experiment, 4 days after, and 8 days after completion and were evaluated. RESULTS: The chlorhexidine group and tooth brushing group showed significant improvement on the oral assessment guide and decrease in the hygiene performance index, compared to the normal saline group. Similarly, pathogenic microorganisms were significantly decreased in the chlorhexidine group and tooth brushing group, when compared to the normal saline group. CONCLUSIONS: Oral treatments with chlorhexidine and toothbrushing improve the oral health state of patients, therefore use of chlorhexidine and toothbrushing could be an effective nursing intervention for intubated patients in intensive care units.
Chlorhexidine ; Humans ; Hygiene ; Critical Care ; Intensive Care Units ; Intubation ; Oral Health ; Oral Hygiene ; Research Design ; Sodium Chloride ; Tooth ; Toothbrushing

PURPOSE: As Korea has been rapidly transformed to be a multicultural society, it becomes essential for nurses to develop cultural competency. The purpose of this descriptive study was to assess the cultural competency level of general hospital nurses and to examine its contributing factors adopting ecological model. METHOD: A convenience sample of 327 nurses from six general hospitals in Seoul metropolitan area was recruited between November 14 to 28, 2011. Cultural competency was measured using the Korean version of the Caffrey Cultural Competence in Healthcare Scale (CCCHS) and Cultural Competence Assessment(CCA). Hierarchical multiple regression analysis was performed to assess the influence of intrapersonal, cultural-experience, and organizational factors on cultural competency. RESULTS: Mean cultural competency in this study was 2.57(+/-0.43). Cultural competency was associated with job position (p=.044) at the intrapersonal level. At the cultural experience level, foreign language classes experience (p=.005), fluency in a foreign language (p=.000), experience of working with foreign health care professionals (p=.000) were associated cultural competency. At the organizational level, training program (p=.000), job description (p=.002), health education materials (p=.016), insufficient job control (p=.000), and interpersonal conflicts (p=.011) showed significant difference. Foreign language class experience, foreign language fluency, experience of working with foreign health care professionals, and job control were the most consistent predictors of cultural competence and explained 20.4% of the total variance in the proposed ecological model. CONCLUSIONS: The findings suggest that to enhance cultural competency in general hospital nurses, cultural experience and organizational factors need to be more fully considered than intrapersonal factors.
Cultural Competency ; Delivery of Health Care ; Health Education ; Hospitals, General ; Job Description ; Korea