Gastric dilatation is a rare life-threatening condition and consists of massive distention of the stomach by gas and fluid. Its etiology is unclear but predisposing factors include recent surgery, diabetic gastroparesis, fundoplication and gastric outlet obstruction. As the distended stomach grows larger, it hangs down across the duodenum, producing a mechanical gastric outlet obstruction, venous obstruction of the mucosa, ischemic necrosis and perforation. The distended stomach pushes the diaphragm upward, causing collapse of the left lung, rotation of the heart, and obstruction of the inferior vena cava. Hypochloremia, hypokalemia, and alkalosis may result from fluid and electrolyte losses and may precipitate cardiac arrhythmias. If acute gastric dilatation is not treated promptly, cardiovascular and pulmonary compromise may compound an increasing intravascular volume deficit leading to hypotension, which may be a cause of death.
Alkalosis ; Arrhythmias, Cardiac ; Causality ; Cause of Death ; Diaphragm ; Duodenum ; Fundoplication ; Gastric Dilatation* ; Gastric Outlet Obstruction ; Gastroparesis ; Heart ; Hypokalemia ; Hypotension ; Lung ; Mucous Membrane ; Necrosis ; Stomach ; Vena Cava, Inferior

Gastric dilatation is a rare life-threatening condition and consists of massive distention of the stomach by gas and fluid. Its etiology is unclear but predisposing factors include recent surgery, diabetic gastroparesis, fundoplication and gastric outlet obstruction. As the distended stomach grows larger, it hangs down across the duodenum, producing a mechanical gastric outlet obstruction, venous obstruction of the mucosa, ischemic necrosis and perforation. The distended stomach pushes the diaphragm upward, causing collapse of the left lung, rotation of the heart, and obstruction of the inferior vena cava. Hypochloremia, hypokalemia, and alkalosis may result from fluid and electrolyte losses and may precipitate cardiac arrhythmias. If acute gastric dilatation is not treated promptly, cardiovascular and pulmonary compromise may compound an increasing intravascular volume deficit leading to hypotension, which may be a cause of death.
Alkalosis ; Arrhythmias, Cardiac ; Causality ; Cause of Death ; Diaphragm ; Duodenum ; Fundoplication ; Gastric Dilatation* ; Gastric Outlet Obstruction ; Gastroparesis ; Heart ; Hypokalemia ; Hypotension ; Lung ; Mucous Membrane ; Necrosis ; Stomach ; Vena Cava, Inferior

Panoramic radiography, which can show dental characteristics in one film and evaluate postmortem information, may be highly valuable in human identification. The purpose of this study is to evaluate usefulness of human identification with dental characteristics shown in panoramic radiography through panoramic radiographies of 300 randomly selected patients who visited Yonsei University Dental Hospital. Dental characteristics of each film were classified into 8 types and diversity of dental characteristics was evaluated by turning the informations into codes. Diversity of panoramic radiography using both maxillary and mandibular dental characteristics was 99.58%. When mandibular dental characteristic (98.99%) was used alone, the diversity was found to be higher than that of maxillary dental characteristic (97.92%). Maxillary dental characteristics showed diversity in the order of right molars (92.32%), left molars (92.02%), and incisors (41.54%), while that of mandible was in the order of right molars (96.09%), left molars (95.70%), and incisors (18.97%). As a result, human identification using panoramic radiography proved to be useful not only when the whole teeth are present but also when only molars are present. Therefore, it is expected to be applied more economically and practically in identifying a large number of victims from mass disasters as well as wars.
Disasters ; Forensic Anthropology* ; Humans* ; Incisor ; Mandible ; Molar ; Radiography, Panoramic* ; Tooth

Tyrosine kinase A (TrkA)is an essential component of the high affinity nerve growth factor (NGF) receptor necessary to the mediate the biological effects of the neurotrophins, NGF. This study examined the distribution of TrkA-immunoreactivity (IR)cells in the postnatal rat cerebral cortex and the changes that occur in postnatal development as a result of the expression of this protein. TrkA-IR was detected at postnatal day (PD)3, PD6, PD9 and PD15. Base upon their somatodendritic morphology, the most commonly labeled cell type was the pyramidal neurons. At PD3 and PD6, layer I, II, III and V was immunopositive for TrkA, at PD9, not only at layer I, II, III, and V but also at layer VI. At PD15, the TrkA-positive cells were distributed in all layers. These TrkA-positive cells were not detected at PD0. In contrast, there was significant increase in the percentage of cells exhibiting TrkA-IR with development and the highest level was detected at PD15. These results suggest that the cerebral cortex expresses TrkA strongly during the postnatal period. Moreover, the postnatal development-related increase in the expression of TrkA-cells shows that NGF may have a trophic effect on these cerebral cortex neurons from the postnatal period.
Animals ; Animals, Newborn ; Cerebral Cortex/*growth&development/*metabolism ; Gene Expression Regulation, Developmental/*physiology ; Neurons/*metabolism ; Rats ; Rats, Sprague-Dawley ; Receptor, trkA/*metabolism

OBJECTIVES: To estimate the complication rate and the societal cost of measles, a survey was conducted in Seoul, Jeonju city, and Kyonggi province in 2001. METHODS: A telephone survey was conducted in Jeonju city (175/307) and four local areas of Kyonggi province (793/1,238) to gather information on the complications of measles. To estimate societal cost, the telephone survey was conducted for the sampled subject by complication type and the age group. The response rate was 78% (180/230). Paid bills were examined for direct cost estimation, and the time cost and the transportation expense were analyzed for indirect cost estimation. RESULTS: The incidence of a complication of measles was 3.1% which found to be higher in younger age group. The incidence of pneumonia, otitis media, and encephalitis were 2.1%, 0.8%, and 0.2% respectively. Direct and indirect costs of in-patients without a complication were $417.00 (US $1.00 = 1,000 won) and $256.00 per case, respectively, and the out-patients who have no complication were $54.00 and $65.00, respectively. The average cost for a patient with measles without complication was $119.00 as the result. The societal cost of encephalitis was high as $6,660. Estimated total societal cost of measles ranges from $14 million to $69 million in the year 2000. CONCLUSION: Complication rate of measles was fairly low compared to foreign countries. The lower rate could result from the difference in vaccination rate and the age distribution of the measles patients. The cost of measles without complication was not high. However, the cost for the complication and the total disease burden caused by measles shown to be high in the year 2000.
Age Distribution ; Cost of Illness ; Encephalitis ; Gyeonggi-do ; Humans ; Incidence* ; Jeollabuk-do ; Korea* ; Measles* ; Otitis Media ; Outpatients ; Pneumonia ; Seoul ; Telephone ; Transportation ; Vaccination

Abstract: This paper describes the development of neurological signs of two prematurely born calves four days after birth. The pathological examination results indicated fibrinopurulent polyserositis, including meningoencephalitis with suppurative bronchopneumonia. Bovine viral diarrhea virus subtype 2a was detected in most of the internal organs, and the bacterial colonies cultured from the samples were identified as Klebsiella (K.) pneumoniae. Molecular analysis via multilocus sequence typing identified a different K.pneumoniae isolate in each calf-type 14 in calf A and type 65 in calf B. This is the first report identifying K.pneumoniae sequence types 14 and 65 in cattle.

Recently, Harms and Melcher modified Goel's approach, the C1 lateral mass and C2 pedicle screw fixation, and the new technique is currently in favor among neurosurgeons. Comparing to the advantages of Harms construct, the disadvantages were not extensively investigated. We experienced a patient with severe occipital pain developed after the C1 lateral mass screw placement for the traumatic atlantoaxial instability. We reviewed literatures about Harms construct with focus on the occipital neuralgia as a postoperative complication and suggest here technical tips to avoid the troublesome pain.
Humans ; Neuralgia ; Postoperative Complications

BACKGROUND: The correlation between the high resolution computed tomography(HRCT) emphysema score and the physiologic parameters including resting and exercise pulmonary function test was investingated in 14 patients(60.6±10.3 years) with pulmonary emphysema. METHODS: The patients underwent a HRCT, a resting pulmonary function test, and incremental exercise testing(cycle ergometer, 10 W/min). Computed tomography scans were obtained on a GE highlight at 10 mm intervals using 10 mm collimation, from the apex to the base after a full inspiration. The emphysema scores wer determined by a CT program 'Density mask' outlining the areas with attenuation values less than -900 HU, indicating the emphysema areas, and providing an overall percentage of lung involvement by emphysema. RESULTS: Among the resing PFT parameters, only the diffusing capacity(r=-0.75) and PaO2 (r=-0.66) correlated with the emphysema score(p<0.05). Among the exercise test parameers, the emphysema score correlated significantly with the maximum power(r=-0.74), maximum oxygen consumption(r=-0.68), anaerobic threshold(V-slope method : r=-0.69), maximal O2-pulse(r=-0.73), and the physiologic dead space ratio at the maximum workload(r=-0.80)(p<0.01). CONCLUSION: We could find that exercise testing parameters showed a much better correlation with the HRCT emphysema score, which is known to have a good correlation with the pathologic severity than the resting PFT parameters. Therefore it is suggested that exercise testing is superior to resting PFT for estimating in the estimation of the physiologic disturbance in emphysema patients.
Emphysema* ; Exercise Test ; Humans ; Lung ; Oxygen ; Pulmonary Emphysema ; Respiratory Function Tests

PURPOSE: Neural stem cells (NSCs) effectively reverse some severe central nervous system (CNS) disorders, due to their ability to differentiate into neurons. Agmatine, a biogenic amine, has cellular protective effects and contributes to cellular proliferation and differentiation in the CNS. Recent studies have elucidated the function of microRNA let-7a (let-7a) as a regulator of cell differentiation with roles in regulating genes associated with CNS neurogenesis. MATERIALS AND METHODS: This study aimed to investigate whether agmatine modulates the expression of crucial regulators of NSC differentiation including DCX, TLX, c-Myc, and ERK by controlling let-7a expression. RESULTS: Our data suggest that high levels of let-7a promoted the expression of TLX and c-Myc, as well as repressed DCX and ERK expression. In addition, agmatine attenuated expression of TLX and increased expression of ERK by negatively regulating let-7a. CONCLUSION: Our study therefore enhances the present understanding of the therapeutic potential of NSCs in CNS disorders.
Agmatine* ; Biogenic Amines ; Cell Differentiation ; Cell Proliferation ; Central Nervous System ; MicroRNAs* ; Neural Stem Cells* ; Neurogenesis ; Neurons

PURPOSE: Neural stem cells (NSCs) effectively reverse some severe central nervous system (CNS) disorders, due to their ability to differentiate into neurons. Agmatine, a biogenic amine, has cellular protective effects and contributes to cellular proliferation and differentiation in the CNS. Recent studies have elucidated the function of microRNA let-7a (let-7a) as a regulator of cell differentiation with roles in regulating genes associated with CNS neurogenesis. MATERIALS AND METHODS: This study aimed to investigate whether agmatine modulates the expression of crucial regulators of NSC differentiation including DCX, TLX, c-Myc, and ERK by controlling let-7a expression. RESULTS: Our data suggest that high levels of let-7a promoted the expression of TLX and c-Myc, as well as repressed DCX and ERK expression. In addition, agmatine attenuated expression of TLX and increased expression of ERK by negatively regulating let-7a. CONCLUSION: Our study therefore enhances the present understanding of the therapeutic potential of NSCs in CNS disorders.
Agmatine* ; Biogenic Amines ; Cell Differentiation ; Cell Proliferation ; Central Nervous System ; MicroRNAs* ; Neural Stem Cells* ; Neurogenesis ; Neurons