BACKGROUND: Postherpetic neuralgia (PHN) is usually managed pharmacologically. It is not uncommon for patients with chronic kidney disease (CKD) to suffer from PHN. It is difficult to prescribe a sufficient dose of anticonvulsants for intractable pain because of the decreased glomerular filtration rate. If the neural blockade and pulsed radiofrequency ablation provide only short-term amelioration of pain, spinal cord stimulation (SCS) with a low level of evidence may be used only as a last resort. This study was done to evaluate the efficacy of spinal cord stimulation in the treatment of PHN in patients with CKD. METHODS: PHN patients with CKD who needed hemo-dialysis who received insufficient relief of pain over a VAS of 8 regardless of the neuropathic medications were eligible for SCS trial. The follow-up period was at least 2 years after permanent implantation. RESULTS: Eleven patients received percutaneous SCS test trial from Jan 2003 to Dec 2007. Four patients had successfully received a permanent SCS implant with their pain being tolerable at a VAS score of less than 3 along with small doses of neuropathic medications. CONCLUSIONS: SCS was helpful in managing tolerable pain levels in some PHN patients with CKD along with tolerable neuropathic medications for over 2 years.
Anticonvulsants ; Electric Stimulation Therapy ; Follow-Up Studies ; Glomerular Filtration Rate ; Health Resorts ; Humans ; Kidney ; Kidney Diseases ; Neuralgia, Postherpetic ; Pain, Intractable ; Renal Insufficiency, Chronic ; Spinal Cord ; Spinal Cord Stimulation

OBJECTIVES: The purpose of this study was to investigate the use of various treatment modalities including pharmacotherapy, education-behavior therapy, and complementary alternative treatment for children with mental retardation (MR) or autism spectrum disorder (ASD) in Korea. METHODS: The sample consisted of 50 parents who have children with MR (N=28) or ASD (N=22), 38 boys, 12 girls ; mean age 14.06 (4.14) years old. A questionnaire was composed of the experienced modality, duration, cost, satisfaction etc. RESULTS: According to the results, 56.0%, 100.0%, and 36.0% of children with MR or ASD have experienced pharmacological treatment, educational-behavioral therapy and complementary alternative medicine (CAM), respectively. Children who experienced education-behavioral therapy and CAM experienced 3.52 kinds of education-behavioral therapy and 2.78 kinds of CAM, respectively. Monthly cost of pharmacological treatment was lowest among three modality categories. Regarding treatment satisfaction by parental report, the lowest score was recorded fir CAM. CONCLUSION: Parents who have a child with MR or ASD are trying many treatment modalities and feeling the burden of their treatment.
Child ; Autism Spectrum Disorder* ; Complementary Therapies ; Drug Therapy ; Female ; Humans ; Intellectual Disability* ; Korea ; Parents ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: The aims of this study were to evaluate the anatomical features of patients with obstructive sleep apnea syndrome (OSAS) using upper airway computed tomography (CT) in the awake state, and to analyze the correlation between anatomical features and severity of polysomnography (PSG) findings. MATERIALS AND METHODS: Sixty-eight patients presenting with snoring and sleep apnea were included, and upper airway CT in the awake state and PSG were performed in all patients. The average apnea-hypopnea index (AHI) and minimal arterial oxygen saturation (minSaO2) values were calculated. The axial and sagittal images from the level of the nasopharynx to that of the hypopharynx were obtained and measured. The correlations of the anatomical parameters with AHI and minSaO2 were statistically analyzed. RESULTS: The significant parameters correlated with AHI were nasopharynx anterior-posterior (A-P) diameter and transverse diameter, soft palate transverse diameter, uvula length, tongue length, lingual transverse diameter, and hypopharynx A-P diameter & transverse di-ameter. The parameters correlated with minSaO2 were nasopharynx transverse diameter and lingual transverse diameter. Conclusions: Upper airway analysis using CT in awake OSAS patients provides anatomical parameters which correlate with the severity of OSAS. Therefore, upper airway CT in the awake state may be helpful in diagnosing OSAS.
Airway Obstruction ; Humans ; Hypopharynx ; Nasopharynx ; Oxygen ; Palate, Soft ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Snoring ; Tongue ; Uvula ; Wakefulness

OBJECTIVE: The association of neurotrophic factors with the etiology of schizophrenia has been widely studied. Among them, glial cell line-derived neurotrophic factor (GDNF) is known to promote the survival and differentiation of dopaminergic neurons. Considering dopamine hypothesis and neurodevelopmental theory, GDNF gene may be related with schizophrenia. In this study, we tried to clarify the association between schizophrenia and GDNF gene polymorphism. METHODS: Genotype and allele frequencies in the promoter and intron regions of GDNF gene were studied by using restriction fragment length polymorphism to compare 180 Korean schizophrenics with 105 Korean controls. RESULTS: We found significant differences between the schizophrenics and the controls in genotype and allele frequencies of BsaI polymorphism in the promoter region of GDNF gene (x2=18.208, df=2, p=0.0001/x2=11.264, df=1, p=0.0008). But no significant differences were found in intron region (p=0.06, p=0.984). CONCLUSION: These results suggest that polymorphism of GDNF gene might be related to the pathogenesis of schizophrenia.
Dopamine ; Dopaminergic Neurons ; Gene Frequency ; Genotype ; Glial Cell Line-Derived Neurotrophic Factor* ; Introns ; Nerve Growth Factors ; Polymorphism, Restriction Fragment Length ; Promoter Regions, Genetic ; Schizophrenia

No abstract available.

PURPOSE: To investigate the rate of lateral retinacular release and the contributing factors between the patellar resur- faced total knee arthroplasty(TKA) and patellar retained TKA. MATERIAL AND METHODS: From Jan. 2003 to Jan. 2006, 179 cases(90 patella retained, PR; 89 patellar resurfaced, PS) were enrolled in this study. To investigate the contributing factors on the lateral retinacular release along the patellar replacement, the preoperative and postoperative radiographic evaluation was done. Patellar height, congruence angle and medial displacement was measured with the Merchant view. Anterior-posterior knee distance was measured at a lateral film. The statistical significance between two groups was analyzed using the student's t-test. RESULTS: Lateral retinacular release was done in 59 of 179 cases. Thirty-six cases of PR group and 23 cases of PS group were undertaken. The rate of lateral retinacular release was higher in PR group(p<0.05). The difference between preoperative and postoperative patellar height at a Merchant was 2.5, 0.5mm reduction in PS and PR group respectively. PS group showed more medial displacement(mean 2.5mm) than PR group(mean 1.2mm)(p<0.05). CONCLUSION: In PR group, higher rate of a lateral retinacular release was shown than PS group. Less reduction of patellar height and less medial displacement of patella might be related with the high rate of a lateral retinacular release in PR group.
Arthroplasty* ; Knee* ; Patella*

OBJECTIVES: The aim of this study was to investigate average working lengths of Korean posterior teeth and evaluate validity of endodontic file length. MATERIALS AND METHODS: The endodontic working length of the posterior teeth of 670 Korean patients were measured than each mean value and standard deviation were investigated than the frequency deviation and standard deviation per each length were calculated. RESULTS: Among the canals of premolar, 66.5% of canal length was marked under 20 mm by endodontic working length and 95.4% could be measured under 22 mm and Among the canals of molars, 95.5% of canal length was marked under 20 mm endodontic working length. CONCLUSIONS: With the result of measurement of endodontic working length of premolars of Korean, it suggested that 23 mm endodontic file is more proper than the 21 mm and 25 mm file on the market.
Bicuspid ; Humans ; Molar ; Tooth

The molecular mechanisms control the function of PDL(periodontal ligament) cells and/or fibroblasts remain unclear. PDLs17, PDL-specific gene, had previousely identified the cDNA for a novel protein from cultured PDL fibroblasts using subtraction hybridization between gingival fibroblasts and PDL fibroblasts. The purpose of this study was to determine the regulation by growth factors and cytokines on PDLs17 gene expression in cultured human periodontal ligament cells and observe the immunohistochemical localization of PDLs17 protein in various tissues of mouse. Primary PDL fibroblasts isolated by scraping the root of the extracted human mandibular third molars. The cells were incubated with various concentration of human recombinant IL-1beta, PDGF-BB and TGF betafor 48h and 2 weeks. At each time point total RNA was extracted and the levels of transcription were assessed by reverse transcription-polymerase chain reaction (RT-PCR assay). Polyclonal antiserum raised against PDLs17 peptides, CLSVSYNRSYQINE and SEAVHETDLHDGC, were made, and stained the tooth, periodontium, developing bone, bone marrow and mid-palatal suture of the mouse. The results were as follows. 1. PDLs17 mRNA levels were increased in response to PDGF (10ng/ml) and TGF beta(20ng/ml) after treatment of the IL-1beta, PDGF-BB and TGFbetafor 48 h. 2. PDLs17 was up-regulated only by TGFbeta(20 ng/ml) after treatment of the IL-1beta, PDGF-BB and TGF betafor 2 weeks and unchanged by the other stimulants. 3. PDLs17 was a novel protein coding the 142 amino acid peptides in the ORF and the nucleotide sequences of the obtained cDNA from RT-PCR was exactly same as the nucleotides of the database. 4. Immunohistochemical analysis showed that PDLs17 is preferentially expressed in the PDL, differentiating osteoblast-like cells and stromal cells of the bone marrow in the adult mouse. 5. The expression of PDLs17 protein was barely detectable in gingival fibroblasts, hematopoetic cells of the bone marrow and mature osteocytes of the alveolar bone. These results suggest that PDLs17 might upregulated by PDGF-BB or TGFbetaand acts at the initial stage of differentiation when the undifferentiated mesenchymal cells in the bone marrow and PDL differentiate into multiple cell types. However, more research needs to be performed to gain a better understanding of the exact function of PDLs17 during the differentiation of bone marrow mesenchymal and PDL cells.
Adult ; Animals ; Base Sequence ; Blood Platelets* ; Bone Marrow ; Clinical Coding ; Cytokines ; DNA, Complementary ; Ecthyma, Contagious ; Fibroblasts* ; Gene Expression ; Humans* ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Interleukins* ; Mice ; Molar, Third ; Nucleotides ; Osteocytes ; Peptides ; Periodontal Ligament* ; Periodontium ; RNA ; RNA, Messenger* ; Stromal Cells ; Sutures ; Tooth ; Transforming Growth Factor beta

PURPOSE: Transient global amnesia (TGA) patients were retrospectively reviewed to determine the usefulness of high-field strength MRI in detecting probable ischemic lesions in TGA. MATERIALS AND METHODS: We investigated the lesion detection rate in patients with TGA using 1.5T and 3.0T MRI. Acute probable ischemic lesions were defined as regions of high-signal intensity in diffusion weighted image with corresponding low-signal intensity in apparent diffusion coefficient map. RESULTS: 3.0T MRI showed 11 out of 32 patients with probable ischemic lesions in the hippocampus with mean lesion size of 2.8 +/- 0.6 mm, whereas 1.5T MRI detected no lesion in any of 11 patients. There were no significant differences in clinical characteristics between the groups of 1.5 and 3.0T MRI. CONCLUSION: High-field strength MRI has a higher detection rate of probable ischemic lesions than low-field strength MRI in patients with TGA.
Adult ; Aged ; Aged, 80 and over ; Amnesia, Transient Global/*diagnosis/pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Neutrophilic eccrine hidradenitis (NEH) is a rare neutrophilic dermatosis which is characterized by the erythematous papules or plaques with a neutrophilic infiltrates around eccrine glands and coils. In 90% of cases, NEH develops in patients who have received chemotherapy for malignant diseases, but other drugs, infections, and paraneoplastic phenomenons are considered as possible etiologic factors. Furthermore, NEH is known to be extremely rare in infants. Herein we report a case of NEH in nine-month-old infant with acute myelogenous leukemia (AML), which lesions appeared on the extremities including palms and soles before starting chemotherapy.
Drug Therapy ; Eccrine Glands ; Extremities ; Hidradenitis* ; Humans ; Infant* ; Leukemia, Myeloid, Acute ; Neutrophils* ; Skin Diseases