No abstract available.
Athletes* ; Forearm* ; Humans ; Magnetic Resonance Spectroscopy* ; Metabolism* ; Phosphorus*

Lumbar apophyseal ring fracture occurs between the vertebral ring apophyses and the cartilaginous rim of the superior or inferior margins of the vertebral end plates. This fracture is an unusual disease that if typically seen in adolescents or young adults. We analyzed the clinical records and neuroradiologic imagings of 49 patients who were less than 29 years old diagnosed with posterior lumbar apophyseal ring fractures in regards to the age, trauma history, the type and distribution of the fracture, clinical presentation, and postoperative outcome. The posterior lumbar apophseal ring fractures were detected in 29(9.2%) out of 533 young adult patients with herniated lumbar discs. There was trauma history in 37(75.5%) out of the 49 patients. The main presenting symptoms in most of the patients were low back pain and radiating leg pain. In patients who presented with symptoms, thirty-five patients(75.5%) had a positive straight leg-raising test. According to classification by Takata, they were type I in 12 cas es(24.0%), type II in 9 cases(18.0%), and type III in 29 cases(58.0%). The type III with trauma history was more common than with non-trauma history(p<0.01). Twenty-one patients(42.0%) had bony fragments projecting into the spinal canal from the upper border of S1. Partial hemilaminectomy(18 patients) and total laminectomy(3 patients) were performed. We could easily remove the bony fragments in all of the surgical cases. Chemonucleolysis were done in three patients. The overall results were good. We conclude that knowledge of this entity and correct radiographic diagnosis will help to facilitate the operative planning.
Adolescent ; Adult ; Classification ; Diagnosis ; Humans ; Intervertebral Disc Chemolysis ; Laminectomy ; Leg ; Low Back Pain ; Spinal Canal ; Young Adult*

OBJECTIVES: The aim of this study is to investigate the correlation between 2-dimensional (2D) cephalometric measurement and 3-dimensional (3D) cone beam computed tomography (CBCT) measurement, and to evaluate the availability of 3D analysis for asymmetry patients. MATERIALS AND METHODS: A total of Twenty-seven patients were evaluated for facial asymmetry by photograph and cephalometric radiograph, and CBCT. The 14 measurements values were evaluated and those for 2D and 3D were compared. The patients were classified into two groups. Patients in group 1 were evaluated for symmetry in the middle 1/3 of the face and asymmetry in the lower 1/3 of the face, and those in group 2 for asymmetry of both the middle and lower 1/3 of the face. RESULTS: In group 1, significant differences were observed in nine values out of 14 values. Values included three from anteroposterior cephalometric radiograph measurement values (cant and both body height) and six from lateral cephalometric radiographs (both ramus length, both lateral ramal inclination, and both gonial angles). In group 2, comparison between 2D and 3D showed significant difference in 10 factors. Values included four from anteroposterior cephalometric radiograph measurement values (both maxillary height, both body height) and six from lateral cephalometric radiographs (both ramus length, both lateral ramal inclination, and both gonial angles). CONCLUSION: Information from 2D analysis was inaccurate in several measurements. Therefore, in asymmetry patients, 3D analysis is useful in diagnosis of asymmetry.
Cephalometry ; Cone-Beam Computed Tomography ; Facial Asymmetry ; Humans ; Malocclusion

Pheochromocytomas are catecholamine-producing tumors that typically cause hypertension. They are rare tumors that can pose problems in diagnosis and detection. Although they usually present classic symptoms, they can at times present symptoms that mimic other clinical conditions. Especially, children have fewer malignant tumors, non-extra-adrenal tumors, and tumors with greater bilaterality and multiplicity. The diagnosis of pheochromocytomas is based upon clinical suspicion and biochemical study. Radiologic localization is obtained before operation because of the variable location of this tumor. The treatment of choice is surgical resection. We reports a case of asymptomatic pheochromocytoma that was treated with tumor excision. To prevent intraoperative and postoperative complications, precise preoperative diagnosis and localization, as well as adequate preoperative management, are necessary.
Child ; Diagnosis ; Humans ; Hypertension ; Pheochromocytoma* ; Postoperative Complications

No abstract available.
DNA*

BACKGROUND: Tc-99m myocardial perfusion imaging agents have recently found wide spread use as detecting agents of coronary diseases. Unfortunately, false positive results are not infrequent. METHODS: We analyzed Tc-99m myocardial perfusion SPECT (Tc-SPECT) findings in angina patients showing normal coronary angiography. Seventy patients who underwent myocardial SPECT wihin one month of coronary angiography which revealed no significant stenosis were studied. RESULTS: Forty six (65.7%) patients showed perfusion defects on Tc-SPECT. Eighteen were due to soft tissue attenuation, thirteen were due to technical problems such as low count rate, six were associated with intraventricular conduction abnormalities, four with coronary spasms, three with old infarctions, and one with slow coronary flow. CONCLUSION: Photon attenuation and inadequate count rates were the main causes of false positive results on myocardial SPECT imaging with Tc-99m agents. However, pathological conditions such as conduction disturbance, coronary spasm or slow coronary flow were also associated with positive SPECT findings in patients with normal coronary angiograms.
Constriction, Pathologic ; Coronary Angiography* ; Coronary Disease ; Humans ; Infarction ; Myocardial Perfusion Imaging ; Perfusion* ; Spasm ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND AND OBJECTIVES: Surfactant protein A (SP-A) which plays a role in the innate host defense of lung is also expressed in Eustachian tube. However the genes underlying the susceptibility to otitis media with effusion (OME) are known insufficiently. The current study attempts to evaluate the difference in the allele distribution of SP-A1 and SP-A2 between normal subjects and subjects with otitis media with effusion. SUBJECTS AND METHOD: PCR-cRFLP-based methodology was used to detect SP-A genotypes in the 38 children with OME, and in the 55 normal newborns for control. RESULTS: The frequencies of specific genotypes such as 6A(2), 1A(2) were increased in OME group, but the frequency of 6A3 was increased in control group. CONCLUSION: It is presumed that SP-A alleles may be inductive (6A(2), 1A(2)) or protective (6A(3)) factors for OME. Specific genoytypes of SP-A may be an important determinant for the predisposition to OME.
Alleles* ; Child ; Eustachian Tube ; Genotype ; Humans* ; Infant, Newborn ; Lung ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Pulmonary Surfactant-Associated Protein A*

Niemann-Pick disease, type C (NP-C), is caused by NPC1 or NPC2 gene mutations. Progressive neurological, psychiatric, and visceral symptoms are characteristic. Here, we present cases of a brother (Case 1) and sister (Case 2) in their mid-20s with gait disturbance and psychosis. For the Case 1, neurological examination revealed dystonia, ataxia, vertical supranuclear-gaze palsy (VSGP), and global cognitive impairment. Case 2 showed milder, but similar symptoms, with cortical atrophy. Abdominal computed tomography showed hepatosplenomegaly in both cases. NPC1 gene sequencing revealed compound heterozygote for exon 9 (c.1552C>T [R518W]) and exon 18 (c.2780C>T [A927V]). Filipin-staining tests were also positive. When a young patient with ataxia or dystonia shows VSGP, NP-C should be considered.
Abdomen/diagnostic imaging ; Asian Continental Ancestry Group/genetics ; Carrier Proteins/genetics ; DNA Mutational Analysis ; Exons ; Female ; Gait Disorders, Neurologic/etiology ; Humans ; Male ; Membrane Glycoproteins/genetics ; Niemann-Pick Disease, Type C/*diagnosis/genetics ; Psychotic Disorders/etiology ; Republic of Korea ; Siblings ; Tomography, X-Ray Computed ; Young Adult

Flecainide acetate is a potent class Ic anti-arrhythmic drug with a major sodium channel-blocking effect. Flecainide toxicity can cause myocardial impairment and precipitate circulatory collapse, particularly in patients with renal failure. Electrical and hemodynamic deterioration during flecainide toxicity may not respond to conventional treatments. We report the successful management of flecainide toxicity using extracorporeal membrane oxygenation (ECMO), hemoperfusion, and bicarbonate administration maintaining alkalinity.
Extracorporeal Membrane Oxygenation ; Flecainide* ; Hemodynamics ; Hemoperfusion ; Humans ; Renal Insufficiency ; Shock ; Sodium ; Tachycardia, Supraventricular*

BACKGROUND: Oxidative stress possiby contributes to the development of diabetic nephropathy. Glutathione S-transferases (GSTs) can work as one of endogenous antioxidants to protect cells from oxidative stress. The activity of GSTM1 or GSTT1 are determined genetically. The homologous deletion of the gene (null genotype) which reduced the GSTM1/T1 activity, may be associated with diabetic nephropathy development in diabetic patients. METHODS: We examined 94 patients with diabetic nephropathy and 102 patients without diabetic nephropathy in Korean type 2 diabetic patients. We used multiplex polymerase chain reaction (PCR) to analyze polymorphisms of two endogenous antioxidant genes, GSTM1 and GSTT1. RESULTS: The two patients groups were well matched with regard to age, body mass index, duration of diabetes and HbA1c. GSTM1 null genotype was observed in 50% of patients with nephropathy versus 51% of patients without nephropathy. GSTT1 null genotype was observed in 48.9% of patients with nephropathy versus 51% of patients without nephropathy. No association between homozygous deletion of GSTM1 or GSTT1 and development of diabetic nephropathy in diabetic patients. CONCLUSION: This study is the first to investigate the association of GSTM1/TT1 gene polymorphism which development of diabetic nephropathy in Korean type 2 diabetic patients. The present result suggest that GSTM1/TT1 null genotype does not contribute to the development of diabetic nephropathy in Korean type 2 diabetic patients.
Antioxidants ; Body Mass Index ; Diabetic Nephropathies* ; Genotype ; Glutathione Transferase ; Glutathione* ; Humans ; Multiplex Polymerase Chain Reaction ; Oxidative Stress ; Polymorphism, Genetic*