PURPOSE: The purpose of this study is to evaluate visual acuity and refractive state in preschool children and to find the environmental factors that cause visual acuity and refractive change. METHODS: The initial subjects were 3, 225 preschool children, aged 4 to 6 years old, selected randomly from 15 preschools in Daejeon from August to November, 1997. Among them, 759 (23.5%) children showed 0.6 or less visual acuity or had different visual acuity of more than 2 lines between two eyes. In addition, 537 (70.8%) children who did not showed organic ocular abnormality during the first examination received refraction. Five years later, 120 (22.3%) children were reexamined and enrolled in this study. RESULTS: Uncorrected visual acuity was 0.44 (log MAR -0.36 +/- 0.27) and corrected visual acuity was 0.85 (logMAR -0.07 +/- 0.09) on average in 1997. Generally there was a myopic shift by -1.30 +/- 1.16 diopter (D) for 5 years (p<0.001) and astigmatism was significantly decreased by 0.32 +/- 0.48 D in the hyperopic group (p<0.001). The amount of myopic shift was lower in the children who were wearing eyeglasses than in those who were not in the hyperopic group (p<0.05). Corrected visual acuity was significantly increased by 0.13 (logMAR 0.06 +/- 0.08, p<0.001). The degree of myopic shift was larger in the children whose parents were wearing eyeglasses than in those whose parents were not wearing eyeglasses (p<0.05) but other environmental factors did not influence on visual acuity or refractive change. CONCLUSIONS: Early examination of visual acuity and refractive state, and adequate treatment are important to increase visual function in preschool children.
Astigmatism ; Child ; Child, Preschool* ; Eyeglasses ; Follow-Up Studies* ; Humans ; Hyperopia ; Myopia ; Parents ; Refractive Errors* ; Visual Acuity*

OBJECTIVE: To determine optimal stimulation site for median motor conduction study, we compared fixed distance (7 cm proximal to the recording electrode) stimulation method and distal wrist crease stimulation method. METHOD: Nerve conduction studies were performed in 65 hands of 36 healthy adults without neurologic abnormality. Median motor responses were recorded from abductor pollicis brevis (APB) with the stimulations at the point 7 cm proximal to the recording electrode and at the distal wrist crease. The distal latencies and onset-to-peak amplitudes were measured and compared between two techniques. The distal latencies were also compared to that of ulnar compound muscle action potential (CMAP) obtained with fixed distance stimulation (7 cm proximal to the recording electrode). And we measured median nerve actual length from distal wrist crease to APB muscle motor point by anatomic dissection of 12 hands. RESULTS: The distal latencies of median CMAP to APB with 7 cm fixed distance stimulation and distal wrist crease stimulation were 2.91+/-0.37 ms and, 2.75+/-0.41 ms respectively. The differences were statistically significant. The distal latency of ulnar CMAP was 2.50+/-0.32 ms. Differences in distal latencies between ulnar CMAPs and not only 7 cm fixed distance median stimulation but also distal wrist crease median stimulation were also statistically significant. The mean length of median nerve from distal wrist crease to APB motor point was 5.91+/-0.77 cm. CONCLUSION: We suggest that the median motor nerve conduction study using distal wrist crease stimulation was an easier and more rapid procedure than fixed distance median motor nerve conduction study.
Action Potentials ; Adult ; Electrodes ; Hand ; Humans ; Median Nerve ; Muscles ; Neural Conduction ; Wrist

BACKGROUND: Endometrial carcinomas are pathogenetically classified into two major types; endometrioid carcinoma (EC) and serous carcinoma (SC). The most frequently altered gene in EC is the PTEN tumor suppressor gene (TSG). SC is usually associated with mutations in the p53 TSG. METHODS: To further determine the role of PTEN and p53 mutation in endometrial carcinogenesis, the analysis of 33 endometrial carcinomas, including 28 ECs and 5 SCs, for loss of heterozygosity (LOH) on 10q23 and for mutation in all 9 coding exons of PTEN and the 5-8 exons of p53, using SSCP-PCR methods was carried out. RESULTS: LOH was detected in at least one marker in 12 (54.5%) of 22 ECs, but in only one (20.0%) of 5 SCs. Somatic PTEN mutations were detected in 10 (35.7%) of 28 ECs. PTEN was altered in 67.9% of ECs and in 20.0% of SCs, including those with 10q23 LOH. No PTEN mutations were found among the SCs. Somatic p53 mutations were detected in 2 (7.1%) of 28 ECs and 3 (60.0%) of 5 SCs. CONCLUSIONS: PTEN gene alterations contribute to the pathogenesis of an endometrioid subtype of endometrial carcinoma, but not to the serous type. In contrast, p53 plays an important role in the pathogenesis of SCs.
Carcinogenesis ; Carcinoma, Endometrioid ; Clinical Coding ; Endometrial Neoplasms* ; Exons ; Female ; Genes, p53 ; Genes, Tumor Suppressor ; Loss of Heterozygosity

OBJECTIVE: To determine the prevalence of denervation potentials from the foot intrinsic and the lumbosacral paraspinal muscles in asymptomatic persons in Korea. METHOD: Nerve conduction studies were performed in 80 asymptomatic persons at sural, peroneal and tibial nerves. We excluded 15 persons with abnormal values of nerve conduction studies. In our study, 36 males and 29 females participated and the mean age of subjects was 52.9 years. We checked denervation potentials from unilateral lumbosacral paraspinal (L4-S1) and foot intrinsic muscles (abductor hallucis and extensor digitorum brevis muscle) by needle EMG. RESULTS: The prevalence of denervation potentials from foot intrinsic muscles was 3% (2 cases out of 65 asymptomatic subjects). Denervation potentials consisting of a positive sharp wave were seen from the abductor hallucis muscle. No subjects showed any denervation potentials from the lumbosacral paraspinal muscles in our study. Abnormal X-ray findings were seen in subjects who had denervation potentials from the foot intrinsic muscles. CONCLUSION: The prevalence of denervation potentials from the foot intrinsic and the lumbosacral paraspinal muscles in asymptomatic person was not as high as previously reported
Denervation ; Female ; Foot ; Humans ; Korea ; Male ; Muscles ; Needles ; Neural Conduction ; Organic Chemicals ; Prevalence ; Tibial Nerve

OBJECTIVE: To identify the optimal site for piriformis muscle injection, using easily detectable sacroiliac joint as a landmark, under fluoroscopic guidance. METHOD: We examined the anatomic relationships of the sciatic nerve, piriformis muscle and sacroiliac joint in 18 buttocks from 9 cadavers. The distance from the inferior margin of the sacroiliac joint to the piriformis muscle at the crossing point with the sciatic nerve, and the width of the sciatic nerve at that point were measured. We assessed the depth of the piriformis muscle and the sciatic nerve using ultrasonography in asymptomatic controls. RESULTS: The mean distance from the inferior margin of the sacroiliac joint to the piriformis muscle at the crossing point with the sciatic nerve was 15.7+/-3.4 (12~22) mm laterally and 16.5+/-4.1 (10~25) mm caudally. The mean width of the sciatic nerve at that point was 15.4+/-3.7 (12~22) mm. Ultrasonographic findings revealed the mean distance as 4.48+/-0.49 cm from the skin to the surface of the piriformis muscle and as 5.68+/-0.62 from the skin to the surface of the sciatic nerve. CONCLUSION: The most optimal injection site for piriformis syndrome was located 15.6+/-3.4 (12~22) mm laterally and 16.5+/-4.1 (10~25) mm caudally from the inferior margin of the sacroiliac joint.
Buttocks ; Cadaver ; Muscles ; Piriformis Muscle Syndrome ; Sacroiliac Joint ; Sciatic Nerve ; Skin

Granulocytic sarcoma of the uterine adnexa is a rare event. A 50-year-old woman, who had previously been diagnosed as chronic myeloid leukemia (CML), but had a complete hematologic response, presented with lower abdominal pain and a large pelvic mass involving the right uterine adnexa region and extending to the right posterior wall of the bladder and right distal ureter. A biopsy of the uterine adnexa revealed granulocytic sarcoma, and a subsequent bone marrow biopsy confirmed the diagnosis of CML in the blastic phase.
Abdominal Pain ; Adnexa Uteri ; Biopsy ; Bone Marrow ; Diagnosis ; Female ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Middle Aged ; Recurrence* ; Sarcoma, Myeloid* ; Ureter ; Urinary Bladder

OBJECTIVE: To investigate and quantify functional deficit in ischemic stroke rat. METHOD: Male Sprague-Dawley rats were divided into sham group and stroke group. Permanent cerebral ischemia was inflicted on the stroke group by occluding the middle cerebral artery (MCAO). The proportion of hind limb weight bearing pressure was also measured. The withdrawal threshold values in the hindpaws were measured by using von-Frey hair for seven days from the day before ischemia. RESULTS: The proportion of paretic hind limb pressure to whole hind limb pressure in stroke group was significantly reduced than sham group (p<0.05). The withdrawal threshold values of the paretic hindpaw in stroke group were not different from those in the sham group during whole experimental session (p>0.05). Garcia motor score of stroke group was reduced significantly than sham group in whole experimental session after MCAO (p<0.05). The proportions of right hind limb pressure showed no correlation with Garcia motor score after MCAO (p>0.05). CONCLUSION: Ischemic stroke in rats can lead to the reduction of pressure at paretic hind limb. The motor test for pressure weight borne on the paretic leg may provide functional information in the future studies with ischemic stroke rat.
Animals ; Brain Ischemia ; Extremities ; Hair ; Humans ; Infarction, Middle Cerebral Artery ; Leg ; Male ; Middle Cerebral Artery ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Stroke ; Weight-Bearing

BACKGOUND: Recently it has been reported that several cytokine gene polymorphisms regulate cytokine production and play an important role in immune and inflammatory response. We evaluated IL-1beta IL-1Ra, and TNF-alpha gene polymorphism in patients with primary glomerulonephritis to determine the association between cytokine polymorphism and disease susceptibility. METHODS: In this study, we enrolled 118 patients with primary glomerulonephritis and healthy 300 persons who had visited the health screening center. We analyzed -511C/T polymorphism of IL-1beta tandem repeats polymorphism in intron 2 of IL-1Ra and -308G/A polymorphism of TNF-alpha We classified primary glomerulonephritis according to pathologic finding and clinical diagnosis. RESULTS: There were no differences with IL-1betaand TNF-alpha gene polymorphism between patient and control group. The carriage of IL1RN*2 was significantly associated with an increased risk of primary glomerulonephritis (patients:control=12.75:5.4%, p<0.01). IL1RN*2 was significantly frequent in patients with membranous GN or minimal change disease (p<0.05). When we classified glomerulonephritis according to clinical diagnosis, IL1RN*2 carriage rate was higher in patients with nephrotic syndrome and RPGN or acute nephritic syndrome than patients with asymptomatic urinary abnormalities (p<0.05). IL-1beta(TT) genotype was more prevalent in acute glomerulonephritis (68.4%) than asymptomatic urinary abnormalities or other glomerulonephritis. TNF2 carriage rate showed a lower tendency in patients with asymptomatic urinary abnormalities. CONCLUSION: IL1RN*2 is significantly associated with an increased risk of development of primary glomerulonephritis. We suggest cytokine gene polymorphism is also related to clinical manifestations of glumerulonephritis.
Diagnosis ; Disease Susceptibility ; Genotype ; Glomerulonephritis* ; Humans ; Interleukin 1 Receptor Antagonist Protein* ; Introns ; Mass Screening ; Nephrosis, Lipoid ; Nephrotic Syndrome ; Tandem Repeat Sequences ; Tumor Necrosis Factor-alpha*

Background/Aims: Endoscopic submucosal dissection (ESD) of gastric tumors in the mid-to-upper stomach is a technically challenging procedure. This study compared the therapeutic outcomes and adverse events of ESD of tumors in the mid-to-upper stomach performed under general anesthesia (GA) or monitored anesthesia care (MAC). Methods: Between 2012 and 2018, 674 patients underwent ESD for gastric tumors in the midbody, high body, fundus, or cardia (100 patients received GA; 574 received MAC). The outcomes of the propensity score (PS)-matched (1:1) patients receiving either GA or MAC were analyzed. Results: The PS matching identified 94 patients who received GA and 94 patients who received MAC. Both groups showed high rates of en bloc resection (GA, 95.7%; MAC, 97.9%; p=0.68) and complete resection (GA, 81.9%; MAC, 84.0%; p=0.14). There were no significant differences between the rates of adverse events (GA, 16.0%; MAC, 8.5%; p=0.18) in the anesthetic groups. Logistic regression analysis indicated that the method of anesthesia did not affect the rates of complete resection or adverse events. Conclusions ESD of tumors in the mid-to-upper stomach at our high-volume center had good outcomes, regardless of the method of anesthesia. Our results demonstrate no differences between the efficacies and safety of ESD performed under MAC and GA.

Background/Aims: Previous studies have reported an association between Helicobacter pylori (H. pylori) infection and nonalcoholic fatty liver disease (NAFLD). Our study examined whether eradication for H. pylori infection reduces the risk of incident NAFLD. Materials and Methods: This retrospective cohort study examined 3,780 adults who had no NAFLD at baseline but were infected with H. pylori. The study population was followed from January 1995 until January 2020. H. pylori infection was determined by an H. pylori-specific IgG antibody test. Fatty liver was diagnosed by ultrasound. Results: During a median follow-up of 7.9 years, 1,294 participants developed NAFLD. In a multivariable model adjusted for age, sex, BMI, smoking status, alcohol intake, and metabolic variables, the uneradicated (for H. pylori) group exhibited a higher risk of incident NAFLD than the eradicated group (hazard ratio [HR], 1.36; 95% CI, 1.18~1.56). The multivariable analysis also demonstrated that higher BMI, current smoking and several metabolic abnormalities were significant risk factors for NAFLD. Subgroup analyses revealed that persistent H. pylori infection correlated with an increased risk of NAFLD. H. pylori eradication was associated with a decreased risk of NAFLD development. Conclusions H. pylori infection may have a pathophysiological role in NAFLD development. Hence, successful eradication of H. pylori decreases the risk of incident NAFLD.