OBJECTIVES: To examine the association of subjective depressive symptoms and cognitive dysfunction in patients with mild traumatic brain injury (mTBI). METHODS: 36 patients with mTBI without structural abnormality in the brain imaging study were recruited. Participants were subdivided into two groups by a cutoff score of 70T in the Beck Depression Inventory (BDI). Cognitive functions including intelligence, memory, and executive function were significantly lower in the <70T group compared to the > or =70T group. In addition, BDI scores were negatively correlated with performances in most of the neuropsychological tests. RESULTS: Patients group who scored 70T or more in the BDI showed significantly lower scores in most items of the neuropsychological tests. CONCLUSION: High subjective depression is associated with low neuropsychological performance in mTBI.
Brain Injuries ; Depression ; Executive Function ; Humans ; Intelligence ; Memory ; Neuroimaging

BACKGROUND: Vitiligo is a common disorder caused by a loss of epidermal pigment cells. The pigment cells in the skin and uveal tract are similar in their physiology and morphology and share a common embryologic origin. OBJECT: The purpose of our study was to determine the nature of the relationship between vitiligo and ocular disease. METHODS: Fifty-two patients with vitiligo were examined for ocular abnormalities. RESULTS: There were 17ocular abnormalities our study; 5 fundal focal hypopigmented spots (9.6%), 6 iris pigment clumps(11.5%), and 6 lens opacity(11.5%). CONCLUSION: We believe that vitiligo may affect pigment cells in the eye. Therefore, all patients with vitiligo should have ocular examinations.
Humans ; Iris ; Physiology ; Skin ; Vitiligo*

OBJECTIVE: To establish intrauterine growth curve for the birth weight of twins on the basis of gestational age. METHODS: The medical records of twin gestations delivered between 1980 and 2001 were reviewed. 610 Twin pairs (1,220 infants) were comprised our study population. The newborns were grouped according to gestational age and the median, 10th, 50th, and 90th percentile birth weight for each gestational week were calculated. Intrauterine growth curve of twins was compared with that of singletons of Wonju Christian Hospital. We studied the differences of birth weights of twins as sex, parity, chorionicity in twins. RESULTS: The birth weights of twins fall below that of singleton after 32-33 weeks. The 50th percentile for twins falls below the 10th percentile for singleton after 37 weeks, and 90th percentile for twins falls below the 50th percentile for singleton. The mean birth weight in male twin infant was heavier than in female twin infant through all gestational week. The mean brith weight in multiparity was heavier than in nulliparity through all gestational week. The mean birth weight in dichorionic twins was heavier than in monochorionic twins through all gestational week. CONCLUSION: We presented twin specific birthweight curve on the basis of gestational age. The growth pattern of twins was different from that of singleton. We recommend the twin specific birthweight curve in the management of twin gestations.
Birth Weight* ; Chorion ; Female ; Gangwon-do ; Gestational Age* ; Humans ; Infant ; Infant, Newborn ; Male ; Medical Records ; Parity ; Parturition* ; Twins*

PURPOSE: The purpose of this study was to analyze the clinical effectiveness of open reduction in the treatment of distal humeral fracture using a newly designed combined approach of anterolateral and lateral approaches to protect the radial nerve. MATERIALS AND METHODS: We investigated 24 consecutive cases of distal humeral fracture who received open reduction and internal fixation with a plate and screws with a minimum follow-up period of 1 year. We analyzed the patients' age, sex, fracture pattern, timing of the union, range of motion of the elbow joint, and complications. The Mayo elbow performance index (MEPI) was employed for the assessment of elbow joint function. RESULTS: Clinical union was observed at 10.8 weeks (6~20 weeks) on average. Pre-operatively, there were 3 cases of incomplete radial nerve palsy. All of the cases recovered, and there was no additional radial nerve palsy due to surgery. According to the MEPI, 13 cases were "excellent" and 10 cases were "good" or better, comprising 95.83% of the cases. The range of motion at the elbow was 5.5 degrees (0~15 degrees) of extension, and 131.5 degrees (120~145 degrees) of flexion, suggesting no functional disability. The duration of return to work was 11.2 weeks (5~32 weeks) on average. There were no nonunion, malunion, or infection complications. CONCLUSION: The combined anterolateral and lateral approach we designed is a clinically effective approach due to facilitation of protection of the radial nerve and attainment of adequate fixation space.
Elbow ; Elbow Joint ; Follow-Up Studies ; Humeral Fractures ; Humerus ; Paralysis ; Radial Nerve ; Range of Motion, Articular ; Return to Work

Umbilical vein varix has diverse clinical features and an unpredictable course during the pregnancy and/or perinatal period. We report a rare case of isolated fetal varix of the intra-abdominal umbilical vein, which was associated with fetal cardiomegaly. After birth, the umbilical vein varix remained with continuous blood flow through the patent ductus venosus. In addition, persistent cardiomegaly was complicated with an atrial septal defect.
Cardiomegaly ; Heart Septal Defects, Atrial* ; Parturition ; Pregnancy ; Prenatal Diagnosis ; Umbilical Veins* ; Varicose Veins*

OBJECTIVE: Mild traumatic brain injury (mTBI) is frequently associated with psychiatric symptoms and cognitive dysfunction, as well as with the receipt of workers' compensation, as many mTBIs occur due to work-related accidents. We hypothesized that depression and insufficient cognitive effort mediate the relationship between sociodemographic variables and cognitive dysfunction in mTBI. METHODS: A retrospective chart review study was conducted using 115 records of patients with mTBI. Cognitive effort was measured based on scores on the Rey 15-Item Test. Multivariate linear regression analysis was performed to examine factors predictive of cognitive functions. Path analysis was subsequently performed to investigate the mediating effects of depression and cognitive effort in relation to receipt of workers' compensation and demographic variables. RESULTS: Fifteen of the 115 participants (13.0%) received failing scores on the Rey 15-Item Test, which indicated insufficient cognitive effort. Path analysis indicated that cognitive effort mediated the effects of age and workers' compensation on cognitive functions. CONCLUSION: Given the significant mediating effects of cognitive effort on cognitive performance, it is important to address patient motivation and encourage mTBI patients covered by workers' compensation to perform tests with authentic effort.
Brain Concussion ; Brain Injuries* ; Compensation and Redress ; Depression* ; Retrospective Studies ; Executive Function* ; Humans ; Intelligence* ; Linear Models ; Memory* ; Motivation ; Negotiating* ; Neuropsychological Tests ; Workers' Compensation

BACKGROUND: Notified tuberculosis (TB) cases in Korea have not decreased over the last decade (2001-2010). METHODS: To clarify the reasons, we analyzed an annual report on notified tuberculosis patients and age-specific population drift in Korea. RESULTS: Compared to the age-specific notified TB cases between 2001 and 2010, distinctive features in notified TB cases and new cases increased markedly in people aged 45-54 years and in patients over 65 years old, whereas those between 15-34 years in 2010 decreased drastically. In particular, notified TB individuals over 65 years old occupied 29.6% of the cases in 2010, which was 1.5 times higher than that in 2001. The main reason not to decrease in notified TB patients for the last decade (2001-2010) was due to the increasing elderly population as well as the aging of baby boomers, which have a higher risk of TB development. CONCLUSION: Korea needs to pay attention to the older population in order to successfully decrease the burden of TB in the future.
Aged ; Aging ; Humans ; Korea ; Population Dynamics ; Population Growth ; Tuberculosis

PURPOSE: Mizoribine (MZR), an inhibitor of Inosine monophosphate (IMP) dehydrogenase which depletes cellular GTP, is clinically used as an immunosuppressive drug. This study was designed to evaluate the mechanism by which MZR exerts the cytotoxic effect on Jurkat T cells. METHODS: Jurkat T cell is a human T lymphocytic cell line. It was obtained from the Korean Type Culture Collection. Cell viability was measured by the MTT assay and flow cytometry. Caspase activity assay, Western blotting, 2-D PAGE, and mitochondrial membrane potential were detected using biochemical analysis. Morphologic finding was observed by Hoechst staining. RESULTS: The data demonstrated that the treatment of MZR decreased cell viability in a dose- and time-dependent manner. MZR-induced cell death was confirmed as apoptosis, which was characterized by chromatin condensation and H2AX phosphorylation. MZR increased the catalytic activity of caspase-3 protease, -8 protease and -9 proteases. The activation of caspase-3 protease was further confirmed by the degradation of polymerase (PARP), a substrate of caspase-3 protease by MZR in Jurkat T cells. Furthermore, MZR induced the changes of the mitochondrial transmembrane potential (MTP) and the cytosolic release of cytochrome c from the mitochondria. In addition, MZR induced the decrease of Bcl-X(L) expression whereas the increase of Bcl-X(S), Bak and Bim expression. Guanosine markedly inhibited cell viability and apoptosis through consistent suppression of the activity of caspase-8 protease, an upstream caspase among the caspase family, H2AX phosphorylation and PARP cleavage in MZR-treated cells. Also, I have screened the expression profile of proteins in the Jurkat T cells by using two-dimensional (2-D) gel electrophoresis. Among 300 spots resolved in the 2-D gels, the comparison of the control versus apoptotic cells revealed that the signal intensity of 10 spots was decreased and 5 spots was increased. CONCLUSION: The results suggest that MZR functions as an inhibitor of IMP dehydrogenase in apoptosis of Jurkat T cells via activation of intrinsic caspase cascades as well as mitochondrial dysfunction.
Apoptosis* ; Blotting, Western ; Caspase 3 ; Caspase 8 ; Cell Death ; Cell Line ; Cell Survival ; Chromatin ; Cytochromes c ; Cytosol ; Electrophoresis ; Flow Cytometry ; Gels ; Guanosine ; Guanosine Triphosphate ; Humans ; IMP Dehydrogenase ; Inosine Monophosphate ; Membrane Potential, Mitochondrial ; Membrane Potentials ; Mitochondria ; Oxidoreductases ; Peptide Hydrolases ; Phosphorylation ; T-Lymphocytes*

PURPOSE: Mizoribine (MZR), an inhibitor of Inosine monophosphate (IMP) dehydrogenase which depletes cellular GTP, is clinically used as an immunosuppressive drug. This study was designed to evaluate the mechanism by which MZR exerts the cytotoxic effect on Jurkat T cells. METHODS: Jurkat T cell is a human T lymphocytic cell line. It was obtained from the Korean Type Culture Collection. Cell viability was measured by the MTT assay and flow cytometry. Caspase activity assay, Western blotting, 2-D PAGE, and mitochondrial membrane potential were detected using biochemical analysis. Morphologic finding was observed by Hoechst staining. RESULTS: The data demonstrated that the treatment of MZR decreased cell viability in a dose- and time-dependent manner. MZR-induced cell death was confirmed as apoptosis, which was characterized by chromatin condensation and H2AX phosphorylation. MZR increased the catalytic activity of caspase-3 protease, -8 protease and -9 proteases. The activation of caspase-3 protease was further confirmed by the degradation of polymerase (PARP), a substrate of caspase-3 protease by MZR in Jurkat T cells. Furthermore, MZR induced the changes of the mitochondrial transmembrane potential (MTP) and the cytosolic release of cytochrome c from the mitochondria. In addition, MZR induced the decrease of Bcl-X(L) expression whereas the increase of Bcl-X(S), Bak and Bim expression. Guanosine markedly inhibited cell viability and apoptosis through consistent suppression of the activity of caspase-8 protease, an upstream caspase among the caspase family, H2AX phosphorylation and PARP cleavage in MZR-treated cells. Also, I have screened the expression profile of proteins in the Jurkat T cells by using two-dimensional (2-D) gel electrophoresis. Among 300 spots resolved in the 2-D gels, the comparison of the control versus apoptotic cells revealed that the signal intensity of 10 spots was decreased and 5 spots was increased. CONCLUSION: The results suggest that MZR functions as an inhibitor of IMP dehydrogenase in apoptosis of Jurkat T cells via activation of intrinsic caspase cascades as well as mitochondrial dysfunction.
Apoptosis* ; Blotting, Western ; Caspase 3 ; Caspase 8 ; Cell Death ; Cell Line ; Cell Survival ; Chromatin ; Cytochromes c ; Cytosol ; Electrophoresis ; Flow Cytometry ; Gels ; Guanosine ; Guanosine Triphosphate ; Humans ; IMP Dehydrogenase ; Inosine Monophosphate ; Membrane Potential, Mitochondrial ; Membrane Potentials ; Mitochondria ; Oxidoreductases ; Peptide Hydrolases ; Phosphorylation ; T-Lymphocytes*

Depression and executive dysfunction are common neuropsychiatric sequelae of stroke. Patients with stroke are more predisposed to depression and executive dysfunction compared to patients with similar degree of physical disability. Both depression and executive dysfunction are also associated with poor prognosis such as high mortality and delayed recovery after stroke. Complex neurobiological and anatomical mechanisms are associated with the development of depression and executive dysfunction after stroke. Activation of pro-inflammatory cytokines is thought to be associated with onset of depression, whereas injuries in frontal-subcortical circuit are thought to be a link between depression and executive dysfunction. Early detection of depressive symptoms and both pharmacological and non-pharmacological treatment would be helpful. In this review paper, the authors investigated 1) biological and neuroanatomical substrate for poststroke depression and executive dysfunction, 2) the relationship and common etiopathology for poststroke depression and executive dysfunction, and 3) pharmacological and non-pharmacological treatment for poststroke depression. The contents of the paper are as follows : the prevalence, clinical manifestation, and biological etiology for poststroke depression, neuroanatomical abnormalities as a common etiological factor for depression and executive dysfunction, pharmacotherapy and non-pharmacological approach.
Aluminum Hydroxide ; Carbonates ; Cytokines ; Depression ; Humans ; Prevalence ; Prognosis ; Stroke