PURPOSE: All masks are created by craftspeople. Accordingly, most masks are generally predictable in dimensions, and the portraitures usually depict the faces and heads of humans. The authors found some masks representing the features of facial asymmetry, such as hemifacial microsomia and rerely lateral facial cleft. METHODS: Reviewing the legends of wearing masks with a medley of grotesque features, the authors could deduce the tone of society in those days. RESULTS: A mask, 'crooked mouth', of Native Americans shows typical lineament of hemifacial microsomia. The deformity of the face was legendarily regarded as resulting from trauma caused by either 'one's fault' or a 'curse of God'. 'Grandmother' mask, used in the Korean masque dance of the Kosung province and Sooyoung province also shows the typical features of hemifacial microsomia which represent the old, deserted wife. 'Kori sanni yakka' mask in Sri Lanka, shows the facial asymmetry. In the legend, the child who became demon captured humans and caused illness through wind, phlegm, and bile to revenge on his father who killed his mother by deception of her maid. CONCLUSION: The authors presume that the victims of severe facial asymmetry were treated contemptuously at that time.
Bile ; Child ; Congenital Abnormalities ; Deception ; Facial Asymmetry ; Fathers ; Head ; Humans ; Indians, North American ; Masks ; Mothers ; Spouses ; Sri Lanka ; Wind

OBJECTIVES: Purpose of this study is investigation the influence of intravenous and oral bisphosphonate to bone union and clinical results in patient treated with plate fixation in an osteoporotic distal radius fracture. MATERIALS AND METHODS: The medical records of 160 patients with an osteoporotic distal radius fracture treated with plate fixation in our hospital between January 2008 and April 2012 were reviewed retrospectively. The patients were classified by 3 groups; who did not administrate bisphosphonate after surgery as Group I (n=69), administrated oral bisphosphonate after surgery as Group II (n=44), and administrated intravenous bisphosphonate as Group III (n=47). After surgery, bone union, radiologic parameters, disabilities of the DASH score and range of motion of wrist were assessed. RESULTS: Mean time of bone union was 6.7 weeks in Group I, 6.8 weeks in Group II, and 7.1 weeks in Group III. There was no significant difference between three groups (P=0.571). Bone union rate on 6weeks shows no significant differences between three groups (P=0.16). Three groups also have no significant differences in all radiologic and clinical parameters. CONCLUSION: This study shows that early initiation of oral and Intravenous bisphosphonate did not affect bone union and clinical results compared to group who did not administrate bisphosphonate result in patient treated with plate fixation in an osteoporotic distal radius fracture.
Humans ; Medical Records ; Osteoporosis ; Radius Fractures ; Radius ; Range of Motion, Articular ; Retrospective Studies ; Wrist

BACKGROUND: The aim of this study was to assess the feasibility of targeted ultrasound imaging on apoptosis with annexin A5 microbubbles (A5MB) in acute doxorubicin-induced cardiotoxicity. METHODS: Avidinated and octafluoropropan-filled phospholipid microbubbles were conjugated with biotinylated annexin A5. To confirm the specific binding of A5MB, flow cytometry was performed with hydrogen peroxide induced apoptosis in rat aorta smooth muscle cells incubated with fluorescein-5-isothiocyanate (FITC) labeled annexin A5 and A5MB. Adult male rats were injected intraperitoneally with 5 mg/kg doxorubicin weekly for 3 weeks (n = 5). Control rats were injected with normal saline (n = 5). At 24 hours after the final treatment, triggering imaging was performed 15 min after an intravenous bolus injection of A5MB for washout of freely circulating microbubbles. After echocardiography, the heart was isolated for histological detection of apoptosis by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay. RESULTS: In the in vitro tests, fluorescence intensity was low for healthy cells and high for apoptotic cells when incubated with FITC-labeled annexin A5 and A5MB. Rats treated with doxorubicin showed significant contrast opacification of the myocardium on contrast echocardiography using A5MB. However, no opacification was observed in control rats. Apoptosis was confirmed by TUNEL assay in doxorubicin treated rats. CONCLUSION: Acute doxorubicin-induced cardiomyopathy based on early apoptosis can be assessed and imaged with targeted ultrasound imaging using A5MB in rats.
Adult ; Animals ; Annexin A5 ; Aorta ; Apoptosis ; Avidin ; Cardiomyopathies ; Doxorubicin ; Echocardiography ; Flow Cytometry ; Fluorescein-5-isothiocyanate ; Fluorescence ; Heart ; Humans ; Hydrogen Peroxide ; In Situ Nick-End Labeling ; Male ; Microbubbles ; Myocardium ; Myocytes, Smooth Muscle ; Rats

OBJECTIVES: The purpose of this study was to investigate the current status of and problems with the Safe Community Programs in Gangbuk-gu, one of the 25 districts of the capital city of Korea. METHODS: The study subjects were 396 individuals who were involved in Safe Community Programs between 2009 and 2011. We examined the effectiveness and willingness of respondents to participate as a safety leader of the Safe Community Program with a questionnaire. We examined the injury death rates of Gangbuk-gu by using of the death certificate data of Korea's National Statistical Office. Descriptive statistics and chi-squared tests were used. RESULTS: The effectiveness of programs did not differ but active participation differed significantly among subjects (p<0.05). The injury death rate of Gangbuk-gu as a whole increased during the implementation period. However, senior safety, in particular, may be a helpful program for reducing injuries in Gangbuk-gu. CONCLUSIONS: This study suggests that the lack of active participation may be a major problem of Safe Community Programs in Gangbuk-gu. Therefore, Safe Community Programs should be expanded to the entire district of Gangbuk-gu and more active participation programs should be developed.
Adult ; Aged ; Community Health Centers ; Data Collection ; Female ; Humans ; Male ; Middle Aged ; Mortality/trends ; *Program Evaluation ; Questionnaires ; Republic of Korea ; Safety/*statistics & numerical data

PURPOSE: Studies on the relationship of metabolic syndrome (MS) and prostate cancer are controversial. We evaluated the association between MS and prostate cancer characteristics in patients who underwent transrectal ultrasound-guided prostate biopsy. MATERIALS AND METHODS: From October 2003 to May 2011, patients with a prostate-specific antigen (PSA) value> or =4 ng/ml or abnormal digital rectal examination (DRE) result underwent transrectal ultrasound-guided prostate biopsy. MS was diagnosed according to the Adult Treatment Panel III. Clinicopathologic factors including PSA, DRE, prostate volume, age, waist circumference, body mass index (BMI), lipid profiles, fasting blood sugar level, and MS were considered for analysis. RESULTS: Three hundred fifty-four patients were enrolled (mean age, 68.86+/-8.95 years; mean PSA, 13.97+/-20.42 ng/ml). Seventy-five patients (21.2%) had MS and 90 patients (25.4%) were diagnosed as having prostate cancer, including 27 (30%) with MS and 63 (70%) without MS. Total PSA value and prostate volume were significant predictors for prostate cancer. However, MS and BMI were not significantly related to increased cancer risk. Prostate cancer patients with MS had significantly lower Gleason scores (average, 6.63+/-1.92) than did prostate cancer patients without MS (average, 7.54+/-1.71; p=0.029). CONCLUSIONS: Presence of MS was associated with a significantly decreased risk of high-grade prostate cancer. A larger, prospective, multicenter investigation is mandatory to clarify the relationship between MS and prostate cancer.
Adult ; Biopsy ; Blood Glucose ; Body Mass Index ; Digital Rectal Examination ; Fasting ; Humans ; Neoplasm Grading ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Waist Circumference

Emergency Medicine is a medical specialty that provides comprehensive emergency care. The spectrum of emergency medicine includes humanity as well as medical care for emergency patients. Since the Korean Society of Emergency Medicine has been established and the training course for emergency residents has begun, quality improvement of the training course still remains to be one of the most important issues in emergency medicine. This report is to understand the current status of training of emergency residents and to improve the quality of training of emergency residents. The survey was performed with questionnaires regarding current status of training and opinions to improve quality of training. The questionnaires were sent to all emergency physicians and emergency residents registered to the Korean Society of Emergency Medicine via an electronic mail or a printed letter. The response rates were 49.6% for emergency physicians and 35.8% for emergency residents. On the basis of the result of this survey, we suggest five proposals for improving the quality of resident training course. These include complete adherence of each institution to training guidelines presented by the Korean Society of Emergency Medicine, development of the education program compatible to each institution, shortening of length of training duration from 4 years to 3 years, promotion of the training environment, and introduction of evaluation examination to the training course.
Education ; Electronic Mail ; Emergencies* ; Emergency Medical Services ; Emergency Medicine ; Humans ; Internship and Residency ; Quality Improvement ; Surveys and Questionnaires

The prognostic significance of age in renal cell carcinoma (RCC) is a subject of debate. The aim of the present multi-institutional study was to evaluate the impact of age on clinicopathological features and survival in a large cohort of patients with RCC. A total of 5,178 patients who underwent surgery for RCC at eight institutions in Korea between 1999 and 2011 were categorized into three groups according to age at diagnosis as follows: young age (< 40 years, n = 541), middle-age (≥ 40 and < 60 years, n = 2,551), and old age (≥ 60 years, n = 2,096) groups. Clinicopathological variables and survival rates were compared between the three groups. Young patients had lower stage tumors with a low Fuhrman grade, a lower rate of lymphovascular invasion than patients in the other age groups. Regarding histologic type, the young age group had a lower percentage of clear cell histology and a greater incidence of Xp11.2 translocation RCC. Kaplan-Meier estimates showed that cancer-specific survival was significantly better in the young age group than in the other groups (log rank test, P = 0.008). However, age at diagnosis was not an independent predictor of survival in multivariate analysis. In conclusion, young age at diagnosis was associated with favorable pathologic features, although it was not an independent prognostic factor for survival in patients with surgically-treated RCC. Age itself should not be regarded as a crucial determinant for the treatment of RCC.
Carcinoma, Renal Cell* ; Cohort Studies ; Diagnosis* ; Humans ; Incidence ; Korea ; Multivariate Analysis ; Nephrectomy ; Recurrence ; Survival Rate

Advanced glycation endproducts (AGEs) have been reported to play a role in neointimal formation and increase the rate of in-stent restenosis (ISR) in the diabetic coronary artery disease patients treated with stents, but the potential pathogenic mechanisms of AGEs in vascular smooth muscle cell proliferation remain unclear. We sought to determine the AGEs related pathobiological mechanism of diabetic vasculopathy. Rat aortic smooth muscle cell (RAoSMC) culture was done with different concentrations of AGEs and proliferation was assessed. Immunohistochemistry for receptor of AGEs (RAGE) was performed with human carotid atheroma. Western blotting was performed to assess the activation of MAP kinase system in the cultured RAoSMC. AGEs increased RAoSMC proliferation and were associated with increased phosphorylation of ERK and p38 kinase by time and dose dependent manner. The MAP kinase activity was decreased by RNA interference for RAGE. AGEs stimulation increased reactive oxygen species (ROS) generation in cultured RAoSMC. From this study it is concluded that AGEs played a key role in RAoSMC proliferation via MAP kinase dependent pathways. Activation of vascular smooth muscle cell (VSMC) proliferation by MAP kinase system and increased formation of ROS may be the possible mechanisms of AGEs induced diabetic vasculopathy.
Animals ; Carotid Artery Diseases/metabolism/pathology ; Cell Proliferation/drug effects ; Cells, Cultured ; Diabetic Angiopathies/*etiology/metabolism/pathology ; Extracellular Signal-Regulated MAP Kinases/metabolism ; Glycosylation End Products, Advanced/adverse ; Humans ; MAP Kinase Signaling System/drug effects/*physiology ; Phosphorylation/drug effects ; RNA, Small Interfering/pharmacology ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species/metabolism ; Receptors, Immunologic/antagonists & inhibitors/metabolism

Advanced glycation endproducts (AGEs)-induced vascular smooth muscle cell (VSMCs) proliferation and formation of reactive oxygen species (ROS) are emerging as one of the important mechanisms of diabetic vasculopathy but little is known about the antioxidative action of HMG CoA reductase inhibitor (statin) on AGEs. We hypothesized that statin might reduce AGEs-induced intracellular ROS of VSMCs and analyzed the possible mechanism of action of statin in AGEs-induced cellular signaling. Aortic smooth muscle cell of Sprague-Dawley rat (RASMC) culture was done using the different levels of AGEs stimulation in the presence or absence of statin. The proliferation of RASMC, ROS formation and cellular signaling was evaluated and neointimal formation after balloon injury in diabetic rats was analyzed. Increasing concentration of AGEs stimulation was associated with increased RASMC proliferation and increased ROS formation and they were decreased with statin in a dose-dependent manner. Increased NF-kappaB p65, phosphorylated ERK, phosphorylated p38 MAPK, cyclooxygenase-2, and c-jun by AGEs stimulation were noted and their expression was inhibited by statin. Neointimal formation after balloon injury was much thicker in diabetic rats than the sham-treated group but less neointimal growth was observed in those treated with statin after balloon injury. Increased ROS formation, subsequent activation of MAPK system and increased VSMC proliferation may be possible mechanisms of diabetic vasculopathy induced by AGEs and statin may play a key role in the treatment of AGEs-induced diabetic atherosclerosis.
Animals ; Aorta/metabolism/pathology ; Cell Proliferation/drug effects ; Cyclooxygenase 2/metabolism ; Diabetes Mellitus, Experimental/drug therapy/metabolism/pathology ; Diabetic Angiopathies/*drug therapy/*metabolism/pathology ; Glycosylation End Products, Advanced/*metabolism ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/*pharmacology/therapeutic use ; Male ; Myocytes, Smooth Muscle/*metabolism/pathology ; Oxidative Stress/*drug effects ; Proto-Oncogene Proteins c-jun/metabolism ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species/metabolism ; Signal Transduction/drug effects ; Simvastatin/*pharmacology/therapeutic use ; Transcription Factor RelA/metabolism ; p38 Mitogen-Activated Protein Kinases/metabolism