Brain size is a useful parameter describing ontogenic character and function. Despite its potential contribution to functional study and diagnosis of disease, it has been hampered by poor assessment tools in vivo and postmortem changes. Recent development of medical imaging techniques such as MRI and CT enable us to understand brain structures in vivo. Many morphometirc studies of the brain has given us new insights in the field of functional neuroanatomy and neuropsychiatric diseases. In spite of these advances, volumetric data of normal Korean brain is not available yet. As an initial approach to Korean standard brain size, we measured the cerebellar volume between 20 and 80 years old Koreans. The MRI films free from lesions in brain was analyzed and measured by NIH image program. The Korean cerebellar volume were ranged between 86.2cm(3) and 141.3 cm(3) and average male cerebellum volume was significantly larger than that of female[male : 118.2+/-11.2cm(3)] > female : 108.0+/-9.6cm(3), P=0.1021E-07<0.05]. And we could not find volume change according to aging process. This is the first report on normal Korean cerebellar volume and the presence of gender difference in the Korean cerebellar volume. These data will be used for the standard useful in studying cerebellar function and cerebellum associated disorders in the future.
Aged, 80 and over ; Aging ; Brain ; Cerebellum ; Diagnosis ; Diagnostic Imaging ; Female ; Humans ; Magnetic Resonance Imaging* ; Male ; Neuroanatomy ; Postmortem Changes

Charcot-Marie-Tooth disease (CMT) is the most common inherited motor and sensory neuropathy. Previous studies have found that, according to CMT patients, neuropathic pain is an occasional symptom of CMT. However, neuropathic pain is not considered to be a significant symptom associated with CMT and, as a result, no studies have investigated the pathophysiology underlying neuropathic pain in this disorder. Thus, the first animal model of neuropathic pain was developed by our laboratory using an adenovirus vector system to study neuropathic pain in CMT. To this end, glycyl-tRNA synthetase (GARS) fusion proteins with a FLAG-tag (wild type [WT], L129P and G240R mutants) were expressed in spinal cord and dorsal root ganglion (DRG) neurons using adenovirus vectors. It is known that GARS mutants induce GARS axonopathies, including CMT type 2D (CMT2D) and distal spinal muscular atrophy type V (dSMA-V). Additionally, the morphological phenotypes of neuropathic pain in this animal model of GARS-induced pain were assessed using several possible markers of pain (Iba1, pERK1/2) or a marker of injured neurons (ATF3). These results suggest that this animal model of CMT using an adenovirus may provide information regarding CMT as well as a useful strategy for the treatment of neuropathic pain.
Animals ; Charcot-Marie-Tooth Disease/*diagnosis/*physiopathology ; *Disease Models, Animal ; Glycine-tRNA Ligase/*genetics/metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Transgenic ; Mutagenesis, Site-Directed ; Mutation/genetics ; Neuralgia/*diagnosis/*physiopathology

Charcot-Marie-Tooth disease (CMT) is the most common inherited motor and sensory neuropathy. Previous studies have found that, according to CMT patients, neuropathic pain is an occasional symptom of CMT. However, neuropathic pain is not considered to be a significant symptom associated with CMT and, as a result, no studies have investigated the pathophysiology underlying neuropathic pain in this disorder. Thus, the first animal model of neuropathic pain was developed by our laboratory using an adenovirus vector system to study neuropathic pain in CMT. To this end, glycyl-tRNA synthetase (GARS) fusion proteins with a FLAG-tag (wild type [WT], L129P and G240R mutants) were expressed in spinal cord and dorsal root ganglion (DRG) neurons using adenovirus vectors. It is known that GARS mutants induce GARS axonopathies, including CMT type 2D (CMT2D) and distal spinal muscular atrophy type V (dSMA-V). Additionally, the morphological phenotypes of neuropathic pain in this animal model of GARS-induced pain were assessed using several possible markers of pain (Iba1, pERK1/2) or a marker of injured neurons (ATF3). These results suggest that this animal model of CMT using an adenovirus may provide information regarding CMT as well as a useful strategy for the treatment of neuropathic pain.
Animals ; Charcot-Marie-Tooth Disease/*diagnosis/*physiopathology ; *Disease Models, Animal ; Glycine-tRNA Ligase/*genetics/metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Transgenic ; Mutagenesis, Site-Directed ; Mutation/genetics ; Neuralgia/*diagnosis/*physiopathology

Background: The purpose of this study was to evaluate the clinical and radiological outcomes of high-flexion total knee arthroplasty (TKA) using Vega Knee System (B. Braun, Aesculap) at a long-term follow-up and to analyze the implant survivorship. Methods: We enrolled 165 patients (232 knees) with a minimum 7-year follow-up after TKA (VEGA Knee System). For clinical assessment, range of motion (ROM), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were used. For radiologic assessment, hip-knee-ankle angle, component position, and the existence of radiolucent lines and loosening were used. Survival analysis was conducted using the Kaplan-Meier method. Results: The mean follow-up period was 9.8 years. The mean ROM increased from 124.4° to 131.4° at the final follow-up. The WOMAC score decreased from 38.5 to 17.4 at the final follow-up (p < 0.001). All 5 subscales of the KOOS improved at the final follow-up (all subscales, p < 0.001). Revision TKA was performed in 10 cases (4.3%), which included 9 cases of aseptic loosing and 1 case of periprostatic joint infection. Of the 9 aseptic loosening cases (3.9%), 8 cases (3.4%) were loosening of the femoral component and 1 case (0.4%) was loosening of the tibial component. When revision for any reason was considered an endpoint, the 10-year survivorship was 96.2% (95% confidence interval [CI], 93.9%–98.5%). On the other hand, when revision for aseptic loosening was considered the endpoint, the 10-year survivorship was 96.6% (95% CI, 94.4%–98.8%). Conclusions The Vega Knee System provided good clinical results in the long-term follow-up period. Although the VEGA Knee System showed acceptable implant survivorship, loosening of the femoral component occurred in about 3.4% of the patients. For more accurate evaluation of the survivorship of high-flexion design TKA with a short posterior flange, it is necessary to conduct more long-term follow-up studies targeting diverse races, especially Asians who frequently perform high-flexion activities.

OBJECTIVES: People at ultra-high risk for psychosis have heterogenous character and different long-term outcomes. We divided ultra-high risk subjects into two subgroups by presence of familial history and tried to find different pattern of functional connectivity of the default mode network (DMN) between the two groups in order to examine the effects familial loading. METHODS: Eleven subjects at clinical-high risk (CHR) group with familial history of psychiatric illness and nineteen subjects of CHR group without familial history were recruited. All the subjects were scanned using resting-state functional magnetic resonance imaging. A posterior cingulate cortex was the seed region of the analysis, and the DMN of the both high risk group were analyzed with voxel-wise two sample T test. RESULTS: The CHR group with familial history showed greater functional connectivity in the precuneus area in contrast with the other high risk subjects (peak-level t=5.49, p<0.001). There were no significant differences in total score on the Positive and Negative Syndrome Scale and Scales of Psychosis-risk Syndrome between the two groups. CONCLUSION: The study suggests that the abnormalities of functional connectivity between precuneus and posterior cingulate area may be associated with the genetic vulnerability of high risk trait.
Gyrus Cinguli ; Magnetic Resonance Imaging ; Pilot Projects ; Psychotic Disorders ; Seeds ; Weights and Measures

OBJECTIVE: To evaluate the clinical course of the patient who had the gynecologic operation using minolaparotomy. METHODS: We reviewed the chart of the patient who had the gynecologic operation using minilaparotomy in department of obstetrics and gynecology of St. Mary's hospital during Jan. 2000 Sept. 2002. RESULTS: Postopertive diagnosis is myoma (154 cases), adenomyosis (41 cases), ovary cyst (89 cases) and so on. We had performed hysterectomy (225 cases), myomectomy (86 cases), cystectomy or adenexectomy (85 cases) for these patient. There is no significant difference in clinical course between two total hysterecomized groups, one who had the operation history and the other who had not the operation history. CONCLUSION: In gynecological operations, minilaparotomy is the useful methods in any kind of the indication of operation, and show good clinical course.
Adenomyosis ; Cystectomy ; Diagnosis ; Female ; Gynecology ; Humans ; Hysterectomy ; Laparotomy* ; Myoma ; Obstetrics ; Ovary

Benign Joint Hypermobility Syndrome (BJHS) is characterized by generalized ligamentous laxity, with associated tendency to recurrent sprain and dislocation. Whereas ankylosing spondylitis (AS) is characterized by ankylosis and loss of mobility of the affected joints by fibrosis and ossification of cartilage and enthesis. The association of these two pathologies is rare. We report on a 18-year old man with a joint hypermobility and laxity as well as accompanying 18-month history of back pain at the lumbar spine, both knee and left buttock pain. At physical examination the patient presented 5 points of Nine-Point Beighton hypermobility score and limitation of movement in the lumbar spine due to back pain. Magnetic resonance imaging of the pelvis showed bilateral sacroiliitis and erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were elevated and HLA B27 was positive. Transthoracic echocardiography and opthalmologic examination excluded other cause of joint hypermobility. We diagnosed co-existent BJHS and AS.
Adolescent ; Ankylosis ; Back Pain ; Blood Sedimentation ; Buttocks ; C-Reactive Protein ; Cartilage ; Dislocations ; Echocardiography ; Fibrosis ; Humans ; Joint Instability* ; Joints* ; Knee ; Ligaments ; Magnetic Resonance Imaging ; Pathology ; Pelvis ; Physical Examination ; Sacroiliitis ; Spine ; Spondylitis, Ankylosing* ; Sprains and Strains

The purpose of this study was to investigate the operational characteristics of the contract-managed highschool foodservice and to analyze the factors to effect the menu price. The data was collected from 249 highschools in Seoul. The results are as follows; Those surveyed highschools were established as 1 national, 74 public, and 174 private institution. Highschools were classified as 176 academic, 66 vocational, and 7 specific purposed institution. Students were organized as 70 boys', 23 girls', and 41 coeducational highschools. Most highschool started contract-managed highschool foodservice from 1999 and the period of foodservice contract was most 3 years and the operation styles in food distribution were 96 classrooms, 105 dining halls and 17 classrooms combined dining halls. The scale of contract foodservice management companies was 63.1% small and medium and 36.9% large enterprises. The surveyed highschools had the average meal price 2,141 won per meal and they had 1,518 pupils on the register. The participating rate to the foodservice was 68.5%. The facilities investment cost of the contract foodservice management company was 179,204,230 won for private institutions and was 138,119,010 won for national&public institutions. The period of the contract was 3.22 years in private institutions, which was significantly higher than national&public institutions which showed 2.85 years. The commissary foodservice schools had higher facilities investment cost than conventional foodservice schools. Classrooms foodservice had higher participating foodservice rate than Dining halls. The investment cost for facilities showed high in order of girls', boys', and coeducational high schools, and the number on the register and the number participating in the foodservice showed high in order of boys', girls', and coeducational high schools. The number on the register showed the highest in academic and vocational schools, specific purposed institutions in sequence, and the number participating in the foodservice showed high in order of academic schools, specific purposed institutions and vocational. However, the participating foodservice rate showed high in specific purposed institution, academic and vocational schools in order, and the meal price, the investment cost for facilities showed high in specific purposed institution, academic and vocational schools in sequence. Regionally, the district south of Han river had the average meal price 2,266.13 won, which showed higher in the eastern part which had 2,033.33 won. The western part had the average investment cost for facilities of 233,331,060 won, and the central district 126,137,140 won. The number on the register showed 1845.68 in the eastern part and 1308.00 in Dong-Jak area, that had clear differences among areas. When the period of the contract went longer, the investment cost for facilities had a tendency to increase. The significant differences were existed among meal price, the investment cost for facilities, the number on the register, the number participating in the foodservice, and the participating foodservice rate. The investment cost for facilities had increased according to the number participating in the foodservice and the participating foodservice rate. And the large enterprises showed higher participating foodservice rate than the small and medium enterprises.
Costs and Cost Analysis ; Humans ; Investments ; Meals ; Pupil ; Rivers ; Seoul*

PURPOSE: To identify the recovery of joint movement and decrease in pain through the radiological findings after open synovectomy for the elbow with rheumatoid arthritis which was not cured by medication. MATERIALS AND METHODS: From 1997 to 2008, the research on open synovectomy for the elbow with rheumatoid arthritis was done in 19 patients with 21 cases whose average follow-up was 12 months. Despite the medical treatment, the indication of operation was towards the patients with Larsen grade I~III rheumatoid arthritis whose joint swelling and pain had not been improved. Also, the indication of operation included the patients with Larsen grade IV who rejected joint replacement or needed to postpone the operation due to young age. Main symptom was pain in all cases; Preoperative flexion contracture and flexion-extension movement on average was 29 degree and 86 degree, respectively.Postoperative radiological and physical examination were done; Visual analogue scale and Mayo elbow performance score were measured. RESULTS: Joint swelling recurred in two cases (9.5%). However, the size of swelling was mild compared to preoperative condition. Preoperative total mean flexion contracture was 29 degree (10~45 degree) and total mean flexion-extension movement was 86 degree (60~135degree). Last follow-up total mean flexion contracture was 18 degree (5~50 degree) and total mean flexion movement was 102 degree (35~150 degree). Statistically, the increase of range of joint movement was not significant. Radiologically, there were 11 cases(52.3%) showing no changes in preoperative and postoperative grade while there were 10 cases(47.6%) with increase in grade. As for VAS score, total mean preoperative score was 5 and postoperative score was 2.3(0~8) showing less pain than the past. After statistical analysis separated by Grade I, II, III and IV, last follow-up of VAS score, Mayo elbow performance score and elbow joint movement showed no statistical difference compared to Larsen grade (p=0.075). CONCLUSIONS: Open Synovectomy for elbow with rheumatoid arthritis can not stop radiological progress, and the increase in range of joint movement is not statistically meaningful. However the operation displays clinical improvement such as decrease in pain and increase in range of joint movement.
Arthritis, Rheumatoid ; Contracture ; Elbow ; Elbow Joint ; Follow-Up Studies ; Humans ; Joints ; Physical Examination ; Synovitis

Multiple extradural arachnoid cysts of the spine are extremely uncommon in children with only a few cases reported. The authors report a case of multiple extradural spinal arachnoid cysts in children with a review of the relevant literature.
Arachnoid ; Arachnoid Cysts ; Child ; Humans ; Spine