No abstract available.
Blood Group Incompatibility* ; Bromelains*

Myotonia dystrophica(Synonym: Myotonia atrophica, Dystrophia myotonia, Steinert's disease) is a autosomal dominant hereditary multisystemic disorder involving several organs besides skeletal muscle, and commonly called with myotonia congenita, paramyotonia congenita as myotonia. Although most cases are of adult onset, where a mother has the disease, neonatal dystrophia myotonia can occur in her offspring. The main feature is a steadily progressive muscle dystrophy, complicated by myotonia, which is a failure of muscles to relax normally after a forceful contraction. Steinert in 1909 was the first to report the finding of atrophic testes and baldness in patients with myotonia dystrophica, and the other clinical feature of myotonia dystrophica were reported by many authors after that time. We are reporting a case of myotonia dystrophica, which showing familial history with brief review of literature.
Adult ; Alopecia ; Humans ; Mothers ; Muscle, Skeletal ; Muscles ; Myotonia Congenita ; Myotonia ; Myotonic Disorders ; Myotonic Dystrophy ; Testis

Purpose: This study aimed to evaluate angiographic and contrast enhancement (CE) patterns on three-dimensional (3D) black blood (BB) contrast-enhanced MRI in patients with acute medulla infarction. Materials and Methods: From January 2020 to August 2021, we retrospectively analyzed stroke 3D BB contrast-enhanced magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) findings of patients visiting the emergency room for symptom evaluation of acute medulla infarction. In total, 28 patients with acute medulla infarction were enrolled in this study. Four types of 3D BB contrast-enhanced MRI and MRA were classified as follows: 1=unilateral contrast-enhanced vertebral artery (VA)+no visualization of VA on MRA; 2=unilateral enhanced VA+hypoplastic VA; 3=no enhanced VA+unilateral complete occlusion of VA; 4=no enhanced VA+normal VA (including hypoplasia) on MRA. Results: Of the 28 patients with acute medulla infarction, 7 (25.0%) showed delayed positive findings after 24 hours on diffusion-weighted imaging (DWI). Of these patients, 19 (67.9%) showed CE of the unilateral VA on 3D BB contrast-enhanced MRI (type 1 and 2). Of the 19 patients with CE of VA on 3D BB contrast-enhanced MRI, 18 showed no visualization of enhanced VA on MRA (type 1), and 1 showed hypoplastic VA. Of the 7 patients with delayed positive findings on DWI, 5 showed CE of the unilateral VA and no visualization of the enhanced VA on MRA (type 1). Symptom onset to door time or initial MR check time was significantly shorter in the groups with delayed positive findings on DWI (P<0.05). Conclusion Unilateral CE on 3D BB contrast-enhanced MRI and no visualization of the VA on MRA are related to the recent occlusion of the distal VA. These findings suggest that the recent occlusion of the distal VA is related to acute medulla infarction, including delayed visualization on DWI.

OBJECTIVE: Traumatic brain injury (TBI) in children under age 24 months has characteristic features because the brain at this age is rapidly growing and sutures are opened. Moreover, children this age are completely dependent on their parents. We analyzed the demographic data and risk factors for outcomes in TBI patients in this age group to elucidate their clinical characteristics. METHODS: We retrospectively reviewed the medical records and radiological films of children under 24 months who were admitted to Kyungpook National University Hospital from January 2004 to December 2013 for TBI. Specifically, we analyzed age, cause of injury, initial Glasgow coma scale (GCS) score, radiological diagnosis, seizure, hydrocephalus, subdural hygroma, and Glasgow outcome scale (GOS) score, and we divided outcomes into good (GOS 4–5) or poor (GOS 1–3). We identified the risk factors for post-traumatic seizure (PTS) and outcomes using univariate and multivariate analyses. RESULTS: The total number of patients was 60, 39 males and 21 females. Most common age group was between 0 to 5 months, and the median age was 6 months. Falls were the most common cause of injury (n=29, 48.3%); among them, 15 were falls from household furniture such as beds and chairs. Ten patients (16.7%) developed PTS, nine in one week; thirty-seven patients (61.7%) had skull fractures. Forty-eight patients had initial GCS scores of 13–15, 8 had scores of 12–8, and 4 had scored 3–7. The diagnoses were as follows: 26 acute subdural hematomas, 8 acute epidural hematomas, 7 focal contusional hemorrhages, 13 subdural hygromas, and 4 traumatic intracerebral hematomas larger than 2 cm in diameter. Among them, two patients underwent craniotomy for hematoma removal. Four patients were victims of child abuse, and all of them had PTS. Fifty-five patients improved to good-to-moderate disability. Child abuse, acute subdural hematoma, and subdural hygroma were risk factors for PTS in univariate analyses. Multivariate analysis found that the salient risk factor for a poor outcome was initial GCS on admission. CONCLUSION: The most common cause of traumatic head injury in individuals aged less than 24 months was falls, especially from household furniture. Child abuse, moderate to severe TBI, acute subdural hematoma, and subdural hygroma were risk factors for PTS. Most of the patients recovered with good outcomes, and the risk factor for a poor outcome was initial mental status.
Accidental Falls ; Brain ; Brain Injuries* ; Child Abuse ; Child* ; Contusions ; Craniocerebral Trauma ; Craniotomy ; Demography ; Diagnosis ; Family Characteristics ; Female ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Gyeongsangbuk-do ; Hematoma ; Hematoma, Subdural, Acute ; Hemorrhage ; Humans ; Hydrocephalus ; Infant ; Interior Design and Furnishings ; Male ; Medical Records ; Multivariate Analysis ; Parents ; Retrospective Studies ; Risk Factors* ; Seizures* ; Skull Fractures ; Subdural Effusion ; Sutures

PURPOSE: In South Korean ferry disaster in 2014, the captain abandoned the ship with passengers including high school students still aboard. We noticed the resemblance of abandoning the ship with passengers still aboard the ferry (named the Sewol) and the ship Patna, which was full of pilgrims, in Joseph Conrad's novel "Lord Jim." The aim of this study is to see how medical students think about the role of a medical doctor as a captain of a ship by analyzing book reports on Conrad's "Lord Jim." METHODS: Participants included 49 third-year medical students. Their book reports were analyzed. RESULTS: If placed in the same situation as the character of Jim, 24 students of the 49 respondents answered that they would stay with the passengers, while 18 students indicated they would escape from the ship with the crew. Most of the students thought the role of a doctor in the medical field was like that of a 'captain.' The medical students reported that they wanted to be a doctor who is responsible for his or her patients, highly moral, warm-hearted, honest, and with high self-esteem. CONCLUSION: In conclusion, we found that "Lord Jim" induced the virtue of 'responsibility' from the medical students. Consequently, "Lord Jim" could be good teaching material for medical humanities.
Surveys and Questionnaires ; Disasters ; Humanities ; Humans ; Ships* ; Students, Medical ; Teaching Materials ; United Nations ; Virtues

Y-STR haplotyping is a powerful forensic and anthropological tool for identifying male lineages. We used high-resolution Y-STR haplotyping to evaluate the possibility of an ancestral relationship between two individuals with the different surname. Of the 17 Y-STRs genotyped, 16 had identical alleles in two individuals, except for an unambiguously sporadic mutation (one-step mutation) at DYS385 locus. The common allele 11.1 (U3Ains) at DYS439 locus was also observed in these two individuals. Sequencing analysis of these alleles of two samples demonstrated an A insertion at base 3 upstream from the repeat region's first GATA motif. These findings suggested that two individuals were paternally related, even if male individuals live with different surname.
Alleles ; Haplotypes ; Humans ; Male

PURPOSE: In Korea, emergency department overcrowding in large hospitals have caused social concern. Moreover, patients with low socioeconomic status visit the emergency department more frequently. This kind of visitation also causes a burden on the national budget, but emergent patient should be treated in emergency department regardless of economic state. So, on establishment of policy about the patient with low socioeconomic status, the frequency of emergency visitation alone is difficult to obtain a sufficient basis for policy-making. METHODS: We retrospectively analyzed adult patients with a disease who visited the Pusan Wide-regional Emergency Center in 2015. Korean Triage and Acuity Scale level I, II or III were defined as emergency, and level IV or V was defined as non-emergency. The ratio of emergency and non-emergency was compared in the National Health Insurance and Medicaid database. RESULTS: The number of patients with National Health Insurance was 16,208 (90.3%) and with Medicaid was 1,737 (9.7%). Among those with National Health Insurance, there were 12,720 (78.5%) emergency cases and 3,488 (21.5%) non-emergency cases. Among those with Medicaid, 1,379 (79.4%) emergency cases and 358 (20.6%) non-emergency cases. Between National Health Insurance and Medicaid, there was no statistically significant difference in the ratio of emergency and non-emergency (p=0.380) CONCLUSION: Accessibility of emergency and non-emergency patients with National Health Insurance and Medicaid to Pusan Wide-regional Emergency Center was not different.
Adult ; Budgets ; Busan ; Emergencies* ; Emergency Service, Hospital ; Humans ; Insurance Coverage* ; Insurance* ; Korea ; Medicaid ; National Health Programs ; Retrospective Studies ; Social Class ; Triage

OBJECTIVE: This study was conducted to examine the correlation between clinical outcomes and the size of the syrinx in post-operative magnetic resonance imaging(MRI) and symptom duration. METHODS: The authors investigated twelve patients who underwent various operations for syringomyelia from January 1995 to December 2003. The authors retrospectively analyzed medical records, pre- and post-operative MRI findings, features and durations of symptoms, and the method of surgical treatments. The clinical outcomes were assessed on Prolo scale at 6 months of post-operative period. RESULTS: Neurologic symptoms did not promptly disappear after the shrinkage of syrinx, but post-operative MRI demonstrated most patients showed reductions in the size of the syrinx. There is no statistical relationship between clinical improvements and decrements of the syrinx size. However, patients who underwent surgical treatment within 2 years from the symptom onset had more favorable outcome than those who had operations after 2 years from the onset of symptoms. CONCLUSION: Change in the size of the syrinx in post-operative MRI is not directly proportional to favorable clinical outcomes. However, symptom duration before surgical treatment has considerable impact on the clinical outcomes.
Humans ; Magnetic Resonance Imaging ; Medical Records ; Neurologic Manifestations ; Retrospective Studies ; Syringomyelia

Cavernous malformations (CMs), characterized by the presence of a hemosiderin rim and intralesional hemorrhage, are relatively common intracranial vascular malformations. Extralesional hemorrhages arising from CMs are seen in a minority of cases, but most of them show typical CM findings on magnetic resonance imaging. Here, the authors report two cases of pathologically confirmed CM presenting with unusual and large intracerebral hemorrhages, which were not surrounded by the typical hemosiderin rim. CMs presenting with large intracerebral hemorrhage should be considered in the differential diagnosis of massive intracerebral hemorrhages.
Cerebral Hemorrhage* ; Diagnosis, Differential ; Hemorrhage ; Hemosiderin ; Magnetic Resonance Imaging ; Vascular Malformations

OBJECT: To analyze the CT findings of intracranial tuberculosis in children at initial stage and during follow-up after treatment. MATERIALS AND METHODS: We evaluated 25 patients who were diagnosed by CSF analysis or response to anti-tuberculous medication as suffering from intracranial tuberculosis. There were 13 boys and 12 girls aged between 4 months and 14 years. Twenty-five initial and sixty-three follow-up CT scans were retrospectively analyzed. We evaluated the pattern of cisternal enhancement, the locations of infarction, and the presence of calcification and parenchymal granuloma. The changes of hydrocephalus and related complications, aswell as cisternal abnormality during anti-tuberculous medication were also evaluated. RESULTS: The initial findings on CT scan were hydrocephalus(75%), cisternal obliteration in precontrast study(64%), thick-line orring-shaped cisternal enhancement on postcontrast study(44%), infarctions(32%), calcifications(32%), periventricular edema(28%), and parenchymal granulomas(16%). On follow-up CT scan, hydrocephalus and cisternal enhancement had decreased to 35% and 82%, respectively, and the granulomas had changed to calcified nodules(100%). Ventriculo-peritoneal shunt or external ventricular drainage was needed in nine patients, and ventriculitis or complication of shunt procedure developed in four. CONCLUSION: Intracranial tuberculosis in children presented predominantly as meningitis involving basal cisterns and was associated with hydrocephalus. Infarction and calcification may be seen as parenchymal lesion. In spite of medical treatment, drainage was needed in about half the patients. During this treatment, the resolution of hydrocephalus, decreased cisternal enhancement, and calcification of the granulomas were seen.
Child* ; Drainage ; Follow-Up Studies ; Granuloma ; Humans ; Hydrocephalus ; Infarction ; Meningitis ; Tomography, X-Ray Computed ; Tuberculosis* ; Tuberculosis, Central Nervous System