STUDY DESIGN: A case of brain infarction due to occlusion of vertebral artery after cervical spine fracture is reported. OBJECTIVES: Documentation of possibility and clinical significances of brain infarction as one of grave complications after cervical spine injury. SUMMARY OF LITERATURE REVIEW: Occlusion of vertebral artery and consequent brain infarction can be associated with cervical spine injuries because vertebral arteries course through the transverse foramina from sixth to second corvical vertebrae. Infarction of vertebrobasilar system may cause impairment of cerebral, cerebellar, or brain stem function and can occasionally bring grave functional loss, even death. MATERIALS AND METHODS: A case of occlusion of vertebral artery and consequent cerebral infarction after cervical spine fracture in a 66 year-old man. Brain CT and angiogram were performed. He was managed with anticoagulants. RESULTS: Neurologic deficits from brain infarction disappeared after 2 weeks. CONCLUSIONS: Attention to the possibility of these complications and awareness of their clinical features seem to be mandatory in managing cervical spine injury patients.
Aged ; Anticoagulants ; Brain ; Brain Infarction ; Brain Stem ; Cerebral Infarction* ; Humans ; Infarction ; Neurologic Manifestations ; Spine* ; Vertebral Artery*

The authors preEented the 6th human thelaziasis case in Korea with the review of the literatures. The patient was 18 years old high-school girl who had lived in Seoul since birth. She experienced epiphora and moving foreign body Eensation of the right eye since one week prior to examination, and extracted 2 living worms from the right eye by herEelf on 1 and 2 days prior to examination. Morphological features of an extracted worm are as follows; Gross appearance of the worm is slender milky, white nematode, and microscopic measurements are 12.51mm in length. 0.34mm in maximum width, 15.5micro in depth of oral cavity, 0.667mm in length of the esophagus, 180~220 cuticular striations per mm, anal-opening on 0.088 mm from posterior end, and vulvar-opening on 0.544mm from anterior end. From the above findings it was confirmed as female worm of Thelazia callipaeda Railliet and Henry 1910.
Adolescent ; Esophagus ; Female ; Foreign Bodies ; Humans* ; Korea ; Lacrimal Apparatus Diseases ; Mouth ; Parturition ; Seoul ; Thelazioidea

PURPOSE: To assess the impact of physical characteristics on the incidence of varicoceles. Although previous reports have alluded to the fact that taller individuals may have a higher incidence of varicoceles, this has not been systematically studied. We hypothesized that physical characteristics such as height and weight could have a significant impact on the incidence of varicoceles. MATERIALS AND METHODS: We retrospectively reviewed charts of 145 patients who presented for evaluation of varicocele between 2000~2005. Each patients' age, symptoms, height, weight and body mass index (BMI) were recorded. Independent t-tests were performed to determine whether a correlation existed between presence of a varicocele and height, weight, or BMI. Moreover, we selected 90 patients whose varicocele was detected by pain and performed the same analysis in order to exclude selection bias. Additionally, we compared varicocele grade with height, weight and BMI by one-way ANOVA test. RESULTS: Our analysis showed that there was no association between height and the presence of a varicocele. However, the weight of the patient and the incidence of varicocele approached significance with greater weight associated with a lower incidence of varicoceles. There was also an association between BMI and the presence of varicoceles but the correlation did not depended on varicocele grade. CONCLUSIONS: Although previous reports have alluded to a higher incidence of varicoceles in taller patients, the current study found no correlation between height and the presence of a varicocele. Increased weight, however, was associated with a significantly lower incidence of varicoceles. Varicocele grade was not correlated with any factor. This study demonstrates that height is not a consideration when evaluating the infertile male, whereas weight may affect the ability to diagnose the varicocele.
Body Height ; Body Mass Index ; Humans ; Incidence ; Male ; Retrospective Studies ; Selection Bias ; Varicocele*

PURPOSE: The prostate of the young adult is not a subject which has received much attention, and the vast majority of prostate studies have placed their emphasis predominantly on elderly patients. It seems, then, that an investigation of the prostate in younger patients is warranted, and perhaps long past due. Thus, we attempted to determine the mean prostate volume in Koreans in their 20's. We also reported on the relationships between prostate size and body mass index, as well as body surface area, and compared the prostates of normal Korean youths with those of chronic prostatitis patients. MATERIALS AND METHODS: Between March 2002 and February 2008, we chronicled 583 cases of transrectal ultrasonography(control group: 271, chronic prostatitis group: 314) and calculated prostate volumes via the biplane method. 178 of the cases in the chronic prostatitis group were again examined after treatment. In all of the cases, body mass index and body surface area were assessed. RESULTS: The mean age of the patient was 22.83+/-2.46 years. The mean prostate volume of the 583 young adults was 15.58+/-3.11ml(control group: 15.61+/-3.16ml, chronic prostatitis group: 15.56+/-3.07ml). We ensured that there were no differences between the normal group and the chronic prostatitis group. The prostate volumes of the chronic prostatitis patients made no odds with the treated prostates. Additionally, prostate volume was directly proportional to the body mass index and the body surface area. CONCLUSIONS: The prostate volume of young Korean adults in their 20's was approximately 15.6ml. The development of chronic prostatitis in young men had no appreciable effect on prostate size, but was shown to induce a variety of histologic changes in the prostate, and these changes were similar to those observed in older patients.
Adolescent ; Adult ; Aged ; Body Mass Index ; Body Surface Area ; Humans ; Male ; Prostate ; Prostatitis ; Young Adult

Blepharoplasty is a commonly performed aesthetic surgery, but there is still no commonly used standard method for the correction of orbital fat bulging in lower blepharoplasty. We performed dual plane method by elevating skin flap and muscle flap separately, and then repositioned orbital fat with preserving orbital septum for correction of orbital fat bulging in lower blepharoplasty. Between July, 1998 and June, 2005, one hundred and fifty six patients underwent lower blepharoplasty by author's method. The results were satisfactory in all of the patients. Complications were six cases of hematoma and ten cases of visible scar in lateral canthal area. There was no skin flap necrosis, hyperpigmentation, skin irregularity or ectropion. In lower blepharoplasty for the sufficient excision of skin and operation of orbicularis oculi, we performed precise correction of skin and muscle independently by dual plane approach, by separate elevation of skin flap and muscle flap, and were able to reposition orbital fat easily and safely with preservation of orbital septum.
Blepharoplasty* ; Cicatrix ; Ectropion ; Hematoma ; Humans ; Hyperpigmentation ; Necrosis ; Orbit* ; Skin

BACKGROUND: There has been proposing reports that the autonomic nervous system (ANS) is involved in the pathophysiological mechanism of migraine. However, previous reports suggesting ANS dysfunction during migraine attack was not consistent and were focused mainly on comparison between migraine patients in interictal period and normal controls. The current study is designed to evaluate quantitative evidence of ANS dysfunction by comparing patients in ictal period with those in interictal period. METHODS: We prospectively included 30 migraineurs in ictal period and 30 migraineurs in interictal period from August 2008 to August 2009. Sympathetic function was evaluated by blood pressure response to standing and isometric exercise. Parasympathetic function was evaluated by heart rate response to deep breathing, standing and the Valsalva maneuver. RESULTS: In orthostatic test, falling of systolic blood pressure (SBP) after standing was prominent in ictal group. Although both groups showed elevation of diastolic blood pressure (DBP) after standing, the change was smaller in ictal group than intercital group. Elevation of DBP after isometric exercise was lower in ictal group without statistical significance. Results of parasympathetic function test were not significantly different between ictal and interictal patients. CONCLUSIONS: This study suggests that subjects with migraine had sympathetic hypofunction during migraine attack.
Autonomic Nervous System ; Blood Pressure ; Exercise ; Heart Rate ; Humans ; Migraine Disorders ; Prospective Studies ; Respiration

OBJECTIVE: This study was performed to evaluate the possibility of prolonged culture of human embryonic stem cells (hESC; SNUhES2) on human amniotic fluid cells (hAFC), which had been storaged after karyotyping. METHOD: The hAFC was prepared for feeder layer in the presence of Chang's medium and STO medium (90% DMEM, 10% FBS) at 37degrees C in a 5% CO2 in air atmosphere. Prior to use as a feeder layer, hAFC was mitotically inactivated by mitomycin C. The hESCs on hAFC were passaged mechanically every seven days with ES culture medium (80% DMEM/F12, 20% SR, bFGF). RESULTS: The hAFC feeder layer support the growth of undifferentiated state of SNUhES2 for at least 59 passages thus far. SNUhES2 colonies on hAFC feeder appeared slightly angular and flatter shape as compared with circular and thicker colonies observed with STO feeder layer and showed higher level with complete undifferentiation in seven days. Like hESC cultured on STO feeders, SNUhES2 grown on hAFC expressed normal karyotype, positive for alkaline phosphatase activity, high telomerase activity, Oct-4, SSEA-3, SSEA-4, Tra-1-60 and Tra-1-81 and formed embryoid bodies (EBs). CONCLUSION: The hAFC supports undifferentiated growth of hESC. Therefore, these results may help to provide a clinically practicable method for expansion of hESC for cell therapies.
Alkaline Phosphatase ; Amniotic Fluid* ; Atmosphere ; Embryoid Bodies ; Embryonic Stem Cells* ; Feeder Cells ; Female ; Humans* ; Karyotype ; Karyotyping ; Mitomycin ; Telomerase

PURPOSE: The human fetus is primarily dependent on the placenta for its nutrition. However, as the fetus matures, it swallows increasing amounts of amniotic fluid, which contributes to the growth of fetus. Accordingly fetuses with congenital obstruction of the gut at high level have a reduced capacity for intestinal absorption of amniotic fluid. We undertook a study to investigate the effect of congenital gut obstruction on fetal growth. METHOD: A retrospective review of the records of all patients presenting congenital gut obstruction over 6-year period (from 1992 to 1997) in Chung-ang Gil hospital was performed. Patients with a complete proximal obstruction were included in group A; patients with incomplete or lower obstruction were included in group B. RESULT: 1) The ratio of male to female was 1.5:1. The mean birth weight and gestational age were 2.89+/-0.60kg and 38.7+/-0.20weeks. The mean birth weight and gestational age in group A were 2.68+/-0.69kg and 37.8+/-0.25weeks. The mean birth weight and gesnal age in group B were 2.980.54kg and 39.1+0.17weeks. There was significant difference between group A and B (P<0.01). 2) Significant differences were found between group A and B in prematurity and growth retardation rate (P<0.01). No significant difference was found between group A and B in associated anomaly rate (P>0.05). 3) In group A, 3 (42.8%) of 7 patients with associated anomalies had IUGR, whereas 8 (40.0%) of 20 patients without associated anomalies had IUGR (P>0.05). The corresponding figures for group B were 23.0% and 14.8%, respectively (P>0.05). CONCLUSION: Congenital gut obstruction causes IUGR by reducing intestinal absorption of amniotic fluid and the effect of IUGR is more pronounced as the obstruction is proximal to jejunum rather than distal to it.
Amniotic Fluid ; Birth Weight ; Female ; Fetal Development* ; Fetal Growth Retardation ; Fetus ; Gestational Age ; Humans ; Intestinal Absorption ; Jejunum ; Male ; Placenta ; Retrospective Studies ; Swallows

BACKGROUND: Bacteria of the Mycobacterium abscessus group are the second most common pathogens responsible for lung disease caused by nontuberculous mycobacteria in Korea. There is still a lack of studies investigating the genetic mechanisms involved in M. abscessus resistance to antibiotics other than clarithromycin. This study investigated the characteristics of drug resistance exhibited by M. abscessus clinical isolates from Korea. METHODS: We performed drug susceptibility testing for a total of 404 M. abscessus clinical strains. Subspecies were differentiated by molecular biological methods and examined for mutations in drug resistance-related genes. RESULTS: Of the 404 strains examined, 202 (50.00%), 199 (49.26%), and 3 (0.74%) strains were identified as M. abscessus, M. massiliense, and M. bolletii, respectively. Of the 152 clarithromycin-resistant strains, 6 possessed rrl mutations, while 4 of the 30 amikacin-resistant strains contained rrs mutations, and 5 of the 114 quinolone-resistant strains had gyr mutations. All mutant strains had high minimal inhibitory concentration values for the antibiotics. CONCLUSIONS: Our results showed the distribution of the strains with mutations in drug resistance-related genes was low in the M. abscessus group. Furthermore, we performed drug susceptibility testing and sequence analyses to determine the characteristics of these genes in the M. abscessus group.
Anti-Bacterial Agents/pharmacology ; Bacterial Proteins/genetics ; Clarithromycin/pharmacology ; DNA Gyrase/genetics ; *Drug Resistance, Bacterial ; Humans ; Methyltransferases/genetics ; Microbial Sensitivity Tests ; Mutation ; Mycobacterium/drug effects/*isolation & purification ; Mycobacterium Infections, Nontuberculous/diagnosis/*microbiology ; Republic of Korea ; Sequence Analysis, DNA

PURPOSE: Cyclooxygenase-2 (Cox-2) is the rate-limiting enzyme in the conversion of arachidonic acid to prostaglandins and can be induced by various agents such as growth factors and tumor promoters. Cox-2 contributes to carcinogenesis and tumor growth. This study was performed to demonstrate the correlation between elevated expression of Cox-2 and pathologic factors in breast cancer. METHODS: Cox-2 expression was analyzed immunohistochemically in paraffin-embedded tumor samples from 40 patients with breast cancer. Cox-2 expression was defined as negative or positive. The correlation between Cox-2 expression and pathologic factors (tumor size, axillary lymph node metastasis, TNM stage and histologic grade) was analyzed. RESULTS: Cox-2 was highly expressed in proportion to tumor size, but the difference was not significant (P>0.05). High Cox-2 expression was observed in the presence of axillary lymph node metastasis and TNM stage III, but was not significant (P>0.05). The Cox-2 expression rate was significantly associated with high histologic grade (I: 42.9%, II: 50.0%, III: 80.0%) (P=0.046). CONCLUSION: Elevated levels of Cox-2 expression were associated with large tumor size, presence of axillary lymph node metastasis, high TNM stage and high histologic grade, and can therefore be a possible marker for poor prognosis. Due to the small number of cases, we couldn't confirm the statistical significance except in terms of histologic grade. Further prospective studies with a large number of cases are required.
Arachidonic Acid ; Breast Neoplasms* ; Carcinogenesis ; Carcinogens ; Cyclooxygenase 2* ; Humans ; Intercellular Signaling Peptides and Proteins ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Prostaglandins