The paroxysmal kinesigenic choreoathetosis is characterized by choreathetoic, dystonic and/or tonic movements induced by sudden voluntary movements, without loss of consciousness, urinary incontinence and clonic movement. These attacks begin in childhood, and are occasionally familial. The response to anticonvulsants is usually excellent. We present 4 cases of paroxysmal kinesigenic choreoathetosis with a brief review of literature, which is believed to be the first report in Korea.
Anticonvulsants ; Korea ; Unconsciousness ; Urinary Incontinence

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

No abstract available.

The glucose uptake rate by Fasciola hepatica was a mean value of 9.62 +/- 0.54 micro-mole/hr/g, and total CO(2) production rate by the flukes averaged 24.28 +/- 4.26 micro-mole/hr/g wet wt. The relative specific activity of respiratory CO(2) showed a mean value of 79.89 +/- 1.78 per cent. The rate of CO(2) production derived from medium C(14)-glucose was a mean of 19.55 +/- 3.56 micro-mole/hr/g of we wt. Therefore, the average value of 32.72 +/- 4.8 percent of glucose utilized by the flukes from the medium C(14)-glucose was oxidized to respiratory CO(2). The tissue concentration of glycogen in F. hepatica was a mean of 38.36 +/- 2.91 mg/g or 3.84 +/- 0.29 %/g of wet wt, and the turnover rate of glycogen pool was a mean of 1.6+/-0.22 %/hr or 0.65 +/- 0.13 mg/hr/g. The average value of 37.26 +/- 3.86 per cent of glucose utilized by the fluke from the medium C(4)-glucose was incorporated to the glycogen. These data account for that approximately 70 per cent of the utilized glucose by the flukes participated in furnishing the oxidation into respiratory CO(2) and the synthetic process into glycogen.
parasitology-helminth-trematoda-Fasciola hepatica ; glucose ; biochemistry ; autoradiograhy ; glycogen ; CO(2)

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.

Spontaneous hemo-pneumothorax, a hemothorax that occurs without trauma, is a very rare condition; however, as a result of excessive bleeding, it can be lethal. Also, if the bleeding is scanty, the physician might recognize hemothorax in case of performing invasive procedures, such as chest tube insertion, and may misunder stand as a complication of the procedure. For this reason, acknowledgement of the spontaneous hemo-pneumothorax in the emergency department is very important. We report on a case of a spontaneous hemo-pneumothorax in a healthy 18-year-old male presenting with chest pain who developed a spontaneous pneumothorax with a profuse amount of hemothorax.
Chest Pain ; Chest Tubes ; Emergencies ; Hemorrhage ; Hemothorax ; Humans ; Male ; Pneumothorax

PURPOSE: Recently, the incidence of malignant melanoma has been steadily increasing. Malignant melanoma is already known to have poorer prognosis than other primary skin cancers. Despite the poor prognosis, it is relatively less known to the public so that a number of patients visit hospital carrying advanced stage tumor. Yet, extensive study about malignant melanoma is currently insufficient, and specific guidelines and statistical figures in Korea are almost inexistent. Therefore, authors reviewed patients with malignant melanoma who have visited our hospital for last 14 years. METHODS: Between January 1994 and January 2008, 62 patients were diagnosed with malignant melanoma at our hospital. A retrospective study was performed with data from patients' charts and biopsy results. Annual incidence, mean age of onset, gender, tumor location, tumor thickness, pathologic ulceration, clinicopathologic subtype, and clinical AJCC stage were evaluated. Analysis of factors associated with survival were performed using the Cox proportional hazard model. Kaplan-Meier method was used to generate survival curves. RESULTS: Clinicopathologic features of 62 patients (32 male, 30 female) with average age of 57 years were evaluated. Most lesions were found in lower limb, and the most common subtype was acral lentiginous melanoma. We could also find that age, tumor thickness, and clinical stage were the only significant prognostic factors. CONCLUSION: Clinicopathologic features of malignant melanoma were analyzed in this study, but the result is not ready to be generalized because of the limited number of cases. Further study must be performed to report clinical guidelines for prognosis and treatment for malignant melanoma patients in Korea.
Age of Onset ; Biopsy ; Humans ; Incidence ; Korea ; Lifting ; Lower Extremity ; Male ; Melanoma ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Skin Neoplasms ; Survival Rate ; Ulcer

OBJECTIVE: To evaluate the usefulness of alendronate for prevention and treatment of postmenopausal osteoporosis this study was taken. METHODS: This prospective randomized clinical trial examined the effects of oral alendronate and HRT(conjugated estrogen plus medroxyprogesterone acetate), in combination and seperately, on BMD, biochemical markers of bone turnover in 79 women with low bone mass. Treatment included alendronate(10mg daily) plus HRT(group I, n=38), or HRT(group II, n=41) for 6 months. Bone density measurements were performed at months 0 and 6 at the lumbar spine. Biochemical markers of bone turnover were also measured every three months. RESULTS: Serum Osteocalcin decreased by 19.2% in group I and by 10.0% in group II at 3 months(p<0.05), and by 30.9% in group I and by 19.8% in group II at 6 months(p<0.05). Urinary deoxypyridinoline showed decrease of 19.75%(I) vs. 10.4%(II) at 3 months, 30.1%(I) vs. 20.7%(II) at 6 months, the difference was significant. Percent change of BMD measurements from baseline at 6 months in group I was 6.2% and in group II 0.6% on the lumbar spine(p<0.05). CONCLUSION: The treatment with alendronate is useful to postmenopausal women with osteoporosis by decreasing bone turnover markers, and by increasing the BMD.
Alendronate* ; Biomarkers ; Bone Density ; Estrogens ; Female ; Humans ; Medroxyprogesterone ; Osteocalcin ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Prospective Studies ; Spine

OBJETIVE: To investigate the efficacy of high infusion frequency of liquid nitrogen on pregnancy in human embryo after freezing and thawing. MATERIALS AND METHODS:: 150 infertile patients underwent 162 consecutive thawing-ET cycles. In the high infusion frequency group (Group A), 47 patients (50 cycles) underwent cryopreservation with high infusion frequency of liquid nitrogen. In the low infusion frequency group (Group B), 103 patients (112 cycles) underwent cryopreservation with low infusion frequency of liquid nitrogen. We analyzed the clinical characteristics, fertilization rates, development of embryo, good quality embryo ratio, implantation rates, and pregnancy rates between these two groups. RESULTS: There was no difference between the groups with regard to clinical characteristics (mean age, infertility duration, infertility factors, hormone profile), mean number of oocyte retrieval, fertilization rates, and mean embryo number of transfers. The survival rates in group A was 64.9% (228 of 350 embryos), and among the 228 embryos 190 embryos (83.3%) which progressed to the two- to eight-cell stage. After thawing, the embryo numbers were 65 (34.2%), 29 (15.3%), 35 (18.4%), and 37 (19.5%) of grades 1, 2, 3, and above 4, respectively. The survival rates in group B was 63.8% (482 of 755 embryos), and among the 482 embryos 465 embryos (96.5%) which progressed to the two- to eight-cell stage. After thawing, the embryo numbers were 106 (22.8%), 94 (20.2%), 89 (19.1%), and 112 (24.1%) of grades 1, 2, 3, and above 4, respectively. There was no difference in embryo quality change after the freezing-thawing procedure between the groups. Implantation rates (31.1% vs. 34.3%) were not significant. However hCG positive rates in group A (40%) were higher than group B, but not statistically significant. Clinical pregnancy rate (26% vs. 25.9%), on going pregnancy rates (>20 weeks) were not significant (26% vs. 25%). CONCLUSION: We compared embryo quality change, survival rates, and pregnancy rates between high infusion frequency group and low infusion frequency group and the results were similar between the two groups. Therefore, high infusion frequency of liquid nitrogen for cryopreservation is a worthy method to preserve in human embryos.
Cryopreservation ; Embryonic Development* ; Embryonic Structures* ; Female ; Fertilization ; Freezing* ; Humans* ; Infertility ; Nitrogen* ; Oocyte Retrieval ; Pregnancy ; Pregnancy Rate* ; Pregnancy* ; Survival Rate

PURPOSE: We wanted to determine the multidetector computed tomography (MDCT) findings for differentiating benign ulcers from malignant ones. MATERIALS AND METHODS: 18 clinicopathologically proven benign ulcers that had been detected by both endoscopy and MDCT were the focus of this study. 26 ulcerative advanced gastric cancers and 26 early gastric cancers with ulceration, all of which had been surgically proven, were selected as a control group. Five of the 26 early gastric cancers that were confined to the mucosa and that were not detected on CT were excluded in this study. The following CT findings were reviewed by two radiologists; ulcer size, the degree of enhancement and the thickness of inner enhancing layer in the ulcer base, the total thickness and the enhancing inner layer thickness in the largest part of the thickened ulcer mound, the presence of ulcer that projected beyond the healthy lumen, and the presence of perigastric fat infiltration and perigastric lymphadenopathy. RESULTS: An indiscernible thin-walled ulcer base (less than 1.5 mm) and suboptimal enhancement of the ulcer base for the discrimination of benign gastric ulcers from the malignant gastric ulcers showed sensitivities of 100% (18/18) and 78% (14/18), respectively, with specificities of 98% (46/47) and 92% (43/47), respectively. Ulcer projection was more significantly present in benign ulcer (13/18, 72%) than in the malignant gastric ulcers (7/47, 15%). The enhancing inner layer thickness in the ulcer mound was significantly greater in the AGC (mean: 7.4 mm) than in the benign gastric ulcers (mean, 2.2 mm). There were insignificant differences for ulcer size, total thickness of the ulcer mound, the perigastric fat infiltration and perigastric lymphadenopathy between the benign and malignant gastric ulcers. CONCLUSION: MDCT is an additional helpful diagnostic tool when benign gastric ulcers are histologically difficult to distinguish from malignant gastric ones.
Discrimination (Psychology) ; Endoscopy ; Lymphatic Diseases ; Mucous Membrane ; Multidetector Computed Tomography ; Stomach Neoplasms ; Stomach Ulcer ; Stomach* ; Ulcer*