In order to obtain novel genes for craniofacial development of human, molecular cloning and sequencing were performed and followed by in situ hybridization in tissue sections. Subtracted cDNA library of craniofacial tissue from 8 weeks old human embryo was made by the subtraction with cDNA of RHEK cells. A total of 231 clones were obtained and their partial sequence data disclosed that 214 clones were nonredundant in Genebank search. We have done in situ hybridization screening on the craniofacial sections of a 10 weeks old human fetus, and found significant positive reaction in 30 clones. Depending on the cell type of similar developmental origin, the positive reactions could be divided into four groups: first group showed an intense positive reaction in neural tube, ganglion, and a part of peripheral nerve tissue, second group relatively diffuse positive reaction in neural tube, cartilage, epithelium, and muscle, third group localized positive reaction in nerve, and muscle, and fourth group positive reaction in almost all kinds of cells of craniofacial tissues. Although every clone showed different expression patterns in the craniofacial development, some of them showed intense mRNA expressions in the characteristic cell type. Because this study also aimed to test a screening methods to find out novel genes related to craniofacial development by the subtracted cDNA library and in situ hybridization, the intense positive reaction of a certain clone by in situ hybridization may indicate its role in the developmental processes. We presumed that 30 clones selected in this study are possibly important new genes for the development of human craniofacial structure.
Cartilage ; Clone Cells ; Cloning, Molecular* ; DNA, Complementary ; Embryonic Structures* ; Epithelium ; Fetus ; Ganglion Cysts ; Gene Library ; Humans* ; In Situ Hybridization ; Mass Screening ; Neural Tube ; Peripheral Nerves ; RNA, Messenger

Carcinoid tumors are the most common endocrine tumors of gastrointestinal tract. Argentaffin cells are the origin of carcinoids. These cells belong to the amino precursor uptake and decarboxylation (APUD) system. These cells give the tumor its most distinguishing feature: the ability to produce biogenic amines and polypeptide hormones that, in turn, give rise to the dramatic carcinoid syndrome. We treated a case of multi-centric carcinoid tumor of the duodenum in a 63-year-old male patient. He was admitted to the hospital because of epigastric pain. On the gastrofiberscopic examination, 1.0 x1.5 cm and 0.7 x0.8 cm sized two polyps (Yamada type II, I) were noticed on the duodenal bulb. The biopsy specimen showed carcinoid tumors of different histologic types. The level of 24-hour urine 5-HIAA of this case was normal. He was treated with subtotal gastrectomy with Billroth-II anastomosis. We report this case with literature review.
Biogenic Amines ; Biopsy ; Carcinoid Tumor* ; Decarboxylation ; Duodenum ; Enterochromaffin Cells ; Gastrectomy ; Gastrointestinal Tract ; Humans ; Hydroxyindoleacetic Acid ; Male ; Middle Aged ; Peptide Hormones ; Polyps

No abstract available.
Behcet Syndrome* ; Renal Insufficiency*

A 73-year-old man was scheduled for the surgical reduction of fractured femur which occurred ar 3 months ago by the accident. The mental status of the patient was stuporous (Glasgow coma scale: 5) due to the complication of the head trauma. We performed nerve blocks (femoral, sciatic, lateral femoral cutaneous, and illiohypogastric nerve blocks) for the surgical reduction of left femur with 55 ml of 0.25% ropivacaine. The electroencephalography was monitored continuously during the 4 hour operation as well as monitoring the hemodynamic and respiratory parameters. The operation was performed successfully and the patient recovered uneventfully.
Aged ; Coma ; Craniocerebral Trauma ; Electroencephalography ; Femur ; Hemodynamics ; Humans ; Lower Extremity* ; Nerve Block* ; Stupor

PURPOSE: To analyze the clinical results in an ACL reconstruction according to the amount of the tibial remnant of the ACL using a hamstring graft and looped sutures. MATERIALS AND METHODS: Sixteen patients who were followed up for at least 12 months after the ACL reconstruction with four strands of a hamstring tendon using a looped suture technique were enrolled in this study. The average follow-up was 35.1 months. At the last follow-up period, the patients were evaluated using the International Knee Documentation Committee (IKDC) scale and the HSS score, Lachman test, ant. drawer test, KT-1000, one-leg hoop test and proprioceptive function test (motion and position sense). They were then divided two groups according to whether they had more or less than 30% of the ACL remaining. The final results of the two groups were statistically compared. RESULTS: Average HSS score improved from 65.8 (preoperative) to 95.2 (last follow-up). No significant differences in functional outcome and mechanical stability were found except for proprioception. Regarding the threshold of the detection of the passive motion test at 30 degrees (p=0.030) and the reproduction of the passive positioning test at 15 degrees (p=0.032) and 30 degrees (p=0.024), the more remnant preserved group (>30%) showed better results than the less preserved group. CONCLUSION: Preserving the tibial remnant will preserve function of the mechanoreceptors and be helpful to the recovery of the function and healing of a graft after surgery.
Ants ; Follow-Up Studies ; Humans ; Knee ; Mechanoreceptors ; Proprioception ; Reproduction ; Suture Techniques ; Sutures ; Tendons ; Transplants*

Henoch-Shonlein(H-S) purpura, or anaphylactoid purpura is a hypersensitivity vasculitis characterized by palpable purpura usually on buttock and low extremities; arthralgia mostly polyarhtralgia in the absence of frank arthritis; gastraintestinal involvement with colicky abdominal pain, nausea, vomiting, diarrhea, constipation and bleeding; and renal involvement, manifested chiefly by hematuria and proteinuria. Gastrointestinal involvement is seen in 70 percent of pediatric patients and one third of adult patients. Any portion of the gastrointestinal tract distal to the esophagus maybe involved, but most frequently affected sites are jejunum and ileum. We report one case of H-S purpura with duodenal involvement observed in 16, male patient.
Abdominal Pain ; Adult ; Arthralgia ; Arthritis ; Buttocks ; Constipation ; Diarrhea ; Esophagus ; Extremities ; Gastrointestinal Tract ; Hematuria ; Hemorrhage ; Humans ; Ileum ; Jejunum ; Male ; Nausea ; Proteinuria ; Purpura* ; Purpura, Schoenlein-Henoch ; Vasculitis, Leukocytoclastic, Cutaneous ; Vomiting

OBJECTIVES: Hemifacial spasm is painless uncommon disorder characterized by involuntary paroxysmal movement on one side of face. It is known that hemifacial spasm is mainly due to pulsatile compression by vessels at the root exit zone(REZ) of the facial nerve. Microvascular decompression at REZ of the facial nerve has become the standard treatment modality for hemifacial spasm. The authors have analized patients with hemifacial spasm treated with microvascular decompression to evaluate operation result and clinical course after operation. PATIENTS AND METHODS:From 1992 to 1999, 41 patients with hemifacial spasm underwent this operation. Retrospective analysis of operation results and clinical recovery patterns was done. The length of observation had been more than 6 months in all cases. RESULTS: The ratio of male to female was 1: 1.4, and age at operation ranged from 24 to 66 years. Their mean age was 47.6 years and the mean preoperative duration of symptoms was 7.2 years. Most common offending vessels were AICA in 18 cases(48%) and second most common were PICA in 13 cases(31.7%). The rest of them were 3 case in vertebral artery, and 7 cases(13%) in multiple offending vessels. Patterns of improvement after surgery could be divided into 4 clinical types. There was complete recovery in 3 days after operation in 24 cases(58.6%, Immediate complete recovery). There was complete recovery in 3 days after operation, and symptom was recurred partially, which was gradually subsided in 2 weeks after operation in 4 cases(9.8%, Delayed complete recovery type I). There was partial recovery after operation and symptom was compretely disappeared gradually in 6 months after operation in 7 cases(17.1%, Delayed complete recovery type II). Finally, there was partial recovery after operation, and symptom was somewhat remained after 6 months later(14.5%, Delayed partial recovery). CONCLUSION: In conclusion, microvascular decompression for hemifacial spasm is a safe and reliable treatment modality with good results of improvement and there are 4 recovery patterns in clinical course after operation in our series. Therefore, follow-up observation after microvascular decompression is necessary to evaluate the operative results and complication, especially in the delayed resolved cases.
Facial Nerve ; Female ; Follow-Up Studies ; Hemifacial Spasm* ; Humans ; Male ; Microvascular Decompression Surgery* ; Pica ; Retrospective Studies ; Vertebral Artery

BACKGROUND: A practical RNA in situ hybridization method using digoxigenin labeled RNA probes is described in order to evaluate the technical difficulties and problems in RNA in situ hybridization. METHODS: The paraffin sections, routinely processed in the Pathology Laboratory, were tested for the possibility of RNA in situ hybridization instead of the RNase free paraffin sections, fixed in 4% paraformaldehyde and prepared using RNase protection procedures. RESULTS: Most of the paraffin sections, fixed in 10% neutral formalin solution in fresh condition, showed relatively good reaction of RNA in situ hybridization, although the necrotic tissue and autopsy specimens showed poor reaction of RNA in situ hybridization. A refixation procedure using a 4% paraformaldehyde solution was evaluated for optimal expression of mRNA in the paraffin sections. CONCLUSION: The treatment of 4% paraformaldehyde before the treatment of proteinase K showed better in situ hybridization than did the treatment of 4% paraformaldehyde after the treatment of proteinase K. Also a new Polymerase Chain Reaction (PCR)-based method of RNA probe production showed consistently good results.
Autopsy ; Digoxigenin* ; Endopeptidase K ; Formaldehyde ; In Situ Hybridization* ; Paraffin ; Pathology ; Polymerase Chain Reaction ; Ribonucleases ; RNA Probes ; RNA* ; RNA, Messenger

OBJECTIVES: To survey the incidence and risk factors of dementia on a rural elderly cohort. METHODS: Two follow-up studies in 2000 and 2003 were done on 966 non-demented elderly residents who participated in 1st wave in 1996. A two-phase study was conducted using the Korean version of Psychogeriatric Assessment Scale in phase I and the diagnostic interview according to DSM-III R criteria by psychiatrists in stage II. RESULTS: Of the 966 elderly residents who had not dementia in 1996 prevalence study, 592 residents in 2nd wave and 508 residents in 3rd wave completed the incidence study. Dementia was incident in 96 residents. The annual incidence rates per 1000 persons were 27.2 (CI:22.2-33.2). Annual incidence rates were rapidly raised from 10.6 (CI:5.3-21.2) in the age range 65-69 years to 88.9 (CI:55.3-143) in the age range 85+. Older age was a risk factor of dementia (p<0.05), and Education was a preventive factor of dementia (p<0.001). But, female, history of depression, alcohol use history and tobacco use history were not risk factors. CONCLUSION: The annual incidence rates in Korea were higher than those of other countries. High percentage of no educated person (58.8%) in this community may be related to the higher incidence rates. Weighting to sex and age in normal elderly population in Korea at 2003, The annual incidence rates of dementia per 1000 persons were 25.2, and the numbers of newly incident elderly persons every year were approximately hundred thousand.
Aged ; Cohort Studies ; Cross-Sectional Studies ; Dementia* ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Female ; Follow-Up Studies ; Humans ; Incidence* ; Korea ; Psychiatry ; Risk Factors* ; Tobacco Use

PURPOSE: To compare differences in overall satisfaction with emergency department (ED) services with the results obtained 10 years previously, in order to study effects of several component factors on patients' willingness to re-visit and to give recommendations. METHODS: This study was performed with questionnaires from 318 patients and proxies who were admitted to the emergency ward through the emergency medical center from February 19th, 2007 to March 18th, 2007. Evaluation of data was by frequency analysis, chi-square test, t-test, multiple regression analysis, and path analysis. RESULTS: During a one month study period, 244 patients and proxies (77% of those eligible) completed on-site questionnaires. Sociodemographic factors had no statistically significant influence on satisfaction with ED services. In multiple regression analysis to evaluate the correlation of various factors with satisfaction, the regression coefficients were 0.435(p<0.001) for reliability, 0.248(p<0.001) for accessibility, 0.179(p<0.001) for kindness, and 0.133 (p=0.004) for environmental respectively. In path analysis, the direct effect of overall satisfaction on patient willingness for re-visit was 0.582. The direct effect of overall satisfaction reliability on willingness to give recommendations were 0.594, and 0.250 respectively. CONCLUSION: In slight contrast to the study performed 10 years previously, the factors with the most correlation to overall satisfaction with ED services in this study were environment, kindness of hospital personnel, accessibility, and reliability of medical personnel. We confirmed that overall satisfaction is the most important factor influencing willingness for re-visit and willingness to recommend services, but found that the component factors vary as the point of survey or hospital conditions changes.
Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Personal Satisfaction ; Personnel, Hospital ; Proxy ; Surveys and Questionnaires