Cricopharyngeal incoordination of infancy is a rare disease, characterized by difficult swallowing soon after birth. regurgitation, frequent choking and aspiration with deglutition, recurrent aspiration pneumonia, and to-and-fro movement of the contrast medium in the posterior pharynx on upper esophageal cineroentgenography. Clinical investigation was performed in the infants who were admitted due to difficult swallowing, regurgitation, and recurrent pneumonia from March 1, 1989 to June 30, 1992. The results were as follows: 1) Male to female sex ratio was great, and major symptoms such as difficult swallowing, regurgitation, choking and aspiration with deglutition, and those of pneumonia developed soon after birth in most cases. 2) The typical findings of this disease were noted on the cineroentgenography of upper esophagus in all cases and those of aspiration pneumonia in 10 cases. 3) The infants had been fed via gavage tube until they were able to swallow without difficulties before and after 6 months after birth. 4) Cricopharyngeal incoordination is a rare disease, but we suggest this disease should be considered in differential diagnosis in the infants with difficult swallowing soon after birth and recurrent episodes of aspiration pneumonia.
Airway Obstruction ; Ataxia* ; Deglutition ; Diagnosis, Differential ; Esophagus ; Female ; Humans ; Infant ; Male ; Parturition ; Pharynx ; Pneumonia ; Pneumonia, Aspiration ; Rare Diseases ; Sex Ratio

Purpose: To evaluate the risk factors for the development of osteonecrosis in civilian professional divers by an epidemiologic study and to determine the correlation between osteonecrosis in divers and coagulopathy by analysis of serologic markers that are related to thrombophilia and hypofibrinolysis. Materials and Methods: Forty-two divers, who collected pen shells (Atrina pinnata), and among whom 10 had osteonecrosis (group 1), were compared with 32 divers without osteonecrosis (group 2). Both groups were evaluated based on the number of years of diving experience, number of dives per year, mean number of dives per day, mean diving time and depth, and diving methods. We determined any statistically significant differences among these variables. We measured the levels of serologic markers that were related to hyperlipidemia, thrombophilia, and hypofibrinolysis from the divers and a control group of 20 physicians (group 3). The levels of the serologic markers were compared between groups 1 and 2 and between the divers and the control group, in order to determine the relationship between the serologic markers and the development of dysbaric osteonecrosis. Results: None of the variables demonstrated any statistically significant differences, except for the mean diving time, in which group 1 had a mean diving time of 124 minutes and group 2 had a mean diving time of 62.1 minutes (P<0.05). In the analysis of the serologic markers, there were no statistically significant differences between groups 1 and 2; however, in comparison with the group 3, the divers demonstrated significantly decreased activity levels of proteins C and S (Protein C: P<0.05; Protein S: P<0.05), and an increase in the levels of plasminogen activator inhibitor-1 (PAI-1) (P<0.05). Conclusion: The divers with osteonecrosis had a longer mean diving time than did those divers without osteonecrosis. In the serologic marker analysis, the divers with osteonecrosis demonstrated significantly decreased activity levels of Proteins C, S and a significant increase in the levels of PAI-1, compared with the control group.
Biomarkers* ; Diving ; Epidemiologic Studies* ; Epidemiology ; Hyperlipidemias ; Osteonecrosis* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Protein S ; Risk Factors ; Thrombophilia

A Fourier transform infrared spectrophotometric method was described for the determination of quartz, mica(sericite) and feldspar(potassium feldspar) in respirable dust in Taebaek area. The results were as follows; 1) The concentration of minerals were determined from the intensity of absorption peak of quartz at 799 cm-1, sericite at 539 cm-1, and potassium feldspar at 648 cm-1 respectively. 2) The precision(C. V. %) for the quartz determination was 7.70+/-2.68 % from 10 to 200 microgram of quartz. 3) The precision for the sericite determination was 16.34+/-6.82 % from 30 to 500 microgram of serictite. 4) The precision for the potassium feldspar determination was 5.28+/-1.74 % from 30 to 500 microgram of potassium feldspar. 5) The concentration of respirable dust in Taebaek area was 4.90+/-3.29 mg/m3(0.4-93.7%), percent quartz was 1.80+/-4.14% (0.01-20.56%), percent sericite was 11.37+/-6.43% (0.00-29.69%), percent potassium feldspar was 8.15 % (n=7, 3.41-19.70%). 6) The difference of respirable coal dust, quartz, and sericite concentration in drilling, coal cutting, hauling and separating was significant respectively (p<0.05).
Absorption ; Coal ; Dust* ; Fourier Analysis* ; Minerals ; Potassium ; Quartz* ; Spectrophotometry, Infrared*

PURPOSE: Lipiodol CT is a important modality for the diagnosis of hepatocellular carcinoma and compared is usually performed at 2-3 week after Lipiodol injection. Therefore, we assessed and the diagnostic value and merits of immediate CT after chemoembolization from there of 2-3 week delayed Lipiodol CT. MATERIALS AND METHODS: Thirty three cases of chemoembolization which were performed both immediate CT after chemoembolization and 2-3 week delayed Lipiodol CT were reviewed retrospectively. They were divided into four grades according to pattern of lipiodol uptake by three radiologists. The diagnostic value of immediate Lipiiodol CT was compared to delayed Lipiodol CT. RESULTS: Grade 0 was two cases(3.0%) and Grade 1 was seven cases(21.2%). In the cases of Grade 2(23/33, 69.7%) tumor uptake could be dishng wished from parenchymal uptake of Lipiodol by its density and pattern. Tumor uptake showed dense and homogeneous pattern, but parenchymal uptake revealed less dense and hepatoram-like wedge shaped pattern. Lipiodol uptake of tumor in Grade 3(1/24, 3.0%) was equal to that in delayed Lipiodrl CT. Grade 3 and 2(72.7%) of the immediate Lipiodol CT were not inferior to delayed Lipiodol CT in its diagnostic value. CONCLUSION: The immediate Lipiodol CT could make rapid establishment of treatment plan and are expected to be more convenient than delayed CT for the patients.
Carcinoma, Hepatocellular* ; Diagnosis ; Ethiodized Oil ; Humans ; Retrospective Studies

Unlike the United States, cases of firearm suicides in Korea are rare and are usually limited to military soldiers and policemen. In addition, there is no case report of a suicide by a homemade handgun in Korea. The present victim was a 24-year-old soldier with a fascination for firearms. He had a history of depression and social phobia during his military service. He constructed a homemade handgun from a plastic model gun, also known as a BB gun. During the vacations, he committed suicide with the homemade gun, which caused a penetrating gunshot wound to his chest. The structure and ammunition of the homemade handgun is demonstrated in this report. We have also discussed a few details of the forensic investigation and evaluation of the homemade handgun fatality.
Depression ; Firearms ; Humans ; Korea ; Military Personnel ; Plastics ; Phobic Disorders ; Suicide ; Thorax ; United States ; Wounds, Gunshot ; Young Adult

No abstract available.
Amino Acid Sequence* ; HIV* ; Phenotype*

PURPOSE: For the early diagnosis of Henoch-Schonlein purpura(HSP) presenting with acute abdominal pain preceding skin rash. METHODS: The clinical, endoscopic and radiological records of 23 cases of HSP, presenting with gastrointestinal symptoms preceding skin rash were reviewed. RESULTS: The intervals from the onset of abdominal pain to the development of the skin rash were one day to 30 days(median five days), most of them were within two weeks. The presenting abdominal symptoms were abdominal pain(23 cases), vomiting(16 cases), hematochezia or melena(eight cases) and hematemesis(three cases). The abnormal endoscopic findings include coalescing erythematous lesions, areas of submucosal hemorrhage and superficial erosions and ulcers. The upper gastro intestinal endoscopy showed the abnormalities in 21 of 23 cases, which were observed in the duodenum(21 cases), the stomach(12 cases) and the esophagus(one case). Duodenitis with hemorrhage and/or erosions in the descending duodenum was the sole endoscopic abnormality in two cases and was the most marked finding in three cases. Sigmoidoscopy showed the abnormalities in six of eight cases. The abdominal ultrasonogram showed abnormalities in 12 of 17 cases, which included small bowel wall thickening(eight cases) and intramural hemorrhage(three cases). Recurrences after three months of symptom free intervals developed in four cases; three of them had persistent nephritis beyond one year. CONCLUSION: The erosive hemorrhagic duodenitis in the descending duodenum in the upper endoscopy and the small bowel wall thickening in the abdominal ultrasonogram can be useful findings in the diagnosis of HSP presenting with acute abdomen.
Abdomen, Acute ; Abdominal Pain* ; Diagnosis ; Duodenitis ; Duodenum ; Early Diagnosis ; Endoscopy ; Exanthema* ; Gastrointestinal Hemorrhage ; Hemorrhage ; Nephritis ; Purpura* ; Recurrence ; Sigmoidoscopy ; Skin* ; Ulcer ; Ultrasonography

No abstract available.
Mediastinum*

To investigate effects of cytokines on rheumatoid synovial cells, proliferation and expression of cytokine and metalloproteinase genes were studied with the primary culture of rheumatoid synovial cells which was treated with TNF-alpha, GM-CSF, TGF-alpha, PDGF and IL-B. By [3H] thymidine incorporation assay, TGF-beta and PDGF increased proliferation of synovial cells by 1.5 and 2.5 folds respectively. Cytokine gene expression was assessed by RT-PCR. Rheumatoid synovial cells expressed constitutively TGF-beta and IL-B at a high level and IL-1B, GM-CSF, and MIP-1a at a relatively low level. TGF-beta, GM-CSF and PDGF increased IL-B expression. Expression of pro-inflammatory cytokines and chemokines was increased by GM-CSF and PDGF. Both GM-CSF and PDGF increased the expression of IL-1B, GM-CSF MIP-la and IL-8. In addition, GM-CSF enhanced expression of TNF-alpha. Stromelysin and collagenase are the major proteinases responsible for destruction ot joints in rheumatoid arthritis (RA). These genes were expressed constitutivefy in rheumatoid synovial cells. In summary, PDGF and GM-CSF may piay an important role by inducing or increasing expression of IL-1B, TGF-beta and PDGF by increasing proliferation of rheumatoid synovial cells.
Tumor Necrosis Factor-alpha

Quantitative medical genetics including genetic epidemiological studies, linkage studies, and association studies are the basis for molecular genetic studies to find the susceptible genes or responsible mutations for psychiatric disorders. Epidemiological studies on recurrence risk, twin studies and adoption studies have shown that genetic components are contributing for the development of psychiatric disorders. The basic concept of quantitative genetics is recombination and linkage phenomenon. Linkage is that two genetic loci located close enough to each other will not be separated after recombination in meiosis. Linkage analysis and association studies can be accomplished by appropriate genetic analysis methods with genetically well defined phenotype data and genotype data generated by PCR. Linkage analysis are focused on simultaneous transmission of genotype and phenotype in multiplex pedigrees. Linkage analysis could be divided into two categories: parametric and nonparametric methods. Association studies are designed to find linkage disequilibrium between candidate gene and disease phenotype. Family-based association study methods are recommended to exclude possible population stratification of population-based case control studies. In spite of lots of evidence supporting great genetic influence on psychiatric disorders, genetic studies on psychiatric disorders have not been easy. It is probably because psychiatric disorders are composed of complex traits which do not follow Mendelian inheritance and several genes may contribute to only a small proportion of variances in the trait. In order to solve this complexity, animal models and genetically proper endophenotypes should be developed and be applied to QTL (Quantitative Trait Loci) analysis. At the same time, statistically powerful sample size should be established through worldwide collaboration to overcome small gene effects of psychiatric disorders.
Case-Control Studies ; Cooperative Behavior ; Endophenotypes ; Genetic Loci ; Genetics* ; Genetics, Medical ; Genotype ; Linkage Disequilibrium ; Meiosis ; Models, Animal ; Molecular Biology ; Phenotype ; Polymerase Chain Reaction ; Recombination, Genetic ; Recurrence ; Sample Size ; Wills