We have studied morphologic characteristics and apoptosis on the fetal brain of the trisomy 16 mouse, a model for human trisomy 21 syndrome. This study was based on serial sections of the whole brain from a sample of sixteen trisomy 16 mice and forty-six age-matched control littermates from embryonic day (ED) 12 to ED 18. Trisomy 16 brains showed a reduction of telencephalic size and abnormal cortical development. At ED 13 trisomy 16 and control brains appeared similar. By ED 14 difference in the cortical thickness and telencephalic growth became evident, and by ED 16 a marked size difference had developed between the trisomy 16 and control brains. By ED 18, however, the thickness of the trisomy 16 cortex had increased considerably and was not significantly different with respect to the thickness and cross-sectional areas of the pallium and its constituent cortical layers. The cell density of the trisomy 16 cortex had persistently decreased before ED 17, when the cell density of control and trisomy 16 corteces was similar within each layer. At ED 18 cell density of trisomy 16 cortex in each layer increased. There was inverse relationship between a number of TUNEL positive apoptotic cells and cell density in the trisomy 16 brains. Our results suggest that developmental abnormalities of the trisomy 16 brain indicated developmental delay of the telencephalon growth, which may be caused by apoptosis rather than by a proliferation defect.
Animals ; Apoptosis* ; Brain* ; Cell Count ; Down Syndrome ; Humans ; In Situ Nick-End Labeling ; Mice* ; Telencephalon ; Trisomy*

Carcinoma of Gall bladder remains a terminal illness in most patients despite improved diagnostic capabilities, better perioperative care and a more aggresive surgical approch based on improved knowledge of this tumors natural histiory. Overall 5-year survival rates remain below 5%. This failure to significantly improve patient oucome is largely due to late recognition of gall badder cancer. Authors experienced 21 cases of gall bladder cancer confirmed by operation at the Kwang Ju Christian hospital from march 1983 to March 1991, and the results obtained were summarized as follows. (continue...)
Gallbladder Neoplasms ; Gwangju ; Humans ; Perioperative Care ; Survival Rate ; Urinary Bladder*

BThere are many materials which can make beautiful, clear eyelid crease with temporary effect. Double fold tape and glue are the most popular materials to make artificial double eye lids. However, the long-term use of these materials seems to make cause many local problems. This study was conducted to identify the long-term side effects of double-fold tape and glue. A total of 191 patients who have experienced double fold tape or glue were enrolled. The information of age, double-fold making product, and side effects were collected, based on medical records and, Patient & Observer scale(1: 'Normal', 5: 'Abnormal/Severe). The mean period of use was 23.7 months. The time required to make double-fold was 5~30 minutes. The most common symptom was itching sense, followed by decrease skin elasticity, skin dryness, and change of skin color. The most common signs was skin laxity, followed by eruption, keratinization, pigmentation, and local inflammation. One patient underwent medical treatment for conjunctivitis after double-fold glue usage. Double fold tape or glue can lead a problem with skin due to lack of oxygen exposure and rubbing eye lids with a stick. Appropriate use of double-fold products and careful monitoring of side effects are needed.
Adhesives ; Blepharoplasty ; Conjunctivitis ; Elasticity ; Eye ; Eyelids ; Humans ; Inflammation ; Keratins ; Medical Records ; Oxygen ; Pigmentation ; Pruritus ; Skin ; Surgical Tape

OBJECTIVES: Numerous studies have revealed the adverse health effects of acute and chronic exposure to particulate matter less than 10 mum in aerodynamic diameter (PM10). The aim of the present study was to examine the spatial distribution of PM10 concentrations and cardiovascular mortality and to investigate the spatial correlation between PM10 and cardiovascular mortality using spatial scan statistic (SaTScan) and a regression model. METHODS: From 2008 to 2010, the spatial distribution of PM10 in the Seoul metropolitan area was examined via kriging. In addition, a group of cardiovascular mortality cases was analyzed using SaTScan-based cluster exploration. Geographically weighted regression (GWR) was applied to investigate the correlation between PM10 concentrations and cardiovascular mortality. RESULTS: An examination of the regional distribution of the cardiovascular mortality was higher in provincial districts (gu) belonging to Incheon and the northern part of Gyeonggido than in other regions. In a comparison of PM10 concentrations and mortality cluster (MC) regions, all those belonging to MC 1 and MC 2 were found to belong to particulate matter (PM) 1 and PM 2 with high concentrations of air pollutants. In addition, the GWR showed that PM10 has a statistically significant relation to cardiovascular mortality. CONCLUSIONS: To investigate the relation between air pollution and health impact, spatial analyses can be utilized based on kriging, cluster exploration, and GWR for a more systematic and quantitative analysis. It has been proven that cardiovascular mortality is spatially related to the concentration of PM10.
Air Pollutants ; Air Pollution ; Gyeonggi-do ; Incheon ; Mortality* ; Particulate Matter ; Seoul ; Spatial Analysis*

BACKGROUND: To evaluate the effect of spondylolisthesis on lumbar lordosis on the OSI (Jackson; Orthopaedic Systems Inc.) frame. Restoration of lumbar lordosis is important for maintaining sagittal balance. Physiologic lumbar lordosis has to be gained by intraoperative prone positioning with a hip extension and posterior instrumentation technique. There are some debates about changing lumbar lordosis on the OSI frame after an intraoperative prone position. We evaluated the effect of spondylolisthesis on lumbar lordosis after an intraoperative prone position. METHODS: Sixty-seven patients, who underwent spinal fusion at the Department of Orthopaedic Surgery of Gwangmyeong Sungae Hospital between May 2007 and February 2012, were included in this study. The study compared lumbar lordosis on preoperative upright, intraoperative prone and postoperative upright lateral X-rays between the simple stenosis (SS) group and spondylolisthesis group. The average age of patients was 67.86 years old. The average preoperative lordosis was 43.5degrees (+/- 14.9degrees), average intraoperative lordosis was 48.8degrees (+/- 13.2degrees), average postoperative lordosis was 46.5degrees (+/- 16.1degrees) and the average change on the frame was 5.3degrees (+/- 10.6degrees). RESULTS: Among all patients, 24 patients were diagnosed with simple spinal stenosis, 43 patients with spondylolisthesis (29 degenerative spondylolisthesis and 14 isthmic spondylolisthesis). Between the SS group and spondylolisthesis group, preoperative lordosis, intraoperative lordosis and postoperative lordosis were significantly larger in the spondylolisthesis group. The ratio of patients with increased lordosis on the OSI frame compared to preoperative lordosis was significantly higher in the spondylolisthesis group. The risk of increased lordosis on frame was significantly higher in the spondylolisthesis group (odds ratio, 3.325; 95% confidence interval, 1.101 to 10.039; p = 0.033). CONCLUSIONS: Intraoperative lumbar lordosis on the OSI frame with a prone position was larger in the SS patients than the spondylolisthesis patients, which also produced a larger postoperative lordosis angle after posterior spinal fusion surgery. An increase in lumbar lordosis on the OSI frame should be considered during posterior spinal fusion surgery, especially in spondylolisthesis patients.
Aged ; Aged, 80 and over ; Female ; Humans ; Intraoperative Care/*methods ; Lumbar Vertebrae/*surgery ; Male ; Middle Aged ; Postoperative Complications/*prevention & control ; Posture/physiology ; Prone Position/*physiology ; Retrospective Studies ; Spinal Stenosis/*surgery ; Spondylolisthesis/*surgery

STUDY DESIGN: Retrospective evaluation. PURPOSE: To compare quality of life in postmenopausal women with osteoporotic vertebral fractures (OVFs) who underwent vertebroplasty (VP) or kyphoplasty (KP). OVERVIEW OF LITERATURE: Patient with OVFs who do not respond to conservative treatment can be treated with VP or ballon KP for faster pain relief. There are controversies on which procedure is more effective. METHODS: Five hundred twenty-eight postmenopausal women in nationwide hospitals with age of 50 years or older who underwent VP of KP for OVFs were enrolled in this study. Health related quality of life was measured using the European Quality of Life 5 Domains (EQ-5D) and visual analogue scale (VAS). RESULTS: In the VP group, average EQ-5D dimension was 1.95 in mobility, 1.86 in self care, 2.02 in usual activity, 2.19 in pain, 1.69 in anxiety or depression. In the KP group, average EQ-5D dimension was 1.83 in mobility, 1.78 in self care, 1.98 in usual activity, 2.03 in pain, 1.55 in anxiety or depression. Quality of life of KP group was significantly better than that of the VP group in mobility (p=0.016), pain (p=0.001), and anxiety or depression (p=0.008). Average EQ-5D index of the VP and the KP group was 0.353 (+/-0.472) and 0.485 (+/-0.357), respectively. The EQ-5D index of the KP group was significantly (p<0.001) higher than that of the KP group. The difference of VAS between VP and KP group was not statistically significant (p=0.580). CONCLUSIONS: Quality of life in patient with OVFs who underwent KP was significantly better than that of patients who underwent VP.
Anxiety ; Depression ; Female ; Humans ; Kyphoplasty* ; Quality of Life* ; Retrospective Studies ; Self Care ; Vertebroplasty*

BACKGROUND: Consensus guidelines clearly define how epinephrine is administered during cardiopulmonary resuscitation (CPR). In South Korea, it is not known whether epinephrine is administered in accordance with the current advanced cardiovascular life support (ACLS) guidelines during actual practice. We sought to investigate adherence to ACLS guidelines during actual CPR in terms of the dose of epinephrine and the interval between doses. METHODS: A retrospective review of medical records was performed on 394 adult cardiac arrest patients who received CPR at an emergency room. Data including the duration of CPR, the dose of epinephrine, and the interval between doses was collected from CPR records. RESULTS: Standard-dose epinephrine (1 mg) was used in 166 of 394 patients (42.1%). In 58.8% of patients, the average between-dose interval was within the 3-5 min recommended in the guidelines, whereas it was shorter than 3 min in 31.4% of patients. As a whole, epinephrine was administered in accordance with the current ACLS guidelines in only 96 of 394 patients (24.4%). Logistic regression analysis revealed the duration of CPR to be an independent factor affecting the use of standard-dose epinephrine and the adequate between-dose interval. CONCLUSIONS: Epinephrine was not administered according to the ACLS guideline in most patients. A national multi-center study is required to determine whether the poor adherence to the ACLS guideline is a widespread problem. In addition, efforts to improve adherence to the ACLS guideline are required.
Adult ; Cardiopulmonary Resuscitation ; Compliance ; Consensus ; Emergencies ; Epinephrine ; Heart Arrest ; Humans ; Logistic Models ; Medical Records ; Republic of Korea ; Retrospective Studies

PURPOSE :The goals of this study were to investigate the medical care utilization and statistics of lengths of admissions such as the means, modes, medians, maximums, and minimums for patients with some musculoskeletal diseases among the National Health Insurance Corporation data. We provided basic recommendations for the proper lengths of admissions of occupationally injured workers with these diseases in Korea. METERIALS AND METHODS: The study subjects were 20 to 59 year-old patients who were admitted from January 1, 2000 to June 30, 2001, over 4-day lengths of admission for the management of 20 different musculoskeletal disorders. We calculated means, standard deviations, modes, medians, maximums, minimums, and points of inflection for the lengths of admission of patients with these disorders. RESULTS: The mean length of admission for carpal tunnel syndrome was 8.0+/-6.2 days, that of Raynaud's syndrome was 10.5+/-7.7 days, that of internal derangements of the knee was 12.9+/-11.8 days, that of unspecified internal derangements of the knee was 13.3+/-13.0 days, that of cervical disc disorder with radiculopathy was 16.8+/-19.0 days, that of other cervical disc displacements was 15.9+/-15.9 days, that of lumbar and other intervertebral disc disorders with radiculopathy was 14.9 +/-13.8 days, that of unspecified intervertebral disc displacements was 14.9+/-13.9 days, that of unspecified synovitis and tenosynovitis was 12.5+/-9.9 days, that of ganglions was 7.5+/-7.3 days, that of fasciitis, NEC, was 19.8+/-24.7 days, that of adhesive capsulitis of the shoulder was 15.2+/-15.5 days, that of impingement syndrome of the shoulder was 11.4+/-12.0 days, that of medial epicondylitis was 11.2+/-7.3 days, that of lateral epicondylitis was 12.1+/-11.5 days, that of myalgias was 12.4+/-19.5 days, that of sprain and strain of the cervical spine was 12.4+/-10.2 days, that of sprain and strain of the lumbar spine was 12.3+/-10.9 days, that of a current tear of the meniscus was 13.3+/-13.2 days, and that of sprain and strain involving the cruciate ligaments of the knee was 18.2+/-17.0 days. Every point of inflection was the 80th percentile or the 90th percentile of the lengths of admission of the subjects. CONCLUSION: This study has significant weaknesses, such as limitations of applicable ranges and errors in the National Health Insurance Corporation data, among others. However, the authors present various statistics and points of inflection of lengths of admissions for patients suffering from 20 work-related musculoskeletal disorders in the general population. Those cases in which the lengths of admissions of patients with the above-mentioned musculoskeletal disorders that are greater than the points of inflection, need to be evaluated carefully.
Bursitis ; Carpal Tunnel Syndrome ; Fasciitis ; Ganglion Cysts ; Humans ; Intervertebral Disc ; Intervertebral Disc Displacement ; Knee ; Korea ; Ligaments ; Middle Aged ; Musculoskeletal Diseases ; Myalgia ; National Health Programs* ; Occupations ; Radiculopathy ; Shoulder ; Spine ; Sprains and Strains ; Synovitis ; Tenosynovitis

OBJECTIVE: The aims of this study were to refer descriptive statistics of the disability duration in musculoskeletal injured patients in the automobile accidents. METHOD: The authors chose 469,319 injured patients in traffic accidents as subjects that met inclusion criteria with 8 representative Abbreviated Injury Scale (AIS) comparable with 4th edition of Korean standard classification of diseases. Mean, standard deviation, mode, median, maximum and minimum of 8 representative AIS code were calculated. RESULTS: Mean disability duration for minor cervical sprain was 18.8 days, that of moderate cervical disc herniation was 56.2 days, that of serious cervical disc herniation was 141.5 days, that of minor lumbar sprain was 21.2 days, that of moderate lumbar disc herniation was 53.5 days, that of serious lumbar disc herniation was 128.1 days, that of sprain of 3 major joint in lower limb without desmorrhexis was 24.0 days, and that of dislocation or desmorrhexis of 3 major joint in lower limb was 101.2 days. CONCLUSION: Disability duration of the representative musculoskeletal diseases comparable to AIS code in 4th edition of Korean standard classification of diseases was presented and this study can be utilized as a basic recommended disability duration of automobile injured persons.
Abbreviated Injury Scale ; Accidents, Traffic ; Automobiles* ; Classification ; Dislocations ; Humans ; Insurance, Disability ; Joints ; Length of Stay ; Lower Extremity ; Musculoskeletal Diseases ; Sprains and Strains

Botulinum toxin (BoNT) injection is widely used to improve spasticity. However, after the treatment, the patient may experience pain, inflammation, swelling and redness at the injection site. In this case, we addressed deep vein thrombosis (DVT) after BoNT treatment of the upper limb. A male aged 37 years had spasticity and dystonia in his left upper extremity. BoNT-A 100 U was injected into the left biceps brachii and an equal amount into the brachialis to relieve spasticity. After three days, he developed redness and painful swelling in the left upper arm and the next day, through the upper extremity computed tomography venography, DVT was identified in the left cephalic vein. The thrombus resolved after the anticoagulation therapy with rivaroxaban (Xarelto). We hypothesized the role of mainly three mechanisms in the development of DVT in this case: repetitive strenuous activity, relative stasis due to reduced muscle tone, and possible direct mechanical damage to the vessel wall.