Reconstruction of calvarial bone defects from congenital anomaly or from bone loss due to traumatic or neoplastic processes remains a significant problem in craniofacial surgery and neurosurgery. To facilitate bone regeneration, there have been many trials such as autologous bone graft or allograft, and the addition of demineralized bone matrix and matrix-derived growth factor. Guided bone regeneration is one of the methods to accelerate bone healing for calvarial bone defects especially in children. Pericranium is one of the most usable structure in bone regeneration. It protects the dura and sinus, and provides mechanical connection between bone fragments. It supplies blood to bone cortex and osteoprogenitor cells and enhances bone regeneration. For maximal effect of pericranium in bone regeneration, authors used pericranium as a flap for covering calvarial defects in surgeries of 11 craniosynostosis patients and achieved satisfactory results: The bone regeneration of original cranial defect in one year after operation was 74.6%(+/-8.5%). This pericranial flap would be made more effectively by individual dissection after subgaleal dissection rather than subperiosteal dissection. In this article, we reviewed the role of pericranium and reported its usefulness as a flap in surgery of craniosynostosis to maximize bone regeneration.
Allografts ; Bone Matrix ; Bone Regeneration ; Child ; Craniosynostoses* ; Equipment and Supplies ; Humans ; Neoplastic Processes ; Neurosurgery ; Transplants

OBJECTIVE: We compared the prevalence of injury and poisoning in the agricultural and fishery population with that of the general population. METHODS: The national health insurance data and agricultural and fishery qualification data were used for this study. The age-adjusted standardized morbidity ratio was used to compare the prevalence of all injuries and poisonings of the agricultural and fishery population with that of the general population for the year 2002, as well as the prevalence of certain injuries and poisonings common to the agricultural and fishery population. The age-adjusted standardized morbidity ratio and 95% confidence intervals were attained by using the general population as the standard population group. RESULTS: The age-adjusted standardized morbidity ratio of total injuries and poisonings was significantly high in the agriculture and fishery population. The standardized morbidity ratio was 137.6 in the male agriculture and fishery population and 123.3 in the female agriculture and fishery population. In terms of injuries and poisonings common to the agriculture and fishery population, the age-adjusted standardized morbidity ratio was significantly high regarding the dislocations and strains of lumbar spine/pelvis, shoulder and neck, the fracture of rib/thoracic spine/sternum and pesticide poisoning. CONCLUSIONS: The overall prevalence of injury/poisoning was significantly higher in the agriculture and fishery population than in the general population. Various forms of research should be conducted on the injuries of the agriculture and fishery population in the future. In order to compare the differences in the prevalence rates of injuries according to time and region, standard definitions of injuries and occupation related injuries are required.
Agriculture ; Dislocations ; Female ; Fisheries ; Humans ; Male ; National Health Programs ; Neck ; Occupations ; Prevalence ; Shoulder

Neurofibroma may present as multiple or solitary lesions. Although there is no predilection site of solitary lesion, the occurrence on hands is rare. We herein report a case of solitary neurofibroma in 33-year-old female patient, who presented with a 0.5 x 0.5 cm sized, soft, dome-shaped papule on the left palm with typical histologic findings.
Adult ; Female ; Hand ; Humans ; Neurofibroma*

PURPOSE: This study was designed to identify current status of the subspecialist training programs and related factors affecting subspecialists' job selection. METHODS: The study subjects were 5,569 subspecialist trainees in 61 hospitals between 1989 and 1999. Among them, 1,260 subjects were selected to identify employment status after training. Also we analysed factors affecting career selection for 863 subspecialists on which basic information was available. RESULTS: About 26.6% of all subspecialist trainees trained in 1999 was for subspecialties in internal medicine, the largest majority, and 89.3% was in metropolitan areas. Also 91.1% were trained in teaching hospitals. Among subspecialists completed training, 79.5% selected career to work at general or teaching hospitals as of 1999, but 13.5% practised at clinics. The factors affecting career selection after training were gender, ownership of medical school, and specialty. CONCLUSION: The fact that not a few subspecialists work at primary care clinics means there are unreasonable human resource allocation and planning, with probable poor quality of primary care. Therefore, it is necessary to have a human resource plan at the national level for appropriate number of subspecialists, based on each specialty, in particular. Any structural factors affecting destination of subspecialist trainees, such as gender and graduated medical school, etc, should be dealt with in the long run.
Education* ; Employment ; Hospitals, Teaching ; Humans ; Internal Medicine ; Ownership ; Primary Health Care ; Resource Allocation ; Schools, Medical

Deletion and duplication of the -3.7-Mb region in 17p11.2 result in two reciprocal syndrome, Smith-Magenis syndrome and Potocki-Lupski syndrome. Smith-Magenis syndrome is a well-known developmental disorder. Potocki-Lupski syndrome has recently been recognized as a microduplication syndrome that is a reciprocal disease of Smith-Magenis syndrome. In this paper, we report on the clinical and cytogenetic features of two Korean patients with Smith-Magenis syndrome and Potocki-Lupski syndrome. Patient 1 (Smith-Magenis syndrome) was a 2.9-yr-old boy who showed mild dysmorphic features, aggressive behavioral problems, and developmental delay. Patient 2 (Potocki-Lupski syndrome), a 17-yr-old boy, had only intellectual disabilities and language developmental delay. We used array comparative genomic hybridization (array CGH) and found a 2.6 Mb-sized deletion and a reciprocal 2.1 Mb-sized duplication involving the 17p11.2. These regions overlapped in a 2.1 Mb size containing 11 common genes, including RAI1 and SREBF.
Adolescent ; Asian Continental Ancestry Group/*genetics ; Child, Preschool ; *Chromosomes, Human, Pair 17 ; Comparative Genomic Hybridization ; Developmental Disabilities/etiology/genetics ; Gene Deletion ; Gene Duplication ; Humans ; Intellectual Disability/etiology/genetics ; Karyotyping ; Male ; Smith-Magenis Syndrome/diagnosis/*genetics ; Sterol Regulatory Element Binding Protein 1/genetics ; Transcription Factors/genetics

PURPOSE: This study analyzed and evaluated the demographic, clinical, and cytogenetic data [G-banded karyotyping and array-based comparative genomic hybridization (array CGH)] of patients with unexplained developmental delay or intellectual disability at a single Korean institution. MATERIALS AND METHODS: We collected clinical and cytogenetic data based on retrospective charts at Ajou University Medical Center, Suwon, Korea from April 2008 to March 2012. RESULTS: A total of 190 patients were identified. Mean age was 5.1+/-1.87 years. Array CGH yielded abnormal results in 26 of 190 patients (13.7%). Copy number losses were about two-fold more frequent than gains. A total of 61.5% of all patients had copy number losses. The most common deletion disorders included 22q11.2 deletion syndrome, 15q11.2q12 deletion and 18q deletion syndrome. Copy number gains were identified in 34.6% of patients, and common diseases among these included Potocki-Lupski syndrome, 15q11-13 duplication syndrome and duplication 22q. Abnormal karyotype with normal array CGH results was exhibited in 2.6% of patients; theses included balanced translocation (n=2), inversion (n=2) and low-level mosaicism (n=1). Facial abnormalities (p<0.001) and failure to thrive were (p<0.001) also more frequent in the group of patients with abnormal CGH findings. CONCLUSION: Array CGH is a useful diagnostic tool in clinical settings in patients with developmental delay or intellectual disability combined with facial abnormalities or failure to thrive.
Adolescent ; Adult ; Child ; Child, Preschool ; Comparative Genomic Hybridization/*methods ; Female ; Gene Dosage/genetics ; Humans ; Infant ; Intellectual Disability/*genetics ; Karyotype ; Male ; Republic of Korea ; Retrospective Studies ; Tertiary Healthcare/statistics & numerical data ; Young Adult

OBJECTIVES: Obesity is currently an epidemic in Korea, and sleep duration is thought to be one of the risk factors for obesity. The objective of this study was to test the hypothesis that short sleep duration is associated with obesity in Korean adults. METHODS: The data from the 2001 Korean National Health and Nutrition Survey were used, and 6,174 subjects aged 18~80 years were included in the analysis. Sleep duration was measured using information obtained from self-reported questionnaires. Obesity, the main outcome variable, was measured according to body mass index. Multiple regression modeling was used to adjust for potential confounding variables. RESULTS: The study results revealed a negative association between sleep duration and body mass index among Korean adults. These associations persisted after controlling for the potential confounding variables. CONCLUSIONS: These findings support the hypothesis that sleep duration is associated with obesity in Korean adults. In addition, these observations support earlier experimental sleep studies and provide a basis for future studies on weight control intervention by increasing the amount of sleep.
Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Obesity/*epidemiology/etiology ; Questionnaires ; Risk Factors ; Sleep Disorders/*epidemiology/physiopathology

OBJECTIVES: To determine the impacts of Diagnosis-Related Groups/Prospective Payment System (DRG/PPS) on the quality of care in cases of Cesarean section and to describe the policy implications for the early stabilization of DRG/PPS in Korea. METHODS: Data was collected from the medical records of 380 patients who had undergone Cesarean sections in 40 hospitals participating in the DRG/PPS Demonstration Program since 1999. Cesarean sections were performed in 122 patients of the FFS(Fee-For-Service) group and 258 patients of the DRG/PPS group. Measurements of quality used included essential tests of pre- and post-operation, and the PPI(Physician Performance Index) score. The PPI was developed by two obstetricians. RESULTS: Univariate analysis demonstrated significant differences in PPI scores according to the payment systems. With respect to the mean of PPI scores, a higher score was found in the DRG/PPS group than in the FFS group. However, the adjusted effect did not show significant differences between the FFS group and the DRG/PPS group. CONCLUSION: This study suggested that the problem of poor quality may not be related to the implementation of DRG/PPS in Cesarean section. However, this study did not consider the validity and reliability of the process measurement, and it did not exclude the possibility of data omission in medical records.
Cesarean Section* ; Female ; Humans ; Korea ; Medical Records ; Pregnancy ; Reproducibility of Results

Cutaneous Müllerian cyst (CMC) is a rare benign cystic lesion that typically occurs on the lower extremity of young females shortly after puberty. They have been widely regarded as Müllerian heterotopias due to the morphological similarities of the cyst lining cells to the epithelium of the fallopian tubes. A 16-year-old female presented with a two-year history of a solitary, subcutaneous mass involving the left ankle. She had no specific symptoms associated with the skin lesion. However, the lesion had been growing in size. Histopathological findings revealed cystic structures lined by pseudostratified ciliated cuboidal to columnar cells, accompanying intraluminal papillary projection. The immunohistochemical staining profiles, including positive staining for estrogen and progesterone receptors, were characteristic of the fallopian tube epithelium. After being surgically removed, the lesion was cured without recurrence. Based on her typical presentation and histopathological findings, we present this patient as a case of CMC.

Background/Aims: Clinical equivalence of generic antiviral agents for chronic hepatitis B (CHB) has not been demonstrated, particularly in cases with previous antiviral resistance. Entecavir 1 mg is prescribed frequently as a mono- or combination therapy in antiviral-resistant CHB patients. This study evaluated the efficacy and safety of switching to generic entecavir 1 mg (Baracle ® ) in CHB patients taking brand-name entecavir 1 mg (Baraclude ® ) alone or in combination with other nucleotide analogs after the development of antiviral resistance. Methods: This study was a single-arm prospective study. The primary endpoint was undetectable HBV DNA (<20 IU/mL) at 12 months after switching treatment. The biochemical and serologic responses, virologic breakthrough, and antiviral resistance rates were also evaluated. Results: Forty CHB patients with undetectable HBV DNA through the brand-name entecavir 1 mg treatment as a mono- or combination therapy after developing antiviral resistance to nucleos(t)ide analogs were enrolled in this study. No significant difference in the HBV DNA non-detection rate was observed between the baseline and 12 months after switching therapy (p=0.324).Furthermore, non-inferiority of the generic entecavir 1 mg to the brand-name entecavir 1 mg with 10% margin in maintaining undetectable HBV DNA was demonstrated (95% CI -2.80 to 8.20%). Similarly, no difference in the biochemical response rate was observed after switching therapy. Serum hepatitis B e antigen loss was observed in 12.5%. No virologic breakthrough was reported. Conclusions Generic entecavir 1 mg is a reasonable alternative to the brand-name entecavir 1 mg in antiviral-resistant CHB patients with viral suppression.