The Ross operation, a procedure of replacement of the diseased aortic valve with an autologous pulmonary valve, has many advantages such as no need for anticoagulation therapy and similar valve function and growth potential as native valves. However secondary aortic disease has emerged as a significant complication and indication for reoperation. We report a 48-year-old woman who had Ross operation in 1997 for a damaged bicuspid aortic valve and severe aortic regurgitation due to subacute bacterial endocarditis complicated by aortic root abscess. In 2009, 12 years later, progressive severe aortic regurgitation with incomplete coaptation and mild dilatation of the aortic root was shown on echocardiography and contrasted CT, while the pulmonary homograft retained normal function. She subsequently underwent aortic valve replacement. Histopathological examination of the explanted neo-aortic valve and neo-arterial wall revealed pannus formation at the nodulus Arantii area of the three valve cusps, ventricularis, and arterialis. The amount of elastic fibres in the neo-aorta media was less than usual for an aorta of this patient's age but was similar to a pulmonary artery. The pathological findings were not different from other studies of specimens removed between 7 to 12 years after Ross operation. However, the pathophysiology and long-term implications of these findings remain debatable. Considering the anatomical and physiological changes induced by the procedure, separate mechanisms for aortic dilatation and regurgitation are worthy of consideration.
Aorta/*pathology ; Aortic Valve/*surgery ; Aortic Valve Insufficiency/*etiology ; Cardiovascular Surgical Procedures/*adverse effects ; Dilatation, Pathologic ; Heart Valve Diseases/*surgery ; Prostheses and Implants ; Pulmonary Valve/*transplantation

A 65-year-old man with diabetes mellitus was presented with left visual aura, followed by a versive seizure, each lasting approximately 3 minutes. Neurological examination showed an intermittent left homonymous hemianopsia. Brain magnetic resonance imaging (MRI) showed right occipital lobe lesion, with cytotoxic edema. Blood glucose was 593 mg/dL and serum osmolarity was 309 mOsm/kg. The seizures were controlled by normalization of blood sugar and short-term anticonvulsant, and the lesions were resolved in a follow-up MRI. We report a case of visual seizures associated with non-ketotic hyperglycemia.
Aged ; Blood Glucose ; Brain ; Diabetes Mellitus ; Edema ; Epilepsy ; Epilepsy, Partial, Motor ; Follow-Up Studies ; Hemianopsia ; Humans ; Hyperglycemia ; Magnetic Resonance Imaging ; Neurologic Examination ; Occipital Lobe ; Osmolar Concentration ; Seizures

The purpose of this study was to investigate effects of nutrition education program and pamphlet for the lower grades elementary students focused on individual daily needed food exchange units using Food Exchange System. Program consisted of four lessons (40 min/lesson), "5 major nutrients & function", "6 food group and sources", "daily needed food exchange units for normal body weight", and "smart snack choice and exercise". Pamphlet as activity book was developed for the program. The subjects were 3rd grade elementary students (educated group, 31 vs. non-educated group, 31). Educated group were lessoned as group and/or individual. We examined the differences in nutrition knowledge, dietary attitudes, dietary intakes and satisfaction of the program and pamphlet. In educated group, there were positive improvements on nutrition knowledge score "function and foods of 5 nutrients" and on dietary attitudes "type of breakfast and snacks". In the evaluation of dietary intakes according to KDRI, there were positive improvements on intakes level of riboflavin, vit. C, folate, Ca, P, Fe and Zn in educated group. In satisfaction with the program and pamphlet, contents, font size, visual, figure, difficulty and program curriculum were over 2.90/3.0. It showed that the developed nutrition education program and pamphlet focused on individual daily needed food exchange units using Food Exchange System improved nutrition knowledge, dietary attitudes and nutrients intake level in the lower grades elementary students.
Breakfast ; Curriculum ; Folic Acid ; Humans ; Pamphlets ; Riboflavin ; Snacks

BACKGROUND: Mirror movements are symmetric, identical, contralateral involuntary movements that accompany vol-untary movements on one side of the body. The aim of this study is to examine the patterns of brain activation during motor and sensory tasks using a functional magnetic resonance imaging (fMRI) and to compare them between normal subjects and a patient with congenital mirror movements. METHODS: A 19 year-old patient with congenital mirror movements and seven normal volunteers (mean age: 29 years old), performed finger-tapping and tactile stimulation tasks with the right, left, and both hands, while gradient echo EPI (echo planar imaging) images were acquired in a 1.5T scanner. RESULTS: During the motor and sensory tasks, the patient showed a bilateral activation of the primary motor and sensory cortices, whereas normal subjects showed only unilateral activations. Activations related to the motor task was observed in the primary sensory cortex, the supplementary motor area, and the cerebellum as well as the primary motor cortex in the case of the patient, while only the primary motor cortex was significantly activated in normal subjects. CONCLUSIONS: These findings suggest that the abnormality underlying congenital mirror movements involves not only the primary motor cortices and interhemispheric connections between them, but also the more extended motor-sensory circuitry including the primary sensory cortex, supplementary motor area, and cerebellum.
Brain ; Cerebellum ; Dyskinesias ; Hand ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging* ; Motor Cortex ; Young Adult

BACKGROUND: Mirror movements are symmetric, identical, contralateral involuntary movements that accompany vol-untary movements on one side of the body. The aim of this study is to examine the patterns of brain activation during motor and sensory tasks using a functional magnetic resonance imaging (fMRI) and to compare them between normal subjects and a patient with congenital mirror movements. METHODS: A 19 year-old patient with congenital mirror movements and seven normal volunteers (mean age: 29 years old), performed finger-tapping and tactile stimulation tasks with the right, left, and both hands, while gradient echo EPI (echo planar imaging) images were acquired in a 1.5T scanner. RESULTS: During the motor and sensory tasks, the patient showed a bilateral activation of the primary motor and sensory cortices, whereas normal subjects showed only unilateral activations. Activations related to the motor task was observed in the primary sensory cortex, the supplementary motor area, and the cerebellum as well as the primary motor cortex in the case of the patient, while only the primary motor cortex was significantly activated in normal subjects. CONCLUSIONS: These findings suggest that the abnormality underlying congenital mirror movements involves not only the primary motor cortices and interhemispheric connections between them, but also the more extended motor-sensory circuitry including the primary sensory cortex, supplementary motor area, and cerebellum.
Brain ; Cerebellum ; Dyskinesias ; Hand ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging* ; Motor Cortex ; Young Adult

46,XX male is a rare abnormality of sex determination with an incidence of 1 in 20,000 male neonates. The clinical manifestations of 46,XX males are usually hypogonadism, gynecomastia, azoospermia, and hyalinations of seminiferous tubules, with altered hormonal levels at puberty. Less frequently, some sexual ambiguities are found, always with sterility owing to reduced testicular development. The origin of male phenotype in 46,XX male could be the results of at least three different mechanisms:translocations of Y sequence, including the SRY gene, to an X chromosome or to an autosome(about 90% of cases); a mutation in a yet unknown X-linked or autosomal gene in the testis-determinating pathway, and cryptic Y chromosome mosacism. We experienced a case of SRY-positive 46,XX male in a 21-year-old man with small testes. (J Korean Soc Pediatr Endocrinol 2003;8:184-188)
Adolescent ; Azoospermia ; Genes, sry ; Gynecomastia ; Humans ; Hyalin ; Hypogonadism ; Incidence ; Infant, Newborn ; Infertility ; Male* ; Phenotype ; Puberty ; Seminiferous Tubules ; Testis ; X Chromosome ; Y Chromosome ; Young Adult

46,XX male is a rare abnormality of sex determination with an incidence of 1 in 20,000 male neonates. The clinical manifestations of 46,XX males are usually hypogonadism, gynecomastia, azoospermia, and hyalinations of seminiferous tubules, with altered hormonal levels at puberty. Less frequently, some sexual ambiguities are found, always with sterility owing to reduced testicular development. The origin of male phenotype in 46,XX male could be the results of at least three different mechanisms:translocations of Y sequence, including the SRY gene, to an X chromosome or to an autosome(about 90% of cases); a mutation in a yet unknown X-linked or autosomal gene in the testis-determinating pathway, and cryptic Y chromosome mosacism. We experienced a case of SRY-positive 46,XX male in a 21-year-old man with small testes. (J Korean Soc Pediatr Endocrinol 2003;8:184-188)
Adolescent ; Azoospermia ; Genes, sry ; Gynecomastia ; Humans ; Hyalin ; Hypogonadism ; Incidence ; Infant, Newborn ; Infertility ; Male* ; Phenotype ; Puberty ; Seminiferous Tubules ; Testis ; X Chromosome ; Y Chromosome ; Young Adult

No abstract available.
Urticaria*

No abstract available.
Fistula*

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Trachea*