To determine the usefulness of MR axial images for diagnosis ACL tears, we reviewed MRIs of 67 patients with ACL tear confirmed by arthroscopic examination, retrospectively. There were 53 acute and 14 chronic tears. The axial MR images had a 97% sensitivity(acute: 96%, chronic: 100%). Findings of acute ACL tears on sequential axial imaging could be categorized as 1) diffuse swelling with abnormal substance signal in 14 cases(27.5%), 2) focal bulging or irregularity of medial border in 11 cases(21.6%) or 3) combination of the two in 26 cases(50.9%). Findings of chronic ACL tears also could be categorized as abnormally irregular thin fibers in 6 cases(42.9%) or nonvisualization(empty lateral wall) in 8 cases(57.1%). We concluded that MR axial images could provide additional useful information in the diagnosis of ACL tear.
Diagnosis ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

Objective: In South Korea, the placement of orphans in institutions is still common, despite evidence of its adverse influence on children’s psychological, emotional, physical, and cognitive development. In this preliminary study, we evaluate whether system-wide positive behavior support (SWPBS) is effective for decreasing externalizing problems in institutionalized children. Methods: SWPBS was provided for one month to 36 school-aged boys who had lived in an orphanage for an average of 8.72 years (SD=2.52), along with their 10 caregivers. Direct observation of the frequency of target behaviors in the participating children, caregivers’ ratings of the severity of children’s problematic behaviors, self-reported caregiving stress (i.e., Parenting Stress Scale), and intervention fidelity were dependent variables. Results: After receiving SWPBS, the frequency of problematic behaviors in the participating children showed a mean decrease of 73.6%. The caregivers also reported seeing a decrease in the severity of their children’s problematic behaviors after SWPBS compared to before. Conclusion SWPBS may be a promising intervention to decrease externalizing behaviors in school-aged children who have been living in institutions for a long time and have shown mental health issues.

Objective: In South Korea, the placement of orphans in institutions is still common, despite evidence of its adverse influence on children’s psychological, emotional, physical, and cognitive development. In this preliminary study, we evaluate whether system-wide positive behavior support (SWPBS) is effective for decreasing externalizing problems in institutionalized children. Methods: SWPBS was provided for one month to 36 school-aged boys who had lived in an orphanage for an average of 8.72 years (SD=2.52), along with their 10 caregivers. Direct observation of the frequency of target behaviors in the participating children, caregivers’ ratings of the severity of children’s problematic behaviors, self-reported caregiving stress (i.e., Parenting Stress Scale), and intervention fidelity were dependent variables. Results: After receiving SWPBS, the frequency of problematic behaviors in the participating children showed a mean decrease of 73.6%. The caregivers also reported seeing a decrease in the severity of their children’s problematic behaviors after SWPBS compared to before. Conclusion SWPBS may be a promising intervention to decrease externalizing behaviors in school-aged children who have been living in institutions for a long time and have shown mental health issues.

BACKGROUND: The genetic and environmental factors involved in the development of obesity and several candidate genes have been suggested to have an influence on energy and fuel metabolism. However, the specific genetic defects responsible for human obesity have not been identified yet. It is likely that a combination of polymorphisms in one or more candidate genes may affect energy metabolism and the development of obesity. We performed this study to determine the role of 45 bp insertion in the uncoupling protein (UCP)2 exon 8 and Trp64Arg polymorphism of beta3-adrenergic receptor ( 3-AR) gene in the regulation of body weight and the pattern of fat distribution. METHODS: In 114 subjects (male: 40, female: 74, mean body mass index: 24.1+/-2.7 kg/m2, 80 subjects with normal glucose tolerance, 34 subjects with impaired glucose tolerance), body fat distribution patterns were assessed by anthropometric measurement, bioelectric impedance analysis and computed tomogram. The genotypes of UCP genes were determined by polymerase chain reaction (PCR), and mutation in 3-AR gene by PCR followed by enzymatic digestion. RESULTS: In UCP2 genes, the frequency of deletion homozygote (DD) was 59.4%, heterozygote (DI) was 3.5% and insertion homozygote (II) was 3.1% Meanwhile, in 3-AR, the frequency of TrpTrp was 67.9%, TrpArg was 29.5% and ArgArg was 2.7%. In the lean group (subjects with a BMI less than 25 kg/m2), the frequencies of insertion allele and Arg64 allele were not significantly different than those among the overweight subjects (BMI > or = 25 kg/m2). There was not significant difference in clinical, biochemical or body fat distribution patterns between the groups according to UCP2 polymorphism. In the case of the polymorphism in 3-AR gene, the subjects with ArgArg homozygotes had lower HDL-cholesterol level (p<0.05). For the individuals over 40 years of age, BMI was greater among those with the deletion homozygotes and Arg64 allele, as compared to other groups according to the combination of UCP2 and 3-AR genotypes (p<0.05). CONCLUSION: These results suggest that genetic variations in UCP2 and 3-AR can synergistically affect metabolic rate and susceptibility to weight gain, thereby and contribute to the change in body weight in later life.
Adult* ; Alleles ; Body Fat Distribution ; Body Mass Index ; Body Weight ; Digestion ; Electric Impedance ; Energy Metabolism ; Exons ; Female ; Genetic Variation ; Genotype ; Glucose ; Heterozygote ; Homozygote ; Humans ; Metabolism ; Obesity* ; Overweight ; Polymerase Chain Reaction ; Weight Gain

A 66-year-old male was admitted for increasing azotemia. He was diagnosed with chronic antibody- mediated rejection and had received a livingdonor renal transplant from his 32-year-old son prior to his admission. The peritubular capillaries of his kidney were diffusely positive on C4d immunostaining. It is known that there is an agreement between C4d staining and serological and histopathological data during rejection that is thought to have a humoral component. The role of alloantibodies in chronic renal allograft deterioration and the corresponding morphologic changes have been increasingly recognized during the recent years. However the treatment guidelines for chronic antibody-mediated rejection have not yet been established. Intravenous immunoglobulin (IVIG) has been shown to decrease the titers of anti-HLA antibodies in highly sensitized patients awaiting transplant. There are also numerous proposed mechanisms regarding how IVIG exerts its immunomodulatory action. As we have experienced chronic antibody-mediated rejection and how IVIG treatment improves renal function, we recognize that IVIG has the potential to be used for treating certain subgroups of chronic allograft nephropathy patients with positive C4d staining and anti-HLA antibodies.
Adult ; Aged ; Antibodies ; Azotemia ; Capillaries ; Complement C4b ; HLA Antigens ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Isoantibodies ; Kidney ; Male ; Peptide Fragments ; Rejection (Psychology) ; Transplantation, Homologous ; Transplants

OBJECTIVE: To examine the relation between the presence of penetration or aspiration and the occurrence of the clinical indicators of dysphagia. The presence of penetration or aspiration is closely related to the clinical indicators of dysphagia. It is essential to understand these relationships in order to implement proper diagnosis and treatment of dysphagia. METHODS: Fifty-eight poststroke survivors were divided into two groups: patients with or without penetration or aspiration. Medical records and videofluoroscopic swallowing examinations were reviewed. The occurrence of clinical indicators of dysphagia between two groups was analyzed with Cross Tabulation and the Pearson chi-square test (p<0.05). RESULTS: Poststroke survivors with penetration or aspiration had significantly high occurrences of delayed initiation of the swallow (p=0.04) and reduced hyolaryngeal elevation (p<0.01) than those without penetration or aspiration. CONCLUSION: The results of this study indicate that delayed initiation of the swallow is a strong physiological indicator of penetration or aspiration during the oral stage of swallowing in poststroke survivors. For the pharyngeal stage of swallowing, hyoid and laryngeal elevation is a key event related to occurrence of penetration or aspiration. Clinical indicators should be investigated further to allow appropriate implementation of treatment strategies for stroke survivors.
Deglutition ; Deglutition Disorders* ; Diagnosis ; Humans ; Medical Records ; Oral Stage ; Stroke ; Survivors*

Although renal artery aneurysms (RAAs) rarely occur, rupture of RAAs may be life-threateningand result in nephrectomy. To date, there has been only one case report providing histologic evidence of a true aneurysm in a transplanted renal artery. We report here a 51-year-old male with a de novo trueaneurysm in a donor renal artery that was detected 12 years postoperatively. This RAA was corrected by ex vivo repair and allograft autotransplantation.
Aneurysm ; Humans ; Kidney Transplantation ; Male ; Middle Aged ; Nephrectomy ; Renal Artery ; Rupture ; Tissue Donors ; Transplantation, Homologous ; Transplants

We intended to describe a case of chaunocephalosis and morphological characteristics of its causative agent, Chaunocephalus ferox, recovered from an oriental white stork, Ciconia boyciana, in the Republic of Korea. An oriental white stork was referred to the Wildlife Center of Chungbuk in Korea in February 2014 for severe depression with cachexia and it died the next day. At necropsy, the stomach was severely expanded and 7 thick-walled nodules were observed in the upper part of the intestine. Although the stomach was filled with full of foreign materials, the intestine was almost empty. The nodules were globular and total 9 flukes were recovered. They were 8,030–8,091 μm in length and 3,318–3,333 μm in maximum width. Because the flukes had bulbous forebody with short narrow subcylindrical hindbody, 27 collar spines, and vitelline follicles not reaching to the posterior end, the specimens were identified as being C. ferox. The cyst formation induced thickening of the intestinal wall with narrowing of the lumen that could have contributed to the gastric impaction to the death of the host. This is the first described case of chaunocephalosis and its causative agent C. ferox found from an oriental white stork in Korea.
Cachexia ; Chungcheongbuk-do ; Depression ; Intestines ; Korea* ; Republic of Korea ; Spine ; Stomach ; Trematoda ; Vitellins

Autism spectrum disorder (ASD) is a neurodevelopmental disorder marked by impaired social communication and repetitive, restricted behaviors and activities. The prevalence of ASD has been increasing for the past 2 decades, but evidence-based therapeutic approaches are lacking for patients with ASD. To date, there is no cure for the core symptoms of ASD, and the existing treatments focus on improving the patient's function and adaptation by using behavioral intervention methods. Behavioral interventions have been proven to show the greatest effect when applied before the age of 2 years, for at least 40-60 hours per week. Many clinicians and ASD families are unfamiliar with the treatment methods, and consequently, may seek unproven and potentially hazardous methods. The purpose of this article was to present an extensive and updated review on evidence-based ASD behavioral interventions that are commonly used in clinical settings.
Child ; Autism Spectrum Disorder* ; Humans ; Prevalence

PURPOSE: Arterial hypotension after return of spontaneous circulation (ROSC) from out of hospital cardiac arrest (OHCA) occurs frequently. However, few studies have described post-ROSC hypotension and the relationship with outcome in OHCA. This study aimed to find the prevalence of post-ROSC hypotension and to determine whether post-ROSC hypotension predicts outcome in OHCA. METHODS: This was a retrospective cohort study of patients with ROSC (>20 minutes) after OHCA and who were admitted to the emergency department in a tertiary hospital from July, 2005 to June, 2009. Patients' baseline characteristics, presence of arterial hypotension (<90 mmHg), mortality, and neurologic outcome were evaluated. Mortality rates were compared and multivariate logistic regression was used to determine if post-ROSC hypotension independently predicted death. RESULTS: One hundred forty seven patients (93 males) were studied. Post-ROSC hypotension occurred in 108(73%) patients and was associated with significantly higher mortality compared to non-exposure (82% vs. 44% p<0.001). In multivariate logistic regression analysis, post-ROSC hypotension (OR 4.4 [95% CI]) and non-cardiogenic causes (OR 19.7 [95% CI]) were independent predictors of death. CONCLUSION: Post-ROSC hypotension is common and can be an independent predictor of death in OHCA.
Cohort Studies ; Emergencies ; Heart Arrest ; Humans ; Hypotension ; Logistic Models ; Out-of-Hospital Cardiac Arrest ; Prevalence ; Resuscitation ; Retrospective Studies ; Tertiary Care Centers