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1.
Article in English | WPRIM | ID: wpr-874808

ABSTRACT

Objective@#: Given the high risk of rebleeding and recurrence of blood blister-like aneurysms (BBAs), we treated ruptured BBAs of the internal carotid artery (ICA) with stent-assisted coil embolization (SAC). This study aimed to evaluate the efficacy and safety of SACs. @*Methods@#: We retrospectively reviewed clinical and radiological data from eight patients with ruptured BBAs of the supraclinoid ICA. The modified Rankin Scale (mRS) was used to assess clinical outcomes, while radiological outcomes were evaluated on angiographs. For a pooled analysis, data from literature reporting the outcomes of ruptured BBAs treated with SAC were collected and analyzed in conjunction with our data. @*Results@#: In our cohort, the mean Raymond classification score was 1.57±0.53 immediately after initial endovascular treatment. There were no perioperative complications or rebleeding events during the follow-up period. The mean mRS score at patient discharge was 1.00±0.81 and improved to 0.28±0.48 by the last follow-up day. The recurrence rate was 25% with an asymptomatic presentation and successful treatment with multiple stent insertion. Pooled analysis of 76 cases of SAC revealed a complete occlusion rate immediately after treatment of 54.8%, rebleeding rate 7.94%, and recurrence rate 24.2%. Good clinical outcomes with mRS score 0–2 were observed in 89.9% by the last clinical follow-up. Total mortality rate was 7.7%. @*Conclusion@#: This treatment appears to not only minimize the hemodynamic burden on the fragile dome specific to this type of aneurysm, but also provides an opportunity for safe and effective treatment in recurrent cases.

2.
Ultrasonography ; : 17-24, 2017.
Article in English | WPRIM | ID: wpr-731217

ABSTRACT

PURPOSE: The purpose of this study was to investigate the accuracy and reliability of the semi-automated ultrasonographic volume measurement tool, virtual organ computer-aided analysis (VOCAL), for measuring the volume of parathyroid glands. METHODS: Volume measurements for 40 parathyroid glands were performed in patients with secondary hyperparathyroidism caused by chronic renal failure. The volume of the parathyroid glands was measured twice by experienced radiologists by two-dimensional (2D) and three-dimensional (3D) methods using conventional sonograms and the VOCAL with 30°angle increments before parathyroidectomy. The specimen volume was also measured postoperatively. Intraclass correlation coefficients (ICCs) and the absolute percentage error were used for estimating the reproducibility and accuracy of the two different methods. RESULTS: The ICC value between two measurements of the 2D method and the 3D method was 0.956 and 0.999, respectively. The mean absolute percentage error of the 2D method and the 3D VOCAL technique was 29.56% and 5.78%, respectively. For accuracy and reliability, the plots of the 3D method showed a more compact distribution than those of the 2D method on the Bland-Altman graph. CONCLUSION: The rotational VOCAL method for measuring the parathyroid gland is more accurate and reliable than the conventional 2D measurement. This VOCAL method could be used as a more reliable follow-up imaging modality in a patient with hyperparathyroidism.


Subject(s)
Follow-Up Studies , Humans , Hyperparathyroidism , Hyperparathyroidism, Secondary , Imaging, Three-Dimensional , Kidney Failure, Chronic , Methods , Organ Size , Parathyroid Glands , Parathyroidectomy , Ultrasonography
3.
Ultrasonography ; : 355-362, 2017.
Article in English | WPRIM | ID: wpr-731014

ABSTRACT

PURPOSE: The aim of this study was to assess the characteristics of papillary thyroid carcinoma (PTC) in patients aged 65 and older in order to predict postoperative recurrence based on the results of ultrasonographic surveillance. METHODS: Among 1,494 patients (200 male and 1,294 female; mean age, 46.6±11.3 years) who underwent surgery for thyroid cancer at our institution between 2006 and 2015, we retrospectively enrolled 150 PTC patients (29 male and 121 female; mean age, 69.4±4.2 years). To identify the risk factors for recurrence, we analyzed age, gender, multiplicity, size, number, extrathyroidal extension (ETE) of the tumor, lymph node metastasis (LNM), type of surgery, and the dose of radioactive ablation using a Cox regression model to identify hazard ratios (HRs). RESULTS: Among the 115 asymptomatic patients with PTCs detected by screening ultrasonography (n=86), other cross-sectional imaging modalities (computed tomography or positron emission tomography-computed tomography, n=13), or incidentally through a surgical specimen (n=16), 78 patients were confirmed to have papillary thyroid microcarcinomas (PTMCs). The other 35 patients presented with palpable neck masses (n=25), vocal cord palsy (n=9) or blood-tinged sputum (n=1). During the follow-up period (mean, 43.6 months), 17 patients (12.5%) experienced recurrence in the neck. None of the patients died due to PTC-related recurrence or distant metastasis during the follow-up period. Cox regression analysis demonstrated that tumor size (HR, 2.12; P<0.001) and LNM (central LNM: HR, 9.08; P=0.004; lateral LNM: HR, 14.71; P=0.002; both central and lateral LNM: HR, 58.41; P<0.001) significantly increased the recurrence rate. ETE, LNM, and recurrence were significantly less frequent in PTMCs than in non-PTMC (all P<0.001). CONCLUSION: PTCs of small size and absent LNM showed significantly better prognoses in patients 65 years and older.


Subject(s)
Aged , Electrons , Female , Follow-Up Studies , Humans , Korea , Lymph Nodes , Male , Mass Screening , Neck , Neoplasm Metastasis , Prognosis , Recurrence , Retrospective Studies , Risk Factors , Sputum , Thyroid Gland , Thyroid Neoplasms , Ultrasonography , Vocal Cord Paralysis
4.
Article in English | WPRIM | ID: wpr-91203

ABSTRACT

A 6-month-old mature intact female Siamese cat presented with exertional dyspnea. Diagnostic studies revealed pleural effusion, grade 4/6 left basal systolic murmur, deep S-wave in electrocardiograph leads I, II, and III, cardiomegaly with pleural effusion on radiography, pulmonic systolic (~5.8 m/sec) and tricuspid (3.6 m/sec) regurgitant jets, atrial septal defect, and a hypoplastic right outflow tract. Based on these results, the case was diagnosed as pulmonic stenosis with atrial septal defect. To the best of our knowledge, this is the first case report describing pulmonic stenosis with atrial septal defect in a cat in Korea.


Subject(s)
Animals , Cardiomegaly , Cats , Dyspnea , Electrocardiography , Female , Heart Defects, Congenital , Heart Septal Defects, Atrial , Humans , Infant , Korea , Pleural Effusion , Pulmonary Valve Stenosis , Radiography , Systolic Murmurs
5.
Article in English | WPRIM | ID: wpr-215760

ABSTRACT

This study evaluated several known echocardiographic markers related to the assessment of severity in dogs with patent ductus arteriosus (PDA) after the closure of ductus arteriosus (DA). Forty-two dogs with patent ductus arteriosus were enrolled in this study. Evaluated echocardiographic markers were left atrial to aortic root ratio, left ventricular end-diastolic dimension to aortic root ratio, indexed left ventricular end-diastolic and end-systolic dimensions, end-diastolic and end systolic volume index, pulmonic flow to systemic flow (Qp/Qs) ratio, velocities of pulmonary regurgitant and systolic jets, pulmonary flow profiles and the presence of mitral regurgitation. Those markers were evaluated before, 1 day, and 30 days after the closure of DA. Statistically significant changes in some echocardiographic markers (i.e., Qp/Qs) were observed. Although several studies in human and dogs have evaluated the clinical outcome of PDA occlusion using several echocardiographic markers, this study has firstly evaluated all echocardiographic markers known to be useful for assessing the clinical outcome of PDA occlusion in human, and has demonstrated that those markers including the Qp/Qs and pulmonary flow profiles were useful in evaluating of clinical outcome of PDA in dogs and the reduction of LA and LV preload after ductal closure could dramatically reduce after successful ductal occlusion of PDA in dogs.

6.
Article in English | WPRIM | ID: wpr-215758

ABSTRACT

This study evaluated the levels of cardiac biomarkers in dogs with either pulmonic stenosis or aortic stenosis and the correlation between biomarkers and the severity of stenosis assessed by the echocardiography. To achieve this study goal, 38 dogs (10 healthy control dogs, 15 dogs with pulmonic stenosis and 13 dogs with aortic stenosis) were examined. The jet velocity and pressure gradient in this study population were measured by echocardiographic estimation, after which the study group was subdivided by the severity of stenosis. The plasma cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured in this study group. The median concentrations of cTnI and NT-proBNP of the disease group were significantly higher than those of the control group, and these increased gradually as stenosis worsened. The severity of stenosis and the concentrations of cTnI and NT-porBNP were also found to be significantly correlated. Finally, the plasma cTnI and NT-proBNP tests were found to beneficial for differentiating clinical patients, predicting the progression of disease, and monitoring the outcome of interventional therapy for stenosis.

7.
Annals of Dermatology ; : 787-788, 2016.
Article in English | WPRIM | ID: wpr-181438

ABSTRACT

No abstract available.


Subject(s)
Aneurysm, False
8.
Neurointervention ; : 78-85, 2016.
Article in English | WPRIM | ID: wpr-730322

ABSTRACT

PURPOSE: To assess patient radiation doses during cerebral angiography and embolization of intracranial aneurysms across multi-centers and propose a diagnostic reference level (DRL). MATERIALS AND METHODS: We studied a sample of 490 diagnostic and 371 therapeutic procedures for intracranial aneurysms, which were performed at 23 hospitals in Korea in 2015. Parameters including dose-area product (DAP), cumulative air kerma (CAK), fluoroscopic time and total angiographic image frames were obtained and analyzed. RESULTS: Total mean DAP, CAK, fluoroscopy time, and total angiographic image frames were 106.2 ± 66.4 Gy-cm2, 697.1 ± 473.7 mGy, 9.7 ± 6.5 minutes, 241.5 ± 116.6 frames for diagnostic procedures, 218.8 ± 164.3 Gy-cm², 3365.7 ± 2205.8 mGy, 51.5 ± 31.1 minutes, 443.5 ± 270.7 frames for therapeutic procedures, respectively. For diagnostic procedure, the third quartiles for DRLs were 144.2 Gy-cm² for DAP, 921.1 mGy for CAK, 12.2 minutes for fluoroscopy times and 286.5 for number of image frames, respectively. For therapeutic procedures, the third quartiles for DRLs were 271.0 Gy-cm² for DAP, 4471.3 mGy for CAK, 64.7 minutes for fluoroscopy times and 567.3 for number of image frames, respectively. On average, rotational angiography was used 1.5 ± 0.7 times/session (range, 0-4; n=490) for diagnostic procedures and 1.6 ± 1.2 times/session (range, 0-4; n=368) for therapeutic procedures, respectively. CONCLUSION: Radiation dose as measured by DAP, fluoroscopy time and image frames were lower in our patients compared to another study regarding cerebral angiography, and DAP was lower with fewer angiographic image frames for therapeutic procedures. Proposed DRLs can be used for quality assurance and patient safety in diagnostic and therapeutic procedures.


Subject(s)
Angiography , Cerebral Angiography , Fluoroscopy , Humans , Intracranial Aneurysm , Korea , Patient Safety , Radiation Exposure
9.
Neurointervention ; : 10-17, 2016.
Article in English | WPRIM | ID: wpr-730293

ABSTRACT

PURPOSE: The purpose of this study was to assess the safety and early outcomes of the Pipeline device for large/giant or fusiform aneurysms. MATERIALS AND METHODS: The Pipeline was implanted in a total of 45 patients (mean age, 58 years; M:F=10:35) with 47 large/giant or fusiform aneurysms. We retrospectively evaluated the characteristics of the treated aneurysms, the periprocedural events, morbidity and mortality, and the early outcomes after Pipeline implantation. RESULTS: The aneurysms were located in the internal carotid artery (ICA) cavernous segment (n=25), ICA intradural segment (n=11), vertebrobasilar trunk (n=8), and middle cerebral artery (n=3). Procedure-related events occurred in 18 cases, consisting of incomplete expansion (n=8), shortening-migration (n=5), transient occlusion of a jailed branch (n=3), and in-stent thrombosis (n=2). Treatment-related morbidity occurred in two patients, but without mortality. Both patients had modified Rankin scale (mRS) scores of 2, but had an improved mRS score of 0 at 1-month follow-up. Of the 19 patients presenting with mass effect, 16 improved but three showed no changes in their presenting symptoms. All patients had excellent outcomes (mRS, 0 or 1) during the follow-up period (median, 6 months; range, 2-30 months). Vascular imaging follow-up (n=31, 65.9%; median, 3 months, range, 1-25 months) showed complete or near occlusion of the aneurysm in 24 patients (77.4%) and decreased sac size in seven patients (22.6%). CONCLUSION: In this initial multicenter study in Korea, the Pipeline seemed to be safe and effective for large/giant or fusiform aneurysms. However, a learning period may be required to alleviate device-related events.


Subject(s)
Aneurysm , Carotid Artery, Internal , Follow-Up Studies , Humans , Korea , Learning , Middle Cerebral Artery , Mortality , Retrospective Studies , Thrombosis
10.
Neurointervention ; : 18-23, 2016.
Article in English | WPRIM | ID: wpr-730292

ABSTRACT

OBJECTIVE: To evaluate progressive enhancement in the carotid arterial wall overlying plaque in the symptomatic side for patients with cerebrovascular symptoms until delayed phase using MDCTA. MATERIALS AND METHODS: Twenty-one patients (all men; ages, 49-82 years; mean, 67.8 +/- 8.4 years) with recent stroke and severe extracranial carotid stenosis were retrospectively analyzed. Pre-, early- and delayed phase images of MDCTA were obtained, and Hounsfield units (HU) of carotid walls were measured. We also measured HU of the asymptomatic contralateral carotid arterial wall for comparison. Friedman's test and Wilcoxon signed-rank test were used to evaluate the differences between groups. RESULTS: The averaged HU of the carotid wall in the symptomatic side was higher on the delayed phase (65.8 +/- 14.2 HU) compared to early arterial phase (54.2 +/- 12.6 HU). The averaged HU difference of wall enhancement between pre-contrast and delayed phase (28.0 +/- 14.8 HU) was significantly higher than the between pre-contrast and early arterial phase (16.4 +/- 12.1 HU) with P < 0.05. In analysis of the contralateral asymptomatic side, the HU difference between pre-contrast and delayed phase (15.5 +/- 12.0 HU) showed no significant higher value than between pre-contrast and early arterial phase (14.9 +/- 10.9 HU). CONCLUSION: The pronounced enhancement of the carotid wall in the delayed phase on MDCTA was demonstrated in symptomatic patients with severe internal carotid artery stenosis. In the future, we need more comparative studies to verify this finding as one of risk stratification.


Subject(s)
Angiography , Carotid Stenosis , Humans , Male , Retrospective Studies , Stroke
11.
Neurointervention ; : 7-13, 2015.
Article in English | WPRIM | ID: wpr-730307

ABSTRACT

Carotid artery angioplasty with stenting (CAS) is being performed in many hospitals in Korea. Most of the guidelines which are being used are similar, but the practical aspects such as techniques are different between hospitals. For example, usage of various protective devices, the oral antiplatelet regimen prior to procedure and placing of temporary pacemaker to prevent bradycardia are different between hospitals. In this article, we summarize and propose the guidelines for CAS which is currently being accepted in Korea. These guidelines may be helpful in providing protocol to neurointerventionalist who perform CAS and to standardize the process including reporting of CAS in the future comparative trials in Korea.


Subject(s)
Angioplasty , Bradycardia , Carotid Arteries , Korea , Protective Devices , Stents
12.
Article in English | WPRIM | ID: wpr-47856

ABSTRACT

An 8-year-old spayed female Maltese (2.5 kg of body weight) presented with the primary complaint of loud heart murmur and exercise intolerance. Diagnostic imaging revealed severe pulmonic stenosis (peak velocity 5.2 m/s) with right ventricular hypertrophy. The dog revisited after 2 years, at which time, diagnostic imaging revealed severe biventricular hypertrophy, dynamic left ventricular outflow tract obstruction, left atrial dilation and pulmonary hypertension with worsened pre-existing pulmonic stenosis. Postmortem investigation revealed hypertrophic cardiomyopathy and regional myocardial infarction. The case was diagnosed as hypertrophic cardiomyopathy secondary to severe right and left ventricular outflow tract obstruction.


Subject(s)
Animals , Cardiomyopathy, Hypertrophic , Child , Diagnostic Imaging , Dogs , Female , Heart Murmurs , Humans , Hypertension, Pulmonary , Hypertrophy , Hypertrophy, Right Ventricular , Myocardial Infarction , Pulmonary Valve Stenosis
13.
Article in English | WPRIM | ID: wpr-47855

ABSTRACT

A 12-year-old female Cocker Spaniel (7.5 kg of body weight) was presented for resection of a mammary gland tumor. During surgery, the heart rate was remarkably decreased due to a second-degree type I atrioventricular block. Atropine (0.05 mg/kg) was administered to increase the heart rate. Although the heart rate was elevated, atrial bigeminy occurred and persisted until the dog fully recovered from general anesthesia. These results highlight the possibility of atrial bigeminy caused by atropine administration during anesthesia.


Subject(s)
Anesthesia , Anesthesia, General , Animals , Atrial Premature Complexes , Atrioventricular Block , Atropine , Child , Dogs , Female , Heart Rate , Humans , Mammary Glands, Human
14.
Article in English | WPRIM | ID: wpr-119554

ABSTRACT

Mitral valvular prolapse (MVP) in dogs is characterized by myxomatous valvular degeneration, which is caused by abnormal valvular thickening and incomplete coaptation of the mitral valve leading to mitral regurgitation. Mitral regurgitation causes left atrial and left ventricular enlargement. Pathogenesis of the disease is unknown, although some studies have suggested the involvement of endothelin and systemic connective tissue diseases. Mitral valvular prolapse in dogs commonly occurs in aged small dog breeds, including Malteses and Shih Zhus. This case study investigated the clinical features of an affected Maltese family and performed pedigree analysis. To the best of the authors' knowledge, this is the first report of putative familial mitral valve prolapse and regurgitation in Maltese dogs. All family members in this study showed degenerative valvular changes and echocardiographic features of mitral valvular prolapse. Although disease progression differed, all dogs progressed to advanced heart failure stage within 2-3 years after diagnosis. Therefore, this is the first study to identify putative familial mitral valve prolapse in Maltese dogs. This finding suggests strong genetic etiology involved in the development of degenerative mitral valve disease in Maltese dogs. Furthermore, this finding could be a valuable resource for the identification of gene mutations in dogs with familial mitral valvular prolapse.


Subject(s)
Animals , Connective Tissue Diseases , Diagnosis , Disease Progression , Dogs , Echocardiography , Endothelins , Heart Failure , Humans , Mitral Valve , Mitral Valve Insufficiency , Mitral Valve Prolapse , Pedigree , Prolapse
15.
Article in English | WPRIM | ID: wpr-95915

ABSTRACT

An 8-year-old intact male Pekingese (weighing 13 kg) was presented for evaluation of chronic coughing. Thoracic radiography found a redundant tissue swelling (protruded on expiration and collapsed on inspiration) on the ventral neck just cranial to the thoracic inlet. Fluoroscopy also identified that the cranial portion of the right/left cranial lung lobe was seen to protrude through the thoracic inlet into the ventral neck on expiration. On the echocardiogram, there were no abnormal jets in all cardiac valves and no dilation in all cardiac chambers. Based on diagnostic imaging studies, the case was diagnosed as cervical lung lobe herniation.


Subject(s)
Animals , Bays , Child , Cough , Diagnostic Imaging , Dogs , Fluoroscopy , Heart Valves , Humans , Lung , Male , Neck , Radiography, Thoracic
16.
Neurointervention ; : 63-71, 2014.
Article in English | WPRIM | ID: wpr-730170

ABSTRACT

PURPOSE: An intracranial aneurysm, with or without subarachnoid hemorrhage (SAH), is a relevant health problem. The rupture of an intracranial aneurysm is a critical concern for individual health; even an unruptured intracranial aneurysm is an anxious condition for the individual. The aim of this guideline is to present current and comprehensive recommendations for the management of intracranial aneurysms, with or without rupture. MATERIALS AND METHODS: We performed an extensive literature search, using Medline. We met in person to discuss recommendations. This document is reviewed by the Task Force Team of the Korean Society of Interventional Neuroradiology (KSIN). RESULTS: We divided the current guideline for ruptured intracranial aneurysms (RIAs) and unruptured intracranial aneurysms (UIAs). The guideline for RIAs focuses on diagnosis and treatment. And the guideline for UIAs focuses on the definition of a high-risk patient, screening, principle for treatment and selection of treatment method. CONCLUSION: This guideline provides practical, evidence-based advice for the management of patients with an intracranial aneurysm, with or without rupture.


Subject(s)
Advisory Committees , Diagnosis , Humans , Intracranial Aneurysm , Mass Screening , Rupture , Subarachnoid Hemorrhage
18.
Article in English | WPRIM | ID: wpr-162483

ABSTRACT

Maxillary enlargement is a rare complication of secondary hyperparathyroidism (SHPT). A 35-year-old Korean man undergoing chronic hemodialysis presented with a painless enlargement involving the maxilla and mandible. Plain radiography and CT scan showed bony expansion at the maxilla and mandible with multiple radiolucency. Serum intact parathyroid hormone (iPTH) was >1,600 pg/mL. Tc-99m sestamibi (MIBI) parathyroid scan and neck sonogram were compatible with SHPT. He underwent limited parathyroidectomy and commenced a course of paricalcitol. Fifteen months after surgery, maxillary enlargement and bony resorptions involving both hands markedly improved. Thirty-six months after the surgery, the serum iPTH level was 109.3 pg/mL. This is the first report in Korea documenting a patient with maxillary enlargement in SHPT who was successfully treated with limited parathyroidectomy and paricalcitol.


Subject(s)
Adult , Ergocalciferols , Hand , Humans , Hyperparathyroidism , Hyperparathyroidism, Secondary , Korea , Mandible , Maxilla , Neck , Parathyroid Hormone , Parathyroidectomy , Renal Dialysis , Chronic Kidney Disease-Mineral and Bone Disorder
19.
Article in English | WPRIM | ID: wpr-78435

ABSTRACT

Radiologic findings of Bing-Neel syndrome, which is an extremely uncommon complication resulting from malignant lymphocyte infiltration into the central nervous system (CNS) in patients with Waldenstrom's macroglobulinemia (WM), have been infrequently reported due to extreme rarity of the case. A 75-year-old man with WM presented at a neurology clinic with progressive gait and memory disturbances, and dysarthria of 2 months duration. Cerebrospinal fluid and serum protein electrophoresis and immunofixation electrophoresis showed IgM kappa-type monoclonal gammopathy. Brain magnetic resonance imaging revealed multifocal, hyperintense lesions on T2 weighted-images. Brain diffusion-weighted imaging (DWI) demonstrated hyperintensities in cerebral and cerebellar lesions that appeared isointense on apparent diffusion coefficient maps, which were compatible with vasogenic edema. Although histologic analysis is a confirmative study to prove direct cell infiltration into the brain, brain MRI with DWI may be a good supportive study to diagnose Bing-Neel syndrome.


Subject(s)
Aged , Brain , Central Nervous System , Diffusion , Dysarthria , Edema , Electrophoresis , Gait , Humans , Immunoglobulin M , Lymphocytes , Magnetic Resonance Imaging , Magnetics , Magnets , Memory , Neurology , Paraproteinemias , Waldenstrom Macroglobulinemia
20.
Article in English | WPRIM | ID: wpr-173544

ABSTRACT

Pelizaeus-Merzbacher disease (PMD) is a rare X-linked recessive disorder with a prototype of a dysmyelinating leukodystrophy that is caused by a mutation in the proteolipid protein 1 (PLP1) gene on the long arm of the X chromosome in band Xq22. This mutation results in abnormal expression or production of PLP. We here present a Korean boy with spastic quadriplegia, horizontal nystagmus, saccadic gaze, intentional tremor, head titubation, ataxia, and developmental delay. The brain magnetic resonance imaging (MRI) showed abnormally high signal intensities in the white matter tract, including a subcortical U fiber on the T2-weighted and fluid attenuated inversion recovery (FLAIR) image. The chromosomal analysis was normal; however, duplication of the PLP1 gene in chromosome Xq22 was detected when the multiplex ligation-dependent probe amplification (MLPA) method was used. We also investigated the pedigree for a genetic study related to PMD. This case suggests that the duplication mutation of the PLP1 gene in patients with PMD results in a mild clinical form of the disorder that mimics the spastic quadriplegia of cerebral palsy.


Subject(s)
Brain/pathology , Child, Preschool , Chromosome Mapping , Chromosomes, Human, X , Developmental Disabilities/diagnosis , Exons , Gene Duplication , Humans , Korea , Magnetic Resonance Imaging/methods , Mutation , Myelin Proteolipid Protein/genetics , Myelin Sheath/chemistry , Pelizaeus-Merzbacher Disease/diagnosis , Polymerase Chain Reaction/methods
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