Diphenylbydantoin-induced movement disorders have been rarely reported. They include choreoathetosis, orofacial dyskinesia, asterixis, dystonia, and ballismus. A patient with epllepsy, who showed orofacial dyskinesia with toxic cerebellar syrnptoms after longterm use of diphenylhydantoin is presented. The involuntary movement rapidily disappeared with a reduction of diphenylhydantoin dose.
Dyskinesias ; Dystonia ; Humans ; Movement Disorders* ; Phenytoin

This review-article is aimed at shedding a light upon the nature of age-associated changes in the human skeletal system. When the anatomical, physiological and biochemical consequences of bone aging are considered together with the hardening, drying and the diminished repair capabilities of the elderly, it can be seen that fractures assume greater importance as a clinical problem in the geriatric population. Older people start out with a deficit of cortical bone, making them more fracture prone and once fractures occur, the necessary treatments (immobilization, use of casts, etc.) accelerate the rate of bone loss. In addition, aged individuals stand a higher risk for complications of the hospital and enforced bed rest that may ensue. The problems resulting from bone loss in the elderly may be partially alleviated by providing adequate health service support which should include consideration of the following points : 1. Age, sex and general health status ; 2. Habits and inclinations towards physical activities ; 3. Nutritional and endocrine background ; 4. Presence of any specific bone diseases, including osteoporosis, osteoarthritis, osteomalacia and ankylosis ; 5. Psychosocial adaptability and other behavioral elements.
Aged ; Aging ; Ankylosis ; Bed Rest ; Biology* ; Bone Diseases ; Health Services ; Humans* ; Motor Activity ; Osteoarthritis ; Osteomalacia ; Osteoporosis

Background: As a risk factor for diabetes, there are many evidences for physical characteristics and lifestyle habits. There are studies showing that resting heart rate is also related, but evidence is still lacking. Therefore, this study attempted to determine the effect of resting heart rate on diabetes. Methods: The subject of this study was analyzed with 6,622 people who had fasting blood glucose test data out of a total of 7,993 people who participated in the 7th National Health and Nutrition Survey. Fasting blood glucose above 126 mg/dL was defined as a diabetic group and a multiple logistic regression analysis was used. General characteristics, lifestyle and blood chemistry test results were adjusted to investigate the association with diabetes according to the resting heart rate level in the subjects. Results: The risk of diabetes according to the resting heart rate level was 1.434 times in the 2nd quartile, 1.714 times in the 3rd and 1.785 times in the 4th, compared to the 1st quartile. In model 4, except for the 2nd, which was not significant the analysis with all related variables adjusted for the risk rate in the 3rd and 4th order showed that the risk rate increased to 2.364 times and 3.477 times, respectively as the resting heart rate increased. Conclusions This study shows that high resting heart rate is associated with increased diabetes, and suggests that high heart rate, along with other known risk factors, may be a useful tool in predicting diabetes risk.

Objective: The treatment outcomes of ruptured intracranial aneurysms using the Neuroform Atlas stent were evaluated. Methods: This study represents a retrospective review that included patients who underwent endovascular treatment for ruptured aneurysms at a single institution. Between January 2018 and September 2022, endovascular treatments including simple coiling or Neuroform Atlas stent-assisted coil embolization were performed in 191 patients with ruptured intracranial aneurysms. Results: Intraprocedural rupture was observed in 11 (8.7%) patients in the Simple Coiling (SC) group, which was slightly higher than that in 4 (6.3%) patients in the Neuroform Atlas stent-assisted coiling (NASAC) group (p=0.241). However, Thromboembolic event (TEE) was slightly more prevalent in the NASAC group, with 4 (6.3%) cases as compared to the 5 (3.9%) cases in the SC group (p=0.235). The retreatment rate was slightly higher in the SC group, with 19 (26.4%) patients as compared to the 10 patients (22.2%) in the NASAC group (p=0.342). Conclusions The use of the Neuroform Atlas stent (NAS) for ruptured aneurysms might be safe and effective.

Objective: The treatment outcomes of ruptured intracranial aneurysms using the Neuroform Atlas stent were evaluated. Methods: This study represents a retrospective review that included patients who underwent endovascular treatment for ruptured aneurysms at a single institution. Between January 2018 and September 2022, endovascular treatments including simple coiling or Neuroform Atlas stent-assisted coil embolization were performed in 191 patients with ruptured intracranial aneurysms. Results: Intraprocedural rupture was observed in 11 (8.7%) patients in the Simple Coiling (SC) group, which was slightly higher than that in 4 (6.3%) patients in the Neuroform Atlas stent-assisted coiling (NASAC) group (p=0.241). However, Thromboembolic event (TEE) was slightly more prevalent in the NASAC group, with 4 (6.3%) cases as compared to the 5 (3.9%) cases in the SC group (p=0.235). The retreatment rate was slightly higher in the SC group, with 19 (26.4%) patients as compared to the 10 patients (22.2%) in the NASAC group (p=0.342). Conclusions The use of the Neuroform Atlas stent (NAS) for ruptured aneurysms might be safe and effective.

Objective: The treatment outcomes of ruptured intracranial aneurysms using the Neuroform Atlas stent were evaluated. Methods: This study represents a retrospective review that included patients who underwent endovascular treatment for ruptured aneurysms at a single institution. Between January 2018 and September 2022, endovascular treatments including simple coiling or Neuroform Atlas stent-assisted coil embolization were performed in 191 patients with ruptured intracranial aneurysms. Results: Intraprocedural rupture was observed in 11 (8.7%) patients in the Simple Coiling (SC) group, which was slightly higher than that in 4 (6.3%) patients in the Neuroform Atlas stent-assisted coiling (NASAC) group (p=0.241). However, Thromboembolic event (TEE) was slightly more prevalent in the NASAC group, with 4 (6.3%) cases as compared to the 5 (3.9%) cases in the SC group (p=0.235). The retreatment rate was slightly higher in the SC group, with 19 (26.4%) patients as compared to the 10 patients (22.2%) in the NASAC group (p=0.342). Conclusions The use of the Neuroform Atlas stent (NAS) for ruptured aneurysms might be safe and effective.

BACKGROUND: More than 90% of acute stroke patients have measurable cardiovascular sequelae, but we have been often overlooked in formal discussions of treatment. If we estimate the incidence of myocardial injury in patient with spontaneous SAH, we may figure the possibility of cardiac dysfunction in such patients. This study was designed to investigate the incidence of myocardial injury in patients with spontaneous SAH using cardiac troponin I(cTnI). METHODS: A prospective single emergency center study was performed to determined preoperative incidence of unrecognized cardiac injury in patients suffering spontaneous SAH. We include the spontaneous SAH patients who underwent serum measurements of the cardic troponin I immediately upon admission last six month period. ECG, CK, CK-MB and myoglobin were also performed at admission. We excluded the spontaneous SAH patients who had past history of myocardial ischemia and ECG abnormality. RESULTS: Fifty-two patients(34 females, 18 males) with spontaneous SAH were studied prospectively. 18 patients(34.6% of the total study population) had cTnI level above 0.5ng/ml. ECG was performed in 52 patients and was abnormal in 15 of the 52 patients(28.8%). CONCLUSION: The measurement of cTnI has provided physicians with a myocardial marker that has a cardiac sensitivity for cardiac injury equal to that of CK-MB yet with greater specificity. So, cardiac troponin I is useful to estimate the incidence of myocardial injury in patients with spontaneous SAH. And we may estimate the possibility of cardiac dysfunction in such patients. This knowledge will hopefully aid in the care and improve the outcome.
Electrocardiography ; Emergencies ; Female ; Humans ; Incidence* ; Myocardial Ischemia ; Myoglobin ; Prospective Studies ; Sensitivity and Specificity ; Stroke ; Troponin I* ; Troponin*

Some herbal medications induce acute kidney injury. The acute kidney injuries caused by herbal medications are mild and commonly treated by palliative care. A 51-years-old man who drank the juice squeezed from the raw tubers of Dioscorea quinqueloba (D. quinqueloba) was admitted with nausea, vomiting and chilling. He developed a seizure with decreased level of consciousness. He was diagnosed with acute kidney injury, which was cured by continuous venovenous hemodialfiltration. Non-detoxified D. quinqueloba can cause severe acute kidney injury with toxic encephalopathy. It is critical to inform possible adverse effects of the medicinal herbs and to implement more strict regulation of these products.
Acute Kidney Injury/*chemically induced/*complications ; Dioscorea/*adverse effects ; Disease Progression ; Electroencephalography ; Humans ; Length of Stay ; Male ; Middle Aged ; Neurotoxicity Syndromes/*complications

PURPOSE: To evaluate clinical results of combined phacotrabeculectomy (PHACO-TRAB) and trabeculectomy (TRAB) for primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). METHODS: Forty-two eyes of 42 patients with POAG and 60 eyes of 60 patients with PACG were studied retrospectively. Fifty-two patients underwent PHACO-TRAB and 50 patients underwent TRAB. The IOP, number of anti-glaucoma medications, and duration of filtering bleb survival for 3 years after surgery were compared. RESULTS: For 12 months after surgery, the TRAB group maintained significantly lower IOP than the PHACO-TRAB group (p < 0.05, t-test), and there was no significant difference thereafter. The filtering bleb survival rate was significantly higher in the TRAB group during the study period. In patients with POAG, the TRAB group showed higher filtering bleb survival rate for 3 years (p = 0.016, log-rank test). However, in patients with PACG, there was no significant difference in filtering bleb survival between the 2 groups. In patients with POAG, the TRAB group maintained significantly lower IOP for 12 months after surgery, and there was no significant difference afterwards. In patients with PACG, the TRAB group maintained lower IOP only at 1, 3, and 6 months after surgery. However, the PHACO-TRAB group showed significantly lower IOP at 18 months and 36 months after surgery. CONCLUSIONS: In patients with POAG, TRAB was more effective in lowering IOP and maintaining filtering bleb. However in patients with PACG, there was no difference in filtering bleb survival between the 2 groups. TRAB was more effective in maintaining IOP during the early period after surgery, but PHACO-TRAB was superior to TRAB beyond 1 year after surgery in patients with PACG.
Blister ; Eye ; Glaucoma ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Retrospective Studies ; Survival Rate ; Trabeculectomy

PURPOSE: To evaluate clinical results of combined phacotrabeculectomy (PHACO-TRAB) and trabeculectomy (TRAB) for primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). METHODS: Forty-two eyes of 42 patients with POAG and 60 eyes of 60 patients with PACG were studied retrospectively. Fifty-two patients underwent PHACO-TRAB and 50 patients underwent TRAB. The IOP, number of anti-glaucoma medications, and duration of filtering bleb survival for 3 years after surgery were compared. RESULTS: For 12 months after surgery, the TRAB group maintained significantly lower IOP than the PHACO-TRAB group (p < 0.05, t-test), and there was no significant difference thereafter. The filtering bleb survival rate was significantly higher in the TRAB group during the study period. In patients with POAG, the TRAB group showed higher filtering bleb survival rate for 3 years (p = 0.016, log-rank test). However, in patients with PACG, there was no significant difference in filtering bleb survival between the 2 groups. In patients with POAG, the TRAB group maintained significantly lower IOP for 12 months after surgery, and there was no significant difference afterwards. In patients with PACG, the TRAB group maintained lower IOP only at 1, 3, and 6 months after surgery. However, the PHACO-TRAB group showed significantly lower IOP at 18 months and 36 months after surgery. CONCLUSIONS: In patients with POAG, TRAB was more effective in lowering IOP and maintaining filtering bleb. However in patients with PACG, there was no difference in filtering bleb survival between the 2 groups. TRAB was more effective in maintaining IOP during the early period after surgery, but PHACO-TRAB was superior to TRAB beyond 1 year after surgery in patients with PACG.
Blister ; Eye ; Glaucoma ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Retrospective Studies ; Survival Rate ; Trabeculectomy