Wernicke's encephalopathy is a reversible but potentially critical disease caused by thiamine deficiency. Most patients complain of symptoms such as ophthalmoplegia, ataxia and confusion. Heavy alcohol drinking is commonly associated with the disease, but other clinical conditions also can provoke it. In pregnant women, hyperemesis gravidarum can lead to the depletion of body thiamine due to poor oral intake and a high metabolic demand. We report a case of Wernicke's encephalopathy following hyperemesis gravidarum in a 36-year-old female at 20 weeks of pregnancy, who visited our hospital because of shock with vaginal bleeding. This case suggests that although the initial presentation may include atypical symptoms (e.g., shock or bleeding), Wernicke's encephalopathy should be considered, and thiamine replacement should be performed in pregnant women with neurologic symptoms and poor oral intake.
Acute Kidney Injury ; Adult ; Alcohol Drinking ; Ataxia ; Female ; Humans ; Hyperemesis Gravidarum* ; Neurologic Manifestations ; Ophthalmoplegia ; Pregnancy ; Pregnant Women ; Shock ; Thiamine ; Thiamine Deficiency ; Uterine Hemorrhage ; Wernicke Encephalopathy*

PURPOSE: The purpose of this study was to determine the effect of dehydroepiandrosterone (DHEA) on recovery of muscle atrophy induced by Parkinson's disease. METHODS: The rat model was established by direct injection of 6-hydroxydopamine (6-OHDA, 20 microg) into the left striatum using stereotaxic surgery. Rats were divided into two groups; the Parkinson's disease group with vehicle treatment (Vehicle; n=12) or DHEA treatment group (DHEA; n=22). DHEA or vehicle was administrated intraperitoneally daily at a dose of 0.34 mmol/kg for 21 days. At 22-days after DHEA treatment, soleus, plantaris, and striatum were dissected. RESULTS: The DHEA group showed significant increase (p<.01) in the number of tyrosine hydroxylase (TH) positive neurons in the lesioned side substantia nigra compared to the vehicle group. Weights and Type I fiber cross-sectional areas of the contralateral soleus of the DHEA group were significantly greater than those of the vehicle group (p=.02, p=.00). Moreover, extracellular signal-regulated kinase (ERK) phosphorylation significantly decreased in the lesioned striatum, but was recovered with DHEA and also in the contralateral soleus muscle, Akt and ERK phosphorylation recovered significantly and the expression level of myosin heavy chain also recovered by DHEA treatment. CONCLUSION: Our results suggest that DHEA treatment recovers Parkinson's disease induced contralateral soleus muscle atrophy through Akt and ERK phosphorylation.
Animals ; Corpus Striatum/drug effects/metabolism ; Dehydroepiandrosterone/*pharmacology/therapeutic use ; Extracellular Signal-Regulated MAP Kinases/metabolism ; Male ; Muscle Fibers, Slow-Twitch/drug effects ; Muscle, Skeletal/drug effects/metabolism ; Muscular Atrophy/drug therapy/*etiology/*pathology ; Myosins/metabolism ; Neurons/drug effects/enzymology ; Oxidopamine/toxicity ; Parkinson Disease, Secondary/*chemically induced/*complications ; Phosphorylation ; Proto-Oncogene Proteins c-akt/metabolism ; Rats ; Rats, Sprague-Dawley ; Tyrosine 3-Monooxygenase/metabolism

This study was to determine the effect of exercise on the recovery of dopaminergic neuron loss and muscle atrophy in 6-OHDA-induced hemi Parkinson's disease model. Exercise was loaded twice per day for 30 minutes each time, at 5 days after 6-OHDA lesioning and continued for 16 days using a treadmill. Exercise significantly increased the number of tyrosine hydroxylase positive neuron in the lesioned substantia nigra and the expression level of tyrosine hydroxylase in the striatum compared with the control group. To examine which signaling pathways may be involved in the exercise, the phosphorylation of GSK3beta and ERK were observed in the striatum. In the control group, basal level of GSK3beta phosphorylation was less than in both striatum, but exercise increased it. ERK phosphorylation decreased in the lesioned striatum, but exercise recovered it. These findings suggest that exercise inactivates GSK3beta by phosphorylation which may be involved in the neuroprotective effect of exercise on the 6-OHDA-induced cell death. In the exercise group, weight, and Type I and II fiber cross-sectional area of the contralateral soleus significantly recovered and expression of myosin heavy chain and Akt and ERK phosphorylation significantly increased by exercise. These results suggest that exercise recovers Parkinson's disease induced dopaminergic neuron loss and contralateral soleus muscle atrophy.
Animals ; Atrophy ; Cell Death ; Dopaminergic Neurons ; Glycogen Synthase Kinase 3 ; Muscle, Skeletal ; Muscles ; Muscular Atrophy ; Myosin Heavy Chains ; Neurons ; Neuroprotective Agents ; Oxidopamine ; Parkinson Disease ; Phosphorylation ; Rats ; Substantia Nigra ; Tyrosine 3-Monooxygenase

PURPOSE: This study was performed to evaluate clinical and radiographical results of treatment of chronic lateral ankle instability with modified Brostrom procedure. MATERIALS AND METHODS: This is a retrospective study of 22 cases in 22 patients treated with modified Brostrom procedure under the diagnosis of chronic lateral ankle instability from May 2000 to August 2004. Average age was 32.3 years. Average follow-up period was 23 months. Preoperative and postoperative radiographs of ankle anteroposterior view, lateral view and varus stress view were analyzed. The clinical evaluation was performed according to the Americal Orthopaedic Foot and Ankle Society scales. RESULTS: After the modified Brostrom procedure, Americal Orthopaedic Foot and Ankle Society scales score was improved by average 28 points. Among the 22 cases, 13 cases were excellent, 3 cases good, 4 cases fair, and 2 cases poor with satisfaction of 73%. Five cases had intermittent ankle pain of whom 3 cases had difficulty during competitive sports activity. Lateral tilting of talus improved by average 5.4 degrees on varus stress view. CONCLUSIONS: The modified Brostrom procedure is one of the most effective methods for treating of chronic lateral ankle instability.
Ankle* ; Diagnosis ; Follow-Up Studies ; Foot ; Humans ; Retrospective Studies ; Sports ; Talus ; Weights and Measures

No abstract available.
Diabetic Ketoacidosis* ; Lung Abscess* ; Lung* ; Mucormycosis*

STATEMENT OF PROBLEM: Dental ceramics exhibit excellent esthetic property, compressive strength, chemical durability, biocompatibility and translucency. However, it suffers from inherent brittle fractures. Various techniques and materials for intraoral porcelain repair has been suggested. PURPOSE: This study is to compare the tensile bond strength of four commonly used porcelain repair systems (Vivadent, Bisco, Ultradent, Voco) and to insure the best system for the clinical application to the fractured porcelain. MATERIALS AND METHODS: A total of fifty specimens were fabricated. Specimens were stored in 37degrees C distilled water for 7 days and thermocycling was performed(1000 cycles), and subjected to a tensile force parallel to the repair resin and porcelain interface by use of an Universal Testing Machine. RESULT: 1. Voco showed the highest tensile bond strength. In decreasing order, the tensile bond strength of the other materials was as follows : Ultradent, Bisco, Vivadent. 2. There was a statistically significant difference between the porcelain repair systems(Voco, Ultradent > Bisco, Vivadent) (p<0.05). 3. SEM examination of prepared porcelain surfaces revealed that the surface treated with Voco showed brittle fracture. However, Ultradent, Bisco and Vivadent showed ductile fracture. 4. All specimens treated with four porcelain repair systems showed adhesive failure between porcelain and composite resin.
Adhesives ; Ceramics ; Compressive Strength ; Dental Porcelain* ; Water

Caudal regression syndrome is rare malformative syndrome characterized by lower vertebral agenesis, accompanied by abnormalities of the pelvis, lower extremities and urogenital malformation. Although the cause is not clear, hyperglycemia during the organogenesis may be important teratogen. Strict evaluation of diabetes and its control in preconception and early pregnancy are important to prevent this malformation. And ultrasonography in the first trimester should be recommended for early detection of this syndrome. We report a case of caudal regression syndrome detected by prenatal ultrasonography of the gestational diabetic mother.
Female ; Humans ; Hyperglycemia ; Lower Extremity ; Mothers ; Organogenesis ; Pelvis ; Pregnancy ; Pregnancy Trimester, First ; Ultrasonography ; Ultrasonography, Prenatal*

PURPOSE: To evaluate between DHS and ITST nail (2nd generation) on the treatment of unstable femur intertrochanteric fracture in patients over 70 years old. MATERIALS AND METHODS: 61 cases of unstable intertrochanteric fracture (grouped 37 patients with DHS and 24 patients with ITST) who were taken the operation from Mar. 2003 to Sep. 2007 were analysed regarding to union time, sliding length of lag screws, operation time, blood loss, postoperative complications and functional recovery score by Skovron. RESULTS: The mean union time was 14.7 weeks in study group (ITST). The mean union time was 16.2 weeks in control group (DHS). The lag screw slidings were 7.2 mm in study group and 8.7 mm in control group. The operation times were 57.9 min in study group and 76.9 min in control group. The amount of blood loss were 67.7 ml in study group and 227.4 ml in control group. The complications were 4 cases in study group and 4 cases in control group. The Skovron recovery scores were 76.5% in study group and 73.7% in control group. CONCLUSION: From a practical point of short operation time, less amount of bleeding and less complication, author think that the ITST nail is useful implant for treatment of unstable femur intertrochanteric fracture in patient of old age.
Femur ; Hemorrhage ; Hip ; Humans ; Nails ; Postoperative Hemorrhage

PURPOSE: This study was undertaken to obtain basic data about the megakaryocyte colony formation of fetal liver cells by using immunocytochemical staining and ex vivo culture with growth factors. METHODS: The mononuclear cells were isolated from fetal liver and bone marrow with idiopathic thrombocytopenic purpura(ITP) and pancytopenia. These mononuclear cells were cultured in MegaCultTM-C(Stem Cell Tech, Canada) media in the presence of growth factors and CFU-Megakaryocyte(CFU-Mk) colonies were counted on day 12. The expansion of CD34+ and CD41+ cell was analyzed by flow cytometry after 5 days incubation using flask culture. RESULTS: The numbers of CFU-Mk colonies of mononuclear cells obtained from fetal liver in the 11th week gestational age were more than those in the 19th week specimens; growth factors could not enhance the colony expansion in all cases. Total numbers of CFU-Mk colony of fetal liver cells were higher than bone marrow from ITP or pancytopenia groups. The numbers of pure or large CFU-Mk colonies of fetal liver cells were also higher than bone marrow specimens. The rate of CD34+ cell expression of fetal liver was increased after flask culture and the enhancement effect of epression was seen only in cases which added thrombopoietin. The rate of CD41+ cell expression of fetal liver was increased after incubation, but the enhancement effect of growth factors was unclear. CONCLUSION: This study revealed good results about the megakaryocyte colony assay of fetal liver mononuclear cells using MegaCultTM-C media. This study suggests that the fetal liver could be a good source of megakaryocytic progenitor cells for clinical application in hematopoietic stem cell transplantation.
Bone Marrow ; Flow Cytometry ; Gestational Age ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Intercellular Signaling Peptides and Proteins ; Liver* ; Megakaryocytes* ; Pancytopenia ; Stem Cells ; Thrombopoietin

BACKGROUND: Selective neck dissection has been performed as a primary purpose of management for the lymph node groups that are at highest risk of containing metastasis according to the location of the primary tumor. OBJECTIVES: We were to evaluate the clinical application and effectiveness of selective neck dissection through analysis of the medical records about treatment results and postoperative recurrences. MATERIALS AND METHOD: The medical records of 61 patients who had 86 neck dissections performed at the Kangnam St. Mary's Hospital during the period of 1993 through 1995 were reviewed. RESULTS: Forty four selective neck dissections had been performed in 35 patients. Sites of primary tumor were 22 larynx cancers(62.9%), 5 thyroid cancers(14.3%), 4 tongue cancers(11.4%), 2 lip cancers(5.7%), 1 oropharynx cancer(2.9%) and 1 malignant melanoma(2.9%). The types of neck dissection were 29 lateral neck dissections(65.9%), 9 supraomohyoid neck dissections(19.2%), 5 anterior neck dissections(11.4%), and 1 posterolateral neck dissection(2.3%). Elective neck dissections were performed on 26 Cases(59.1%). Lymph nodes were histologically positive in 10 of 18 therapeutic neck Dissections(55.6%) and in 5 of 26 electeve neck dissections(19.2%). Recurrence in the dissected neck occured in two cases(4..5%) of selective neck dissections. Both of the two cases were larynx cancer, which developed concomitant primary and neck recurrence after lateral neck dissection. CONCLUSION: Selective neck dissection was effective approach to neck management of head and neck cancer patients.
Head and Neck Neoplasms ; Humans ; Laryngeal Neoplasms ; Larynx ; Lip ; Lymph Nodes ; Medical Records ; Neck Dissection* ; Neck* ; Neoplasm Metastasis ; Oropharynx ; Recurrence ; Thyroid Gland ; Tongue