Ischemic stroke is a serious neurological complication of infective endocarditis. Intravenous tissue plasminogen activator (t-PA), which has only been approved for treatment of hyperacute stroke, has been excluded as an ischemic stroke treatment due to infective endocarditis according to current expert consensus guidelines. Here, we describe a case of a hyperacute stroke patient treated with intravenous t-PA, who was later diagnosed with infective endocarditis.

A global increase in the incidence of tuberculosis has prompted the need for earlier diagnosis, treatment, and isolation of the disease. In tuberculosis, concomitant tuberculous meningitis and vascular complications such as intracranial aneurysms and subarachnoid hemorrhage are very rare. Because of the poor prognosis of tuberculous meningitis as well as intracranial aneurysm and subarachnoid hemorrhage, early diagnosis and management are crucial. We present the case of a 76-year-old woman who had two intracranial aneurysms complicated by subarachnoid hemorrhage, who had concomitant tuberculous meningitis. She remained well with medical management.

There is an increasing need for revision of the femoral stem due to a high frequency of total hip arthroplasty. Recently, many orthopedic professionals are paying particular attention to the durability of revision arthroplasty. This review article includes the most recent information and published studies about revision of the femoral stem. It is ordered as follows: preoperative evaluation, surgical planning, surgical approaches, implant removal, reimplantation, perioperative complications and clinical results according to implant type.
Arthroplasty ; Hip ; Orthopedics ; Replantation

BACKGROUND: Some research viewed that effective dietary therapy was enough to control proper blood glucose level, but in the most patient, dietary therapy was not practiced and the most difficult part of managing their diabetes. The purpose of this research study was to investigate dietary practice adherence and perceived barriers among the elderly diabetes. METHODS: The survey was mailed to 852 persons with diabetes member via diabetic educator of 156 hospitals or clinics and 24 health centers. Questionnaire had background information of patients, meal regularity, food intake as a dietary practice adherence, barriers of 36 items which have 3 areas such as motive/attitude, knowledge, authority/resource. We asked the person with diabetes to rate barrier to dietary practice adherence. 432 questionnaire were returned the response. we selected 69 persons who were over 65 year old. RESULTS: 1) meal regularity was more satisfactory than food intake. 2) deficit of meal regularity were evening snack and resonable spacing between evening meal and evening snack. 3) deficit of food intake was serving of milk. 4) main barrier to dietary practice adherence was that of knowledge. CONCLUSION: For practice effectively dietary therapy to elderly diabetes, individual consultation or small group education must be pursued and more easily educational skills should be required.
Aged* ; Blood Glucose ; Eating ; Education ; Humans ; Meals ; Milk ; Postal Service ; Surveys and Questionnaires ; Snacks

Methylglyoxal (MGO) is a highly reactive metabolite of glucose which is known to cause damage and induce apoptosis in endothelial cells. Endothelial cell damage is implicated in the progression of diabetes-associated complications and atherosclerosis. Hypericin, a naphthodianthrone isolated from Hypericum perforatum L. (St. John’s Wort), is a potent and selective inhibitor of protein kinase C and is reported to reduce neuropathic pain. In this work, we investigated the protective effect of hypericin on MGO-induced apoptosis in human umbilical vein endothelial cells (HUVECs). Hypericin showed significant anti-apoptotic activity in MGO-treated HUVECs. Pretreatment with hypericin significantly inhibited MGO-induced changes in cell morphology, cell death, and production of intracellular reactive oxygen species. Hypericin prevented MGO-induced apoptosis in HUVECs by increasing Bcl-2 expression and decreasing Bax expression. MGO was found to activate mitogen-activated protein kinases (MAPKs). Pretreatment with hypericin strongly inhibited the activation of MAPKs, including P38, JNK, and ERK1/2. Interestingly, hypericin also inhibited the formation of AGEs. These findings suggest that hypericin may be an effective regulator of MGO-induced apoptosis. In conclusion, hypericin downregulated the formation of AGEs and ameliorated MGO-induced dysfunction in human endothelial cells.
Apoptosis ; Atherosclerosis ; Cell Death ; Endothelial Cells* ; Glucose ; Glycosylation End Products, Advanced ; Human Umbilical Vein Endothelial Cells ; Humans* ; Hypericum ; Mitogen-Activated Protein Kinases ; Neuralgia ; Protein Kinase C ; Pyruvaldehyde ; Reactive Oxygen Species

BACKGROUND: The human homologue of the SC2 gene from a human dermal papilla cell cDNA library has been isolated and designated hSC2. HSC2 protein also shares similarity with 5 -reductase, a protein important in testosterone metabolism. OBJECTIVE: Prior to knowing the functions of hSC2 in dermal papilla, we cloned it and analyzed its relative expression levels in adult tissues and cancer cell lines. METHODS: hSC2 was isolated from low abundant clones in dermal papilla cDNA library using cDNA array hibridization method. Full-length clone was sequenced and we studied its expression in different tissues by Northern blot hybridization. RESULTS: Sequence data reveals a single open reading frame, encoding a putative hydrophobic protein with a calculated molecular weight of 36 kDa. Its deduced amino acid sequences are almost 97.4% identical to t4ose of rat protein. Northern blot hybridization shows that hSC2 cDNA recognizes a 1.35 kb transcript that was expressed in various epithelial and mesenchymal tissues including testis and liver. CONCLUSION: We have cloned and analysed tissue distributions of hSC2. It was interesting that it had homology with 5α-reductase isozymes. Further studies will be needed to understand the involvement of hSC2 in androgen hormone signaling.
Adult ; Amino Acid Sequence ; Animals ; Blotting, Northern ; Cell Line ; Clone Cells ; Cloning, Molecular* ; DNA, Complementary ; Gene Library ; Humans ; Isoenzymes ; Liver ; Metabolism ; Molecular Weight ; Oligonucleotide Array Sequence Analysis ; Open Reading Frames ; Rats ; Testis ; Testosterone ; Tissue Distribution

No abstract available.
Humans ; Spondylolisthesis*

No abstract available.
Hematoma* ; Orbit*

A 49-year-old woman with anemia who developed headache and seizure after blood transfusion was diagnosed with posterior reversible encephalopathy syndrome (PRES). Magnetic resonance imaging showed typical PRES findings including lesions in bilateral parieto-occipital subcortical white matter and overlying cortex. Only a few cases of PRES after transfusion have been reported and this case is unique in that there was a latent period between infusion and development of PRES. We postulate that rapid change of hemoglobin level may disrupt cerebral autoregulation and result in delayed PRES. We suggest that neurological symptoms after blood transfusion should be appropriately investigated.

Takotsubo cardiomyopathy is considered a neurogenic heart disease resulting from impaired autonomic function and is known to be associated with various neurological and medical conditions. To our knowledge, although tetanus is frequently accompanied by autonomic instability, there has been no report of Takotsubo cardiomyopathy in patients with tetanus. Here we describe a patient with Takotsubo cardiomyopathy as a manifestation of autonomic instability in severe tetanus.