No abstract available.
Blepharoplasty* ; Eyelids* ; Granuloma, Plasma Cell*

BACKGROUND: The cerebellum and its neural circuitry have been assumed to play a major role in the pathophysiology of essential tremor (ET). In this study, we sought to find associations between ET and cerebellar dysfunction. METHODS: We performed tandem gait test in 41 ET patients and 44 age-matched controls. Investigators assessed tandem gait by counting the number of missteps during ten-step tandem walk and each subject repeated the trial three times. RESULTS: ET patients had a higher average and total numbers of missteps during tandem gait tests than control subjects (p<0.05). Sex-adjusted odds ratio of the association between tandem gait abnormality and ET was 3.40 (95% confidence intervals 1.06-10.85). According to age stratification, aged ET patients (age > or =70 years) showed significantly higher prevalence of tandem gait abnormality than young ones. Interaction terms determined by a likelihood ratio test was also statistically significant (p<0.05). CONCLUSIONS: Dysfunction of cerebellar neural circuitry may be associated with the pathophysiological mechanism of ET. In addition, aging may be an important factor modifying the association.
Aging ; Cerebellar Diseases* ; Cerebellum ; Essential Tremor* ; Gait ; Humans ; Odds Ratio ; Prevalence ; Research Personnel

Streptococcus pneumoniae is a major human pathogen that is involved in community-acquired pneumonia. Tumor necrosis factor-alpha (TNF-alpha) is a pro-inflammatory cytokine that activates immune responses against infection, invasion, injury, or inflammation. To study the role of TNF-alpha during S. pneumoniae infection, a murine pneumococcal pneumonia model was used. We intranasally infected C57BL/6J wild-type (WT) and TNF-alpha knockout (KO) mice with S. pneumoniae D39 serotype 2. In TNF-alpha KO mice, continuous and distinct loss of body weight, and low survival rates were observed. Bacterial counts in the lungs and blood of TNF-alpha KO mice were significantly higher than those in WT mice. Histopathological lesions in the spleen of TNF-alpha KO mice were more severe than those in WT mice. In TNF-alpha KO mice, severe depletion of white pulp was observed and the number of apoptotic cells was significantly increased. Interferon-gamma (IFN-gamma), IL-12p70 and IL-10 levels in serum were significantly increased in TNF-alpha KO mice. TNF-alpha is clearly involved in the regulation of S. pneumoniae infections. Early death and low survival rates of TNF-alpha KO mice were likely caused by a combination of impaired bacterial clearance and damage to the spleen. Our findings suggest that TNF-alpha plays a critical role in protecting the host from systemic S. pneumoniae infection.
Animals ; Bacterial Load ; Body Weight ; Humans ; Inflammation ; Interferon-gamma ; Interleukin-10 ; Lung ; Mice ; Pneumonia ; Pneumonia, Pneumococcal ; Spleen ; Streptococcus pneumoniae* ; Survival Rate ; Tumor Necrosis Factor-alpha*

PURPOSE: The purpose of this study was to estimate the effects of a video low intensity exercise program provided during hemodialysis on fatigue, activity of daily living, positive psychological capital and blood pressure of patients being treated. METHODS: A non-equivalent control group pre-post test design was used. Participants were 85 hemodialysis patients assigned to either the experimental group (n=41) or the control group (n=44). The experimental group exercised for about 25 minutes 3 times a week for 8 weeks. Data analyses involved descriptive statistics, χ2 test, t-test, multiple regression and repeated measure ANOVA using SPSS/WIN 23.0. RESULTS: The exercise intervention significantly reduced post hemodialysis fatigue and significantly increased positive psychological capital. There was a significant interaction effect on time by group in blood pressure. Systolic blood pressure changes in the experimental group were stable but, changes in the control group tended to increase gradually. CONCLUSION: To reduce fatigue and increase positive psychological capital for hemodialysis patients, providing exercise during hemodialysis is recommended. Furthermore individualized exercise in terms of intensity, time, duration, etc should be developed and tested. Also, to reduce drastic blood pressure changes during hemodialysis, exercise should be provided.
Blood Pressure ; Evaluation Studies as Topic ; Fatigue ; Humans ; Renal Dialysis ; Statistics as Topic

Extraadrenal pheochromocytomas developed from the paraganglia other than adrenal medulla are uncommon tumors. Such lesions have been reported that as much as 10% of retroperitoneal paragliomas arise outside the adrenal gland. But their incidence and prognosis are changing partly as a result of progression in developmental mechanism, diagnostic tools and concepts including ultrastructure, immunohistochemistry. The ultrastructure of chromaffine neoplasm from adrenal and extraadrenal tissues has been studied with chrarnaffine granule specificity and type of catecholamine content. With rare exceptions, extraadrenal chrornaffine tumor mainly has high concentration of norepinephrine which is suggested as dict relationship to numoruos electrone dense granular bodies in the cell cytoplasrn. High or intermediate level of epinephrine in tissue is associated with cytoplasmic granular bodies of much less density, Recently we experienced the exception, a case of norepinephrine secreting pheochrom-ocytoma in the organ of Zuckerkandl with epinephrine granules in cytoplasm and this discrepancy probably due to the plasticity
Adrenal Glands ; Adrenal Medulla ; Cytoplasm ; Epinephrine ; Immunohistochemistry ; Incidence ; Norepinephrine ; Para-Aortic Bodies ; Pheochromocytoma ; Plastics ; Prognosis ; Sensitivity and Specificity

BACKGROUND: The objective of this article is to evaluate clinical outcomes of combined orbital floor and medial wall fracture repair using a three-dimensional pre-bent titanium implant in an East Asian population. METHODS: Clinical and radiologic data were analyzed for 11 patients with concomitant orbital floor and medial wall fractures. A combined transcaruncular and inferior fornix approach with lateral canthotomy was used for the exposure of fractures. An appropriate three-dimensional preformed titanium implant was selected and inserted according to the characteristics of a given defect. RESULTS: Follow-up time ranged from 2 to 6 months (median, 4.07 months). All patients had a successful treatment outcome without any complications. Clinically significant enophthalmos was not observed after treatment. CONCLUSIONS: Three-dimensional pre-bent titanium implants are appropriate for use in the East Asian population, with a high success rate of anatomic restoration of the orbital volume and prevention of enophthalmos in combined orbital floor and medial wall fracture cases.
Asian Continental Ancestry Group* ; Enophthalmos ; Follow-Up Studies ; Humans ; Orbit* ; Orbital Fractures ; Orbital Implants ; Titanium* ; Treatment Outcome

No abstract available.
Adolescent ; Humans

BACKGROUND: The eyelid and canthal areas are common locations for cutaneous tumors. The medial canthus includes, among many other apparatuses, the canthal tendon and lacrimal canaliculi, and its characteristic thin and supple skin is hard to mimic and restore using tissue from other regions. Accordingly, reconstruction of the canthal area can prove challenging for surgeons. Although various methods, such as skin grafts and local flaps from adjacent regions, have been utilized for reconstructive purposes, they present known disadvantages. However, we were able to successfully reconstruct both lateral and medial canthal area defects by using orbicularis oculi myocutaneous island flaps. METHODS: Our study included seven patients who underwent medial or lateral canthal region reconstruction, using orbicularis oculi myocutaneous island flaps, between 2011 and 2014, following either cutaneous tumor excision or traumatic avulsion injury. RESULTS: Five patients had basal cell carcinoma, one had squamous cell carcinoma of the eyelid, and one had sustained a traumatic avulsion injury of the eyelid and canthal area. Entire flap loss was not observed in any patient, but one-a heavy smoker-showed partial flap loss, which healed with secondary intention and yielded acceptable results. Donor site morbidity was not observed, and all patients were satisfied with their surgical outcomes. CONCLUSIONS: The canthal regions can be successfully reconstructed with orbicularis oculi myocutaneous island flaps. These flaps offer several key advantages, including similarity in texture, color, and thickness to the recipient site and a negligible incidence of donor site morbidity.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Eyelids ; Humans ; Incidence ; Intention ; Myocutaneous Flap ; Skin ; Surgical Flaps ; Tendons ; Tissue Donors ; Transplants

BACKGROUND: Despite aggressive treatment, the mortality rate of cardiogenic shock with acute myocardial infarction (AMI) is high. We performed extracorporeal membrane oxygenation (ECMO) prior to coronary reperfusion, and evaluated the early clinical results and risk factors. MATERIALS AND METHODS: From May 2006 to November 2009, we reviewed the medical records of 20 patients in cardiogenic shock with AMI (mean age 67.7+/-11.7 yrs, M : F 14 : 6). After initially performing ECMO using the CAPIOX emergency bypass system (EBS(R)Terumo, Tokyo, Japan), patients underwent coronary reperfusion (coronary artery bypass grafting, 13; percutaneous coronary intervention, 7). RESULTS: All patients were in a cardiogenic shock state, cardiopulmonary resuscitations (CPR) were performed for fourteen patients (mean CPR time 20.8+/-26.0 min). The mean time from vascular access to the initiation of ECMO was 17.2+/-9.4 min and mean support time was 3.8+/-4.0 days. Fourteen patients were able to be weaned from ECMO and ten patients were discharged (mean admission duration 50.1+/-31.6 days). Patients survived on average 476.6+/-374.6 days of follow-up. Longer CPR and support time, increased cardiac enzyme, lower ejection fraction, lower albumin, and major complications were the risk factors of mortality (p<0.05). CONCLUSION: The early application of ECMO prior to coronary reperfusion and control of risk factors allowed for good clinical results in cardiogenic shock with AMI.
Arteries ; Cardiopulmonary Resuscitation ; Emergencies ; Extracorporeal Membrane Oxygenation ; Follow-Up Studies ; Humans ; Medical Records ; Myocardial Infarction ; Myocardial Reperfusion ; Percutaneous Coronary Intervention ; Resuscitation ; Risk Factors ; Shock, Cardiogenic ; Tokyo ; Transplants

BACKGROUND: Despite aggressive treatment, the mortality rate of cardiogenic shock with acute myocardial infarction (AMI) is high. We performed extracorporeal membrane oxygenation (ECMO) prior to coronary reperfusion, and evaluated the early clinical results and risk factors. MATERIALS AND METHODS: From May 2006 to November 2009, we reviewed the medical records of 20 patients in cardiogenic shock with AMI (mean age 67.7+/-11.7 yrs, M : F 14 : 6). After initially performing ECMO using the CAPIOX emergency bypass system (EBS(R)Terumo, Tokyo, Japan), patients underwent coronary reperfusion (coronary artery bypass grafting, 13; percutaneous coronary intervention, 7). RESULTS: All patients were in a cardiogenic shock state, cardiopulmonary resuscitations (CPR) were performed for fourteen patients (mean CPR time 20.8+/-26.0 min). The mean time from vascular access to the initiation of ECMO was 17.2+/-9.4 min and mean support time was 3.8+/-4.0 days. Fourteen patients were able to be weaned from ECMO and ten patients were discharged (mean admission duration 50.1+/-31.6 days). Patients survived on average 476.6+/-374.6 days of follow-up. Longer CPR and support time, increased cardiac enzyme, lower ejection fraction, lower albumin, and major complications were the risk factors of mortality (p<0.05). CONCLUSION: The early application of ECMO prior to coronary reperfusion and control of risk factors allowed for good clinical results in cardiogenic shock with AMI.
Arteries ; Cardiopulmonary Resuscitation ; Emergencies ; Extracorporeal Membrane Oxygenation ; Follow-Up Studies ; Humans ; Medical Records ; Myocardial Infarction ; Myocardial Reperfusion ; Percutaneous Coronary Intervention ; Resuscitation ; Risk Factors ; Shock, Cardiogenic ; Tokyo ; Transplants