No abstract available.
Surgery, Oral* ; Transplants* ; Veins*

OBJECTIVES: The aim of this study was to assess the changes of the spasticity and gait pattern after botulinum toxin A injection on the gastrocnemius muscle. METHOD: Thirty five legs of twenty-six ambulatory cerebral palsy children aged from two to sixteen year old were treated. Botulinum toxin A (Allergan, USA) from 2 to 8 U/Kg bodyweight was injected on the gastrocnemius without sedation and electromyographic guidance. The modified Ashworth scale, the reflex excitability test were used for the assessment of spasticity. The changes of gait pattern were collected using 6 camera VICON system. All assessments were measured before and at two weeks after injection. RESULTS: 1) The modified Ashworth scale of ankle plantar flexor improved significantly. 2) The reflex excitability test result decreased significantly in gain. 3) The kinematic data showed significant improvements in sagittal plane of the ankle at two weeks after injection. The children with the genu recurvatum showed improvement in sagittal plane of the knee and those with the crouch gait didn't show aggravation of gait pattern after the injection. CONCLUSION: The intramuscular botulinum toxin A injection reduced the spasticity and improved the gait pattern in the cerebral palsied children with ankle plantar flexor spasticity.
Ankle ; Botulinum Toxins* ; Cerebral Palsy ; Child* ; Gait ; Humans ; Knee ; Leg ; Muscle Spasticity* ; Muscle, Skeletal ; Reflex

No abstract available.
Cell Line* ; Cytokines* ; Nitric Oxide*

No abstract available.
Humans* ; Leukemia*

PURPOSE: The purpose of this study was to determine the significant factors for risk estimate of aspiration and to evaluate the efficiency of the dysphagia assessment tool. METHODS: A consecutive series of 210 stroke patients with aspiration symptoms such as cough and dysphagia who had soft or regular diet without tube feeding were examined. The dysphagia assessment tool for aspiration was compared with videofluoroscopy using Classification and Regression Tree (CART) analysis. RESULTS: In CART analysis, of 34 factors, the significant factors for estimating risk of aspiration were cough during swallowing, oral stasis, facial symmetry, salivary drooling, and cough after swallowing. The risk estimate error of the revised dysphagia assessment tool was 25.2%, equal to that of videofluoroscopy. CONCLUSION: The results indicate that the dysphagia assessment tool developed and examined in this study was potentially useful in the clinical field and the primary risk estimating factor was cough during swallowing. Oral stasis, facial symmetry, salivary drooling, cough after swallowing were other significant factors, and based on these results, the dysphagia assessment tool for aspiration was revised and complemented.
Adult ; Aged ; Cough ; Deglutition ; Deglutition Disorders/complications/*diagnosis ; Facial Asymmetry ; Female ; Fluoroscopy/methods ; Humans ; Inhalation ; Male ; Middle Aged ; Risk Assessment ; Stroke/*complications/radiography/therapy

OBJECTIVE: Thrombotic thrombocytopenic purpura (TTP) is a disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, fluctuating neurological symptoms and a variable degree of impairment of renal function, which are thought to be due to endothelial cell injury, platelet activation and subsequent formation of thrombi in the microcirculaion. It usually occurs in adults but few reports are available on etiology, clinical manifestation, progression and the outcome of disease in Korea. METHODS: We investigated 10 adult patients who had admitted and were diagnosed as TTP in Department of Internal Medicine, Chungnam National University Hospital from Dec. 1994 to Jul. 2001. RESULTS: The male to female ratio was 1 : 4. The etiologic antecedants were infectious diarrhea in 3 patients, upper respiratory infection in 3 patients and pregnancy was related with TTP in 2 patents. The clinical manifestations were variable neurologic symptoms(100%), renal involvement(90%), hemorrhagic manifestations(80%), fever(60%), and diarrhea(40%). Acute renal failure was noted in 6 patients and hemodialysis was required in 5 patients. Plasma exchange was performed in 9 patients and corticosteroid was prescribed in 8 patients, simultaneously. Vincristine, azatioprine and cyclophosphamide were added in 2 patients. One patient died of hepatic failure. Seven patients showed complete recovery. One patient progressed to end-stage renal failure. The other patient showed multiple recurrences. CONCLUSION: It is thought that a considerable number of TTP patients show very serious acute renal failure and plasma exchange should be included in therapeutic modalities of TTP.
Acute Kidney Injury ; Adult* ; Anemia, Hemolytic ; Chungcheongnam-do ; Cyclophosphamide ; Diarrhea ; Endothelial Cells ; Female ; Humans ; Internal Medicine ; Kidney Failure, Chronic ; Korea ; Liver Failure ; Male ; Plasma Exchange ; Platelet Activation ; Pregnancy ; Purpura, Thrombotic Thrombocytopenic* ; Recurrence ; Renal Dialysis ; Thrombocytopenia ; Thrombotic Microangiopathies ; Vincristine

Objective: This study investigated whether adding outer-well medium to inhibit osmotic changes in culture media in a dry-type incubator improved the clinical outcomes of in vitro fertilization-embryo transfer (IVF-ET) cycles. Methods: In culture dishes, the osmotic changes in media (20 µL)-covered oil with or without outer-well medium (humid or dry culture conditions, respectively) were compared after 3 days of incubation in a dry-type incubator. One-step (Origio) and G1/G2 (Vitrolife) media were used. Results: The osmotic changes in the dry culture condition (308 mOsm) were higher than in the humid culture conditions (285–290 mOsm) after 3 days of incubation. In day 3 IVF-ET cycles, although the pregnancy rate did not significantly differ between the dry (46.2%) and humid culture (52.2%) groups, the rates of abortion and ongoing pregnancy were significantly better in the humid culture group (2.3% and 50.2%, respectively) than in the dry culture group (8.3% and 37.8%, respectively, p<0.05). In day 5 IVF-ET cycles, the abortion rate was significantly lower in the humid culture group (2.2%) than in the dry culture group (25.0%, p<0.01), but no statistically significant difference was observed in the rates of clinical and ongoing pregnancy between the dry (50% and 25.0%, respectively) and humid culture groups (59.5% and 57.3%, respectively) because of the small number of cycles. Conclusion Hyperosmotic changes in media occurred in a dry-type incubator by evaporation, although the medium was covered with oil. These osmotic changes were efficiently inhibited by supplementation of outer-well medium, which resulted in improved pregnancy outcomes.

Acute recurrent pancreatitis results most commonly from gallstone disease. Although transabdominal ultrasound is a common procedure for evaluating biliary tract, it may not be effective in minilithiasis. We here report a case of acute recurrent pancreatitis, in which endoscopic ultrasonography revealed minilithiasis in the gallbladder with a review of the literature. A 57-year-old woman had suffered from idiopathic recurrent pancreatitis four times for the past 4 months. While transabdominal ultrasonography and abdominal computerized tomography revealed no evidence of bliary stones, but EUS exhibited minilithiasis in the gallbladder. After laparoscopic cholecystectomy, no further events of pancreatitis happened.
Biliary Tract ; Cholecystectomy, Laparoscopic ; Endosonography* ; Female ; Gallbladder ; Gallstones ; Humans ; Middle Aged ; Pancreatitis* ; Ultrasonography

Acute recurrent pancreatitis results most commonly from gallstone disease. Although transabdominal ultrasound is a common procedure for evaluating biliary tract, it may not be effective in minilithiasis. We here report a case of acute recurrent pancreatitis, in which endoscopic ultrasonography revealed minilithiasis in the gallbladder with a review of the literature. A 57-year-old woman had suffered from idiopathic recurrent pancreatitis four times for the past 4 months. While transabdominal ultrasonography and abdominal computerized tomography revealed no evidence of bliary stones, but EUS exhibited minilithiasis in the gallbladder. After laparoscopic cholecystectomy, no further events of pancreatitis happened.
Biliary Tract ; Cholecystectomy, Laparoscopic ; Endosonography* ; Female ; Gallbladder ; Gallstones ; Humans ; Middle Aged ; Pancreatitis* ; Ultrasonography

Adenomas of the major duodenal papilla are rare but clinically important since they are a premalignant condition. Endoscopic mucosal resection has emerged as the first line therary for ampullary adenoma. However, various complications such as pancreatitis, bleeding or duodenal perforation have been reported after endoscopic mucosal resection. To our knowledge, cholangitis has not been reported as a complication of the procedure in the literature. We report a case of papillary stenosis and cholangitis caused by endoscopic mucosal resection of ampullary adenoma. We performed the endoscopic biliary spincterotomy followed by biliary stenting and cholangitis was successfully controlled.
Adenoma* ; Ampulla of Vater ; Cholangitis* ; Constriction, Pathologic* ; Hemorrhage ; Pancreatitis ; Stents