In August 2000, the American Heart Association and the European Resuscitation Council published the conclusions of the International Guidelines 2000 Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care which contains both the new recommendations and an in-depth review. The most important changes in the recommendations according to the authors are discontinuation of the pulse-check for lay people, 500 ml instead of 800~1,200 ml tidal volume during bag-valve-mask ventilation (FiO2 >0.4) of a patient with an unprotected airway, unifying correct endotracheal intubation size as 8.0 mm, vasopressin (40 units) and epinephrine (1 mg) as comparable drugs to treat patients with ventricular fibrillation, early prehospital survey and intravenous lysis for patients who have suffered coronary artery syndrome and stroke.
American Heart Association ; Cardiopulmonary Resuscitation* ; Coronary Vessels ; Emergencies ; Epinephrine ; Heart Arrest ; Humans ; Intubation, Intratracheal ; Resuscitation ; Stroke ; Tidal Volume ; Vasopressins ; Ventilation ; Ventricular Fibrillation

BACKGROUND: Reactive oxygen species (ROS) contribute to development of neuropathic pain. A neuropathic pain syndrome was produced in rats following prolonged hindpaw ischemia/reperfusion injury, creating an animal model of complex regional pain syndrome-Type I (CRPS-I). This study was designed to evaluate the validity of this model for ROS and pain research. Herein we show superoxide produces N-methyl-D-aspartate (NMDA) mediated mechanical allodynia. METHODS: Male adult SD rats were used for neuropathic pain model. Plasma superoxide production rates of before ischemia (BI) and 5 min after reperfusion (JR) were measured via cytochrome C reduction in the presence of xanthine (without xanthine oxidase, kinetics, 550 nm). Mechanical allodynia was measured in both hindpaws. Activation of NMDA receptor subunit 1 (P-NR1) of lumbar spinal cord (L4-L6) in accordance with the change of allodynia was analyzed by the Western blot. RESULTS: Allopurinol-inhibitable, xanthine oxidase-mediated plasma superoxide production was increased at AR. Mechanical allodynia was present in both hindpaws as early as 1 hr after reperfusion, and lasted at least 1 week. The expression of P-NR1 was the highest at 3 days after reperfusion when the withdrawal threshold was the lowest point. SOD significantly blocked P-NR1 activation. CONCLUSIONS: This study suggests that ischemia/reperfusion injury induced neuropathic pain model is a good candidate for the research fields of ROS and pain mechanism. The generation of ROS, especially superoxide is partly responsible for NMDA-mediated mechanical allodynia.
Adult ; Animals ; Blotting, Western ; Central Nervous System Sensitization ; Cytochromes c ; Hindlimb ; Humans ; Hyperalgesia ; Ischemia ; Kinetics ; Male ; Models, Animal ; N-Methylaspartate ; Neuralgia ; Plasma ; Rats ; Reactive Oxygen Species ; Reperfusion ; Spinal Cord ; Superoxides ; Xanthine ; Xanthine Oxidase

OBJECTIVE: The purpose of this study was to examine the symmetry and parallelism of the skeletal and soft-tissue poria by three-dimensional (3D) computed tomographic (CT) imaging. METHODS: The locations of the bilateral skeletal and soft-tissue poria in 29 patients with facial asymmetry (asymmetric group) and 29 patients without facial asymmetry (symmetric group) were measured in 3D reconstructed models of CT images by using a 3D coordinate system. The mean intergroup differences in the anteroposterior and vertical angular deviations of the poria and their anteroposterior and vertical parallelism were statistically analyzed. RESULTS: The symmetric and asymmetric groups showed significant anteroposterior angular differences in both the skeletal and the soft-tissue poria (p = 0.007 and 0.037, respectively; Mann-Whitney U-test). No significant differences in the anteroposterior and vertical parallelism of the poria were noted (p < or = 0.05; Wilcoxon signed-rank test). CONCLUSIONS: In general, the skeletal poria are parallel to the soft-tissue poria. However, patients with facial asymmetry tend to have asymmetric poria.
Facial Asymmetry* ; Humans ; Poria*

We experienced 5 cases of acute rubella encephalitis, a serious complication of rubella. The patients presented with convulsions and a deteriorated mental state, both of which occurred with a vanishing maculopapular rash and a low grade fever. The cerebrospinal fluid analysis showed pleocytosis and increased protein and normal glucose levels. We diagnosed the rubella encephalitis by detection of IgM in the serum. Rubella encephalitis is known to be a serious complication of rubella, and with poor prognosis. The mortality rate may reached as high 20%. Our cases recovered without any sequelae.
Cerebrospinal Fluid ; Encephalitis* ; Exanthema ; Fever ; Glucose ; Humans ; Immunoglobulin M ; Leukocytosis ; Mortality ; Prognosis ; Rubella* ; Seizures

Cervical spondylolysis is an extremely rare abnomality of unknown etilogy, first described by Hadley. It is defined s a corticated cleft between the superior and inferior articular facets of the articular pillar, the cervical equivalent of the pars interarticularis in the lumbar spine. A 50-yar-old woman was presented with occipital headache, and pain in the upper neck region. Neurological examination revealed the patients inability to walk because of quadriparesis with mild hypesthesia in both hands and feet. The DTR was hyperactive and pathological reflexes, including Babinski's and Hoffman's, were positive bilaterally. CT showed the bilateral pars interarticularis defects and spinal canal stenosis. MRI revealed signal alteration on the upper spinal cord which was compromised due to the hypertrophied ligamentum flavum. Decompressive laminectomy of C2 was performed and the patient's neurological deficits had recovered to some extent and resulting to her ability to walk without assistance.
Axis, Cervical Vertebra* ; Constriction, Pathologic ; Female ; Foot ; Hand ; Headache ; Humans ; Hypesthesia ; Laminectomy ; Ligamentum Flavum ; Magnetic Resonance Imaging ; Neck ; Neurologic Examination ; Quadriplegia* ; Reflex ; Spinal Canal ; Spinal Cord ; Spine ; Spondylolysis*

No abstract available.
Hand* ; Hyperpigmentation* ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

Intraarterial embolization for a congenital vascular malformation can provide transient symtomatic relief but recurrence of the lesion occurs in most cases. The authors present a 29-year-old female patient with extensive pelvic vascular malformation who was underwent preoperative embolzation twice and a final operative intervention.
Adult ; Female ; Humans ; Recurrence ; Vascular Malformations

Philadelphia chromosome-positive acute myeloid leukemia (Ph+AML) is a rare disease characterized by a poor prognosis with resistance to standard chemotherapy. We report a patient with Ph+AML with a minor BCR-ABL-positive mRNA transcript who achieved a hematologic, cytogenetic, and major molecular complete response after cytarabine-based chemotherapy followed by imatinib. After more than 6 months of continuous imatinib therapy, the patient is in continuous complete remission. Our results show that imatinib mesylate is effective in treating Ph+AML.
Benzamides ; Cytogenetics ; Humans ; Leukemia ; Leukemia, Myeloid, Acute ; Mesylates ; Philadelphia ; Philadelphia Chromosome ; Piperazines ; Prognosis ; Pyrimidines ; Rare Diseases ; RNA, Messenger ; Imatinib Mesylate

Wernicke's encephalopathy (WE) is an acute neuropsychiatric syndrome resulting from thiamine deficiency. Traditionally, diagnosis of WE rests on a clinical symptom triad consisting of ocular signs, altered consciousness, and ataxia. However, the complete triad is only present in a fraction of cases, which means that WE tends to be under-diagnosed, especially in nonalcoholic patients. Brain MRI of WE patients usually shows symmetrical signal intensity alterations in the thalami, mammillary bodies, and periaqueductal area, because of cytotoxic edema in the same region. These typical findings are useful diagnostic leads in WE patients with atypical symptoms. However, atypical findings can occasionally be seen in the vermis of cerebellum and cerebellar nuclei. Notably, alterations of signal intensity in the cerebellar dentate nuclei, which is a typical finding of metronidazole-induced encephalopathy (MIE), need to be distinguished according to medication history and response to thiamine.
Ataxia ; Brain ; Cerebellar Nuclei ; Cerebellum ; Consciousness ; Edema ; Humans ; Mamillary Bodies ; Metronidazole ; Thiamine ; Thiamine Deficiency ; Wernicke Encephalopathy

Avian influenza (AI) virus infects both animal and human. Low pathogenic AI virus infections (some H7 and H9 subtypes) have been reported all over the world and pose a potential threat to the poultry industry. Vaccination is the most effective way to prevent virus infection. However, vaccination makes it difficult to differentiate between vaccinated chickens and infected chickens. In order to differentiate vaccinated chickens from naturally infected chickens, we adopted synthetic peptide-based enzyme-linked immunosorbent assay (ELISA) using the peptide sequences from nonstructural protein 1 (NS1) of H9N2. Five synthetic peptides were designed using Protein Variability Sever (http://imed.med.ucm.es/PVS/) and synthesized. NS1-1 ~ NS1-4 peptides failed to detect serum antibodies from both vaccinated and naturally infected chickens. NS1-5 peptide from the C-terminal NS1 protein detected serum antibody from naturally infected chickens but not vaccinated chickens. These results imply that NS1-5 peptide may be a useful tool to differentiate naturally infected chicken from vaccinated chicken as being used in the synthetic peptide-based ELISA.
Animals ; Antibodies ; Chickens ; Enzyme-Linked Immunosorbent Assay ; Humans ; Influenza in Birds ; Peptides ; Poultry ; Vaccination ; Viruses