The time course of recovery in vestibular neuritis varies between individuals. The aim of this study was to identify the predictors for the early or late recovery of vestibular neuritis. The inclusion criteria were patients 1) who had an acute onset of vertigo lasting at least 24 hours, 2) with a horizontal-torsional unidirectional spontaneous nystagmus, and 3) with a canal paresis of 20% or more on the bithermal caloric tests. The primary endpoint for this study was an early or late recovery of vestibular neuritis as a dependent variable. A functional level scale was used to define the late recovery (5 or more points) at seven days after the symptom onset. The secondary endpoint was the duration of hospitalization. One hundred twenty eight patients met the inclusion criteria for this study, and among them, 71 patients had an early recovery. Multiple logistic regression analysis showed that diabetes mellitus was the only independent significant variable for the prediction of a late recovery of vestibular neuritis. In addition, the diabetes mellitus was a predicting variable for long duration of hospitalization. Diabetes mellitus was a predictor for a late recovery of vestibular neuritis.

No abstract available.
Atherosclerosis* ; Oxidative Stress*

Kidney transplantation is the treatment of choice for end-stage renal disease. A successful kidney transplant improves the quality of life and reduces the mortality risk of patients, as compared to maintenance dialysis. The number of patients awaiting kidney transplantation has steadily increased, and the gap between allograft supply and demand continues to widen despite initiatives to expand the use of nonstandard deceased-donor allografts. The use of organs from living donors is one strategy to address the need for transplants. A medical, surgical, and psychosocial evaluation is mandatory prior to living kidney donation to ensure that the donor candidate is in good health and has normal kidney function, is not a risk to the recipient with respect to transmission of infections and malignancy, and will not face unacceptable risks after donation.

The effect of general anesthesia for cesarean section, before and after the delivery, varies according to the anesthesia type, drug dosage and concentration of the anesthetics. If a light plane of general anesthesia using a minimal concentration of anesthetics is chosen for fetal safety and rapid recovery, there is an increased incidence of maternal awareness and/or unpleasant dreams. in general, however, for cesarean section a lighter depth of anesthesia is indicated than that for non-obstetric operations because of the change in humoral factors such as increased levels of progestrone and beta-endorphin. We studied the effects of general anesthesia for 100 healthy parturients. The method used consisted of administration of thiopental (group l) or a combination of thiopental and 66% N2O(group ll) before delivery. For maintenance after delivery we used 66% nitrous oxide and a small dose of meperidine The results are as follows: 1) Apgar scores below 8 at one minute after delivery in group l and group ll were 4cases and 5cases, respectively. At 5 minutes after delivery 98% of both groups had Apgar scores of above 8. 2) The incidence of maternal awareness during anesthesia in group l was 10%, and group ll, 6%. 3) During the maintenance phase of the anesthesia after delivery, the systolic pressures, diastolic pressure and pulse rate increased as much as 2~11%, 5~13% and 14~16% respectively. 4) The duration of operation, on the average, was 64 minutes, and the average dosage of meperidine administered was 120mg.
Anesthesia ; Anesthesia, General ; Anesthetics ; beta-Endorphin ; Blood Pressure ; Cesarean Section* ; Dreams ; Female ; Heart Rate ; Incidence ; Intraoperative Awareness ; Meperidine ; Nitrous Oxide ; Pregnancy ; Thiopental

BACKGROUND: Steroid-responsive encephalopathy associated with subacute thyroiditis has, to our knowledge, not been reported previously. CASE REPORT: A 49-year-old woman was found collapsed and brought to our institution with decreased mentality, dysarthria, and gait disturbance. Brain magnetic resonance imaging and angiography were normal but blood tests revealed thyroid-autoantibody-negative thyrotoxicosis. Results of a (99m)technetium-pertechnetate scan were compatible with the thyrotoxic phase of subacute thyroiditis. 14-3-3 proteins were detected in cerebrospinal fluid. Her mental status began to improve from the day following steroid administration. Recurrent encephalopathy was found 2 months after the initial admission, which was also effectively treated with steroid. CONCLUSIONS:We speculate that steroid-responsive recurrent encephalopathy associated with subacute thyroiditis is a subtype of Hashimoto's encephalopathy, and consider that steroid treatment should not be delayed in suspected patients.
14-3-3 Proteins ; Angiography ; Brain ; Brain Diseases ; Dysarthria ; Female ; Gait ; Hashimoto Disease ; Hematologic Tests ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Thyroiditis, Subacute ; Thyrotoxicosis

Felty's syndrome is an uncommon condition characterized by the combination of rheumatoid arthritis (RA), splenomegaly, and neutropenia. Disease-modifying anti-rheumatic drugs and biologic agents have been used to treat early RA to achieve remission. Anti-tumor necrosis factor (TNF)-alpha agents are effective for controlling the disease; however, some studies have suggested the possibility of adverse effects such as increased frequency of infection or malignancy. Bowen's disease, known as squamous cell carcinoma in situ, is a skin cancer that can be caused by sun exposure, arsenic ingestion, human papilloma virus, skin damage, and prolonged immunosuppression. We report the case of a 64-year-old female diagnosed with Bowen's disease during treatment with an anti-TNF agent for Felty's syndrome with a review of the literature.
Antibodies, Monoclonal, Humanized ; Antirheumatic Agents ; Arsenic ; Arthritis, Rheumatoid ; Bowen's Disease ; Carcinoma, Squamous Cell ; Eating ; Felty Syndrome ; Female ; Humans ; Immunosuppression ; Middle Aged ; Necrosis ; Neutropenia ; Papilloma ; Skin ; Skin Neoplasms ; Solar System ; Splenomegaly ; Viruses ; Adalimumab

We report a case of isolated primary medullary hemorrhage with a review of the literature to analyze the clinical presentation and radiological character. A 46-year-old man with chronic alcoholism developed tegmental medullary syndrome secondary to spontaneous hemorrhages in the medulla oblongata. Magnetic resonance imaging study was carried out on the third day after the second event, which showed two distinct isolated hematomas in the medulla oblongata. Digital subtraction angiography was normal. The cause of hemorrhage was presumed to be cryptic vascular malformation. The primary medullary hemorrhage usually presents with a characteristic syndrome of sudden onset vertigo with neurological signs that correspond to various combination of medial and lateral medullary involvement. Usually, the prognosis is good only with conservative treatment.
Alcoholism ; Angiography, Digital Subtraction ; Hematoma ; Hemorrhage* ; Humans ; Magnetic Resonance Imaging ; Medulla Oblongata ; Middle Aged ; Prognosis ; Vascular Malformations ; Vertigo

A cerebral infarction involving the nodulus usually produce contralateral lateropulsion and ipsilateral spontaneous nystagmus to the lesion. Here, we report a case of atypical isolated nodular infarction showed ipsilateral lateropulsion and contralateral spontaneous nystagmus to the lesion with a normal head impulse test. A right-handed 70-year-old man developed sudden vertigo with an unsteady gait. Neurologic examination revealed spontaneous left-beating nystagmus with a torsional component. He also displayed imbalance of walking and axial lateropulsion to the right side. Head impulse test was normal. Magnetic resonance imaging indicated acute infarction in the right nodulus on diffusion-weighted images.
Cerebral Infarction ; Gait Disorders, Neurologic ; Head ; Infarction ; Magnetic Resonance Imaging ; Neurologic Examination ; Vertigo ; Vestibular Neuronitis ; Walking

BACKGROUND AND PURPOSE: Sudden cardiac death is one of the leading causes of death in patients with myotonic dystrophy type 1 (DM1). It has been proposed that a prolonged QT interval is associated with sudden cardiac death in several neurological diseases, including multiple system atrophy, idiopathic Parkinson's disease, and diabetic autonomic neuropathy. However, analyses of the corrected QT (QTc) interval in DM1 patients are rare in the literature. The purposes of this study were to determine the association between the QT interval and DM1, and the affecting factors. METHODS: Thirty-nine patients diagnosed with DM1 through genetic testing were enrolled. The QTc interval (calculated using Bazett's formula: QTc=QT/radicalRR) was compared between these patients and 39 normal healthy controls. The clinical and laboratory factors affecting QTc interval in the patient group were investigated. RESULTS: The QTc interval was significantly longer in the DM1 group (411.2+/-44.7 msec, mean+/-SD) than in the normal control group (355.6+/-20.6 msec). Intragroup analysis revealed that a prolonged QTc interval in DM1 patients was associated with being female and older, having a longer disease duration, and exhibiting abnormal electrocardiography findings. CONCLUSIONS: The higher incidence of sudden cardiac death in the DM1 population is associated with the observed prolonged QTc interval in those patients.
Cause of Death ; Death, Sudden, Cardiac ; Diabetic Neuropathies ; Electrocardiography ; Female ; Genetic Testing ; Humans ; Incidence ; Multiple System Atrophy ; Myotonic Dystrophy ; Parkinson Disease

Lung volume reduction surgery, resecting the most severely affected regions of emphysema, was designed to improve quality of life for selected patients with severe emphysema. We report a case of a 72 year old severe emphysema patient who received bilateral lung volume reduction surgery and showed marked improvement of quality of life and lung function.
Aged ; Emphysema* ; Humans ; Lung* ; Pneumonectomy* ; Quality of Life