No abstract available.
Intussusception*

BACKGROUND: The basal ganglia plays a major role in regulating motor, cognitive and emotional functions. In addition, it has been proposed that the functions of the basal ganglia is also related to control of sensory discrimination and sensorimotor integration. One possible way to test this hypothesis would be to investigate sensory functions in patients with various diseases affecting basal ganglia functions. Since idiopathic Parkinson's disease (IPD) is caused by selective impairment of basal ganglia functions, it could be a good model for this purpose. METHODS: We measured the grating resolution threshold (GRT) using the JVP (Johnson-Van Boven-Phillips) dome in 52 patients with IPD and 25 age-matched healthy controls. Statistical analysis employed unpaired t-test, paired t-test and simple regression analysis. P-values less than 0.05 were considered as significant. RESULTS: Patients showed significantly higher GRT than controls (3.07 +/- 0.74 vs 2.03 +/- 0.80; p<0.05). In patients, the mean GRT was not different between symptomatically dominant and non-dominant hands (3.10 +/- 0.95 vs 2.93 +/- 0.82). In the patients with hemiparkinsonism, GRT was also significantly higher in asymptomatic hands compared with controls (3.00 +/- 0.71 vs 2.03 +/- 0.80; p<0.05). The severity of sensory dysfunction in patients was not correlated with symptom duration or to symptom severity, measured by the modified Columbia rating scale (MCRS). CONCLUSIONS: The present results demonstrate that spatial discrimination is impaired in IPD, suggesting the basal ganglia plays a role in sensory regulation.
Basal Ganglia ; Discrimination (Psychology)* ; Dopamine ; Hand ; Humans ; Parkinson Disease* ; Regression Analysis ; Sensation

PURPOSE: To investigate the influence of 2 phases of short interval intracortical inhibition (SICI) on the cortical silent period (SP). MATERIALS AND METHODS: Single- and paired-pulse transcranial magnetic stimulations (TMSs) at 1 and 2.5ms interstimulus intervals (ISIs) were applied to the left motor cortex in 12 healthy subjects while their right hand muscles were moderately activated. Conditioning stimulation intensity was 90% of the active motor threshold (AMT). Test stimulation intensities were 120, 140, 160, 180, 200, 220, 240, 260% of the AMT and at 100% of the maximal stimulator output, the order of which was arranged randomly. The rectified electromyography area of motor evoked potential (MEP) and duration of the SP were measured off-line using a computerized program. RESULTS: At high-test stimulation intensities, MEP areas were saturated in both single- and paired-pulse stimulations, except that saturated MEPs were smaller for the paired-pulse TMS at 1ms ISI than for the other conditions. As the test stimulation intensity increased, SP was progressively prolonged in both single- and paired-pulse stimulations but was shorter in paired-pulse than single-pulse TMS. Overall, the ratio of SP duration/MEP area was comparable between single- and paired-pulse TMS except for the paired-pulse TMS at 1 ms ISI with a test stimulation intensity at 140-180% of the AMT, in which the ratio was significantly higher than in the single pulse TMS. CONCLUSION: These results suggest that 2 phases of SICI modulate MEP saturation and SP duration differently and provide additional evidence supporting the view that 2 phases of SICI are mediated by different inhibitory mechanisms.
Adult ; Evoked Potentials, Motor/*physiology ; Female ; Humans ; Male ; Motor Cortex/*physiology ; Transcranial Magnetic Stimulation

PURPOSE: To determine (1) the relationship between the cortical defects seen on 99 mTc-DMSA renal scans and age, and (2) the presence and degree of vesicoureteral reflux, and then to depict the risk factors for cortical defects in children with acute urinary tract infection (UTI). Furthermore, to assess the diagnostic value of VCUG in predicting a defect on 99 mTc-DMSA renal scans. MATERIALS AND METHODS: We studied 134 kidneys in 67 children aged 15 days-10 years (M:F=39:28) in whom symptomatic UTI was present. In all these children, both DMSA renal scans and voiding cystourethrography (VCUG) were performed. Scanning took place within 7 days of diagnosis and VCUG was performed after one month of diagnosis. Scintigraphic findings were graded according to the extent and number of cortical defects. We evaluated the relationships between the cortical defects seen on DMSA scans and age, and the grade of vesicoureteral reflux. The diagnostic value of VCUG in predicting cortical defects was analysed. Results: The prevalence of cortical defects was greater in patients older than two years (38/54, 70%) than in those aged less than two (38/80, 48%). The frequency of cortical defects was related to vesicoureteral reflux (p<0.05) and grade of reflux (p<0.05). As this latter increased, the extent of cortical defects also increased (p<0.05), and DMSA scans revealed the presence of these in 76 of the 134 kidneys (57%) with acute UTI. In 30 of these 76 (39.5%), VCUG demonstrated the presence of vesicoureteral reflex. On the other hand, vesi-coureteral reflex was found in 36 of the 134 kidneys (27%), and in 30 of these 36 (83%), cortical defects were noted. The sensitivity of VCUG in predicting cortical defect was 39.5%, while specificity was 89.7%. The positive predictive value for defects was 83.3%, and the negative predictive value was 53.1%. The relative risk of cortical defect in the presence of vesicoureteral reflux was 1.78. CONCLUSION: Renal cortical defects are significantly related to age and grade of vesicoureteral reflux. Risk factors for developing cortical defects were older age (> or =2yrs) at the time of acute UTI, and high grade of vesicoureteral reflux. The specificity of VCUG in predicting cortical defects is relatively high but the sensitivitiy is low, and a significant proportion of cortical defects therefore occurred in the absence of vesicoureteral reflux.
Child* ; Diagnosis ; Hand ; Humans ; Kidney ; Prevalence ; Radionuclide Imaging* ; Reflex ; Risk Factors* ; Sensitivity and Specificity ; Succimer* ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

This study was performed to investigate the in vitro proliferation and migration of rabbit auricular chondrocytes into the various sized pore of PLLA and PLGA scaffolds. The chondrocytes were harvested, expanded, and seeded onto PLGA(50 : 50, 75 : 25, 85 : 15) and PLLA scaffold having either small(50 - 100 micrometer) or large(300 - 350 micrometer) pores. On the 4th and 8th week after culture, histologic observation and quantitative DNA assay were done. We noted that the largest amount of DNA was found in the 85 : 15 PLGA sponges than others, and in the 4th and 8th week, some amount of DNA was detected in the lower portion of 85 : 15 PLGA sponge only, and DNA amounts were increased during the culture period in the 85 : 15 PLGA, significantly. We also found that the numbers of cells were low in middle portion of scaffolds, and in large pore-sized group of 85 : 15 PLGA, there were many cells in the lower portion of the scaffolds more than that of small pore group. In conclusion, the pore size of the scaffold for chondrocyte culture is important for cell migration and proliferation, and PLGA, especially 85 : 15 PLGA with 300- 350 micrometer sized pore is the more suitable biomatrix for proliferation and migration of the chondrocytes.
Cell Movement ; Chondrocytes* ; DNA ; Porifera

PURPOSE: To report a case of endogenous endophthalmitis due to Aeromonas hydrophila in a patient with distal common bile duct carcinoma and biliary sepsis. METHODS: A 72-year-old woman with distal common bile duct carcinoma, obstructive jaundice, diabetes mellitus, and hypertension had a 1-day history of blurred vision, redness, and eye discharges in the right eye. An ophthalmic examination showed no light perception vision, increased intraocular pressure, severe corneal edema, severe anterior chamber reaction, exudative membranes on the anterior lens surface, and severe vitreal reaction. There was no ocular history of trauma, infection, or surgery in either eye. RESULTS: Under the impression of endogenous bacterial endophthalmitis, immediate intraocular cultures and intravitreal antibiotic injections were performed, but the anterior chamber reaction, and the ultrasonogram findings were deteriorated. Evisceration was undertakened because of extrusion of the intraocular contents, and Aeromonas hydrophila was isolated by intraocular culture. CONCLUSIONS: Endogenous endophthalmitis due to Aeromonas hydrophila is rare, but has a rapid clinical course and a poor prognosis, despite of prompt diagnosis and management.
Vitreous Body ; Ultrasonography ; Treatment Failure ; Tomography, X-Ray Computed ; Injections ; *Immunocompromised Host ; Humans ; *Gram-Negative Bacterial Infections/drug therapy ; Female ; Eye Evisceration ; Endophthalmitis/diagnosis/*microbiology/pathology ; Anti-Bacterial Agents/administration & dosage/therapeutic use ; Aged ; *Aeromonas hydrophila

BACKGROUND: This randomized study was designed to evaluate the analgesic effectiveness and to determine the optimal dose of remifentanil when administered as intermittent bolus injection during infiltration of local anesthetics for patients undergoing plastic surgery. METHODS: Forty five ASA I or II patients undergoing plastic surgery were randomly assigned to one of the three bolus doses of remifentanil injection. Five minutes after receiving midazolam 0.05 mg/kg IV, remifentanil was injected intravenously one minute before the infiltration of local anesthetics: A bolus of remifentanil 0.25microgram/kg was injected in Group R0.25 (n = 15), 0.50 microgram/kg in Group R0.5 (n = 15), or 0.75microgram/kg in Group R0.75 (n = 15). After assessment of the patients' Observer's Assessment of Alertness/Sedation (OAA/S) scale, the subjective pain level during local anesthetic infiltration was evaluated. Respiratory rate, SpO2, mean blood pressure, and heart rate were recorded during the study period. Postoperative nausea/vomiting and patient's satisfaction were checked by telephone call. RESULTS: OAA/S scale values were similar among the three groups (3-4). The number of the patients who complained of moderate or severe pain level is significantly higher in group R0.25 than in group R0.5 or group R0.75 (P < 0.05). Adverse events such as hypoventilation, desaturation, and bradycardia were observed with significantly high frequency in R0.75 than in other two groups (P < 0.05). All three groups showed no occurrence of hypotension or postoperative nausea/vomiting. CONCLUSIONS: The above results demonstrate that intermittent bolus injection of remifentanil 0.50microgram/kg is recommended to accomplish desirable pain control during local anesthetic infiltration in those who received midazolam 0.05 mg/kg.
Anesthetics, Local ; Blood Pressure ; Bradycardia ; Heart Rate ; Humans ; Hypotension ; Hypoventilation ; Midazolam ; Respiratory Rate ; Surgery, Plastic* ; Telephone

BACKGROUND: Luminex panel reactive antibody (PRA) is a method that is well known for its high sensitivity and specificity. By using a single antigen assay, the presence or absence of donor specific antibody (DSA) can be determined and its strength can be quantified in terms of the mean fluorescence intensity (MFI). In this study, we analyzed the correlation between the pre-transplant PRA and DSA measured by the Luminex method and the post-transplant clinical features after kidney transplantation. METHODS: A total of 123 pre-transplant sera samples from kidney transplanted patients were tested. Luminex-PRA identification tests were performed using a Luminex fluoroanalyzer and a LifeCodes class I, II ID Kits. Single antigen assay by the Luminex method was used for detecting DSA and its MFI. RESULTS: The positive Luminex-PRA group included more highly-sensitized patients such as women, patients with a previously positive lymphocyte cross match test and patients who were undergoing retransplantation. There was no correlation between the acute rejection rate and positive PRA on the Luminex-PRA. However, pretransplant DSA detected by the single antigen assay was significantly associated with episodes of antibody mediated rejection (P=0.047, OR=10.2), and DSA with higher MFI values (MFI> or =3,000) was associated with antibody mediated rejection (P=0.023). CONCLUSIONS: Although pre-transplant positive PRA was not correlated with acute rejection episodes, the DSA measured by the Luminex single antigen assay seems to have a predictive value for post-transplant antibody mediated rejection.
Female ; Fluorescence ; Histocompatibility Antigens ; Humans ; Kidney ; Kidney Transplantation ; Lymphocytes ; Rejection (Psychology) ; Sensitivity and Specificity ; Tissue Donors ; Transplants

OBJECTIVES: Various sleep patterns may be shown in adolescents to be busy for studying. The aim of this study was to investigate sleep-wake patterns and to evaluate predictors of daytime sleepiness. METHODS: Among 1011 high school students living in Cheonan-si, demographic variables and self-reported questionnaires, including items about menstruation, Morningness-Eveningness Questionnaire (MEQ), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale (ESS) were admitted. RESULTS: total of 839 students (male=453, female=386) completed questionnaires. Significant differences in sleep pattern, categorized by score of MEQ (p=0.004), ESS (p<0.001), and BDI (p=0.012) were observed between male and female subjects. Logistic regression analysis showed that excessive daytime sleepiness was predicted by female [odds ratio (OR)=2.039, p=0.022] and sleep quality (OR=1.238, p=0.004). In the regression analysis of female students, dysmenorrhea (beta=0.108, p=0.029), eating of caffeine (beta=-0.114, p=0.019), MEQ (beta=-0.108, p=0.027), insomnia (beta=0.180, p=0.002), and depression (beta=0.116, p=0.029) might be associated with daytime sleepiness. CONCLUSION: In Korean high school students, female and sleep quality might be risk factors of daytime sleepiness. Daytime sleepiness was known to be related with cognitive dysfunction. Therefore, an education program for improving sleep quality in these adolescents should be considered for mental health.
Adolescent ; Caffeine ; Depression ; Dysmenorrhea ; Eating ; Education ; Female ; Humans ; Logistic Models ; Male ; Menstruation ; Mental Health ; Surveys and Questionnaires ; Risk Factors ; Sleep Initiation and Maintenance Disorders

The purpose of this study was: (1) to compare nanoleakage patterns of a conventional 3-step etch and rinse adhesive system and two experimental hydrophobic adhesive systems and (2) to investigate the change of the nanoleakage patterns after load cycling. Two kinds of hydrophobic experimental adhesives, ethanol containing adhesive (EA) and methanol containing adhesive (MA), were prepared. Thirty extracted human molars were embedded in resin blocks and occlusal thirds of the crowns were removed. The polished dentin surfaces were etched with a 35% phosphoric acid etching gel and rinsed with water. Scotchbond Multi-Purpose (MP), EA and MA were used for bonding procedure. Z-250 composite resin was built-up on the adhesive-treated surfaces. Five teeth of each dentin adhesive group were subjected to mechanical load cycling. The teeth were sectioned into 2 mm thick slabs and then stained with 50% ammoniacal silver nitrate. Ten specimens for each group were examined under scanning electron microscope in backscattering electron mode. All photographs were analyzed using image analysis software. Three regions of each specimen were used for evaluation of the silver uptake within the hybrid layer. The area of silver deposition was calculated and expressed in gray value. Data were statistically analyzed by two-way ANOVA and post-hoc testing of multiple comparisons was done with the Scheffe's test. Silver particles were observed in all the groups. However, silver particles were more sparsely distributed in the EA group and the MA group than in the MP group (p < .0001). There were no changes in nanoleakage patterns after load cycling.
Adhesives ; Chimera ; Crowns ; Dentin ; Electrons ; Ethanol ; Humans ; Methanol ; Molar ; Phosphoric Acids ; Resin Cements ; Silver ; Silver Nitrate ; Tooth ; Water