Segmentally distributed cutaneous eruptions and neuralgia are common manifestations of herpes zoster. However, motor loss is another aspect of this manifestation, which is less well known and considered a rare finding. In many cases the loss of motor function may be easily overlooked because the pain is the more prominent feature and the weakness probably goes unrecognized with only a mild impairment of the motor function. We experienced a 71-year-old male patient with a herpes zoster-related motor paralysis of right arm whose clinical features of a weak limb mimicked other spinal motor diseases and confirmed motor involvement using electromyographic (EMG) and motor nerve conduction velocity (MNCV) studies.
Aged ; Arm ; Extremities* ; Herpes Zoster* ; Humans ; Male ; Neural Conduction ; Neuralgia ; Paralysis*

Papillary thyroid carcinoma is the most common type of thyroid cancer, for which surgery following preoperative staging and risk assessment is the standard treatment. Afatinib is an orally active irreversible ErbB-family inhibitor that binds to the kinase domain of epidermal growth factor receptors (EGFRs), HER2, and HER4, and has been approved as monotherapy for the treatment of locally advanced or metastatic non-small cell lung cancer with activated EGFR mutations. Recently, we observed an unexpected effect of afatinib administered to treat lung cancer on untreated papillary thyroid carcinoma.

BACKGROUND: In the Republic of Korea, there had been no reports about indigenous malaria cases since 1984 until a vivax malaria case was detected in 1993. Thereafter vivax malaria has been a reemerging disease in Korea, the number of cases of malaria increasing recently and the prevalent area being more wider. We suggested that we should take malaria into consideration as the differential diagnosis whenever we meet the febrile patients. We analyzed the cases of malaria who were treated in Myoungji hospital located in Goyang-Si during 4years. METHODS: We retrospectively analyzed data of 79 confirmed cases of malaria treated in the Myoungji hospital from January 1, 1998 to December 31, 2001. All of the patients had no histories of traveling abroad, drug abuse or blood transfusion. The clinical manifestation, hematologic abnormalities and prognosis of patients were reviewed. RESULTS: Seventy-nine cases of malaria were diagnosed as vivax malaria by blood smears. Vivax malaria was developed in Goyang-Si from May through November. Common symptoms were fever (100%), chilling (84.8%), headache (64.6%) and myalgia (55.7%). Splenomegaly was detected in 77.2% of cases by sonography. In 1998, Tertian fever pattern was most frequent. Since 1999, irregular and atypical fever patterns, such as almost-daily high fever or the every fourth or fifth-day fever, were increased in numbers. Laboratory findings included thrombocytopenia (92.4%), anemia (29.1%), leukopenia (25.3%) and leukocytosys (5.1%). CONCLUSION: ICases of indigenous malaria have been progressively increasing in the Republic of Korea. Therefore early diagnosis, treatment and prevention of malaria are very important. Fortunately, patients were well responsed to treatment.
Anemia ; Blood Transfusion ; Diagnosis, Differential ; Early Diagnosis ; Fever ; Headache ; Humans ; Korea ; Leukopenia ; Malaria* ; Malaria, Vivax ; Myalgia ; Plasmodium vivax ; Prognosis ; Republic of Korea ; Retrospective Studies ; Splenomegaly ; Substance-Related Disorders ; Thrombocytopenia

In 1, 345 patients suspected of having pancreatic or biliary tract disease, 23 patients were shown to have biliary ascariasis demonstrated by endseopic retrograded cholangiopancreatog raphy, at Kwang Ju Christian Hospital from Sep. 1976 to Aug. 1983. Authors report the clinical study and ERCP finding of 23 cases of biliary ascariasis. The result were as follows. 1) Out of 1,345 cases of ERCP, biliary ascariasis were 28 cases, The ascaris were found in CHD & IHD in 21 cases, and 2 casee were found in Ampulla of Vater. 2) There was no specifia age incidence and male to female ratio was 1: 1.9, 3) The disease was more prevalent in spring & summer, and more prevalent in rural area than urban area. 4) The chief eomplaints were RUQ and epigastric abdominal pain. The cases which were admitetted within 2weeks of onset were 16 cases. 5) Ascaris in biliary tract were removed by operation in 14 cases, and EST were performed in 5 cases. Two cases werere moved by DORMIA basket under the endoscopic direct visualization. 6) We report E.S.T. as a new therapeutic method of biliary ascariasis.
Abdominal Pain ; Ampulla of Vater ; Ascariasis* ; Ascaris ; Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis* ; Female ; Gwangju ; Humans ; Incidence ; Male

The three mammalian isoforms of transforming growth factor-beta (TGF-beta1, beta2, beta3) are potent regulators of cell growth, differentiation, and extracellular matrix deposition. To study their role in skin differentiation, we investigated the expression of TGF-beta isoforms on cell growth and differentiation induction of the human keratinocyte cell line, HaCaT by elevating the Ca2+ concentration. An ELISA and RT-PCR assay revealed secreted TGF-beta 1 protein and TGF-beta1 mRNA were increased during calci-um-induced differentiation. In contrast, major differences were seen for TGF-beta 2 and TGF-beta 3 mRNA which were decreased during differentiation, but TGF-beta 2 and TGF-3beta protein were not evident on an ELISA. These results suggest different functions for each TGF-beta isoforms in epidermal differentiation, such that TGF-beta 1 is associ-ated with the more differentiated state, and TGF-beta 2 and TGF-beta 3 may be associ-ated the more proliferated state.
Cell Differentiation/physiology ; Cell Line ; Gene Expression Regulation, Developmental/*physiology ; Humans ; Keratinocytes/*cytology/*physiology ; Protein Isoforms/metabolism ; Transforming Growth Factor beta/*metabolism

BACKGROUND: A mixture of local anesthetics such as lidocaine and bupivacaine has frequently been used in clinical practice. The rationale behind this is to take advantage of lidocaine's rapid onset and bupivacaine's perpetuation in anesthesia. The purpose of this study was to examine the changes in the onset and recovery of nerve blocking action exerted by the different combinations of these two in the mixture. METHODS: Isolated sciatic nerve preparations obtained from adult male Sprague-Dawley rats were used in this study. Recordings of A-fiber compound action potentials (A-CAPs) were made at the end of the isolated nerve while single pulse stimuli (0.5 msec, supramaximal intensity, 2 Hz) were applied to the opposite end of the nerve. Seven different composition of lidocaine-bupivacaine mixtures were prepared (0 : 6, 1 : 5, 2 : 4, 3 : 3, 4 : 2, 5 : 1, 6 : 0 vol./vol.), where basal concentrations of lidocaine and bupivacaine were 0.2% and 0.05%, respectively. Amplitudes of A-CAPs were measured before, during and after perfusion of mixture solution. The time needed for A-CAPs amplitude to decrease to 10% of the basal value after starting perfusion (onset time) and that needed to reach to 50% of the basal value after ceasing the perfusion (recovery time) were measured. RESULTS: With increasing concentration ratios of lidocaine to bupivacaine in the mixture as mentioned above, the following onset and recovery times were obtained (6.0 +/- 0.3, 5.6 +/- 0.3, 6.0 +/- 0.5, 8.3 +/- 0.5, 7.3 +/- 0.6, 7.8 +/- 0.3, and 10.8 +/- 0.8, minutes; 38 +/- 4, 63 +/- 12, 87 +/- 19, 100 +/- 13, 104 +/- 18, 137 +/- 27, and 157 +/- 18 minutes, respectively). CONCLUSION: Onset times were, in general, exponentially decreased with the increase in the lidocaine concentration. However, recovery times were lineary increased with the increase in the bupivacaine concentration. So, it should be kept in mind that rapid onset can only be obtained with the expense of substantial reduction in the duration of local anesthetic effect of the mixture, and vice versa.
Action Potentials ; Adult ; Anesthesia ; Anesthetics ; Anesthetics, Local ; Bupivacaine ; Humans ; Lidocaine ; Male ; Nerve Block ; Neural Conduction* ; Perfusion ; Rats, Sprague-Dawley ; Sciatic Nerve

Background: This study aimed to investigate the changes of incidence and treatment of choice for hyperthyroidism from 2003 to 2018 and explore the treatment-related complications and concomitant comorbidities in South Korea using data from the National Health Insurance Service. Methods: This is a retrospective observational study. Hyperthyroidism was defined as a case having two or more diagnostic codes of thyrotoxicosis, with antithyroid drug intake for more than 6 months. Results: The average age-standardized incidence of hyperthyroidism from 2003 to 2018 was 42.23 and 105.13 per 100,000 men and women, respectively. In 2003 to 2004, hyperthyroidism was most often diagnosed in patients in their 50s, but in 2017 to 2018, people were most often diagnosed in their 60s. During the entire period, about 93.7% of hyperthyroidism patients were prescribed with antithyroid drugs, and meanwhile, the annual rates of ablation therapy decrease from 7.68% in 2008 to 4.56% in 2018. Antithyroid drug-related adverse events, mainly agranulocytosis and acute hepatitis, as well as complications of hyperthyroidism such as atrial fibrillation or flutter, osteoporosis, and fractures, occurred more often in younger patients. Conclusion In Korea, hyperthyroidism occurred about 2.5 times more in women than in men, and antithyroid drugs were most preferred as the first-line treatment. Compared to the general population, hyperthyroid patients may have a higher risk of atrial fibrillation or flutter, osteoporosis, and fractures at a younger age.

BACKGROUND: Obstacles to the use of patient-controlled analgesia (PCA) by elderly surgical patients have not been well documented. This study was designed to compare the effectiveness of PCA in an older and a young group, and the satisfaction of PCA use in older patients. METHODS: The 122 patients who received intravenous PCA during the first 48 hours postoperatively were divided into a young and older group. Visual analog scale (VAS) scores at rest and movement were assessed on 8, 16, 24, 36, 40, and 48 hours postoperatively. When the PCA was discontinued, satisfaction and concerns about it were assessed. RESULTS: There were no age differences with regard to pain at rest or with movement. Satisfaction with PCA was high and did not differ between the groups. CONCLUSIONS: Younger and older patients attained comparable levels of analgesia and were equally satisfied with their pain control. However we must have further studies to learn how effective PCA would be in a group over the age of 75 yrs.
Aged ; Analgesia ; Analgesia, Patient-Controlled ; Humans ; Passive Cutaneous Anaphylaxis* ; Visual Analog Scale

PURPOSE: We recently reported on a randomized, open-label, phase 3 trial comparing pemetrexed-cisplatin chemotherapy followed by gefitinib maintenance therapy (PC/G) with gefitinib monotherapy in patients with non-small cell lung cancer (NSCLC). Here, we report on a post hoc subgroup analysis of that study assessing the demographics and disposition of the Korean patient subgroup, and comparing the tolerability of PC/G and gefitinib monotherapy and the tumor response with respect to epidermal growth factor receptor (EGFR) status. MATERIALS AND METHODS: Patients, who were ≥ 18 years, chemonaïve, Korean, light ex-smokers/never-smokers with advanced NSCLC, were randomly assigned (1:1) to PC/G or gefitinib monotherapy. Treatment-emergent adverse events (TEAEs) were graded, and tumor response was measured as change in lesion sum from baseline at best response. The study was registered with ClinicalTrials. gov, NCT01017874. RESULTS: Overall, 111 Korean patients were treated (PC/G, 51; gefitinib, 60). Between-arm characteristics were balanced and similar to those of the overall population. Treatment discontinuations due to adverse events were low (PC/G: 1, 2.0%; gefitinib: 7, 11.7%). Overall, 92 patients (82.9%) reported ≥ 1 TEAE (PC/G, 44; gefitinib, 48); few patients (PC/G, 16; gefitinib, 7) reported severe TEAEs; the most frequent was neutropenia (PC/G arm) and elevated alanine aminotransferase (gefitinib arm). The lesion sum was decreased by PC/G treatment in most patients, regardless of EGFR mutation status, while gefitinib monotherapy reduced the lesion sum in EGFR-positive patients but had no effect in EGFR-negative patients. CONCLUSION: Our results confirm that both PC/G and gefitinib were well tolerated in Korean patients, regardless of EGFR status; however, patients with EGFR wild-type NSCLC may not benefit from gefitinib monotherapy.
Alanine Transaminase ; Carcinoma, Non-Small-Cell Lung* ; Demography ; Drug Therapy ; Humans ; Korea ; Neutropenia ; Receptor, Epidermal Growth Factor

Developed proteome-scale ortholog and paralog prediction methods are mainly based on sequence similarity. However, it is known that even the closest BLAST hit often does not mean the closest neighbor. For this reason, we added conserved interaction information to find orthologs. We propose a genome-scale, automated ortholog prediction method, named OrthoInterBlast. The method is based on both sequence and interaction similarity. When we applied this method to fly and yeast, 17% of the ortholog candidates were different compared with the results of Inparanoid. By adding protein-protein interaction information, proteins that have low sequence similarity still can be selected as orthologs, which can not be easily detected by sequence homology alone.
Diptera ; Proteins ; Sequence Homology ; Yeasts