PURPOSE: To report a case of ocular myasthenia gravis in conjunction with thyroid-associated ophthalmopathy in a patient who showed incomitant strabismus and blepharoptosis as well as to discuss the clinical features and tests that may help distinguish these 2 diseases. CASE SUMMARY: A 46-year-old man without any previous history of systemic and ophthalmic disease presented with binocular diplopia that occured a month earlier. The patient had no other systemic symptoms except a 7 kg weight loss within the last month. The patient was referred to the department of internal medicine and brain magnetic resonance imaging was performed to ascertain the cause of suspected left superior oblique muscle palsy. The patient was diagnosed with Graves' disease and underwent medical treatment. One month later, the patient presented with consistent diplopia and exophthalmos and showed a swelling of eyelid and ptosis in the right eye. Intravenous high-dose steroid therapy was administered to the patient. After the treatment, symptoms of diplopia and lid swelling were improved, however ptosis persisted. Ocular myasthenia gravis was suspected and various tests were conducted. Anti-acetylcholine receptor antibodies were detected in large amounts and ptosis was improved dramatically by an administration of an anticholinesterase agent. The patient was diagnosed with ocular myasthenia gravis in conjunction with thyroid-associated ophthalmopathy. CONCLUSIONS: Ocular myasthenia gravis should be suspected in patients with thyroid-associated ophthalmopathy who have signs or symptoms of ptosis.
Antibodies ; Blepharoptosis ; Brain ; Diplopia ; Exophthalmos ; Eye ; Eyelids ; Graves Disease ; Graves Ophthalmopathy ; Humans ; Internal Medicine ; Magnetic Resonance Imaging ; Middle Aged ; Muscles ; Myasthenia Gravis ; Paralysis ; Polyenes ; Strabismus ; Telescopes ; Weight Loss

OBJECTIVE: To evaluate the effect of IL-10 on development of collagen-induced arthritis, on humoral and cellular immunity and on the endogenous production of IL-10 in DBA/1J mice. METHODS: DBA/1J mice were immunized with chicken type II collagen in Freund s complete adjuvant. Murine recombinant IL-10 was given intraperitoneally twice a week from the day of second immunization (week 3) in doses of 0.002ug, 0. 02ug and 0. 2ug for 3 different groups, respectively. Dexamethasone was injected in one group to suppress the arthritis development and this group was used as negative control group. Levels of anti-collagen antibodies, serum IL-10 and stimulation indices of splenic monocytes to collagen were measured at the end of study. RESULTS: The 0. 02ug IL-10 and 0. 2ug IL-10 treated groups developed earlier and more severe arthritis (week 6 and 8) compared to that of the control group while the 0. 002ug IL-10 group has shown similar course to the control group in terms of incidence and severity of arthritis, At week 10, all groups with or without IL-10 injections developed arthritis with similar degree of severity while dexamethasone group showed far less incidence and severity of arthritis. The serum levels of anti-collagen antibody, IL-10 and spleen monocyte stimulation indices to collagen antigen showed no difference among control group, IL-10 injected groups and dexamethasone injected group. CONCLUSION: This study shows IL-10 could worsen the arthritis in CIA with the dosage used in this study without significant influence on the level of anti-collagen antibodies or stimulation indices of spenic monocyte to collagen.
Animals ; Antibodies ; Arthritis ; Arthritis, Experimental* ; Chickens ; Collagen ; Collagen Type II ; Dexamethasone ; Immunity, Cellular ; Immunization ; Incidence ; Interleukin-10* ; Mice ; Monocytes ; Spleen

No abstract available.
Baroreflex* ; Cyclosporine* ; Rabbits*

The clinicolaboratory findings, cardiac catheterization, and outcome of operation were analyzed in 78 patients with tetralogy of Fallot, which were diagnosed by echocardiography, cardiac catheterization, and a cardiac angiography and confirmed by operation at Dong San Hospital, Keimyung University, during a 4(1/2)-year period from January 1984 to June 1988. The following results were obtained : 1) Out of the 78 cases, 45 were male and 64 were female. 2) The electrocardiogram showed right axis deviation in 71 cases(91%) and right ventricular hypertrophy in 66 cases(84.6%). 3) Chest X-ray revealed that, the cardiothoracic ratio was normal or decreased in 68 cases(87.3%), and cardiac apex elevation was noticed in 57 cases(73%). 4) Pulmonary stenosis were chiefly valvular and infundibular type(53.8%). 5) The associated heart diseases with TOF were patent foramen ovale(64.1%), right sided aortic arch(19.2%), and secundum ASD(10.3%), in that order. 6) There was an intimate correlation between secondary polycythemia and thrombocytopenia. 7) Among the 78 Cases, 73 cases had total correction, 1 case had shunt operation, and 4cases had total correction after shunt operation. The highest mortality rate occurred in the cases of total correction after shunt operation(25%). The cases with a main pulmonary artery size of 1/3 to 2/3 against, the aorta had a higher mortality than the other group, and no cases expired in the group with a ratio of more than 2/3. The overall surgical mortality was 8.9%.
Angiography ; Aorta ; Axis, Cervical Vertebra ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography ; Electrocardiography ; Female ; Heart Diseases ; Humans ; Hypertrophy, Right Ventricular ; Male ; Mortality ; Polycythemia ; Pulmonary Artery ; Pulmonary Valve Stenosis ; Tetralogy of Fallot* ; Thorax ; Thrombocytopenia

We experienced a case of congenital rubella syndrome manifesting patent ductus arteriosus, petechiae, microcephaly, intrauterine growth retardation, and hepatomegaly in one-day-old female newborn infant. Congenital rubella syndrome was confirmed by positive results of anti-rubella IgM in the sera of patient. Anti-rubella IgM was negative in the sera of mother, while anti-rubella IgG was positive.
Ductus Arteriosus, Patent ; Female ; Fetal Growth Retardation ; Hepatomegaly ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Infant, Newborn ; Microcephaly ; Mothers ; Purpura ; Rubella Syndrome, Congenital*

One of the complication during or after subclavian vein cannulation is intravascular catheter or wire embolization. Although some studies have reported safety of retaining foreign body embolization, and even death. The intravascular foreign body can be removed surgically or non-surgically. With improvement in instrument technology and technique, percutaneous retrieval of intravascular foreign bodies has become a relatively common procedure. Commonly used methods to remove intravascular foreign bodies are loop snare and basket technique. Sometimes biopy forcep can be used. We have experienced 2 cases of non-surgical removal of intravascular foreign bodies. One of the foreign bodies was 7cm wire fragment in right atrium(RA), the other was a 50cm guide wire. We used the standard loop snare technique for removal of 7cm wire fragment in RA and stone removal basket and 3.0mm ACS PTCA balloon to remove the 50cm short guide wire.
Catheterization ; Catheters ; Foreign Bodies* ; SNARE Proteins ; Subclavian Vein ; Surgical Instruments

OBJECTIVES: The number of healthcare institutions adopting smartphones continues to increase, implying that their utilization is undoubtedly gaining attention. Understanding the needs of smartphone users will provide a greater opportunity for successful information technology acceptance by expanding the scope of its utilization. This study focuses on how smartphones are accepted and utilized in hospitals and analyzes the factors influencing users' attitude, social influence, and intention of use. METHODS: For the study model, the researcher has mainly adopted the Theory of Reasoned Action and further modified and used the models of Technology Acceptance and Information Systems Success. To test the model empirically, a survey was conducted with 122 professionals on information development teams in Korean tertiary hospitals. RESULTS: The common smartphone usage modes were Internet searching, e-mail, scheduling, and social networking in consecutive order. Phone calls consisted of 51.4% of work-related purposes, while other functions, such as text message, Web browser, and scheduling, were mostly used for personal purposes. Costs, contents quality, innovation, ease of use, and support were shown to have statistically significant effects on user attitude, and social influence, portability, security, content quality, and innovation were significant. User attitude and social influence were both statistically significant with respect to intention of use, with user attitude greater than social influence. CONCLUSIONS: The participating staff were analyzed as having strong personal faith and principles, independent from their external environment. Timely information exchanges among medical staff will facilitate appropriate communication and improved health services to patients in need.
Consumer Health Information ; Delivery of Health Care ; Electronic Mail ; Health Information Management ; Health Services ; Humans ; Information Systems ; Intention ; Internet ; Medical Staff ; Smartphone ; Telecommunications ; Tertiary Care Centers ; Text Messaging ; Web Browser ; Wireless Technology

No abstract available.
Epidermolysis Bullosa Dystrophica* ; Epidermolysis Bullosa*

Background & Objective: Hiccups is a disabling condition of lateral medullary infarction (LMI). Unlike other symptoms of LMI, the anatomical lesions of hiccups are not well known. Few studies have evaluated the relationship between the lesional location of LMI and hiccups. We performed this study to correlate hiccups and magnetic resonance imaging (MRI)-based lesional location in pure LMI. Methods: Between January 1997 and February 2013, we identified 24 patients with pure LMI who presented with hiccups in addition to typical lateral medullary syndrome. Sixty six pure LMI patients without hiccups were included as a control group. Clinical and radiologic findings were compared between the two groups. MRI-identified lesions were classified rostrocaudally as rostral, middle and caudal, and horizontally as typical, ventral, large, lateral and dorsal. Results: The pure LMI patients with hiccups had significantly more frequent aspiration pneumonia (P = 0.001) and longer hospital stay (P = 0.03). The patients with hiccups significantly more often had dorsal rather than ventral lesion at horizontal levels (P = 0.012). But, there were no rostro-caudal differences at vertical levels (P = 0.162). Conclusions: We suggest that pure LMI associated with hiccups often locates in the dorsal medulla at horizontal correlation. This MRI-based comparative study has advanced the understanding of the neural substrate for hiccups in LMI, and indicates that hiccups become predictable when specific lesional locations in the lateral medulla are considered.

Here, we investigated the temporal change of post synapse signaling molecules, post synaptic density-95 (PSD-95) and neuronal nitric oxide synthase (nNOS) using immunohistochemistry during voluntary running with upregulated neurogenesis. Rate of running was stabilized after two weeks of the six week trial. By using immunohistochemsitry for phosphorylated cAMP response element binding protein (pCREB) and polysialylatedneural cell adhesion molecules (PSA-NCAM), we observed that the differentiation in dentate granule cells of adult mouse hippocampus increased at 1 and 2 weeks of voluntary running. We found that, at 6 weeks of voluntary running, the differentiation in dentate granule cells of adult mouse hippocampus returned to sedentary control levels. On the other hand, PSD-95 and nNOS immunoreactivity decreased in the inner molecular layer in the dentate gyrus of hippocampus after 1 and 2 weeks of voluntary running. At 6 weeks of voluntary running, the density of the PSD-95 and nNOS in the inner molecular layer was returned to the sedentary control level. The reactivity of nicotinamide dinucleotide phosphate diaphorase (NADPH-diaphorase), the marker of nitric oxide synthase activity, confirmed the change of nNOS in the inner molecular layer during voluntary running. These results demonstrate that the differentiation and the synaptic activity of granule cells during voluntary running are changed reciprocally once the rate of running has stabilized. These granule cell changes during voluntary running suggest an adaptation response to the new environment.
Adult ; Animals ; Cell Adhesion Molecules ; Cyclic AMP Response Element-Binding Protein ; Dentate Gyrus* ; Hand ; Hippocampus ; Humans ; Immunohistochemistry ; Mice* ; Neurogenesis ; Neurons* ; Niacinamide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type I* ; Running* ; Synapses