No abstract available.
Appendicitis* ; Barium* ; Enema*

STUDY DESIGN: A case report. OBJECTIVE: We wanted to present the clinical manifestation and imaging findings of a rare case of acute sciatic nerve palsy with a foot drop similar to lumbar disc herniation developed after sleeping for 8 hours in a sitting position in inebriated condition. SUMMARY OF LITERATURE REVIEW: Sciatic nerve palsy as a complication from being operated in a sitting position have been reported, but here have not been any reported cases of after-sleep sciatic nerve palsy. STUDY SUBJECT AND METHODS: Sixty eight year old male admitted to hospital due to acute onset of right foot drop, subsequent walking difficulty, and numbness of the right calf and foot. Symptoms began after 8 hours of sleeping in a sitting position. Pelvic MRI exam revealed sciatic neuropathy, and also electrophysiological exam revealed sciatic nerve palsy. RESULTS: The subject patient's conditions started improving after 6 weeks and he was able to walk again on his own. CONCLUSION: Sciatic nerve injury by prolonged pressure around the buttocks or posterior thighs, albeit rare, can develop and may cause foot drop, parethesia and sciatica.
Buttocks ; Foot ; Humans ; Hypesthesia ; Male ; Sciatic Nerve ; Sciatic Neuropathy ; Sciatica ; Thigh ; Walking

Clinical presentation of supplementary motor area (SMA) syndrome includes complete akinesia of the contralateral side of the body and mutism, with secondary recovery of neurologic deficit. Multi-joint coordination is frequently impaired following the development of a brain lesion and is generally restricted by abnormal patterns of muscle activation within the hemiparetic limb, clinically termed muscle synergies. However, no work to date has confirmed this observation with the aid of objective methods, such as gait analysis, and the development of reflex pattern has not been suggested as a possible cause. We describe two unusual cases of flexor synergy after tumor resection of SMA lesions.
Brain ; Brain Neoplasms ; Extremities ; Gait ; Lower Extremity* ; Motor Cortex ; Muscles ; Mutism ; Neurologic Manifestations ; Reflex

BACKGROUND: In order to improve the quality of life of dying patients so that they may die with dignity, they need to receive not only the physical, psychological, social, and spiritual care, but also systematic and continuous care. However, their is no adequate medical service at present. We studied terminal cancer patients'behavior patterns of health care utilization, the problems of caring for the patient, and medical services that bereaved families suggested for terminal cancer patients and their families. METHODS: From 271 patients'families who participated in our hospice program from March 1991 to February 1996, 108 bereaved families whom we able to had been contact were interviewed by three student nurses with a structured questionnaire. RESULTS: The terminal cancer patients received their medical care through admission to hospital(45.4%), outpatient clinic(22.2%), emergency room(16.7%), and oriental medicine(12.0%). But during their terminal phase of the illness, 32.4% of patients never received medical care including oriental medicine, and 28.7% received alternative medicine care such as intake of mushroom and elm tree. 26 bereaved families(24.1%) pointed out the indifference of the medical team as a problem receiving proper hospital care, and 22 bereaved families(20.4%) emphasized emotional strain of their helplessness with the patient's suffering as a problem of caring for the patient at home. Over 90% of bereaved families from their experience suggested needs of continuous care, hospice care, home care, and 24hr telephone service. CONCLUSIONS: There were inappropriate behavior patterns of health care utilization which resulted in large proportion of terminal cancer patients received alternative medicine never receiving proper medical care. Therefore, there is a need to develop the continuous and comprehensive care for terminal cancer patients and their family, such as hospice.)
Agaricales ; Complementary Therapies ; Delivery of Health Care* ; Emergencies ; Home Care Services ; Hospice Care ; Hospices ; Humans ; Medicine, East Asian Traditional ; Outpatients ; Quality of Life ; Telephone ; Ulmus ; Surveys and Questionnaires

Gingival fibroblasts are major cellular component of gingiva. However, the molecular mechanisms of senescence of human gingival fibroblasts are unknown. Human fibroblasts undergo replicative senescence in vitro after a limited number of population doublings. A reduced rate of proliferation is a prominent phenomenon observed in senescent fibroblasts. This phenomenon is happened with cell cycle arrest that was controled by cell cycle regulatory proteins. The purpose of present study was to investigate the effect of replicative senescence on cell cycle progression and to find out its molecular mechanisms in human gingival fibroblasts. Replicative senescence of gingival fibroblasts were induced by subsequent cultures that were repeated up to 18 passage. In the present study, I examined change of cell proliferation, cell activity, cell viability and cell cycle progression during the replicative process. Also, I examined expression of cell cycle regulatory proteins which was estimated by western blot analysis. Cell proliferation, cell activity and cell viability of gingival fibroblasts were notably decreased with increase of population doubling level(PDL). S phase was decreased and G1 phase was increased with increase of PDL. Western blot analysis showed that levels of p16, p21 and p53 of senescent gingival fibroblasts(PDL41, PDL58) were higher than young fibroblasts(PDL27) and cdk4 were lower than young fibroblasts(PDL27). In conclusion, these results suggest that proliferative function of human gingival fibroblasts may be decreased by replicative senescence and its molecular mechanisms may be activatied with p16, p21, p53 and pRB, and repressed wtih cdk4.
Aging ; Blotting, Western ; Cell Aging* ; Cell Cycle Checkpoints ; Cell Cycle Proteins ; Cell Cycle* ; Cell Proliferation ; Cell Survival ; Fibroblasts* ; G1 Phase ; Gingiva ; Humans* ; S Phase

OBJECTIVE: To investigate whether transcranial direct current stimulation (tDCS) can improve dysarthria in stroke patients. METHOD: Twelve patients who developed dysarthria after acute middle cerebral artery (MCA) infarction were included in this study. In a prospective, double blinded, randomized case control study performed between January 2007 and December 2008, six patients were randomized to anodal tDCS application and conventional speech therapy, and six patients were randomized to the sham group which received only conventional speech therapy. tDCS was delivered for 30 minutes at 2 mA with 25cm2, five times/week, for a total two weeks. The effects were assessed in maximal phonation time (MPT), alternative motion rates (AMR)-Pa, AMR-Ta, AMR-Ka, and sequential motion rates (SMR)-PaTaKa using the Multi-Media Dimension Voice Program. RESULTS: Pre-treatment patient evaluation showed no significant difference between the two groups for all parameters. The MPT, AMR-Pa, AMR-Ta, AMR-Ka, and SMR-PaTaKa were improved pre- and post-treatment in the stimulation group, while MPT, SMR-PaTaKa were improved in the sham group (p<0.05). The AMR-Pa significantly improved in the stimulation group compared to the sham group (p<0.05). CONCLUSION: As these results demonstrated the beneficial effects of anodal tDCS on dysarthria, tDCS can successfully be used as a treatment modality for patients suffering from dysarthria after stroke.
Case-Control Studies ; Dysarthria ; Humans ; Infarction ; Middle Cerebral Artery ; Phonation ; Prospective Studies ; Salicylamides ; Speech Therapy ; Stress, Psychological ; Stroke ; Voice

Brachial amyotrophic diplegia is a rare disease presenting with severe weakness that is completely confined to the upper limbs over time without upper motor neuron sign. It might be a stable and relatively benign variant of motor neuron disease and should be differentiated from other motor neuropathies. A 60-year-old man presented with a two year history of symmetrical muscle wasting and weakness in his arm and shoulder girdle. Bulbar and leg muscle were not affected and he was independent in ambulation. Nerve conduction studies revealed normal except the low amplitude of median and ulnar compound muscle action potential with no evidence of conduction block. Needle electromyography showed denervation potential and neuropathic motor unit action potential throughout the upper limb. We report this case with a brief review of related literatures.
Action Potentials ; Amyotrophic Lateral Sclerosis ; Arm ; Denervation ; Electromyography ; Humans ; Leg ; Middle Aged ; Motor Neuron Disease ; Motor Neurons ; Muscles ; Needles ; Neural Conduction ; Rare Diseases ; Shoulder ; Upper Extremity ; Walking

Behcet's disease is a chronic multisystem inflammatory disorder. Genetic, environmental, and immunological factors have been suggested as possible causes of Behcet's disease. Although seen at any age, Behcet's disease generally begins when individuals are in their 20s or 30s. The common major symptoms of Behcet's disease include recurrent oral ulcers, genital ulcers, and eye inflammation. The disorder may also cause various skin lesions, arthritis, bowel inflammation, meningitis, and cranial nerve palsies. The common urinary system manifestations are glomerulonephritis, cystitis, epididymitis, orchitis, and genital ulceration, whereas ureteral ulcers and strictures are uncommon. Here, we report an uncommon case of a ureteral ulcer and stricture in a 34-year-old man with Behcet's disease.
Adult ; Arthritis ; Constriction, Pathologic ; Cranial Nerve Diseases ; Cystitis ; Epididymitis ; Eye ; Glomerulonephritis ; Humans ; Immunologic Factors ; Inflammation ; Male ; Meningitis ; Oral Ulcer ; Orchitis ; Skin ; Ulcer ; Ureter

PURPOSE: Minimally invasive gastrectomy (MIG), including laparoscopic distal subtotal gastrectomy (LDG) and robotic distal subtotal gastrectomy (RDG), is performed for gastric cancer, and requires a learning period. However, there are few reports regarding MIG by a beginner surgeon trained in MIG for gastric cancer during surgical residency and fellowship. The aim of this study was to report our initial experience with MIG, LDG, and RDG by a trained beginner surgeon. MATERIALS AND METHODS: Between January 2014 and February 2015, a total of 36 patients (20 LDGs and 16 RDGs) underwent MIG by a beginner surgeon during the learning period, and 13 underwent open distal subtotal gastrectomy (ODG) by an experienced surgeon in Bundang CHA Medical Center. Demographic characteristics, operative findings, and short-term outcomes were evaluated for the groups. RESULTS: MIG was safely performed without open conversion in all patients and there was no mortality in either group. There was no significant difference between the groups in demographic factors except for body mass index. There were significant differences in extent of lymph node dissection (LND) (D2 LND: ODG 8.3% vs. MIG 55.6%, P=0.004) and mean operative time (ODG 178.8 minutes vs. MIG 254.7 minutes, P<0.001). The serial changes in postoperative hemoglobin level (P=0.464) and white blood cell count (P=0.644) did not show significant differences between the groups. There were no significant differences in morbidity. CONCLUSIONS: This study showed that the operative and short-term outcomes of MIG for gastric cancer by a trained beginner surgeon were comparable with those of ODG performed by an experienced surgeon.
Body Mass Index ; Demography ; Fellowships and Scholarships ; Gastrectomy* ; Humans ; Internship and Residency ; Laparoscopy ; Learning ; Leukocyte Count ; Lymph Node Excision ; Mortality ; Operative Time ; Robotics ; Stomach Neoplasms* ; Surgical Procedures, Minimally Invasive

BACKGROUND: Chronic neuropathic pain is often associated with altered immune function and the modulated immune cell response play a role in neuropathic pain by experimental nerve injury. In order to assess the possible changes in lymphocytes function following peripheral mononeuropathy, this study examined the lymphocyte subpopulation of the spleen using the monoclonal antibodies against the membrane surface markers in neuropathic BALB/c mice by a partial transection of sciatic nerve (PST). METHODS: After confirming tactile allodynia by paw withdrawal threshold, the splenic lymphocytes were stained with fluorescein isothiocyanate (FITC)-conjugated anti-mouse CD45R/B220 (B cell) and CD4 (helper/inducer T cell) or with phycoerythrin (PE)-conjugated anti-mouse CD90.2 (total T cell) and CD8 (suppressor/cytotoxic T cell). The proportions of subsets were analyzed using a FACScan laser flow cytometry system on postoperative day 5 and day 18 respectively. RESULTS: PST induced a mechanical allodynia as verified by the von Frey test at both 5 and 8 days postoperatively compared to pre-surgery (P < 0.05). Lymphocyte subpopulation was affected by PST. The proportion of CD4+ subset was significantly larger in the PST group than in the sham operated group on day 5, while the proportion of CD8+ subset was larger on day 18. In the PST group, there were significantchanges in the proportion of CD4+ on day 5 and in the proportion of CD8+ on day 18 (P < 0.05) compared to pre-surgery. There were no significant fluctuations in the proportion of total splenic T cell and B cell subsets of PST group compared to sham operated group. CONCLUSIONS: These results suggest that development of mononeuropathy is responsible for the proportional changes in splenic lymphocyte subsets in mice.
Animals ; Antibodies, Monoclonal ; B-Lymphocyte Subsets ; Flow Cytometry ; Fluorescein ; Hyperalgesia ; Lymphocyte Subsets* ; Lymphocytes* ; Membranes ; Mice* ; Mononeuropathies ; Neuralgia ; Peripheral Nerve Injuries* ; Peripheral Nerves* ; Phycoerythrin ; Sciatic Nerve ; Spleen*