The diagnosis of painful hips of the children are very difficult in their early stage of diseases. Transient synovitis, Legg-Calve-Perthes' diseas juvenile rheumatoid arthritis and pyogenic hip are very similar in clinical manifestation and plane radiology. But the treatment methods and prognoses are very different, so it is very important to make an accurate diagnosis and differential diagnosis as early as possible. In the above mentioned diseases hip joint effusion is one of common manifestations, so we studied the hip joint effusion by ultrasonography in 49 children with painful hips and also we studied both hips of healthy children to determine the criteria of the normal hip joint. And the results are summerized as follows: l. Ultrasonography was very good method for detection of hip joint effusion. 2. In healthy children, the average bone-to-capsule distance was 2.95mm. 3. In children patients with unilateral painful hip, the average bone-to-capsule distance was 2.96mm, so it was very similar to that of healthy children. 4. The difference more than 2mm between both hips was abnormal. 5. In 49 children with painful hips, over all positive rate was 63.3%.
Arthritis, Juvenile ; Child ; Diagnosis ; Diagnosis, Differential ; Hip Joint ; Hip ; Humans ; Methods ; Prognosis ; Synovitis ; Ultrasonography

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

PURPOSE: To analyze the effects of soft contact lenses on central corneal thickness and morphologic characteristics of the corneal endothelium in diabetic patients. MATERIALS AND METHODS: Ultrasound pachymetry and noncontact specular microscopy were performed on 26 diabetic patients who regularly use soft contact lenses (group 1), 27 diabetic patients who do not use soft contact lenses (group 2) and 30 normal subjects (group 3). We compared the values in each group using the Mann-Whitney test. RESULTS: The central cornea was found to be thicker in diabetic patients, both those who use and do not use contact lenses, than in the normal control group. The central corneal thickness was significantly higher in group 1 (564.73 +/- 35.41 microm) and group 2 (555.76 +/- 45.96 microm) than in the control group (534.05 +/- 27.02 microm), but there was no statistically significant difference between groups 1 and 2. Endothelial cell density was significantly different between the groups, and was smallest in the group of diabetic patients using contact lenses. The coefficient of variation of cell size was significantly higher and the percentage of hexagonal cells was significantly lower in contact lens using diabetic patients than in non-contact lens using diabetic patients and in the control group. CONCLUSION: Central corneal thickness and endothelial cell density is more affected by diabetes mellitus, and corneal endothelial cell morphology is more affected by contact lens use, when compared with normal subjects.
Adolescent ; Adult ; Case-Control Studies ; Contact Lenses, Hydrophilic/*adverse effects ; Cornea/pathology ; Corneal Endothelial Cell Loss/*etiology/pathology ; Diabetes Complications/*etiology/pathology ; Endothelium, Corneal/pathology ; Female ; Humans ; Male ; Statistics, Nonparametric ; Young Adult

No abstract available.
Microsurgery* ; Radiosurgery* ; Trigeminal Neuralgia*

OBJECTIVE: Individuals with dyslexia experience reading difficulties, whereas their other cognitive abilities seem normal. The purpose of this study was to investigate the event-related potential (ERP) patterns of children with dyslexia during a target-detection task. METHODS: Seventeen children with dyslexia and 18 children without this disorder participated in this study. We evaluated their writing and reading ability, symptoms of attention-deficit/hyperactivity disorder, and intelligence quotient. ERPs were recorded while participants performed a target-detection task, and the peak amplitude and latency of P100 and P300 were analyzed. The lateral asymmetry index (LAI) was calculated for each ERP component. RESULTS: The dyslexic group exhibited longer reaction times and larger P100 amplitudes than the non-dyslexic group in the right hemisphere. The P100 latency was also significantly delayed in the right hemisphere of those in the dyslexic group compared with those in the non-dyslexic group. The P300 amplitude was larger in the right hemisphere compared with left hemisphere in the dyslexic group, whereas no interhemispheric differences were observed with respect to the P300 latency. The LAI for P100 showed a significant right hemispheric dominance, whereas the LAI for P100 was significantly correlated with the accuracy of target detection in children with dyslexia. CONCLUSION: Our results suggest that right hemispheric dominance acts as an ancillary system that compensates for poor reading in children with dyslexia.
Child* ; Dyslexia* ; Evoked Potentials* ; Humans ; Intelligence ; Reaction Time ; Reading ; Writing

PURPOSE: The study present the central retina arterial supply, optic disc shape, RNFL (retinal nerve fiber layers) thickness and optic disc rim area. METHODS: To evaluate the relationship between central retina artery pattern, optic disk shape, and RNFL thickness was measured using optical coherence tomography (OCT3000) and pattern of the central retinal artery were investigated by TRC50IX. Healthy Koreans (107 males, 97 females) were enrolled in this study. The classification is made by dividing surface of the nerve head into ten sector. RESULTS: As a result of the shape of the optic disc divided into four group, vertically oval were 54%. The results showed the central retinal artery, in 252 eyes, had its origin in the center. None of the eyes had their origin on temporal side. RNFL thickness according to OCT parameter was superior, 127.68+/-16.16 micrometer; temporal quadrants, 79.60+/-16.05 micrometer; inferior quadrants. CONCLUSIONS: In summary, this study indicates that in healthy Koreans the shape of the optic disc is vertically oval and the origin of their central retinal artery is at the center. The RFNL thickness of both the superior and inferior quadrants was 127 micrometer according to OCT.
Arteries ; Classification ; Head ; Humans ; Male ; Nerve Fibers* ; Optic Disk ; Retina ; Retinal Artery ; Retinal Vessels* ; Retinaldehyde* ; Tomography, Optical Coherence

No abstract available.
Cytarabine* ; Cytosine* ; Drug Therapy, Combination* ; Idarubicin* ; Leukemia, Myeloid, Acute*

Prolonged ischemic-reperfusion induces cellular damages and apoptosis in rat skeletal muscle. Such injury takes place in the phase of reperfusion following ischemia induction in part via regulating of apoptosis-related gene inductions. Among apoptosis-related gene products, Bcl-2 and Bax regulate the apoptotic response by inhibiting and promoting cell death, respectively. The present study was performed to examine the age-related alertation of expression of Bcl-2 and Bax along with apoptosis in rat tibialis anterior muscles following ischemia-reperfusion. 9 weeks, 30 weeks and more than 65 weeks old male Sprague-Dawley rats were divided into 2 groups such as controls, 4 hour ischemia. 4 hour ischemia group was divided into 3 subgroups based on reperfusion time. For ischemia, left commom iliac artery was occulded for 4 hours. The tibialis anterior muscles were removed 0, 3, and 24 hours after onset of reperfusion. Muscle samples were embeded in paraffin and 6 micrometer sections were made. The expression level of Bcl-2 and Bax were examed using immunohistochemical methods and apoptotic reactions was detected using TUNEL methods. The results obtained were as follows; 1. In control group, Bcl-2 and Bax were weakly immunostained in 9 weeks old rat tibialis anterior muscles. In 30 and 65 weeks old rat tibialis anterior muscles, Bcl-2 immunostaning was minimal. The level of Bax staining was increased in 30 and 65 weeks old rat tibialis anterior muscles, compared with those of 9 weeks old rats. The level of apopto-sis among different age groups were not altered. 2. In the 4 hour ischemia group, the level of Bax staining was correlated with the level of apoptosis in 9 weeks, 30 weeks and 65 weeks old rat tibialis anterior muscles. 3. The level of apoptosis was increased in older groups relative to younger groups in 4 hour ischemia. These results suggested that the level of apoptosis induced by ischemic-reperfusion in tibialis anterior muscle increase with ageing in rat tibialis anterior muscles, and that a increase of Bax expression is related to increased apoptosis.
Animals ; Apoptosis* ; Cell Death ; Humans ; Iliac Artery ; In Situ Nick-End Labeling ; Ischemia ; Male ; Muscle, Skeletal ; Muscles* ; Paraffin ; Rats* ; Rats, Sprague-Dawley ; Reperfusion

Background: and Purpose The optimal blood pressure (BP) control after successful endovascular thrombectomy (EVT) in acute ischemic stroke (AIS) with large vessel occlusion (LVO) remains debatable. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) that evaluate the efficacy and safety of standard BP control (with systolic BP ≤180 mm Hg) versus intensive BP control (systolic BP <140 mm Hg) during the 24 hours after successful EVT in AIS with LVO. Methods: PubMed, Scopus, the Cochrane Central Register of Controlled Trials, and Embase were searched to identify relevant trials. The crude odds ratio (OR) and 95% confidence interval (CI) were calculated and estimates using random-effects models were pooled. This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO ID: CRD42023450673). Results: Four RCTs involving 1,559 participants were included. Regarding efficacy outcomes, intensive BP control was associated with a lower likelihood of functional independence (OR: 0.68; 95% CI: 0.51–0.91 for modified Rankin Scale [mRS] ≤2) and walking without assistance (OR: 0.65; 95% CI: 0.53–0.81 for mRS ≤3). For safety outcomes, consistent with the efficacy findings, intensive BP control was significantly associated with severe disability or death (mRS 5 or 6) (OR: 1.34; 95% CI: 1.07–1.69). However, there were no significant differences including all-cause mortality, any intracerebral hemorrhage (ICH), symptomatic ICH, parenchymal hematoma type 2, and stroke recurrence. Conclusion While all four RCTs were conducted to demonstrate the superiority of intensive BP control over standard BP control, standard BP control may be beneficial for the outcome after EVT for AIS with LVO without increasing adverse safety outcomes. Caution should be needed with the application of intensive BP control during the 24 hours following successful recanalization after EVT.

Paraplegia is a relatively rare complication of epidural anesthesia. Several possible factors may contribute to the development of paraplegia including arachnoiditis, trauma and ischemia. We experienced a case where paraplegia had developed after epidural anesthesia for cesarean section. So we present the case and consider the possible etiologies. A 30-year-old previously healthy woman was referred to our hospital for postpartum motor weakness of the lower limbs. Six days prior, the patient was admitted at a local obstetric clinic for delivery at 39 weeks gestation. The patient underwent a Cesarean section under epidural anesthesia induced with 20 ml 2% lidocaine and 5 ml 0.5% bupivacaine. In the early morning of the day following the Cesarean section, a motor and sensory deficit in both lower extremities was noted. A lumbar MRI showed diffuse enhancement along the cauda equina and spinal cord surface in the lower lumbar spine, suggesting diffuse arachnoiditis.
Adult ; Anesthesia, Epidural ; Arachnoid ; Arachnoiditis ; Bupivacaine ; Cauda Equina ; Cesarean Section ; Female ; Humans ; Ischemia ; Lidocaine ; Lower Extremity ; Paraplegia ; Postpartum Period ; Pregnancy ; Spinal Cord ; Spine