No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

PURPOSE: To report a case of migraine attacks with aura that occurred after percutaneous closure of an atrial septal defect (ASD) with the Amplatzer septal occluder device. CASE SUMMARY: A 58-year-old female presented with glare and scintillation that lasted 3 days. She had a history of percutaneous ASD intervention 3 weeks prior. Because ophthalmologic examination revealed nothing remarkable, the patient underwent observation. However, two months later, she revisited our department, presenting with aggravated glare, scintillation, and severe photophobia. Also, she presented with scintillation followed by a headache starting from the right temporal area extending to the occipital area. The patient was diagnosed with migraine with aura, which was newly developed after percutaneous ASD closure. After switching medication from acetylsalicylic acid to clopidogrel, the frequency and intensity of the headaches were reduced. No recurrence of ophthalmic symptoms or headache was observed during the 1-year follow-up. CONCLUSIONS: Percutaneous closure of ASD can be complicated by the appearance of migraine attacks with aura. When patients present with glare and scintillation, ophthalmologists must consider the possibility of migraine with aura and migraine induced by secondary causes. Thus, detailed history taking should be taken in order to make an early diagnosis of migraine.
Aspirin ; Early Diagnosis ; Epilepsy ; Female ; Follow-Up Studies ; Glare ; Headache ; Heart Septal Defects, Atrial* ; Humans ; Middle Aged ; Migraine Disorders* ; Migraine with Aura* ; Photophobia ; Recurrence ; Septal Occluder Device

PURPOSE: To investigate the effectiveness of infliximab as treatment for refractory uveitis that recurred in spite of immunosuppressive agents. METHODS: Thirty patients who were treated for refractory uveitis from 2002 to 2011 were included in this study. We retrospectively reviewed the medical records of 15 patients who were treated with Infliximab and 15 patients not treated with Infliximab. Infliximab was injected intravenously (5 mg/kg) 3 times every 4 weeks, and the patients were followed-up at 1 week, 2 weeks, and every month thereafter. Anterior chamber cell reaction with a score greater than 0.5+ was defined as recurrence of uveitis. RESULTS: Among 15 patients treated with Infliximab, only one showed no response to the medication. The recurrence rate was significantly higher in patients receiving Infliximab treatment (1.1 +/- 0.2 times) than in those not receiving Infliximab treatment (3.1 +/- 0.3 times) (p=0.022). CONCLUSIONS: Infliximab can be used effectively on patients with refractory uveitis. However, a future prospective randomized study is needed to demonstrate the effectiveness of Infliximab and to determine an accurate protocol regarding dosage and number of injections.
Anterior Chamber ; Humans ; Immunosuppressive Agents ; Medical Records ; Prospective Studies ; Recurrence ; Retrospective Studies ; Tumor Necrosis Factor-alpha ; Uveitis* ; Infliximab

Noise is not only affecting the ear and the auditory cortex locally, but its influence is widely spread throughout the brain structures, e. g., the reticular formation, the brain stem nuclei or the subcortical forebrain area. Hence, any of the organism's activities can be hindered or stimulated by noise. High noise is a stressor and the catecholamine level can be used both as a stress marker and as an indicator of modified sympathetic nervous system activity. Several recent studies have found that the urinary excretion of catecholamines is increased due to high noise intensity, especially unexpectedly high and long lasting noise. The present study was conducted in order to examine the effects of noise stress on urinary excretion of catecholamines in rats and humans. Rats were exposed to 90 dB noises for 10, 30, and 60 minutes, 3 and 12 hours. 24 hour urinary samples were collected and the catecholamines were extracted by alumina and analyzed by HPLC-ECD. Catecholamine levels increased with time of exposure up to 60 minutes: norepinephrine concentration at 60 min of noise=1.038 ng/ml, epinephrine=0.636 ng/ml. Urine catecholamines of blue collar workers exposed to 90 dB of noise at the workplace were collected between 2 and 4 p.m. and compared to that of white collar workers exposed to 70 dB. Mean norepinephrine level of the blue collar workers was 0.89 ng/ml(+/-0.25), epinephrine 0.24 ng/ml(+/-0.09), and that of the white collar workers 0.48 ng/ml(+/-0.12), epinephrine 0.19 ng/ml(+/-0.05). It was concluded that noise acts as a stressor and increases the catecholamine levels in both rats and humans.
Aluminum Oxide ; Animals ; Auditory Cortex ; Brain ; Brain Stem ; Catecholamines ; Ear ; Epinephrine ; Humans ; Noise* ; Norepinephrine ; Prosencephalon ; Rats ; Reticular Formation ; Sympathetic Nervous System

No abstract available.
Cerebral Infarction* ; Craniocerebral Trauma* ; Head* ; Humans ; Oxygen*

BACKGROUND AND OBJECTIVES: Attic cholesteatoma which develops from the papillary or retracted from progresses through various anatomic sites such as the mesotympanium, the mastoid process and the epitympanium. Although the most common site for attic cholesteatoma is the lateral attic space, it has also been found frequently in the medial attic space. We hoped to understand the pathogenesis of attic cholesteatoma through clinical analyses in order to contribute to the cholesteatoma treatment. MATERIALS AND METHODS: We chose 60 attic cholesteatoma patients showing attic retraction or perforation. These cases of attic cholesteatomas were classified into either the lateral or the medial types depedning on the main site of occurence. They were further classified into anterior, posterior and inferior types according to the direction of cholesteatomatic progression. CONCLUSION: The accurate assessment and clear understanding of the pathogenesis of different forms of cholesteatoma enabled a successful operation and helped to minimize the operative field.
Cholesteatoma* ; Hope ; Humans ; Mastoid

Purpose: We performed intra-arterial thrombolysis within 6 hours of presentation in Korean patients with acute retinal artery occlusion. The treatment outcomes of our patients were compared with those from a literature review of this procedure. Methods: Visual acuity, intraocular pressure, fundus photo, and fluorescein angiography were examined in five Korean patients who ultimately underwent intra-arterial thrombolysis due to central retinal artery occlusion. The visual acuity of patients was evaluated after the procedure. The treatment outcomes of our patients were compared with those presented in six foreign intra-arterial thrombolysis studies with respect to age, sex, and visual acuity before and after intra-arterial thrombolysis. Results: In our five cases (three males and two females), the average age was 63.4 years and the average time to the procedure of intra-arterial thrombolysis was 4.8 hours. In the five cases, the visual acuity before intra-arterial thrombolysis were hand movements, 0.1, finger counting at 30 cm, hand movements, and 0.08. Visual acuity after intra-arterial thrombolysis were 0.9, 0.5, finger counting at 30 cm, 0.7, and 1.2. The average age of patients in the six studies from the literature was 60 years, and the most common visual acuity before intra-arterial thrombolysis was light perception and hand movements. A slight improvement in visual acuity (>0 to 0.1) was common in most of the studies; however, three studies showed a partial recovery (from 0.2 to 0.4). Conclusions For retinal artery occlusion, intra-arterial thrombolysis within 6 hours should be considered as a treatment option.

Purpose: We performed intra-arterial thrombolysis within 6 hours of presentation in Korean patients with acute retinal artery occlusion. The treatment outcomes of our patients were compared with those from a literature review of this procedure. Methods: Visual acuity, intraocular pressure, fundus photo, and fluorescein angiography were examined in five Korean patients who ultimately underwent intra-arterial thrombolysis due to central retinal artery occlusion. The visual acuity of patients was evaluated after the procedure. The treatment outcomes of our patients were compared with those presented in six foreign intra-arterial thrombolysis studies with respect to age, sex, and visual acuity before and after intra-arterial thrombolysis. Results: In our five cases (three males and two females), the average age was 63.4 years and the average time to the procedure of intra-arterial thrombolysis was 4.8 hours. In the five cases, the visual acuity before intra-arterial thrombolysis were hand movements, 0.1, finger counting at 30 cm, hand movements, and 0.08. Visual acuity after intra-arterial thrombolysis were 0.9, 0.5, finger counting at 30 cm, 0.7, and 1.2. The average age of patients in the six studies from the literature was 60 years, and the most common visual acuity before intra-arterial thrombolysis was light perception and hand movements. A slight improvement in visual acuity (>0 to 0.1) was common in most of the studies; however, three studies showed a partial recovery (from 0.2 to 0.4). Conclusions For retinal artery occlusion, intra-arterial thrombolysis within 6 hours should be considered as a treatment option.

OBJECTIVE: The purpose of this study was to observe stress distribution and displacement patterns of the entire maxillary arch with regard to distalizing force vectors applied from interdental miniscrews. METHODS: A standard three-dimensional finite element model was constructed to simulate the maxillary teeth, periodontal ligament, and alveolar process. The displacement of each tooth was calculated on x, y, and z axes, and the von Mises stress distribution was visualized using color-coded scales. RESULTS: A single distalizing force at the archwire level induced lingual inclination of the anterior segment, and slight intrusive distal tipping of the posterior segment. In contrast, force at the high level of the retraction hook resulted in lingual root movement of the anterior segment, and extrusive distal translation of the posterior segment. As the force application point was located posteriorly along the archwire, the likelihood of extrusive lingual inclination of the anterior segment increased, and the vertical component of the force led to intrusion and buccal tipping of the posterior segment. Rotation of the occlusal plane was dependent on the relationship between the line of force and the possible center of resistance of the entire arch. CONCLUSIONS: Displacement of the entire arch may be dictated by a direct relationship between the center of resistance of the whole arch and the line of action generated between the miniscrews and force application points at the archwire, which makes the total arch movement highly predictable.
Alveolar Process ; Dental Occlusion ; Dentition* ; Periodontal Ligament ; Tooth ; Weights and Measures

WPW syndrome is the most common variaty of preexcitaton syndrome in which whole or part of ventricular muscle is activated by the atrial impulse earlier than would be expected if the impulse reached the ventricle by way of normal conduction system alone. WPW syndrome result from existence of accessory muscle bridge(atrio ventricular connection) between atrium and ventricle. The ventricular complex observed in WPW syndrome during periods of sinus rhythm is the result of fusion, with intial phase of ventricular activation representing excitation via accessory pathway and later forces produced by excitation of residual portions of ventricle via normal His-purkinje system. The variations in QRS aberrancy in WPW syndrome depend on varying degree of preexcitation. This experimental study was undertaken to increase our knowledge on the ventricular fusion in WPW syndrome through epicardial mapping after experimental induction of ventricular preexcitaion of WPW type. In 5 normal dogs, the heart was widely exposed through transverse thoracotomy and positioned in a pericardial cradle, then electric wires were fixed on the epicardium of right atrium and ventricular bases(anterobasal and posterobasal) areas of right ventricle, anterobasal and poaterobasal areas of left ventricle for atrial and ventricular pacing. Epicardial mapping was then performed during atrial pacing alone and during atrioventricular sequential pacing at the same rate. Atrioventricular sequential pacing was done with various short AV intervals(60-110 msec) for the purpose of premature stimulation on ventricular base. In mapping we used the grid system which consisted of 29 areas to cover the right ventricle and 23 areas to cover the left ventricle. We drew 9 epicardial ishochrone maps in 5 dogs. The epicardial data during atrio-ventriclar sequential pacing were then compared with those during atrial pacing at an identical rate to study the ventricular fusion in WPW syndrome. The results were as follows; 1) The preexciting wave spread radially from the stimulated basal area to the right and left(or anterior and posterior wall) and the apex. 2) Preexciting wavefronts collided with the normal wavefronts in a wide range of ventricular activation time. 3) Preexcitation widened according to the degree of the shortening of the AV interval. 4) The duration of ventricular activation was greater in preexcited ventricles than in normally activated ventricles. The more prematurely the ventricle was stimulated, the greater the duration of ventricular activation was.
Animals ; Dogs ; Epicardial Mapping ; Heart ; Heart Atria ; Heart Ventricles ; Pericardium ; Thoracotomy ; Wolff-Parkinson-White Syndrome*