No abstract available.
Child* ; Humans ; Visual Acuity*

Tetanus is a neurologic disease which features the muscle spasm as the hallmark. It is an infectious disease with high mortality rate triggered by tetanospasmin produced by Clostridium tetani. This report concerns incidence of tetanus consequent to oriental medical care such as acupuncture and moxibustion. Although the tetanus occurrence has shown a remarkable decline since nationwide vaccinations in some of the developed countries, including Korea, it still remains to be an important issue, to be dealt within Korea, as the majority of the patients are old aged and Korean population is rapidly becoming an aging society. Furthermore, since more elders are coming to rely on Oriental medicine in Korea, the Korean elders are at a higher risk than elsewhere. The lack of medical experiences, including those in oriental medical field, has been hindering early diagnosis of Tetanus. This study aims to encourage rapid and accurate decisions in diagnosis and treatment through reviewing symptoms particularly specific to tetanus, and also to arouse attention to the riskiness of invasive procedures involving skin puncture.
Acupuncture ; Aged ; Aging ; Clostridium tetani ; Communicable Diseases ; Developed Countries ; Early Diagnosis ; Humans ; Incidence ; Korea ; Medicine, East Asian Traditional ; Metalloendopeptidases ; Moxibustion ; Punctures ; Skin ; Spasm ; Tetanus ; Tetanus Toxin ; Vaccination

No abstract available.
Echocardiography* ; Mass Screening*

No abstract available.
Cardiac Catheterization* ; Cardiac Catheters* ; Echocardiography* ; Exercise Tolerance* ; Humans ; Tetralogy of Fallot*

PURPOSE: We assessed the efficacy and safety of the tyrosine kinase inhibitor sunitinib in Korean patients with metastatic renal cell carcinoma (mRCC). MATERIALS AND METHODS: Between September 2007 and December 2009, all twenty-one patients who had mRCC with a clear-cell component were retrospectively reviewed. Sunitinib was administered orally at a dose of 50 mg daily until disease progression or intolerance to treatment occurred. The primary end point of this study was the objective tumor response assessed by Response Evaluation Criteria in Solid Tumors (RECIST), and the secondary end points were progression-free survival (PFS) and overall survival (OS) rates as well as assessment of adverse effects. RESULTS: After a median of 17.4 months (range, 5.7-33.1 months) of treatment, 11 patients (52.4%) had an objective response with a complete response in 1 patient (4.8%), and a partial response in 10 patients (47.6%) as the best tumor response. The median PFS was 13.4 months (95% confidence interval [CI], range, 12.3-14.5 months), and the median OS was 28.1 months (95% CI, 21.8-34.4 months). All patients experienced adverse events of some sort, but the studied treatment protocol was well tolerated and most patients experienced reversible grade 1 or 2 toxicities. CONCLUSIONS: Sunitinib was efficacious in the treatment of metastatic clear-cell RCC, and was well tolerated in Korean patients. Although sunitinib treatment-related adverse events such as hand-foot syndrome and facial/generalized edema were observed with a higher incidence than in Western trials, they were mainly mild to moderate, and readily managed.
Carcinoma, Renal Cell* ; Clinical Protocols ; Disease Progression ; Disease-Free Survival ; Edema ; Hand-Foot Syndrome ; Humans ; Incidence ; Neoplasm Metastasis ; Protein-Tyrosine Kinases ; Retrospective Studies

PURPOSE: We assessed the efficacy and safety of the tyrosine kinase inhibitor sunitinib in Korean patients with metastatic renal cell carcinoma (mRCC). MATERIALS AND METHODS: Between September 2007 and December 2009, all twenty-one patients who had mRCC with a clear-cell component were retrospectively reviewed. Sunitinib was administered orally at a dose of 50 mg daily until disease progression or intolerance to treatment occurred. The primary end point of this study was the objective tumor response assessed by Response Evaluation Criteria in Solid Tumors (RECIST), and the secondary end points were progression-free survival (PFS) and overall survival (OS) rates as well as assessment of adverse effects. RESULTS: After a median of 17.4 months (range, 5.7-33.1 months) of treatment, 11 patients (52.4%) had an objective response with a complete response in 1 patient (4.8%), and a partial response in 10 patients (47.6%) as the best tumor response. The median PFS was 13.4 months (95% confidence interval [CI], range, 12.3-14.5 months), and the median OS was 28.1 months (95% CI, 21.8-34.4 months). All patients experienced adverse events of some sort, but the studied treatment protocol was well tolerated and most patients experienced reversible grade 1 or 2 toxicities. CONCLUSIONS: Sunitinib was efficacious in the treatment of metastatic clear-cell RCC, and was well tolerated in Korean patients. Although sunitinib treatment-related adverse events such as hand-foot syndrome and facial/generalized edema were observed with a higher incidence than in Western trials, they were mainly mild to moderate, and readily managed.
Carcinoma, Renal Cell* ; Clinical Protocols ; Disease Progression ; Disease-Free Survival ; Edema ; Hand-Foot Syndrome ; Humans ; Incidence ; Neoplasm Metastasis ; Protein-Tyrosine Kinases ; Retrospective Studies

We report a rare case in which a 35-year-old multiparous healthy woman developed a right sciatic neuropathy after epidural anesthesia and analgesia for caesarean section.She presented with premature rupture of membrane at 37 weeks and 4 days gestation.Epidural anesthesia was done without any paresthesia or pain and there were no special events during operation. Postoperative pain was controlled by fentanyl, ropivacaine and saline through epidural catheter for 2 days.When the epidural catheter was removed, the patient complained of both legs weakness and hypoesthesia.On the 4th day after surgery, she gained normal sensation and motor function of left leg but was still unable to move and sense her right leg without medial side of femur. She dragged her right feet.MRI of the lumbarsacral spine showed no evidence of a lesion in the spinal cord.Electomyographic study (EMG) performed 25 days after surgery showed incomplete right sciatic nerve lesion.She received persistent physical therapies and put a ankle brace.Four months after surgery she had made a recovery but not full yet.
Adult ; Amides ; Analgesia ; Anesthesia ; Anesthesia, Epidural ; Animals ; Ankle ; Anniversaries and Special Events ; Catheters ; Cesarean Section ; Female ; Femur ; Fentanyl ; Humans ; Leg ; Membranes ; Pain, Postoperative ; Paresthesia ; Pregnancy ; Rupture ; Sciatic Nerve ; Sciatic Neuropathy ; Sensation ; Spine

BACKGROUND: Neuromyelitis optica (NMO) is characterized by optic neuritis and longitudinally extensive transverse myelitis. Generally, the brain had been considered healthy in NMO patients, though recent studies have demonstrated that T2-weighted abnormalities may be observed in various brain regions. Logically, NMO brain lesions are localized at sites of high aquaporin-4 expression. CASE REPORT: A 68-year-old right-handed man with dysuria, weakness in the bilateral upper and lower limbs, and decreased sensation of the lower extremities, was diagnosed with neuromyelitis optica. The patient was gradually speaking less, was showing reduced interest in hobbies, and had undergone changes in character and behavior. An examination was performed using the Seoul Neuropsychological Screening Battery (SNSB), which revealed that the profile of frontal lobe dysfunctions was prominent as compared with other cognitive domains. The patient was treated with prednisolone and azathioprine for about 1 year without recurrence, and showed prognostic improvement according to further SNSB testing. CONCLUSIONS: Further studies are considered necessary in order to find the most effective medication regimen for improving cognitive functions in those accurately diagnosed with NMO, and to develop systematic treatment using even more diversified immune-related agents.
Aged ; Azathioprine ; Brain ; Dysuria ; Frontal Lobe* ; Hobbies ; Humans ; Logic ; Lower Extremity ; Mass Screening ; Myelitis, Transverse ; Neuromyelitis Optica* ; Optic Neuritis ; Prednisolone ; Recurrence ; Sensation ; Seoul

PURPOSE: To find the risk factors associated with coronory artery lesions, non-responsiveness to intravenous immunoglobulin(IVIG) treatment, and recurrences in Kawasaki disease patients. METHODS: We retrospectively analyzed 1,000 Kawasaki disease patients who were admitted to Yonsei University Medical Center from September 1990 to December 2003. We compared between responder and non-responder groups to IVIG treatment as well as between relapsed and non-relapsed groups, and as to the relapsed group, we also compared variables between patients in their first and second attack states. Finally, factors associated with longer-fever duration from disease onset were evaluated. RESULTS: Longer fever durations before and after IVIG treatment, male sex, lower Hgb and Hct level, higher WBC count and segmented WBC proportion, and higher CRP and Harada's score were related with coronary artery lesions. Non-responsiveness was related to higher WBC count, segmented WBC proportion, CRP, SGPT, Harada's score, and pyuria. Moderate-to-severe coronary artery dilatations and recurrences were more commonly seen among the non-responder group. No significant predictive factors for recurrence were found. In the relapsed group, lower WBC count, CRP, and shorter fever duration from disease onset were observed in their second attack state. Fever duration from disease onset showed positive correlation with WBC count, CRP, and Harada's score and negative correlation with Hgb levels. CONCLUSION: Higher WBC count, CRP, and higher Harada's score were related to both higher incidences of coronary artery lesions and non-responsiveness to IVIG treatment, and these factors were also related with longer fever duration. Non-responders to IVIG treatment showed higher recurrence rate and more moderate-to-severe coronary artery dilatations than responders.
Academic Medical Centers ; Alanine Transaminase ; Arteries ; Coronary Vessels ; Dilatation ; Fever ; Humans ; Immunoglobulins, Intravenous ; Incidence ; Male ; Mucocutaneous Lymph Node Syndrome* ; Pyuria ; Recurrence ; Retrospective Studies ; Risk Factors ; Treatment Failure ; Treatment Outcome

PURPOSE: To evaluate the clinical presentation, surgical outcome of rhegmatogenous retinal detachment(RRD) after laser refractive surgery and the relationship between RRD and laser refractive surgery. METHODS: We examined age distribution, refractive error, time interval of RRD onset after refractive surgery, shape and location of retinal break, extent of RD, refractive change and postoperative complications in fifteen patients who experienced RRD after LASIK(9 eyes), or PRK(6 eyes) from March 1993 to August 2001. RESULTS: 66% of patents were in twenties, 47% of patients developed RD within 1 year after refractive surgery, 80% of patients had horse shoe type retinal tear and refractive changes after RD surgery were within 2 diopters. Patients who had undergone LASIK had shorter time interval in developing RRD, more refractive change, and more complications than those with PRK. CONCLUSIONS: These results suggest that laser refractive surgery can be one of the cause of RD. LASIK had more association with RD than PRK. Thorough retinal exam will be needed in patients undergoing LASIK.
Age Distribution ; Horses ; Humans ; Keratomileusis, Laser In Situ ; Postoperative Complications ; Refractive Errors ; Refractive Surgical Procedures* ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Shoes