Mechanochemical ablation (MOCA) is a non-thermal, non-tumescent technique for the treatment of incompetent saphenous vein. It is sometimes difficult to maintain consistency when simultaneously implementing wire rotation, sclerosant injection, and wire pullback. Here, we report a simple technique for achieving constant injection during MOCA with the help of a syringe pump; thus, the operator can focus on wire pullback only with convenience and consistency.

OBJECTIVE: The purpose of this study is to compare the clinical outcomes of the patients with acute traumatic central cord syndrome (ATCCS) who were managed between early surgical treatment and conservative treatment. METHODS: Between March 2004 and May 2007, 45 patients with ATCCS were treated. 27 patients were treated surgically and 18 patients were treated conservatively. Early decompressive surgery was performed within 24 hours after the trauma in all surgical patients. All patients were admitted within 8 hours of injury and high-dose methylprednisolone was administered. The clinical and radiological data were collected for each patient. RESULTS: The significant improvement of American Spinal Injury Association (ASIA) score was achieved within the first 6 months of the surgery. There were statistically significant differences (p<0.05) between the surgical and conservatively treated patients at 1, 3 and 6 months follow-ups. However, there were no statistically significant differences of the improvements between two groups at 1 year. The ASIA score improvement had a positive correlation with the age at injury. The patients who were older than 65 years at injury showed statistically lower motor improvement than the patients who were younger than 65 years. The lengths of hospital stay were significantly shorter in patients with surgical treatments (p<0.05) than those in patients without surgery. CONCLUSION: Comparing with conservative treatment, early surgical decompression may be associated with rapid neurologic improvement, early mobilization, and shorter periods of hospitalization.
Asia ; Central Cord Syndrome ; Decompression ; Decompression, Surgical ; Early Ambulation ; Follow-Up Studies ; Hospitalization ; Humans ; Length of Stay ; Methylprednisolone ; Spinal Injuries

Lymphomatoid granulomatosis (LYG) is a lymphoproliferative disease involving the lungs most frequently; however, it may also involve the kidneys, skin and especially the central nervous system. Unique initial presentation of spinal involvement is extremely rare and epidural lesion of thoracic spine has not been reported. The prognosis for LYG has been reported to be poor, and there currently exists no satisfactory established treatment protocol. The purpose of this study is to report a case of successful treatment with surgery and rituximab combination therapy in thoracic spinal LYG.
Antibodies, Monoclonal, Murine-Derived ; Central Nervous System ; Clinical Protocols ; Herpesvirus 4, Human ; Kidney ; Lung ; Lymphomatoid Granulomatosis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis ; Skin ; Spine ; Rituximab

BACKGROUND: Red blood cell (RBC) sorbitol has been implicated in the pathogenesis of organic complications of diabetes mellitus. W8 investigated RBC sorbitol level as an indicator of glucose control or diabetic complications, and also evaluated whether RBC sorbitol/plasma glucose ratio is an indicator of diabetic complications. METHODS: RBC sorbitol levels were measured in 43 healthy persons and 133 diabetes mellitus (DM) patients by enzymatic method. We also tested linearity, inter- and intra- assay precisions. Plasma glucose and Hb Alc were measured by hexokinase method and HPLC, respectively. Hospital records were reviewed. RESULTS: The intra- and inter-assay coefficients of variation of RBC sorbitol test are 8.7% and 28.5%, respectively. Linearity is good. The RBC sorbitol level(3.60+/-1.00 ug/mL) and RBC sorbitol/plasma glucose ratio (2.37+/-0.98%) in diabetic patients are significantly higher than those in normal control (1.69+/-0.43 ug/mL, 1.85+/-0.49 per mill), respectively(p<0.0001). We can't observe correlation between RBC sorbitol and Hb Alc in BM patients, but observe that in non-treatment DM patients. We also observed correlation between Hb Alc and glucose and reverse correlation between RBC sorbitol ratio and Hb Alc. We can't find significant relation between diabetic complications and RBC sorbitol or RBC sorbitol/plasma glucose. CONCLUSIONS: We suggest that the reference range of normal RBC sorbitol level and RBC sorbitol/plasma glucose ratio by enzymatic method are 1.69+/-0.86 ug/mL and 1.85+/- 0.98%,. These Ire significantly different from DM patients and may be useful in diagnosis of DM.
Blood Glucose ; Chromatography, High Pressure Liquid ; Diabetes Complications ; Diabetes Mellitus* ; Diagnosis ; Erythrocytes ; Glucose ; Hexokinase ; Hospital Records ; Humans ; Reference Values ; Sorbitol*

BACKGROUND: Red blood cell (RBC) sorbitol has been implicated in the pathogenesis of organic complications of diabetes mellitus. W8 investigated RBC sorbitol level as an indicator of glucose control or diabetic complications, and also evaluated whether RBC sorbitol/plasma glucose ratio is an indicator of diabetic complications. METHODS: RBC sorbitol levels were measured in 43 healthy persons and 133 diabetes mellitus (DM) patients by enzymatic method. We also tested linearity, inter- and intra- assay precisions. Plasma glucose and Hb Alc were measured by hexokinase method and HPLC, respectively. Hospital records were reviewed. RESULTS: The intra- and inter-assay coefficients of variation of RBC sorbitol test are 8.7% and 28.5%, respectively. Linearity is good. The RBC sorbitol level(3.60+/-1.00 ug/mL) and RBC sorbitol/plasma glucose ratio (2.37+/-0.98%) in diabetic patients are significantly higher than those in normal control (1.69+/-0.43 ug/mL, 1.85+/-0.49 per mill), respectively(p<0.0001). We can't observe correlation between RBC sorbitol and Hb Alc in BM patients, but observe that in non-treatment DM patients. We also observed correlation between Hb Alc and glucose and reverse correlation between RBC sorbitol ratio and Hb Alc. We can't find significant relation between diabetic complications and RBC sorbitol or RBC sorbitol/plasma glucose. CONCLUSIONS: We suggest that the reference range of normal RBC sorbitol level and RBC sorbitol/plasma glucose ratio by enzymatic method are 1.69+/-0.86 ug/mL and 1.85+/- 0.98%,. These Ire significantly different from DM patients and may be useful in diagnosis of DM.
Blood Glucose ; Chromatography, High Pressure Liquid ; Diabetes Complications ; Diabetes Mellitus* ; Diagnosis ; Erythrocytes ; Glucose ; Hexokinase ; Hospital Records ; Humans ; Reference Values ; Sorbitol*

BACKGROUND: Rapid identification of the causative agent among potential bacterial and viral pathogens is important for the management of acute respiratory disease. In this study, we evaluated the analytical performance and clinical usefulness of a recently-introduced multiplex PCR assay, Seeplex(TM)Pneumobacter detection kit (Seegene Inc., Korea) for the identification of respiratory bacterial pathogens. METHODS: One hundred and eighty one nasopharyngeal aspirates were collected from pediatric patients with respiratory symptoms and analysed by multiplex PCR for the detection of Streptococcus pneumoniae (S.P), Haemophilus influenzae (H.I), Mycoplasma pneumoniae (M.P), Chlamydophila pneumoniae (C.P), Bordetella pertussis (B.P) and Legionella pneumophila (L.P). A comparison of multiplex PCR with conventional culture for the isolation of S.P and H.I was performed on 112 specimens. The cross reactivity of multiplex PCR was also evaluated. RESULTS: Of 181 cases, 81 cases were positive by multiplex PCR (44.8%): 52 cases for S.P (28.7%), 47 cases for H.I (26.0%), 9 cases for M.P (5.0%), 3 cases for B.P (1.7%) and 1 case for C.P (0.6%) including multiple infection cases. The agreement rates between multiplex PCR and culture for S.P and H.I were 92.9% (kappa index=0.84, P<0.001) and 91.1% (kappa index=0.75, P<0.001), respectively. There was no cross reactivity with common bacterial and viral pathogens. CONCLUSIONS: Seeplex(TM) Pneumobacter detection kit could be a useful screening tool for the rapid detection of respiratory bacterial pathogens. Further studies with lower respiratory tract specimens would be needed for the clinical evaluation of S. pneumoniae and H. influenzae detected by multiplex PCR.
Adolescent ; Bacterial Infections/*diagnosis ; Child ; Child, Preschool ; DNA, Bacterial/analysis ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mycoplasma pneumoniae/*isolation & purification ; Pneumonia, Mycoplasma/diagnosis ; *Polymerase Chain Reaction ; Reagent Kits, Diagnostic ; Respiratory Tract Infections/*diagnosis/microbiology ; Sensitivity and Specificity

No abstract available.
Tissue Therapy*

Hemolytic uremic syndrome is characterized by a triad of clinical findings including microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. The precise etiology and pathogenesis of hemolytic uremic syndrome are not established by now. According to clinical reports, hemolytic uremic syndrome is associated with infection(bacteria, virus), connective tissue disease, malignancy, drug and pregnancy. Recently, many investigators have reported that cyclosporine induces hemolytic uremic syndrome. Cyclosporine is one of the immunosuppressants that are essential for kidney transplantation. We experienced one case of hemolytic uremic syndrome that developed after kidney transplantation receiving cyclosporine. A 43-yr-old woman with end-stage renal failure received kidney transplantation from her daughter. After operation, she received cyclosporine for immunosuppression and thrombocytopenia, microangiopathic hemolytic anemia and acute renal failure were developed. She was diagnosed as cyclosporine induced hemolytic uremic syndrome and plasma exchange was started with fresh frozen plasma. The plasma exchange was done 16 times and the clinical symptoms were improved. We present this case with review of literatures.
Acute Kidney Injury ; Anemia, Hemolytic ; Connective Tissue Diseases ; Cyclosporine* ; Female ; Hemolytic-Uremic Syndrome* ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Kidney Failure, Chronic ; Kidney Transplantation ; Kidney* ; Nuclear Family ; Plasma Exchange* ; Plasma* ; Pregnancy ; Research Personnel ; Thrombocytopenia

OBJECTIVE: The aim of this study is to establish the value of hand elevation test as a reproducible provocative test for the diagnosis of carpal tunnel syndrome (CTS). METHODS: We had a prospective study of 45 hands of 38 patients diagnosed with CTS between April 2005 and February 2009. The diagnosis of CTS was based on the American Academy of Neurology clinical diagnostic criteria. Experimental and control group patients underwent Tinel's test, Phalen's test, carpal compression test and hand elevation test as provocative tests for CTS. RESULTS: We used chi-square analysis to compare Tinel's test and Phalen's test, carpal compression test with hand elevation test. The sensitivity and specificity of the hand elevation test is 86.7% and 88.9% each. Tinel's test had 82.2% sensitivity and 88.9% specificity. Phalen's test had 84.4% sensitivity and 86.7% specificity. Carpal compression test had 84.4% sensitivity 82.2% specificity. Comparisons of sensitivity and specificity between hand elevation test and Tinel's test, Phalen's test, and carpal compression test had no statistically significant differences. To compare the diagnostic accuracies of four tests, the area under the non-parametric receiver operating character curve was applied. CONCLUSION: The hand elevation test has higher sensitivity and specificity than Tinel's test, Phalen's test, and carpal compression test. Chi-square statistical analysis confirms the hand elevation test is not ineffective campared with Tinel's test, Phalen's test, and carpal compression test.
Carpal Tunnel Syndrome ; Hand ; Humans ; Neurology ; Prospective Studies ; Sensitivity and Specificity

OBJECTIVE: The aim of this study is to elucidate the clinical characteristics of patients with spinal epidural abscess (SEA) and demonstrate the risk factors, treatments and neurologic outcomes. METHODS: We retrospectively reviewed the medical records and radiologic images of 35 patients admitted to our department with SEA between March 1987 and April 2011. While we performed decompressive laminectomy and abscess drainage on 19 patients (54.3%), and 16 patients (45.7%) initially received conservative therapy with antibiotics alone. Medical Research Council (MRC) scale was applied to estimate results objectively. RESULTS: The neurological outcome data showed improved MRC scale from 14 (40%) patients. 13 (37.1%) patients showed unchanged MRC scale and 8 (22.9%) patients revealed worsened MRC scale at the time of discharge. The patients with surgical treatment showed more improved MRC scale than the patients with conservative treatment and this was statistically significant (p=0.001) on univariate analysis. Initially, patients with decreased MRC scale and rapidly progressing neurological deficit underwent emergency surgery within 24 hours. Patients with intact MRC scale and minor neurological deficit received delayed surgery or conservative management with antibiotics. Among 19 patients those who experienced emergent operations within 24 hours showed better prognosis than those who underwent delayed operations after 24 hours. CONCLUSION: Surgical treatment is the modality of choice in patients with SEA and urgent surgery especially is indicated in patients with neurological deficits. And early surgery is more effective in neurological improvements than delayed surgery and conservative management.
Abscess ; Anti-Bacterial Agents ; Drainage ; Emergencies ; Epidural Abscess ; Humans ; Laminectomy ; Medical Records ; Prognosis ; Retrospective Studies ; Risk Factors ; Spine