BACKGROUND: Recent evidences suggest that anesthetic action within the spinal cord is important in suppressing somatic responses to painful stimuli. Intrathecal endothelin-1 (ET-1) is known to have antinociceptive effect. The purpose of this experiment was to determine whether intrathecal ET-1 may influence the minimum alveolar concentration (MAC) of isoflurane in rats and access the role of the spinal cord as the sites of anesthetic action in blocking somatic responsiveness. METHODS: In Sprague-Dawley rats fitted with an indwelling intrathecal catheter, we determined the MAC of isoflurane using a tail-clamp technique as a painful stimulus, combined with end-tidal anesthetic sampling. In experiment 1, the control MAC was determined and changes of control MAC were observed after intrathecal ET-1 (4x10-2 nmol, 4x10-3 nmol) administration. In experiment 2, we observed the effects of L or N type Ca++ channel blocker such as verapamil (50 g) or W-conotoxin (0.5 g) on the MAC after measurement of the control MAC. In experiment 3, after measurement of the control MAC, ET-1 (10-2 nmol) was administered intrathecally and the MAC was determined again. Next, intrathecal verapamil (50 g) or W-conotoxin (0.5 g) was injected. After that, the MAC was determined again. RESULTS: In experiment 1, ET-1 decreased the MAC of isoflurane and its effect was sustained over 2 hours. In experiment 2, the MAC, determined following administration of verapamil or W-conotoxin, was not different from that of the control. In experiment 3, the MAC was decreased after ET-1 administration and then increased following injection of verapamil or W-conotoxin. CONCLUSIONS: These results suggested that ET-1, in relation to calcium, might play an important role in determining the MAC of isoflurane in the spinal cord.
Animals ; Calcium ; Catheters ; Endothelin-1* ; Isoflurane* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Verapamil

Vibrio vulnificus infections occur between May and October, and most often involve men over age 40. V. vulnificus has been linked to two distinct syndromes: primary sepsis and primary wound infections. Primary sepsis occurs most commonly in patients with antecedent liver disease such as cirrhosis. Mortality approaches about 50 percent, with most deaths due to uncontrolled sepsis. We experienced a case of septicemia without dermatologic lesion by serovar type O1 V. vulnificus, and reported this case with a review of literature.
Fibrosis ; Humans ; Liver Diseases ; Male ; Mortality ; Sepsis* ; Skin* ; Vibrio vulnificus* ; Vibrio* ; Wound Infection

No abstract available.
Cutaneous Fistula ; Glomerulonephritis, Membranous* ; Humans ; Sarcoma, Kaposi*

No abstract available.
Folliculitis* ; Herpesvirus 3, Human ; Scalp*

BACKGROUND: Ropinirole is a non-ergoline D2 agonist which has a highly selective affinity to D2 receptor. The aim of this study was to evaluate the efficacy and safety of ropinirole in the treatment of Parkinson's disease (PD). METHODS: Seventy-six cases with PD (Hoehn and Yahr stage II to IV) were included in this trial. Each patient was randomly allocated to receive either ropinirole (n=37) or bromocriptine (n=39) over a 16-week period. All subjects were not optimally controlled on levodopa due to motor fluctuations. The response rate was defined as the percentage of patients who had at least 20% reduction of levodopa doses. The clinical status was also assessed using the Unified Parkinson's Disease Rating Scale (UPDRS), Clinical Global Impression (CGI), and reduction of off durations. RESULTS: The end-point analysis, on an intention-to-treat basis, revealed significantly higher response rate in the ropinirole group compared with the bromocriptine group (odds ratio 2.995, 95% C.I. (1.157, 7.751)). A statistically significant improvement in CGI was also observed in the ropinirole group (p=0.046). The mean off duration was significantly reduced in the ropinirole group (p=0.0001). Other parameters using the UPDRS motor score or off duration did not show significant differences between the two groups. The overall incidence of adverse effects was not significantly different between the two groups. The most common side effects were dizziness, dyskinesia, and nausea/vomiting. No subjects were withdrawn from the study due to side effects. CONCLUSION: Ropinirole is a safe and well-tolerated drug and provides superior overall efficacy compared with bromocriptine as an adjunct to levodopa. (J Korean Neurol Assoc 19(2):102~109, 2001)
Bromocriptine ; Dizziness ; Dyskinesias ; Humans ; Incidence ; Levodopa* ; Parkinson Disease*

BACKGROUND: Ropinirole is a non-ergoline D2 agonist which has a highly selective affinity to D2 receptor. The aim of this study was to evaluate the efficacy and safety of ropinirole in the treatment of Parkinson's disease (PD). METHODS: Seventy-six cases with PD (Hoehn and Yahr stage II to IV) were included in this trial. Each patient was randomly allocated to receive either ropinirole (n=37) or bromocriptine (n=39) over a 16-week period. All subjects were not optimally controlled on levodopa due to motor fluctuations. The response rate was defined as the percentage of patients who had at least 20% reduction of levodopa doses. The clinical status was also assessed using the Unified Parkinson's Disease Rating Scale (UPDRS), Clinical Global Impression (CGI), and reduction of off durations. RESULTS: The end-point analysis, on an intention-to-treat basis, revealed significantly higher response rate in the ropinirole group compared with the bromocriptine group (odds ratio 2.995, 95% C.I. (1.157, 7.751)). A statistically significant improvement in CGI was also observed in the ropinirole group (p=0.046). The mean off duration was significantly reduced in the ropinirole group (p=0.0001). Other parameters using the UPDRS motor score or off duration did not show significant differences between the two groups. The overall incidence of adverse effects was not significantly different between the two groups. The most common side effects were dizziness, dyskinesia, and nausea/vomiting. No subjects were withdrawn from the study due to side effects. CONCLUSION: Ropinirole is a safe and well-tolerated drug and provides superior overall efficacy compared with bromocriptine as an adjunct to levodopa. (J Korean Neurol Assoc 19(2):102~109, 2001)
Bromocriptine ; Dizziness ; Dyskinesias ; Humans ; Incidence ; Levodopa* ; Parkinson Disease*

Cutis marmorata telangiectatica congenita (CMTC) is a rare congenital vascular disorder. The skin lesions associated with CMTC include persistent, reticulated vascular patches and telangiectasia, and they are sometimes associated with underlying atrophy and ulceration. The condition is present at birth and tends to improve with age, although some skin lesions remain unchanged throughout life. We encountered two patients with CMTC: a 12-day-old infant and a 21-year-old woman with a history of CMTC since birth. Both patients had localized reticulated purpuric patches with atrophy. During follow-up, although the purpuric patches improved in both patients, there were no changes in the skin atrophy in either patient. Herein, we present these cases showing the changes in the cutaneous features of CMTC over time and demonstrate that CMTC at birth may persist throughout life.
Atrophy ; Female ; Follow-Up Studies ; Humans ; Infant ; Parturition ; Skin ; Telangiectasis ; Ulcer ; Young Adult

We report a 77-year-old woman with bilateral pons infarction who presented with severe trismus, which was responsive to botulinum toxin-A injection. She was unable to open her mouth and showed anterior displacement of her temporo-mandibular (TM) joint on MRI findings. She was fed via nasogastric tube because of mouth opening limitation. There was no improvement of her mouth opening after range of motion exercise. She underwent closed reduction of the TM joints under general anesthesia but there was no significant improvement. Electromyography studies revealed continuous muscle activities on masseter and temporalis muscles during mouth opening. Botulinum toxin-A (Botox(R)) was injected into both the masseter and left temporalis muscles under ultrasonographic guidance. There was some improvement in mouth opening at post-injection 5 days. The inter-incisal distance improved gradually, and she could start oral feeding after 18 days. She could maintain an inter-incisal distance of 1.8 cm with favorable response during post-injection 4 months.
Aged ; Anesthesia, General ; Botulinum Toxins ; Displacement (Psychology) ; Electromyography ; Female ; Humans ; Infarction ; Joints ; Mouth ; Muscles ; Pons ; Range of Motion, Articular ; Trismus

Background & Significance : Hallervorden-Spatz disease (HSD) is a rare neurologic disorder characterized by progressive dystonia, retinal degeneration, pyramidal sign, and mental deterioration. The neuropathological findings include preferential deposition of iron within the extrapyramidal nuclei, including globus pallidus, substantia nigra, and red nuclei. The final diagnosis depends on the typical pathologic findings. MRI brain imaging study commonly shows so-called "eye-of-the-tiger" in the globus pallidus. However 1H-MRS findings of HSD have not been reported. We experienced a case with clinically suspicious HSD whose diagnosis was further supported by 1H-MRS. Case : A forty four year-old man presented with slowly progressive dystonia for six years. He had been well until age of thirty eight, when he noticed clumsy hand-writing. Three years later, he developed difficulty in chewing. Clumsiness of his hands and arm movements progressed to the point of difficulty in using spoon and chopsticks. While walking, arm swing was decreased and both arms and neck took more dystonic posture. Brain MRI (T2Wl) showed symmetric high signal intensity lesions in the globus pallidus, surrounded by a peripheral zone of exaggerated low signal. On 1H-MRS of basal ganglia, although choline, creatine and N-acetyl-aspartate (NAA) peaks were detected, marked noise probably due to paramagnetic substance (iron), made quantitative analysis difficult. Conclusion : 1H-MRS of HSD is characterized by "noise", which may be suggestive of HSD.
Adult* ; Arm ; Basal Ganglia ; Brain ; Choline ; Creatine ; Diagnosis ; Dystonia ; Globus Pallidus ; Hand ; Humans ; Iron ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy* ; Mastication ; Neck ; Nervous System Diseases ; Neuroimaging ; Noise ; Pantothenate Kinase-Associated Neurodegeneration* ; Posture ; Protons* ; Retinal Degeneration ; Substantia Nigra ; Walking

STATEMENT OF PROBLEM: Recently various implant components such as premachined gold cylinder, plastic cylinder, gold UCLA abutment and plastic abutment were developed and used clinically without clinical investigation. PURPOSE: The purpose of this study was to evaluate the effects of fabrication of gold cylinder on the fitness and preload of the standard abutment and also the effects of fabrication of UCLA gold abutment on the fitness and stress transfer around the implant fixture. MATERIAL AND METHOD: Three kinds of gold cylinders such as, as-received gold cylinder((Nobel Biocare, Sweden), gold cylinder after casting, and plastic cylinder after casting with type IV gold alloy were tested over the top of the standard abutment. At the same time, three types of abutments such as, gold UCLA abutment before and after casting, and plastic abutment after casting were tested. The cylinder and abutment was secured over the fixture with conventional preload values using an electronic torque controller (Nobel Biocare Sweden). The fitness of the abutment on the fixture and gold cylinder over the standard abutment were measured using the microhardness tester (MXT 70, Matsuzawa, Japan). Preload and the strain values were recorded using the strain balance unit (SB-10, Measurement group, Raleigh, USA) and strain indicator (P-3500, Measurement group, Raleigh, USA) systems. RESULTS AND CONCLUSION: 1. Significant differences were found in the fit between the gold cylinder and plastic cylinder. 2. There were significant differences between the preload of the gold cylinder and that of the plastic cylinder. 3. Significant differences were found in the fit between the gold UCLA abutment and plastic UCLA abutment. 4. There were no significant differences in the stress generated on the supporting structure of the fixture among different cylinder and abutment groups.