Adult ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Lead ; blood ; Lead Poisoning ; blood ; epidemiology ; Middle Aged

Although most of the known pathogenic mutations in the progranulin gene (PGRN) are null mutations leading to a reduction in the serum PGRN protein levels, missense mutations also have been identifi ed in patients with frontotemporal lobar degeneration and in patients with Alzheimer disease. Among these, p.R564C mutation was identifi ed in a late-onset AD patient with a reduced serum PGRN level. However, recently, we found the p.R564C mutation in a healthy control subject raising doubts whether this is a pathogenic mutation. In this report, we measured the serum PGRN levels in 20 subjects without the p.R564C mutation and in one subject with the p.R564C mutation, to determine whether the p.R564C mutation is associated with reduced serum PGRN levels. We found that the serum PGRN level in the subject with the p.R564C mutation was not reduced compared to the subjects without the p.R564C mutation. Our result reiterates that p.R564C may not be a pathogenic mutation.

Twenty five patients (twenty seven hips) who had Chiari osteotomy at Kang Nam St. Marys Hospital between 1980 and 1995 were reviewed to evaluate the factors in the operative technique that contribute to successful outcome and assess the clinical results in various conditions. The length of follow-up ranged from one to fourteen years and the age of at operation ranged from four to twentythree years. Eighteen patients had developmental dysplasia of the hip: four, septic hip: three had another disorders, Prior to the Chiari osteotomy, fourteen hips had an femoral osteotomy and four, trochanteric arthroplasty. We used to the standard osteotomy as described by Chiari with certain modification. A pneumatic saw and osteotome are used instead of Gigli saw. This technique is simple procedure to make the correct level and angle. Bone graft was not performed in all cases even the osteotomy was displaced more than 50 percent of the iliac width. The overall results were 12 excellent, eight good, five fair, and two poor. In eleven patients, the osteotomy had to be displaced more than 50 percent to provide good coverage of the femoral head. Their results were good or excellent. A good result will be obtained if enough attention is paid to displacing the osteotomy. The osteotomy using the pneumatic saw provides accurate level and direction of osteotomy and it is an simple procedure also.
Adolescent* ; Arthroplasty ; Child* ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Osteotomy* ; Transplants

Objective To investigate the role of BMSCg on enhancing the implant survival and bacheal epithelium regeneration. Methods After transplanted with cryopreserved 2 weeks and 6 weeks allocraft, PHK-26 labeled 3-5 passage BMSCs were injected into the recipient rats via tail vein. Rats in the control groups were injected with the same amount of PBS.We observed the histology of the transplanted trachea including epithelium growth and regeneration, and the PKH-26 fluorescence levels at the para-anastomotic trachea to evaluate the role of BMSC transplantation on the epithelium regeneration. Results Rats from BMSCs injection group survived a long period. Histological observation showed that the tracheal lumen was covered by psudo-striated ciliated columnar epithelium. The cartilage structure was intact. There are no signs of denaturation and necrosis. In the PBS injection group, epithelium regeneration is better in PBS-6-week group than PBS-2-week group. The longest survival time in PBS-6-week group was 32 days, whereas it was 10 days in PBS-2-week group. In BMSCs injection group, rats in BMSC-6-week groups survived longer than 8-week group(12 rats were terminated at 1 week, 4 weeks and 8weeks as planned). There was one rat who survived and were terminated at the designated 8 weeks time point (there were 8regenerated epithelium was similar in the two BMSC transplanted groups. PKH-26 labeled BMSCs migrated to the implant site and showed red fluorescence, with most red fluorescence shown at the anastomotic part. Conclusion BMSCs can migrate to the impaired tissue to repair it. BMSCs may exert their reparation function via enhancing epithelium regeneration.

Fracture of acetabular are relatively uncommon, but when they occur they seem to pose management difficulties for attending surgeon. They are, however, important injuries because they may give rise to disabling symptoms. Furthermore, they are increasing in frequency due to the increasing number of traffic accidents. Forty cases of acetabular fracture were treated in the National Medical Center during the period 1980 to 1987. The short summary of observation were as follows : 1) There was a preponderance of young patients, the majority being in the 31–40 age group(68%). The ratio between males and females was 2.6:1. 2) The most common cause of injury was traffic accident(68%). 3) The most common associated fracture was pelvic bone fracture(48%), and most common associated other injury was abdominal visceral injury(30%). 4) The most common fracture was posterior wall fracture(28%) following to Judet & Letournel's anatomocal clsssification. 5) Twenty-five fracture(63%) were treated by conservative measures, and 15 fractures (37%) were treated by open reduction and internal fixation. 6) The results were as follows : excellent in 13(33%), good in 19(47%), fair in 5(13%), and poor in 3(7%). 7) The complication of acetabular fracture were traumatic arthritis in 6 cases, sciatic nerve injury in 2 cases, avascular necrosis of femoral head in 2 cases. 8) Not only choice of treatment but also determination of surgical approch require accurate assessment of the fracture pattern in this region of complex bony architecture by careful radiologic analysis.
Accidents, Traffic ; Acetabulum ; Arthritis ; Female ; Head ; Humans ; Male ; Necrosis ; Pelvic Bones ; Sciatic Nerve

High tibial osteotomy is now an accepted procedure in the treatment of osteoarthritis of the knee. Since the effect of this procedure is to shift the line of weight bearing from one compartment of the other, the procedure is of value in knees with osteoarthritis only when there is predominant involvement of one compartment. The osteoarthritis of knee developed bilaterally in many case, so simultaneous bilateral high tibial osteotomy under one anesthetic was considered. Eight cases of osteoarthritis with genu varum deformity were treated by simultaneous bilateral high tibial osteotomy at the Department of Orthopaedic Surgery of NMC during the,period from January, 1984 to December, 1987. The results were as follows: l. All case were female, and the mean age was 56 years old. 2. Preoperative mean varus angle were 4° in right, 3.4° in left, and postoperative mean valgus angle were 8° in right, 6° in left at final follow-up. 3. The results after average 2.2 years of follow-up were as follows: good in 5 cases(63%), fair in 1 cases(12%), poor in 2 cases(25%) 4. The complications were one proximal tibial fracture, one displacement of distal fragment, and one transient peroneal nerve palsy. 5. Mean immobilization period was 7 wks and mean hospitalization period was 48 days. 6. More rigid internal fixation was recommended in simultaneous procedure to reduce the period of hospitalization and early ambulation.
Congenital Abnormalities ; Early Ambulation ; Female ; Follow-Up Studies ; Genu Varum ; Hospitalization ; Humans ; Immobilization ; Knee ; Osteoarthritis ; Osteoarthritis, Knee ; Osteotomy ; Paralysis ; Peroneal Nerve ; Tibial Fractures ; Weight-Bearing

Cognitive deficits due to posttraumatic stress disorder (PTSD) affect patients’ social and occupational functioning and lead to social costs. Thus, it is important to understand the nature and extent of PTSD-related neurocognitive deficits to clarify the mechanisms underlying cognitive changes, identify factors that interfere with treatment, and help interpret clinical profiles. This study reviewed recent studies on the relationships between PTSD and neurocognitive domains. The magnitude of the influence of PTSD differs across cognitive function domains. Also, the extent of the effect on any given domain may also differ according to the type of trauma experienced by the subject. In addition to its negative effects on cognitive functioning, PTSD was associated with increased response to threats or trauma-related stimuli, which compromised task performance. Although each PTSD symptom may have a different effect on each cognitive function, it was difficult to generalize the results. This study is significant in that our conclusions, which emerged through a review of studies regarding the relationship between PTSD and cognitive functioning, provide a theoretical basis for further research.

PURPOSE: To investigate the actual adherence to treatment with preservative-free dorzolamide-timolol fixed combination (DTFC) eyedrops of primary open-angle glaucoma (POAG) patients by counting the number of unused single-dose units of DTFC. METHODS: This study included 34 POAG patients newly prescribed with preservative-free DTFC eyedrops (formulated in single-dose units). The enrolled patients were asked to bring the unused DTFC units on their next visit after 2 weeks of treatment with DTFC. On their second visit, they were asked to complete a questionnaire regarding the self-reported adherence and the number of unused DTFC single-dose units was counted. The actual adherence (%) was calculated by dividing the expected number of used DTFC units by the actual number of used DTFC units. The correlation between the self-reported adherence and the measured adherence was assessed. RESULTS: Twenty-nine (93.5%) patients answered they adhered to the medication by more than 90% and 2 (6.5%) answered they instilled the eyedrops at 80-90% of the dosing schedule. However, after counting the unused DTFC single-dose units, 9 (29.0%) patients showed an actual adherence of <90%. Moreover, the actual adherence of 3 (9.7%) patients was <60%. Unexpectedly, 4 (12.9%) patients showed the actual adherence exceeding 100% (196%, 1 patient; 107-132%, 3 patients). CONCLUSIONS: We demonstrated a large difference between the self-reported and the actual adherence to treatment by counting the unused single-dose units of eyedrops. Preservative-free topical anti-glaucoma medications (formulated in single-dose units) provide clinicians an opportunity to assess the actual adherence of glaucoma patients by counting the unused units of eyedrops.
Appointments and Schedules ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Ophthalmic Solutions ; Surveys and Questionnaires

The amniotic band syndrome is a collection of congenital deformities presurmably due to rupture of amniotic sac. It appears to cause fetal injury through three basic mechanisms including malformation, disruption, and deformation. The associated anomalies vary firom minor digital defect to major craniofacial and visceral defects. They can be categorized as neural tube-like defects, craniofacial anomalies, limb anomalies, abdominal and thoracic wall defects, visceral anomalies, and constriction bands. We had expericnced a case of severe congenital craniofacial anomaly due to amniotic bands diagnosed by ultrasonogram in the antenatal period is presented with a brief review of the literatures.
Amniotic Band Syndrome* ; Congenital Abnormalities ; Constriction ; Extremities ; Infant, Newborn ; Rupture ; Thoracic Wall ; Ultrasonography

Metronidazole-induced encephalopathy is a very rare complication of the long standing use of metronidazole. The encephalopathy is bilateral and symmetric in nature. We report on the magnetic resonance imaging (MRI) and clinical course of metronidazole-induced encephalopathy in a 60-year-old female with a persistent anaerobic brain abscess after draining of the abscess. After 3 months of metronidazole administration, the patient complained of dysarthria, tingling sense of all extremities, and left hemiparesis. MRI revealed symmetric hyperintensity lesions in medulla, pons, dentate nuclei of cerebellum, and splenium of corpus callosum, all of which represent typical findings of metronidazole-induced encephalopathy. In addition, asymmetric lesions in midbrain, thalamus, putamen and cerebral subcortical white matter were noted. The patient recovered after discontinuation of metronidazole and the remaining abscess was successfully treated with meropenem and levofloxacine.
Abscess ; Brain ; Brain Abscess ; Brain Diseases, Metabolic ; Cerebellum ; Corpus Callosum ; Dysarthria ; Extremities ; Female ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Metronidazole ; Middle Aged ; Ofloxacin ; Paresis ; Pons ; Putamen ; Thalamus ; Thienamycins