Wernickes encephalopathy is an illness characterized by mental disturbance, paralysis of eye movements and ataxia of gait. The specific factor for most, if not all, of these symptoms is a deficiency of thiamine. Wemicke's encephalopathy mostly occurs in developing countries when the patient is in a state such as nutritionally deprived state, anorexia nervosa, stomach cancer, long duration of parenteral nutrition. Wernickes encephalopathy was recognized as a complication of hyperemesis of pregnancy in 1914. Unfortunately, cases continue to occur. We present here a case of Wernickes encephalopathy in a 36-year-old pregnant woman. We discuss the clinical picture, histopathology, radiology, therapeutic management and prognosis with review of the literature.
Adult ; Anorexia Nervosa ; Developing Countries ; Eye Movements ; Female ; Gait Ataxia ; Humans ; Hyperemesis Gravidarum* ; Hyperthyroidism* ; Paralysis ; Parenteral Nutrition ; Pregnancy ; Pregnant Women ; Prognosis ; Radiation Oncology ; Stomach Neoplasms ; Thiamine ; Wernicke Encephalopathy*

PURPOSE: This study was undertaken to determine whether the clinical presentation of patients with central precocius puberty(CPP) varies according to the etiology, whether this permits the differentiation between idiopathic and organic forms and to examine whether LH determination in a single timed blood sample after GnRH administration is sufficient to diagnose CPP. METHODS: This study included 33 girls with signs of breast development, of whom 23 were diagnosed as definite central precocious puberty. Sixteen patients had idiopathic CPP; the remaining 7 patients had organic CPP. Ten patients were classified as non-CPP. Potential clinical and laboratory predictors of CNS abnormalities were assessed and GnRH stimulation test was done. RESULTS: The age of onset in patients with organic CPP was 4.11+/-2.08 years, whereas the age in patients with idiopathic CPP was 7.25+/-1.34 years. This parameter is the only one showing statistical significance. We compared sensitivities and specificities at 0, 15, 30, 60, 90 and 120 min which yielded sensitivities of 8.7%, 87.0%, 91.3%, 87.0%, 73.9%, 60.9%. CONCLUSION: It is impossible to exclude a central nervous system lesion in patient with central precocious puberty without performing central nervous system imaging. However, this study indicates earlier the onset of disease, higher the possibility of presence of CNS lesion. According to the mean GnRH stimulated LH levels and sensitivity at each times, a single blood sample obtained for LH determined after GnRH administration at 30 min can be used to diagnose the central precocious puberty.
Age of Onset ; Breast ; Central Nervous System* ; Female ; Gonadotropin-Releasing Hormone* ; Humans ; Luteinizing Hormone ; Puberty, Precocious*

This experiment was aimed to investigate the contractile responses of the fermoral artery to the electrical stimulation and the inhibitory effects of verapamil and papaverine on the electrical stimulation of the fermoral artery in the control (n=46) and the diabetic rabbits(n=40). Diabetic rabbits were made by and administration of alloxan (100 mg/kg) intravenously and sacrified 8 weeks later. Femoral arterial rings 3 mm in length were taken and mounted on the force-displacement transducer for the measurements of isometric tension. All experiments were done in the aerated (95% O2 with 5% CO2)biological chamber filled with Kreb's solution and the initial tension of 1.5g was applied to the rings. After 1 hour of equilibrium of the rings, the contractile responses of the electrical stimulation on the femoral arterial rings were taken without vasoactive drugs and then, under verapamil and papaverine solution. And we compared the morphologic findings of the vessels in the two groups in relation to the functional changes by transmission electron miroscopy. The results are as follows: 1. The contractile responses in the presence of verapamil or papaverine solutions to the electrical stimulation were lowed significantly in the fermoral arterial rings of the diabetic rabbits compared with that of the control rabbits (verapamil; 10M~10M: p<0.01, papaverine; 10M & 10M: p<0.01). 2. Transmission electron microphotographs showed many morphological differences of the femoral arteries between the control and the diabetic rabbits. These were irregularities of the internal elastic lamina and the hypertrophy of the cytoplasms of the smooth muscle cells. And also, there were many vacuoles in the cytoplasm of the endothelial cells, lateral to the internal elastic laminaes, and between the smooth muscle cells in the diabetic rabbit femoral artery. By this study, we found that the contractile responses of the femoral arterial rings to the electrical stimulation were decreased in the diabetic rabbits, and the vasodiatory effects of verapamil and papaverine on the electrically stimulated femoral arterial rings were also lowered in the diabetic rabbits compared with the control rabbits. These changes of the vasular responses of the diabetic vessel may be associated with morphological changes manifested by transmission electron microscopy or any other functional derangement of the vessels.
Alloxan ; Arteries ; Cytoplasm ; Electric Stimulation* ; Endothelial Cells ; Femoral Artery ; Hypertrophy ; Microscopy, Electron, Transmission ; Myocytes, Smooth Muscle ; Papaverine ; Rabbits ; Transducers ; Vacuoles ; Vasodilator Agents* ; Verapamil

A nineteen year-old boy with progressive enlargement of the joints and distal extremities, clubbing, coarse facial features and hyperhidrosis was investigated. In physical examination, thickening of the scalp with furrowing (cutis verticis gyrata) and greasy thickening of skin (pachyderma) was prominent. His endocrine profile was normal. Radiological studies demonstrated bilateral symmetrical periosteal new bone formation with acroosteolysis and incidental microadenoma of pituitay gland. After extensive investigation to exclude systemic and endocrine causes, the patient was diagnosed as pachydermoperiostosis (PDP). PDP is a rare syndrome manifested clinically by finger clubbing, extremity enlargement, hypertrophic skin changes, and periosteal bone formation. The pathogenesis of the disorder has not been clarified though few endocrine abnormalities were seen. To aware of these clinical phenotype would help to differentiate PDP from acromegaly.
Acro-Osteolysis ; Acromegaly ; Extremities ; Fingers ; Humans ; Hyperhidrosis ; Joints ; Male* ; Osteoarthropathy, Primary Hypertrophic* ; Osteogenesis ; Phenotype ; Physical Examination ; Scalp ; Skin ; Young Adult*

We report a case of clinical features corresponding to Eosinophilia-Myalgia syndrome, with no causal relationship with L-tryptophan. Since the epidemic of L-tryptophan associated Eosinoghilia-Myalgia Syndrome in 1989, only 2% of the cases were found not to be related to L-tryptophan in America. We believe that this is the first case report of Eosinophilin-Myalgia Syndrome not related to L-tryptophan in Korea.
Americas ; Electrodiagnosis ; Eosinophilia-Myalgia Syndrome* ; Korea ; Tryptophan*

STATEMENT OF PROBLEM: Among the physical properties of adhesion luting cement, the aspect that requires the most important factor is the degree of solubility and water sorption. Dissolution or an inadequate due to excessive water sorption inside the oral cavity compromises the while concurrently increasing the susceptibility to secondary dental caries. Susceptibility to dissolution and difficulty of removing remnant cement from the gingival sulcus have hindered the use of dental resin cement in the clinical practice, but the improved characteristics of newer generation resin cements have interest in and enabled resin cements to be widely used in adhesion of fixed prosthesis, such as laminate veneers and all-ceramic crowns. PURPOSE: The purpose of this study is to compare and analyze the degrees of solubility and water sorption of a variety of resin cements widely used for clinical purposes with different curing methods. MATERIALS AND METHODS: Self-curing resin cements, Avanto(R), CandB(TM) CEMENT and Superbond CandB cements comprised group 1, 2 and 3. The dual-curing resin cements Panavia(TM) F, Calibra(R) and Variolink(R) II were divided into groups 4, 5, and 6, respectively. The investigation was carried out using disc-shaped specimens as specified by ANSI/ADA Specification No. 27. The degree of water sorption, water solubility and lactic acid solubility of each test group was analyzed statistically leading to the following conclusion. RESULTS: The degree of water sorption was shown to increase in the following order : group 6, 5, 4, 2, 1 and 3. There were significant differences between the water sorption of each group. Results of the degree of water solubility were shown to increase in the following order : group 6, 5, 4, 2, 1 and 3. Statistically significant differences were found between each group, with the exception of groups 1 and 3. Finally, the degree of lactic acid solubility was found to increase in the following order : group 6, 5, 4, 2, 3 and 1. Significant differences were found between each group. In general dual-curing resin cements displayed substantially lower values than self-curing resin cements with regard to water sorption, water solubility, and lactic acid solubility. CONCLUSIONS: From the results of this study, dual-curing resin cements show a significantly lower degree of water sorption and solubility than their self-curing counterparts. Clinically, when selecting resin cements, the product with a lower degree of water sorption and solubility are preferred. The results of this study indicate that the use-of dual-curing resin cements is preferable to self-curing cements.
Crowns ; Dental Caries ; Fibrinogen ; Lactic Acid ; Mouth ; Prostheses and Implants ; Resin Cements* ; Resins, Synthetic ; Solubility* ; Water*

STATEMENT OF PROBLEM: Ceramic and composite resin have been used to fulfill the demand for esthetic prosthesis. However, ceramic is easy to break and wears off the opposite natural teeth. Conventional composite resin also has low abrasive resistance and color stability. Ceramic Optimized Polymer (ceromer) was developed in mid-1990s to overcome the shortfalls of ceramic and composite resin. Ceromer has similar abrasiveness with the natural tooth and has relatively high strength. Color stability affects esthetics and long-term prognosis of the prosthesis. PURPOSE: The purpose of this study was to compare color stability of ceromers(2 types : Artglass., Targis.) with ceramics(Vintage.-polishing, Vintage.-glazing). MATERIAL AND METHOD: The color difference(E*) was measured by spectrophotometer with different immersion time. Twenty disks, 3mm in thickness and 10mm in diameter, were fabricated for each specimen in shade A2(Vita Lumin shade guide). Specimens(5 samples in each group) were immersed in the food colorants(Red no.3, Yellow no.4, Blue no.1, Distilled water) for 24 hours, 48 hours and 72 hours respectively. L*, a* and b* value were measured with spectrophotometer (CM 503i : Minolta Co., Japan) and mean E* value was calculated for statistical analysis. RESULTS: The results of this study were obtained as follows. 1. The E* values of all test samples increased with the time of immersion. 2. The E* values of all materials increased in order of Distilled Water, Yellow no.4, Blue no.1 and Red no.3. There was significant difference between Red no.3 and the other food colorants(p<0.05). 3. The E* values increased in order of Vintage-glazing, Vintage-polishing, Artglass and Targis. There was significant difference between Vintage.-glazing and the other materials (p<0.05). CONCLUSION: By means of the above results, immersion time was found to be a critical factor for color stability of ceromer. For the long-term color stability of prosthesis it is recommended patients having ceromer prosthesis(Artglass., Targis.) to reduce the habitual intake of Red no.3 colorants con taining foods.
Ceramics ; Esthetics ; Food Coloring Agents* ; Humans ; Immersion ; Polymers ; Prognosis ; Prostheses and Implants ; Tooth ; Water

The purpose of this study was to compare the microleakage of the composite resin cores according to surface treatment, dentin bonding agents, and thermocycling. For this study, 120 extracted premolar teeth were used. Flat occlusal surfaces were prepared with diamond disk, and treated with air-abrasion, acid-etching, combination. The composite resin core was built with Z-100 after application of Scotchbond Multi-Purpose and All-Bond 2. Prepared specimens were thermocycled for 2,000 cycles. Specimens were immersed in 1% methylene blue solution for 24hours at 371C. The microleakage was measured with a inverted metallurgical microscope(BHS313, Olympus, Japan). The following conclusions were drawn from this study 1. The microleakages in the groups treated with air-abrasion and with acid etching were greater than that of the groups treated with combination method before thermocycling(p<0.05), the microleakages of the groups treated with air-abrasion were greater than that of the groups treated with acid-etching and combination method after thermocycling(p<0.05). 2. There were no significant difference between groups using Scotchbond Multi-Purpose and the groups using All-Bond 2. 3. Thermocycling didri t affect the change of microleakage in all cases.
Bicuspid ; Dentin-Bonding Agents ; Diamond ; Methylene Blue ; Tooth

The purpose of this study was to compare the microleakage of the composite resin cores according to surface treatment, dentin bonding agents, and thermocycling. For this study, 120 extracted premolar teeth were used. Flat occlusal surfaces were prepared with diamond disk, and treated with air-abrasion, acid-etching, combination. The composite resin core was built with Z-100 after application of Scotchbond Multi-Purpose and All-Bond 2. Prepared specimens were thermocycled for 2,000 cycles. Specimens were immersed in 1% methylene blue solution for 24hours at 371C. The microleakage was measured with a inverted metallurgical microscope(BHS313, Olympus, Japan). The following conclusions were drawn from this study 1. The microleakages in the groups treated with air-abrasion and with acid etching were greater than that of the groups treated with combination method before thermocycling(p<0.05), the microleakages of the groups treated with air-abrasion were greater than that of the groups treated with acid-etching and combination method after thermocycling(p<0.05). 2. There were no significant difference between groups using Scotchbond Multi-Purpose and the groups using All-Bond 2. 3. Thermocycling didri t affect the change of microleakage in all cases.
Bicuspid ; Dentin-Bonding Agents ; Diamond ; Methylene Blue ; Tooth

Our purpose is to describe a successful twin pregnancy and delivery after intracytoplasmic sperm injection (ICSI) followed by calcium ionophore with spermatozoa from a globozoospermic man. On the second attempt of ICSI, all of eight metaphase II oocytes were fertilized with treatment with calcium ionophore. Day 3 transfer of six normally developing embryos resulted in an ongoing twin pregnancy, and two preterm healthy babies were born in the 33th week of gestation. To the best of our knowledge, this is the first report of pregnancy and delivery after ICSI followed by calcium ionophore with spermatozoa from a globozoospermic man in Korea.
Calcium* ; Embryonic Structures ; Humans ; Metaphase ; Oocytes ; Pregnancy ; Pregnancy, Twin* ; Sperm Injections, Intracytoplasmic* ; Spermatozoa*