No abstract available.
Abscess* ; Diverticulum* ; Humans ; Infant*

A customized vestibular rehabilitation (VRT) is an important treatment modality in patients with vestibular dysfunction with gaze instability, motion-provoked vertigo, disequilibrium and gait disturbance. We discuss in this paper the patient selection criteria for VRT, rehabilitation strategies for vestibular deficits, and the factors that affect the outcome.
Gait ; Humans ; Patient Selection ; Vertigo

PURPOSE: We evaluated Valsalva and cough-induced leak point pressure measurements identically and compared their reliability in the patients with stress urinary incontinence (SUI). MATERIALS AND METHODS: Seventy-five patients complaining of SUI were assessed with medical history, uro-gynecological examination, any factors that could affect voiding symptoms, and videourodynamic study consisting of Valsalva leak point pressure (VLPP), cough-induced leak point pressure (CILPP) on supine and erect position, prospectively. We observed the location and descent of bladder neck on fluoroscopic images, and VLPP, CILPP synchronously. The bladder neck position, the degree of bladder neck descent, VLPP and CILPP were compared, then the correlation of each was analysed. RESULTS: The lower the position of initial bladder neck is, the more severe the descent of the bladder neck is in supine (Valsalva; r=0.305, p<0.01, cough; r=0.333, p=0.01) and erect (Valsalva; r=0.341, p<0.01, cough; r=0.512, p<0.01). The descent of bladder neck and VLPP is significantly correlated in supine (r=0.251, p<0.05) and erect (r=0.293, p<0.01). The descent of bladder neck and CILPP is also significantly correlated in erect (r=0.254, p<0.05), but not in supine position (r=0.232, p>0.05). VLPP and CILPP in SUI type III are significantly lower than those in SUI type I and II (p<0.05), but VLPP and CILPP were not correlated to subjective symptoms of SUI. CONCLUSIONS: Both VLPP and CILPP are reliable in evaluation of SUI. However, ecause VLPP is reliable regardless of position and easier than CILPP in the measurement, it is expected as more useful method. If CILPP is used, it must be evaluated in the erect position.
Cough ; Humans ; Neck ; Prospective Studies ; Supine Position ; Urinary Bladder ; Urinary Incontinence*

OBJECTIVE: To understand the neural generator of double-peak potentials and the change of latency and amplitude of double peaks with aging. METHOD: In 50 healthy subjects made up of groups of 10 people per decade from the age of 20 to 60, orthodromic sensory nerve conduction studies were performed on the median nerves using submaximal stimulation. Various stimulus durations and interstimulation distances were used to obtain each double peak in the different age groups. The latency and amplitude of the second peak were measured. Statistical analyses included one-way ANOVA and correlation tests. p-values<0.05 were considered significant. RESULTS: When the cathode moved in a proximal direction, the interpeak intervals increased. Second peak amplitudes decreased, and second peak latencies were delayed with aging (p<0.05). In some older people, second peaks were not obtained. CONCLUSION: Our experiments indicate that the double-peak response represented the two stimulation sites under the cathode and anode. The delayed latency and decreased amplitude of the second peak that occurs with aging represented peripheral nerve degeneration in aging, which starts at the distal nerve.
Aging ; Electrodes ; Humans ; Median Nerve ; Nerve Degeneration ; Neural Conduction ; Peripheral Nerves

OBJECTIVE: To determine the function of the normal upper trapezius and scalenus medius muscles during neck motion by quantitative eletromyographic analysis. METHOD: Nine subjects were evaluated electromyographically with monopolar fine wire electrodes. The isometric tilting and rotation of neck with manual resistance were performed in the sitting position. The Root Mean Square (RMS) and Mean Rectified Voltage (MRV) were recorded. RESULTS: The RMS and MRV of upper trapezius muscle were significantly higher at each degree of ipsilateral rotation than contralateral rotation. But the RMS and MRV of scalenus medius muscle were significantly higher at each degree of contralateral rotation than ipsilateral rotation. The RMS and MRV of upper trapezius and scalenus medius muscles were significantly higher at ipsilateral tilting than at contralateral tilting. CONCLUSION: Based on these results, we concluded that the upper trapezius muscle acts more in ispilateral rotation, while scalenus medius muscle acts in contralateral rotation, and upper trapezius and scalenus medius muscles act in ipsilateral tilting.
Electrodes ; Muscles ; Neck* ; Superficial Back Muscles*

The thalamus, located between the cerebrum and midbrain, is a nuclear complex connected to the cerebral cortex that influences motor skills, cognition, and mood. The thalamus is composed of 50-60 nuclei and can be divided into four areas according to vascular supply. In addition, it can be divided into five areas according to function. Many studies have reported on a thalamic infarction causing motor or sensory changes, but few have reported on behavioral and executive aspects of the ophthalmoplegia of the thalamus. This study reports a rare case of a paramedian thalamus infarction affecting the dorsomedial area of the thalamus, manifesting as oculomotor nerve palsy, an abnormal behavioral change, and executive dysfunction. This special case is presented with a review of the anatomical basis and function of the thalamus.
Cerebral Cortex ; Cerebrum ; Cognition ; Executive Function ; Infarction* ; Mesencephalon ; Motor Skills ; Oculomotor Nerve Diseases ; Ophthalmoplegia ; Thalamus

Primary renal lymphoma is a controversial entity and extremely rare disease, possibly due to the fact that the kidney is one of the extranodal organs usually not containing lymphoid tissue. It is unclear if this conditions can be diagnosed preoperatively with imaging studies. In most cases the diagnosis is made after removal or biopsy of a kidney for suspected primary renal tumor or at autopsy. Treatment usually consists of surgery and chemotherapy with or without radiation therapy and the prognosis is poor. We report a case of primary renal lymphoma presenting with fever in a 13-month- old boy who was treated with surgical intervention and combination chemotherapy.
Autopsy ; Biopsy ; Child* ; Diagnosis ; Drug Therapy ; Drug Therapy, Combination ; Fever ; Humans ; Kidney ; Lymphoid Tissue ; Lymphoma* ; Male ; Prognosis ; Rare Diseases

Chikungunya infection is caused by an arbovirus transmitted by the Aedes mosquito. A 19-year-old man who had traveled to the Republic of Surinam to perform volunteer work complained of a fever, arthralgia, articular stiffness, and a skin rash on both the arm and trunk. Chikungunya fever was diagnosed using a Chikungunya virus specific IgM antibody in an enzyme-linked immunosorbent assay (ELISA) using blood samples obtained during follow-up visits. In this report, we describe a case of imported Chikungunya fever that presented with arthralgia and a skin rash, with islands of normal skin, that occurred following travel to Surinam, South America.
Aedes ; Arboviruses ; Arm ; Arthralgia ; Chikungunya virus* ; Culicidae ; Enzyme-Linked Immunosorbent Assay ; Exanthema ; Fever ; Follow-Up Studies ; Humans ; Immunoglobulin M ; Islands ; Skin ; South America* ; Suriname* ; Volunteers ; Young Adult

Purpose: This study aimed to evaluate the natural growth of subepithelial tumors of the small bowel detected on CT. Materials and Methods: Consecutive patients who were suspected of having subepithelial tumors of the small bowel between January 2005 and December 2020 were reviewed. Eligible patients with suspected small (< 30 mm) subepithelial tumors on at least two CT evaluations were included in the analysis. The patients’ data on demographic characteristics, tumoral characteristics, and tumoral size changes during the follow-up were collected. Results: This study included 64 patients with suspected small subepithelial tumors (n = 64) of the small bowel. After a median follow-up of 15.8 months, the diameter and volume growth rates were 0.02 mm/month and 1.5 mm3/month, respectively. A significant correlation was observed between the initial size and the growth rate of the small bowel subepithelial tumors. The group of large-sized tumors (initial diameter ≥ 10 mm) tended to show lobulated contours, heterogeneous enhancement, and necrotic changes more frequently than the group of small-sized tumors (initial diameter < 10 mm). Conclusion Small bowel subepithelial tumors measuring less than 10 mm grew more slowly than those measuring 10–30 mm.

OBJECTIVE: To evaluate the effect of multiple sensory stimulation on cortical excitability by using transcranial magnetic stimulation (TMS). METHOD: Thirteen right handed young adults without neurological deficit were enrolled. Cortical excitability was tested by measuring recruitment of motor evoked potentials [recruitment curve (RC)], intracortical inhibition (ICI), and intracortical facilitation (ICF) at the abductor pollicis brevis of the dominant hand in two different conditions: (1) group A: active thumb and index finger pinch movement while observing the congruent finger movement in a screen with 0.2 Hz bell sound for 30 minutes, (2) group B: the same active finger movement in a dark screen with the same bell sound for 30 minutes. All of these procedures were done with a randomized crossover design. RESULTS: The amplitude of MEP and the slope of all RC (140%,160% of the resting motor threshold) of group A showed increment after visually-guided finger movement and the level of ICI showed decrement after visually guided finger movement (p<0.05), but there was no change in the level of ICF (p>0.05) in group A. In group B, the amplitude of MEP and the levels of ICI, ICF showed no significant changes following finger movement with no visual guidance (p>0.05), but the slope of RC with 140% showed increment (p<0.05). CONCLUSION: These findings suggest that cortical excitability can be enhanced by simple repetitive motor practice. The congruent sensori-motor stimulations lead to corresponding additional effect on cortical excitability, presumably by recruitment of remote motor neurons.