Postoperative epidural hematoma (EDH) usually present with neurological deficit. Massive EDH presenting with only severe pain without neurological deficit are rare. Atypical presentations of postoperative EDHs may lead to delayed diagnosis and treatment. We present three such cases after posterior cervical spine surgery. Three patients presented with severe neck pain and spasms without motor deficits several days after posterior cervical decompressive procedures. Imaging studies identified compressive EDHs at the surgical site with severe compression of the spinal cord. All were treated with emergent decompression, with resulting improvement of symptoms and pain relief without further neurological sequelae. In conclusion, postoperative EDHs after posterior cervical spine surgery may result in minimal neurological deficit. Our report reminds surgeons to keep this possibility in mind when patients complain of unusually severe neck pain and spasms after posterior cervical spine surgery.
Decompression ; Delayed Diagnosis ; Hematoma* ; Humans ; Neck Pain* ; Neck* ; Postoperative Complications ; Spasm ; Spinal Cord ; Spine*

No abstract available.

BACKGROUND: IgE is closely related to the development of allergies. However, the poor relationship between the specific IgE level and the severity of allergic diseases suggests the possibility of functionally different IgE isoforms. With this in mind, rat basophilic leukemia (RBL)-2H3 activation was analyzed with each type of rat IgE for two parameters, exocytosis and IL-4 mRNA production. RBL-2H3 has been well documented in the rat mucosal mast cell line. METHODS: RBL-2H3 cells sensitized with each kind of rat IgE was activated by cross-linking FcRI with B5 (monoclonal anti-rat IgE mouse IgG antibodies). The RBL-2H3 exocytosis was measured by analyzing the beta-hexosaminidase level, and the level of IL-4 mRNA synthesis was analyzed using semi- quantitative RT-PCR. Rat IgE, which was produced by a parasite infection (REP), was prepared using either Paragonimus westermani metacercariae (REP-PW) or Anisakis simplex third stage larvae (REP-AS). A rat IgE prototype of IR162 was prepared by a peritoneal injection of immunocytoma. RESULTS: The level of exocytosis showed a linear relationship with the rat IgE concentration when REP-PW or REP-AS was applied. However, it exhibited a biphasic response with IR162. In addition, the time course of heating at 56oC illustrated the similarity between REP-PW and REP-AS, which differed from that of IR162. In contrast, the level of IL-4 mRNA synthesis in the RBL-2H3 cells with IR162 was comparable to that of either REP-PW or REP-AS. CONCLUSION: These results suggest that functionally different rat IgE isoforms exists in RBL-2H3 exocytosis.
Animals ; Anisakis ; Basophils ; beta-N-Acetylhexosaminidases ; Exocytosis* ; Heating ; Hot Temperature ; Hypersensitivity ; Immunoglobulin E* ; Immunoglobulin G ; Interleukin-4 ; Larva ; Leukemia ; Mast Cells ; Metacercariae ; Mice ; Paragonimus westermani ; Parasites ; Protein Isoforms ; Rats* ; RNA, Messenger

PURPOSE: To determine whether insulin-like growth factor (IGF-1) affects transforming growth factor (TGF-beta)- mediated fibronectin accumulation in human lens epithelial cell line (HLE B-3) cells. MATERIALS AND METHODS: HLE B-3 cells were incubated for 24 hours with TGF-beta (10ng/ mL), IGF-1 (10ng/mL), or both. Expression of the fibronectin gene was determined using a real-time reverse transcriptase-polymerase chain reaction (RT-PCR). Fibronectin levels were examined using western blot analysis and immunofluorescence staining. RESULTS: Expression of the fibronectin gene was not different between the TGF-beta/IGF-1 treated group and the TGF-beta treated group (p= 0.116). However, western blot analysis demonstrated decreased fibronectin levels in human lens epithelial cells treated with TGF-beta and IGF-1 compared to those treated with TGF-beta only (p < 0.01). Immunofluorescence staining disclosed inhibition of TGF-beta-induced fibronectin in the presence of IGF-1. CONCLUSION: This study suggests that IGF-1 counteracts TGF-beta-mediated fibronectin accumulation in human lens epithelial cells.
Cell Line ; Epithelial Cells/cytology/*drug effects/metabolism ; Fibronectins/*genetics/metabolism ; Fluorescent Antibody Technique ; Gene Expression Regulation/drug effects ; Humans ; Insulin-Like Growth Factor I/*pharmacology ; Lens, Crystalline/cytology ; Reverse Transcriptase Polymerase Chain Reaction ; Transforming Growth Factor beta/*pharmacology

OBJECTIVE: To investigate the effect of Comprehensive Hand Repetitive Intensive Strength Training (CHRIST) on upper limb function in children with cerebral palsy using motion analysis. METHOD: The subjects in this study included 19 children (10 males, 9 females, mean age=8.8 years) with cerebral palsy. The experimental group (n=10) received CHRIST and general rehabilitation therapy. The control group (n=9) received a home program as well as general rehabilitation therapy. Both groups received 30 sessions of CHRIST or home program training for 60 minutes per session 3 times a week during the 10-week period. The reaching movements were captured by a motion analysis system. Kinematic variables including movement time (MT), mean velocity (MV), normalized jerk score (NJS), mean angular velocity (MAV) and normalized jerk score of the shoulder, elbow and wrist joint with comfortable and fast speed were analyzed between groups and the pre-post training group. RESULTS: After pre- and post-training experimental group, MT, MV, NJS, MAV of shoulder, elbow, wrist and NJS of elbow and wrist improved significantlyin reaching movement of both comfortable and fast speed (p<0.05). However, After pre- and post-training control group, MV improved significantlyin reaching movement of only comfortable speed (p<0.05). Between two groups, MT and MAV of the elbow at comfortable speed and NJS of the elbow at fast speed were statisticallysignificant (p<0.05). CONCLUSION: CHRIST proved to be an effective intervention for improving upper limb extremity function of reaching movement in children with cerebral palsy.
Cerebral Palsy ; Child ; Elbow ; Extremities ; Female ; Hand ; Humans ; Male ; Muscle Strength ; Resistance Training ; Shoulder ; Upper Extremity ; Wrist ; Wrist Joint

PURPOSE: We evaluated the efficacy of the PCR which is known as more sensitive method than culture in the diagnosis of causal microorganisms of the infective endophthalmitis. METHODS: We used 0.3 ml of aqueous humor and 0.5 ml of vitreous sample in 3 cases of postoperative and 1 case of endogenous endophthalmitis for detecting causal microorganisms. To detect the bacteria we used universal, Gram positive and negative primers, and to detect the fungus we used fungal primer. RESULTS: Three cases of endophthalmitis, there was no bacteria in the bacterial culture for 10 days but PCR results identified causal microorganisms in all cases. CONCLUSIONS: PCR is effective in the fast and accurate diagnosis of infective endophthalmitis and especially in the culture-negative endophthalmitis.
Aqueous Humor ; Bacteria ; Diagnosis* ; Endophthalmitis* ; Fungi ; Polymerase Chain Reaction*

Increasing concern is being given to the association between risk of cancer and exposure to low-dose bisphenol A (BPA), especially in young-aged population. In this study, we investigated the effects of repeated oral treatment of low to high dose BPA in juvenile Sprague-Dawley rats. Exposing juvenile rats to BPA (0, 0.5, 5, 50, and 250 mg/kg oral gavage) from post-natal day 9 for 90 days resulted in higher food intakes and increased body weights in biphasic dose-effect relationship. Male mammary glands were atrophied at high dose, which coincided with sexual pre-maturation of females. Notably, proliferative changes with altered cell foci and focal inflammation were observed around bile ducts in the liver of all BPA-dosed groups in males, which achieved statistical significance from 0.5 mg/kg (ANOVA, Dunnett’s test, p<0.05). Toxicokinetic analysis revealed that systemic exposure to BPA was greater at early age (e.g., 210-fold in C(max), and 26-fold in AUC at 50 mg/kg in male on day 1 over day 90) and in females (e.g., 4-fold in C(max) and 1.6-fold in AUC at 50 mg/kg vs. male on day 1), which might have stemmed from either age- or gender-dependent differences in metabolic capacity. These results may serve as evidence for the association between risk of cancer and exposure to low-dose BPA, especially in young children, as well as for varying toxicity of xenobiotics in different age and gender groups.
Animals ; Area Under Curve ; Bile Ducts* ; Bile* ; Body Weight ; Child ; Female ; Humans ; Inflammation ; Liver Neoplasms* ; Liver* ; Male ; Mammary Glands, Human ; Rats* ; Rats, Sprague-Dawley ; Toxicokinetics ; Xenobiotics

Diffuse alveolar damage (DAD) is a histological change in lung tissue, and is generally caused by an acute lung injury, which is characterized by bilateral and widespread damages. Localized DAD occurs very rarely. The causes for DAD are numerous, but the chief cause is acute interstitial pneumonia or acute exacerbation of idiopathic interstitial pneumonia, in cases of idiopathic manifestation. The 82-year-old patient, in this case study, showed a DAD lesion in only 1 lobe. The patient was otherwise healthy, with no previous symptoms of DAD. He was admitted to our medical center owing to localized infiltration, observed on his chest radiograph. Laboratory studies showed no signs of infections. DAD was confirmed by a surgical lung biopsy. The patient received corticosteroid treatment and had gradually improved. We report the case of a patient with localized, idiopathic DAD that cannot be classified as acute interstitial pneumonia or acute exacerbation of idiopathic interstitial pneumonia.
Acute Lung Injury ; Aged, 80 and over ; Biopsy ; Humans ; Idiopathic Interstitial Pneumonias ; Idiopathic Pulmonary Fibrosis ; Lung ; Lung Diseases, Interstitial ; Lung Injury ; Thorax

PURPOSE: We collected tear or scleral tissues of necrotizing scleritis after pterygium excision, and evaluated them for tumor necrosis factor (TNF)-alpha and matrix metalloproteinase (MMP)-9 to elucidate the molecular basis and seek for treatment of this disease. METHODS: Three patients with necrotizing scleritis after pterygium excision were evaluated for MMP-9 and TNF-alpha in tear and scleral tissue by Western blot analysis. RESULTS: Before treatment with corticosteroid, the patients' tear samples showed increased expression of TNF-alpha and MMP-9 compared to those of the contralateral eye. After treatment, the expression of TNF-alpha and MMP-9 was decreased compared to those of the pre-treated tear samples. The patients' sclera showed increased expression of MMP-9 compared to that of the donors' sclera and the patients' conjunctiva. CONCLUSIONS: Our results suggest that cytokine-related inflammation plays a role in the pathophysiology of necrotizing scleritis and strongly supports, under the guarantee of negative microbiological culture, the prompt use of corticosteroid and immunosuppressive agents to help suppress the progression of this disease.
Blotting, Western ; Conjunctiva ; Humans ; Immunosuppressive Agents ; Inflammation ; Matrix Metalloproteinase 9 ; Pterygium* ; Sclera ; Scleritis* ; Tears* ; Tumor Necrosis Factor-alpha*

BACKGROUND: Pulmonary infiltrate in immunocompromised hosts has many infectious and non- infectios etiologies. To evaluate the diagnostic yield and therapeutic implication of two invasive diagnostic methods, such as bronchoscopy and surgical lung biopsy, we performed retrospective analysis of these patients. METHODS: All immunocompromised patients admitted to Samsung Medical Center from October 1995 to August 1998 who underwent bronchoscopy and/or surgical lung biopsy for the diagnosis of pulmonary infiltrates were included in this study. Confirmative diagnostic yield, the rate of changed therapeutic plan and patients' survival were investigated. RESULTS: Seventy-five episodes of pulmonary infiltrates developed in 70 patients(M : F = 46 : 24, median age 51). Underlying diseases of patients were hematologic malignancy(n=30), organ transplantatio n(n=11), solid tumor(n=12), connective tissue disease(n=6) and others. Confirmative diagnosis was made in total 53 cases (70.7%), of which 70.2% had infectious etiology. Diagnostic yields of bronchoscopy, bronchoalveolar lavage(BAL), transbronchial lung biopsy(TBLB) and surgical lung biopsy were 35.0%(21/60), 31.4%(16/51), 25.0%(9/36) and 80.0%(20/25). Therapeutic plan was changed in 40%(24/60) of patients after bronchoscopy and in 36%(9/25) of patients after surgical lung biopsy. More patients survived (84.4% vs 60.5%, p=0.024) when therapeutic plan was changed after invasive diagnostic study. CONCLUSION: Bronchoscopy and surgical lung biopsy are helpful for the therapeutic implication of pulmonary infiltrates in immunocompromised hosts. Large-scale prospective case-control study may further clarify their limitation and usefulness.
Biopsy* ; Bronchoscopy* ; Case-Control Studies ; Connective Tissue ; Diagnosis* ; Humans ; Immunocompromised Host* ; Lung* ; Retrospective Studies