No abstract available.
Candida albicans* ; Candida*

The purpose of this review is to provide a comprehensive approach for optimal strategies of upper limb motor rehabilitation after stroke. Stroke is a common, serious, and disabling global health-care problem. Optimal organization of rehabilitation for stroke patients has been extensively documented. However, between 30% and 66% of individuals with stroke do not obtain satisfactory motor recovery of the affected upper limb with rehabilitative interventions. The recovery of the affected upper extremity depends on intensity, task progression, and repetition to neural plasticity, namely, the ability of central nervous system cells to modify their structure and function in response to external stimuli. Recently, constraint-induced movement therapy, motor imagery, action observation, or mirror therapy has emerged as interesting options as add-on interventions to standard physical therapies. In this review, we will discuss to establish a framework by which several promising interventions for neural plasticity.
Central Nervous System ; Humans ; Neuronal Plasticity ; Plastics ; Rehabilitation* ; Stroke* ; Upper Extremity*

BACKGROUND: The reversal of neuromuscular blocker might be accelerated if the anticholinesterase was administered in divided doses. This study has been conducted to evaluate the correct ratio of divided doses of neostigmine for the rapid recovery in the rabbits after pancuronium when the profound relaxation(PTC=0) was confirmed. METHODS: Rabbits(n=60) were randomly allocated to 6 groups. After pancuronium 0.2 mg/kg intravenously, spontaneous recovery was evaluated in group 1. When the profound relaxation(PTC=O) was confirmed at 5 min. after pancuronium, neostigmine 50 ug/kg was injected as a bolus in group 2. At that time, neostigmine was given at 10 ug/kg followed by 40 ug/kg 3 min. later in group 3. At that time, neostigmine was given at 20 ug/kg followed by 30 ug/kg 3 min. later in group 4. At that time, neostigmine was given at 30 ug/kg followed by 20 ug/kg 3 min. later in group 5. At that time, neostigmine was given at 40 ug/kg followed by 10 ug/kg 3 min. later in group 6. RESULTS: The mean time from injection of pancuronium to 95% recovery was 99.3 min. in group 1, 59.8 min. in group 2, 53.2 min. in group 3, 51.5 min. in group 4, 50.8 min. in group 5 and 41.1 min. in group 6. The recovery index was significantly reduced in group 6(p<0.05). CONCLUSIONS: We conclude that the recovery time is reduced when neostigmine is administered in divided doses: a larger priming dose followed by a smaller bolus at profound relaxation.
Muscle Relaxation* ; Neostigmine* ; Neuromuscular Blockade ; Pancuronium* ; Pharmacokinetics ; Rabbits* ; Relaxation

BACKGROUND: The addition of bupivacaine to lipid soluble opioids have improved analgesia and can reduce opioid related side effects in the epidural analgesia. The use of the combination of bupivacaine and lipid soluble opioid fentanyl is gaining in popularity after surgery. But recent work has produced conflicting results, and the ideal combination of local anesthetics and opioid for Patient Controlled Epidural Analgesia (PCEA) is unknown. We have compared the efficacy and the safety of 0.1% bupivacaine and 0.2% bupivacaine combined with fentanyl 5 microgram/ml for PCEA. METHODS: Forty women undergoing lower abdominal gynecological surgery under general anesthesia were assigned to receive an epidural initial bolus of 0.1% (0.1% group) or 0.2% bupivacaine (0.2% group) combined with 5 microgram/ml fentanyl mixture 10 ml, followed by a PCEA with 2 ml/hr continuous background infusion and demand-dose of 2 ml in prospective, random, double blind fashion. Resting and coughing visual analogue scale (VAS) for pain, infusion rates of the mixture, and side effects were recorded at 4, 8, 24, 48 hr postoperatively, and satisfaction were noted after 48 hr. RESULTS: No differences in resting and coughing VAS scores, hypotension, nausea, itching sensation, and somnolence were observed between the two groups. The mean infusion rates of mixtures during the first 4 hr were higher in the 0.1% group (3.3 1.3 ml/hr) than the 0.2% group (2.5 0.6 ml/hr) (p<0.05). The incidence and the degree of sensory and motor block were higher in the 0.2% group (p<0.05). CONCLUSIONS: Both groups provided sufficient postoperative analgesia and satisfaction with some side effects. The high incidence and degree of sensory and motor block were resulted in the 0.2% group, which is not optimal for early ambulation. To search for more titrated bupivacaine concentration between 0.1% and 0.2%, loading doses or appropriate epidural puncture level having reduced demand dose and decreased side effects, further studies are expected.
Analgesia ; Analgesia, Epidural* ; Analgesics, Opioid ; Anesthesia, General ; Anesthetics, Local ; Bupivacaine* ; Cough ; Early Ambulation ; Female ; Fentanyl* ; Gynecologic Surgical Procedures ; Humans ; Hypotension ; Incidence ; Nausea ; Prospective Studies ; Pruritus ; Punctures ; Sensation

Absorptiometry, Photon ; Adult ; Animals ; Bone Density ; Euthanasia ; Humans ; Latency Period (Psychology) ; Mandible ; Mandibular Osteotomy ; Molar ; Osteogenesis, Distraction ; Osteomyelitis ; Osteotomy ; Radiography ; Rats ; Wound Healing

This is to report a case of immediate reconstruction after hemimandibulectomy by using of bicorticocancellous block bone harvested from the iliac crest in the case of an ameloblastomaon the mandible. Because the lesion involved condylar area, it was reconstructed with titanium artificial condyle attached to A/O metal plate. Three weeks after the operation, infection developed with suppuration and was well treated with adequate antibiotic therapy and drainage. The patient has been followed up over a four-year period and taken an orthopantomogram every three or six month for the examination of mandibular movement, the potentiality of recurrence and the remodeling of the grafted bone. At present, the patient is satisfied with her appearence and has a normal occlusion with proper masticatory function, and there is no sign of recurrence.
Ameloblastoma* ; Drainage ; Humans ; Mandible ; Mandibular Osteotomy ; Recurrence ; Suppuration ; Titanium ; Transplants*

Appendiceal mucoceles are usually associated with hyperplastic or neoplastic mucosal proliferation and obstructive lesions such as postinflammatory scarring, fecalith, carcinoid tumor, and endometriosis. Among these, an association with endometriosis is known to be very exceptional. We herein report on a rare case of obstructive mucocele of the appendix that was secondary to endometriosis in a 42-year-old patient with pelvic endometriosis. A computed tomography scan demonstrated a periappendiceal abscess-like lesion with a left adnexal mass that was suggestive of endometriosis. On gross examination, the periappendiceal lesion consisted of a mucin-filled cavity (the so-called mucocele) that was 1.8 cm in diameter, and it protruded into the cecal lumen. Microscopically, the lining epithelium of the cavity was almost totally denuded. A small amount of mucus spilled over outside the mucocele, but pseudomyxoma peritonei was not present. The wall of the mucocele showed the characteristic multiple foci of endometriosis involving predominantly the muscularis propria and the serosa of the appendix and adjacent cecal walls.
Adult ; Appendix* ; Carcinoid Tumor ; Cicatrix ; Endometriosis* ; Epithelium ; Fecal Impaction ; Female ; Humans ; Mucocele* ; Mucus ; Pseudomyxoma Peritonei ; Serous Membrane

No abstract available.
Ring Chromosomes*

BACKGROUND: Unexpected failed mask ventilation can result in brain damage or death. The purpose of this study was to demonstrate that the tests for predicting difficult tracheal intubation can be used to predict difficult mask ventilation in Koreans. METHODS: One hundred ninety one patients were assessed before operation using the modified Mallampati test and by measuring the atlanto-occipital angle (AOA), thyromental distance (TM), hyomental distance (HM), sternomental distance (SM), and horizontal length of mandible (HLM). The mask ventilation grades and the laryngeal grades were determined. The sensitivities, specificities and positive predictive values of tests were calculated. RESULTS: Eleven patients (5.7%) had difficulty in mask ventilation and 8 patients (4.1%) had difficulty in intubation. AOA grade had the highest sensitivity and every tests had relatively high specificities for predicting difficult mask ventilation. CONCLUSIONS: The tests for predicting difficult tracheal intubation can be used to predict difficult mask ventilation.
Brain ; Humans ; Intubation* ; Mandible ; Masks* ; Ventilation*

Acute mountain sickness is an illness caused by climbing to a high altitude without prior acclimatization. Neurological consequences, like parkinsonism following acute mountain sickness without lesion of brain MRI have been reported rarely. A healthy 56-year-old man presented with dysarthria and gait disturbance. Neurological examination revealed tremor of hands, limb rigidity, and bradykinesia. The symptoms developed approximately 30 days following a 3,500 m climb of the Annapurna in the Himalayas. Brain MRI did not reveal any abnormalities including globus pallidus. The parkinsonism symptoms persisted for about 3 months before a complete recovered was made. We suggest that parkinsonism can develop after climbing to a high altitude but that the symptoms can be transient if a brain MRI detects no abnormalities.