OBJECTIVE: To determine the effect of functional electrical stimulation (FES) in the paralyzed muscles of rabbits with spinal cord injury (SCI). METHOD: Fifteen male New Zealand white rabbits were injured by spinal cord transection at the T6 level. We classified animals into a normal control group (n=3), and SCI without FES (n=3), SCI with 10 Hz FES (n=6) and SCI with 40 Hz FES (n=6) groups. FES was applied on both tibialis anterior (TA) muscles at two frequencies (10 Hz, 40 Hz) for 1 hour daily for 2 weeks. After treatment TA muscles were separated and apoptotic features were measured by in situ DNA nick-end labeling (TUNEL), DNA fragmentation assays and western blotting for Bcl-2and Bax protein. RESULTS: In TUNEL and DNA fragmentation assay results, the FES groups showed more fragmented myonuclei and DNA, and western blotting showed more Bax protein expression in FES groups than no FES group and control (higher in 40Hz group), whereas Bcl-2 protein expressions were similar in all groups. CONCLUSION: Apoptosis of paralyzed muscle was increased in FES group with higher Bax/Bcl-2 in 40 Hz than in 10 Hz. To evaluate the clinical significance of muscle apoptosis with FES in SCI, further study would be needed.
Animals ; Apoptosis* ; bcl-2-Associated X Protein ; Blotting, Western ; DNA ; DNA Fragmentation ; Electric Stimulation* ; Humans ; In Situ Nick-End Labeling ; Male ; Muscles ; Rabbits ; Spinal Cord Injuries* ; Spinal Cord*

Extracorporeal membrane oxygenation (ECMO) during acute respiratory failure due to any cause aids in the recovery of respiratory function. The use of ECMO for acute respiratory failure due to near drowning was reported to be a successful therapeutic option in those patients who do not respond to optimal conventional therapies. We performed veno-venous ECMO for 2 acute respiratory failures due to near-drownings. All cannulations were performed percutaneously via both femoral veins. The 2 patients were successfully weaned off ECMO, but one patient experienced diffuse hypoxic brain damage and a subarachnoid hemorrhage.
Cardiopulmonary Bypass ; Catheterization ; Extracorporeal Membrane Oxygenation ; Femoral Vein ; Humans ; Hypoxia, Brain ; Near Drowning ; Respiratory Distress Syndrome, Adult ; Respiratory Insufficiency ; Subarachnoid Hemorrhage

Purpose: In the recent antiretroviral therapy (ART) era, a large proportion of Korean patients with human immunodeficiency virus (HIV) infection were shown to have low CD4 cell counts at diagnosis and during ART initiation. We investigated the survival trends in patients living with HIV/acquired immunodeficiency syndrome (AIDS) in Korea who started ART in the 2000s, and evaluated the risk factors for mortality to elucidate the association between survival and low CD4 cell counts at ART initiation. Materials and Methods: Patients with HIV infection who were aged >18 years and had started ART between 2001 and 2015 in the Korean HIV/AIDS cohort study were enrolled. We compared the clinical characteristics, mortality, and causes of death among the enrolled subjects based on the time of ART initiation. Cox regression analysis was used to estimate the adjusted hazard ratios of mortality based on the time of ART initiation. Results: Among the 2474 patients enrolled, 105 (4.24%) died during the follow-up period of 9568 patient-years. Although CD4 cell counts at the time of ART initiation significantly increased from 161 [interquartile range (IQR), 73.5–303] in 2001–2003 to 273 (IQR, 108–399) in 2013–2015 (p<0.001), they remained low during the study period. The incidence of all-cause mortality was 10.97 per 1000 patient-years during the study period. There was no decreasing trend in mortality between 2001 and 2015. Age >40 years [adjusted hazard ratio, 3.71; 95% confidence interval (CI), 2.35–5.84] and low CD4 counts (<100 cells/mm3: adjusted hazard ratio, 2.99; 95% CI, 1.44–6.23) were significant risk factors for mortality. Conclusion Despite excellent HIV care available in the recent ART era, the survival of patients with HIV/AIDS undergoing ART did not improve between 2001 and 2015 in Korea.

PURPOSE: The majority of electrical injuries coming to emergency department are low voltage injuries cases. Therefore this study was designed to investigate the clinical characteristics and the treatment outcomes of patients with low voltage electrical injury in one emergency center. METHODS: We, retrospectively, reviewed the medical records of the patients who visited emergency department between July, 2007 and May, 2012. We noted demographics, entrance and exit point of burn injuries, associated injuries and symptoms, electrocardiograms, laboratory results, results of treatment, and so on. RESULTS: There are 103 patients enrolled. Sixty-eight (66%) patients were men with a mean age of 24 years. Pediatric patients (< or =15) were 41 (40.0%). The right upper extremity was the most common entry point, and exit point was unclear in almost cases. There were no lethal complications, except 1 case. The case with lethal complication was 57 year old man who survived from out-of hospital cardiac arrest. He was injured by 220 V electric current during 2 minutes and total arrest time was 20 minutes. He was applied with mild therapeutic hypothermia and later, discharged with favorable neurologic outcome (Cerebral Performance Categories scale 2). Overall rate of discharge, admission and transfer were 67.0%, 28.2% and 4.9%, respectively. Among the discharged patients, no patient re-visited to emergency department with severe complication. After admission, all patients discharged without severe complication. CONCLUSION: There were neither unexpected complications nor delayed complication in our study. Therefore, ED physicians might consider discharge if patients had only minor complications that can manage out-patients follow up at the initial evaluation.
Arrhythmias, Cardiac ; Burns ; Demography ; Electric Injuries ; Electrocardiography ; Emergencies ; Follow-Up Studies ; Heart Arrest ; Humans ; Hypothermia ; Male ; Medical Records ; Outpatients ; Retrospective Studies ; Upper Extremity

Listeria monocytogenes is the causative agent in a spectrum of human disease ranging from gastroenteritis to invasive infections such as meningitis, encephalitis, and septicemia. Elderly patients or persons who have lower cell-mediated immunity with predisposing conditions such as transplants, lymphomas, and AIDS, are especially susceptible. The tropism of L.monocytogenes for the central nervous system leads to severe disease, often with high mortality. We report a case of L. monocytogenes meningitis in a 58-year old woman with end stage renal disease. The patient was discharged without neurological sequelae after antibiotic treatment.
Aged ; Central Nervous System ; Encephalitis ; Female ; Gastroenteritis ; Humans ; Immunity, Cellular ; Kidney Failure, Chronic* ; Listeria monocytogenes* ; Listeria* ; Lymphoma ; Meningitis ; Meningitis, Listeria* ; Middle Aged ; Mortality ; Sepsis ; Tropism

Generally we use the preauricular incision to access and remove the parotid gland tumor. But the preauricular approach has some complications such as damage of facial nerve and sensory nerve, Frey's syndrome, and postoperative scar. Especially, the postoperative scar can often cause an unesthetic result and mental stress in young patients. Therefore, if we avoid preauricular incision to be performed outside of tragus, the postoperative scar would be hardly remarkable, and patients would be satisfied cosmetically. We performed surgical excision using a modified endaural and neck approach in a 21-year-old female with a pleomorphic adenoma and 15-year-old male with a neurofibroma occured in the parotid gland. A new, modified endaural and neck approach is a combined method of the modified endaural incision by Starck et al and Gutierrez's neck extension. We obtained an adequate access and the cosmetically acceptable postsurgical scar. The postoperative scars were hidden in the external ear and the hairline. Moreover, except the neck dissection can this approach be applied to the surgery of temporomandibular joint as well as the parotid gland tumor.
Adenoma, Pleomorphic ; Adolescent ; Cicatrix ; Ear, External ; Facial Nerve ; Female ; Humans ; Male ; Neck Dissection ; Neck* ; Neurofibroma ; Parotid Gland* ; Sweating, Gustatory ; Temporomandibular Joint ; Young Adult

OBJECTIVES: Accurate diagnosis of the mechanism and origin site of paroxysmal supraventricular tachycardia(PSVT) can be made using electrophysiologic study(EPS). Recently, radiofrequency catheter ablation technique has been introduced and widely used for the definitive treatment of various forms of PSVT, thereby precise determination of the mechanism of PSVT can be possible. It has been known that atrioventricular reentry tachycardia (AVRT) using concealed bypass tract is more frequent than atrioventricular nodal reentry tachycardia (AVNRT) in Korea. But it is not certain that those studies represent actual distribution of PSVT in Korea. This study was designed to determine the mechanism and clinical characteristics of PSVT in Korea. METHODS: We investigated 136patients in whom electrophysiolosic study was performed from October 1992 through October 1994 at the Chonnam National University Hospital, the only tertiary referral center of the Kwangju-Chonnam area of Korea. RESULTS: 1) The electrophysiologic mechanism of PSVT was AVNRT in 44patients(32.4%), WPW syndrome in 46(33.8%), AVRT using concealed bypass tract in 40(29.4%), sinoatrial nodal reentry tachycardia (SANRT) in 4(2.9%), and automatic atrial tachycardia(AAT) in 2(1.5%), ensuing that AVNRT is most common mechanism of PSVT with no preexcitation during sinus rhythm. 2) Male is more frequent than female in AVNRT, WPW syndrome, and AVRT, which was most prominent in WPW syndrome. 3) The first episode of symptom occured at the age of 34.9 +/- 17.3 years in AVNRT, 25.5 +/- 13.3 years in WPW and 26.3 +/- 15.0 years in AVRT(p<0.05). There was no significant difference in the duration of symptom. The tachycardia rate in WPW syndrome was 183.6 +/- 23.9 per minute and AVRT was 186.7 +/- 38.0 per minute, which were faster than that of AVNRT(161.7 +/- 28.6/min)(p<0.05). 4) There was no significant difference in the presenting symptoms and in the provocation factors between AVNRT and AVRT. CONCLUSION: AVNIlT is most common mechanism of PSVT with no preexcitation during sinus rhythm, developed at older age than WPW syndorme and AVRT, and had lower tachycardia rate than WPW syndrome and AVRT.
Catheter Ablation ; Diagnosis ; Female ; Humans ; Jeollanam-do ; Korea ; Male ; Tachycardia ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Sinoatrial Nodal Reentry ; Tachycardia, Supraventricular* ; Tertiary Care Centers ; Wolff-Parkinson-White Syndrome

Parvimonas micra is a non-spore-forming anaerobic gram-positive coccus, widely distributed as normal flora in the skin, vagina and mucosa, and able to cause opportunistic infections, particularly endocarditis and brain abscess following dental manipulations. A 49-year-old woman was hospitalized due to fever and headache. She had been diagnosed with periodontitis at the beginning of fever. A brain abscess was noted in the right temporal lobe on the brain CT, and she was treated with ceftriaxone, isepamicin and metronidazole. In the next day, abscess was aspirated and drained by a surgical procedure. An organism was isolated from an anaerobic culture of the abscess aspirate, and was identified as P. micra by a commercial kit and 16S rRNA sequencing.
Abscess ; Brain ; Brain Abscess ; Ceftriaxone ; Endocarditis ; Female ; Fever ; Gentamicins ; Headache ; Humans ; Metronidazole ; Middle Aged ; Mucous Membrane ; Opportunistic Infections ; Peptostreptococcus ; Periodontitis ; Skin ; Temporal Lobe ; Vagina

A 31-year-old woman had a history of fatigue and hypokalemia and metabolic alkalosis and hypocalciuria. The patient had a subtotal thyroidectomy and denied ingestion of diuretic medication. Her clinical and laboratory findings were consistent with Gitelman's syndrome. Normal blood pressure, hypokalemic metabolic alkalosis, hypocalciuria were present. She confessed to us that she had been taking a pill due to constipation for 7 years. She was afraid that her husband know it. But we don't know the reason why she had concealed it Surreptious ingestion of diuretics must be excluded in any adult patient in whom a diagnosis of Bartter's or Gitelman's syndrome is considered.
Adult ; Alkalosis ; Bartter Syndrome ; Blood Pressure ; Constipation ; Diagnosis ; Diuretics ; Eating ; Fatigue ; Female ; Gitelman Syndrome* ; Humans ; Hypokalemia ; Spouses ; Thyroidectomy

Hemorrhagic fever with renal syndrome frequently found in Korea is a acute infectious disease caused by Hantaan virus. Its clinical manifestations include high fever, cardiovascular collapse, hemorrhagic tendency and acute renal failure. Many patients with hemorrhagic fever with renal syndrome show hemorrhagic tendency such as subconjunctival hemorrhage and mucocutaneous petechia. In vital organs such as lung, kidney, spleen, brain, and pituitary, hemorrhage occasionally occurs spontaneously or by minor trauma. As a results, hematemesis, hemoptysis, melena and gross hematuria can be developed in some patients. Anemia and circulatory shock may result from large hematoma formed in third spaces like retroperitoneal and pleural space. But retroperitoneal hematoma and hemothorax was rarely reported. We report a case of hemorrhagic fever with renal syndrome complicated by retroperitoneal hematoma and hemothorax with review of literatures.
Acute Kidney Injury ; Anemia ; Brain ; Communicable Diseases ; Fever ; Hantaan virus ; Hematemesis ; Hematoma* ; Hematuria ; Hemoptysis ; Hemorrhage ; Hemorrhagic Fever with Renal Syndrome* ; Hemothorax* ; Humans ; Kidney ; Korea ; Lung ; Melena ; Shock ; Spleen