No significant difference was noted in canine hookworm infection due to hormone influence between the control group and the gonadectomized rats which were sacrificed 17 days after gonadectomy and 7 days after the infection. However in the rats which were infected 20 days after oophorectomy a significant difference was thought to be present in this group(176 +- 12.9 larvae/rat) compared with the control group (138 +- 21.2 larvae/rat). On the other hand, in the castrated group the number of larvae (138 +- 37.1 larvae/rat) was less than that in the control group (208 +- 43.4 larvae/rat). In the estrogen-injected male and female groups, there were no difference compared to the control, but the testosterone-injected groups of males and females showed more susceptibility to infection by A. caninum than in the control group. The Capillaria hepatica infection to the castracted host showed no significant difference between the gonadectomized and the control group. (oophorectomy; 214 +- 28.0), castration; 250 +- 36.5 and control; 191 +- 58.2 and 270 +- 30.1 adults/rat). Concerning the influence of the host's sex hormone on egg production of canine hookworm, there was a significantly decreased egg production in castrated dogs(6,578 +- 664.0 egg per gram) compared to the control dogs(9,711 +- 1,322.3 egg per gram). The same results were observed in vitro test. In the host, the susceptibility to hookworm infection was reduced in castrated rats, while oophorectomy group had a little or no effect. In the favorable or unfavorable hosts, testosterone gave the tendency of increasing susceptibility of the host to infection, while estrogen did a little or no effect.
parasitology-helminth-nematoda ; hookworm ; estrogen ; testosterone ; rat ; dog Ancylostoma caninum ; Capillaria hepatica ; gonadectomy ; estrogen ; testosterone

OBJECTIVE: This study was designed to clarify the phasic changes and distinctive spectral features of the brain abscess in the in vivo proton MR spectroscopy during the processes of abscess formation in rats, in relation to MR images. METHODS: Staphylococcus aureus was stereotactically inoculated into the predetermined location of the right frontal brain of SPF controlled Sprague-Dawley female rats(200-250gm). T1 weighted image(WI), T2WI and gadolinium enhanced image(CEMR) were obtained serially prior to each MR spectroscopy in order to visualize the infected lesions. RESULT: Three characteristic peaks, from proton MR spectroscopy, were found. A dominant peak was shown at 1.3ppm, which was due to the high concentration of mobile lipid or lactate, and smaller two peaks were shown at 0.8-1.0ppm and 1.9ppm, due to the small concentration of aminoacid(leucine, isoleucine. valine) and acetate, respectively. The lactate peak has increased during the stage of cerebritis and started to decrease in its early capsulation stage, finally invisible in its late capsulation stage(p=0.0001). The change of lactate peak was conspicuous at the early stage of cerebritis while the change of MR image was rather subtle. The aminoacids peak remained small throughout all stages. The acetate peak was shown in the late stage of cerebritis. However, it's peak area of integration was not exactly measured because of overlapping on the N-acetylaspartate peak. On the other hand, the peak of N-acetylaspartate and creatines, which could be observed in normal brain, remained at low level after sharp decrease in the early stage of cerebritis(p=0.004, p=0.005). The cholines peak decreased in the early stage of cerebritis, but it was not statistically significant(p=0.124). CONCLUSION: From this study, we were able to observe the characteristic MR spectroscopic features of each stage even from such a small volume of abnormal lesions with a 2X2X3mm 3 voxel size. Furthermore, based on our results that inflammatory change could be detected earlier by MR spectroscopy than by MR images, MR spectroscopy may be applied for early diagnosis of the brain abscess.
Abscess ; Animals ; Brain Abscess* ; Brain* ; Early Diagnosis ; Female ; Gadolinium ; Hand ; Humans ; Isoleucine ; Lactic Acid ; Magnetic Resonance Spectroscopy ; Protons* ; Rats* ; Rats, Sprague-Dawley ; Staphylococcus aureus

A newer atypical antipsychotic, aripiprazole has been shown to be effective in the treatment of schizophrenia and other psychotic disorders. A 44-year-old woman who developed psychotic symptoms and parkinsonism a month after carbon monoxide poisoning and did not respond to other atypical antipsychotics, was successfully treated with aripiprazole. This case suggests that aripiprazole may be helpful to those developed psychotic symptoms and movement disorders associated with toxic brain injury such as carbon monoxide poisoning.
Adult ; Antipsychotic Agents ; Brain Injuries ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Female ; Humans ; Movement Disorders ; Parkinsonian Disorders* ; Psychotic Disorders ; Schizophrenia ; Aripiprazole

Sclerotic fibroma is a rare fibrous tumor of the skin associated with Cowden’s disease. In 1989, Rapini described sclerotic fibroma without Cowden’s disease as solitary sclerotic fibroma of the skin. It is a solid, well-circumscribed, slow-growing nodular tumor and it looks similar to a keloid scar. Consequently, it is extremely difficult to make a differential diagnosis of solitary sclerotic fibroma with keloid scar based on clinical findings only. The authors report a case of solitary sclerotic fibroma arising at the left lateral thigh of a 25-year-old man.

Diabetes has been associated with more severe outcomes and higher mortality in coronavirus disease 2019 (COVID-19) patients compare to morbidity and mortality in patients without diabetes. Several mechanisms may play a role in this greater morbidity and mortality, especially uncontrolled hyperglycemia, an impaired immune system, pre-existing proinflammatory states, multiple comorbidities, and dysregulated angiotensin-converting enzyme 2 signaling. Thus, the diabetes medical community emergently needs to know about COVID-19 and its effects on patients with diabetes, as they must take precautions to carefully manage these patients during the COVID-19 pandemic. The Korean Diabetes Association provides some guidance and practical recommendations for the management of diabetes during the pandemic. This report provides insight into the association between diabetes and COVID-19, proper management of diabetes in patients with COVID-19 and an official suggestion by the Korean Diabetes Association for managing the COVID-19 outbreak.

PURPOSE: The isolated exercise therapy and its effect for the treatment of posterior tibial tendon dysfunction (PTTD) is not well known. The purpose of this study was to identify the clinical effect of stretching and strengthening exercise program on the patients' muscle function and range of motion, pain and gait in the management of the early stage PTTD. MATERIALS AND METHODS: From October 2006 to March 2007, 14 patients with early stage PTTD (stage I or IIa) without surgical intervention were randomly assigned into two groups and we analyzed their clinical results. All patients were female and one who have sprained the same ankle during the program and one who withdrew from the program due to her private reason were excluded. At the last, the exercise group (EG) was seven and the control group (CG) was five. Mann-Whitney U test was used for the comparison of pain, ROM, muscle power, AOFAS score and 5 minute walking test of both groups. Wilcoxon-signed rank test was used for the comparison between the pre and post exercise program in EG. RESULTS: The pain was significantly reduced in EG compare to CG and only the dorsiflexion was significantly increased in EG in the analysis of ROM. The dorsi flexion and plantar flexion power were significantly increased in EG. CONCLUSION: Our 6 weeks stretching and strengthening exercise program showed noticeably improved clinical result, and therefore it is recommended as one of the useful treatment option in the management of early stage PTTD.
Animals ; Ankle ; Exercise Therapy ; Female ; Gait ; Humans ; Muscles ; Posterior Tibial Tendon Dysfunction ; Range of Motion, Articular ; Sprains and Strains ; Walking

Since 1920, when Harvey Cushing first used radiofrequency in electrosurgery, the procedural technique has developed rapidly. Even though this procedure is minimally invasive and safer than other neurodestructive procedures, it is still not free of complications. A 72-year-old female patient had constant facial pain, despite several operations and radiotherapies for her maxillary cancer. The region innervated ophthalmic branch and maxillary branch of the trigeminal nerve was involved, with radiofrequency procedure of the gasserian ganglion for pain control also performed at the area. After the procedure, her blood pressure became elevated and she complained of a headache, and six hours later, she became irritable and distracted. Bacterial meningitis was diagnosed by a spinal tap, with third-generation cephalosporin administered as the treatment. The following day, her symptoms had improved and the pain was also reduced. She was discharged from hospital after 14 days, without any sequelae.
Aged ; Blood Pressure ; Electrosurgery ; Facial Pain ; Female ; Headache ; Humans ; Meningitis ; Meningitis, Bacterial* ; Radiotherapy ; Spinal Puncture ; Trigeminal Ganglion ; Trigeminal Nerve

BACKGROUND: Neurologic and neuropsychologic dysfunction after cardiopulmonary bypass is frequent and can be caused by inadequate cerebral perfusion and oxygenation. A decrease of SjvO2 suggests a situation in which the oxygen supply to the brain is insufficient to meet metabolic demands. This study investigated the effects of normocapnia and hypercapnia on changes in SjvO2 and lactate levels during rewarming from hypothermic cardiopulmonary bypass. METHODS: Anesthesia was induced and maintained with bolus and continuous infusion of fentanyl, midazolam and vecuronium. Patients were assigned to a normocapnic (PaCO2: 35 - 40 mmHg, n = 10) or hypercapnic (PaCO2: 45 50 mmHg, n = 10) group during rewarming. SjvO2 and lactate levels at the jugular bulb were measured at 30, 34 and 37degrees C nasopharyngeal temperature. RESULTS: There was not a reduction in SjvO2 to < 50% in normocapnic and hypercapnic group during the rewarming period, and there was no significant difference in lactate levels at the jugular bulb. However, the hypercapnic group had a higher SjvO2 than the normocapnic group at 30, 34 and 37degrees C nasopharyngeal temperature during rewarming (P<0.05). CONCLUSIONS: Hypercapnia is more effective increasing SjvO2 than normocapnia and may contribute to the prevention of postoperative neurologic dysfunction, especially in patients having a low SjvO2.
Anesthesia ; Brain ; Cardiopulmonary Bypass* ; Fentanyl ; Humans ; Hypercapnia* ; Lactic Acid* ; Midazolam ; Neurologic Manifestations ; Oxygen* ; Perfusion ; Rewarming* ; Vecuronium Bromide

BACKGROUND: Thiopental anesthesia increases the seizure threshold of patients receiving electroconvulsive therapy. However, excessive neuronal suppression could result in an unacceptably short seizure duration. We sought to identify the correlation between the pre-ictal Bispectral index (BIS) score and seizure duration during electroconvulsive therapy (ECT) under thiopental anesthesia. METHODS: Thirty patients with major depressive disorders underwent ECT. Anesthesia was induced by a bolus injection of 2 mg/kg of thiopental. BIS was monitored continuously, and recorded at specific end points, i.e., before anesthesia, just before ECT (pre-ictal BIS), on awaking (eye opening), before discharge to the recovery room and before discharge to the ward. The durations of motor and electroencephalographic seizures were recorded. RESULTS: The BIS score just before ECT was 52+/-9. Both motor and electro encephalographic seizure durations were positively correlated with the pre-ictal BIS score (R = 0.59 and 0.60, respectively; P < 0.01). On eye opening, BIS showed 48+/-13 and slowly recovered but remained low until discharge to the ward, reflecting post-ictal suppression. CONCLUSIONS: Pre-ictal BIS score is positively correlated with seizure duration, but the BIS score may not accurately reflect the depth of sedation after ECT.
Anesthesia* ; Depressive Disorder, Major ; Electroconvulsive Therapy* ; Humans ; Neurons ; Recovery Room ; Seizures* ; Thiopental*

PURPOSE: Plantarmedial release and first ray extension osteotomy are often combined to treat paralytic cavovarus foot deformity. The purpose of this study is to evaluate the effect of additional first ray extension osteotomy in terms of dynamic pedobarography. MATERIALS AND METHODS: We reviewed findings of pre- and postoperative plain radiography and dynamic pedobarography for 25 patients in whom the flexibility of the hindfoot was confirmed by the Coleman block test. The results of treatment by extensive plantar medial release with first ray osteotomy (group I) were compared with the results of treatment by extensive plantar medial release alone (group II). RESULTS: Plain radiographs obtained pre- and postoperatively showed no statistically significant improvement in each group. Only in group I, peak forces at the 1st metatarsal head, 2nd metatarsal head and medial calcaneus were increased after operation. CONCLUSION: In paralytic hindfoot flexible cavovarus, extensive plantarmedial release with first ray osteotomy improve foot pressure distribution more than extensive plantarmedial release alone.
Adolescent ; Calcaneus/abnormalities/*radiography/surgery ; Child ; Child, Preschool ; Female ; Foot Deformities/*radiography/surgery ; Humans ; Male ; Osteotomy ; Retrospective Studies ; Treatment Outcome