No abstract available.
Animals ; Arteries* ; Rats*

Solid organ transplantation is a therapeutic option for end-stage organ diseases. However, complications including infection and graft rejection, which are related to immunosuppressive therapy, remain the major causes of morbidity and mortality following solid organ transplantation. The optimal approach to infection in solid organ transplant recipients is prevention; failing this, prompt and aggressive diagnosis and therapy are essential. In addition, the epidemiology of infections after solid organ transplantation has shifted as a result of changes in immunosuppressive strategies and improved survival. Immunosuppression must be linked with appropriate vaccinations, donor and recipient screening, patient education regarding infectious risks and lifestyle, monitoring, and antimicrobial prophylaxis.
Diagnosis ; Epidemiology ; Graft Rejection ; Humans ; Immunosuppression ; Life Style ; Mass Screening ; Mortality ; Opportunistic Infections* ; Organ Transplantation* ; Patient Education as Topic ; Tissue Donors ; Transplants* ; Vaccination

OBJECTIVE: Meige syndrome is the combination of blepharospasm and oromandibular dystonia. We assessed the surgical results of bilateral globus pallidus internus (GPi) deep brain stimulation (DBS) in patients with medically refractory Meige syndrome. METHODS: Eleven patients were retrospectively analyzed with follow-ups of more than 12 months. The mean follow-up period was 23.1 +/- 6.4 months. The mean age at time of surgery was 58.0 +/- 7.8 years. The mean duration of symptoms was 8.7 +/- 7.6 years. DBS electrodes were placed under local anesthesia using microelectrode recording and stimulation. After 2.4 +/- 1.3 days of trial tests, the stimulation device was implanted under general anesthesia. Patients were evaluated using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS). RESULTS: BFMDRS total movement scores improved by 59.8%, 63.5%, 74.1%, 74.5%, and 85.5% during the immediate postoperative period of test stimulation, 3, 6, 12, and 24 months (n = 5) after surgery, respectively. The BFMDRS total movement scores were reduced gradually and the results reached statistical significance in the postoperative period (test period, p < 0.001; 3 months, p < 0.001; 6 months, p = 0.003; 12 months, p < 0.001; 24 months, p = 0.042). There was no statistical difference between 12 months and 24 months. BFM subscores improved by 63.3% for the eyes, 80.9% for the mouth, 68.4% for speech/swallowing, and 87.9% for the neck at 12 months after surgery. The adverse effects were insignificant. CONCLUSION: The bilateral GPi-DBS can be effective for the treatment of intractable Meige syndrome without significant side effects.
Anesthesia, General ; Anesthesia, Local ; Blepharospasm ; Deep Brain Stimulation ; Dystonia ; Electrodes ; Eye ; Follow-Up Studies ; Globus Pallidus ; Humans ; Meige Syndrome ; Microelectrodes ; Mouth ; Neck ; Postoperative Period ; Retrospective Studies

No abstract available.
Osteoporosis* ; Radionuclide Imaging*

Acute arterial occlusion is a rare complication following total knee arthroplasty (TKA). This is a report of a case of acute femoral artery occlusion and its sequelae following TKA in a patient with a history of atrial fibrillation. Arterial circulation of the lower limb could not be restored by thrombectomy treatments, and above-knee amputation had to be carried out.
Amputation ; Arteries ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Atrial Fibrillation ; Femoral Artery ; Humans ; Knee ; Lower Extremity ; Thrombectomy

PURPOSE: Intermittent bronchial obstruction and increased airway responsiveness to inhaled nonspecific stimuli are main features of asthma. We retrospectively studied a group of children with asthma to investigate the contribution of childhood asthma characteristics and degree of bronchial responsiveness in combination with other variables in the prediction of adult level of pulmonary function & bronchial responsiveness. METHODS: We carried out the retrospective study on 65 adult patients who had been performed methacholine provocation test at Yonsei university children's allergic clinic from March 1994 to July 1997. These cases were diagnosed bronchial asthma on childhood. RESULTS: 1) In this study 65 patients were investigated, 45 subjects(69.3%)(A) were negative on methacholine provocation test, & 20 subjects(30.7%)(B) were positive. 2) Age of onset of asthma, A group was earlier than B group.(1.2 vs. 3.8 year) 3) There was significant relationship between mean PC20-methacholine and % predicted FEV. 4) There was no significant difference between A & B group in the number of allergen & duration included in the immunotherapy. CONCLUSIONS: We conclude that age of onset, degree of symptoms, % predicted FEV of childhood asthma are relevant to predict the outcome of the adult pulmonary function level, and the childhood degree of bronchial responsiveness are important for the prediction of adult degree of bronchial responsiveness among children with asthma.
Adult ; Age of Onset ; Asthma* ; Child ; Follow-Up Studies* ; Humans ; Immunotherapy ; Methacholine Chloride ; Retrospective Studies

OBJECTIVE: The purpose of this study was to analyze in detail the relationship between outcome and time course of effect in medically refractory primary cervical dystonia (CD) with phasic type that was treated by bilateral globus pallidus internus (Gpi) deep brain stimulation (DBS). METHODS: Six patients underwent bilateral implantation of DBS into the Gpi under the guide of microelectrode recording and were followed for 18.7 +/- 11.1 months. The mean duration of the CD was 5.8 +/- 3.4 years. The mean age at time of surgery was 54.2 +/- 10.2 years. Patients were evaluated with the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and relief scale using patient self-reporting. RESULTS: The TWSTRS total scores improved by 64.5%, 65.5%, 75.8%, and 76.0% at 3, 6, 12 months, and at the last available follow-up after surgery, respectively. Statistically significant improvements in the TWSTRS scores were observed 3 months after surgery (p = 0.028) with gradual improvement up to 12 months after surgery, thereafter, the improvement was sustained. However, there was no statistically significant difference between the scores at 3 and 12 months. Subjective improvement reported averaged 81.7 +/- 6.8% at last follow-up. Mild dysarthria, the most frequent adverse event, occurred in 3 patients. Conclusions: Our results show that the bilateral Gpi-DBS can offer a significant therapeutic effect from 3 months postoperatively in patients with primary CD with phasic type, without significant side effects.
Deep Brain Stimulation ; Dysarthria ; Follow-Up Studies ; Globus Pallidus ; Humans ; Microelectrodes ; Torticollis

The clinicopathological manifestations of gastric mucormycosis range from colonization of ulcer disease to infiltration of tissue with or without vascular involvement. The prognosis of this disease is extremely poor when blood vessel invasion is observed. Herein, we report on a rare case of ischemic gastric perforation that was associated with vascular invasive mucormycosis in a renal recipients 7 years after transplantation.
Blood Vessels ; Colon ; Kidney Transplantation ; Mucormycosis* ; Prognosis ; Transplantation* ; Ulcer

Urinary tract complications, manifesting as leakage or obstruction, generally occur in 3.0~13% of renal recipients. Most complications occur at the ureterovesical anastomosis and are secondary to technical causes and ureteric ischemia. Ultrasound and computed tomographic images are described in a recipient who underwent oversea deceased donor renal transplantation and presented with recurrent ureteral obstruction and hydronephrosis secondary to combination of unusually located transplant kidney, long-coiled ureter, ureteric compression and ischemia of the transplant ureter.
Humans ; Hydronephrosis ; Ischemia ; Kidney ; Kidney Transplantation ; Tissue Donors ; Ultrasonography ; Ureter* ; Ureteral Obstruction ; Urinary Tract*

BACKGROUND: Carotid atherosclerosis has been known to be associated with systemic inflammatory status. The present study aimed to investigate the relationship between hepatitis viral infection or vaccination and carotid atherosclerosis in a relatively healthy population. METHODS: A cross-sectional study was performed in 281 subjects (mean age+/-SD, y; 43.8+/-7.2) in the Chonbuk national university hospital. All the participants were examined for the carotid intima-media thickness (IMT) in both common carotid, carotid bulb, and internal carotid arteries. Hepatitis B surface antigen (HBsAg) and IgG antibodies against hepatitis B and C virus (anti-HBs and anti-HCV) were determined by enzyme linked immunosorbent assays. RESULTS: Twelve subjects (4.3%) were HBsAg seropositive and 6 (2.1%) were anti-HCV positive but the positivity did not affect the mean carotid IMT. However, the hepatitis B-exposure group including both the HBsAg positive and anti-HBs positive without vaccination history showed a significantly higher carotid IMT (mean+/-SD, mm; 0.757+/-0.107 vs. 0.728+/-0.105, P=0.031), even after adjusting for the potential confounders. And, in the subgroup having anti-HBs, the carotid IMT was lower in the hepatitis B vaccinated subjects than in the others (0.725+/-0.103 vs. 0.760+/-0.111, P=0.019). CONCLUSIONS: Subjects exposed to the hepatitis B pathogen, even though they had anti-HBs, showed the higher carotid IMT, and the participants with a vaccination history demonstrated the lower IMT values. Subsequent study in a large representative population might be needed to further delineate the characteristic associations.
Antibodies ; Carotid Artery Diseases ; Carotid Artery, Internal ; Carotid Intima-Media Thickness* ; Cross-Sectional Studies ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis* ; Immunoglobulin G ; Jeollabuk-do ; Vaccination