No abstract available.
Animals ; Arteries* ; Rats*

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*

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

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

BACKGROUND: Resting ankle brachial pressure index is a non-invasive method to assess the patency of lower extremity arterial system and it can be measured using traditional Doppler method or photoplethysmography. Automated blood pressure measurement is a easy and quick method for measurement of ankle brachial pressure index, but usefulness of this method have not been investigated. So we evaluated the accuracy of Automated blood pressure measurement device as flow detector in determining the ankle brachial pressure index in comparison to photoplethysmography. METHODS: A total 136 subjects containing 117 diabetic patients and 19 volunteers were included in the study. With each subject in the supine position, dorsalis pedis arterial pulses were palpated by examiner. And the brachial and ankle systolic blood pressure were recorded using photoplethysmography (Rheoscreen, Medis, Germany) and automated blood pressure measurement device (MD-800, Meditec, Korea). Ankle brachial pressure index for each leg was separately calculated by dividing the ankle systolic pressure by the higher brachial systolic pressure. Statistical analyses were performed by SPSS for Windows (version 10.0 SPSS Inc.) RESULTS: Brachial and ankle systolic pressure measured using automated blood pressure measurement device were higher than photoplethysmography and correlations between both method were significant (r=0.886, r=0.844). Ankle brachial pressure index derived using automated blood pressure measurement have a better correlation with photoplethysmography method (r=0.622) than pulse palpation (r=0.255). The subject was considered to have peripheral arterial disease if either leg ABI was 0.9 or less. Peripheral arterial disease was more frequent when it was defined using photoplethysmography (13.8%) vs automated blood pressure measurement device (6.3%). The sensitivity of the automated blood pressure measurement is 32.4%, the specificity is 97.8% and the accuracy is 88.8% for peripheral arterial disease defined using photoplethysmography. CONCLUSION: Automated blood pressure measurement was easier and quicker and less expensive as compared with photoplethysmography. Automated blood pressure measurement was not sensitive but more accurate as compared with pulse palpation. So we recommend that it be used on a routine screening basis of peripheral arterial disease in primary care.
Ankle* ; Blood Pressure* ; Humans ; Leg ; Lower Extremity ; Mass Screening ; Palpation ; Peripheral Arterial Disease ; Photoplethysmography* ; Primary Health Care ; Sensitivity and Specificity ; Supine Position ; Volunteers

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

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

Atopic dermatitis (AD) is a common inflammatory skin disorder mediated by inflammatory cells, such as macrophages and mast cells. Rifampicin is mainly used for the treatment of tuberculosis. Recently, it was reported that rifampicin has anti-inflammatory and immune-suppressive activities. In this study, we investigated the effect of rifampicin on atopic dermatitis in vivo and in vitro. AD was induced by treatment with 2, 4-dinitrochlorobenzene (DNCB) in NC/Nga mice. A subset of mice was then treated with rifampicin by oral administration. The severity score and scratching behavior were alleviated in the rifampicin-treated group. Serum immunoglobulin E (IgE) and interleukin-4 (IL-4) levels were also ameliorated in mice treated with rifampicin. We next examined whether rifampicin has anti-atopic activity via suppression of mast cell activation. Rifampicin suppressed the release of β-hexosaminidase and histamine from human mast cell (HMC)-1 cultures stimulated with compound 48/80. Treatment with rifampicin also inhibited secretion of inflammatory mediators, such tumor necrosis factor-α (TNF-α) and prostaglandin D₂ (PGD₂), in mast cells activated by compound 48/80. The mRNA expression of cyclooxygenase 2 (COX-2) was reduced in the cells treated with rifampicin in a concentration-dependent manner. These results suggest that rifampicin can be used to treat atopic dermatitis.
Administration, Oral ; Animals ; Cyclooxygenase 2 ; Dermatitis, Atopic ; Histamine ; Humans ; Immunoglobulin E ; Immunoglobulins ; In Vitro Techniques* ; Interleukin-4 ; Macrophages ; Mast Cells ; Mice ; Necrosis ; Rifampin* ; RNA, Messenger ; Skin ; Tuberculosis

Atopic dermatitis (AD) is a common inflammatory skin disorder mediated by inflammatory cells, such as macrophages and mast cells. Rifampicin is mainly used for the treatment of tuberculosis. Recently, it was reported that rifampicin has anti-inflammatory and immune-suppressive activities. In this study, we investigated the effect of rifampicin on atopic dermatitis in vivo and in vitro. AD was induced by treatment with 2, 4-dinitrochlorobenzene (DNCB) in NC/Nga mice. A subset of mice was then treated with rifampicin by oral administration. The severity score and scratching behavior were alleviated in the rifampicin-treated group. Serum immunoglobulin E (IgE) and interleukin-4 (IL-4) levels were also ameliorated in mice treated with rifampicin. We next examined whether rifampicin has anti-atopic activity via suppression of mast cell activation. Rifampicin suppressed the release of β-hexosaminidase and histamine from human mast cell (HMC)-1 cultures stimulated with compound 48/80. Treatment with rifampicin also inhibited secretion of inflammatory mediators, such tumor necrosis factor-α (TNF-α) and prostaglandin D₂ (PGD₂), in mast cells activated by compound 48/80. The mRNA expression of cyclooxygenase 2 (COX-2) was reduced in the cells treated with rifampicin in a concentration-dependent manner. These results suggest that rifampicin can be used to treat atopic dermatitis.
Administration, Oral ; Animals ; Cyclooxygenase 2 ; Dermatitis, Atopic ; Histamine ; Humans ; Immunoglobulin E ; Immunoglobulins ; In Vitro Techniques* ; Interleukin-4 ; Macrophages ; Mast Cells ; Mice ; Necrosis ; Rifampin* ; RNA, Messenger ; Skin ; Tuberculosis