BACKGROUND AND OBJECT: Cheiro-oral syndrome (COS) is characterized by a sensory disturbance in the unilateral hand and ipsilateral mouth corner. It is usually due to a lesion in the parietal cortex, thatamocortical projections, thalamus, or rarely brain stem. However, the syndrome is relatively unknown and rarely mentioned in most neurological textbooks. We presented ten cases of COS with a review of the clinical symptoms and signs and the neuroradiological methods used to demonstrate the responsible site. METHODS AND RESULTS: We studied 10 patients with stroke who showed restricted sensory disturbance on the one hand and ispilateral mouth. The study forms consisted of clinical manifestaion, neurological examination, electrophysiological, and neuroradiologic studies. Computed tomography and/or magnetic resonance imaging identified lesion in the thalamus in 5, brain stem in 3, and corona radiata in 1 patient. But, the anatomical responsible site for one case was not founded. Infarction had occurred in nine cases and hemorrhage in one. Seven of the 10 patients showed sensory disturbances restricted to the perioral area, hands, fingers when they were first examined; the remaining patients complained more diffuse sensory disturbances at first, but it had become restricted to perioral and fingers, usually within 2-3 weeks. The durations of symptom varied from 5 days to more than 15 months and these symptoms were improved within 2-3 weeks to 4 months in treated patients. CONCLUSION: When the symptoms and signs of the COS were presented, especially if a history of migraine is lacking, neuroradiological methods such as CT or MRI should be undertaken to localize and diffentiate the nature of lesion.
Brain Stem ; Fingers ; Hand ; Hemorrhage ; Humans ; Infarction ; Magnetic Resonance Imaging ; Migraine Disorders ; Mouth ; Neurologic Examination ; Rabeprazole ; Stroke ; Thalamus

PURPOSE: In this study, the medication effects of Milnacipran and Pregabalin, as well known as fibromyalgia treatment medicine, in fibromyalgia syndrome patients were compared through the change of BOLD signal in pain related functional MRI. MATERIALS AND METHODS: Twenty fibromyalgia syndrome patients were enrolled in this study and they were separated into two groups according to the treatment medicine: 10 Milnacipran (MLN) treatment group and 7 Pregabalin (PGB) treatment group. For accurate diagnosis, all patients underwent several clinical tests. Pre-treated and post-treated fMRI image with block-designed pressure-pain stimulation for each group were obtained to conduct the statistical analysis of paired t-test and two sample t-test. All statistical significant level was less than 0.05. RESULTS: In clinical tests, the clinical scores of the two groups were not significantly different at pre-treatment stage. But, PGB treatment group had lower Widespread Pain Index (WPI) and Brief Fatigue Inventory (BFI) score than those of MLN treatment group at post-treatment stage. In functional image analysis, BOLD signal of PGB treatment group was higher BOLD signal at several regions including anterior cingulate and insula than MLN treatment group at post-treatment stage. Also, paired t-test values of the BOLD signal in MLN group decreased in several regions including insula and thalamus as known as 'pain network'. In contrast, size and number of regions in which the BOLD signal decreased in PGB treatment group were smaller than those of MLN treatment group. CONCLUSION: This study showed that MLN group and PGB group have different medication effects. It is not surprising that MLN and PGB have not the same therapeutic effects since these two drugs have different medicinal mechanisms such as antidepressants and anti-seizure medication, respectively, and different detailed target of fibromyalgia syndrome treatment. Therefore, it is difficult to say which medicine will work better in this study.
Antidepressive Agents ; Diagnosis ; Fatigue ; Fibromyalgia* ; Follow-Up Studies* ; Humans ; Magnetic Resonance Imaging* ; Prostaglandins B ; Thalamus ; Pregabalin

PURPOSE: We evaluated whether Cyberknife radiosurgery is an effective and safe method of therapy for medically intractable trigeminal neuralgia (TN). MATERIALS AND METHODS: We retrospectively analyzed the outcome of 26 patients, who failed to surgery or were not suitable candidates for invasive intervention and were treated by Cyberknife radiosurgery between March 2004 and May 2005. Radiosurgery doses of 60~64 Gy were delivered to the 80% isodose line prescribed to an 6 mm length of the nerve, sparing the most proximal 3 mm away from the trigeminal nerve root entry zone (median dose: 64 Gy). RESULTS: Follow-up period was 3~15 months (median follow-up period: 9 months) Preliminary results from a cohort of 26 patients undergoing Cyberknife radiosurgery for TN showed that pain relief was achieved in 50% (13/26) of patients within the first 24 hrs after treatment. At last follow-up, 96.2% (25/26) of patients reported early pain relief within 7 days. Treatment failure developed in 2 of 26. Poor response occurred in one patient and relapse was observed in the other patient. 3 patients had hypoesthesia (11.5%), which was the only complication observed with any of our patients. CONCLUSION: With these results, authors assumed that Cyberknife radiosurgery for TN could be one of safe and effective therapeutic methods.
Cohort Studies ; Follow-Up Studies ; Humans ; Hypesthesia ; Radiosurgery* ; Recurrence ; Retrospective Studies ; Treatment Failure ; Trigeminal Nerve ; Trigeminal Neuralgia*

There have been many reports regarding complications associated with cardiopulmonary resuscitation(CPR) and it may be true that there are many unrevealed complications. Although it is used to say that 'any CPR is better than no CPR', inadvertent or inadequate CPR may insult in serious organ injury. This report describes a 64-year-old woman who suffered Mallory-Weiss tear resulting from inadvertent cardiopulmonary resuscitation by a bystander who had never been trained. Possible mechanisms of gastric injuries caused by CPR are suggested, and importance of adequate CPR training are emphasized in this report.
Cardiopulmonary Resuscitation* ; Female ; Humans ; Mallory-Weiss Syndrome* ; Middle Aged

No abstract available.
Leukemia, Monocytic, Acute* ; Leukemic Infiltration* ; Lymphatic Diseases* ; Skin*

No abstract available.
Echocardiography, Doppler, Color* ; Mitral Valve Insufficiency*

BACKGROUND: Laparoscopic surgery is replacing conventional surgical techniques due to its many advantages. However the possibility of respiratory complications during CO2-induced pneumoperitoneum remain. Tracheal gas insufflation (TGI) has been shown to be a useful adjunct to mechanical ventilation in hypercapneic patients. This study investigated the effectiveness of TGI in reducing the PaCO2 level in hypercapneic patients during laparoscopic surgery without increasing the peak inspiratory pressure (PIP) and usefulness of a Univent tube(R) as a device for TGI. METHODS:Twenty-four patients who were scheduled to undergo gynecological laparoscopic surgery, were enrolled in this study. Anesthesia was induced and maintained with propofol, rocuronium and N2O-O2-sevoflurane. The suction port of the endobronchial blocker of the Univent tube(R) was used for the path of TGI. Data including the ABGA and respiratory parameters were measured three times, the pre-CO2 peritoneum (pre-CO2 pneumoperitoneum point, PCP), 15 min after CO2 peritoneum (after-CO2 pneumoperitoneum point, ACP) and after 15 min TGI (TGI point, TGIP). RESULTS: At ACP, the PaCO2 and PIP had increased more significantly than PCP. After TGI, the PaCO2 was decreased more significantly than ACP, but the PIP did not increased. CONCLUSIONS: TGI is a useful adjunct to mechanical ventilation in hypercapneic patients during laparoscopic surgery, and a univent tube(R) is an economic and convenient device for TGI.
Anesthesia ; Humans ; Insufflation* ; Laparoscopy* ; Peritoneum ; Pneumoperitoneum ; Propofol ; Respiration, Artificial ; Suction

Recently, the incidence of fungal infection increases because of immunosuppressive therapy and chemotherapy. In immunosuppressed transplant recipients, Aspergillus can be a dangerous pathogen, capable of inducing fulminant clinical disease. Invasive fungal infections are life-threatening complications in solid-organ transplantation. Although the rate of fungal infections in transplant recipients is lower than that of other infections, the mortality rate is higher. A 34 year-old male was admitted to our hospital with fever and gross hematuria. He had received renal transplantation 2 years ago and had been transferred the other hospital 1 month ago. Initial laboratory data evaluation showed a pancytopenia and azotemia. We thought that pancytopenia was caused by immunosuppressive agents and infection. The patient was treated with antibiotics but fever was not subsided. After 4 days, he complained of transplant site pain and tenderness to percussion. A percutaneous renal biopsy was performed. Microscopic examination showed invasive aspergillosis in transplanted kidney and perirenal area. We removed the transplanted kidney and perirenal tissue, and prescribed antifungal agents for 3 months.
Anti-Bacterial Agents ; Antifungal Agents ; Aspergillosis ; Aspergillus ; Azotemia ; Biopsy ; Fever ; Hematuria ; Humans ; Immunosuppressive Agents ; Incidence ; Kidney ; Kidney Transplantation ; Male ; Pancytopenia ; Percussion ; Transplants

Pheochromocytomas can arise wherever chromaffin cells are found, and most of them(90%) are in one or both adrenal glands. But they may be located anywhere along the sympathetic chain and rarely in aberrant sites. One of the common extra-adrenal sites from which these tumors can arise is a collection of para-aortic and para-ganglion cells around the origin of the inferior mesenteric artery. We experienced a case of extra-adrenal pheochromocytoma located at the organ of Zukerkandl in a 21-year-old female patient with abdominal colic and paroxysmal hypertension, whose symptoms and blood pressure returned to normal after successful surgical excision of the tumor.
Adrenal Glands ; Blood Pressure ; Chromaffin Cells ; Colic* ; Female ; Humans ; Hypertension* ; Mesenteric Artery, Inferior ; Pheochromocytoma* ; Young Adult

BACKGROUND: Korean mistletoe (Viscum album) extract has been found to posses immunostimulatory activity. In this study, Korean mistletoe extract, M11C (non-lectin components), was used to know whether this extract might activate mouse peritoneal macrophages to produce interleukin 1 beta (IL-1 beta). METHODS: Hemagglutination assay was carried out to examine whether M11C contained a lectin or not . To know the effect of M11C on the production of IL-1 beta, the macrophages were treated by the M11C, and then collected the supernatant (M11C stimulated macrophages-conditioned media; MMCM). MMCM was analyzed for the IL-1 beta quantification and mRNA expression by means of ELISA and RT-PCR, respectively. RESULTS: Maximum effective dose and time of M11C on IL-1 beta production from macrophages were 20 micro gram/ml and 8 hours, respectively . This ELISA data was reconfirmed by immunoblotting assay . indicating that M11C is a good candidate for an immunomodulator. The dose and time dependent effect s of M11C on the expression of IL-1 beta mRNA from macrophages was also shown in expression of mRNA detected by RT-PCR. Treatment dose and time for the maximum expression of IL-1 beta mRNA were 20 micro gram/ml and 4 hours, respectively . Maximum gene expression of IL-1 beta was much earlier than maximum production of it. CONCLUSION: As results, Korean mistletoe extract, M11C, may be used for an immunomodulator. This will be able to make up for and solve the problems caused by existent immunoagent with many adverse effects through many other studies in future including one molecule extraction.
Animals ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Hemagglutination ; Immunoblotting ; Interleukin-1beta ; Macrophages* ; Macrophages, Peritoneal ; Mice ; Mistletoe* ; RNA, Messenger