OBJECTIVE: The purpose of this study was to investigate the immediate and delayed effects of electrical stimulation of sensory nerve pathway on spasticity in patients with brain lesions. METHOD: Sixteen stroke and traumatic brain injured subjects participated in this study. Electrical stimulation on the der matome of spastic muscles was applied for 30 minutes a day for 4 weeks. Spasticity was quantified through the use of a relaxation index obtained from pendulum test and a amplitude and latency from knee tendon reflex test. The measurements were performed 6 times in treatment period. The data were analyzed by repeated measures one way ANOVA. RESULTS: Relaxation index was significantly increased in treatment period (p<0.05). In each therapeutic stimulation session, relaxation index of post-stimulation was increased in comparison with that of pre-stimulation (p<0.01). The amplitude of post-stimulation was significantly decreased in comparison with pre-stimulation status in each measurement session (p<0.01). The latency of tendon reflex was not changed after stimulation. CONCLUSION: These results showed that the electrical stimulation was useful method to decrease spasticity in patients with brain lesions. Further studies are needed to explore the effects of functional improvement and the long-lasting carry over effects on spasticity in electrical stimulation.
Brain* ; Electric Stimulation ; Electric Stimulation Therapy* ; Humans ; Knee ; Muscle Spasticity* ; Muscles ; Reflex, Stretch ; Relaxation ; Stroke

BACKGROUND/AIMS: ERCP is being used increasingly as a diagnostic and therapeutic tool for children with pancreaticobiliary disorders. Differences between thirteen pediatric ERCPs and adult ERCPs were reviewed with respect to their indications, method of anesthesia, choice of endoscope and complications. METHODS: The medical records of 13 ERCPs for 10 children (age: 23 months to 14 years) done between 2005 and 2008 were reviewed retrospectively. RESULTS: ERCP was indicated for gallstone pancreatitis (6), choledocholithiasis (3), and unexplained pain (1). The method of anesthesia was intravenous sedation with a single agent or a combination of midazolam, propofol or ketamine. The quality of sedation was satisfactory in 10 cases and unsatisfactory in three cases. These 3 cases were less than 8 years old and sedated with a combination of midazolam and propofol. Selective biliary cannulation was successful in 92.3% (12/13) of attempts. Therapeutic ERCP included sphincterotomy (4), endoscopic papillary balloon dilatation (3), and both (5). Complications occurred in 7.7% of attempts (1/13; 1 duodenal perforation) which was successfully managed by surgery. CONCLUSIONS: Pediatric ERCP is a feasible and useful technique. Special caution is needed, however, because of differences with adult ERCP in terms of the effectiveness of intravenous sedation, complications, and size of the gastrointestinal tract.
Adult ; Anesthesia ; Catheterization ; Child ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Dilatation ; Endoscopes ; Gallstones ; Gastrointestinal Tract ; Humans ; Ketamine ; Medical Records ; Midazolam ; Pancreatitis ; Propofol ; Retrospective Studies

Pseudomelanosis duodeni is a rare benign condition that manifests endoscopically as diffuse, small brownish-black spots in the duodenal mucosa, and the histochemical findings show an accumulation of hemosiderin pigment in the duodenal villi's lamina propria. This condition produces no specific symptoms, and it may be reversible. The cause and natural history of the pigmentation have not been clarified, although it is associated with a variety of systemic illnesses and medications. We describe two cases of pseudomelanosis duodeni and the patients had histories of diabetes mellitus, hypertension, chronic renal insufficiency and specific medications. We also review the relevant medical literature on this rare condition.
Diabetes Mellitus ; Duodenum ; Hemosiderin ; Humans ; Hypertension ; Iron ; Melanosis ; Mucous Membrane ; Natural History ; Pigmentation ; Renal Insufficiency, Chronic

Glycogenic acanthosis(GA) of the esophagus,is often found in routine endoscopic examination of the upper GI tract but has not drawn much attention. However, there is controversy concerning the nature, clinical significance and prevalence of this candition. An endoscopic study, performed in 1041 patients, showed that the incidence of GA was 32,9%. Its incidence was found to be significantly higher in male than in female(40.0% vs. 22.1%; p<0.0001) and frequency of high grade(II+III) GA was higher in male than in female(58.1% vs. 45.3~%; p<0.0D01). An increasing tendency was observed with respect to age(X 36~343, p~<0,0001). The frequency of GA was higher in smoker than in non-smoker(49.2% vs. 20.8%; p<0.0001). GA did not have a clear relationship with alcohol intake, dietary habit, condiments, and diet temperature. The frequency of GA was higher in the patient with reflux esophagitis than without reflux esophagitis(3.8% vs. 1.7%; p~<0.05). Therefore, age, sex and smoking appear to be risk factors of GA, as in esophageal carcinoma.
Condiments ; Diet ; Esophagitis, Peptic ; Esophagus ; Food Habits ; Glycogen* ; Humans ; Incidence ; Male ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Upper Gastrointestinal Tract

Background/Aims: The mucoprotective drug rebamipide is used to treat gastritis and peptic ulcers. We compared the efficacy of Mucosta Ⓡ (rebamipide 100 mg) and its new formulation, AD-203 (rebamipide 150 mg), in treating erosive gastritis. Methods: This double-blind, active control, noninferiority, multicenter, phase 3 clinical trial randomly assigned 475 patients with endoscopically proven erosive gastritis to two groups: AD-203 twice daily or Mucosta Ⓡ thrice daily for 2 weeks. The intention-to-treat (ITT) analysis included 454 patients (AD-203, n=229; Mucosta Ⓡ , n=225), and the per-protocol (PP) analysis included 439 patients (AD-203, n=224; Mucosta Ⓡ , n=215). The posttreatment assessments included the primary (erosion improvement rate) and secondary endpoints (erosion and edema cure rates; improvement rates of redness, hemorrhage, and gastrointestinal symptoms). Drug-related adverse events were evaluated. Results: According to the ITT analysis, the erosion improvement rates (posttreatment) in AD-203-treated and Mucosta Ⓡ -treated patients were 39.7% and 43.8%, respectively. According to the PP analysis, the erosion improvement rates (posttreatment) in AD-203-treated and Mucosta Ⓡ -treated patients were 39.3% and 43.7%, respectively. The one-sided 97.5% lower limit for the improvement rate difference between the study groups was −4.01% (95% confidence interval [CI], –13.09% to 5.06%) in the ITT analysis and −4.44% (95% CI, –13.65% to 4.78%) in the PP analysis. The groups did not significantly differ in the secondary endpoints in either analysis. Twenty-four AD-203-treated and 20 Mucosta Ⓡ -treated patients reported adverse events but no serious adverse drug reactions; both groups presented similar adverse event rates. Conclusions The new formulation of rebamipide 150 mg (AD-203) twice daily was not inferior to rebamipide 100 mg (Mucosta Ⓡ ) thrice daily. Both formulations showed a similar efficacy in treating erosive gastritis.