No abstract available.
Humans ; Rectus Abdominis* ; Tissue Donors*

PURPOSE: We expected the motion fraction could be checked, with simple radiographic examination, according to the guide-line of fluoroscopic technique, and recovery of the function also could be correlated with the improvement of the motion fraction. MATERIALS AND METHODS: We measured the motion fraction of the glenohumeral and scapulothoracic movement using fluoroscope in 30-degree intervals of arm elevation in the scapular plane. The ratio of glenohumeral to scapulothoracic movement (thetaGH/thetaST) was 1.6 for the full range of motion in scapular plane. During arm elevation, scapular tilting from the coronal plane was decreased from 42 degrees to 20 degrees tilting as well as internal rotation (scapular extension). We also measured the motion fraction (thetaGH/thetaST) and functional recovery of the shoulder in 11 patients after operative treatment of the shoulder instability in 15 patients from December 1996 to August 1997. RESULTS: We could find out a significant correlation between the recovery of motion fraction and shoulder function. These results would be applied in planing rehabilitation program after treatment of the shoulder instability. CONCLUSIONS: The measuring technique of glenohumeral to scapulothoracic movement (thetaGH/thetaST) with fluoroscopy could be applied to the simple radiographic measurement at the out-patient clinic in order to identify the pathology and recovery of shoulder motion after treatment
Arm ; Fluoroscopy ; Humans ; Outpatients ; Pathology ; Range of Motion, Articular ; Rehabilitation ; Shoulder*

An oculogyric crisis which was resolved after intravenous injection of diazepam 10 mg developed in a 16-year-old girl after an oral dose of 400 mg of albendazole. Although ocular side effects of albendazole are rare, it can induce an alarming oculogyric crisis in some sensitive subjects. The mechanism of the oculogyric crisis is unclear.
Adolescent ; Albendazole* ; Diazepam ; Female ; Humans ; Injections, Intravenous

Cerebral gigantism(Sotos syndrome) is a growth disorder that consists of large size at birth, rapid early growth rate with accompanying advanced bone age, acromegalic features, and developmental delay. Clumsiness in the absence of other abnormal neurologic findings is common. The cause is unknown. We report here a case of 238/12-year-old Sotos syndrome with final adult height above 97 percentile, abnormal brain MRI findings(large ventricles, prominent trigone, prominent occipital horn & thining of corpus callosum), clumsiness, and some behavioral problems.
Adult ; Animals ; Brain ; Growth Disorders ; Horns ; Humans ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Parturition ; Sotos Syndrome

No abstract available.
Hematoma*

Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae, which is an obligate intracelluar pathogen. It presents broad spectrum of clinical manifestations depending on the host's specific cell-mediated immune response to M. leprae. Especially, type I Th cells and macrophages are important in defense mechanism to M. leprae, and the immune response is regulated by cytokines secreted by immune cells. Recent investigations showed nitric oxide(NO) was the key molecule in the killing activity of macrophages, which was enhanced by IFN-gamma but suppressed by TGF-beta1 and IL-10. Since cytokine is secreted by activated immune cells with antigenic stimulation, decreased antigens by treatment modulates the expression of cytokines in leprosy. In this study, we observed the dynamics of cytokines expression using RT-PCR, such as TGF-beta1 and IL-10, which suppress the activity of macrophages, IFN-gamma, which activates macrophages, and iNOS, which represents the killing activity of macrophages, in the lesions taken from fifteen borderline lepromatous leprosy patients before and after multiple drug therapy for 4 weeks. The results are summarized as follows: 1. Before treatment, cytokines were expressed in order of IL-10, iNOS, TGF-beta1 and IFN-gamma(p>0.05). 2. After 4 weeks treatment, cytokines were expressed in order of iNOS, IL-10, TGF-beta1 and IFN-gamma(p<0.05). 3. Fifty-four percent of patients showed a non-polarized Th 0 pattern, 33% a polarized Th 1 pattern, and 20% Th-negative. Th 2 pattern was not observed. 4. The changes of cytokines expression after 4 weeks treatment were not significant, although mRNA of IL-10, TGF-beta1 and IFN-gamma were somewhat decreased. 5. There was negative correlation between TGF-beta1 and iNOS(gamma(2)=0.499, p<0.05, before treatment), positive correlation between TGF-beta1 and IFN-gamma(gamma(2)= 0.622, p<0.05, before treatment), and positive correlation between IFN-gamma and IL-10(gamma(2)= 0.935, p<0.05, before treatment; gamma(2)= 0.937, p<0.05, after treatment). In conclusion, these results suggest that TGF-beta1 and IL-10 may contribute to immune suppression in multibacterial leprosy patients, and that TGF-beta1 suppresses iNOS expression in macrophages. With 4 weeks treatment, the significant changes in cytokines expression were not observed. Interestingly, the majority of BL patients showed Th 0 pattern of cytokine, and none of Th 2 pattern.
Cytokines ; Drug Therapy ; Granulomatous Disease, Chronic ; Homicide ; Humans ; Interleukin-10* ; Leprosy* ; Leprosy, Multibacillary* ; Macrophages ; Mycobacterium leprae ; RNA, Messenger* ; Transforming Growth Factor beta1*

A 1D point-prevalence study was performed to describe the characteristics of conventional mechanical ventilation in intensive care units (ICUs). In addition, a survey was conducted to determine the characteristics of ICUs. A prospective, multicenter study was performed in ICUs at 24 university hospitals. The study population consisted of 223 patients who were receiving mechanical ventilation or had been weaned off mechanical ventilation within the past 24 hr. Common indications for the initiation of mechanical ventilation included acute respiratory failure (66%), acute exacerbation of chronic respiratory failure (15%) (including tuberculosis-destroyed lung [5%]), coma (13%), and neuromuscular disorders (6%). Mechanical ventilation was delivered via an endotracheal tube in 68% of the patients, tracheostomy in 28% and facial mask with noninvasive ventilation (NIV) in 4%. NIV was used in 2 centers. In patients who had undergone tracheostomy, the procedure had been performed 16.9+/-8.1 days after intubation. Intensivists treated 29% of the patients. A need for additional educational programs regarding clinical practice in the ICU was expressed by 62% of the staff and 42% of the nurses. Tuberculosis-destroyed lung is a common indication for mechanical ventilation in acute exacerbation of chronic respiratory failure, and noninvasive ventilation was used in a limited number of ICUs.
APACHE ; Acute Disease ; Aged ; Data Collection ; Education, Professional, Retraining ; Female ; Hospitals, University ; Humans ; *Intensive Care Units ; Intubation, Intratracheal ; Male ; Middle Aged ; Prospective Studies ; *Respiration, Artificial/instrumentation ; Respiratory Insufficiency/therapy ; Tracheostomy

Brainstem lesions may produce a cheiro-oral syndrome infrequently. The cheiro-oral syndrome in pontine lesion is due to involvement of ventral trigeminothalamic tract and the medial part of the medial lemniscus. The cheiro-oral syndrome rarely associates with internuclear ophthalmoplegia. A 58-year-old hypertensive man complained of dizziness, diplopia, and dysesthesia in the right hand and ipsilateral perioral region. On neurologic examination, there was left internuclear ophthalmoplegia. Others were unremarkable. Brain MRI demonstrated a small round lesion in the paramedian tegmentum of the left upper pons and lower midbrain, which involved ventral trigeminothalamic tract, medial part of medial lemniscus and medial longitudinal fasciculus. We report a case of brainstem infarction with a rare combination of cheiro-oral syndrome and internuclear ophthalmoplegia.
Brain ; Brain Stem Infarctions* ; Brain Stem* ; Diplopia ; Dizziness ; Hand ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Middle Aged ; Neurologic Examination ; Ocular Motility Disorders ; Paresthesia ; Pons

BACKGROUND: Hyperhomocysteinemia has been known to be associated with cerebrovascular disease. It is toxic to vascular endothelial cell and promotes arteriosclerotic detachment. There was no study of the homocysteine level in ischemic stroke patients in Korea except case report. Therefore we measured total plasma homocysteine level in ischemic stroke patients and evaluated association with other stroke risk factors. METHODS: We measured total plasma homocysteine level in 44 patients with ischemic stroke and 16 age-matched normal controls, and analyzed its relationship to other stroke risk factors. Total plasma homocysteine level was determined by using a radioenzymatic method. RESULTS: Total plasma homocysteine level was 12.12 5.11 micromol/L in patients and 9.40 1.93 micromol/L in controls. It was 13.03 5.78 micromol/L in lacunar infarction and 9.96 1.57 micromol/L in territory infarction. The total plasma homocysteine level of the patients with hypertension, DM, hyperlipidemia, heart disease, smoking, alcohol, previous stroke, carotid bruit was not different statistically from those without them. CONCLUSIONS: Total plasma homocysteine level was significantly higher in the ischemic stroke patients than that of controls. Lacunar infarction showed significantly higher level of total plasma homocysteine compared to territory infarction.
Cerebral Infarction* ; Endothelial Cells ; Heart Diseases ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Hyperlipidemias ; Hypertension ; Infarction ; Korea ; Pilot Projects* ; Plasma* ; Risk Factors ; Smoke ; Smoking ; Stroke ; Stroke, Lacunar

BACKGROUND: To investigate the mechanisms of myocardial ischemia induced changes of electrophysiological properties, influences of various ischemic-simulated Tyrode's solutions on the changes of action potential characteristics were examined. METHOD: Action potential characteristics were measured during superfusion with various ischemic-simulated solutions (modified physiologic salt solution: MPSS) by the method of conventional microelectrode technique in rat atrial fibers. RESULTS: Hypoxic-, hyperkalemic-, and mixed-MPSS decreased 'maximum diastolic potential' (MDP) and 'action potential amplitude' (APA), however, no significant changes of MDP and APA were observed by acidic- and glucose-free-MPSS. 'Maximum velocity of phase 0 depolarization' (dV/dt(max)) and 'time for 90% repolarization' (APD90) significantly decreased during hypoxic- and mixed-MPSS superfusion, and hyperkalemic-MPSS also decreased the dV/dt(max) and APD90. However, no significant changes in dV/dt(max) and APD90 were observed by acidic- and glucose-free-MPSS. The decreasing effects of dV/dt(max) and APD90 by the MPSSes were attenuated when the MPSSes were replaced with normal Tyrode's solution. DPCPX (2x10(-6)M), a purinergic antagonist, inhibited the decreasing effects of APD90 at 5, 10, and 20 min superfusion of the mixed-MPSS, and glibenclamide (10(-6)M), a K(ATP) channel blocker, inhibited those at 10 and 20 min superfusion of the mixed-MPSS. Diclofenac (10(-6)M), a cyclooxygenase inhibitor inhibited only those at 20 min superfusion of the mixed-MPSS. CONCLUSION: The primary factors for changing the electrophysiological characteristics during ischemic insults could be hypoxia and high-extracellular K+, and the mechanisms of the electrophysiological changes are inferred that adenosine through purinoceptors is involved initially, and followed by K(ATP) channel and prostanoids.
Action Potentials* ; Adenosine ; Animals ; Anoxia ; Diclofenac ; Glyburide ; Ischemia ; Microelectrodes ; Myocardial Ischemia ; Prostaglandin-Endoperoxide Synthases ; Prostaglandins ; Rats* ; Receptors, Purinergic