Dermatomyositis (DM) is an idiopathic inflammatory myopathy with bimodal onset age distribution. The age of onset is between 5-18 yr in juvenile DM and 45-64 yr in adult DM. DM has a distinct clinical manifestation characterized by proximal muscle weakness, skin rash, extramuscular manifestations (joint contracture, dysphagia, cardiac disturbances, pulmonary symptoms, subcutaneous calcifications), and associated disorders (connective tissue disease, systemic autoimmune diseases, malignancy). The pathogenesis of juvenile and adult DM is presumably similar but there are important differences in some of the clinical manifestations, associated disorders, and outcomes. In this study, we investigated the clinical characteristics and outcomes of 16 patients with juvenile DM and 48 with adult DM. This study recognizes distinctive characteristics of juvenile DM such as higher frequency of neck muscle involvement, subcutaneous calcifications, and better outcomes.
Adolescent ; Adult ; Age of Onset ; Aged ; Anti-Inflammatory Agents/therapeutic use ; Calcification, Physiologic ; Dermatomyositis/*diagnosis/mortality/therapy ; Exanthema/diagnosis ; Female ; Humans ; Male ; Middle Aged ; Muscle Weakness/diagnosis ; Prednisolone/therapeutic use ; Prognosis ; Severity of Illness Index ; Survival Rate

PURPOSE: Laparoscopic wedge resection of gastric submucosal tumor may be difficult in case of the endophytic mass or the mass located unreachable area such as cardia, and intragastric approach can be useful. We would present the experiences of the intragastric wedge resection. MATERIALS AND METHODS: There were 7 patients diagnosed as gastric submucosal tumor and underwent the intragastric wedge resection at Surgery, Chungnam National University Hospital. We reviewed medical record. RESULTS: There were 3 male and 4 female. Mean age was 65 years-old (57~73). Mean body mass index was 26.28 kg/m2 (21.28~35.30). Location of lesions was 4 cardia, 2 fundus and 1 midbody, respectively. Mean operation time was 83.6 minutes (70~105). All patients were healed without any complication. Mean postoperative hospital stay was 5.4 days (4~6). Mean size was 2.7 cm (2.3~3.8). Pathologic finding was 5 gastrointestinal stromal tumor and 2 leiomyoma. CONCLUSIONS: The single incision intragastric wedge resection of gastric submucosal tumor is feasible and acceptable, especially in mass of gastric upper part.
Body Mass Index ; Cardia ; Female ; Gastrectomy ; Gastrointestinal Stromal Tumors ; Humans ; Laparoscopy ; Length of Stay ; Male ; Stomach Neoplasms ; Surgical Procedures, Minimally Invasive

BACKGROUND/AIMS: The distribut ion of HCV genotypes varies with geographical area, and genot ypes can affect t he nat ur al course of HCV infection, but adequate genot yping data were not accumulat ed in Korea. This study was des igned to det ermine the pattern of distribution of HCV genotypes in Korea and it's clinical implications. METHODS: 100 cons ecut ive anti- HCV( +), RT-PCR(+) cases were recruited. Genotype specific oligonucleotide primers were made according to the sequence variation of NS5 region of HCV genome. Heminested PCR with mixed primersets was per formed, and genotype specific PCR products of different size were verified. Sequencing of cloned PCR products was done in cases with representative genotypes. Clinical profiles of genotype 1b and 2a were compared. RESULTS: Genotyping was done in 78 among 100 cases. Genotype 1b (48/ 78, 57.7%) and 2a (25/ 78, 32.1%) were most prevalent , and 1a (1/ 78, 1.3%) and mixed form (7/ 78, 9.0%) were also found. Milder cases with persistent normal ALT levels were more frequently seen in genotype 2a ( 9/ 25, 36.0%) than in genot ype 1b (3/ 45, 6.7%) (p< 0.01). CONCLUSIONS: Genotype 1b and 2a were major ones in anti- HCV( +) Korean adults, and the tendency of milder clinical course of genotype 2a was suggested.
Adult ; Clone Cells ; DEET ; DNA Primers ; Genome ; Genotype ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Korea ; Polymerase Chain Reaction*

Muscular Diseases* ; Myopathies, Structural, Congenital*

OBJECTIVE: The aims of this study were to evaluate quantitatively the effect of tizanidine on spasticity reduction and to evaluate the effective and tolerable dosage of it in stroke patients. METHOD: A prospective, randomized controlled study was carried out. 24 stroke patients were included and randomly assigned to a control and experimental group. In experimental group, tizanidine was medicated from starting dose of 3 mg/day and titrated up by 3 mg/day increments every 3 days to a maximal dose of 15 mg/day. In both group assessment of spasticity was done by clinical and biomechanical-neurophysiological methods one day before medication (baseline), on 9th and 15th days after medication. Biomechenical-neurophysiological assessment was done through isokinetic dynamometer and BIOPAC system. RESULTS: In control group, no significant changes were found in the degree of spasticity between each assessment. In experimental group, most of the parameters that determine the degree of spasticity revealed the significant reduction of spasticity on the post-medication assessment compared with the baseline assessment (p<0.01). The degree of spasticity reduction was increased with the increase of dosage. The incidence of adverse effect was also increased with the increase of dosage, but tolerable within the dosage of 15 mg/day. CONCLUSION: Tizanidine was effective in reducing spasticity in stroke patients. Its efficacy and adverse effects were dosage-related.
Humans ; Incidence ; Muscle Spasticity* ; Prospective Studies ; Stroke*

PURPOSE: The aim of this study was to examine the prevalence of upper extremity musculoskeletal (MSK) diseases and to identify factors influencing disability among fruit tree farmers in Korea. MATERIALS AND METHODS: Of the 1150 subjects of the Namgaram study, 460 fruit tree farmers completed a questionnaire and underwent clinical evaluations, including physical assessments, laboratory tests, simple radiographic examinations, and magnetic resonance imaging studies of the upper extremities. Disability was assessed using the Disabilities of the Arm, Shoulder, and Hand outcome measure. Data were analyzed with descriptive statistics and regression analyses using SPSS Win 24.0. RESULTS: The prevalences of upper extremity MSK diseases were 60.4% for rotator cuff tear, 20.9% for golf elbow, 40.9% for tennis elbow, and 58.0% for hand osteoarthritis. Disability in fruit farmers was associated with female sex (B=−4.47, p<0.001), smoking (B=−4.00, p=0.026), depression (B=2.83, p<0.001), working hours (B=0.96, p=0.001), injuries of the arms (B=10.78, p<0.001) and shoulders (B=6.75, p<0.001), and numbers of upper extremity MSK diseases (B=2.02, p=0.001), with 26.5% of the variance explained (R2=0.265, Durbin-Watson test=1.81, p<0.001). CONCLUSION: Fruit tree farmers remain at risk for MSK diseases of the upper extremities. Disability tended to worsen with more MSK diseases. It is necessary to not only educate farmers about prevention strategies, but also to develop an effective management system for agricultural work-related MSK diseases and a surveillance system at the government level for the health problems of farmers.
Arm ; Cross-Sectional Studies ; Depression ; Elbow ; Farmers ; Female ; Fruit ; Golf ; Hand ; Humans ; Korea ; Magnetic Resonance Imaging ; Musculoskeletal Diseases ; Osteoarthritis ; Outcome Assessment (Health Care) ; Prevalence ; Rotator Cuff ; Shoulder ; Smoke ; Smoking ; Tears ; Tennis Elbow ; Trees ; Upper Extremity

Background: This study aimed to retrospectively assess results of intracranial meningioma surgerywith or without intraoperative neuromonitoring (IONM) in a single institution. Methods: Two cohorts (a historical cohort and a monitoring cohort) were collected for the analy-sis. Before IONM was introduced, a total of 107 patients underwent intracranial meningioma operation without IONM from January 2000 to December 2008 by one neurosurgeon (historical cohort). After IONM was introduced, a total of 99 patients with intracranial meningioma were operated under IONM between November 2018 and February 2023 by two neurosurgeons (monitoring cohort). A retrospective comparison was made on the complications from meningioma surgery between the two groups. Results: In the monitoring cohort, warning signals of motor evoked potential (MEPs) or so-matosensory evoked potential (SSEPs) were alarmed in 10 patients. Two of these 10 patients aborted the operation and eight of these 10 patients with warning signals underwent tumor resection. Of these eight patients, five showed postoperative morbidity. Five of 89 patients without warning signals developed neurological deficits. In the historical cohort, 14 of 107 patients showed postoperative morbidity or mortality. Conclusion Even after successful resection of intracranial meningiomas prior to the advent ofIONM, integration of MEPs and SSEPs monitoring yielded valuable insights for surgical teams during operative procedures.

Mycobacterium marinum (M. marinum) is a nontuberculosis mycobacterium that is normally associated with cutaneous lesions. Most cases occur after an individual has suffered minor trauma in association with contaminated fresh or salt water. In immunocompromised patients, M. marinum can cause osteomyelitis, synovitis and/or disseminated infection, which can be mistaken for rheumatoid arthritis (RA) or remitting seronegative symmetrical synovitis with pitting edema (RS3PE). Therefore, precise history taking and specimen culture are very important for early diagnosis and appropriate treatment. We report an unusual case of septic polyarthritis due to M. marinum that was diagnosed by culture and improved with antibiotic therapy.
Arthritis ; Arthritis, Rheumatoid ; Early Diagnosis ; Edema ; Immunocompromised Host ; Mycobacterium ; Mycobacterium Infections, Nontuberculous ; Mycobacterium marinum ; Osteomyelitis ; Synovitis

We present three neuropathologically-verified and two clinically-probable cases of Creutfeldt Jakob disease. All five had nonspecific prodromal complaints or symptoms prior to overt neurological signs and showed striking progressive neurologic deterioration, especially cognitive decline and cerebellar dysfunction. Myoclonic involuntary movements and complete decapitated states followed in one or two months. The characteristic even pathognomonic in proper clinical settings, features of electroencephalography, magnetic resonance imaging and positron emission tomography and pathologic findings are presented.
Cerebellar Diseases ; Creutzfeldt-Jakob Syndrome* ; Dyskinesias ; Electroencephalography ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Strikes, Employee

BACKGROUND: Essential hyperhidrosis is caused by an unexplained over activity of the high thoracic sympathetic nervous system. Since the development of video endoscopic surgery, the use of thoracoscopic sympathectomy has gradually increased. However, reports on major anesthetic problems related to bilateral thoracic symathectomy and one lung ventilation (reventilation of a collapsed lung), which are commonly used for this operation are few. The aim of this study was to evaluate changes in cardiovascular function and arterial oxygenation during reventilation of the collapsed lung for bilateral thoracoscopic sympathectomy. METHODS: Twenty one patients with essential hyperhidrosis in ASA physical status class 1, undergoing bilateral thoracoscopic T2-3 sympathectomy in the semi-Fowler's position were selected. Mean arterial blood pressure (MBP) of both radial arteries, skin temperature of both palmar area, and heart rate (HR) were recorded just before and after, 5 min and 10 min after sympathectomy. Simultaneously, arterial oxygen tension was obtained 30 min after left lung ventilation (LLV, baseline) and right lung ventilation (RLV, left lung collapse) and 10, 20, 30, 40, 50 and 60 min after LLV (reventilation of the collapsed left lung) under general anesthesia (isoflurane-100% oxygen). RESULTS: MBPs of bilateral radial arteries were significantly reduced after sympathectomy. However, there were no difference in the percent change of the MBP between both sides. HR was reduced only after right sympathectomy. The skin temperature of ipsilateral thenar area was significantly elevated after sympathectomy. Aterial oxygen tension was markedly reduced after 10 min of reventilation of the collapsed left lung (246.9 +/- 11.3 --< 102.3 +/- 5.7 mmHg) and then slowly returned to the baseline value after 50 min of reventilation. CONCLUSIONS: Thoracic sympathectomy in patients with essential hyperhidrosis causes a marked decrease of HR and MBP of the bilateral radial arteries and an increase of skin temperature of the ipsilateral palmar area. Reventilation of the collapsed lung for bilateral thoracoscopic T2-3 sympathectomy, causes a marked reduction in the arterial oxygen tension.
Anesthesia* ; Anesthesia, General ; Arterial Pressure ; Heart Rate ; Humans ; Hyperhidrosis ; Lung* ; One-Lung Ventilation ; Oxygen* ; Radial Artery ; Skin Temperature ; Sympathectomy* ; Sympathetic Nervous System ; Ventilation