Transverse myelitis (TM) extending from midbrain to the entire spinal cord accompanied by internuclear ophthalmoplegia is extremely rare but cause serious central nervous system complications in patients with systemic lupus erythematosus. We report a case of a 28-yr-old woman with TM extending from the midbrain to the conus medullaris longitudinally and internuclear ophthalmoplegia associated with systemic lupus erythematosus. Her neurological symptoms had an abrupt catastrophic onset and rapidly progressed to respiratory failure within 24 hr. Bilateral internuclear ophthalmoplegia was also followed by TM. Brain MR images showed definite brainstem lesions, which were deeply associated with internuclear ophthalmoplegia, and diffuse signal changes in the whole spinal cord, medulla, pons and midbrain. Clinical improvement of her ophthalmoplegia and of neurological dysfunction of the upper extremities was noted after prompt and aggressive treatment with intravenous pulsed methylprednisolone and cyclophosphamide. However, the neurological dysfunction of the lower limbs and bladder and colon paralysis were almost unchanged until six months passed.
Adult ; Cyclophosphamide/therapeutic use ; Female ; Humans ; Lupus Erythematosus, Systemic/*complications ; Magnetic Resonance Imaging ; Myelitis, Transverse/diagnosis/drug therapy/*etiology ; Ocular Motility Disorders/diagnosis/drug therapy/*etiology ; Prednisolone/therapeutic use

BACKGROUND: The aim of the current study was to assess the effects of total arterial myocardial revascularization (TAMR) with bilateral internal mammary arteries. MATERIAL AND METHOD: 139 consecutive patients who underwent off pump coronary artery bypass surgery from January 2000 to December 2001 were included in the current retrospective study. Patients were divided into those receiving bilateral internal mammary artery, BITA (n=85) and those receiving single internal mammary artery, SITA (n=54). RESULT: There was only one death in each group. No significant differences were noted in the total ICU and hospital stay; 2.4+/-1.7 and 11.2+/-17.7 days, in the BITA group, respectively and 2.8+/-2.7 and 9.7+/-7.1 days in the SITA group, respectively (P>0.05). The mean number of distal anastomosis of 3.9+/-0.7 was slightly higher in the BITA group compared to the SITA group, which was 3.1+/-0.8. Myocardial infarction occurred in 7 patients (BITA group: 2, SITA group: 5) and deep sternal infection necessitating reoperation occurred in 4 patients (BITA group: 3, SITA group: 1). Coronary angiogram was performed in the immediate postoperative period in 104 patients (BITA group: 64/85, SITA group: 40/54). Of these patients, stenosis in the LAD anastomosis site occurred in 4 patients (BITA group: 2, SITA group: 2). A total of 8 anastomotic sites were stenotic in the entire series of which percutaneous intervention was performed in 3 patients and none required reoperative coronary artery bypass. CONCLUSION: The results of the current data did not show a significant difference in patency rate with bilateral internal mammary artery use for CABG supporting the feasibility of its use as a viable alternative method for TAMR.
Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump* ; Humans ; Length of Stay ; Mammary Arteries* ; Myocardial Infarction ; Myocardial Revascularization ; Postoperative Period ; Reoperation ; Retrospective Studies ; Skeleton* ; Surgical Procedures, Minimally Invasive ; Transplants*

PURPOSE: The purpose of this study was to assess the prevalence and extent of clinical attachment loss of periodontal tissue and to find out variables related to clinical attachment loss (CAL) in Korean adults older than 40 years of age. MATERIALS AND METHODS: Data were collected from 2,519 subjects who were part of a cohort study conducted in Ansan city by Korea University Medical School for Korean Genome project. Age, sex, smoking, drinking, fast glucose, blood pressure, obesity and total cholesterol levels were examined. The oral examination included probing pocket depth, gingival recession and CAL of Ramford's teeth. The severity of periodontitis was classified based on the mean value of CAL. The relationship between each risk factor and the severity of CAL was independently estimated using the chi-square test, the test or one-way ANOVA. Multiple regression analysis was used to determine the significance of each factor in the periodontal disease. RESULTS: The prevalences of clinical attachment between 1 and 3 mm, between 3 and < 5 mm, and > or = 5 mm were 80.27%, 16.75% and < 1%, respectively. Although the univariate analysis showed age, gender, smoking, fasting glucose, blood pressure and total cholesterol levels were significantly related to the severity of CAL, multiple regression analysis indicated that age (P < .0001), gender (P < .0001) and smoking (P < .05) were only significantly related. CONCLUSION: Older age, male gender and smoking were significant risk factor for the increase of CAL, and these may be useful indicators of periodontitis high-risk groups.
Adult ; Blood Glucose ; Cholesterol ; Cohort Studies ; Diagnosis, Oral ; Drinking ; Fasting ; Genome ; Gingival Recession ; Humans ; Korea ; Male ; Obesity ; Periodontal Attachment Loss ; Periodontitis ; Prevalence ; Risk Assessment ; Risk Factors ; Schools, Medical ; Smoke ; Smoking ; Tooth