Hypoglycemic encephalopathy is a rare problem among diabetic patients who are receiving treatment with insulin or other glucose-lowering drugs. The MRIs of patients with hypoglycemic encephalopathy commonly show scattered lesions in the cerebral cortex, hippocampus and basal ganglia, but lesions in the cerebellum or brain stem are extremely rare. A 44-year-old alcoholic woman without diabetes was admitted with a semicomatose mentality and seizure with severe hypoglycemic encephalopathy with extensive brain lesions seen on MRI at the middle cerebellar peduncle and midbrain, as well as in the other brain areas.
Adult ; Alcoholics ; Alcoholism ; Basal Ganglia ; Brain ; Brain Stem ; Cerebellum ; Cerebral Cortex ; Female ; Hippocampus ; Humans ; Insulin ; Mesencephalon ; Seizures

Although the global prevalence of peptic ulcer disease (PUD) is decreasing, PUD is still one of the most common upper gastrointestinal diseases in the world due to Helicobacter pylori infection and increased use of non-steroidal anti-inflammatory drugs. In Korea, the prevalence of H. pylori infection is also declining, but it is still the major cause of PUD. The outcomes of H. pylori infection are caused by imbalances between bacterial virulence factors, host factors, and environmental influences. In this review, we describe the prevalence trends of H. pylori infection in Korea, the mechanism of H. pylori infection-related PUD, and treatment strategies.
Epidemiology ; Gastrointestinal Diseases ; Helicobacter pylori* ; Helicobacter* ; Korea ; Peptic Ulcer* ; Prevalence ; Virulence Factors

Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Transplant type. Epidemic or AIDS categories is found approximately 20 % of all AIDS and has strong predilection for head and neck region. The first case of Kaposi's sarcoma observed in patients with kidney transplants was reported in 1969. Kaposi's sarcoma now accounts for 5% of all tumors associated with transplanted patients and alteration of the immunosuppression may have played a key role in these recipients. The most common site of Kaposi's sarcoma in transplanted patients are extremities but rare in head and neck area. We report a case of Kaposi's sarcoma on the hard palate in the kidney transplantation patient.
Extremities ; Head ; Humans ; Immunosuppression ; Kidney ; Kidney Transplantation ; Mouth* ; Neck ; Palate, Hard ; Sarcoma ; Sarcoma, Kaposi*

Purpose: To retrospectively compare the fixation methods for reattaching a trochanteric fragment in a pertrochanteric fracture treated with bipolar hemiarthroplasty. Materials and methods: Forty cases of an unstable femur pertrochanteric fracture were analyzed and followed up for average of 19(6~40) months. There were 18 cases fixed with tension band wiring (group 1), 7 cases treated using modified tension band wiring with K-wires (group 2) and 15 cases treated with the GTRD (Greater Trochanteric Reattachment Device) (group 3). Result: Group 1 was treated with simple a surgical procedure and the results were good. The second group had firm fixation postoperatively but required additional surgery in two cases to remove the K-wires because of wire migration after ambulation. Group 3 had relatively good results but required more dissection and a longer operating time. Conclusion: Tension band wiring or GTRD are good fixation methods for reattaching trochanteric fragments in pertrochanteric fractures. Moreover, tension band wiring is recommended for old osteoporotic patients due to a simple procedure and firm fixation. The use of modified tension band wiring using K-wire or a Steinmann-pin should not be used due to the possibility of distant migration.
Femur* ; Hemiarthroplasty* ; Humans ; Retrospective Studies ; Walking

PURPOSE: The purpose of this study was conducted to evaluate the clinical results of proximal tibial plateau fractures treated with open reduction and internal fixation through the lateral submeniscal approach and allowed early motion of the knee and to evaluate the effectiveness of the approach. MATERIALS AND METHODS: From January 1998 to December 2002, fifty four patients who underwent open reduction through the lateral submeniscal approach for proximal tibia plateau fracture and had a follow-up more than one year were included in this study. Clinical results were evaluated by postoperative radiographs taken at the last follow-up and Porter's assessment method. RESULTS: Anatomical reduction was achieved under direct vision through the submeniscal approach in most of the cases in this study. The postoperative radiographs showed anatomical reduction in 32 cases (59%) and adequate reduction with displacement within 2 mm in 20 cases (37%). The clinical evaluation by Porter's assessment method revealed that 49 cases (91%) were acceptable results of excellent or good at the final follow-up CONCLUSION: This study indicates that open reduction and internal fixation through the lateral submeniscal approach can be a good option for proximal tibia plateau fractures because it allows accurate reduction of the articular fractures, which is confirmed directly during operation, identification and repair of associated soft tissue injuries are facilitated, sufficient bone graft and stable fixation of the articular fragments under direct vision allow early motion of the knee.
Follow-Up Studies ; Humans ; Knee ; Soft Tissue Injuries ; Tibia ; Transplants

PURPOSE: The purpose of this study was to evaluate the effects of estrogen on detrusor contraction and the expression of muscarinic receptors in ovariectomized rats. MATERIALS AND METHODS: 24 Sprague-Dawley female virgin rats(12 weeks old) were separated into three groups of 8 rats each. Group I served as a control group, group II was the ovariectomized only rats(Ovx group) and Group III was given estradiol benzoate(0.8mg/kg/day) subcutaneously for 7 consecutive days, beginning 1 week after ovariectomy(Ovx+E group). At the end of the experimental period, each rat was sacrificed and the urinary bladder was removed for contractile studies. The expressions of M2 and M3 receptors in the bladder epithelium and the muscle layer were investigated by performing immunofluorescent staining. RESULTS: The Ovx group showed a significantly decreased bladder contractile function on the KCl and carbachol-induced contractile tests, whereas the Ovx+E group showed increased contractility(p<0.05). The Ovx+E group showed an increase of smooth muscle compared to the other groups. Ovariectomy induced a significant increase in the M3 receptors density in the bladder body, as compared to the control group(p<0.05) but there was no significant difference between the Ovx group and the Ovx+E group. CONCLUSIONS: Bladder dysfunction of menopausal women is thought not to be related with the changes of muscarinic receptors. Our results suggest that the detrusor contractility of menopausal women might be improved after estrogen replacement therapy.
Animals ; Contracts ; Epithelium ; Estradiol ; Estrogen Replacement Therapy ; Estrogens ; Female ; Humans ; Muscle Contraction ; Muscle, Smooth ; Muscles ; Ovariectomy ; Rats ; Receptors, Muscarinic ; Urinary Bladder

BACKGROUND: Propofol often causes pain when injected into small peripheral veins, but the pain can be minimized by using a larger vein. This study was designed to determine whether local warming of the injection site and forearm before propofol injection is effective in reducing pain. METHODS: Sixty adult patients undergoing general anesthesia for an elective surgery were randomly allocated to one of two groups. All were unpremedicated and had an 18-gauge cannula inserted into a cephalic vein on the wrist. Patients in group 1 (n = 30) received 1% propofol at room temperature. Patients in group 2 (n = 30) received 1% propofol after local warming (36-37 degrees C) of the injection site and forearm using a forced-air warming system (Bair Hugger(R)). For each patient, the pain during injection of the propofol solution was graded as none, mild, moderate, or severe. RESULTS: Overall the incidence of pain was significantly reduced in group 2 (36.7%) compared with group 1 (66.7%). No patients complained of pain at the injection site and forearm in group 2. However, there was no significant difference in the incidence or severity of pain on the elbow and axilla between the two groups. CONCLUSIONS: We found that local warming applied to the injection site (wrist) and forearm before propofol injection is significantly effective in reducing pain at the injection site and forearm, but there was no improvement of pain on the elbow and axilla when injecting.
Adult ; Anesthesia, General ; Axilla ; Catheters ; Elbow ; Forearm* ; Humans ; Incidence ; Propofol ; Veins ; Wrist

No abstract available.
Lung Neoplasms* ; Lung*

BACKGROUND: Although the topical application of glycolic acid (GA) could possibly exert some effects on the normal epidermal permeability function, the exact effects and its mechanism of action have not been well documented. OBJECTIVE: This study was conducted to investigate the effects of GA on the expression of epidermal cytokines and to clarify its chelation effect on the epidermal calcium ions, which are known to control the secretion of lamellar bodies. METHODS: After topical application of 70% GA aqueous solution on the flank of hairless mice, the expression of epidermal IL-1alpha and TNF-alpha was assessed and the change of epidermal calcium ions was evaluated. RESULTS: The results could be summarized as the following: (1) real time reverse transcriptase polymerase chain reaction and immunohistochemical staining studies showed increases in mRNA and protein expression of epidermal IL-1alpha and TNF-alpha; (2) the GA reduced intracellular calcium ion concentrations in vitro and resulted in the loss of epidermal calcium gradient in vivo. CONCLUSION: These results suggest that, like iontophoresis or sonophoresis, GA could influence the skin's barrier homeostasis, possibly by lowering the epidermal calcium ions.
Animals ; Calcium* ; Cytokines* ; Homeostasis ; Ions ; Iontophoresis ; Mice ; Mice, Hairless* ; Permeability ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Messenger ; Tumor Necrosis Factor-alpha

PURPOSE: This study evaluated the usefulness of resorbable plate and screw for treatment of maxillofacial bone fractures. PATIENTS AND METHODS: From july, 2000 to july, 2002, we used resorbable plates and screws(Biosorb. FX, Bionix Inc, Finland) on 126 patients for treatment of maxillofacial bone fractures. Among them, 80 patients were capable of periodic following up to present season. We evaluated these patients with clinical, radiographic findings and subjective satisfaction. RESULTS: 80 patients composed of 63 men and 17 women. Complication rates are 7.5%(6/80) recorded. 1 of bulging sensation, 3 of infection sign, 2 of the plate detachment were shown. The plates involved in such complications were removed. The other patients(92.5%) were not shown any problems. We could not find complete resorption of screw holes in the mandibular symphysis area even though two years later after surgery. CONCLUSION: Bioresorbable plates and screws are useful as fixation material at maxillofacial fractures although strength is thought to be weaker than titanium plate. But to reduce the possible complicaions, need to careful clinical and radiographical evaluations.
Female ; Fractures, Bone ; Humans ; Male ; Seasons ; Sensation ; Titanium