No abstract available.
Heart Septal Defects, Ventricular* ; Oximetry*

BACKGROUND AND PURPOSE: This study was undertaken to compare the sensitivity of the Repetitive Nerve Stimulation Test (RNST) between the upper and lower extremity muscles in myasthenia gravis(MG) patients. MATERIALS AND METHODS: The study population consisted of 20 normal persons(control group) and 10 MG patients(MG group). Using Stalberg's method. RNST was systemically performed in orbicularis oculi muscle. upper extremity muscles(flexor carpi ulnaris. abductor digiti quinti), and lower extremity muscles(tibialis anterior. extensor digitorum brevis. vastus medialis). RESULTS: There were statistical differences of decremental response(mean+/-SD) in orbicularis oculi and upper extremity muscles between the control and MG groups(p<0.05 or p<0.01). However, there was no statistical difference of decremental response(mean+/-SD) to RNST in lower extremity muscles between the control and MG groups. There were highersensitivity in orbicularis oculi and upper extremity muscles than lower extremity muscles. Although positive reponse were detected in the lower extremity muscles, the positive response rates of lower extremity muscles were lower than o.oculi and upper extremity muscles. CONCLUSIONS: When the response rates of RNST in facial and upper extremity muscles are normal, may not be required RNST in lower extremity muscles.
Humans ; Lower Extremity* ; Muscles* ; Myasthenia Gravis* ; Upper Extremity

No abstract available.
Erythroblastosis, Fetal* ; Infant, Newborn

Objective: Sarcopenic dysphagia is common in elderly subjects with sarcopenia and dysphagia and is not only the result of aspiration pneumonia but also an important cause of its recurrence. The prevention, assessment, and intervention of sarcopenic dysphagia are thus important aspects in management. Methods: This systematic review aimed to analyze the method and effect of interventions for sarcopenic dysphagia, and to provide clinical evidence for the same. Electronic databases, such as Pubmed, CINAHL, and MEDLINE from 2010 to 2020 were used to research theses. “Sarcopenia” AND (“Sarcopenic dysphagia” OR “Dysphagia” OR “Swallowing disorder”) AND (“Intervention” OR “Therapy” OR “Treatment” OR “Program” OR “Strategy”) were used as the main search terminology. The final seven short-listed theses were used for the analysis. Results: The qualitative level analysis included case reports (six articles), and one group non-randomized study (one article). The most common methods of intervention were nutrition, and physical and swallowing rehabilitation. Furthermore, the intervention was provided with a multidisciplinary approach through the cooperation of experts in various fields. Conclusion We suggest that, in the future, intervention methods could be established by conducting intervention studies with a greater number of subjects. Such studies should be actively carried out and used as clinical evidence for formulating methods for evaluation and intervention in patients with sarcopenic dysphagia.

The duplicated origin of vertebral artery (VA) is a very rare condition. It could be easily misdiagnosed as an arterial dissection on selective catheter angiography, especially in a patient with acute cerebellar infarction of unknown etiology. We report a patient with an acute cerebellar infarction and duplicated origin of the left VA, which was found during the selective catheter angiography.
Angiography ; Catheters ; Humans ; Infarction ; Vertebral Artery*

PURPOSE: The authors evaluated the usefulness of the biochemical markers in the elderly hip fracture patients. MATERIALS AND METHODS: Eighty-two hip fractures above 65 years old were enrolled in this study. Serum level of C-telopeptide, osteocalcin, parathyroid hormone, 25-hydroxyvitamin D, calcium were checked and bone mineral density was assessed by DXA. RESULTS: 83% vitamin D deficiency and 43% calcium insufficiency were observed. There were statistically significance between C-telopeptide and osteocalcin, calcium and 25-hydroxyvitamin D, and calcium and DXA results in the Chi-Square test. Spearmann correlation coefficient results showed that there were statically significant correlations between C-telopeptide and osteocalcin, calcium and DXA results. In the multiple logistic regression analysis results, calcium had the statically significant correlations with DXA results. CONCLUSION: There was correlation between bone turnover markers and vitamin D deficiency, and calcium insufficiency was observed in the elderly hip fracture patients.
Aged* ; Biomarkers* ; Bone Density ; Calcium ; Hip Fractures ; Hip* ; Humans ; Logistic Models ; Osteocalcin ; Osteoporosis ; Parathyroid Hormone ; Vitamin D Deficiency

PURPOSE: The authors evaluated the usefulness of the biochemical markers in the elderly hip fracture patients. MATERIALS AND METHODS: Eighty-two hip fractures above 65 years old were enrolled in this study. Serum level of C-telopeptide, osteocalcin, parathyroid hormone, 25-hydroxyvitamin D, calcium were checked and bone mineral density was assessed by DXA. RESULTS: 83% vitamin D deficiency and 43% calcium insufficiency were observed. There were statistically significance between C-telopeptide and osteocalcin, calcium and 25-hydroxyvitamin D, and calcium and DXA results in the Chi-Square test. Spearmann correlation coefficient results showed that there were statically significant correlations between C-telopeptide and osteocalcin, calcium and DXA results. In the multiple logistic regression analysis results, calcium had the statically significant correlations with DXA results. CONCLUSION: There was correlation between bone turnover markers and vitamin D deficiency, and calcium insufficiency was observed in the elderly hip fracture patients.
Aged* ; Biomarkers* ; Bone Density ; Calcium ; Hip Fractures ; Hip* ; Humans ; Logistic Models ; Osteocalcin ; Osteoporosis ; Parathyroid Hormone ; Vitamin D Deficiency

PURPOSE: The purpose of this study was to evaluate the usefulness of our method, which estimated femoral stem alignment using a c-arm when the broach was inserted, for prevention of femoral stem malalignment. MATERIALS AND METHODS: A total of 103 hips were enrolled in this study. All patients underwentprimary hip arthroplasty from October 2011 to February 2013. The study was conductedretrospectively. Intraoperative estimated femoral stem alignments and final femoral stem alignments were classified into three groups. Multinomial logistic regression analysis was performed for analysis of factors (age, sex, diagnosis, body mass index, femoral stem size, osteoporosis, and proximal demur geometry) thatmight affect intraoperatively estimated femoral stem alignment. RESULTS: The distribution of intraoperative estimated femoral stem alignment was 80(78%) in the neutral group, 18(17%) in the varus group, and 5(5%) in the valgus group. The distribution of final femoral stem alignment was 100(97%) in the neutral group, 2(2%) in the varus group, and 1(1%) in the valgus group. There was no statistically significant factor affecting the intraoperatively estimated femoral stem alignment. CONCLUSION: Intraoperative estimated femoral stem alignment using a c-arm is an effective method for prevention of femoral stem malalignment.
Arthroplasty ; Body Mass Index ; Hip ; Humans ; Logistic Models ; Osteoporosis

BACKGROUND: The concept of the effect-site concentration of anesthetic agents is important. The effect compartment model can be explained using the concepts of effect-site concentration and effect-site equilibration rate constant (k e0). This study confirms that the time-to-peak effect (tpe ) can be measured easily in clinical practice by applying a priming dose and train-of-four (TOF) during general anesthesia induction, and k e0 can be calculated from the tpe of the four muscle relaxants that are commonly used in general anesthesia. METHODS: Eighty patients who received general anesthesia were divided into the succinylcholine, rocuronium, atracurium, or vecuronium groups. Priming doses of muscle relaxants were administered. The effects of muscle relaxants were quantified by recording the twitch response of the adductor pollicis muscle after stimulating the ulnar nerve. The tpe was measured at the lowest TOF value. k e0 was calculated from the measured tpe . RESULTS: The k e0 values of the succinylcholine, rocuronium, atracurium, and vecuronium groups were 0.076 (0.030)/min, 0.228 (0.122)/min, 0.062 (0.011)/min, and 0.077 (0.019)/min, respectively. CONCLUSIONS: It is possible to estimate k e0 from the tpe of muscle relaxants using a priming dose and TOF during general anesthesia induction.
Anesthesia, General* ; Anesthetics ; Atracurium ; Humans ; Succinylcholine ; Ulnar Nerve ; Vecuronium Bromide

PURPOSE: Various therapeutic approaches have been suggested for preventing or reducing the adverse effects of topical glucocorticoids, including skin barrier impairment. Previously, we have shown that impairment of skin barrier function by the highest potency topical glucocorticoid, clobetasol 17-propinate (CP), can be partially prevented by co-application of a physiological lipid mixture containing pseudoceramide, free fatty acids, and cholesterol (multi-lamellar emulsion [MLE]). Skin atrophic effects of CP were also partially reduced by MLE. In this study, the preventive effects of MLE on the lowest potency topical glucocorticoid, hydrocortisone (HC), were investigated using animal models. METHODS: Anti-inflammatory activity of topical HC was evaluated using a 12-O-tetradecanoylphobol-13-acetate-induced skin edema model. Topical steroid induced adverse effects were evaluated using hairless mouse. RESULTS: The results showed that the anti-inflammatory activity was not altered by co-application of either MLE or hydrobase. However, co-application of MLE and 1.0% HC showed less impairment in the epidermal permeability barrier function, skin hydration, and skin surface pH compared with hydrobase. Stratum corneum integrity, evaluated by measuring trans-epidermal water loss after repeated tape stripping, showed less damage with MLE co-application. Long-term application of topical HC induced skin atrophy, measured by a reduction in skinfold and epidermal thickness and in the number of epidermal proliferating cell nucleus antigen (PCNA)-positive keratinocytes. Co-application of MLE did not affect the skinfold or epidermal thickness, but the number of PCNA-positive keratinocytes was less decreased with MLE use. CONCLUSIONS: These results suggest that co-application of MLE is effective in reducing the local adverse effects of low-potency topical glucocorticoids and supports the therapeutic efficacy of physiological lipid mixtures on skin barrier function.
Animals ; Atrophy ; Cell Nucleus ; Cholesterol ; Clobetasol ; Edema ; Fatty Acids, Nonesterified ; Glucocorticoids ; Hydrocortisone ; Hydrogen-Ion Concentration ; Keratinocytes ; Permeability ; Skin ; Steroids ; Water Loss, Insensible