No abstract available.
Chungcheongbuk-do* ; Leptospira interrogans* ; Leptospira*

Hemimasticatory spasm is a rare neurologic disorder characterized by unilateral, paroxysmal involuntary contraction of the masticatory muscles. It can be confused with other unilateral facial spasms. In this report, we present two patients with hemimasticatory spasm who were initially misdiagnosed with other disorders. The first patient was a 54-year-old man with a 9-year history of right facial spasm. He underwent microvascular decompression, without benefit, at another hospital with the diagnosis of hemifacial spasm two years prior to presenting at our hospital.On examination, right masseter and temporalis muscles had irregular contractions with twitches and prolonged spasms. His brain magnetic resonance imaging was normal.He showed a good response to carbamazepine. The second case was a 60-year-old man presented with a 10-year history of jaw-closing movement. Previous treatment for temporomandibular joint disorder was ineffective. He was previously diagnosed as oromandibular dystonia at another hospital, and biperiden and diazepam treatment resulted in slight improvement. There was tonic contraction and hypertrophy of the left masseter. He improved with carbamazepine. These cases illustrate the importance of hemimasticatory spasm as differential diagnosis, and the good response to carbamazepine.
Nervous System Diseases

PURPOSE: The committee on trauma of the american college of surgeons, in its manual resources for optimal care of the injured patients involved in falls from less than 20 feet need not be taken to trauma centers. Because triage criteria dictate less urgency for low-level falls, this classification scheme has demerits for early detection and treatment of serious problems in the emergency room. METHODS: A prospective analysis was conducted of 182 patients treated for fall-related trauma from June 2003 to March 2004. Falls were classified as group A (<3 m), group B (> or =3 m, <6 m), and group C (> or =6 m). Collected data included the patient's age, gender, site and height of fall, surface fallen upon, body area of first impact, body regions of injuries, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and Injury Severity Score (ISS). RESULTS: The 182 patients were classified as group A (105) 57.7%, group B (61) 33.5%, and group C (16) 8.8%. There was a weak positive correlation between the height of fall and the patients'ISS in the three groups (p<0.001). There were significant differences in GCS (p=0.017), RTS (p=0.034), and ISS (p=0.007) between group A and B. In cases that the head was the initial impact area of the body, the GCS (p<0.001) and the RTS (p=0.002) were lower, but the ISS (p<0.001) was higher than it was for other type of injuries. Hard surfaces as an impact surface type, had an influence on the GCS (p<0.001) and the ISS (p=0.025). CONCLUSION: To simply categorize patients who fall over 6 meters as severely injured patients doesn't have much meaning, and though patients may have fallen less than 6 meters, they should be categorized by using the dynamics (impact surface type, initial body-impact area) of their fall.
Body Regions ; Classification ; Emergency Service, Hospital ; Foot ; Glasgow Coma Scale ; Head ; Humans ; Injury Severity Score ; Prospective Studies ; Trauma Centers ; Triage

PURPOSE: To evaluate the long-term clinical outcomes of retinal pigment epithelium (RPE) tears after intravitreal injection of anti-vascular endothelial growth factor (VEGF) agent for the treatment of neovascular age-related macular degeneration (AMD). METHODS: The authors performed a retrospective chart review of 13 eyes of 13 patients who developed RPE tears after intravitreal anti-VEGF injection between February 2009 and June 2013. We investigated continuation of the treatment after tear, visual acuity, presence of cystoid macular edema, and central macular thickness (CMT) using optical coherence tomography (OCT) before and after treatment and visual outcomes depending on foveal sparing. RESULTS: After RPE tear, 12 of 13 patients continued injection of an anti-VEGF agent. The average number of injections was 6.08 +/- 5.18. Mean visual acuity immediately after tear was 1.65 +/- 0.8 log MAR, and that at the last visit was 1.82 +/- 0.88 log MAR. Nine eyes with macular edema in OCT continued receiving injection, and improvement of macular edema was observed in four eyes at the final visit. The final visual acuity of patients with foveal involvement was 2.17 +/- 0.49 log MAR, which was worse than the 1.51 +/- 1.06 log MAR in patients without foveal involvement, although the difference was not significant (p = 0.295). CONCLUSIONS: When anti-VEGF injections were continued after RPE tear, no improvement in visual acuity was observed, although better anatomical outcomes did result. Patients with foveal involvement had worse visual acuity than patients without foveal involvement, but the difference was not significant.
Endothelial Growth Factors ; Humans ; Intravitreal Injections ; Macular Degeneration* ; Macular Edema ; Retinal Pigment Epithelium ; Retinaldehyde* ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity

BACKGROUND: It is understood that amylase is poor and lipase is a little better than amylase in specificity for the diagnosis of acute pancreatitis. But we recognized that the general knowledge was resulted from the study of inappropriate design of some researchers. So, we tried to find out the true diagnostic value of amylase and lipase by the study of appropriate design, and with the above result, evaluated the usefulness of lipase as a diagnostic test for acute pancreatitis. METHODS: We reviewed the serum levels of the amylase and lipase in 33 patients complaining acute abdominal pain diagnosed as acute pancreatitis by image study (computed tomography, ultrasonography) , and in the 134 patients of control group who, with abdominal pain, were diagnosed finally as non-pancreatic disease at discharge after admission and treatment. Serum amylase and lipase activity were measured by aca IVTM (Chiron Inc.). RESULTS: The sensitivity of amylase and lipase for the diagnosis of acute pan creatitis was 81.8% and 87.8%, respectively. The specificity of amylase and lipase for the diagnosis of acute pancreatitis was 92.5% and 86.5%, respectively. The sensitivity and specificity was 84.6% and 96.3% respectively, when two enzymes were combined by 'and' strategy. The lipase activity remained elevated longer than the amylase in acute pancreatitis. CONCLUSIONS: On the contrary of the general knowledge, sensitivities and specificities of the amylase and lipase were fairy high and didn't show big dirt ferences between two enzymes. Though only one of the two enzymes could be selected for the diagnosis of acute Pancreatitis, using both of the enzymes increased the specificity, and lipase was useful to detect the patient who came to hospital a few days later after the onset of symptom.
Abdominal Pain ; Amylases ; Diagnosis* ; Diagnostic Tests, Routine ; Humans ; Lipase* ; Pancreatitis* ; Sensitivity and Specificity

No abstract available.
Malaria*

The usefulness of hyperthermia for cancer therapy has been established. The purpose of the present investigation was to access feasibility of heating normal lung and the temperature and power requirement were compared with that for liver as solid organ in rabbits by using radiofrequent heating machine. In this study, 20 rabbits were divided into 2 groups according to the heating site and the method of temperature measurement ; in group I : lung heating and temperature measuring in skin, esophagus and lung parenchyme ; in group ll : liver heating and temperature measuring in skin and liver parenchyme. The results were as follows ; 1) When the maximum temperature was almost same in lung heating group and liver heating group, the power for liver heating was lesser required than the power for lung heating (p<0.05). 2) The temperature of esophagus for the measurement of mediastinum temperature was 1.1+/-0.9 degrees C higher than the temperature of lung parenchyme (p<0.05). Therefore the above findings suggest lung, air containing organ, is well heated as same as liver, solid organ. So more active trials of lung heating in the lung cancer must be likely considered. But whets the lung is heated, the esophageal temperature is higher than lung parenchyme, so the mediastinum damage must be considered seriously.
Esophagus ; Fever ; Heating* ; Hot Temperature* ; Liver ; Lung Neoplasms ; Lung* ; Mediastinum ; Rabbits ; Skin

No abstract available.
Arthrogryposis*

The cauda equina syndrome is a relatively uncommon, but serious complication. And it can have grave long-term consequences for the patient. The purpose of the study is to analyse the causes, clinical courses and to find the methods of prevention of cauda equina syndrome following lumbar spine surgery. We reviewed 6 cases among 287 patients wbo had been operated on and followed for minimum 12 months at Seoul Adventist Hospital from March 1991 to March 1996. The obtained results were as follows. 1. All six cases was noted only in patients who had operative procedures for spinal stenosis and possible causes were 3 cases of epidural hamatoma, 1 case of unrecognized and recurred disc herniation, 1 case of retained ligament flavum and 1 case of pseudomeningocele formation due to unrecognized dura tear. 2. Progressive neurologic deficits, decreased perianal sensation and loss of anal wink were present in all cases and were diagnostic. 3. Only three cases which were occurred within 24 hours and early treated within 12 hours, had no specific residual neurologic deficits. In conclusion, it is recommended that operators should be very cautious during the spine surgery. And also early recognition and surgical decompression is very important. During early postoperative periods, only repeated and regular neurologic examinations will enable early diagnosis and treatment to reduce permanent neurological damage.
Cauda Equina* ; Decompression, Surgical ; Early Diagnosis ; Humans ; Ligaments ; Neurologic Examination ; Neurologic Manifestations ; Polyradiculopathy* ; Postoperative Period ; Sensation ; Seoul ; Spinal Stenosis ; Spine* ; Surgical Procedures, Operative

No abstract available.
Fibrin*