BACKGROUND: The neuropathy disability score (NDS) is a type of clinical grading method for diabetic polyneuropathy. In clinical practice, a nerve conduction study (NCS) is routinely employed as a non-invasive test for the evaluation of polyneuropathy. However, the consensus regarding the degree of abnormalities in NCS as a parameter for the severity of the disease is lacking. The objective of our study is to assess the relation between NDS and NCS parameters and thus verifying the reliability of our new NCS grading method in the representation of objective neurological defects. METHODS: Seventy three patients (man 31, women 42) with diabetes mellitus were included in the study. The NDS was scored in each patient by a single examiner and a NCS was performed on one side of extremities by an experiencedtechnician. Also, the gastrocnemius-soleus H-reflex was performed and analysed for the representation of a deep tendon reflex. The observed values of CMAP and CNAP were transformed into square root and log values. The transformed individual amplitudes and nerve conduction velocities were graded in relation to the mean normal values and standard deviations of our control group study. Then, the sum of the graded score was calculated in each individual and was correlated to the NDS using correlational analysis. RESULTS: There has been a significant linear relationship between NDS and our new NCS scoring system (Pearson's correlation coefficient r=0.703, p<0.01) CONCLUSIONS: The study showed significant correlations between NDS and our new grading system for NCS. Thus, NCS appears to reliably represent theobjective neurologic findings. In asddition, the quantititive grading of NCS would be useful in determining the grade of peripheral polyneuropathy in diabetic patients.
Consensus ; Diabetes Mellitus ; Diabetic Neuropathies* ; Extremities ; Female ; H-Reflex ; Humans ; Neural Conduction ; Neurologic Manifestations ; Polyneuropathies ; Reference Values ; Reflex, Stretch

We examined the clinical results of silicone IOL[SI-30NB]for 3 years or more. A total of 50 eyes underwent phacoemulsification and foldable silicone posterior chamber lens implantation through 3.2 millimeter temporal clear corneal incision. Preoperative and post-operative intraocular pressure, visual acuity, corneal astigmatism and complications were evaluated. More than 94%of all cases showed best corrected visual acuity better than 20/40 and intraocular pressure was decreased for 2 months. At 1 day after operation, mean surgically induced astigmatism was minimal[0.64 +/-1.42]and recovered fast. Posterior capsular opacity was found in 26%;however, Nd-YAG laser capsulotomy was performed in 18%. In conclusion, foldable silicone lens implantation through 3.2 millimetertemporal clear corneal incision revealed a low incidence of complication, minimally induced astigmatism, and rapid visual rehabilitation.
Astigmatism ; Follow-Up Studies* ; Incidence ; Intraocular Pressure ; Lasers, Solid-State ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Phacoemulsification ; Rehabilitation ; Silicones ; Visual Acuity

OBJECTIVE: T(-)-Epigallocatechin gallate(EGCG) `a green tea polyphenol' is a potent antioxidant and known to reduce the free radical-induced lipid peroxidation. In our previous study, systemic administration of EGCG immediately after ischemia has been shown to inhibit the hippocampal neuronal damage in the gerbil model of global ischemia. Polyamines, especially putrescine(PU) is thought to be important in the generation of brain edema and neuronal cell damage associated with various types of excitotoxic neuronal injury. We investigate the effects of delayed administration of EGCG on the changes in polyamine levels and neuronal damage after transient global ischemia in gerbils. METHODS: To produce transient global ischemia, both common carotid arteries were occluded for 3 min with micro-clips. The gerbils were treated with EGCG(50mg/kg, i.p.) immediately or 2hr after ischemia. Putrescine levels were examined in the cerebral cortex and hippocampus 24 hours after ischemia using high performance liquid chromatography. RESULTS: PU levels in the cerebral cortex and hippocampus were increased significantly after the ischemia. The administrations of EGCG immediately after the ischemia attenuated the ischemia-induced increase of PU level, however, 2 hr delayed EGCG administration did not reduce the increase of PU level. EGCG administered immediately or 2 hr after ischemia significantly reduced neuronal damage in the hippocampal CA1 region, respectively. CONCLUSION: These findings suggest that EGCG may has a promise in the management of stroke.
Brain Edema ; CA1 Region, Hippocampal ; Carotid Artery, Common ; Cerebral Cortex ; Chromatography, Liquid ; Gerbillinae* ; Hippocampus ; Ischemia* ; Lipid Peroxidation ; Neurons* ; Polyamines ; Putrescine* ; Stroke ; Tea*

Instrumentation for periodontal therapy may induce marginal damage which increases plaque accumulation and result in periodontal disease. But there have not been many reports of instrumentations on the artificial crown so far. Therefore this study is conducted to evaluate the effects of various repeated instrumentations on the porcelain crown marginal portion. Of the 10 extracted periodontally diseased maxillary first premolars, were 12 proximal surface used in this study. The finishing line of the preparation was placed on the root surface below CEJ and then the crown was cast and cemented in usual manner. Every 4 surfaces of the 3 instruments-curet, ultrasonic scaler, and ultrasonic curet- is used. and four samples used in each instruments. The relevant procedures and measurements were repeated 3 times in each surfaces. Marginal gap is measured by the microscope and surface roughness, Scannig Probe Microscope. Measurements are made at 5 points in each surfaces, making 20 points in each instrument. The results evaluated statistically were as follows 1. As instrumentation was repeated, both marginal gap and roughness were increased in all group 2. In the hand curet, marginal gap was increased every instrumentation and roughness was increased after second. 3. In the ultrasonic scaler, both marginal gap and roughness were increased every instrumentation. 4. In the ultrasonic curet, marginal gap was increased after third instrumentation and roughness was increased after second. 5. Marginal gap and roughness used by the ultrasonic curet were lower than the others and no difference was seen between the hand curet and ultrasonic scaler From the results of this study, the ultrasonic curet was useful in some aspect, but careful instrumentation was needed. Furthermore it was important to minimize the instrumentation through complete periodontal therapy before setting and adequate plaque control.
Bicuspid ; Crowns* ; Dental Porcelain* ; Hand ; Periodontal Diseases ; Tooth Cervix ; Ultrasonics

Instrumentation for periodontal therapy may induce marginal damage which increases plaque accumulation and result in periodontal disease. But there have not been many reports of instrumentations on the artificial crown so far. Therefore this study is conducted to evaluate the effects of various repeated instrumentations on the porcelain crown marginal portion. Of the 10 extracted periodontally diseased maxillary first premolars, were 12 proximal surface used in this study. The finishing line of the preparation was placed on the root surface below CEJ and then the crown was cast and cemented in usual manner. Every 4 surfaces of the 3 instruments-curet, ultrasonic scaler, and ultrasonic curet- is used. and four samples used in each instruments. The relevant procedures and measurements were repeated 3 times in each surfaces. Marginal gap is measured by the microscope and surface roughness, Scannig Probe Microscope. Measurements are made at 5 points in each surfaces, making 20 points in each instrument. The results evaluated statistically were as follows 1. As instrumentation was repeated, both marginal gap and roughness were increased in all group 2. In the hand curet, marginal gap was increased every instrumentation and roughness was increased after second. 3. In the ultrasonic scaler, both marginal gap and roughness were increased every instrumentation. 4. In the ultrasonic curet, marginal gap was increased after third instrumentation and roughness was increased after second. 5. Marginal gap and roughness used by the ultrasonic curet were lower than the others and no difference was seen between the hand curet and ultrasonic scaler From the results of this study, the ultrasonic curet was useful in some aspect, but careful instrumentation was needed. Furthermore it was important to minimize the instrumentation through complete periodontal therapy before setting and adequate plaque control.
Bicuspid ; Crowns* ; Dental Porcelain* ; Hand ; Periodontal Diseases ; Tooth Cervix ; Ultrasonics

Boerhaave's syndrome has the worst prognosis of the esophageal perforation, despite the advancement in the treatment of esophageal perforation due to the development of ICU care and antibiotics. There were controversies in the treatment of esophageal perforation when diagnosed after 24hrs. From 1995 to 2000, we performed a buttressed primary repair and mediastinal drainage in 6 Boerhaave's syndrome patients among 13 esophageal perforation patients. Two patients died(33%). They died because of pneumonia, ARDS and sepsis on 38th, 39th post-operative day respectively. Two patients had leak at the site of repair which was treated completely with conservative treatment. We report on the result of a buttressed primary repair and mediastinal drainage for 6 Boerhavve's syndrome patients.
Anti-Bacterial Agents ; Drainage ; Esophageal Perforation ; Esophagoplasty ; Humans ; Pneumonia ; Prognosis ; Sepsis

Methyl bromide is presently used as a fumigant for insects in soil, grains or fruit in storage or transport. It is a neurotoxic agent and has been responsible a number of deaths or acute poisonings among occupationally exposed persons. We report 2 patients, who had worked fumigation warehouse, presented with seizures and altered mental state. The serum concentrations of bromide were elevated 32.9 and 42.5 mg/l, respectively. Brain MRI showed bilateral symmetric high signal intensities in the splenium of corpus callosum, the globus pallidus, the quadrigeminal plate, the periaqueductal gray matter, the red nucleus, the substantia nigra, the medial lemniscus, the pontine tegmentum, the dentate nucleus, and the medulla. There was no brain lesion in the other patient. Appropriate and supervised handling of the chemical and regular education to workers are important to avoid the risk of methyl bromide poisoning.
Brain ; Edible Grain ; Cerebellar Nuclei ; Corpus Callosum ; Education ; Fruit ; Fumigation ; Globus Pallidus ; Humans ; Insects ; Magnetic Resonance Imaging ; Occupations ; Periaqueductal Gray ; Poisoning ; Red Nucleus ; Seizures* ; Soil ; Substantia Nigra ; Tectum Mesencephali

Few patients with traumatic aortic laceration remain undiagnosed and survive long enough to develop a chronic aneurysm. Such aneurysms are frequently asymptomatic: alternatively, they may manifest chest pain, dysphagia, bronchial irritation, or sudden death. A case of aortobronchial fistula secondary to a chronic post-traumatic aneurysm of the aortic isthmus is presented. Hemoptysis was the main sign. The affected segment of the thoracic aorta was repaired with a Hemashield patch and a left upper lobectomy was performed.
Aneurysm ; Aorta, Thoracic ; Chest Pain ; Death, Sudden ; Deglutition Disorders ; Fistula* ; Hemoptysis ; Humans ; Lacerations ; Thorax*

OBJECTIVES: This study was designed to examine whether melatonin has a neuroprotective effect against hippocampal neuronal damage following transient global ischemia in a gerbil. Polyamine is known to play a role in the pathophysiology of ischemic neuronal damage, we evaluated the influences of melatonin on the polyamine level as well as histology. MATERIAL AND METHODS: Male Mongolian gerbils (60-80 g) were used in this study. Transient global ischemia was induced by occlusion of the bilateral common carotid arteries for 3 min with microclips. Melatonin was administered immediately after occlusion. The animals were decapitated 24 h after the occlusion for polyamine measurement by a high performance liquid chromatography (HPLC) and 4 days after the occlusion for histological evaluation (hematoxylin and eosin staining). A histological examination was performed by a blinded investigator. RESULTS: The hippocampal putrescine level increased compared to sham-operated animals and the increase of putrescine was attenuated by 20 mg/kg melatonin administration. Spermidine and spermine levels didn't show significant changes after ischemia. Hippocampal neuronal damage in the CA1 region was markedly observed in vehicle-treated animals compared to sham-operated animals. Melatonin administration (10 or 20 mg/kg) significantly inhibited hippocampal CA1 neuronal damage after ischemia compared to corresponding vehicle-treated animals (p<0.05 and p<0.01, respectively). CONCLUSION: Melatonin attenuates the putrescine level after transient global ischemia and may have putative neuroprotective effects against global ischemia induced neuronal damage.
Animals ; Brain* ; Carotid Artery, Common ; Chromatography, Liquid ; Eosine Yellowish-(YS) ; Gerbillinae* ; Hippocampus ; Humans ; Ischemia* ; Male ; Melatonin* ; Neurons* ; Neuroprotective Agents ; Putrescine ; Research Personnel ; Spermidine ; Spermine

BACKGROUND AND SIGNIFICANCE: Cytomegalovirus(CMV) is the most common opportunistic viral agent encountered in AIDS and its relation to peripheral neuropathy and rapidly developing lumbosacral polyradiculopathy has been well documentated. CASE: A 30-year-old man with acquired immune deficiency syndrome presented with rapidly progressive paraplegia and voiding difficulty. Electrophysiologic studies revealed a lumbosacral polyradiculopathy with loss of bulbocavernous reflex and CSF examination showed polymorphonuclear pleocytosis with elevated protein level. Also, spinal T1-weighted MRI with gadolinium-DTPA showed enhancement of the pial lining of the conus medullaris, cauda equina, and lumbar nerve roots. Anti CMV titers were elevated in CSF and culture for CMV in both blood and urine was positive. The patient was treated with ganciclovir. CONCLUSION: We report a case of polyradiculopathy related to CMV in a patient with acquired immune deficiency syndrome(AIDS). It seems to be important to differentiate this unique syndrome from other causes of rapidly developing paraplegia syndromes among AIDS patients.
Acquired Immunodeficiency Syndrome* ; Adult ; Cauda Equina ; Conus Snail ; Cytomegalovirus* ; Ganciclovir ; Humans ; Leukocytosis ; Magnetic Resonance Imaging ; Paraplegia ; Peripheral Nervous System Diseases ; Polyradiculopathy* ; Reflex