No abstract available.
De Lange Syndrome*

STUDY DESIGN: A retrospective study. OBJECTIVES: To compare the outcome of percutaneous vertebroplasty (VP), with kyphoplasty, in the treatment of osteoporotic painful vertebral compression fractures (VCF). SUMMARY OF LITERATURE REVIEW: There is much controversy relating to the treatment of painful osteoporotic VCF. Recent analytical data exists on VP and kyphoplasty. MATERIALS AND METHODS: A consecutive group of patients, undergoing VP and kyphoplasty at our institution, between July 2000 and November 2002, were retrospectively reviewed. A total of 23 patients underwent 25 VP procedures under local anesthesia, and 8 underwent 8 kyphoplasty procedures, 3 under general and 5 under local anesthesia. A radiological assessment was achieved by the percentage of height restored, using both the preoperative and postoperative radiographs. The Visual analog scale (VAS) scores, obtained pre and postoperatively were used for the clinical assessment. The activity levels were assessed preoperatively, after discharge and at the last follow up period, by the ambulatory stati. RESULTS: The VP restored 27.62% (anterior*) and 30.26% (middle**) of the lost height. The kyphoplasty restored 35.52% (anterior*) and 53.43% (middle**) of the lost height (P=0.3334*, P=0.0264**). The postoperative pain was improved in all patients after both procedures. The postoperative VAS score was 3.826 after the VP and 2.875 after the kyphoplasty (P=0.5647). The activity levels were improved in all patients after both procedures. CONCLUSIONS: The kyphoplasty was more efficient in restoring the middle vertebral body height than the VP in the treatment of osteoporotic painful VCF. However, both procedures showed similar clinical improvements in the pain and restoration of the anterior vertebral body height in the treatment of painful osteoporotic VCF. Both kyphoplasty and VP safely increased the vertebral body height, decreased the acute back pain and quickly returned geriatric patients to higher activity levels, resulting in an increased independence and quality of life.
Anesthesia, Local ; Back Pain ; Body Height ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Kyphoplasty* ; Osteoporosis ; Pain, Postoperative ; Quality of Life ; Retrospective Studies ; Vertebroplasty* ; Visual Analog Scale

A 75-year old man with esophageal cancer presented with mental status change and seizures. He was under cisplatinand developed several times of generalized tonic-clonic seizures. The EEG (electroencephalography) showed triphasic waves and slowed background activity. He was diagnosed with status epilepticus and encephalopathy caused by cisplatin. He was treated with anticonvulsants and cisplatin was replaced by docetaxel. His mentality recovered completely and he had no more seizure. We conclude that physician using cisplatin should be aware of this rare complication.
Anticonvulsants ; Cisplatin ; Electroencephalography ; Esophageal Neoplasms ; Seizures ; Status Epilepticus ; Taxoids

Resveratrol has been known to possess various potent cardiovascular effects in animal, but there is little information on its functional effect on the secretion of catecholamines (CA) from the perfused model of the adrenal medulla. Therefore, the aim of the present study was to determine the effect of resveratrol on the CA secretion from the isolated perfused model of the normotensive rat adrenal gland, and to elucidate its mechanism of action. Resveratrol (10~100micrometer) during perfusion into an adrenal vein for 90 min inhibited the CA secretory responses evoked by ACh (5.32 mM), high K+ (a direct membrane-depolarizer, 56 mM), DMPP (a selective neuronal nicotinic Nn receptor agonist, 100micrometer) and McN-A-343 (a selective muscarinic M1 receptor agonist, 100micrometer) in both a time- and dose- dependent fashion. Also, in the presence of resveratrol (30micrometer), the secretory responses of CA evoked by veratridine 8644 (an activator of voltage-dependent Na+ channels, 100micrometer), Bay-K-8644 (a L-type dihydropyridine Ca2+ channel activator, 10micrometer), and cyclopiazonic acid (a cytoplasmic Ca2+ -ATPase inhibitor, 10micrometer) were significantly reduced. In the simultaneous presence of resveratrol (30micrometer) and L-NAME (an inhibitor of NO synthase, 30micrometer), the CA secretory evoked by ACh, high K+, DMPP, McN-A-343, Bay-K-8644 and cyclopiazonic acid were recovered to a considerable extent of the corresponding control secretion compared with the inhibitory effect of resveratrol alone. Interestingly, the amount of nitric oxide (NO) released from the adrenal medulla was greatly increased in comparison to its basal release. Taken together, these experimental results demonstrate that resveratrol can inhibit the CA secretory responses evoked by stimulation of cholinergic nicotinic receptors, as well as by direct membrane-depolarization in the isolated perfused model of the rat adrenal gland. It seems that this inhibitory effect of resveratrol is exerted by inhibiting an influx of both ions through Na+ and Ca2+ channels into the adrenomedullary cells as well as by blocking the release of Ca2+ from the cytoplasmic calcium store, which are mediated at least partly by the increased NO production due to the activation of NO synthase.
(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethylammonium Chloride ; 3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; Adrenal Glands ; Adrenal Medulla ; Animals ; Calcium ; Catecholamines ; Cytoplasm ; Dihydropyridines ; Dimethylphenylpiperazinium Iodide ; Indoles ; Ions ; Neurons ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Perfusion ; Rats ; Receptor, Muscarinic M1 ; Receptors, Cholinergic ; Receptors, Nicotinic ; Stilbenes ; Veins ; Veratridine

No abstract available.
Catheters* ; Dilatation* ; Esophageal Stenosis*

OBJECTIVE: To evaluate clinical features in general and possible complications in Duchenne muscular dystrophy (DMD) which could be used for comprehensive rehabilitation management. METHOD: One hundred and seventy-two patients with DMD were followed over 3 year period to provide clinical profile causing impairment and disability. We measured height, weight and manual muscle testing (MMT) when the patients visited the hospital. And we could measure pulmonary function, electrocardiogram (EKG), and intelligence quotient (IQ) test in cooporative patients. RESULTS: The median height and weight of DMD boys were normally distributed before age 12, but during the second decade height was markedly reduced, and weight was no longer normally distributed. The MMT measurement showed loss of strength in a fairly linear fashion according to increasing age, and extensor of lower extremities were weaker than flexors showing typical contractures of legs. There was a direct relationship between pulmonary function and MMT scores of upper extremities. There was a high occurrence (40%) of abnormal EKG, but none of the patients had a history of cardiovascular complication. DMD children suffered wide spectrum of psychological disturbance such as somatic complaints, attention and emotional problems in addition to expected psychological problems due to chronic disease and its progression, and 50.9% of them were below average on the IQ test. CONCLUSION: These data on DMD subjects provide clinicians with useful information regarding the prevalence and severity of measurable impairment at different stages of the disease.
Child ; Chronic Disease ; Contracture ; Electrocardiography ; Humans ; Intelligence ; Leg ; Lower Extremity ; Muscular Dystrophy, Duchenne* ; Prevalence ; Rehabilitation ; Upper Extremity

We have determined and analyzed the full-length cDNA sequence of a coxsackievirus B3 (CVB3) Korean isolate (CVB3-Korea/97) which has been known as a general human pathogen. The whole genome contains 7,400 nucleotides and has a single large open reading frame with 6,555 nucleotides that encodes a potential polyprotein precursor of 2,185 amino acids. The genome also contains a 5' non-coding region (NCR) of 741 bases and a 3' NCR of 104 bases followed by poly(A) tail. Sequence homologies of nucleotides and deduced amino acids between the CVB3-Korea/97 strain and the prototype (Nancy strain) were 81.7% and 91.5%, respectively. The genes encoding the functional proteins including viral protease and RNA dependent RNA polymerase showed higher homology than those encoding the structural proteins. We have further analyzed the sequences of 5' NCR, VP1 and VP2 of CVB3-Korea/97, which are known as cardiovirulent determining factors at the nucleotide and amino acid levels. Although the CVB 3-Korea/97 strain was isolated from an aseptic meningitis patient without cardiomyopathy, its 234th nucleotide and 165th amino acid were uracil and Asn as same as those of other cardiovirulent strains one. However, the 155th amino acid of VR1, which closely associated with cardiovirulence, was replaced with Arg155 by single nucleoptide substitution from A2916 to T2916. Moreover, additional amino acid substitutions were observed in the flanking region of Asp155. Taken together, aminoacid(s) substitution in VP1 may play a critical role in determining cardiovirulence of the CVB3-Korea/97 strain rather than individual nucleotide replacements in the 5' NCR and/or an amino acid substitution in VP2.
Amino Acid Substitution ; Amino Acids ; Cardiomyopathies ; Clone Cells* ; Cloning, Organism* ; DNA, Complementary* ; Genome ; Humans ; Korea* ; Meningitis, Aseptic ; Nucleotides ; Open Reading Frames ; RNA Replicase ; RNA, Messenger ; Sequence Analysis* ; Sequence Homology ; Uracil

Recently, the incidence of fungal infection increases because of immunosuppressive therapy and chemotherapy. In immunosuppressed transplant recipients, Aspergillus can be a dangerous pathogen, capable of inducing fulminant clinical disease. Invasive fungal infections are life-threatening complications in solid-organ transplantation. Although the rate of fungal infections in transplant recipients is lower than that of other infections, the mortality rate is higher. A 34 year-old male was admitted to our hospital with fever and gross hematuria. He had received renal transplantation 2 years ago and had been transferred the other hospital 1 month ago. Initial laboratory data evaluation showed a pancytopenia and azotemia. We thought that pancytopenia was caused by immunosuppressive agents and infection. The patient was treated with antibiotics but fever was not subsided. After 4 days, he complained of transplant site pain and tenderness to percussion. A percutaneous renal biopsy was performed. Microscopic examination showed invasive aspergillosis in transplanted kidney and perirenal area. We removed the transplanted kidney and perirenal tissue, and prescribed antifungal agents for 3 months.
Anti-Bacterial Agents ; Antifungal Agents ; Aspergillosis ; Aspergillus ; Azotemia ; Biopsy ; Fever ; Hematuria ; Humans ; Immunosuppressive Agents ; Incidence ; Kidney ; Kidney Transplantation ; Male ; Pancytopenia ; Percussion ; Transplants

Systemic erythematous lupus is a systemic inflammatory autoimmune disease that develops from drug, viral, or chemical irritants. We report a case of lupus-like syndrome after kidney transplantation with an unknown cause. A 55-year-old woman was admitted with severe myalgia, fever, and arthralgia 2 days previously. She had received a kidney transplantation 8 years ago, because an acute kidney injury had progressed to chronic kidney disease. After transplantation, she had no problems. We performed blood, urine, and sputum cultures but could found no microorganisms. We suspected a connective tissue disease, such as adult Still's disease, and performed autoantibody testing. As a result, antinuclear antibody was positive, and we diagnosed her with lupus-like syndrome due to an unknown cause. We increased the prednisolone dose and her symptoms improved.
Acute Kidney Injury ; Adult ; Antibodies, Antinuclear ; Arthralgia ; Autoimmune Diseases ; Connective Tissue Diseases ; Female ; Fever ; Humans ; Irritants ; Kidney ; Kidney Transplantation ; Lupus Erythematosus, Systemic ; Middle Aged ; Prednisolone ; Renal Insufficiency, Chronic ; Sputum ; Transplants

The Heterotopic pancreas is defined as the presence of pancreatic tissue lacking anatomical and vascular continuity with the main body of pancreas. Heterotopic pancreas or ectopic pancreas is found in 0.55% to 13.7% of autopsy series and also found one in approximately every 500 operations in abdominal surgery. The most common sites are the antrum of stomach, duodenum, and proximal jejunum. Most masses of heterotopic pancreas in stomach were encountered in the distal one third, usually within 5 or 6 cm of pylorus. We have recently experienced a case of hetertopic pancreas that was located in fundus which is not the usual site. Gastrofiberscopy revealed a 2 2.5 cm sized protruding mass on the fundus. There was apperared an umbilical shaped dimple on the center with a relatively normal mucosa. Endoscopic ultrasonography revealed a 2.5 cm sized hypoechoic mass of fundus, originating from submucosal and muscular layer. It was considered a submucosal tumor, such as leiomyoma, and subsequently wedge resection was performed. Histologic finding showed pancreatic acni.
Autopsy ; Duodenum ; Endosonography ; Jejunum ; Leiomyoma ; Mucous Membrane ; Pancreas* ; Pylorus ; Stomach*