BACKGROUND: Drug-induced Parkinsonism(DIP) is the second commonest cause of Parkinsonism, after idiopathic Parkinson's disease(IPD). DIP is frequently produced by antipsychotic drugs. But the clinical characteristics of DIP did not get attention by neurologist. So we studied the clinical profiles of DIP patients. METHODS: We studied the clinical profiles of thirthone patients who showed parkinsonism after antipsychotic drug treatment. We compared the score of motor part of the Unified Parkinson's Disease Rating Scale(UPDRS) between trihexyphenidyl(n=15) & amantadine(n=16) monotherapy group(initial & 4 week after treatment). RESULTS: The mean age of patients was 45 years. Bradykinesia was the 1st symptom in 26 patients(94%), tremor in 5 patients(6%). In 25 patients(81%), the first symptom appeared within 1 week after sntipsychotic treatment. There was a statistical significant negative correlation between the dosage of antipsychotic drug and the symptom-onset interval following treatment with antipsychotic drugs(simple correlation analysis, p>0.01). Bradykinesia and rigidity were appeared in all DIP patients, symmetric distribution was more common(94%, 87%) Tremor occurred in 27 patients (87%). In patients with tremor, postural or action tremor was dominant in 15 patients(56%) asymmetric distribution was more common(16/27, 59%). There are no statistical difference in motor score of UPDRS between trihexyphenidyl & amantadine monotherapy group(student t-test, p<0.05) CONCLUSIONS: Bradykinesia was the most common 1st symptom in DIP patients. Asymmertrical postural or action tremor was relativelly common in DIP. Amantadine showed the same efficacy in the treatment of DIP compared to anticholinergics.
Amantadine ; Antipsychotic Agents ; Cholinergic Antagonists ; Humans ; Hypokinesia ; Parkinson Disease ; Parkinsonian Disorders* ; Tremor ; Trihexyphenidyl

No abstract available.

Background & Objectives: To determine the prevalence and characteristics of radiculopathy in Parkinson’s disease (PD) patients through electrodiagnostic tests, to assess associated radicular pain characteristics,and to investigate the relationship between pain and other clinical manifestations of PD. Methods: Electrodiagnostic testing including nerve conduction studies and needle electromyographywas performed to investigate comorbid peripheral neuropathy or radiculopathy. All patients were asked to complete aquality of life (QOL) measurement related to pain. Results: Thirty-two (39%) of 82 PD patients had radiculopathy based on electrodiagnostic testing. 46.9% with radiculopathy patients had involvement of multiple roots level. The most commonly involved root was L5 (83.3%). Patients with radiculopathy had longer PD durations (p=0.011) and higher posture-related axial scores on the UPDRS scale (p=0.017).There was a trend for pain in the leg and low back to occur more frequently in PD patients with radiculopathy. QOL is not significantly different according to the presence of radiculopathy in PD. Conclusions: This study demonstrates a high prevalence of radiculopathy, particularly multiple root involvement, and is correlated with pain complaints and with axial motor scores on UPDRS. These findings might be related to increased shear force at the intervertebral disc by axial rigidity and flexed posture in PD along with the duration and severity of PD disease course.
Parkinson Disease ; Radiculopathy

Background: The aim of this study was to introduce a novel technique to improve the ease of fixing of even small fragments of the coronoid process and report the clinical outcomes of this method. Methods: Forty-nine patients with ulnar coronoid process fractures fixed using the hooked Kirschner wire (K-wire) technique at our hospital from 2007 to 2019 were reviewed. Radiological features and fracture union were assessed using simple radiographs.Functional outcomes of the treated elbows were evaluated at the final follow-up visit using the Mayo Elbow Performance Score (MEPS). Results: All patients were examined at a mean follow-up of 17.7 months (range, 6–62 months). We observed bony union in patients at a mean of 10.9 weeks (range, 6–22 weeks). The mean flexion and extension ranges of the elbow were 132.0° (range, 106° –151°) and 4.5° (range, –20° to 30°), respectively. The mean pronation and supination ranges of the forearm were 81.1° (range, 60°–90°) and 88.3° (range, 60°–120°), respectively. The mean arc of the elbow was 127.4° (range, 78°–160°). All patients were evaluated using the MEPS at the final follow-up visit, with a mean score of 96.9 points (range, 80–100 points). One case of coronoid nonunion was observed and re-fixation was performed. One case of infection was observed and also treated with additional surgery. Three patients complained of ulnar nerve symptoms and 1 patient underwent surgical release for tardy ulnar nerve palsy. Conclusions Despite its limitations, the hooked K-wire technique was a useful method for even smaller coronoid process fractures. K-wires were also a useful temporary intraoperative fixation method and could provide permanent fixation.

BACKGROUND: In most brain operations, the endotracheal tube is kept in postoperatively for airway maintenance during radiologic examinations. But the endotracheal tube causes tracheal irritation and hemodynamic changes. Inhalation anesthetics can not be administered during transport, and minimal concentration is exhaled for several hours after the end of inhalation. The present study was designed : (1) to determine the end tidal isoflurane concentration after the end of administration ; (2) to investigate the effects of intravenous anesthetics in patients with tracheal intubation during radiologic examination postoperatively. METHODS: We selected forty adult patients who were scheduled for elective neurosurgical operation with postoperative brain CT (computerized tomography). The study was performed in 2 steps; in the step 1 (n = 10), end tidal isoflurane concentration was checked after ending inhalation. In the step 2 (n = 30), patients were divided into one of three groups according to anesthesia method; group I (using isoflurane), group P (change from isoflurane to propofol about an hour before operation end), group M (using midazolam instead of propofol, compared to group P). In each group, the frequency of bucking and incidence of hypertension were checked during postoperative radiologic examinations. RESULTS: Minimal concentrations of isoflurane were detected in exhaled gas for about 2 hours after the end of isoflurane inhalation. The frequency of bucking was significantly lower in the group P and M than in group I (P = 0.002). In group P, the incidence of hypertension was significantly reduced compared to group M and I (P = 0.031). CONCLUSIONS: These results suggest that the change of anesthetic technique (from inhalation to intravenous) in the late period of operation, provides postoperative hemodynamic stability, a more comfortable state and minimal environmental pollution in comparison to inhalation anesthesia only.
Adult ; Anesthesia ; Anesthesia, Inhalation ; Anesthesia, Intravenous* ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Brain ; Environmental Pollution ; Hemodynamics ; Humans ; Hypertension ; Incidence ; Inhalation ; Intubation ; Isoflurane ; Midazolam ; Propofol

BACKGROUND: In most brain operations, the endotracheal tube is kept in postoperatively for airway maintenance during radiologic examinations. But the endotracheal tube causes tracheal irritation and hemodynamic changes. Inhalation anesthetics can not be administered during transport, and minimal concentration is exhaled for several hours after the end of inhalation. The present study was designed : (1) to determine the end tidal isoflurane concentration after the end of administration ; (2) to investigate the effects of intravenous anesthetics in patients with tracheal intubation during radiologic examination postoperatively. METHODS: We selected forty adult patients who were scheduled for elective neurosurgical operation with postoperative brain CT (computerized tomography). The study was performed in 2 steps; in the step 1 (n = 10), end tidal isoflurane concentration was checked after ending inhalation. In the step 2 (n = 30), patients were divided into one of three groups according to anesthesia method; group I (using isoflurane), group P (change from isoflurane to propofol about an hour before operation end), group M (using midazolam instead of propofol, compared to group P). In each group, the frequency of bucking and incidence of hypertension were checked during postoperative radiologic examinations. RESULTS: Minimal concentrations of isoflurane were detected in exhaled gas for about 2 hours after the end of isoflurane inhalation. The frequency of bucking was significantly lower in the group P and M than in group I (P = 0.002). In group P, the incidence of hypertension was significantly reduced compared to group M and I (P = 0.031). CONCLUSIONS: These results suggest that the change of anesthetic technique (from inhalation to intravenous) in the late period of operation, provides postoperative hemodynamic stability, a more comfortable state and minimal environmental pollution in comparison to inhalation anesthesia only.
Adult ; Anesthesia ; Anesthesia, Inhalation ; Anesthesia, Intravenous* ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Brain ; Environmental Pollution ; Hemodynamics ; Humans ; Hypertension ; Incidence ; Inhalation ; Intubation ; Isoflurane ; Midazolam ; Propofol

In full-thickness defects of the nasal alar rim, to achieve projection and maintain airway patency, cartilage graft is frequently needed. However, cartilage graft presents a challenge in considerations such as appropriate donor site, skeletal shape and size, and healing of the donor area. To avoid these demerits, we tried primary closure of alar rim defects by also making the contralateral normal ala smaller. We treated two patients who had a full-thickness nasal alar defect after tumor excision. Cartilage graft was considered for the reconstruction. However, their alar rims were overly curved and their nostril openings were large. To utilize their nasal shape, we did primary closure of the defect rather than cartilage graft, and then downsized the contralateral nasal ala by means of wedge resection to make the alae symmetric. Both patients were satisfied with their aesthetic results, which showed a smaller nostril and nearly straight alar rims. Moreover, functionally, there was no discomfort during breathing in both patients. We propose our idea as one of the reconstruction options for nasal alar defects. It is a simple and easy-to-perform procedure, in addition to enhancing the nasal contour. This method would be useful for patients with a large nostril and an overly curved alar rim.
Cartilage ; Humans ; Nose Deformities, Acquired ; Reconstructive Surgical Procedures ; Respiration ; Tissue Donors ; Transplants

No abstract available
Dermatitis, Atopic* ; Eczema* ; Humans ; Nipples*

PURPOSE: The aims of present study were to document the incidence of cytomegalovirus infection in neonatal and infantile periods especially in high-risk patients of associated infection by nested PCR of DNA from leukocytes and to evaluate the effectiveness of nested PCR in the diagnosis of congenital cytomegalovirus infection. METHODS: Genomic DNA was extracted from peripheral leukocytes of 204 neonates and infants during the period from June 1994 to March 1995, and nested PCR was performed. The cases were divided into six groups according to clinical profiles; Group IA-healthy fullterm babies, group IB-fullterm babies with suspected or definite perinatal infection, group IIA-healthy preterm babies, group IIB-preterm babies with suspected or definite perinatal infection, group III-infants with clinical features of viral infection and abnormal liver function tests, group IV-IgM seropositive babies with clinical evidence of cytomegalovirus infection. RESULTS: In group IA(n=70), 2 cases were positive for PCR amplification (2.9%). All of the cases in group IB(n=64), group IIA(n=15), and group IIB(n=20) were negative for cytomegalovirus infection. Only one case(3.3%) among group III(n=30) showed positive reaction, while all of the five cases(100%) in group IV(n=5) were positive. CONCLUSIONS: The incidence of congenital cytomegalovirus infection in our analysis were 1.2% (2/169), and it was similar to that of western countries. Nested PCR was proved to be a both sensitive and specific diagnostic tool in the diagnosis of cytomegalovirus infection and it seems to be useful in the screening of congenital cytomegaloviral infection in the newborn period. Future analysis of samples including non-blood origin from adult women and newborns will be helpful in the epidemiologic analysis of cytomegalovius infection in this period.
Adult ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Diagnosis* ; DNA ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Leukocytes ; Liver Function Tests ; Mass Screening ; Polymerase Chain Reaction*