Wernickes encephalopathy is an illness characterized by mental disturbance, paralysis of eye movements and ataxia of gait. The specific factor for most, if not all, of these symptoms is a deficiency of thiamine. Wemicke's encephalopathy mostly occurs in developing countries when the patient is in a state such as nutritionally deprived state, anorexia nervosa, stomach cancer, long duration of parenteral nutrition. Wernickes encephalopathy was recognized as a complication of hyperemesis of pregnancy in 1914. Unfortunately, cases continue to occur. We present here a case of Wernickes encephalopathy in a 36-year-old pregnant woman. We discuss the clinical picture, histopathology, radiology, therapeutic management and prognosis with review of the literature.
Adult ; Anorexia Nervosa ; Developing Countries ; Eye Movements ; Female ; Gait Ataxia ; Humans ; Hyperemesis Gravidarum* ; Hyperthyroidism* ; Paralysis ; Parenteral Nutrition ; Pregnancy ; Pregnant Women ; Prognosis ; Radiation Oncology ; Stomach Neoplasms ; Thiamine ; Wernicke Encephalopathy*

Histologic reactions of bone and soft tissue to CFRE were explored, and biomechanical properties of both CFRE plate and stainless steel plate were tested and compared. Six achilles tendons of albino rabbits were replaced with CFRE implant after artificial rupture and serial histologic examination of neotendon and histologic response in vivo were done during 8 weeks. Proximal tibia of twelve albino rabbit was selected, subjected the tibia a single osteotomy and internal fixation with CFRE plate in six cases, and stainless steel plate in the others. And then, consequent radiographic and histologic change was observed during 8 weeks. Objectives in this paper is to provide basic data of CFRE in its biomechanical and biologic response in vivo. The results were as follows :1. Foreign body reaction and fibroblast were decreased at 7-8 weeks after operation. Early formation of collagen, which is similar to that found in the normal side, was shown. So, CFRE seems to be ideal material in the aspect of tissue tolerance among biocomaptibility factors. 2. In biomechanical test, CFRE plate is lower than stainless steel plate in flexural strength and flexural modulus. This means that CFRE plate is semirigid in nature. 3. While external callus formation is marked after fixation of CFRE, internal callus for mation is marked after fixation of stainless steel plate. In CFRE plated tibia, the resorption-cavity is much smaller than stainless steel plated, and there is some formation of woven bone beneath the plate. In conclusion, CFRE is ideal material in the aspect of its biomechanical compatibility and tissue tolerance. Further efforts on production and varying design of CFRE make it to use widely in clinical application, Such as internal fixator of fracture and temporary replacement of tendon or ligament.
Achilles Tendon ; Bony Callus ; Carbon ; Collagen ; Fibroblasts ; Foreign-Body Reaction ; Internal Fixators ; Ligaments ; Osteotomy ; Rabbits ; Rupture ; Stainless Steel ; Tendons ; Tibia

No abstract available.
Spinal Stenosis*

No abstract available.

BACKGROUND: Intermittent rhythmic delta activity (IRDA) is classified as a nonspecific abnormal EEG pattern. IRDA is clinically associated with alteration of consciousness, hydrocephalus, cerebral edema, deep midline lesions, subcortical lesions, and tumors of the posterior fossa and the third ventricle. Frontal IRDA(FIRDA) is usually seen in patients over age 15 years, whereas occipital IRDA(OIRDA) occurs mainly in children. We have investigated the clinical feature and significance of IRDA in children. SUBJECTS AND METHODS: We retrospectively reviewed the medical records of 36 children with IRDA of EEG concerning diagnosis, neurologic examination, classification of epilepsy, and CT & MRI findings. RESULTS: 1) The location of the IRDA was frontal(FIRDA) in 11 of 36(30.5%), occipital(OIRDA) in 20 of 36(55.6%) and mixed in 5 of 36(13.9%) patients. 2) Thirty of 36(83.3%) have epilepsy (including 1 each with MELAS and tuberous sclerosis), 4 of 36(11.1%) have migraine and 2 of 36(11.1%) patients have meningitis. 3) Sixteen of 30(53.3%) have partial or partial with secondary generalized seizure, 10 of 30(33.3%) have generalized seizure and 4 of 30(13.3%) patients with epilepsy have absence seizure. 4) Neuroimaging studies (CT or MRI scan) were performed in 27 cases. Among 27 cases of studies, 6 cases(22.2%) were abnormal including; two cases of infections, and each case of infarction, venous angioma, arachnoid cyst, cortical atrophy, and tuberous sclerosis, respectively. CONCLUSIONS: IRDA may be considered an epileptiform pattern in childhood and FIRDA is frequently seen in children than previous reports.
Arachnoid ; Atrophy ; Brain Edema ; Child* ; Classification ; Consciousness ; Diagnosis ; Electroencephalography ; Epilepsy ; Epilepsy, Absence ; Hemangioma ; Humans ; Hydrocephalus ; Infarction ; Magnetic Resonance Imaging ; Medical Records ; MELAS Syndrome ; Meningitis ; Migraine Disorders ; Neuroimaging ; Neurologic Examination ; Retrospective Studies ; Seizures ; Third Ventricle ; Tuberous Sclerosis

Most authorities including WHO recommended immununizing infants with BCG as early as possible in areas prevalent with tuberculosis, however the optimal time for immunization has not well been characterized. Therefore the investigation was undertaken by vaccinating various infant groups of different ages with BCG and subsequently evaluating for adverse effects and tuberculin reactions, in order to contribute to undestanding the optimal time for immunization. Four hundred eighty three infants from the newborn nursery and the well baby clinic of Hanyang University Hospital who had no family history of tuberculosis were divided into three groups; group I of infants immunized within 7 days after birth, group II of infants immunized at about 1 month of age and group III of infants immunized at about 3 months of age. To each infant 0.1 ml of BCG(Institute Merieux, France) was administered intradermaly and approximately 3 months later tuberculin skin test using 5 TU PPD (NIH, Korea) was performed. Adverse reactions following BCG vaccination such as temperature elevation, induration alone or with suppuration at or near the injection site, and lymph node enlargement were also analyzed. The summary of the results is as follows. 1) Distribution of diameters of induration on tuberculin skin test illustrated incomplete bimodal configuration in all three different age groups. The means 2 standard deviations of diameters of indurations distributed on the main bells were 10.07 4.52 mm in group I, 10.65 3.82 mm in group II, and 10.83 5.08 mm in group III, and were not significantly different. 2) Criteria for positive tuberculin reaction was diameters of indurations equal to or greater than 6mm, 2 standard deviations below the mean values of diameters of indurations on the main bells. 3) The positive tuberculin reaction rates of 85.8% in group II and 88.6% in group III were significantly greater than 74.1% in group I. 4) Incidence of complications following BCG vaccination including temperature elevation, induration with suppuration, and localized lymphadenopathy was not different among three groups and the serious complications such as temperature elevation and lymphadenopathy were minimal. The data indicate that it is appropriate to immunize infants with BCG at about one month of age and the incidence of complications following BCG vaccination was not different among three infant groups of different ages.
Humans ; Immunization ; Incidence ; Infant* ; Infant, Newborn ; Lymph Nodes ; Lymphatic Diseases ; Mycobacterium bovis* ; Nurseries ; Parturition ; Skin Tests* ; Skin* ; Suppuration ; Tuberculin Test ; Tuberculin* ; Tuberculosis ; Vaccination*

Congenital absence of nails usually occur as a rare isolated anomaly or combined with other ectodermal defects. This anomaly is regarded as an inherited disorder either dominantly or recessively but quite a few cases were reported as sporadically developed. The patient was a 2-month-old girl who had no nails on both her 2nd, 3rd toes but had rudimentary nails on her left big toe and both 4th toes at birth. We could not find any other congenital deformity, any family history of inherited diseases related to anonychia. Radiological findings revealed no visualization of both 4th distal phalanges, only. We report this case as congenital anonychia of a sporadic type which may have developed independently from an underlying bone abnormality. We also review other reported cases in the literature.
Congenital Abnormalities ; Ectoderm ; Female ; Hallux ; Humans ; Infant ; Parturition ; Toes*

OBJECTIVE: Dorsal root entry zone(DREZ) operation has been the most common surgical treatment for paraplegic pain in the past, but the results differ according to the patients. In this study, we attempt to analyze the results from the patients by the different patterns of the pain before the surgery. METHODS: A total of twelve paraplegic patients have undergone a total of thirteen radiofrequency DREZ coagulation procedures between April 1994, and March 2003. The patients were divided depending on patients' subjective description on the character, frequency, and range of pain. RESULTS: The patients were divided into the two groups, postoperatively: improvement of more than 75% of pain was defined as treatment success, and any level less than 75% of improvement was defined as treatment failure. Eight of the ten mechanical pain group cases were regarded as treatment success, and remaining two cases with thermal type of pain as treatment failure. Also, one case with combined pain failed to obtain any favorable outcome. Intermittent pain group (6 of 7 cases), continuous pain group (2 of 6 cases), and localized pain group (7 of 11 cases) showed treatment success, respectively. However, diffuse pain group (1 of 2 cases) resulted in poor outcome. CONCLUSION: Radiofrequency DREZ coagulation is more effective in managing intermittent and/or mechanical pain than continuous and/or thermal pain in the paraplegic patients following spinal cord injury.
Humans ; Spinal Cord Injuries ; Spinal Nerve Roots* ; Treatment Failure

Familial adenomatous polyposis (FAP) is an hereditary autosomal dominant disease characterized by development of hundreds to thousands of adenomatous polyps in the colon and rectum. The common symptoms are bloody stool, diarrhea, and abdominal pain. The average age at onset of symptoms is 33 years. Because of inevitable progression to malignancy, it is necessary to remove the entire colonic and rectal mucosa. Current surgical options are total proctocolectomy with permanent ileostomy, trans-abdominal colectomy with ileorectal anastomosis (IRA), and restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Recently IPAA can give optimum control of colorectal polyposis in FAP patients with an acceptable incidence of postoperative complications and satisfactory functional results. We experienced one case of FAP who had malignacy in the remained rectum after subtotal colectomy. IPAA was done and the result was satisfactory.
Abdominal Pain ; Adenomatous Polyposis Coli* ; Adenomatous Polyps ; Colectomy* ; Colon ; Diarrhea ; Humans ; Ileostomy ; Incidence ; Mucous Membrane ; Postoperative Complications ; Proctocolectomy, Restorative ; Rectum*

No abstract available.