No abstract available.
Humans

Delayed carbon monoxide (CO) encephalopathy patients can show cognitive impairment, aphasia, affective and personality changes and behavioral symptoms. The prognosis of them is sometimes poor or irreversible. We present a case of 61-year-old woman who visited us at 56 days after CO intoxication and showed moderate to severe cognitive impairment and behavioral problems. We prescribed the donepezil (5 mg/d), memantine (5 mg/d), choline alfoscerate (800 mg/d) and ziprasidone (20 mg/d), based on previous case reports and performed the cognitive rehabilitation. After 30 days treatment in hospital, she showed dramatic improvement in cognitive functions and behavioral problems. This case suggests that adequate pharmacological and cognitive treatment could improve the moderate to severe symptoms of delayed CO encephalopathy even about 2 months later after CO intoxication.
Aphasia ; Behavioral Symptoms ; Brain Diseases* ; Carbon Monoxide* ; Carbon* ; Cognition ; Cognition Disorders ; Female ; Glycerylphosphorylcholine ; Humans ; Memantine ; Middle Aged ; Problem Behavior ; Prognosis ; Rehabilitation

PURPOSE: To assess the clinical outcomes of cyclosporine treatment for noninfectious uveitis. METHODS: A retrospective review of medical records was completed for 182 noninfectious uveitis patients who were treated with cyclosporine between January 2001 and August 2010. Data was obtained relevant to demographic characteristics, anatomic classification, and laterality of uveitis, associated systemic disorder, dosage of cyclosporine and prednisolone, usage of other immunosuppressive drugs, visual acuity (VA), control of uveitic activity, and adverse effects during the cyclosporine use. RESULTS: Uveitic activity was controlled to a level of minimal inflammation in 89.0% and completely in 78.6% of patients by the median duration of 49 and 98 days, respectively. Prednisolone-sparing (dose < or =10 mg) control of inflammation equal to or less than the minimal activity was achieved in 75.3% of patients. VA was aggravated more than 0.2 logarithm of the minimum angle of resolution in 17.3% of eyes in spite of cyclosporine treatment for the mean follow-up of 698.4 days. Dose reduction and cessation of cyclosporine was required only in 3.3% and 9.3%, respectively, due to the intolerable toxicity, although 44.0% of patients experienced mild to moderate adverse effects. CONCLUSIONS: Cyclosporine combined with corticosteroids or other immunosuppressive drugs as needed is an effective treatment for noninfectious uveitis, thus minimizing the adverse effects of corticosteroids and other toxic drugs. However, careful monitoring for the toxicity of cyclosporine is needed, because a small group of patients cannot tolerate its toxicity.
Adolescent ; Adult ; Aged ; Cyclosporine/administration & dosage/*therapeutic use ; Female ; Humans ; Immunosuppressive Agents/administration & dosage/*therapeutic use ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Prednisolone/administration & dosage/therapeutic use ; Republic of Korea ; Retrospective Studies ; Treatment Outcome ; Uveitis/*drug therapy ; Visual Acuity

No abstract available.
Child* ; Humans

Injury of the ankle ligaments is one of the most common sports-related injuries. Although there are some debates as to the best initial treatment for an acute tear of a lateral ligament, persistent functional instability of the ankle develops in approximately 20% of patients regardless of the type of initial treatment. In these patients, late reconstruction of the lateral ankle ligaments may become necessary. Among 13 cases which have been operated with Larsen procedure using peroneus brevis tendon from March 1991 to February 1993, the 11 cases followed up over 1 year were examined clinically and radiologically. We introduced the clinical analysis and results with the brief review of the literatures. 1. The indication of surgical treatment was the ankle instability which had differences over 10° in talar tilting angle or over 3mm in anterior displacement compared wit the uninjured site. 2. The postoperative results were 5 cases in excellent and 4 in good. 3. The Larsen procedure was considered a good method to anatomically and simply stabilize both the ankle and subtalar joint and to fix tendon depending on the type of instability.
Ankle ; Collateral Ligaments ; Humans ; Ligaments ; Methods ; Subtalar Joint ; Tears ; Tendons

PURPOSE: Kawasaki disease is probably driven by abnormalities of the immune system after infectious insult. In this report, a clinical review with laboratory parameters and the changes of the plasma levels of chemokines(RANTES and Gro-alpha was undertaken according to the clinical stage of Kawasaki disease. METHODS: This investigation included 74 samples from 21 patients(10 boys, 11 girls; mean age, 27.8 months) with Kawasaki disease who met the revised diagnostic guidelines and 5 samples from healthy children. The plasma levels of RANTES and Gro-alpha were measured by enzyme- linked immuno-sorbent assay(ELISA). To analyze the pattern of the gene expression of chemokine mRNA for lymphotactin(Ltn), RANTES, IP-10, MIP-1 beta, MIP-1 alpha MCP-1, IL-8 and I-309 in the peripheral blood monocyte, ribonuclease protection assays(RPA) were performed in 3 patients whose plasma levels of RANTES were very low and not significantly changed after intravenous immunoglobulin(IVIG) treatment. RESULTS: The production of RANTES and Gro-alpha were markedly elevated during the acute and subacute phases of Kawasaki disease compared to those of the normal control. In addition, interestingly, the changing patterns of plasma level of chemokines were not consistent(biphasic) after IVIG treatment. According to the RPA, the expression of RANTES was the most prominent among 8 kinds of chemokines and elevated in all phases of Kawasaki disease. But, there was no ovious relation between clinical characteristics of the disease including the coronary artery dilatation and the level of RANTES. CONCLUSION: These finding suggested that RANTES and Gro-alpha may play an important role in pathophysiology of the Kawasaki disease. Longer follow-up and more case studies will be needed to clearly establish the significance of the changes of RANTES and Gro-alpha in the pathophysiology of Kawasaki disease.
Chemokine CCL5* ; Chemokines ; Child ; Coronary Vessels ; Dilatation ; Female ; Follow-Up Studies ; Gene Expression ; Humans ; Immune System ; Immunoglobulins, Intravenous ; Interleukin-8 ; Monocytes ; Mucocutaneous Lymph Node Syndrome* ; Plasma ; Ribonucleases ; RNA, Messenger

A 18 year-old man presented with dyspnea and a swelling of the neck. On physical examination, maculopapular rashes were noted on the face and the whole body and crepitus was noted at the thorax and upper arms. His chest X-ray showed bilateral interstitial infiltrates of the lung, pneumomediastinum and subcutaneous emphysema. On serologic examination, measles IgM was positive. Under the diagnosis of measles pneumonia, the patient was treated with oral ribavirin, which resulted in a complete resolution of the pneumomediastinum, subcutaneous emphysema, pneumonic infiltrate, and subjective symptoms of dyspnea and swelling of the neck in 7 days. Here we report this case with a brief review of the relevant literature.
Adolescent* ; Arm ; Diagnosis ; Dyspnea ; Exanthema ; Humans ; Immunoglobulin M ; Lung ; Measles* ; Mediastinal Emphysema* ; Neck ; Physical Examination ; Pneumonia* ; Ribavirin ; Subcutaneous Emphysema* ; Thorax

PURPOSE: The proper surgical methods for treating acromioclavicular joint dislocation is still controversial. New methods should provide better early motion with sufficient strength. MATERIALS AND METHODS: We performed arthroscopic stabilization using TightRope(R) (Arthrex, Inc, Naples, FL) in 10 cases of acromioclavicular joint dislocation between April, 2007, and December, 2007, and followup for a minimum of 10 months. We performed radiologic evaluation by comparing the clavicle anteroposterior radiograph with the contralateral one. Clinical evaluation was made for pain, function, and range of joint motion by Imatani's methods. RESULTS: In clinical evaluation, 6 cases were excellent, 3 cases were good, and 1 case was poor. In radiologic evaluation, 9 cases were excellent and 1 case was poor. Redislocation occurred in 1 case. CONCLUSION: During short-term followup, 9 of 10 patients who underwent arthroscopic stabilization using TightRope(R) had excellent results in Imatini tests and radiologic evaluation, except 1 patient with redislocation.
Acromioclavicular Joint ; Clavicle ; Dislocations ; Follow-Up Studies ; Humans ; Joints

To investigate the effects of platelet-derived growth factor(PDGF)and laminin on the proliferation and morphological change of retinal pigment epithelial(RPE)cells, RPE cells(5 10(3))were cultured on either plastic or laminin-coated 24-well-plates for 6 days. One percent fetal calf serum and PDGF(0, 10, 20 ng/ml)were added in the culture media. Morphological change and the numbers of attached RPE cells were assessed at the end of the culture, using image analyzer and MTT assay. In image analysis, as the PDGF concentration were increased, area(A), perimeter(P), normalized perimeter(NP), diameter(D), minimum size(MinS), maximum size(MaxS), and eccentricity of binary object(EF)were increased while circle filling(Cfil)was decreased. Compared with the cells cultured on plastic, the cells on the laminin showed increase in all the parameters except EF. The proliferative effect on RPE cells were increased on both plastic and laminin as PDGF concentration were increased(P<0.05). These results suggest that proliferation and morphologic change of RPE cells might be influenced by PDGF and laminin.
Culture Media ; Epithelial Cells* ; Extracellular Matrix ; Laminin* ; Plastics ; Platelet-Derived Growth Factor* ; Retinaldehyde*

PURPOSE: To assess the effect of gestational age and illness severity, and the effect of antenatal exposure to magnesium sulfate, glucocorticoids, and antibiotics, on the timing of the first stool in preterm infants. METHODS: Medical records of all preterm infants admitted to the neonatal ward at Kangnam Sacred Heart Hospital between March 1998 and August 1998 were reviewed. We studied the time of the first stool in 55 infants. RESULTS: The median age of the infant at the time of first stool was 18 hours, and 90% of the infants passed stool by 50 hours. Both the gestational age and the illness severity, as measured by the score for neonatal acute physiology(SNAP), correlated significantly with the timing of the first stool(r=0.47 and P<0.001 for SNAP; r=0.29 and P<0.05 for gestational age). An analysis of covariance showed that the relationship between SNAP and the timing of the first stool was significant even after adjustment for gestational age(P<0.01), but the relationship between the gestational age and the timing of the first stool was not significant after adjustment for SNAP (P=0.14). Antenatal exposure to magnesium sulfate for tocolysis, glucocorticoids for enhancing fetal lung maturity, and antibiotics, had no effect on the timing of the first stool. CONCLUSION: Delayed passage of first stool is a function of illness severity, not of gestational immaturity. Antenatal exposure to magnisium sulfate, dexamethasone, and antibiotics, does not affect the timing of first stool in premature infants.
Anti-Bacterial Agents ; Dexamethasone ; Gestational Age ; Glucocorticoids ; Heart ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Lung ; Magnesium Sulfate ; Medical Records ; Tocolysis