Chlorfenapyr is a widely used, moderately hazardous pesticide. Previous reports have indicated that chlorfenapyr intoxication can be fatal in humans. We reported the first non-fatal case of chlorfenapyr-induced toxic leukoencephalopathy in a 44-year-old female with resolution of extensive and abnormal signal intensities in white matter tracts throughout the brain, brain stem, and spinal cord on serial magnetic resonance imaging.
Adult ; Brain/*radiography ; Brain Stem/radiography ; Female ; Humans ; Insecticides/*toxicity ; Leukoencephalopathies/*etiology/radiography ; *Magnetic Resonance Imaging ; Pyrethrins/*toxicity ; Spinal Cord/*radiography ; White Matter/radiography

OBJECTIVE: The aim of this study is to determine whether any association exists between preeclampsia and the maternal serum level of nitric oxide (NO) and platelet activating factor (PAF). METHODS: NO concentrations were measured using Stuehr's method and PAF concentrations were measured with [3H]PAF scintillation proximity assay (SPA) system (Amersham Pharmacia Biotech). Data were analyzed with SAS windows version 6.12, with significance established at p<0.05. RESULTS: The mean (+/-SD) maternal serum concentrations of NO were significantly higher in the group with severe preeclampsia (5.535+/-0.343 ug/ml) and mild preeclampsia (5.891+/-0.481 ug/ml) than in the normotensive pregnancy group (2.036+/-0.744 ug/ml) (p<0.05). The mean (+/-SD) maternal serum concentrations of PAF were significantly higher in the group with severe preeclampsia (928.9+/-32.3 ng/ml) and mild preeclampsia (789.1+/-63.9 ng/ml) than in the normotensive pregnancy group (435.8+/-59.5 ng/ml) (p<0.05). The mean birth weight was lower in the mild and severe preeclampsia groups than in the normotensive pregnancy group (p<0.05). CONCLUSION: Maternal serum NO and PAF concentrations were more increased in preeclampsia than normotensive pregnancy group. NO may therefore serve as compensatory mechanism for vasoconstriction of preeclampsia and PAF as a marker for the risk of preeclampsia.
Birth Weight ; Blood Platelets* ; Nitric Oxide* ; Platelet Activating Factor* ; Pre-Eclampsia* ; Pregnancy ; Vasoconstriction

PURPOSE: The aim of this study was to investigate the pathologic characteristics of nodular gastritis in children and young adults infected with Helicobacter pylori (H. pylori). MATERIALS AND METHODS: A total of 328 patients were enrolled in this study, and the diagnosis of H. pylori infection was done with gastroduodenal endoscopy concomitant with a CLO
Odds Ratio ; Male ; Humans ; *Helicobacter pylori ; Helicobacter Infections/*pathology ; Gastritis/epidemiology/*pathology ; Gastric Mucosa/microbiology/*pathology ; Female ; Endoscopy ; Child, Preschool ; Child ; Biopsy ; Adult ; Adolescent

PURPOSE: To evaluate the preoperative factors influencing results of pneumatic retinopexy in patients with rhegmatogenous retinal detachment. METHODS: We analyzed retrospectively the preoperative and postoperative retinal findings, visual results, postoperative complications in 98 eyes of 98 patients who had undergone pneumatic retinopexy and followed for at least 3 months. RESULTS: Postoperatively visual acuity improved in 46 out of 59 patients whose preoperative visual acuity was equal to or less than 0.08, and in 20 out of 27 patients whose preoperative visual acuity was equal to or less than 0.5. The success rate of initial surgery was 75.5% and the final reattachment rate 99.0%. The anatomic success rate of each group did not differ in terms of the duration of retinal detachment, the size or quadrantal location of retinal break. The success rate was decreased when retinal detachment was broader or retinal breaks were multiple, although the difference was not statistically significant. The success rate was significantly lower when retinal break was located posterior to the equator than when retinal break was located on or anterior to the equator (40.0% vs 80.3%, 70.4%) (p=0.02). The main causes of failure in primary retinal reattachment were as follows: reopened retinal break in 8 eyes, new retinal break in 7 eyes, delayed absorption or shift of subretinal fluid in 5 eyes, proliferative vitreoretinopathy in 2 eyes, subretinal gas in 1 eye and endophthalmitis in 1 eye. CONCLUSIONS: Our results showed that the axial location of retinal break was the only preoperative factor influencing the success rate of pneumatic retinopexy. However, other factors may not be completely ruled out as influence factors for success rate considering the small number of patients in our study. Further study including larger series will be needed.
Absorption ; Endophthalmitis ; Humans ; Postoperative Complications ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Subretinal Fluid ; Visual Acuity ; Vitreoretinopathy, Proliferative

The vascular actions of local anesthetics are important in determining the uptake and distribution of these agents from their site of injection as well as influencing their hemodynamic effects once absorbed. Because of the importance of the endothelium in determining of modulating the vascular response of a wide variety of agents, cumulative dose-dependent vasular effects of lidocaine, mepivacaine and bupivacaine on isolated rings of thoracic aorta in normotensive rats(NTR) and spontaneously hypertensive rats(SHR) were studied in the presence and absence of intact endothelium. The results were as follows ; The body weight of NTR and SHR averaged 274.71+/-55.80(N = 38) and 241.43+/-17.73gm(N = 18) and mean arterial pressure was 74.4l+/-3.60 and 129.34+/-2.89mmHg respectively. The mean absolute value of the contraction induced by 5Xl0(-6) M phenylephrine was 3.27+/-0.98(N = 18) and 2.3l+/-50.64gm(N = 18) with intact endothelium and 3.12+/-0.92 and 2.46+/-0.87 gm without intact endothelium in aortic rings of NTR and SHR respectively. In the response to local anesthetics in preparation with resting tension(1.0 gm), lidocaine and mepivacaine in concentration of 10(-3) to 1.25X10(-2) M not produced dose dependent contraction in aortic ring with intact endothelium from NTR. but bupivacaine produced dose-dependent contraction in aortic rings with intact endothelium from NTR. In the aortic rings from NTR and SHR previously contracted with phenylephrine, lidocaine in contraction of 10(-3) to 1.25X10(-2) M caused dose related relaxation in aortic rings with or without endothelium but in concentration of 10(-3) to 510(-3) M, aortic rings with endothelium were more relaxed than those af without endothelium in NTR. In SHR, aortic rings without endothelium in concentration of 5X10(-3) to 1.25X10 M were more significantly relaxed than those of with endothelium. In aortic rings from NTR previously contracted with phenylephrine, mepivacaine caused dose-related relaxation, which was more profound in SHR. In aortic rings with endothelium from NTR previously contracted with phenylephrine, bupivacaine in concentration of 10(-3) to 1.5X10(-3) M caused a relaxation and in concentration of 2.5X10(-3) to 7.5X10(-3) M and 1.25X10(-3) M caused a relaxation again. But in the aortic rings without intact endothelium, bupivacaine caused dose-related relaxation. In the aortic rings without intact endothelium, bupivacaine caused dose-related relaxation in NTR. In the aortic rings from SHR previously contracted with phenylephrine, bupivacaine caused dose-related relaxation, which was more profound than those of NTR. The local anesthetics appear to exert their relaxant effect on endothelium independently and more profoundly in SHR.
Anesthetics, Local* ; Aorta, Thoracic* ; Arterial Pressure ; Body Weight ; Bupivacaine ; Endothelium ; Hemodynamics ; Lidocaine ; Mepivacaine ; Muscle, Smooth, Vascular ; Phenylephrine ; Rats, Inbred SHR* ; Relaxation

BACKGROUND: Diastolic function can be assessed by Doppler-derived left ventricular(LV) filling patterns. E/A ratio<1 and prolongation of isovolumic relaxation time(IVRT) are diagnostic of impaired relaxation of left ventricle during diastole. In early stage of acute myocardial infarction, myocardial stiffness can normalize the E/A ratio and mask the Doppler indexes of abnormal relaxation in patients with acute myocardial infarction. METHODS: LV filling patterns were studied with Doppler echocardiography in 10 healthy subjects and 27 patients with recent acute myocardial infarction. Cardiac catherterization was performed in the 11+/-2 days after onset of acute myocardial infarction and left ventricular end-diastolic pressure(LVEDP) and myocardial stiffiness index(MSI) were studied. RESULTS: In patients with acute myocardial infarction, IVRT was significantly prolonged ; E/A ratio and deceleration time were decreased but not significantly different from those of normal subjects. In the patient's group of E/A>1,IVRT and atrial filling fraction(AFF) were significantly shortened, and LVEDP was significantly increased, compared to those of the patient's group of E/A<1. But ejection fraction was similar in both groups. In the patients with acute myocardial infarction, E/A ratio and LVEDP showed good correlation(r=0.64, p<0.05). MSI was increased in the patient's group of E/A>1 and also was well correlated with LVEDP(r=0.8, p<0.05). CONCLUSIONS: Thus we conclude that normal of increased E/A ratio in recent acute myocardial infarction may reflect increased LVEDP due to increased myocardial stiffness.
Deceleration ; Diastole ; Echocardiography* ; Echocardiography, Doppler ; Heart Ventricles ; Humans ; Masks ; Myocardial Infarction* ; Relaxation

Acute ischemic stroke due to embolic occlusion of the middle cerebral artery (MCA) in patients with chronic ipsilateral internal carotid artery (ICA) occlusion is quite rare. Several previous reports demonstrated that intra-arterial (IA) thrombolytic therapy or aspiration thrombectomy using the cross-circulation technique via an alternative collateral pathway is feasible in acute stroke patients with an unfavorable direct route to the occluded sites. However, stent-retriever embolectomy via the cross-circulation approach has not been reported in the literature. The present paper reports the first case of successful stent-retriever embolectomy for acute MCA occlusion via the patent posterior communicating artery (PComA) by using Trevo XP ProVue stent-retriever in a patient with acute MCA stroke and chronic occlusion at the origin site of the ipsilateral ICA.
Arteries* ; Carotid Artery, Internal ; Embolectomy* ; Humans ; Middle Cerebral Artery ; Stroke ; Thrombectomy ; Thrombolytic Therapy

Respiratory failure and pulmonary infection are the major causes of death in the Duchenne muscular dystrophy patients. The purposes of this study are to evaluate pulmonary function of Duchenne muscular dystrophy patients, to verify usefulness of the measurements of maximum static pressures and to define functional classes in Duchenne muscular dystrophy patients. Forty two Duchenne muscular dystrophy patients were assessed for pulmonary function by a routine pulmonary function test and the measurements of maximum static pressures. This study showed significant negative correlations between the subject's functional class and the values of forced vital capacity(FVC), maximum inspiratory and expiratory pressures(MIP and MEP). Significant reduction of maximum static pressures began earlier than FVC in the course of disease. The MEP was as low as 64% of the predicted value before FVC and MIP showed demonstrable decline. A pulmonary care program focusing on maintaining adequate respiratory pressures is suggested to start early for the child with Duchenne muscular dystrophy.
Cause of Death ; Child ; Humans ; Muscular Dystrophy, Duchenne* ; Respiratory Function Tests* ; Respiratory Insufficiency

Objective: Intraprocedural rupture (IPR) is a fatal complication of endovascular coiling for cerebral aneurysms. We hypothesized that contrast leakage period may be related to poor clinical outcomes. This study aimed to retrospectively evaluate the relationship between clinical outcomes and contrast leakage period. Methods: Data from patients with cerebral aneurysms treated via endovascular coiling between January 2010 and October 2018 were retrospectively assessed. The enrolled patient’s demographic data, the aneurysm related findings, endovascular treatment and IPR related findings, rescue treatment, and clinical outcome were analyzed. Results: In total, 2,859 cerebral aneurysms were treated using endovascular coiling during the study period, with IPR occurring in 18 (0.63 %). IPR occurred during initial frame coiling (n=4), coil packing (n=5), stent deployment (n=7), ballooning (n=1), and microcatheter removal after coiling (n=1). Tear sites included the dome (n=14) and neck (n=4). All IPRs were controlled and treated with coil packing, with or without stenting. Flow arrest of the proximal balloon was not observed. Temporary focal neurological deficits developed in two patients (11.1%). At clinical follow-up, 14 patients were classified as modified Rankin Scale (mRS) 0, three as mRS 2, and one as mRS 4. The mean contrast leakage period of IPR was 11.2 min (range: 1-31 min). Cerebral aneurysms with IPR were divided into late (n=9, mean time: 17.11 min) and early (n=9, mean time: 5.22 min) control groups based on the criteria of 10 min of contrast leakage period. No significant between-group differences regarding clinical outcomes were observed after IPR (p=1). Conclusions In our series, all patients with IPR were controlled with further coil packing or stenting without proximal balloon occlusion within 31 min of contrast leakage. There was no difference in clinical outcomes when the long contrast leakage period group and short contrast leakage period group were compared.

From 2004 to 2020, we studied three pediatric patients (age: 9-13 years, all male) and one adult patient (age: 29 years, female) with tectal plate glioma with obstructing hydrocephalus on MRI. One patient had neurofibromatosis type 1. All patients complained about headaches and vomiting, and one patient had diplopia. Endoscopic third ventriculostomy (ETV) was underwent in all patients and a biopsy was obtained from two patients. Pathologic diagnoses were a pilocytic astrocytoma and a lowgrade glioma. After ETV with or without biopsy, neurological symptoms were improved in all patients.Three patients did the clinical and radiological follow-up without adjuvant treatment. One patient underwent gamma knife radiosurgery. In two pediatric patients and the adult patient, there was no clinical and radiological progression after 6.2, 6.9, and 8.0 years, respectively. One pediatric patient whose lesion had focal enhancement had radiologic progression without any neurologic symptoms after 5.1 years. Without adjuvant treatment for this lesion, there was no clinical deterioration neither further radiological progression for 6.2 years after radiological aggravation. Tectal plate gliomas showed indolent clinical courses, even after radiologic tumor progression. After the treatment of obstructing hydrocephalus, clinical and radiologic follow-up can be recommended for indolent tectal plate gliomas.