Strabismus surgery results in the permanent interruption of anterior ciliary blood flow, predisposing the eye to anterior segment ischemia (ASI). A primate model was used to assess the effectiveness of a new muscle-scleral tuck for preserving anterior ciliary artery circulation. The model consisted of removing 3 rectus muscles from both eyes of 2 rhesus monkeys, then performing a tuck on the inferior rectus (IR) right eye while leaving the left IR as a control. Four weeks later, a modified tuck was performed on the virgin left IR. Fluorescein iris angiograms of both eyes were obtained, and preoperative angiograms at 5-15 sec. showed normal 360 degrees perfusion. Postoperative follow-up angiograms showed segmental superior temporal filling defects and preservation of perfusion in the distribution of the IR. Comparison of fellow eyes tucked vs control IR showed no difference in the filling pattern in both monkeys. Comparison of the same eye before and after tuck also showed essentially the same filling pattern in all 4 eyes with preservation of inferior circulation. Our conclusion is that the modified tuck preserves the anterior ciliary blood flow and may be useful as a muscle-strengthening procedure in patients predisposed to developing ASI.
Animals ; Anterior Eye Segment/*blood supply ; Ciliary Body/*blood supply ; Disease Models, Animal ; Fluorescein Angiography ; Follow-Up Studies ; Iris/blood supply ; Ischemia/*prevention & control ; Macaca mulatta ; Oculomotor Muscles/physiology/*surgery ; Perfusion

OBJECTIVE: Team approach for patient-specific rehabilitation for acute stroke patient is important to minimize loss of function and facilitate recovery as well as cost effectiveness. We tried to establish acute stroke rehabilitation algorithm to maximize efficiency of delivering patient-specific and comprehensive rehabilitation in acute stroke patients. METHOD: We developed the clinical algorithms through the informal consensus development process by thorough discussions within the rehabilitation team members. Before and after adoption of the rehabilitation algorithms in clinical activity, we investigated satisfaction of patients and staffs by questionnaire. In addition, length of hospitalization was assessed. RESULTS: Ten algorithms were developed on the general rehabilitation, physical, occupational, and speech therapy, dysphagia, cognitive rehabilitation, nursing care and complication, and psychosocial rehabilitation. Every algorithm was comprised to take care of patients from the acute stage of rehabilitation to long term management. After algorithms to the clinical practice, total mean score of satisfaction was significantly improved in patients and staffs (p<0.05). Mean length of stay for rehabilitation tended to decline without statistical significance. CONCLUSION: Algorithm for patient specific acute stroke rehabilitation could contribute to increase the level of satisfaction among patients and staffs.

The trial of external quality assessment for inborn error of metabolism was performed in 2003. A total 10 specimens for neonatal screening tests were distributed to 43 laboratories with a response rate of 83%. All the control materials were sent as a filter paper form. Each laboratory replied the test result as the screening items they were doing as a rountine test at the reception of the specimen among PKU screening, neonatal TSH, neonatal T4(total/free), galactosemia screen, homocytinuria screen and histidinemia screen. The mean, SD, and CV were analyzed.
Galactosemias ; Infant, Newborn ; Korea* ; Mass Screening ; Metabolism* ; Neonatal Screening

BACKGROUNDPercutaneous kyphoplasty (PKP) using balloon expander has been proved to be effective in the treatment of painful vertebral compression fractures. Recently, Sky-bone expander, an alternative bone expander for PKP has been developed. The purpose of this study was to show our preliminary clinical outcomes of PKP with Sky-bone expander.

METHODSPKP with Sky-bone expander was performed in 25 patients (30 vertebrae). The operation time, bleeding volume, cement volume injected were recorded. The pain and functional activities of the patients before and after the operation were compared using Wilcoxon signed-rank test. The cement distribution in the vertebrae, vertebral height restoration, and kyphosis correction after the procedure were evaluated by radiography. The pre- and post-operative absolute values of the vertebral height and kyphotic angle were compared by paired-sample t test. All the patients were followed up by telephone or clinic consulting after being discharged from our hospital.

RESULTSThe procedure was performed successfully in all the patients. Bipedicular injection was used in 2 of the patients, and unipedicular injection was made in the others. The operation time ranged from 25 to 120 minutes (45 minutes per vertebra on average). The average bleeding volume was about 20 ml. Polymethylmethacrylate 1.5-5.0 ml (mean, (3.15+/-0.78) ml) was injected through each pedicle into all the patients except one, who received calcium sulphate 3.5 ml instead. The patients were followed up for 12-15 months (13.5 months on average). The mean visual analogue scale (VAS) score, Oswestry Disability Index, anterior, midline, and posterior vertebral height, and kyphotic angle of the patients were improved significantly at the end of the follow-up compared with those before the operation. (2.5+/-1.3, 35.1%, (20.94+/-6.15) mm, (20.26+/-4.59) mm, (26.72+/-3.49) mm, and 8.2 degrees vs. 8.5+/-1.9, 61.2%, (19.11+/-6.72) mm, (15.88+/-5.73) mm, (25.78+/-3.67) mm, and 17.3 degrees; all P<0.05). The cement distribution with unipedicular injection was mostly limited within the injection site in the vertebral body. Cement extravasation was seen at ten levels (33.3%).

CONCLUSIONSPKP with Sky-bone expander is an effective and relatively safe alternative to the PKP using balloon expander. It can relieve pain, improve physical function, and restore the height of the collapsed vertebrae, but the cement extravasation is unsolved.

Adult ; Aged ; Bone Cements ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Middle Aged ; Prospective Studies ; Spinal Fractures ; surgery ; Spine ; surgery ; Tissue Expansion Devices ; Treatment Outcome

OBJECTIVE: To assess the clinical usefulness of computer- assisted line bisection task for the patients with sensory- attentional visuospatial neglect. METHOD: Forty patients with unilateral hemispheric stroke (25 right, 15 left) and 15 normal age-matched subjects participated in this study. Computer-assisted line bisection task (CALBT) was designed using modified Milner landmark test to assess the sensory-attentional aspect of visuospatial neglect. Accuracy of response and reaction time for the transected lines, and response rate for the bisected lines were measured. Correlation between the results of CALBT and conventional line bisection test and Albert test was evaluated. RESULTS: In patients with right hemispheric lesion, results of CALBT demonstrated shifting of attention to the right hemifield and neglect of the stimulus in the left hemifield. In contrast, patients with left hemispheric lesion showed significantly decreased attention to the right hemifield and shifting of attention to the left hemifield. Performances of CALBT correlated with the line bisection test, but not with the Albert test. CONCLUSION: Computed assisted line bisection task can be used for the quantitative assessment of the sensory attentional aspect of visuospatial attention in patients with unilateral neglect.
Humans ; Reaction Time ; Stroke

OBJECTIVE: To determine the relationship between cognitive-perceptual function and functional independence in stroke patients. METHOD: Thirty-three patients (16 male, 17 female) with first ever ischemic stroke were enrolled. Their mean age was 60.4 years and the mean post-onset duration was 8.1 months. Subjects underwent detailed cognitive assessment including digit span test, line bisection test, Albert test, Wechsler nonverbal memory scale, Korean Hopkins verbal learning Test, Rey complex figure test, and trail making test A. Their functional outcomes were assessed using Functional Independence Measure (FIM) and Modified Barthel Index (MBI). RESULTS: Among the cognitive subtests, Wechsler nonverbal memory scale, Albert test, and Rey complex figure test scores had significant correlation with both FIM and MBI scores. Patients with right hemispheric stroke showed significantly lower scores in line bisection test and Rey complex figure test than those with left hemispheric stroke patients. CONCLUSION: Visuospatial perception and nonverbal memory functions seemed to be two most important cognitive- perceptual domains for functional recovery of stroke patients.
Humans ; Male ; Memory ; Stroke* ; Trail Making Test ; Verbal Learning

Bacterial Infections ; Humans ; Lymphoma, Large B-Cell, Diffuse/diagnosis* ; Mucormycosis/diagnosis* ; Respiratory Sounds ; Thyroid Gland

No abstract available.
Alopecia* ; Minoxidil*

Overexpressing of ATP-binding cassette (ABC) transporters is the essential cause of multidrug resistance (MDR), which is a significant hurdle to the success of chemotherapy in many cancers. Therefore, inhibiting the activity of ABC transporters may be a logical approach to circumvent MDR. Olmutinib is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), which has been approved in South Korea for advanced EGFR T790M-positive non-small cell lung cancer (NSCLC). Here, we found that olmutinib significantly increased the sensitivity of chemotherapy drug in ABCG2-overexpressing cells. Furthermore, olmutinib could also increase the retention of doxorubicin (DOX) and rhodamine 123 (Rho 123) in ABC transporter subfamily G member 2 (ABCG2)-overexpressing cells. In addition, olmutinib was found to stimulate ATPase activity and inhibit photolabeling of ABCG2 with [I]-iodoarylazidoprazosin (IAAP). However, olmutinib neither altered ABCG2 expression at protein and mRNA levels nor blocked EGFR, Her-2 downstream signaling of AKT and ERK. Importantly, olmutinib enhanced the efficacy of topotecan on the inhibition of S1-MI-80 cell xenograft growth. All the results suggest that olmutinib reverses ABCG2-mediated MDR by binding to ATP bind site of ABCG2 and increasing intracellular chemotherapeutic drug accumulation. Our findings encouraged to further clinical investigation on combination therapy of olmutinib with conventional chemotherapeutic drugs in ABCG2-overexpressing cancer patients.