The Foster Kennedy syndrome is ipsilateral optic disc atrophy and contralateral optic disc edema that is caused not only frontal lobe tumor but also another intracranial tumors and non tumorous conditions. In this case, suspected neurofibromatosis by the skin and ocular manifestations, there are glioblastoma multiforme in left temporoparietal lobe and undefined mass with bony destruction of the ipsilateral sphenoidal wing ridge. Authors asserted that ipsilateral optic atrophy was caused by direct compression of the undefined mass on sphenoidal wing ridge to the optic nerve and the contralateral disc edema was result from high intracranial pressure caused by glioblastoma multiforme.
Adult ; Anterior Chamber ; Atrophy ; Edema ; Female ; Filtering Surgery ; Frontal Lobe ; Glaucoma* ; Glioblastoma ; Humans ; Intracranial Pressure ; Iris ; Neurofibromatoses ; Optic Atrophy ; Optic Nerve ; Optic Nerve Diseases* ; Parturition ; Skin

OBJECTIVE: To investigate whether the serum levels of IL-10 in patients with rheumatoid arthritis are different from those of normal controls and SLE patients and to find out any correlation with disease activity parameters of rheumatoid arthritis. METHODS: Sera from 20 healthy normal persons, 16 rheumatoid arthritis patients and 16 patients with systemic lupus erythematosus were collected and measured for IL-10 and IL-6. Various disease activity parameters were measured in RA patients. RESULTS: The serum level of IL-10 in RA patients was significantly elevated compared to normal controls but lower than those of SLE patients. In RA patients there was no definite correlation between the disease activity parameters and serum IL-10 levels. Despite significant improvements in terms of various disease activity parameters, there was no significant change of serum IL-10 levels after treatment in RA patients. In seropositive RA patients, positive correlation was found between serun IL-10 and rheumatoid factor levels. CONCLUSION: Our findings show that the serum IL-10 levels in patietns with RA are elevated compared to normal controls but lower than those of SLE patients. There was no correlation between serum IL-10 levels and disease acivity parameters of RA.
Arthritis, Rheumatoid* ; Humans ; Interleukin-10* ; Interleukin-6 ; Lupus Erythematosus, Systemic ; Rheumatoid Factor

Thirty patient with essential hypertension were administered Manidipine, a new calcium antagonist, 10~20mg once daily to evaluate the hypotensive efficacy and safety for 8 weeks. And the followings were the result. 1) Patients were consists of 14 male, 16 female, aged 53 in average and classified as mild in 21 and moderate in 9 patients. 2) Optimum intial dose was 10mg and 10 to 20mg were the doses recommended. 3) Blood pressure dropped after 8 weeks 24/13mmHg in average, rewarding 80% effectiveness and normalized in 87%. 4) Most frequent side reaction was facial flushing in 5 patiens followed by palpitation and dizziness, all of which did not disturb the continuation of medication. 5) Most of routine laboratory parameter were normal and unchanged between before and after the trial. 6) Overall rating of usefulness was 77%. In conclusion, Manidipine 10 to 20mg once daily regimen is well tolerated and effective in the treatment of mild to moderate essential hypertension.
Blood Pressure ; Calcium ; Dizziness ; Female ; Flushing ; Humans ; Hypertension* ; Male ; Reward

Torsade de pointes (TdP) is a form of polymorphic ventricular tachycardia that is associated with prolongation of the QT interval. Although it occurs in many clinical settings, torsade de pointes is most commonly caused by drugs. The second generation antihistamines, including terfenadine and astemizole, have little sedation or other adverse effects on the CNS. They have been used widely to treat various allergic diseases, but it has been reported that overdoses or combinations with antifungal agents or macrolide antibiotics may lead to TdP. We report a case of TdP that occured during com-bination therapy of terfenadine and ketoconazole.
Anti-Bacterial Agents ; Antifungal Agents ; Astemizole ; Histamine H1 Antagonists, Non-Sedating ; Ketoconazole* ; Tachycardia, Ventricular ; Terfenadine* ; Torsades de Pointes*

PURPOSE: Rapid antigen test (RAT) is used to screen influenza rapidly. The clinical sensitivity of RAT was poor for 2009 H1N1 influenza. The aim of this study was to identify the correlation of time gap (TG) between fever onset and the sensitivity of RAT for 2009 H1N1 influenza. METHODS: Data were collected retrospectively during the pandemic H1N1 2009 influenza season between October 2009 and February 2010. The RAT was done by using SD Bioline influenza antigen (Standard Diagnostics Inc.) in nasopharyngeal swab. The 2009 H1N1 influenza was confirmed by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). Specimens were categorized according to the TG between fever onset and performance of RAT. They were classified into <24 hours (TG1), 24 to 48 hours (TG2), 48 to 72 hours (TG3), 72 to 96 hours (TG4), 96 to 120 hours (TG5), >120 hours (TG6). RESULTS: The overall sensitivity of RAT was 69.9%. The TG dependent sensitivity of RAT at TG1, TG2, TG3, TG4, TG5, and TG6 was 64.3%, 73.3%, 61.1%, 88.9%, 83.3%, and 61.1% respectively. The sensitivity of RAT was the highest when the TG was 72 to 96 hours. But this result was not statistically significant. CONCLUSION: Correlation of TG between fever onset and the sensitivity of RAT for 2009 H1N1 influenza was not statistically significant. But our study suggested that 72 to 96 hours after fever onset is the most sensitive time of RAT. Timely optimal performance of the RAT could have a significant impact on improving results. Further evaluation for better sensitivity would be needed.
Animals ; Fever ; Influenza, Human ; Pandemics ; Rats ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Seasons

The clinical entity of Dysplasia Epiphyseal Multiplex was first descrihed by Fairbank in 1935, characterized by the disturbance of endochondral ossification in hoth epiphyseal centers and regions of physeal growth. It manifests itself radiologically as late appearance and mottling of the ossification centers and clinically as short stature, stubby digits and painful stiffness of multiple joints. It is typically transmitted as an autosomal dominant trait though recessive forms have been described. The spine is normal apart from a mild increased lumbar lordosis. Many patients are referred to an orthopaedic surgeon for bilateral Perthes disease, as was one of the authors cases. This Paper reports four cases of multiple epiphyseal dysplasia which affected one family.
Animals ; Hip ; Humans ; Joints ; Knee ; Legg-Calve-Perthes Disease ; Lordosis ; Osteochondrodysplasias* ; Spine

This project developed a neural network based on nursing diagnoses among 98 nursing diagnoses Korea Nurses Association recommended when related factors and clinical signs are entered. This nursing diagnosis system consists of five sub-systems: data-input system from which a nurse can obtain knowledge from experts; data-base system in which nurses can manage statistical data; inference support system which provides learning effect; inference system which increases inference ability of nurses using existing data and nursing diagnoses data; and result-retrieve system in which nurses can look at the outcomes of nursing process. This nursing diagnosis system provides a interface which enables maintenance and revision easier as well as to induce a diagnosis through the communication between the nurse and the patient. In addition, this system makes nurses determine the nursing diagnoses in a more accurate manner by linking the learning effect of the system whit intra-neural network algorithm. This nursing diagnosis system will assist nurses to provide foster and more accurate way to implement nursing diagnosis.
Diagnosis ; Humans ; Information Systems* ; Korea ; Learning ; Nursing Diagnosis* ; Nursing Process* ; Nursing*

No abstract available.
Cytomegalovirus* ; DNA* ; Glomerulonephritis* ; Polymerase Chain Reaction*

Activation of the sympathetic nervous system in mediating the stress response attends traumatic brain injury. Plasma dopamine(DA), epinephrine(E), norepinephrine(NE) levels were measured in 26 severe traumatically brain injured patients to determine whether catecholamine levels obtained within 24 hours after injury provide reliable prognostic endogenous markers of outcome. Patient outcome was determine at 1 week using the Glasgow Coma Scale(GCS) and at the time of discharge the Glasgow Outcome Scale(GOS), 7 patients with diseases except those with a severe traumatic brain injury were selected as a control group. Firstly, we analyzed the difference of the average DA, E, and NE between the control group and severe traumatic brain injury patients. Secondly, we analyzed the difference of the average catecholamine levels in the 3 groups according to admission GCS scores(respectively 3~4, 5~7, 8~9). Third, we analyzed the difference of the average catecholamine levels in the 5 groups according to GOS scores at 1 week(respectively dead, 3~4, 5~7, 8~11, >11). Finally, we analyzed the difference of the average catecholamine levels in the 5 groups according to GOS at the time of discharge. As a result, there was no statical difference between the level of DA in the control group and those of the severe brain injury patients. But the level of E an NE in the experimental group were higher than the control group(respectively p<0.03, p<0.04). The admission GCS score correlated highly with the catecholamine levels(NE : r=0.69, p<0.001 ; E ; r=0.42, p<0.03 ; DA ; r=0.42, p<0.03). In patients with admission GCS of 3 to 4, NE levels increaed fourfold above other group(p<0.005). In the 13 patients with GCS scores of 3 or 4 on admission. NE levels predicted outcome at 1 week. All two patients with NE levels less then 750 pg/ml were survived, while 10 of 11 with NE levels greater than 750 pg/ml were died(p<0.02). The levels of NE was significantly higher in patients who died than in those with better outcome(p<0.02). Therefore, these findings indicated that the level of circulating NE is an excellent endogenous marker that appear to reflect the extent of brain injury and that may predict the likelihood of recovery.
Brain ; Brain Injuries* ; Coma ; Dopamine ; Epinephrine ; Humans ; Negotiating ; Norepinephrine ; Plasma* ; Prognosis* ; Sympathetic Nervous System

BACKGROUND: The aim of this study was to assess the relationship between acute physiologic and chronic health examination (APACHE) II and sequential organ failure assessment (SOFA) scores and outcomes of post-cardiac arrest patients treated with therapeutic hypothermia (TH). METHODS: Out-of-hospital cardiac arrest (OHCA) survivors treated with TH between January 2010 and December 2012 were retrospectively evaluated. We captured all components of the APACHE II and SOFA scores over the first 48 hours after intensive care unit (ICU) admission (0 h). The primary outcome measure was in-hospital mortality and the secondary outcome measure was neurologic outcomes at the time of hospital discharge. Receiver-operating characteristic and logistic regression analysis were used to determine the predictability of outcomes with serial APACHE II and SOFA scores. RESULTS: A total of 138 patients were enrolled in this study. The area under the curve (AUC) for APACHE II scores at 0 h for predicting in-hospital mortality and poor neurologic outcomes (cerebral performance category: 3-5) was more than 0.7, and for SOFA scores from 0 h to 48 h the AUC was less than 0.7. Odds ratios used to determine associations between APACHE II scores from 0 h to 48 h and in-hospital mortality were 1.12 (95% confidence interval [CI], 1.03-1.23), 1.13 (95% CI, 1.04-1.23), and 1.18 (95% CI, 1.07-1.30). CONCLUSIONS: APACHE II, but not SOFA score, at the time of ICU admission is a modest predictor of in-hospital mortality and poor neurologic outcomes at the time of hospital discharge for patients who have undergone TH after return of spontaneous circulation following OHCA.
APACHE ; Area Under Curve ; Cardiopulmonary Resuscitation ; Hospital Mortality ; Humans ; Hypothermia* ; Hypothermia, Induced ; Intensive Care Units ; Logistic Models ; Odds Ratio ; Organ Dysfunction Scores* ; Out-of-Hospital Cardiac Arrest* ; Outcome Assessment (Health Care) ; Retrospective Studies ; Survivors