Hemimasticatory spasm is a rare neurologic disorder characterized by unilateral, paroxysmal involuntary contraction of the masticatory muscles. It can be confused with other unilateral facial spasms. In this report, we present two patients with hemimasticatory spasm who were initially misdiagnosed with other disorders. The first patient was a 54-year-old man with a 9-year history of right facial spasm. He underwent microvascular decompression, without benefit, at another hospital with the diagnosis of hemifacial spasm two years prior to presenting at our hospital.On examination, right masseter and temporalis muscles had irregular contractions with twitches and prolonged spasms. His brain magnetic resonance imaging was normal.He showed a good response to carbamazepine. The second case was a 60-year-old man presented with a 10-year history of jaw-closing movement. Previous treatment for temporomandibular joint disorder was ineffective. He was previously diagnosed as oromandibular dystonia at another hospital, and biperiden and diazepam treatment resulted in slight improvement. There was tonic contraction and hypertrophy of the left masseter. He improved with carbamazepine. These cases illustrate the importance of hemimasticatory spasm as differential diagnosis, and the good response to carbamazepine.
Nervous System Diseases

BACKGROUND/AIMS: Colonoscopy is less effective at screening for colorectal cancer in the right side of the colon. Retroflexion during colonoscopy is expected to improve the detection rate of colorectal adenomas. The aim of the present study was to evaluate the usefulness of retroflexion in the right-sided colon. METHODS: From April to November 2013, a total of 398 patients were enrolled in this study. For each patient, a cap-assisted colonoscopic examination was performed. After cecal intubation, a forward view examination from the cecum up to the hepatic flexure was performed and all identified polyps were removed. The colonoscope was reinserted to the cecum, and a careful second forward view examination of the cecum to the hepatic flexure was performed, with removal of additionally identified polyps. The colonoscope was then reinserted to the cecum and retroflexed; a third colonoscopic examination was then performed to the hepatic flexure in retroflexion with removal of additional polyps. Total polyp numbers and characteristics were compared between the two forward view examinations and the retroflexion examination. RESULTS: A successful retroflexion was performed in 90.2% of patients. A total of 213 polyps and 143 adenomas were detected in the right-sided colon using the routine method of examining the right colon twice in forward view. An additional 35 polyps and 24 adenomas were detected on retroflexion. Of these 35 polyps, 27 (77.1%) were small-sized polyps (< or =5 mm) and 24 (71.4%) were adenomas. Finding additional adenomas using the retroflexion technique was associated with older age. CONCLUSIONS: Colonoscopic retroflexion is helpful in the detection of cecum and ascending colon adenomas, especially small-sized adenomas (< or =5 mm). It is particularly useful in older patients.
Adenoma* ; Cecum ; Colon* ; Colon, Ascending ; Colonoscopes ; Colonoscopy ; Colorectal Neoplasms ; Humans ; Intubation ; Mass Screening ; Polyps

We have experienced a case of pericardial tuberculoma, a very rare disease, with massive pericardial effusion in a 63-year-old veteran. He wdimensional echocardiography. Computed tomographic scans confirmed the presence of a pericardial mass and clinically unsuspected "lung mass". The presence of the lung mass led us a diagnostic and therapeutic dilemma. Surgery confirmed the pericardial mass which revealed tuberculosis by patholohy and loculated pleural effusion at the major fissure, so-called "phantom tumor", not a lung mass.
Echocardiography ; Humans ; Lung ; Middle Aged ; Pericardial Effusion ; Pleural Effusion ; Rare Diseases ; Tuberculoma* ; Tuberculosis ; Veterans

BACKGROUND: Cardiac patients undergoing open heart surgery usually require ventilatory support that involves ICU admission in the postoperative period. We tried to find out determinants of postoperative ventilatory support time. METHODS: We reviewed the medical records of 56 open heart surgery patients retrospectively in terms of their disease, preoperative physical status, age, post-bypass arterial oxygen tension/inspired oxygen fraction (PaO2/FIO2) ratio, number of inotropics used and searched the relationship between each factor and postoperative intubation time. RESULTS: None of the factors except the number of inotropics used had an significant influence on the postoperative intubation time. CONCLUSION: In open heart surgical patients their disease, preoperative physical status, age, postbypass PaO2/FIO2 ratio do not affect postoperative intubation time rather than number of inotropics used does.
Heart* ; Humans ; Intubation* ; Medical Records ; Oxygen ; Postoperative Period ; Retrospective Studies ; Thoracic Surgery*

A spontaneous spinal epidural hematoma (SSEH) is a rare disease that accompanies severe axial pain in the spine with various levels of paralysis depending on the location of the hematoma. A SSEH is mainly caused by a coagulating disorder or anticoagulants medication, while certain cases relate this disease with spinal inflammatory conditions. The early diagnosis of a SSEH is important for its treatment. Most cases with neurologic symptoms can be treated with an immediate laminectomy and decompression. If the neurologic symptom improves within 12 hours, a conservative treatment is effective; however few cases have been reported. We report this case with a review of the relevant literature.
Anticoagulants ; Decompression ; Early Diagnosis ; Hematoma ; Hematoma, Epidural, Spinal ; Laminectomy ; Neurologic Manifestations ; Paralysis ; Polymethacrylic Acids ; Rare Diseases ; Spine

BACKGROUND: After uninephrectomy(UNX), proliferation and apoptosis of renal cells are regarded to be closely involved in glomerular hypertrophy and compensatory renal growth. However, exact mechanism has not been well elucidated in relation with the growing status. METHODS: In small, medium and large male New Zealand white rabbits, unilateral kidneys obtained 1, 7, and 30 days after Sham operation were used for control. In experimental groups, the rabbits were sacrificed, and residual kidneys were obtained 1, 7, and 30 days after UNX. Morphometric analysis of glomerular size were performed. Immunohistochemical staining for MIB-1 antigen and Tdt-mediated dUTP-digoxigenin nick end labelling(TUNEL) method were performed. RESULTS: Glomerular hypertrophy was demonstrated in all groups after UNX and pronounced in the small rabbits. The number of renal Ki-67 positive cells were progressively increased in all study groups. The number of TUNEL positive cells was relatively small in controls. however, the numbers of glomerular, tubular and interstitial TUNEL positive cells were progressively increased in all study groups. CONCLUSION: These results demonstrate that different results regarding the compensatory growth in uninephrectomized rabbits of different weights and ages. Apoptosis may play an important role in the regression of hypertrophic and proliferated glomerular and tubulointerstitial cells during compensatory renal hypertrophy.
Apoptosis* ; Cell Proliferation* ; Humans ; Hypertrophy ; In Situ Nick-End Labeling ; Ki-67 Antigen ; Kidney ; Male ; Rabbits* ; Weights and Measures

The present study was performed to evaluate how cellular and humoral immune responses were perturbed by immunization of mixed periodontal bacterial biofilms. Each group of mice was immunizared with 1) Porphyromonas gingivalis (P. gingivalis) grown as a planktonic culture, 2) Fusobacterium nucleatum (F. nucleatum), 3) P. gingivalis grown as a biofilm, or 4) mixed P. gingivalis plus F. nucleatum grown as a biofilm culture, respectively. Immune mouse sera were collected from each mouse. Spleens were harvested to isolate T cells and consequently stimulated with antigen presenting cells and P. gingivalis whole cell antigen to establish P. gingivalis-specific T cell lines. There were no significant differences in the mean anti-P. gingivalis IgG antibody titers among mouse groups. Immunization of mice with pure P. gingivalis biofilm or mixed P. gingivalis plus F. nucleatum biofilm resulted in significant reduction of antibody avidity and opsonophagocytosis function. INF-gammaproduction by P. gingivalis-specific T cell lines was also substantially reduced in mouse groups immunized with the biofilm. It was concluded that P. gingivalis biofilm perturbs the cellular and humoral immune responses in periodontal disease.
Animals ; Antibody Affinity ; Antigen-Presenting Cells ; Biofilms* ; Cell Line ; Fusobacterium nucleatum ; Immunity, Cellular ; Immunity, Humoral ; Immunization ; Immunoglobulin G ; Mice ; Periodontal Diseases ; Plankton ; Porphyromonas gingivalis* ; Porphyromonas* ; Spleen ; T-Lymphocytes

No abstract available.
Adult ; Fingers ; Humans

This study was performed to determine whether there were retinal changes in Parkinson's disease. Photopic and scotopic Flash ERGs were conducted for 21 patients with Parkinson's disease and for 19 control subjects. Seventeen patients were medicated with anticholinergics and L-dopa containing drugs. Five findings were observed from the study. 1. There was no difference in implicit time of photopic and scotopic a-and b-waves between the control and the Parkinsonian groups (p(t)>0.05). 2. Amplitude of photopic b-wave was smaller in the Parkinsonian group than the control group (p(t)<0.05). 3. Amplitudes of photopic and scotopic a-and b-waves did not differ between the control and the medicated Parkinsonian groups (p(t)>0.05). 4. Amplitudes of photopic (p(t)<0.001) and scotopic (p(t)<0.01) b-wave were smaller in the nonmedicated Parkinsonian group than the control group. 5. Age and sex characteristics did not affect the results in either group. From the above findings, it is suggested that there is a retinal cell change responsible for b-wave generation in Parkinson's disease, and it is reversed by anti-Parkinsonian medication.
Cholinergic Antagonists ; Humans ; Levodopa ; Parkinson Disease ; Retinaldehyde ; Sex Characteristics

General epidemiological data regarding herpes zoster (HZ) are necessary for treatment and prevention of this disease. In addition, epidemiological data can play an important role in evaluating the efficacy and impact of vaccination. Though several epidemiological studies of HZ in Korea have been conducted, they usually depend on hospital-based data and may not be representative of HZ characteristics all over Korea. The purpose of this study was to evaluate the incidence and other epidemiological features of HZ in the general Korean population. We used population-based medical records from the Health Insurance Review & Assessment Service, which includes 50,908,646 medical insurance subscribers, to calculate the incidence of HZ. Also, we analyzed an age-stratified random sample of 1,375,842 individuals to study descriptive epidemiologic characteristics of HZ in Korea in 2011. We observed that the incidence of HZ was 10.4 per 1,000 person-years and was strongly correlated with age. Sex had a major influence on HZ incidence; overall, there were 12.6 cases per 1,000 person years in women and 8.3 cases per 1,000 person years in men. There was no difference in incidence according to the locality and season.
Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Herpes Zoster/*diagnosis/*epidemiology ; Hospitalization/*statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Seasons ; Sex Distribution ; Young Adult