No abstract available.
Brain* ; Child* ; Epilepsy* ; Humans ; Seizures*

Surface electromyogram in the lumbar paraspinal muscles was studied to evaluate back muscle impairment in twenty chronic low back pain patients and twenty control subjects. Turns-amplitude and power spectrum analysis of electromyographic signals were performed at different force levels during fatigue from sustained isometric contraction and recovery from fatigue in trunk extensor muscles. Results indicated that with increasing force level mean amplitude and Root Mean Square (RMS) values were increased, but mean and median frequencies increased initially until 20% Maximal Voluntary Contraction (MVC) and decreased tendency after then. Turns, mean amplitude, RMS, mean and median frequencies were all higher in control subject than those of low back pain patients. During sustained isometric contraction at 70% MVC, mean and median frequencies were linearly decreased, and the slopes were steeper in the patients group. Mean amplitude and RMS value showed decreased tendency during fatigue. During recovery from fatigue turns, mean and median frequencies increased especially in the first 3 minutes and nearly completely recovered in the 7~8 minutes in both patients and control groups. Therefore the mean amplitude and RMS value could be used as indicators of the level of muscle contraction and the mean and median frequencies reflect well the muscle fatigue in paralumbar muscle. These results validate the use of surface EMG spectral parameters as an objective measure of back muscle impairment in chronic low back pain patients.
Back Muscles* ; Back Pain ; Fatigue ; Humans ; Isometric Contraction ; Low Back Pain* ; Muscle Contraction ; Muscle Fatigue ; Muscles ; Paraspinal Muscles ; Spectrum Analysis

The branchio-oto-renal (BOR) syndrome is a clinically and genetically heterogeneous disease entity which is characterized by the association of preauricular pits, branchial cleft anomaly, hearing loss and various renal anomalies. The incidence of BOR syndrome is approximately 1 : 40,000 and its genetic pattern of transmission is autosomal dominant. Hearing loss is the most common feature of BOR syndrome and is reported in almost 90% of affected individuals. EYA1, the human homologue of the Drosophila eyes absent gene, has been shown to cause BOR syndrome. We report, with a review of literatures, a female patient with BOR syndrome.
Branchial Region ; Branchio-Oto-Renal Syndrome ; Drosophila ; Eye ; Female ; Hearing Loss ; Humans ; Incidence

Phenylpropanolamine is a sympathomimetic amine used widely as a decongestant or appetite suppressant. Reports of the myocardial injury from the use of phenylpropanolamine are rare and the mechanism of the myocardial injury is not known clearly. We experienced a case of myocardial injury after ingestion of phenyl-propanolamine. A 46-year-old woman was admitted because of chest pain and dyspnea after ingestion of 5 tablets of anorectic pill containing phenylpropanolamine 75 mg per tablet. The serum creatine kinase MB isoenzyme levels were elevated and electrocardiographic abnormalities suggesting myocardial infarction were seen in the precordial lead. In echocardiograpy, left ventricular anteroseptal wall motion was nearly akinetic but coronary angiography showed normal coronary arteries except sluggish blood flow in left anterior descending artery.
Appetite ; Arteries ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Creatine Kinase ; Dyspnea ; Eating* ; Electrocardiography ; Female ; Humans ; Middle Aged ; Myocardial Infarction ; Phenylpropanolamine* ; Tablets

BACKGROUND: Ski injuries depend on many factors which involve the skier's skill, the skiing environment, and skier's equipment. The purpose of this study was to determine the factors associated with fractures by skiing accident. SUBJECT: We evaluated 566 patients with ski injuries who visited to the emergency post located in the YongPyong Ski Resorts from Nov. 1996 to Feb. 1997. Among the patients,379 patients had no fracture(group I) and 187 patients had fracture(group II). RESULT: There was no differences in mean age and sex ratio between two groups. Fractures of the lower extremities were more common than the upper extremities. Slipping was the most common injury mechanism. arming-up was done in 40% of group I and in 17% of group II. The fracture injuries were more common in the skier with intermediate(45%) skill than the beginner(29%) and the ones with advanced skill(12%). The slope with intermediate difficulty was the most frequent site of fracture accidents. The fracture group tended to choose the slope beyond their skiing ability. CONCLUSION: Our results suggest that fracture during skiing can be prevented if skiers do warming-up prior to skiing and choose slope appropriate to their skiing skill.
Emergencies ; Health Resorts ; Humans ; Lower Extremity ; Sex Ratio ; Skiing ; Upper Extremity

BACKGROUND: Rifampicin (RFP) is one of the principal first-line drugs used in combination chemotherapies against Mycobacterium tuberculosis, and its use has greatly shortened the duration of chemotherapy for the successful treatment of drug-susceptible tuberculosis. Compensatory mutations have been identified in rpoC that restore the fitness of RFP-resistant M. tuberculosis strains with mutations in rpoB. To investigate rpoC mutation patterns, we analyzed 93 clinical M. tuberculosis isolates from patients in South Korea. METHODS: Drug-resistant mycobacterial isolates were cultured to determine their susceptibility to anti-tubercular agents. Mutations in rpoC were identified by sequencing and compared with the relevant wild-type DNA sequence. RESULTS: In total, 93 M. tuberculosis clinical isolates were successfully cultured and tested for drug susceptibilities. They included 75 drug-resistant tuberculosis species, of which 66 were RFP-resistant strains. rpoC mutations were found in 24 of the 66 RFP-resistant isolates (36.4%). Fifteen different types of mutations, including single mutations (22/24, 91.7%) and multiple mutations (2/24, 8.3%), were identified, and 12 of these mutations are reported for the first time in this study. The most frequent mutation involved a substitution at codon 452 (nt 1356) resulting in amino acid change F452L. CONCLUSION: Fifteen different types of mutations were identified and were predominantly single-nucleotide substitutions (91.7%). Mutations were found only in dual isoniazid- and RFP-resistant isolates of M. tuberculosis. No mutations were identified in any of the drug-susceptible strains.
Base Sequence ; Codon ; Drug Resistance, Multiple ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Korea* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Rifampin ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

PURPOSE: The purpose of this study is to assess the usefulness of Doppler parameters in transplanted kidney function. MATERIALS AND METHODS: Doppler parameters, including resistive index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end diastolic velocity (EDV) were measured in the interlobar artery of 55 transplant recipients. Patients were grouped according to glomerular filtration rate (GFR): Group A (GFR < 30 ml / min / 1.73 m2, n = 27) and group B (GFR > or = 30 ml / min / 1.73 m2, n = 28). Doppler parameters were compared between groups and correlated with the GFR. RESULTS: GFR (40.1 +/- 26.9) showed a significant negative correlation with RI (0.69 +/- .08) (p = .002, r = -.414). RI (0.72 vs. 0.67), PI (1.42 vs. 1.23), and EDV (10.5 vs. 15.3) differed significantly between groups (p < .05), however, PSV was not (36.9 vs. 47.1). Patients in group A (n = 11) with a lower RI than the mean had significantly lower PSV (31.7 vs. 45.1; p = .027) and EDV (11.1 vs. 16.7; p = .017), compared with such patients in group B (n = 21). CONCLUSIONS: Doppler parameters are useful for evaluation of function of transplanted kidney. Even if the RI is normal, PSV and EDV may be used as hemodynamic indicators.
Arteries ; Glomerular Filtration Rate ; Hemodynamics ; Humans ; Kidney ; Kidney Transplantation ; Transplants

PURPOSE: To evaluate the short-term clinical and radiographic results associated with use of the ceramicon-ceramic articulation uncemented total hip arthroplasty (THA) in patients less than fifty years old with osteonecrosis of femoral head. MATERIALS AND METHODS: Sixty-eight THAs with use of the ceramic-on-ceramic articulation were performed in fifty-nine patients who were younger than fifty years old with the implantation of an uncemented plasma coated Plasma cup and Bicontact stem. All patients were available for complete clinical and radiographic analysis after a mean duration of a follow-up of 31.6 months (range; 24-50 months). The average age of the patients at the index operation was 39.4 years (range; 16-49 years). Preoperative diagnosis was osteonecrosis of femoral head in all hips. The causative factors were idiopathic in twenty-one hips; alcohol abuse in twenty-eight hips, steroid in eleven hips, and posttraumatic in eight hips. Clinical evaluation was done by Harris Hip score (HHS). Radiographic evaluation was done in terms of stability of components and prevalence of osteolysis. RESULTS: The mean preoperative HHS of 61 points improved to 95 points at the time of the final follow-up. Excellent results were found in 57 hips (84%), good results were 11 hips (16%). No acetabular or femoral components were loosened radiographically. There was no evidence of osteolysis. There were two postoperative dislocation, one intraoperative femoral fissuring, and one transient sciatic nerve palsy. CONCLUSION: Short-term clinical and radiographic results associated with use of the ceramic-on-ceramic articulation uncemented THA in patients less than fifty years old with osteonecrosis of femoral head were excellent. However, longer-term follow up is needed.
Acetabulum ; Alcoholism ; Arthroplasty, Replacement, Hip* ; Diagnosis ; Dislocations ; Follow-Up Studies ; Head* ; Hip ; Humans ; Osteolysis ; Osteonecrosis* ; Plasma ; Prevalence ; Sciatic Neuropathy

This study reported the treatment of a patient with excessive worn dentition and limited maxillo-mandibular space for restoration, utilizing the computer-aided design and computer-aided manufacturing (CAD/CAM) technology. After the thorough examination of the patient's occlusal vertical dimension (OVD), full mouth rehabilitation was planned with increase of the OVD. The patient was satisfied with the provisional restorations establishing the increased OVD. The horizontal and vertical data of the patient's jaw relation that the provisional restorations contained were transferred to the definitive metal ceramic fixed prostheses by double scanning and three-dimensional printing. After the fixed restorations were cemented to the abutments, electronic surveying and three-dimensional printing were used to fabricate metal frameworks for the patient's removable partial dentures. The mandibular definitive removable prostheses were delivered to the patient's mouth and the full mouth rehabilitation procedures were completed. The digital technologies used for this case produced fixed and removable restorations satisfactory in masticatory, phonetic and aesthetic functions to both the patient and the dental clinician.
Ceramics ; Computer-Aided Design ; Dentition ; Denture, Partial, Removable ; Humans ; Jaw ; Mouth Rehabilitation ; Mouth ; Printing, Three-Dimensional ; Prostheses and Implants ; Tooth Wear ; Vertical Dimension

Objective: There is insufficient data on the etiology of altered mental status (AMS). This study aimed to classify the causes of AMS in patients transported by the 119 emergency medical services (EMS) and analyze the characteristics of vital signs. Methods: We enrolled patients with AMS based on the Glasgow Coma Scale (GCS) score <15, who were transferred to the emergency department by 119 EMS. The causes of AMS were determined through a retrospective review of their medical records. Results: A total of 2,730 patients were enrolled. The major causes for AMS were stroke (19.9%), intoxication (17.7%), traumatic brain injury (9.6%), sepsis (6.4%), and seizures (6.3%). The proportion of non-central nervous system (non-CNS) causes was higher than CNS-related causes (72.4% vs. 27.6%, P<0.001). The proportion of patients with shock was 6.2%. Age >60 years (odds ratio [OR]=2.30; 95% confidence interval [CI], 1.77-3.00), female (OR=0.69; 95% CI, 0.55-0.87), GCS <9 (OR=1.96; 95% CI, 1.57-2.46), systolic blood pressure (SBP) <90 mmHg (OR=2.96; 95% CI, 2.04-4.29), SBP ≥180 mmHg (OR=1.73; 95% CI, 1.29-2.32), respiratory rate >20/min (OR=1.72; 95% CI, 1.34-2.20), saturation <94% (OR, 1.89; 95% CI, 1.46-2.44), body temperature >37.5 Conclusion The etiologies of AMS in patients were varied. Non-CNS causes were more prevalent than CNS-related causes. Approximately 6% of patients met the criteria for shock.