There are more than 120 different theories on the possible cause of sudden infant death syndrome (SIDS). Recent studies indicate a possible role of infections in SIDS, one of which suggested that a maximum percentage of up to 43.5% of SIDS showed virus-induced myocardial affection. The enterovirus, mainly the cardiotropic coxsackievirus group B, serotypes B1-B5, which causes most of viral myocarditis in infancy, seems to be the most common virus associated with SIDS. The aim of our study was to investigate the enterovirus-induced myocardial affections in cases of SIDS. All 7 cases of postmortem heart samples from SIDS victims were studied. Postmortem heart samples of non-SIDS death in perinatal period, infancy and young childhood, pediatric cases of myocarditis and unnatural death in young adult were served as controls. An immunohistochemical study was performed on all samples using monoclonal mouse anti-enterovirus antibody and anti-LCA with quantification of positive cells. Our results demonstrated that 2 of 7 cases of SIDS showed strong immunoreactivity in the myocardium against antienterovirus antibody and there was more inflammatory cell infiltrate in SIDS cases than controls. Our study suggests that the enteroviral myocardial affection would be a possible role in pathogenesis of SIDS.
Animals ; Enterovirus Infections* ; Enterovirus* ; Heart ; Humans ; Immunohistochemistry ; Mice ; Myocarditis ; Myocardium ; Sudden Infant Death* ; Young Adult

The incidence of the tuberculosis infection has decreased worldwide, but it is still easy to find the patients in some areas or some races. And it is very difficult to diagnose and treat the patients who are infected by the atypical tuberculosis. Facial skin infection by atypical tuberculosis has not been reported. We report the case of a 62-year-old woman who developed facial skin and soft tissue necrosis caused by Mycobacterium abscessus after receiving liquid silicone injections and face lift operation. We cultured the pathogenic organism and treated the wound with radical curettage, debridement, skin graft and tuberculosis medication.
Continental Population Groups ; Curettage ; Debridement ; Female ; Humans ; Incidence ; Middle Aged ; Mycobacterium* ; Necrosis ; Rhytidoplasty ; Silicones ; Skin* ; Transplants ; Tuberculosis ; Tuberculosis, Cutaneous* ; Wounds and Injuries

PURPOSE: To evaluate the effectiveness of magnetic resonance imaging (MRI) for the diagnosis and usefulness of vertebroplasty in osteoporotic occult vertebral fractures. MATERIALS AND METHODS: Of 472 osteoporotic vertebral fractures treated from May 2003 to July 2009, 45 patients were diagnosed with occult osteoporotic vertebral fracture. Their medical charts and radiographs were reviewed. The degree of vertebral body collapse was graded by a semiquantitative method. In order to increase the reliability, interpretation was based on radiographic diagnoses from 3 orthopedic surgeons. Vertebroplasty was performed at 31 of the 45 patients, for whom conservative treatment failed. Pre-operatively and post-operatively, pain was evaluated using a visual analog scale (VAS). RESULTS: We observed 55 occult fractures in 45 patients. Forty vertebrae (72.7%) among the 55 vertebrae were just adjacent to an old vertebral fracture with deformation of the vertebral body. The rediagnosis rate of occult fracture attempted without MRI was only 21.8%. The average pre-operative VAS score of 8.07 (6~9) was improved to 2.43 after surgery and showed no delayed vertebral body collapse. CONCLUSION: Gadolinium enhancement of MRI is critical to the diagnosis of occult vertebral fractures, which are 9% of whole osteoporotic vertebral fractures. Seventy-two point seven percent of occult vertebral fractures were just adjacent to an old vertebral fracture with collapse of the vertebral body. This means that if vertebroplasty is performed without thorough MRI examination, it may fail.
Fractures, Closed ; Gadolinium ; Humans ; Magnetic Resonance Imaging ; Orthopedics ; Osteoporosis ; Spine ; Vertebroplasty

Although Atrial flutter (AFL) in newborn infant with normal cardiac anatomy has benign clinical course, an intractable AFL is associated with an increased risk of development of heart failure and sudden death, and is still difficult to manage. It requires multiple external electrical cardioversions, and it shows a poor response to antiarrhythmic drug therapy. We report a case of a premature infant with an intractable AFL, which we successfully treated with oral flecainide and propranolol in spite of recurred AFL. A 1-month-old, 34-week gestation, premature baby presented with an irregular heart beat and irritability. An AFL with 2:1 atrioventricular conduction was documented. Because of the intractable AFL, repeated electrical cardioversion and amiodarone were continued for 14 days. However, amiodarone was discontinued in favour of flecainide and propranolol because of the recurrent AFL and newly developed transient hypothyroidism. During 1-year follow-up period, in which oral flecainide and propranolol were continued, no AFL was observed.
Amiodarone ; Atrial Flutter* ; Death, Sudden ; Drug Therapy ; Electric Countershock ; Flecainide* ; Follow-Up Studies ; Heart ; Heart Failure ; Humans ; Hypothyroidism ; Infant, Newborn ; Infant, Premature* ; Pregnancy ; Propranolol*

Two cases of tension pneumocephalus follwing surgery are reported. Tension pneumocephalus appears to be another potential complication of the operation and should be considered whenever a patient fail to recover as expected following surgery. Peaking of frontal lobe, mountain appearance of frontal lobe, and air densities at the cisterns are characteristic findings of tension pneumocephalus. Its diagnosis and treatment are easy and simple.
Diagnosis ; Frontal Lobe ; Humans ; Pneumocephalus*

Polyomavirus disease is a re-emerging infectious complication in renal transplantation. It manifests as symptomless renal dysfunction and progresses to graft loss unless the prompt diagnosis and intervention are initiated. A gold standard for diagnosis is the renal biopsy. Recently, the molecular diagnosis can be made using plasma PCR technique before histologic confirmation. Reduction of immunosuppression is a mainstay of treatment. Leflunomide and other antiviral agents could be used successfully in selected cases. The screening using urine decoy cell and subsequent plasma PCR may detect the BK viral replication, and preemptive intervention will prevent development of overt nephropathy without risk of rejection. This review will cover the recent advances and clinical issues in diagnosis and management of polyomavirus disease, mainly BK virus associated nephropathy.
Antiviral Agents ; Biopsy ; BK Virus ; Immunosuppression ; Isoxazoles ; Kidney ; Kidney Transplantation ; Mass Screening ; Plasma ; Polymerase Chain Reaction ; Polyomavirus ; Polyomavirus Infections ; Rejection (Psychology) ; Transplants

PURPOSE: To compare the hematologic changes and the rates of transfusion of patients using rivaroxaban or aspirin for venous thromboembolism prophylaxis after a total knee arthroplasty. MATERIALS AND METHODS: Among patients with total knee arthroplasty from July 2010 to March 2011, two groups of 100 consecutive cases were enrolled in this study, 50 patients with Rivaroxaban group and 50 patients with Aspirin group for venous thromboembolism prophylaxis after a total knee arthoplasty. Hematologic changes and transfusion rates were calculated in each group. RESULTS: The mean of decreased hemoglobin was 4.7 (3.1-6.6) in the Rivaroxaban group and 3.6 (2.0-5.1) in the Aspirin group (p<0.05). The number of patients with decreased hemoglobin of less than 8 g/dl was observed in 23 cases (46%) in the Rivaroxaban group, and 9 cases (18%) in the Aspirin group. The numbers of patients who needed transfusion were 12 in the Rivaroxaban group, and 2 in the Aspirin group (p<0.05). CONCLUSION: Rivaroxaban group revealed more significant decrease of hemoglobin and needed more transfusion than the Aspirin group did. For the prevention of venous thromboembolism after total knee arthroplasty, we should be careful using Rivaroxaban for the standard risk patients of venous thromboembolism.
Arthroplasty ; Aspirin ; Hemoglobins ; Humans ; Knee ; Morpholines ; Thiophenes ; Venous Thromboembolism ; Rivaroxaban

No abstract available.
Hair* ; Transplants*

Previously, we reported that besides retinal ganglion cell (RGC) spike, there is ~ 10 Hz oscillatory rhythmic activity in local field potential (LFP) in retinal degeneration model, rd1 mice. The more recently identified rd10 mice have a later onset and slower rate of photoreceptor degeneration than the rd1 mice, providing more therapeutic potential. In this study, before adapting rd10 mice as a new animal model for our electrical stimulation study, we investigated electrical characteristics of rd10 mice. From the raw waveform of recording using 8x8 microelectrode array (MEA) from in vitro-whole mount retina, RGC spikes and LFP were isolated by using different filter setting. Fourier transform was performed for detection of frequency of bursting RGC spikes and oscillatory field potential (OFP). In rd1 mice, ~10 Hz rhythmic burst of spontaneous RGC spikes is always phase-locked with the OFP and this phase-locking property is preserved regardless of postnatal ages. However, in rd10 mice, there is a strong phase-locking tendency between the spectral peak of bursting RGC spikes (~5 Hz) and the first peak of OFP (~5 Hz) across different age groups. But this phase-locking property is not robust as in rd1 retina, but maintains for a few seconds. Since rd1 and rd10 retina show phase-locking property at different frequency (~10 Hz vs. ~5 Hz), we expect different response patterns to electrical stimulus between rd1 and rd10 retina. Therefore, to extract optimal stimulation parameters in rd10 retina, first we might define selection criteria for responding rd10 ganglion cells to electrical stimulus.
Animals ; Electric Stimulation ; Fourier Analysis ; Ganglion Cysts ; Humans ; Mice ; Microelectrodes ; Models, Animal ; Patient Selection ; Retina ; Retinal Degeneration ; Retinal Ganglion Cells ; Retinaldehyde

BACKGROUND: 1,1-dichloro-1-fluoroethane (HCFC-141b) has been known to be relatively safe except irritation of the skin and upper airway, and pulmonary disease directly associated with HCFC-141b exposure has not been reported yet. OBJECTIVE: We report a highly suspicious case of HCFC-141b-related occupational asthma, which was assessed by workplace challenge, but not confirmed by specific inhalation test. We also performed animal experiment to evaluate whether long-term exposure to HCFC-141b could cause inflammation of the airway and parenchymal lung tissue. METHOD: Forty Sprague-Dawley rats were divided into 4 groups. HCFC-141b exposure for each group was carried out under the condition of 6 hours a day, 5 days a week for 13 weeks by inhalation with different concentration of HCFC-141b; Group A-control: Group B-low concentration, 1500 ppm: Group C-moderate concentration, 3000 ppm: and Group D-high concentration, 6000 ppm. Bronchoalveolar lavage (BAL) and histopathological examination of lung tissue was undertaken after HCFC-141b exposure. RESULTS: HCFC-141b did not induce any abnormal change in the clinical and behavioral signs during and at the termination of the inhalation exposure. Compared with control rat, significantly abnormal findings in the microscopic examination of BAL and tissue preparations was not noted in HCFC-141b exposed rats. CONCLUSION: We report a suspicious case of occupational asthma due to HCFC-141b exposure. Animal experiment, however, revealed that HCFC-141b has no toxic or side effect on the respiratory system regardless of its concentration.
Animal Experimentation ; Animals ; Asthma, Occupational ; Bronchoalveolar Lavage ; Inflammation ; Inhalation Exposure ; Inhalation* ; Lung ; Lung Diseases ; Rats ; Rats, Sprague-Dawley ; Respiratory System* ; Skin