No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

No abstract available.
Actinobacillus* ; Aggregatibacter actinomycetemcomitans* ; Apoptosis* ; Humans ; Jurkat Cells*

Ophthalmoplegic migraine is defined as recurrent unilateral headaches associated with extraocular muscle palsies. This disorder is more common in older children, but it may begin in infancy. Neuroimaging study should be performed to rule out conditions resulting in third nerve compression, such as intracranial aneurysm or mass lesions. Early treatment with corticosteroids could shorten the duration of the ophthalmoplegia and relieve the pain. We report a 8 year old boy who had severe headache with recurrent ipsilateral ophthalmoplegia that developed at the age of 2. The pediatrician should be aware that ophthalmoplegic migraine may occur in infancy and that early systemic steroid therapy is critical to prevent permanent sequelae.
Adrenal Cortex Hormones ; Child ; Headache ; Humans ; Intracranial Aneurysm ; Magnetic Resonance Imaging ; Male ; Neuroimaging ; Ophthalmoplegia ; Ophthalmoplegic Migraine* ; Paralysis

PURPOSE: It is well known that duodenal ulcer disease does not relapse if H. pylori is cleared from the gastric mucosa. Little is known about the recurrence of duodenal ulcer in children. The purpose of this study was to evaluate the effect of the eradication of H. pylori in duodenal ulcer in children upon the duodenal ulcer recurrence. METHODS: 105 patients (M : F=78 : 27) diagnosed as duodenal ulcer by endoscopy in 1987~1995 were reviewed clinically, and were parted into two groups. The two treatment groups were ranitidine/antacid (RAN/ANT) and ranitidine/amoxicillin/denol (RAN/AMX/D). The latter was for H. pylori-positive children with duodenal ulcer who were diagnosed by serology and/or antral biopsies for histology, culture, and urease testing. The recurrence rates were compared between the two groups. RESULTS: 1) 30 patients with primary duodenal ulcer underwent endoscopy for H. pylori and 27 (90.0%) of them were positive for H. pylori. 2) 27 of H. pylori-positive children received RAN/AMX/D. 23(85.2%) of them showed cure of duodenal ulcer and eradication of H. pylori. 3) The duodenal ulcer recurrence rate in RAN/ANT group was 65.3% and the rate in RAN/AMX/D was 4.3% by a year. CONCLUSIONS: There is a strong correlation between the duodenal ulceration and H. pylori infection in children, and the eradication of H. pylori in duodenal ulcer patients reduces the recurrence of the ulcer. Because of the low incidence of duodenal ulcers in children, a multicenter prospective study is required to determine the effect of treating H. pylori infetion on the long term natural history of duodenal ulcer disease.
Biopsy ; Child* ; Duodenal Ulcer* ; Endoscopy ; Gastric Mucosa ; Helicobacter pylori* ; Helicobacter* ; Humans ; Incidence ; Natural History ; Recurrence* ; Ulcer ; Urease

Tumor necrosis factor (TNF) inhibitors are increasingly used in treatment of rheumatoid arthritis (RA), ankylosing spondylitis, psoriatic arthritis, and inflammatory bowel diseases including Crohn's disease and ulcerative colitis. Rarely, anti-TNF therapy is associated with neurological complications, including both central and peripheral nervous system disorders. To the best of our knowledge, only one case of infliximab-associated multifocal motor neuropathy with conduction block in a patient with spondyloarthropathy has been reported to date in Korea. Here, we report on the case of a 58-year-old Korean woman affected by RA who developed multifocal motor neuropathy after infliximab treatment.
Arthritis, Psoriatic ; Arthritis, Rheumatoid* ; Colitis, Ulcerative ; Crohn Disease ; Female ; Humans ; Inflammatory Bowel Diseases ; Infliximab ; Korea ; Middle Aged ; Peripheral Nervous System Diseases ; Spondylarthropathies ; Spondylitis, Ankylosing ; Tumor Necrosis Factor-alpha

BACKGROUND: This retrospective study was performed to determine whether postoperative intravenous ferric carboxymaltose reduces transfusion amounts without influencing clinical outcomes in patients that have undergone hip surgery. METHODS: Between May 2014 and April 2016, the authors adopted a new perioperative blood management protocol involving the administration of intravenous ferric carboxymaltose after hip surgeries. One-to-one matching between the 150 patients treated during this period with 150 patients treated before initiation of the new protocol was performed by propensity scoring for age, sex, diagnosis, and type of hip surgery. Hematologic results and clinical outcomes in these two groups were compared. RESULTS: Average amounts of perioperative blood loss were not different in the two groups. Ninety-two patients (61%) were transfused in the control group and 70 patients (47%) were transfused in the intravenous ferric carboxymaltose group. The average number of transfused blood units was significantly lower in the intravenous ferric carboxymaltose group (1.7 ± 2.7 units vs. 1.0 ± 1.2 units, p = 0.002). At 6 weeks after surgery, the average hemoglobin concentration recovered to baseline in both groups, but the amount of recovered hemoglobin concentration at 6 weeks was significantly greater in the intravenous ferric carboxymaltose group than in the control group. Clinical outcomes including incidences of postsurgical complications were similar between the two groups. CONCLUSIONS: This study suggests that postoperative intravenous ferric carboxymaltose injection is associated with reduced transfusion amounts and that intravenous ferric carboxymaltose does not influence clinical outcomes after hip surgery.
Anemia ; Blood Transfusion ; Diagnosis ; Hip* ; Humans ; Incidence ; Orthopedics* ; Postoperative Hemorrhage ; Retrospective Studies

OBJECTIVES: To summarize the most up-to-date information on the initial management and neurological examination of patients with spinal cord injury (SCI).SUMMARY OF LITERATURE REVIEW: Secondary injuries result from acute pathophysiological processes such as bleeding, hypoperfusion, inflammation, necrosis, and apoptosis around neural elements that initially survive a mechanical injury. MATERIALS AND METHODS: Orthopedic surgeons must be familiar with the anatomy of the spinal cord and the initial management of a patient with SCI. A detailed neurological examination in accordance with the International Standards for the Neurological Classification of Spinal Cord Injury is a prerequisite. It is important to distinguish between spinal shock and neurogenic shock, which are characteristic phenomena in patients with SCI. RESULTS: Rapid realignment of the spine and proper medical management to avoid hypoperfusion are important in the overall care of a patient with SCI. CONCLUSIONS Patients with SCI should be managed and treated properly to enable them to return home and to their work as soon as possible.

STUDY DESIGN: Literature review. OBJECTIVES: To summarize the most up-to-date information on the initial management and neurological examination of patients with spinal cord injury (SCI). SUMMARY OF LITERATURE REVIEW: Secondary injuries result from acute pathophysiological processes such as bleeding, hypoperfusion, inflammation, necrosis, and apoptosis around neural elements that initially survive a mechanical injury. MATERIALS AND METHODS: Orthopedic surgeons must be familiar with the anatomy of the spinal cord and the initial management of a patient with SCI. A detailed neurological examination in accordance with the International Standards for the Neurological Classification of Spinal Cord Injury is a prerequisite. It is important to distinguish between spinal shock and neurogenic shock, which are characteristic phenomena in patients with SCI. RESULTS: Rapid realignment of the spine and proper medical management to avoid hypoperfusion are important in the overall care of a patient with SCI. CONCLUSIONS: Patients with SCI should be managed and treated properly to enable them to return home and to their work as soon as possible.
Apoptosis ; Classification ; Hemorrhage ; Humans ; Inflammation ; Necrosis ; Neurologic Examination ; Orthopedics ; Reflex ; Shock ; Spinal Cord Injuries ; Spinal Cord ; Spine ; Surgeons

Actinobacillus actinomycetemcomitans, a gram-negative, capnophiTic bacterium, is associated with several human diseases including periodontal disease. Products of A. actinomycetemcomitans exert immunomodulatory effects on various lymphoid populations, some of which may be implicated in the pathogenesis of periodontitis. It has been recently suggested that some of periodontopathic bacterial products might possess superantigenic (SAg) activities. In order to examine SAg activity of A. actinomycetemcomitans, we tried to purify immunomodulating factor (IMF) which can induce proliferation of mouse splenocytes and human PBMC. IMF fraction was obtained from the culture supernatant of A. actinomycetemcomitans by alcohol precipitation, ultrafiltration, size exclusion chromatography, and dye ligand affinity chromatography which has been widely used for the puri5cation of known SAgs. SDS-PAGE analysis showed that the factor migrated to a molecular mass of 40 kDa. The concentration of IMF which elicited maximal proliferative response of mouse splenocytes was ranged 1-10 ug/ml of protein on day 3 in culture. Human PBMC gave a similar response profile to IMF, but their maximal response was obtained by lower concentraion of IMF on day 2 in culture. This activity of IMF was heat and proteinase K sensitive and was not blocked by co-incubation with polymyxin B, a ligand for the lipid A region of lipopolysaccharide. T cell-enriched fraction of mouse splenocytes obtained by nylon wool column lost the response to IMF. Even though mitomycin C-treated antigen presenting cells were added to T cell-enriched fraction, the response to IMF was feeble as compared to unfractionated cells. Splenocytes depleted of T cells by anti-Thy 1.2 and complement also did not respond to IMF. These findings demonstrated that T cells are responsible for a minor proportion of the observed proliferation induced by IMF and the help of these cells are essential to the most of the proliferating cells which may be B cells. This observation was confirmed by flow cytometric analysis of responding lymphocyte subpopulations. These results indicate that IMF of A. actinomycetemcomitans does not act in a manner consistent with known SAgs but is more relevant to the explanation of pathologic findings of periodontal lesions.
Actinobacillus* ; Aggregatibacter actinomycetemcomitans* ; Animals ; Antigen-Presenting Cells ; B-Lymphocytes ; Chromatography, Affinity ; Chromatography, Gel ; Complement System Proteins ; Electrophoresis, Polyacrylamide Gel ; Endopeptidase K ; Hot Temperature ; Humans ; Interleukin-2* ; Lipid A ; Lymphocyte Subsets ; Lymphocytes* ; Mice ; Mitomycin ; Nylons ; Periodontal Diseases ; Periodontitis ; Polymyxin B ; T-Lymphocytes ; Ultrafiltration ; Wool