OBJECTIVE: To identify the thickness of gastrocnemius muscles (GCM) in normal children and children with spastic cerebral palsy using ultrasonography and to determine the influencing factors in order to increase the accuracy of intramuscular injection of botulinum toxin A. METHOD: Fifty-six children with spastic cerebral palsy (Group A) with no fixed contractures or operation history were involved in this study and they were compared with normal children (Group B). Children lay prone and one examiner measured the thickness of medial and lateral GCM using ultrasonography. Relationship between GCM thickness and clinical variables (age, height, weight, body mass index (BMI), calf circumference, Gross Motor Function Classification System (GMFCS) level, spasticity, number of botulinum toxin injections) were determined with Pearson's correlation. RESULTS: The thickness of medial and lateral GCM were 78.06+/-14.66 mm, 66.90+/-12.23 mm respectively, in Group A, and 103.44+/-12.04 mm, 79.95+/-9.76 mm respectively, in Group B. Medial GCM were thicker than lateral GCM in both groups. The age, height, weight, BMI, calf circumference and the thickness of GCM were higher in Group B. In group A, weight, BMI, calf circumference showed positive correlations with the thickness of medial GCM and GMFCS showed negative correlation with the thickness of medial GCM. CONCLUSION: To increase the accuracy of intramuscular injection of botulinum toxin A, we should keep in mind that the thickness of GCM may be influenced by several factors. Further controlled study including larger group is needed.
Body Weight ; Botulinum Toxins ; Cerebral Palsy ; Child ; Contracture ; Humans ; Injections, Intramuscular ; Muscle Spasticity ; Muscle, Skeletal ; Muscles

BACKGROUND: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system. Secondary amyloidosis can occur as a complication of chronic systemic inflammatory and infectious diseases. Until now there has been no report of secondary amyloidosis associated with MS. We report herein a case of renal biopsy-proven secondary amyloidosis in a patient with MS. CASE REPORT: A 41-year-old woman with MS was hospitalized due to aggravated quadriparesis and edema in both lower extremities. Laboratory findings showed nephrotic-range proteinuria and hypoalbuminemia. A percutaneous renal biopsy procedure was performed, the results of which revealed secondary amyloid-A-type amyloidosis associated with MS. CONCLUSIONS: This is the first report of secondary amyloidosis associated with MS.
Adult ; Amyloidosis ; Biopsy ; Central Nervous System ; Communicable Diseases ; Demyelinating Diseases ; Edema ; Female ; Humans ; Hypoalbuminemia ; Lower Extremity ; Multiple Sclerosis ; Nephrotic Syndrome ; Proteinuria ; Quadriplegia

The first author's name was misspelled.

This study aimed to assess the effects of different dialysate bicarbonate concentrations in correcting acid-base imbalance in 53 stable hemodialysis patients in a university-hemodialysis unit. Three different bicarbonate concentrations were assigned, i.e. 25 mEq/L in 10, 30 mEq/L in 30, and 35 mEq/L in 13 patients. Blood gas analyses from arterial line blood samples before and after dialysis in the mid-week were performed for the determination of pH and serum bicarbonate concentration ([HCO3-]). The mean values of predialysis arterial [HCO3-] were mildly acidotic in all 3 groups, but not significantly different among them, whereas those of post-dialysis arterial [HCO3-] were alkalotic, especially in the group of 35 mEq/L as compared with the other two groups. The mean blood pH was not significantly different among the 3 groups. As expected, there was a positive correlation between pre-dialysis pH and post-dialysis pH (r=0.45, p=0.001), and pre-dialysis [HCO3-] and post-dialysis [HCO3-] (r=0.58, p=0.000), but with a negative correlation between pre-dialysis [HCO3-] and the increment of intradialytic [HCO3-] following hemodialysis (r=-0.46, p=0.001). In conclusion, this study shows that the impact of conventional dialysate bicarbonate concentrations ranging from 25 to 35 mEq/L is not quite different on the mild degree of predialysis acidemia, but the degree of postdialysis alkalemia is more prominent in higher bicarbonate concentrations. Base supply by hemodialysis alone does not seem to be the main factor to determine the predialysis acidosis in end-stage renal disease patients on chronic maintenance hemodialysis.
Acid-Base Imbalance ; Acidosis* ; Alkalosis* ; Blood Gas Analysis ; Dialysis ; Humans ; Hydrogen-Ion Concentration ; Kidney Failure, Chronic ; Renal Dialysis* ; Vascular Access Devices

PURPOSE: In the present study we compared the intraocular pressure (IOP) after cataract surgery according to incisional techniques. METHODS: Patients who underwent phacoemulsification with intraocular lens implantation were divided into 2 groups: clear corneal incision group (CC group), and scleral tunnel incision group (ST group). All complicated cases were excluded. IOP was measured preoperatively and at 1 week, 1, 3, 6, 12, 18 and 24 months after surgery. RESULTS: Seventy-seven patients (100 eyes) were enrolled in the present study; CC group (28 patients, 33 eyes), ST group (49 patients 67 eyes). Preoperative IOPs in both groups were not significantly different (p = 0.908, student's t-test). IOP in the CC group at 1 week after surgery significantly decreased 2.22 +/- 2.57 mm Hg compared to preoperative IOP (p < 0.001, repeated-measures ANOVA with post hoc analysis), and the IOP of the ST group decreased 2.11 +/- 2.50 mm Hg (p < 0.001, repeated-measures ANOVA with post hoc analysis). The lowered IOP was maintained for 24 months postoperatively. There was no significant difference in IOP change after surgery depending on incisional techniques (p = 0.848, repeated measures ANOVA). CONCLUSIONS: There may be no difference in IOP lowering effect after surgery depending on incisional techniques.
Cataract* ; Humans ; Intraocular Pressure* ; Lens Implantation, Intraocular ; Phacoemulsification

BACKGROUND: Off-pump coronary artery bypass grafting (OPCAB) has shown better outcome in chronic renal failure (CRF) patients by avoiding the effects of cardiopulmonary bypass. We evaluated renal function after OPCAB in CRF patients. MATERIAL AND METHOD: 656 patients underwent OPCAB between January, 2001 and December, 2004. Data were collected in 26 CRF patients (Cr>1.7 mg/dL). Preoperative/postoperative creatinine (Cr) levels, creatinine clearance and postoperative data were evaluated. We divided the patients into group 1 (Cr<3 mg/dL) and group 2 (Cr> or =3 mg/dL). RESULT: Three patients started dialysis after surgery. Preoperative mean creatinine level (4.19+/-3.4 mg/dL) was elevated to 4.36+/-2.7 mg/dL at the third postoperative day and decreased below preoperative level at the fifth postoperative day. In group 1 (mean Cr level=1.87+/-0.25 mg/dL), Cr level reached its peak level of 2.19+/-0.52 mg/dL at the fourth postoperative day (p=0.017), with subsequent decrease. Patients without pre- or postoperative dialysis (n=15) showed peak Cr elevation on postoperative day four (p=0.017) and subsequent decrease (p=0.01). Postoperative creatinine clearance showed reverse correlation with creatinine level. CONCLUSION: Creatinine level was elevated at third/fourth postoperative day, but decreased 5 days after surgery. Thus, if urgent dialysis is not indicated, postoperative renal replacement therapy in CRF patients may be better to be considered after four days observation.
Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump* ; Creatinine ; Dialysis ; Humans ; Kidney Failure, Chronic* ; Renal Replacement Therapy ; Transplants*

BACKGROUND AND OBJECTIVES: Residual platelet reactivity in patients who are taking clopidogrel is commonly measured with VerifyNow assay, which is based on the principle of light transmission aggregometry. However, to evaluate the residual platelet reactivity, it would be more accurate if the reactivity of platelet glycoprotein (GP) IIb/IIIa is directly monitored. In this study, PAC1, a monoclonal antibody against activated platelet GP IIb/IIIa, was used to measure the residual platelet reactivity. SUBJECTS AND METHODS: Twenty seven patients with coronary artery disease taking clopidogrel were enrolled. Platelets in whole blood were stained with fluorescein isothiocyanate (FITC)-conjugated PAC1. Mean fluorescence intensity (MFI) and % positive platelets (PP) were measured with flow cytometry, and the binding index (BI; MFI x %PP/100) was calculated. P2Y12 reaction unit (PRU) and % inhibition of VerifyNow assay were also measured in the usual manner. RESULTS: PRU of VerifyNow assay correlated significantly with MFI, %PP, and BI at 10 microM (r=0.59, 0.73, and 0.60, respectively, all p<0.005) and 20 microM of adenosine diphosphate (ADP; r=0.61, 0.75, and 0.63, respectively, all p<0.005). The % inhibition also correlated significantly with MFI, %PP, and BI at 10 microM (r=-0.60, -0.69, and -0.59, respectively, all p<0.005) and 20 microM of ADP (r=-0.63, -0.71, and -0.62, respectively, all p<0.005). CONCLUSION: Direct measurements of the reactivity of platelet GP IIb/IIIa were feasible using PAC1 and flow cytometry in patients taking clopidogrel. Further clinical studies are required to determine the cut-off values which would define high residual platelet reactivity in patients on this treatment protocol.
Adenosine Diphosphate ; Blood Platelets* ; Coronary Artery Disease ; Flow Cytometry ; Fluorescein ; Fluorescence ; Glycoproteins* ; Humans ; Platelet Function Tests

One step TaqMan real-time reverse transcription polymerase chain reaction (R/T RT-PCR)using a set of primers/probes was developed for the detection of foot-and-mouth disease (FMD)virus. The gene-specific probes labeled fluorogen for the internal ribosomal entry site, Leader sequence and 2B regions were used to detect FMD virus (FMDV). This assay specifically detected FMDV both in cell culture preparations and clinical samples, and was capable of distinguishing FMD from other viral diseases similar to clinical signs (swine vesicular disease, vesicular stomatitis and bovine viral diarrhea). This assay was shown to be 1000-fold more sensitive than the conventional RT-PCR method. The detection limits of this assay was 1 TCID 50 /ml of the FMDV RNA concentration. Quantification was obtained by a standard curves plotting threshold cycle values versus known infectivity titer. The assay was sensitive, specific and rapid enough to detect FMDV RNA genome in probang samples. As such, the described method is reliable and provides faster disease diagnostics than the conventional RT-PCR procedure to detect FMDV.
Animals ; Foot-and-Mouth Disease/*diagnosis/virology ; Foot-and-Mouth Disease Virus/*isolation&purification ; Reverse Transcriptase Polymerase Chain Reaction/*methods ; Sensitivity and Specificity ; Taq Polymerase

The capsid of the foot and mouth disease (FMD) virus carries the epitopes that are critical for inducing the immune response. In an attempt to enhance the specific immune response, plasmid DNA was constructed to express VP1/interleukin-1alpha (IL-1alpha) and precursor capsid (P1) in combination with 2A (P1-2A)/IL-1alpha under the control of the human cytomegalovirus (HCMV) immediateearly promoter and intron. After DNA transfection into MA104 (monkey kidney) cells, Western blotting and an immunofluorescence assay were used to confirm the expression of VP1 or P1-2A and IL-1alpha. Mice were inoculated with the encoding plasmids via the intradermal route, and the IgG1 and IgG2a levels were used to determine the immune responses. These results show that although the immunized groups did not carry a high level of neutralizing antibodies, the plasmids encoding the VP1/ IL-1alpha, and P1-2A /IL-1alpha fused genes were effective in inducing an enhanced immune response.
Animals ; Antibodies, Viral/blood ; Capsid Proteins/biosynthesis/genetics/*immunology ; Cell Line ; DNA, Viral/genetics ; Enzyme-Linked Immunosorbent Assay ; Foot-and-Mouth Disease/*immunology/prevention&control ; Foot-and-Mouth Disease Virus/genetics/*immunology ; Haplorhini ; Immunization ; Interleukin-1/biosynthesis/genetics/*immunology ; Male ; Mice ; Mice, Inbred C57BL ; Plasmids/genetics ; Polymerase Chain Reaction ; Recombinant Fusion Proteins/biosynthesis/genetics/immunology ; Specific Pathogen-Free Organisms ; Transfection ; Vaccines, DNA/genetics/*immunology

From May to June 2002, a total of 16 foot-and mouth disease (FMD) outbreaks due to the serotype O virus, Pan Asia strain, were recorded in Korea. The viruses were identified by antigen ELISA, RT-PCR and sequence analysis. The overall nucleotide sequence divergence of the VP1 region among the 4 isolates in 2002 was 0 to 1.4%, but between O/SKR/2002 and O/SKR/2000 isolates was 1.9-4.9%. Phylogenetic analysis with the some known strains from East Asian countries showed that the 4 Korean isolates in 2002 formed one distinct cluster, which different from clusters of Korean isolates in 2000, with in the same lineage of the ME-SA topotype strains. Deduced amino acid sequences around neutralizable antigenic site on VP1 site of O/SKR/2002 isolates were aligned and compared with other strains. At the antigenic site 1, the replacements of the critical amino acid residues at position 144 from V to L and at position 152 from A to T were observed in O/SKR/2002 viruses. For antigenic site 2 and 4, there were not significant variations in general. At the antigenic site 3, the substitutions of amino acid residues were present at positions 54 and 56 in O/SKR/2002 isolates and an alternative residue I at position 54 are observed only at the sequence of O/SKR/AS/2002 (cow) virus. And the substitution (L-->P) of significant residue at position 144 was detected at the amino acid sequence of the O/SKR/2002 (cow) virus.
Amino Acid Sequence ; Animals ; Antibodies, Viral/blood ; Base Sequence ; Capsid Proteins/genetics/*immunology ; Cattle ; Cattle Diseases/epidemiology/*virology ; Cluster Analysis ; Disease Outbreaks/*veterinary ; Enzyme-Linked Immunosorbent Assay/veterinary ; Epitopes/analysis ; Foot-and-Mouth Disease/epidemiology/*virology ; Foot-and-Mouth Disease Virus/genetics/*immunology ; Korea/epidemiology ; Molecular Sequence Data ; Phylogeny ; RNA, Viral/chemistry/genetics ; Reverse Transcriptase Polymerase Chain Reaction/veterinary ; Sequence Alignment ; Swine ; Swine Diseases/epidemiology/*virology