BACKGROUND: Drug-induced Parkinsonism(DIP) is the second commonest cause of Parkinsonism, after idiopathic Parkinson's disease(IPD). DIP is frequently produced by antipsychotic drugs. But the clinical characteristics of DIP did not get attention by neurologist. So we studied the clinical profiles of DIP patients. METHODS: We studied the clinical profiles of thirthone patients who showed parkinsonism after antipsychotic drug treatment. We compared the score of motor part of the Unified Parkinson's Disease Rating Scale(UPDRS) between trihexyphenidyl(n=15) & amantadine(n=16) monotherapy group(initial & 4 week after treatment). RESULTS: The mean age of patients was 45 years. Bradykinesia was the 1st symptom in 26 patients(94%), tremor in 5 patients(6%). In 25 patients(81%), the first symptom appeared within 1 week after sntipsychotic treatment. There was a statistical significant negative correlation between the dosage of antipsychotic drug and the symptom-onset interval following treatment with antipsychotic drugs(simple correlation analysis, p>0.01). Bradykinesia and rigidity were appeared in all DIP patients, symmetric distribution was more common(94%, 87%) Tremor occurred in 27 patients (87%). In patients with tremor, postural or action tremor was dominant in 15 patients(56%) asymmetric distribution was more common(16/27, 59%). There are no statistical difference in motor score of UPDRS between trihexyphenidyl & amantadine monotherapy group(student t-test, p<0.05) CONCLUSIONS: Bradykinesia was the most common 1st symptom in DIP patients. Asymmertrical postural or action tremor was relativelly common in DIP. Amantadine showed the same efficacy in the treatment of DIP compared to anticholinergics.
Amantadine ; Antipsychotic Agents ; Cholinergic Antagonists ; Humans ; Hypokinesia ; Parkinson Disease ; Parkinsonian Disorders* ; Tremor ; Trihexyphenidyl

OBJECTIVE: Hyperuricemia is known as a risk factor that causes and worsens kidney diseases through a variety of mechanisms. Recent animal studies reported that the correction of hyperuricemia improved the renal function, but there have been few human studies. This study examined whether a hypouricemic treatment affects the renal function in Korean patients with gout. METHODS: Two hundred sixty-seven gout patients who were prescribed uric acid lowering agents for more than 1 year were enrolled at the Division of Rheumatology in the National Health Insurance Corporation Ilsan Hospital and Yonsei University Severance Hospital from January 2005 to January 2010. The following were examined: the levels of serum uric acid and serum creatinine, the amount of 24-hour urine uric acid, glomerular filtration rate (GFR), and abdominal ultrasound findings at baseline and follow-up. RESULTS: Mean age of the study subjects was 54.4+/-13.9 years. Two hundred forty-seven patients were male and 20 patients were female. The mean treatment duration was 35.0+/-19.5 months. Among the 267 patients, 219 and 19 patients received monotherapy with allopurinol and benzbromarone respectively, and 29 patients received combination therapy with allopurinol and benzbromarone. After the treatment with uric acid lowering agents, the serum uric acid and creatinine levels decreased significantly (8.05+/-1.96 mg/dL vs 6.16+/-1.46 mg/dL, p<0.001, 1.25+/-0.46 mg/dL vs 1.18+/-0.42 mg/dL, p=0.001, respectively) and the GFR increased significantly (74.4+/-27.0 mL/min/1.73 m3 vs 80.2+/-31.6 mL/min/1.73 m3, p<0.001). CONCLUSION: Treatment with hypouricemic agents reduced the levels of serum uric acid and improved the renal function. These results suggest that a hypouricemic treatment might improve the kidney function in gout patients.
Allopurinol ; Animals ; Benzbromarone ; Creatinine ; Female ; Glomerular Filtration Rate ; Gout ; Humans ; Hyperuricemia ; Kidney ; Kidney Diseases ; Male ; National Health Programs ; Rheumatology ; Risk Factors ; Uric Acid

Percutaneous endoscopic gastrostomy is used for long-term nutritional support to the patients who cannot maintain the adequate oral intake and can be performed with relatively few complications. Among the complications, migration of the internal bumper into the abdominal wall, so called "buried bumper syndrome" has been described more recently. We decribed a case of buried bumper syndrome in stroke patient with percutaneous endoscopic gastrostomy. He experienced peritubular leakage, resistance of tubal feeding, and abdominal pain which were developed 4 weeks after percutaneous endoscopic gastrostomy. On endoscopic examination, the gastrostomy lumen coud not be found. The gastrostomy tube was replaced with careful manual traction and replaced to new one with endoscopic technique. No complication was occurred and the function of tube has been well preserved.
Abdominal Pain ; Abdominal Wall ; Gastrostomy ; Humans ; Nutritional Support ; Stroke ; Traction

Although the incidence of extrapyramidal reactions associated with metoclopramide has been reported to be approximately 0.2%, such reactions are rare in the anesthetic field. Several anesthetic adjuvants, including ondansetron and pregabalin, have also been associated with extrapyramidal side effect. Here, the authors report the case of a 47-year-old patient, previously administered pregabalin and ondansetron, who developed extrapyramidal side effects after a single injection of metoclopramide (10 mg) in a post-anesthesia care unit.
Adjuvants, Anesthesia ; gamma-Aminobutyric Acid ; Humans ; Incidence ; Metoclopramide ; Middle Aged ; Ondansetron ; Pregabalin

BACKGROUND/AIMS: Due to the recent increase in elderly population, laparoscopic surgery is more frequently performed in the elderly. This study aimed to compare the short-term outcomes of laparoscopic colorectal cancer surgery between the very elderly group (VEG), categorized as those with age over 80 years and the elderly group (EG), categorized as those with age 65 to 79 years. METHODS: We retrospectively compared 48 very elderly patients with 96 elderly patients (1:2 matched) who underwent laparoscopic resection for colorectal cancers at our institution between March 2010 and December 2014. The clinicopathologic parameters, surgical characteristics and short term outcomes were compared. RESULTS: There was no statistically significant difference in clinicopathologic characteristics between VEG and EG. Postoperative pain score (7 points vs. 6 points, p=0.264), time to first flatus (3 days vs. 3 days, p=0.335), hospital stay (15 days vs. 16.5 days, p=0.361), complication rates (47.9% vs. 26.0%, p=0.147) and major complication rate (25% vs. 20.8%, p=0.681) were not statistically different between the two groups. Before surgery, VEG had higher rate of neurologic underlying disease, such as dementia or cerebrovascular disease, than EG (25.0% vs. 7.3%, p=0.007). CONCLUSIONS: There was no significant difference in the clinicopathologic characteristics, short-term outcomes, and complication rates for laparoscopic colorectal resection between VEG and EG, except delirium. Age over 80 years may be relevant for the application of laparoscopic colorectal cancer resection.
Aged* ; Cerebrovascular Disorders ; Colorectal Neoplasms* ; Delirium ; Dementia ; Flatulence ; Humans ; Laparoscopy ; Length of Stay ; Pain, Postoperative ; Retrospective Studies

OBJECTIVE: To evaluate immediate and long term effects of electrical stimulation on upper extremity spasticity following stroke. METHOD: The subjects were 13 hemiplegic patients with cerebral infarction and cerebral hemorrhage. Electrical stimulation was applied to skin over the biceps muscle and the triceps muscle for a period of twenty minutes. The evaluation of spasticity was done by using the modified Ashworth scale, free amount of elbow extension, active range of motion and motor strength of elbow flexion and extension at baseline, immediately, 1 week and 4 weeks after electrical stimulation. RESULTS: Immediately after treatment, free amount of elbow extension increased from 63.8+/-19.1 degrees to 77.7+/-22.5 degrees (p<0.05) and active flexion of elbow flexor increased from 45.0+/-34.8 degrees to 55.3+/-39.1 degrees (p<0.05). The active range of motion of elbow flexor was increased on the 4th week during electrical stimulation (p<0.05). The free amount of elbow extension and modified Ashworth scale of elbow flexor spasticity was improved on the 18th day after treatment cessation (p<0.05). CONCLUSION: The results of this study showed that spasticity tended to decrease and maintain a lower level after a varying number of treatment sessions.
Cerebral Hemorrhage ; Cerebral Infarction ; Elbow ; Electric Stimulation* ; Hemiplegia ; Humans ; Muscle Spasticity* ; Range of Motion, Articular ; Skin ; Stroke ; Upper Extremity* ; Withholding Treatment

Neuroendocrine tumor is a very heterogenous group arising from the neuroendocrine cells. Especially, large cell neuroendocrine tumor of the ovary is a extremely rare aggressive neoplasm, characteristically arising in association with a surface epithelial tumor. This report describes a mixed type of large cell neuroendocrine carcinoma and adenocarcinoma of the ovary. A 63-year old woman presented with abdominal distension and discomfort underwent staging laparotomy under the impression of ovarian cancer. The operation revealed an small ovarian mass with invasion of multiple region in peritoneal cavity by the tumor. Immunohistochemical and ultrastructural analysis confirmed the neuroendocrine nature of the tumor. The adenocarcinoma in this case is mixture of mucinous and endometrioid type. A diagnosis of stage IIIc mixed large cell neuroendocrine tumor and adenocarcinoma of the ovary was rendered. She is subsequently being treated with Paclitaxel and Carboplatin combination chemotherapy.
Adenocarcinoma* ; Carboplatin ; Carcinoma, Neuroendocrine ; Diagnosis ; Drug Therapy, Combination ; Female ; Humans ; Laparotomy ; Middle Aged ; Mucins ; Neuroendocrine Cells ; Neuroendocrine Tumors* ; Ovarian Neoplasms ; Ovary* ; Paclitaxel ; Peritoneal Cavity

Miller-Dieker syndrome involves a severe type of lissencephaly, which is caused by defects in the lissencephaly gene (LIS1). We report the case of a female infant with der(17)t(12;17)(q24.33;p13.3)pat caused by an unbalanced segregation of the parental balanced translocation of 17p with other chromosomes. The proband presented with facial dysmorphism, arthrogryposis, and intrauterine growth retardation. Most cases of Miller-Dieker syndrome have a de novo deletion involving 17p13.3. When Miller-Dieker syndrome is caused by an unbalanced translocation, mild-to-severe phenotypes occur according to the extension of the involved partner chromosome. However, a pure partial monosomy derived from a paternal balanced translocation is relatively rare. In this case, the submicroscopic cryptic deletion in the proband was initially elucidated by FISH, and karyotype analysis did not reveal additional chromosome abnormalities such as translocation. However, a family history of recurrent pregnancy abnormalities strongly suggested familial translocation. Sequential G-banding and FISH analysis of the father's chromosomes showed that the segment of 17p13.3-->pter was attached to the 12qter. Thus, we report a case that showed resemblance to the findings in cases of a nearly pure 17p deletion, derived from t(12;17), and delineated by whole genome array comparative genomic hybridization (CGH). If such cases are incorrectly diagnosed as Miller-Dieker syndrome caused by de novo 17p13.3 deletion, the resultant improper genetic counseling may make it difficult to exactly predict the potential risk of recurrent lissencephaly for successive pregnancies.
Abnormalities, Multiple/genetics ; Adult ; Brain/abnormalities ; Chromosome Banding ; Chromosome Segregation ; *Chromosomes, Human, Pair 12 ; *Chromosomes, Human, Pair 17 ; Classical Lissencephalies and Subcortical Band Heterotopias/*diagnosis ; Female ; Gene Deletion ; Humans ; In Situ Hybridization, Fluorescence ; Infant, Newborn ; Karyotyping ; Magnetic Resonance Imaging ; Male ; Phenotype ; Risk ; Translocation, Genetic

PURPOSE: The aim of this study was to compare the effectiveness of hydroxyapatite containing toothpaste with positive control toothpastes in reducing dentine hypersensitivity. MATERIALS AND METHODS: This clinical trial was a double-blind, randomized, parallel group comparison of two, namely hydroxyapatite containing toothpaste and strontium chloride containing toothpaste. A total of 55 subjects were included in this study. The subjects were given randomly assigned one of the two toothpastes after received tooth brushing instruction at baseline. Some clinical indices(PI, GI, PD), verbal rating score(VRS) for sensitivity to stimulus, the effect in relieving sensitivity and visual analogue scale(VAS) for sensitivity at baseline, week 2, week 4 and week 8 were assessed. All data were evaluated by intention-to-treat analysis. RESULTS: Overall, PI and GI scores were significantly reduced compare baseline in all groups(p<0.05). In addition, there was significant difference in PI at 4 weeks and in GI at 4, 8 weeks between groups. The proportions of subjects relieved sensitivity were 70.4% in experimental group and 57.1% in control group at 8 weeks respectively. The VRS for sensitivity to three kinds of stimuli and VAS for sensitivity decreased according to time, there was no overall difference between two groups(p>0.05). CONCLUSION: This study demonstrated that the new hydroxyapatite containing toothpaste was similarly effective in reducing dentine hypersensitivity with pre-existing benchmark toothpaste.
Dentin ; Dentin Sensitivity ; Durapatite ; Strontium ; Tooth ; Toothpastes

No abstract available.
Antibodies ; Neuromyelitis Optica