No abstract available.
Animals ; Mice* ; Oocytes*

Tetanus is a rare disease in the developed countries, including Korea, as a result of nearly universal active immunization. Because many physicians have little experience with its diagnosis and management, misdiagnosis and therapeutic delay may result in catastrophic consequences. We report one case of generalized tetanus. A previously healthy 35-year-old man was admitted to the emergency department because of stiffness on jaw and neck. board-like abdomen, extended and rigid both legs, chest tightness, and dyspnea. Seven days before admission, he was injured on the right thing at work. In the emergency department, he was given 5,000 units of human tetanus immunoglobulin intramuscularly, as well as diazepam 2 mg/hr intravenously. On the second hospital day, tracheostomy was performed. Ten days later, his condition was improved. Twenty eight days after admission, he was discharged without any complication.
Abdomen ; Adult ; Developed Countries ; Diagnosis ; Diagnostic Errors ; Diazepam ; Dyspnea ; Emergency Service, Hospital ; Humans ; Immunoglobulins ; Jaw ; Korea ; Leg ; Neck ; Rare Diseases ; Tetanus* ; Thorax ; Tracheostomy ; Vaccination

Cysticercosis in the human is caused by infestation by larvae of pork tapeworm, taenia solium. Although they may grow anywhere in the body such as the liver, lung, eyes, heart, muscle, ect., they are most commonly found in the brain and its coverings. The cysticercus vesicles have occasionally been found in spinal structures other than the brain. We present a case of spinal cysticercosis in a 63-year-old male. The patient presented with a marked paraparesis and paresthesia below a T10 dermatome level, and moderately decreased deep tendon reflexes. After performing total laminectomies at T11-12 & L3-5, 30 cysticercus vesicles were removed.
Brain ; Cysticercosis* ; Cysticercus ; Heart ; Humans ; Laminectomy ; Larva ; Liver ; Lung ; Male ; Middle Aged ; Paraparesis ; Paresthesia ; Reflex, Stretch ; Spine ; Taenia solium

Cytomegalovirus infections (CMV) of the gastrointestinal tract (GI) are common, and most often seen in patients with acquired immunodeficiency syndrome (AIDS), inflammatory bowel disease, or those receiving immunosuppressive therapy. CMV enteritis is uncommon in an immunocompetent individual. A CMV infection of the small bowel accounts for 4.3% of all CMV infections of the GI tract. The GI manifestations of CMV include: diarrhea, bleeding, obstruction and perforation, all of which are usually secondary to discrete erosions or ulceration. High mortality rates have been reported for CMV enteritis. Here, a rare case of CMV enteritis, resulting in segmental ileal ischemia, is reported in a 47-year old man following a traffic accident. On the 17th hospital day, he developed melena, watery diarrhea, fever and abdominal pain. An abdominal computed tomography (CT) on the 23rd hospital day showed an enlarged appendix with mild periappendiceal infiltration and segmental wall thickening in the terminal ileum. An ileocecal resection was performed. Pathological evaluation of the operative specimen revealed CMV inclusion bodies, with ulcerations. The patient was treated with ganciclovir therapy for 3 weeks after which his symptoms improved. If a CMV infection is highly suspected in multiply injured trauma victims, the earlier recognition of potential small bowel involvement can hopefully decrease the incidence of bleeding, ischemic demage to the bowel and perforation, which are usually fatal events.
Abdominal Pain ; Accidents, Traffic* ; Acquired Immunodeficiency Syndrome ; Appendix ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Diarrhea ; Enteritis ; Fever ; Ganciclovir ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Incidence ; Inclusion Bodies ; Inflammatory Bowel Diseases ; Ischemia* ; Melena ; Middle Aged ; Mortality ; Multiple Trauma* ; Ulcer

Ma-huang (Ephedra sinica) is a herb that exhibits sympathomimetic activity. We report a patient with acquired myopathy following ingestion of a Ma-huang-based herbal remedy for 6 months. A 50-year-old woman was admitted for progressive muscular weakness. An electrodiagnostic study and muscle biopsy sampling revealed generalized active myopathy with nonspecific inflammation. It appears that Ma-huang, along with Raynaud's phenomenon and pericardial effusion, may be a causative agent of myopathy. As such, attention should be paid to the possibility that herbal medication with Ma-huang can result in myopathy.
Biopsy ; Eating ; Ephedra ; Female ; Humans ; Inflammation ; Middle Aged ; Muscle Weakness ; Muscles ; Muscular Diseases ; Pericardial Effusion

Ischemic stroke caused by spontaneous thrombosis of posterior inferior cerebellar artery (PICA) aneurysm has been rarely reported. A 52-year-old man presented with sudden headache, dizziness, and gait disturbance. Diffusion-weighted MRI showed acute infarction in left PICA territory. A saccular aneurysm with internal thrombus at the distal PICA was detected by CT angiography and conventional angiography. The thrombus resolved spontaneously at 2 months after stroke onset with aspirin medication. At that time, endovascular coiling was underwent successfully to prevent aneurysmal rupture.
Aneurysm* ; Angiography ; Arteries* ; Aspirin ; Cerebral Infarction ; Dizziness ; Gait ; Headache ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Middle Aged ; Pica ; Rupture ; Stroke ; Thrombosis*

BACKGROUND AND PURPOSE: Progression of motor deficits in the acute period is frequently observed in patients with subcortical striatocapsular infarctions. Therefore, we sought to determine the factors associated with early motor progression in patients with infarcts confined to the striatocapsular region. METHODS: We studied 80 consecutive patients with striatocapsular-region infarction, as defined by clinical and MRI criteria, within 24 hours after stroke onset. Motor progression was defined as an increase of >2 points in the motor items of the National Institutes of Health Stroke Scale (NIHSS) within 7 days of stroke onset. The study population was divided into patients with and without motor progression, and risk factors, clinical features, and brain MRI/magnetic resonance angiograpy (MRA) findings were compared between these groups. RESULTS: Motor progression was observed in 40% of the 80 patients. The independent variables associated with motor progression were a history of hypertension (OR=7.8, 95% CI=1.5-39.8, p=0.013) and an initial infarct extent of > or =15 mm (OR=9.2, 95% CI=1.8-45.7, p=0.006). However, there were no differences in the initial NIHSS score, other stroke risk factors, vascular stenosis pattern, or cardioembolic source. CONCLUSIONS: Early motor progression in patients with striatocapsular-region infarction is associated with the initial extent of the lesion. However, the stroke mechanism and vascular stenosis did not differ between the motor progression and stable groups.
Brain ; Constriction, Pathologic ; Humans ; Hypertension ; Infarction ; Magnetic Resonance Imaging ; National Institutes of Health (U.S.) ; Risk Factors ; Stroke

OBJECTIVE: To evaluate the effectiveness and the safety of vaginal total hysterectomy. METHODS: We reviewed the medical records of the 110 patients who underwent vaginal total hysterectomy for the indications other than uterine prolapse from August 2001 to September 2002 at our hospital. RESULTS: The average operating time was 48.7 minutes (range from 20 min to 180 min) and the mean uterine weight was 331 gram (range from 60 g to 890 g). The most common indication for hysterectomy was uterine myoma (59%). No serious complications were occurred but conversion to laparotomy was occurred in 1 case. CONCLUSION: Vaginal total hysterectomy would be recommended method for removing uterus even in the absence of prolapse and previous operation history.
Female ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal ; Laparotomy ; Leiomyoma ; Medical Records ; Prolapse ; Uterine Prolapse ; Uterus

BACKGROUND: A brief episode of global forebrain ischemia produces selective and often extensive neuronal loss in several vulnerable brain structures. This cell death does not occur immediately, but is delayed for hours to days. This process is termed delayed neuronal death (DND). Recently, several reports have suggested that an apoptotic process may be involved in DND. The most effective treatment at present is intraischemic hypothermia. Thus, we designed this study to investigate whether intraischemic mild hypothermia could inhibit apoptosis following transient forebrain ischemia in gerbils. METHODS: Twenty-four gerbils were divided into two groups based on intraischemic rectal temperature: 34 degrees C(n=12) and 37 degrees C(n=12). Two additional gerbils underwent a sham operation. Cerebral ischemia was produced by occluding both carotid arteries for 10 minutes. The DNA fragmentation in the gerbil hippocapal CA1 area was determined by using the TUNEL method, and the results for the normothermic and the hypothermic groups were compared at 1, 3, and 7 days following 10-min transient ischemia (n=4 for each time point, respectively). RESULTS: 1. Percent dead hippocampal neurons were significantly decreased in the hypothermic group compared with the normothermic group at 1, 3, and 7 days following transient ischemia (p<0.05). 2. In the intraischemic normothermic group, TUNEL positive cells were first detected in the hippocampal CA1 at 3 days (1.9+/-0.6 cells/section), and the number was larger at 7 days following transient ischemia (127.8+/-16.3 cells/section). 3. In the intraischemic hypothermic group, no TUNEL positive cells were detected in the hippocampal CA1 at 1, 3, and 7 days following transient ischemia. CONCLUSION: The data suggest that delayed neuronal death following transient ischemia is, in part, apoptotic and that intraischemic mild hypothermia affords significant neuronal protection and prevents DNA fragmentation.
Apoptosis* ; Brain ; Brain Ischemia ; Carotid Arteries ; Cell Death ; DNA Fragmentation ; Gerbillinae* ; Hypothermia* ; In Situ Nick-End Labeling ; Ischemia* ; Neurons ; Prosencephalon*

Prune-belly syndrome is a rare compound fetal anomaly, characterized by absence or hypoplasia of abdominal wall musculature associated with urinary tract abnormalities and cryptorchidism. The prenatal ultrasound diagnosis was based on the findings of a lower abdominal cystic echo caused by abnormal dilatation of the bladder, upward compression of small intestines and decreased amniotic fluid volume. We experienced a case of Prune-belly syndrome diagnosed by ultrasound in a 12 weeks fetus following to IVF-ET pregnancy. Termination was performed at 12 weeks and autopsy confirmed the distended bladder, absence of abdominal muscles and urethra. So, we reported this case with a brief review of literature.
Abdominal Muscles ; Abdominal Wall ; Amniotic Fluid ; Autopsy ; Cryptorchidism ; Diagnosis ; Dilatation ; Female ; Fetus ; Intestine, Small ; Male ; Pregnancy ; Prenatal Diagnosis ; Prune Belly Syndrome* ; Ultrasonography* ; Urethra ; Urinary Bladder ; Urinary Tract