No abstract available.
Skin*

No abstract available.

A 70-year-old woman with Parkinson disease was admitted to the emergency department with altered consciousness, fever and convulsive movements without experiencing withdrawal from antiparkinsonian medication. Six hours after the emergency department visit, the patient had a hyperpyrexia (>40℃) and a systolic blood pressure of 40 mmHg. There was no evidence of bacterial infection based on extensive workups. The patient was discharged without aggravation of Parkinson disease symptoms after treatment that included administration of dantrolene sodium, enforcement of continuous renal replacement therapy and cooling blankets. Malignant syndrome should be suspected if high fever occurs in Parkinson disease patients without evidence of a definitive infection.
Aged ; Bacterial Infections ; Blood Pressure ; Consciousness ; Dantrolene ; Dehydration ; Emergency Service, Hospital ; Female ; Fever ; Humans ; Parkinson Disease* ; Renal Replacement Therapy

Posterior instability of the shoulder is far less common than anterior or multidirectional instability. There is still controversy in the diagnosis and treatment of recurrent posterior instability, and many treatment protocols have been advocated. However the failure rate as high as 50% was reported. The purpose of this study is to introduce characteristic physical findings of posterior instability, to present our operative techniques, and to report the efficacy of a superior shift of the postero-inferior capsule in the treatment of recurrent posterior instability. From June 1995 to September 1996, five patients, six shoulders underwent postero-inferior capsular shift for posterior instahility and were evaluated at an average of 17 months(ranged from 9 to 26 months) after operation. The average age was 22.4 years. Preoperatively, mean scores of pain, stability and function according to American Shoulder and Elbow Society (ASES) scoring system were 21, 9, and 16 points respectively and mean overall ASES score was 46 points. After surgery, the average range of motion was 175 of forward elevation and 74 of external rotation and internai rotation in back was up to the sixth thoracic level. Postoperative mean scores of pain, stability and function were 29, 34 and 25 points respectively and mean overall ASES score was 88.5 points. No patient had a recurrence of posterior instability. All patients had satisfactory results with significant improvement in stability and function except one case who had multidirectional instability that mainly involved the posterior component
Clinical Protocols ; Diagnosis ; Elbow ; Humans ; Range of Motion, Articular ; Recurrence ; Shoulder*

The changes of electroencephalogram(EEG) in patients with dementia are most commonly studied by analyzing power or magnitude in certain traditionally defined frequency bands. However because of the absence of on identified metric which quantifies the complex amount of information, there are many limitations in using such a linear method. According to chaos theory, irregular signals of EEG cal also result from low dimensional deterministic chaos. Chaotic nonlinear dynamics in the EEG can be studied by calculating the correlation dimension. The authors have analyzed EEG epochs from three patients with dementia of Alzheimer type and three matched control subject. The result showed that patients with dementia of Alzheimer type had significantly lower correlation dimension than non-demented controls on 12 channels. Topographic analysis showed that the correlation dimensions were significantly lower in patients with Alzheimer's disease on frontal, temporal, central, and occipital head regions. These results show that brains of patients with dementia with dementia of Alzheimer type have a decreased complexity of electrophysiological behavior. We conclude that the nonlinear analysis such as calculating correlation dimension can be a promising tool for detecting changes in the complexity of brain dynamics.
Alzheimer Disease ; Brain ; Dementia* ; Electroencephalography* ; Head ; Humans ; Nonlinear Dynamics*

A case of congenital absence of right atriovntricular (A-V) connection of heart is reported. Patient was 81 day old male infant with chief complaints of dyspnea and irritability. Clinical evaluation revealed increased pulmonary vascularity on chest x-ray, absence of right A-V connection, regurgitation of left A-V valve, right-sided ventricular hypoplasia and L-TGA. Clinical assessment of the case was tricupsid atresia with LTGA and mitral regurgitation. Pulmonary artery banlding and artial septectomy was performed. Parenteral alimentation through the femoral veins resulted in obstruction of IVC and subsequent multiorgan failure. The autopsy findings of the heart were corrected transposition of great arteries with associated anomallies of right-sided mitral atresia, Ebstein's malformation of left-sided tricuspid valve, ventricular septal defect, muscular hypertrophy of right-sided left ventricle with luminal obliteration. Long segment of IVC was completely occluded due to occlusive thrombi with fungal infection. Bilateral kidneys were infarcted and azygos vein was markedly engorged. Microscopic examination revealed candidal colonization in the inferior vena cava and septic embolzation in brain.
Infant ; Male ; Female ; Humans

A case of congenital absence of right atriovntricular (A-V) connection of heart is reported. Patient was 81 day old male infant with chief complaints of dyspnea and irritability. Clinical evaluation revealed increased pulmonary vascularity on chest x-ray, absence of right A-V connection, regurgitation of left A-V valve, right-sided ventricular hypoplasia and L-TGA. Clinical assessment of the case was tricupsid atresia with LTGA and mitral regurgitation. Pulmonary artery banlding and artial septectomy was performed. Parenteral alimentation through the femoral veins resulted in obstruction of IVC and subsequent multiorgan failure. The autopsy findings of the heart were corrected transposition of great arteries with associated anomallies of right-sided mitral atresia, Ebstein's malformation of left-sided tricuspid valve, ventricular septal defect, muscular hypertrophy of right-sided left ventricle with luminal obliteration. Long segment of IVC was completely occluded due to occlusive thrombi with fungal infection. Bilateral kidneys were infarcted and azygos vein was markedly engorged. Microscopic examination revealed candidal colonization in the inferior vena cava and septic embolzation in brain.
Infant ; Male ; Female ; Humans

HIV-1 p24 was cloned into multiple cloning site of pMV261, extrachromosomal expression vectors carrying BCG replication origin and BCG-specific heat-shock promoter, and then introduced into BCG and E. coli. Western blot experiments showed that the p24 efficiently expressed in recombinant BCG (rBCG), but not in E. coli. Recombinant p24 expression induced by a single heat-shock of rBCG was maintained longer than 3 weeks. Immunoblot experiments with intact rBCG did not show any distinctive positive signal, suggesting that the recombinant protein was not secreted or exposed at the surface of BCG. The guinea pigs immunized with live rBCG showed delayed type hypersensitivity (DTH) by the systemic area as well as an effective humoral immunity, suggesting that tbis rBCG is believed to elicit eKcient immune responses against p24, even though the expression is restricted only in the cytoplasm as reported previously with other antigen. These results demonstrate that BCG can be developed as a live recombinant vaccine vector against a broad spectrum of infectious disease.
Animals* ; Blotting, Western ; Clone Cells ; Cloning, Organism ; Communicable Diseases ; Cytoplasm ; Guinea Pigs ; HIV* ; HIV-1 ; Hypersensitivity ; Immunity, Humoral ; Mycobacterium bovis* ; Replication Origin

No abstract available.
Ear*

Neurofibromatosis is a syndrome of multiple neurofibromas, abnormal skin pigmentation and certain bony abnormalities. Sometimes the growth of plexiform neurofibromatosis on the face or trunk is centripetal and usually involves the mediastinum and skull base. However, it is very rare that neurofibromatosis involves the trigeminal ganglion. Its encroachment around the foramina of the skull base may induce facial palsy or conductive hearing loss. The guiding principle in the treatment of generalized neurofibromatosis is a radical excision with preservation of vital structures and an immediate reconstruction of the bony skeleton and soft tissue defect. The authors experienced 4 cases of neurofibromatosis involving the trigeminal ganglion. All had trigeminal symptoms for 3 to 4 years. These were severe headache and intractable trigeminal neuralgia. Tumors in all 4 cases were spread in the centripetal type from extracranial neurofibromatosis. The facial nerve was affected in 4 cases. Malignat Schwannoma occurred in 1 case. Accurate diagnosis and assessments were necessary with CT, MRI art oomputer-aided simulation design. Intraoperative bleeding was minimal with hypotensive anesthesia. Surgical approach to the middle cranial fossa involved temporary removal of the zygomatic arch and TMJ disarticulation with downward traction of the mandible. Satisfactory results have been obtained far 3 to 7 years(mean 5 years) follow-up.
Anesthesia ; Cranial Fossa, Middle ; Diagnosis ; Disarticulation ; Facial Nerve ; Facial Paralysis ; Follow-Up Studies ; Headache ; Hearing Loss, Conductive ; Hemorrhage ; Magnetic Resonance Imaging ; Mandible ; Mediastinum ; Neurilemmoma ; Neurofibromatoses* ; Neurofibromatosis 1 ; Skeleton ; Skin Pigmentation ; Skull Base ; Temporomandibular Joint ; Traction ; Trigeminal Ganglion* ; Trigeminal Neuralgia ; Zygoma