Liver transplantation (LT) for hepatitis C virus (HCV)-related liver diseases has been increasing in Korea. HCV recurrence, a serious complication after LT, can accelerate liver cirrhosis and fatal graft loss. Therefore, the prevention and appropriate treatment for HCV recurrence can improve a LT patient's quality of life and survival. In considering the relationship between immunosuppressants and HCV recurrence, there is no clear difference in HCV recurrence between the immunosuppressant tacrolimus or cyclosporine, and the use of steroids for patients with HCV is still under debate. In the management of HCV recurrence, direct-acting antivirals, such as protease inhibitors, polymerase inhibitors, or other nonstructural protein inhibitors will open a new era in HCV treatment. However, their safety and drug interactions with immunosuppressants should be evaluated for patients after LT.
Antiviral Agents ; Cyclosporine ; Drug Interactions ; Hepacivirus ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Korea ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Transplantation ; Protease Inhibitors ; Quality of Life ; Recurrence ; Steroids ; Tacrolimus ; Transplants

Restless legs syndrome (RLS) is a common neurological condition characterized by uncomfortable and unpleasant sensations experienced primarily in the legs. Several clinical reports have indicated that many patients with RLS also have the same symptoms in their arms. We report contralateral arm and leg restlessness on resting after acute internal capsular infarction, which resulted in sleep-onset insomnia and disappeared after administering a dopamine receptor agonist. These observations could provide clues to the mechanism underlying the pathophysiology of RLS.
Arm ; Dopamine Agonists ; Humans ; Infarction ; Leg ; Psychomotor Agitation ; Restless Legs Syndrome ; Sensation ; Sleep Initiation and Maintenance Disorders

Cryptococcosis is a global invasive mycosis associated with significant morbidity and mortality. Fever, headache and vomiting are common clinical presentations of the cryptococcal meningitis. But ischemic stroke and cranial nerve impairment are rare neurologic complications. We report a case of cryptococcal meningoencephalitis presenting as cerebral infarction and multiple cranial nerve palsies.
Cerebral Infarction ; Cranial Nerve Diseases ; Cranial Nerves ; Cryptococcosis ; Fever ; Headache ; Meningitis, Cryptococcal ; Meningoencephalitis ; Stroke ; Vomiting

Polychlorinated biphenyls (PCBs) are accumulated in our body through food chain and cause a variety of adverse health effects including neurotoxicities such as cognitive deficits and motor dysfunction. In particular, neonates are considered as a high risk group for the neurotoxicity of PCBs exposure. The present study attempted to analyze the structure-activity relationship among PCB congeners and the mechanism of PCBs-induced neurotoxicity. We measured total protein kinase C (PKC) activities, PKC isoforms, reactive oxygen species (ROS), and induction of neurogranin (RC-3) and growth associated protein-43 (GAP-43) mRNA in cerebellar granule cells of neonatal rats with phorbol 12, 13-dibutyrate ([3H]PDBu) binding assay, western blot, ROS assay, and reverse transcription PCR (RT-PCR) analysis respectively following the different structural PCBs exposure. Only non-coplanar PCBs showed a significant increase of total PKC-alpha and betaII activity as measured with [3H]PDBu binding assay. ROS were more increased with non-coplanar PCBs than coplanar PCBs. The mRNA levels of RC-3 and GAP-43 were more induced with non-coplanar PCBs than coplanar PCBs, indicating that these factors may be useful biomarkers for differentiating non-coplanar PCBs from coplanar PCBs. Non-coplanar PCBs may be more potent neurotoxic congeners than coplanar PCBs. This study provides evidences that non-coplanar PCBs, which have been neglected in the risk assessment processes, should be added in the future to improve the quality and accuracy of risk assessment on the neuroendocrinal adverse effects of PCBs exposures.
Animals ; Blotting, Western ; Food Chain ; GAP-43 Protein ; Humans ; Infant, Newborn ; Nerve Growth Factor ; Neurogranin ; Neurons ; Neurotoxicity Syndromes ; Phorbols ; Polychlorinated Biphenyls ; Polymerase Chain Reaction ; Protein Isoforms ; Protein Kinase C ; Rats ; Reactive Oxygen Species ; Reverse Transcription ; Risk Assessment ; RNA, Messenger ; Structure-Activity Relationship ; Biomarkers

PURPOSE: To evaluate the use of prophylactic antibiotics in glaucoma surgery and the prevalence of postoperative endophthalmitis. METHODS: Retrospective medical record review was performed on 136 eyes which underwent glaucoma operation by one surgeon from March 2008 to February 2010 and were followed at least till 6 months postoperatively (glaucoma drainage device implantation; 95 eyes, trabeculectomy; 41 eyes). RESULTS: For intravenous antibiotics injection, 10 eyes used 3rd generation cephalosporin, 54 eyes used 4-fluoroquinolone, 72 eyes used 2nd generation cephalosporin. For oral antibiotics, 125 eyes used 3rd generation cephalosporin, 1 case used 4-fluoroquinolone, and other 10 cases did not use oral antibiotics after the surgery. Total period of systemic antibiotics use showed various distributions with 14 eyes more than 5 days, 115 eyes 4-5 days, and 8 cases less than 4 days. Six eye which used 4-fluoroquinolone and 3 eyes which used cephalosporin showed side effect such as skin lesion and nausea. There has been no single occurrence of endophthalmitis. CONCLUSIONS: Various kinds of prophylactic antibiotics were used for glaucoma surgery and the period of antibiotics use was different among patients. However, there has been no single occurrence of endophthalmitis till 6 months postoperative follow up.
Anti-Bacterial Agents ; Drainage ; Endophthalmitis ; Eye ; Follow-Up Studies ; Glaucoma ; Humans ; Medical Records ; Nausea ; Prevalence ; Retrospective Studies ; Skin

PURPOSE: The aim of this study was to investigate factors associated with the signal strengths (SS, image quality scores) of optic disc and macular images obtained using Cirrus spectral domain optical coherence tomography (OCT). METHODS: Ninety-two glaucomatous eyes were imaged using the Cirrus OCT macular and optic disc cube modes after pupil dilation. The influences of patient age, spherical equivalent, cataract presence, and cataract and glaucoma severity (visual field mean deviation), on the SS of images obtained using the two cube modes were compared between patients whose images showed high SS (SS > or =7) and low SS (SS <7). RESULTS: The signal strength was significantly higher in images obtained using the macular cube compared to the optic disc cube mode (7.8 +/- 1.3 vs. 6.9 +/- 1.1, respectively; p = 0.001). Age and visual acuity of patients differed significantly between the high- and low-SS groups when data acquired using the optic disc (p = 0.027 and 0.012, respectively) and macular cube modes (p = 0.046 and 0.014, respectively) were analyzed. When the optic disc cube mode was employed, the extent of cataracts was significantly related to SS, whereas when the macular cube mode was used, none of the factors analyzed was significantly associated with SS. CONCLUSIONS: Age, visual acuity, and the extent of cataracts were significantly associated with images of higher SS when the Cirrus OCT optic disc cube mode was employed.
Cataract/complications/pathology ; Female ; Glaucoma/complications/*pathology ; Humans ; Macula Lutea/*pathology ; Male ; Middle Aged ; Nerve Fibers/*pathology ; Reproducibility of Results ; Retinal Ganglion Cells/*pathology ; Retrospective Studies ; Tomography, Optical Coherence/methods