The most common pathogen of respiratory tract infection among school-age children and adolescents is Mycoplasma pneumoniae, which causes clinical manifestations of pneumonia, acute asthmatic attack, pharygitis, and tonsilitis. It can also cause extrapulmonary infections that involves skin, the nervous system, the digestive system, the cardiovascular system, and the hematopoietic system. It is reported that the central nervous system symptoms may occur in 0.1% to 7% of patients hospitalized with Mycoplasma pneumoniae infection. Direct invasion, toxin, immune-mediated, and vascular phenomenon have been proposed for the etiology of the neurological manifestations. We have experienced a six-year-old male patient with Mycoplasma pneumoniae pneumonia who had complained of both leg pains and immobility two weeks after the onset of pneumonia, which was confirmed as peripheral neuropathy of Guillain-Barr syndrome. Three weeks after the disease-onset, altered consciousness and seizure attacks developed and intravenous immunoglobulins infused under the impression of encephalitis induced by Mycoplasma pneumoniae infection. He showed complete recovery of running and mentality five months after the disease-onset. We herein report a case of Mycoplasma pneumoniae pneumonia complicated with Guillain-Barr Syndrome and encephalitis about 2 or 3 weeks after the disease onset with a review of literatures.
Adolescent ; Cardiovascular System ; Central Nervous System ; Child ; Consciousness ; Digestive System ; Encephalitis* ; Guillain-Barre Syndrome* ; Hematopoietic System ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Leg ; Male ; Mycoplasma pneumoniae* ; Mycoplasma* ; Nervous System ; Neurologic Manifestations ; Palatine Tonsil ; Peripheral Nervous System Diseases ; Pneumonia* ; Pneumonia, Mycoplasma* ; Respiratory Tract Infections ; Running ; Seizures ; Skin

OBJECTIVE: The aim of this research was to evaluate the mechanical properties (MP) and degree of the phase transformation (PT) of martensitic (M-NiTi), austenitic (A-NiTi) and thermodynamic nickel-titanium wire (T-NiTi). METHODS: The samples consisted of 0.016 x 0.022 inch M-NiTi (Nitinol Classic, NC), A-NiTi (Optimalloy, OPTI) and T-NiTi (Neo-Sentalloy, NEO). Differential scanning calorimetry (DSC), three-point bending test, X-ray diffraction (XRD), and microstructure examination were used. Statistical evaluation was undertaken using ANOVA test. RESULTS: In DSC analysis, OPTI and NEO showed two peaks in the heating curves and one peak in the cooling curves. However, NC revealed one single broad and weak peak in the heating and cooling curves. Austenite finishing (Af) temperatures were 19.7degrees C for OPTI, 24.6degrees C for NEO and 52.4degrees C for NC. In the three-point bending test, residual deflection was observed for NC, OPTI and NEO. The load ranges of NC and OPTI were broader and higher than NEO. XRD and microstructure analyses showed that OPTI and NEO had a mixture of martensite and austenite at temperatures below Martensite finishing (Mf). NEO and OPTI showed improved MP and PT behavior than NC. CONCLUSIONS: The mechanical and thermal behaviors of NiTi wire cannot be completely explained by the expected degree of PT because of complicated martensite variants and independent PT induced by heat and stress.
Calorimetry, Differential Scanning ; Dental Alloys ; Heating ; Hot Temperature ; Thermodynamics ; Transition Temperature ; X-Ray Diffraction

PURPOSE:We investigated the production of oxygen hydroxyl radicals in the striatum of neonatal rat brain after intrastriatal injection of dopamine (DA) and the effect of growth hormone (GH) on the apoptosis of striatal neurons injured by hypoxia-ischemia. METHODS:The extracellular striatal levels of 2,3-dihydroxybenzoic acid (DHBA) and 2,5-DHBA as indicators of hydroxyl radical(OH-) production were measured by in vivo microdialysis in the striatums of 7 day-old newborn rats (n=10) after direct intrastriatal infusion of dopamine hydrochloride (1.0 micromol/microL). The samples of perfused artificial cerebrospinal fluid (CSF) were collected every 10 minutes interval. The levels of DA, 2,3-DHBA and 2,5-DHBA of CSF were analysed by HPLC (high performance liquid chromatography). Also, the brains were removed at 24 hour after hypoxic-ischemic injury by Rice-Vannucci method. The coronal sections (12 micrometer) of paraffin-fixed brains were stained by TUNEL (terminal transferase-mediated dUTP nick-end-labelling) technique, and the neuronal cells undergoing apoptosis in the striatum were observed by fluorescent microscopy and compared between GH-treated (50 mg/kg, Dong-Ah Pharmacy Co.) and saline-treated rats. RESULTS:The extracellualr striatal levels of 2,3-DHBA and 2,5-DHBA increased abruptly in the first 10 minutes samples after intrastriatal injection of DA. After then, the levels declined slowely. The levels of striatal extracelluar 2.3-DHBA increased up to 621.8+/-508.7% of basal levels (P<0.05), and the levels of 2.5-DHBA increased up to 262.8+/-198.1% of basal levels (P<0.05). GH reduced markedly the number of apoptotic neuronal cells in the striatum after hypoxic-ischemic brain injury. CONCLUSION: The level of hydroxyl radicals increased abruptly after intrastriatal injection of DA and GH reduced markedly the number of apoptotic neuronal cells in the striatum after hypoxic-ischemic brain injury.
Animals ; Apoptosis* ; Brain Injuries ; Brain* ; Cerebrospinal Fluid ; Chromatography, High Pressure Liquid ; Dopamine* ; Growth Hormone* ; Humans ; Hydroxyl Radical* ; In Situ Nick-End Labeling ; Infant, Newborn* ; Microdialysis ; Microscopy ; Neurons* ; Oxygen ; Pharmacy ; Rats*

PURPOSE: Long-term administration of anticonvulsants in children with epilepsy may cause short stature, hypocalcemia and low bone mineral density. This study was performed for the early detection of abnormal bone metabolism in children with epilepsy on taking anticonvulsants. METHODS: Thirty children aged 5 to 16 years who were diagnosed with epilepsy were enrolled in this study. All had taken anticonvulsants for more than one year. Bone mineral density of lumbar vertebra was measured by dual-energy X-ray absorptiometry. Serum calcium, phosphorous, alkaline phosphatase, 25-hydroxycholecalciferol[25(OH)D3], parathyroid hormone, and urine deoxypyridinoline were measured as biochemical bone markers. Bone age and body mass index were also calculated. RESULTS: Bone minreal density, body mass index, bone age, and height were significantly decreased in two female patients who had taken two antiepileptic drugs for more than four years and they also had chronic diseases such as cerebral palsy with microcephaly, encephalomalacia, and microcephaly with atrial septal defect. Bone mineral density had significant positive correlations with body mass index(P<0.01) and bone age(P<0.01). CONCLUSION: This study showed chronic medication of anticonvulsants in children may cause low bone mineral density and short stature. Bone age and body mass index could be the important surrogate markers to find the population at risk. More studies, including a large study population and long term cohort study, will be required.
Absorptiometry, Photon ; Alkaline Phosphatase ; Anticonvulsants* ; Biomarkers ; Body Mass Index ; Bone Density* ; Calcium ; Cerebral Palsy ; Child* ; Chronic Disease ; Cohort Studies ; Encephalomalacia ; Epilepsy* ; Female ; Heart Septal Defects, Atrial ; Humans ; Hypocalcemia ; Metabolism ; Microcephaly ; Parathyroid Hormone ; Population Characteristics ; Spine

OBJECTIVE: The authors examined the efficacy of citalopram, and its effect on the quality of life in patients with panic disorder. METHOD: Seventy three patients who had panic disorder were recruited for this study. They did not have major depression and other axis I diseases. They were scheduled to be examined 4 times (at baseline, 4, 12 and 24 weeks) and took citalopram for 24 weeks with a flexible dosing schedule. The primary efficacy variables were the response and remission rates (response: HAMA total score decreased by at least 50% from baseline; remission: HAMA total score < or = 7). Other variables included the Hamilton Rating Scale for Depression, Panic Disorder Severity Scale (PDSS), Acute Panic Inventory, Clinical Global Impression Scale and Sheehan Disabilities Scale (SDS). RESULTS: The number of patients who completed 24 weeks of treatment was 33 (45.2%). Forty patients who were dropped out consisted of 4 patients with symptom improvement and 36 patients with failure to return. Response/remission rates were 56.2/31.5% in the last-observation-carried-forward methods and 87.9/69.7% in the observed case data. Treatment with citalopram improved anxiety and depressive symptoms during 24 weeks on all efficacy measures. By a completed patient analysis, citalopram also significantly improved the disability scores on SDS. In this study, any serious adverse effects were not observed. CONCLUSION: Treatment with citalopram was effective and well-tolerated for the patients with panic disorder, and also improved quality of life in the patients.
Anxiety ; Appointments and Schedules ; Axis, Cervical Vertebra ; Citalopram* ; Depression ; Humans ; Panic Disorder* ; Panic* ; Prospective Studies* ; Quality of Life ; Treatment Outcome

No abstract available.
Hyperuricemia* ; Kidney Transplantation*

No abstract available.
Hyperuricemia* ; Kidney Transplantation*

Objectives: ：Loneliness and poor sleep quality are common phenomena in old age and are associated with negative physical and mental health. However, little is known regarding the relation between loneliness and sleep quality. The aim of this study was to examine the association of loneliness and sleep quality among the elderly living alone. Methods: ：This is a cross-sectional study that enrolled 1,090 subjects who are the community-residing elderly living alone. Sociodemographic status, medical condition, cognition, mood disorder, sleep quality and levels of loneliness were collected using a self-administered questionnaire and a specific semi-structured interview con-ducted by trained nurses. Descriptive statistics were used to analyze data regarding sociodemographic variable and loneliness. Univariate and Multivariate regression analyses were applied to examine the association between loneliness and sleep quality after adjustment for multiple confounding variables. Results: ：The Pittsburgh Sleep Quality Index (PSQI) mean score of “lonely group” (9.2±4.2) was signifi-cantly higher than that of “not lonely group” (7.3±3.7) (student-t test, p<0.001). Loneliness was significantly as-sociated with PSQI (standardized β= 0.065, p=0.025), sleep disturbance (standardized β=0.086, p=0.005), use of sleep medication (standardized β= 0.065, p=0.034) after adjustment for possible confounding variables including sex and mood disorder. Conclusions ：Loneliness was associated with sleep disturbance and this finding implied negative impact of loneliness on sleep quality of older adults. Public health promotion efforts to reduce loneliness may improve sleep quality and mental health in the elderly living alone.

Objectives: ：Loneliness and poor sleep quality are common phenomena in old age and are associated with negative physical and mental health. However, little is known regarding the relation between loneliness and sleep quality. The aim of this study was to examine the association of loneliness and sleep quality among the elderly living alone. Methods: ：This is a cross-sectional study that enrolled 1,090 subjects who are the community-residing elderly living alone. Sociodemographic status, medical condition, cognition, mood disorder, sleep quality and levels of loneliness were collected using a self-administered questionnaire and a specific semi-structured interview con-ducted by trained nurses. Descriptive statistics were used to analyze data regarding sociodemographic variable and loneliness. Univariate and Multivariate regression analyses were applied to examine the association between loneliness and sleep quality after adjustment for multiple confounding variables. Results: ：The Pittsburgh Sleep Quality Index (PSQI) mean score of “lonely group” (9.2±4.2) was signifi-cantly higher than that of “not lonely group” (7.3±3.7) (student-t test, p<0.001). Loneliness was significantly as-sociated with PSQI (standardized β= 0.065, p=0.025), sleep disturbance (standardized β=0.086, p=0.005), use of sleep medication (standardized β= 0.065, p=0.034) after adjustment for possible confounding variables including sex and mood disorder. Conclusions ：Loneliness was associated with sleep disturbance and this finding implied negative impact of loneliness on sleep quality of older adults. Public health promotion efforts to reduce loneliness may improve sleep quality and mental health in the elderly living alone.

PURPOSE: To determine whether preoperative CT is helpful in predicting the development of recurrent tumor following surgical resection in patients with esophageal cancer. MATERIALS AND METHODS: Thirty patients with esophageal cancer in whom preoperative CT of the chest had been performed were included in the study. All had undergone esophagectomy, esophagogastrostomy and lymph node dissection at our institution between 1995 and 1997. They were divided into two groups according to the development of tumor recurrence during the follow-up period of three years. Sixteen patients (group I) suffered tumor recurrence, while the other 14 (group II) remained tumor-free after surgery. In each group, a review of the preoperative CT scans indicated the length, thickness, location and margin of the tumor, and the presence or absence of lymphadenopathy in the mediastinum and/or upper abdomen. Differences in preoperative CT findings between the two groups were assessed by statistical testing. RESULTS: Lymphadenopathy of the mediastinum and/or upper abdomen was seen in 11 (69%) of 16 patients in group I and three (21%) of 14 in group II (p<.05). The tumor margin was indistinct in seven patients (44%) in group I and in one (7%) in group II (p<.05). The average length and thickness of esophageal tumors were 5.2 and 1.4 cm, respectively, in group I, and 3.5 and 1.5 cm, respectively, in group II (p>.05). In group I, five esophageal tumors were located in the middle esophagus and eleven in the lower esophagus. In group II, such tumor was located one in the upper esophagus, six in the middle esophagus, and seven in the lower esophagus (p>.05). CONCLUSION: Patients with preoperative CT findings of lymphadenopathy and/or an indistinct primary tumor margin are more likely to develop tumor recurrence following surgical resection than those without these findings.
Abdomen ; Esophageal Neoplasms ; Esophagectomy ; Esophagus ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymphatic Diseases ; Mediastinum ; Recurrence* ; Thorax ; Tomography, X-Ray Computed