Cardiac myxoma is rare and has protean clinical manifestations mimicking various disease. Unless clinician has a high index of suspicion, the diagnosis can be easil missed. However diagnosis is all the more important since surgery can be dramatically successful, where as untreated myxoma invariably leads to death. Cardiac myxoma accounts for 50% of primary cardiac tumor and mainly originates in left atrium.(75%). The features of myxoma can be described under the three headings : Constitutional, obstructive, and embolic. From 1977 to 1985, the authors have experienced 30 cases of cardiac myxoma, one of which recurred. Of 29 patients, 8 were male and 21 were female. Their ages ranged from 11 to 55 years with average of 39.8 years. Constitutional manifestation was found in 25 of the 27 patients, obstructive manifestation in 27, and embolic phenomenon in 5. The diagnosis of myxoma was made on the basis of 2-D echocardiography. The sensitivity was 100%. Except 1 case who refused operation, all received surgical treatment. Immediate postoperative complication occurred in 6 patients(23%). Among them serious complication could be found only in 2 cases(7.7%). During long term follow up there was one recurrence and one patient with right ventricular myxoma has tricuspid regurgitation. In other cases, we could not found any problems.
Diagnosis ; Echocardiography ; Female ; Follow-Up Studies ; Head ; Heart Neoplasms ; Humans ; Male ; Myxoma* ; Postoperative Complications ; Recurrence ; Tricuspid Valve Insufficiency

Postconditioning has been shown to protect the mouse brain from ischemic injury. However, the neuroprotective mechanisms of postconditioning remain elusive. We have found that toll-like receptor 5 (TLR5) plays an integral role in postconditioning-induced neuroprotection through Akt/nuclear factor kappa B (NF-κB) activation in cerebral ischemia. Compared to animals that received 30 min of transient middle cerebral artery occlusion (tMCAO) group, animals that also underwent postconditioning showed a significant reduction of up to 60.51% in infarct volume. Postconditioning increased phospho-Akt (p-Akt) levels and NF-κB translocation to the nucleus as early as 1 h after tMCAO and oxygen-glucose deprivation. Furthermore, inhibition of Akt by Akt inhibitor IV decreased NF-κB promoter activity after postconditioning. Immunoprecipitation showed that interactions between TLR5, MyD88, and p-Akt were increased from postconditioning both in vivo and in vitro. Similar to postconditioning, flagellin, an agonist of TLR5, increased NF-κB nuclear translocation and Akt phosphorylation. Our results suggest that postconditioning has neuroprotective effects by activating NF-κB and Akt survival pathways via TLR5 after cerebral ischemia. Additionally, the TLR5 agonist flagellin can simulate the neuroprotective mechanism of postconditioning in cerebral ischemia.
Animals ; Brain ; Brain Ischemia* ; Flagellin ; Immunoprecipitation ; In Vitro Techniques ; Infarction, Middle Cerebral Artery ; Mice* ; Neuroprotection ; Neuroprotective Agents ; NF-kappa B ; Phosphorylation ; Toll-Like Receptor 5

Hemichorea-hemiballsim has been reported as a rare Implication of nonketotic hyperglycemia. Recently, Some reports revealed that brain magnetic resonance images of nonketotic hyperglycemic patients with hemichorea-hemiballism showed characteristic contralateral striatal signal abnormality, We present six patients with hemichorea-heniiballism. All of them had diabetes mellitus and performed brain MR images. The MR images of them showed high signal intensity on Tl-weighted images and low signal intensity on T2 weighted images in the striatum contralateal to the involuntary movement. In general, the striatal high signal intensity on TI weighted images are presumed to have developed following hemorrhagic transformation, osmotic myelinolysis, or mild ischemia with reversible deposition of calcium or other material occurred in association with nonketotic hyperglycemia. However the precise mechanism of this signal change is not clear yet and needs pathological confirmation.
Brain ; Calcium ; Diabetes Mellitus ; Dyskinesias ; Humans ; Hyperglycemia ; Ischemia

PURPOSE: The purpose of this study was to examine the effects of chromium chloride addition on coloration, mechanical property and microstructure of 3Y-TZP. MATERIALS AND METHODS: Chromium chloride was weighed as 0.06, 0.12, and 0.25 wt% and each measured amount was dissolved in alcohol. ZrO2 powder was mixed with each of the individual slurry to prepare chromium doped zirconia specimen. The color, physical properties and microstructure were observed after the zirconia specimen were sintered at 1450degrees C. In order to evaluate the color, spectrophotometer was used to analyze the value of L*, C*, a* and b*, after placing the specimen on a white plate, and measured according to the International Commission on Illumination (CIE) standard, Illuminant D65 and SCE system. The density was measured in the Archimedes method, while microstructures were evaluated by using the scanning electron microscopy (SEM) and XRD. Fracture toughness was calculated Vickers indentation method and indentation size was measured by using the optical microscope. The data were analyzed with 1-way ANOVA test (alpha= 0.05). The Tukey multiple comparison test was used for post hoc analysis. RESULTS: 1. Chromium chloride rendered zirconia a brownish color. While chromium chloride content was increased, the color of zirconia was changed from brownish to brownish-red. 2. Chromium chloride content was increased; density of the specimen was decreased. 3. More chromium chloride in the ratio showed increase size of grains. 4. But the addition of chromium chloride did not affect the crystal phase of zirconia, and all specimens showed tetragonal phase. 5. The chromium chloride in zirconia did not showed statistically significant difference in fracture toughness, but addition of 0.25 wt% showed a statistically significant difference (P<.05). CONCLUSION: Based on the above results, this study suggests that chromium chlorides can make colored zirconia while adding in a liquid form. The new colored zirconia showed a slight difference in color to that of the natural tooth, nevertheless this material can be used as an all ceramic core material.
Ceramics ; Edible Grain ; Chlorides ; Chromium ; Chromium Compounds ; Humans ; Lighting ; Microscopy, Electron, Scanning ; Tooth ; Zirconium

Animals ; Apoptosis ; Blotting, Western ; Brain Ischemia ; Brain ; Caspase 3 ; DNA Nucleotidylexotransferase ; Heme Oxygenase-1 ; Infarction, Middle Cerebral Artery ; Mice ; Reactive Oxygen Species ; Reperfusion ; Stroke ; Up-Regulation ; Water

Ginkgo nuts have been eaten as oriental medicine and food since ancient times in Korea. However, the potential toxicity of the ginkgo nuts is not well-known. It has been reported that 4-O-methoxypyridoxine in ginkgo nuts causes generalized seizures but no status epilepticus. This report describes a 58-year-old male presented with status epilepticus after overconsumption of ginkgo nuts. After treatment with anticonvulsants and pyridoxine, symptoms were resolved. The toxicity of ginkgo nuts should be considered as a cause of status epilepticus.
Anticonvulsants ; Ginkgo biloba ; Humans ; Korea ; Male ; Medicine, East Asian Traditional ; Middle Aged ; Nuts ; Pyridoxine ; Seizures ; Status Epilepticus

BACKGROUND: Hypertension and age are recognized as important risk factors for left ventricular (LV) diastolic dysfunction. Some studies have shown that diabetes itself may also be an independent risk factor for LV diastolic dysfunction, although this is controversial. The aim of this study was to determine the factors associated with LV diastolic dysfunction in patients with type 2 diabetes in the absence of hypertension or ischemic heart disease (IHD). METHODS: Participants in this study consisted of 65 type 2 diabetes patients (M : F = 45 : 20; mean age 51 [26 to 76] years; mean body mass index [BMI] 25.0 +/- 2.5 kg/m2) without hypertension, heart disease, or renal disease. Individuals with ischemic electrocardiographic changes were excluded. LV diastolic function was evaluated by Doppler echocardiographic studies. RESULTS: Fifteen patients (23.1%) showed LV diastolic dysfunction on Doppler echocardiographic studies. Patients with LV diastolic dysfunction were older than those without diastolic dysfunction (60.0 +/- 2.5 vs. 50.5 +/- 1.9 years; P < 0.01). After adjusting for age and sex, BMI was higher (26.6 +/- 0.7 vs. 24.6 +/- 0.3 kg/m2; P < 0.01) and diabetes duration was longer (9.65 +/- 1.48 vs. 4.71 +/- 0.78 years; P < 0.01) in patients with LV diastolic dysfunction than in those without diastolic dysfunction. There were no differences in sex, smoking, blood pressure, lipid profiles, hemoglobin A1C, fasting glucose, fasting insulin, or diabetic microvascular complications between the LV diastolic dysfunction group and the normal diastolic function group. After adjusting for age, sex, and BMI, diabetes duration was found to be independently associated with LV diastolic dysfunction (odds ratio 1.38; confidence interval 1.12 to 1.72; P = 0.003). CONCLUSION: These results suggest that diabetes duration may be a risk factor for LV diastolic dysfunction in type 2 diabetic patients without hypertension or IHD.
Blood Pressure ; Body Mass Index ; Diabetes Mellitus ; Electrocardiography ; Fasting ; Glucose ; Heart Diseases ; Hemoglobins ; Humans ; Hypertension ; Insulin ; Myocardial Ischemia ; Risk Factors ; Smoke ; Smoking

Hutchinson-Gilford progeria syndrome (HGPS) and Werner's syndrome are representative types of progeroid syndrome. LMNA (Lamin A/C) gene mutation with atypical Werner's syndrome have recently been reported. Atypical Werner's syndrome with the severe metabolic complications, the extent of the lipodystrophy is associated with A133L mutation in the LMNA gene and these patients present with phenotypically heterogeneous disorders. We experienced a 15-yr-old Korean female with progeroid features, generalized lipodystrophy, hypertriglyceridemia, fatty liver, steatohepatitis, and type 2 diabetes mellitus. Skin fibroblasts from the patient showed marked abnormal nuclear morphology, compared with that from normal persons. Gene analysis revealed that this patient had T506del of exon 2 in the LMNA gene. We report here the first case of atypical Werner's syndrome with frameshift mutation that was caused by T506del.
Adolescent ; DNA/*genetics ; Exons ; Female ; Genetic Predisposition to Disease ; Humans ; Lamin Type A/*genetics/metabolism ; Lipodystrophy ; *Mutation ; Sequence Analysis, DNA ; Skin/metabolism/pathology ; Werner Syndrome/diagnosis/*genetics/metabolism

Neurological manifestations are commonly observed in systemic lupus erythematosus (SLE). However, cerebellar involvement has rarely been reported. We report a case of SLE presented with cerebellar ataxia as an initial manifestation after influenza vaccination. A 38-year-old woman who had not been diagnosed with SLE presented with dysarthria and gait disturbance after influenza vaccination. On admission, cerebellar ataxia and bilateral sixth cranial nerve palsy were observed. Influenza vaccination may have triggered autoimmunity in the patient with SLE.
Abducens Nerve Diseases ; Adult ; Autoimmunity ; Cerebellar Ataxia ; Dysarthria ; Female ; Gait ; Humans ; Influenza Vaccines ; Influenza, Human ; Lupus Erythematosus, Systemic ; Neurologic Manifestations ; Vaccination

BACKGROUND: Propofol can be used to provide general anesthesia or sedation. The objectives of this study were to assess propofol as sedative agents for outpatient GI endoscopy, amnestic effects, hemodynamic state and oxygenation during the procedure. METHODS: From April and June 2000, 50 patients scheduled outpatient gastrointestinal endoscopy were enrolled in this study. 30 healthy outpatients requesting sedation at diagnostic gastroscopy were received a bolus dose of propofol 2.5 mg/kg and compared with 20 patients with non-sedation. Pulse rate, blood-pressure and arterial oxygen saturation was monitored. RESULTS: Statistically significant decrease in arterial oxygen saturation were observed since 5 min after endoscopy in patients receiving propofol (p=0.006). Patients receiving sedative endoscopy, pulse rate during endoscopy was significantly increased compared with propofol group (p=0.009). Patients receiving propofol are more tolerable than patients with non-sedative endoscopy (p=0.001), therefore all patients receiving propofol wanted the same sedative endoscopy in their next endoscopy. CONCLUSION: Propofol is believed to be a useful, safe sedative agent for upper gastrointestinal endoscopy with satisfactory sedation and conditions. However, due to its untoward effect of hypoxia, careful monitoring is recommended.
Anesthesia, General ; Anoxia ; Conscious Sedation* ; Endoscopy ; Endoscopy, Gastrointestinal* ; Gastroscopy ; Heart Rate ; Hemodynamics ; Humans ; Outpatients ; Oxygen ; Propofol*