No abstract available.

OBJECTIVE: To determine the therapeutic efficacy of fluoroscopic and electrical stimulation guided perineural selective nerve root injection in cervical radiculopathy patients. METHOD: The gold standard of the diagnosis of cervical radiculopathy was based on clinical features, MRI and electrodiagnostic findings. Considering the natural regression of pain in cervical radiculopathy, only patients (n=27, 14 male and 13 female) who had suffered from persisting or aggravating pain for at least 6 weeks or longer duration after the onset of symptoms, were received a selective nerve root injection (SNRI) of steroids to a target nerve root. Patients were followed up at 2 weeks and 2 months, and interviewed via telephone or re-examined at an average of 37.8 weeks 68 weeks after injection by a independent physician. Criteria for a successful outcome were greater than 50% reduction of pain on visual analogue scale and an ability to return to previous level of function. RESULTS: High proportion of patients reported a successful outcome at 2 weeks (88.9%, 24 of 27 patients). Twenty-two of twenty-four patients reported the outcome at 2 months and 20 of 22 patients were followed up for an averrge period of 37.3 weeks. Among these 20 patients 19 patients satisfied with the result of SNRI at an average follow up period of 68 weeks. There was no significant difference of the efficacy according to the duration of the symptoms. There were no complications in any of the patients after injections. CONCLUSION: Fluoroscopic and electrical stimulation guided selective nerve root injections of corticosteroids were an effective and safe treatment modality in cervical radiculopathy. These could be considered as a first line treatment before a surgical intervention in whom another conservative treatments are not effective.
Adrenal Cortex Hormones ; Diagnosis ; Electric Stimulation ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Radiculopathy* ; Steroids* ; Telephone

OBJECTIVE: The comparison of nerve conduction parameters of each laboratory is difficult because those are influenced by many factors. This study was performed to provide comprehensive normative nerve conduction parameters of median nerve by using a meta-analysis. METHOD: We searched MEDLINE between year 1965 to 2000. Among them we selected 7 articles that provided the mean, standard deviation and sample size of median nerve conduction study and estimated the reference value of median nerve conduction parameters using a meta-analysis. RESULTS: The distal latency of median motor nerve was measured at 8 cm proximal to motor point of abductor pollicis brevis and the distal latency of median sensory nerve was measured at 14 cm proximal to interphalangeal joint of 2nd or 3rd finger. Mean of distal onset latency, amplitude, and conduction velocities of median motor nerve were 3.46 msec, 11.12 mV, and 57.10 m/sec, respectively. Mean of onset distal latency, peak distal latency, and amplitude of median sensory nerve conduction study were 2.72 msec, 3.34 msec, and 37.29 mV, respectively. CONCLUSION: Meta-analysis can summarize large quantity of studies and can maximize subject numbers, it can provide reference value approximate to the normal one. So this value can be used in interpretation of the reference value of each laboratories.
Fingers ; Joints ; Median Nerve* ; Neural Conduction ; Reference Values* ; Sample Size

Edwards syndrome, also called trisomy 18, is one of the most common autosomal anomalies. The survival rate of patients with Edwards syndrome is very low and its characteristic findings include cardiac malformations, mental retardation, growth retardation, specific craniofacial anomalies, clenched hands, rocker-bottom feet, and omphalocele. Compared with the classic Edwards syndrome, the symptom of partial duplication of chromosome 18 is relatively mild with a good prognosis. We report the case of a baby with partial duplication 18q11.2-q12. The characteristic phenotype features of Edwards syndrome were observed in the patient. However, the symptom was milder than the typical Edwards syndrome. At present, we can expect better prognosis for this patient.
Chromosomes, Human, Pair 18 ; Foot ; Hand ; Hernia, Umbilical ; Humans ; Intellectual Disability ; Phenotype ; Prognosis ; Survival Rate ; Trisomy

Spontaneous muscle infarction in diabetic patients is a rare condition that usually occurs in those with advanced diabetic complications. Increased clinical awareness is important for early recognition, particularly in a diabetic patient presenting with a painful thigh or leg swelling. However, the disorder has received little attention in the rehabilitation medicine literature. Magnetic resonance imaging is the diagnostic choice of study, and in the appropriate clinical setting, may obviate the need for a muscle biopsy. We reported three patients with diabetic muscle infarction, review additional reported cases, and discussed the principles of diagnosis and management.
Biopsy ; Diabetes Complications ; Diabetes Mellitus ; Diagnosis ; Humans ; Infarction* ; Leg ; Magnetic Resonance Imaging ; Rehabilitation ; Thigh

BACKGROUND: Brain natriuretic peptide (BNP) is expected to play a role in hemodynamic modulation. Its biologically inactive fragment, the 76-amino-acid N-terminal proBNP (NT-pro-BNP), was known as one of the biologic markers of congestive heart failure and other clinical situations. But, there are controversies about clinical significance of NT-pro-BNP in ischemic stroke. This study was performed to find the clinical significance of NT- pro-BNP in early stage of acute ischemic stroke. METHODS: NT-pro-BNP levels were measured in 610 consecutive patients who admitted to the department of neurology at Chonnam National University Hospital. 205 patients were excluded due to incomplete follow-up period (more than 2 weeks), systemic infection, and etc. 286 ischemic stroke patients and 119 patients as control subjects were enrolled. NT-pro-BNP levels between stroke group and control were analyzed. When the patients in stroke group had more than 300 pg/mL of NT-pro-BNP, they were regarded as high group and the others were low group. National Institute of Health Stroke Scale (NIHSS) was checked at admission and 2 weeks later. Relationship between changes of NIHSS and the NT-pro-BNP level was also investigated. RESULTS: The NT-pro-BNP levels were significantly increased in ischemic stroke patients (830.87 pg/mL) compared with control group (378.27 pg/mL) (p=0.002). And the high levels of NT-pro-BNP in stroke patients were related to severity on admission and cardioembolic infarction. But there was no correlation between NT-pro-BNP and improvement of NIHSS. CONCLUSIONS: In this study, significant relationship between the severity of ischemic stroke and NT-pro-BNP was found. But NT-pro-BNP was not related to early prognosis of ischemic stroke.
Biomarkers ; Follow-Up Studies ; Heart Failure ; Hemodynamics ; Humans ; Infarction ; Jeollanam-do ; Natriuretic Peptide, Brain ; Neurology ; Prognosis ; Stroke*

Pseudohypoparathyroidism (PHP) is a disorder characterized by clinical and laboratorial findings of hypoparathyroidism with high plasma parathyroid hormone levels due to resistance by target tissues. Neurologic complications of PHP are not uncommon but recurrent attacks of seizure during the postpartal period have yet to be reported. We report a case of subclinical pseudohypoparathyroidism with recurrent seizures in the postpartal period.
Hypoparathyroidism ; Parathyroid Hormone ; Plasma ; Postpartum Period ; Pseudohypoparathyroidism* ; Seizures*

Klotho deficiency is an early event in acute kidney injury (AKI) that exacerbates acute kidney damage. The present study explored the expression of Klotho and inflammation related factors in cisplatin-induced AKI. Rats (n = 18) were treated with cisplatin intraperitoneal injection (5 mg/kg) or left untreated as controls (n = 6), then sacrificed at 5 (n = 6) and 10 days (n = 6) treatment. Five days after cisplatin injection, the serum kidney enzymes and kidney cell apoptosis were significantly increased. Moreover, the expression of Klotho was decreased when compared to the control group, especially in the cortex and outer medulla regions. In contrast, inflammation related signals including nuclear factor kappa B, tumor necrosis factor-alpha, and tumor necrosis factor-like weak inducer of apoptosis were enhanced. However, 10 days after cisplatin injection, Klotho expression was enhanced upon both IHC and Western blot analysis, with slightly recovered renal function and decreased apoptosis. Furthermore, inflammation related signals expression was decreased relative to the 5 days group. Overall, this study confirmed the opposite expression patterns between Klotho and inflammation related signals and their localization in cisplatin-induced AKI kidney.
Acute Kidney Injury* ; Animals ; Apoptosis ; Blotting, Western ; Cisplatin* ; Inflammation ; Injections, Intraperitoneal ; Kidney ; Necrosis ; NF-kappa B ; Rats ; Tumor Necrosis Factor-alpha

Struma ovarii is a rare monodermal variant of ovarian teratoma accounting for only 2% of all mature teratomas. To be classified as a struma ovarii, teratoma must be composed predominantly of mature thyroid tissue (> 50%). This tumor is generally benign, although malignant transformation has been reported. Struma ovarii occur mostly as unilateral cases, so bilateral cases are quite rare (less than 6% of cases). Struma ovarii occur largely without symptoms or are accompanied by non-specific symptoms, such as abdominal pain, a palpable abdominal mass, and abdominal distension. The preoperative diagnosis is generally difficult. The incidence of hyperthyroidism has been reported to be 5-10% of patients with struma ovarii. Thus, cases of functional bilateral struma ovarii are very rare. We report a case of bilateral struma ovarii with subclinical thyrotoxicosis and a diffuse goiter, mimicking a malignant ovarian tumor, and include a brief review of related literature.
Abdominal Pain ; Accounting ; Goiter ; Humans ; Hyperthyroidism ; Incidence ; Ovarian Neoplasms ; Struma Ovarii ; Teratoma ; Thyroid Gland ; Thyrotoxicosis

Liver cirrhosis is commonly associated with bleeding complications due to portal hypertension or coagulopathy. Spontaneous muscle hematoma is a rare but potentially lethal complication of liver cirrhosis. Here we report three cases of spontaneous muscle hematoma diagnosed in patients with alcoholic liver cirrhosis. All three patients died due to recurrent bleeding and liver failure although they had undergone repeated transcatheter arterial embolization of the actively bleeding vessels. We reviewed 14 cases of spontaneous muscle hematoma that were associated with liver cirrhosis, including our cases, and found that the mortality rate was 86%, despite early diagnosis and treatment. Cirrhosis-associated spontaneous muscle hematoma occurred more frequently in patients with alcoholic liver cirrhosis, who accounted for -93% of cases. Thus, spontaneous muscle hematoma should be considered a life-threatening complication in patients with alcoholic liver cirrhosis, and abstinence from alcohol may help to prevent the occurrence of this deadly condition.
Alcoholics* ; Early Diagnosis ; Fibrosis ; Hematoma* ; Hemorrhage ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic* ; Liver Failure ; Mortality