Narcolepsy is a central neurologic system disease. It begins early in life with disabling symptoms including excessive daytime sleepiness, cataplexy, sleep paralysis, hypnagogic hallucination and nocturnal sleep fragmentation. Patient with typical symptoms of narcolepsy is diagnosed by objective data from nocturnal polysomnography and multiple sleep latency tests. Narcolepsy is controlled with various medications. Nowadays, modafinil with favorable side effects profiles compared with traditional stimulant is mainly used. Gamma hydroxyl butyrate is effective in cataplexy. Cataplexy is also controlled with antidepressant such as Venlafaxine, SSRI, and TCA. As the knowledge of pathophysiology of narcolepsy expands, new treatment including immunological method, application of hypocretin and histamine systems have been tried.
Benzhydryl Compounds ; Butyrates ; Cataplexy ; Cyclohexanols ; Disorders of Excessive Somnolence ; Hallucinations ; Histamine ; Humans ; Intracellular Signaling Peptides and Proteins ; Narcolepsy ; Neuropeptides ; Polysomnography ; Sleep Deprivation ; Sleep Paralysis ; Orexins ; Venlafaxine Hydrochloride

One case of malignant acanthosis nigicans associated with gastric adenocarcinoma (scirrhous type) and papilloma on the oral mucosa is presented. The patient, 36 year old Korean male, visited S.N.U.H, complaining of sore-mouth and sore-tongue of 20 days duration. He had been affected with severe papillomatosis on the oral mucosa and with hyperkeratosis on the periorbital area, the perioral area, the neck, the axillae, the palms, the umbilical area, the inguinal area, the anogenital area and the soles which were moderately hyperpigmented with grayish to brown color. He had not been complaining of G-I troubles except sore-mouth and sore-tongue, but he was diagnosed as stomach carcinoma by gastroendoscopy, He got an operation of extended total gastrectomy with isoperistaltic jejunal interposition. Post-operative histopathologic examination rvealed well differentiated adenocarcinoma of the stomach which had already metastasized to the neighboring lymph nodes. After operation the papillomatosis on the oral mucosa and skin eruptions had been improved but becarne aggravated again one and half month after discharge.
Acanthosis Nigricans* ; Adenocarcinoma ; Adult ; Axilla ; Gastrectomy ; Humans ; Lymph Nodes ; Male ; Mouth Mucosa ; Neck ; Papilloma ; Skin ; Stomach

No abstract available.
Angina, Stable* ; Tumor Necrosis Factor-alpha*

BACKGROUND: The incidence and causative dermatophytes of tinea cruris has been changed with time. Although clinical and mycologic studies of whole dermatophytosis have been reported many times, there have been only a few studies about tinea cruris reported. OBJECTIVE: The purpose of this study was to investigate clinical and mycological features of tinea cruuis. METHODS: We evaluated the clinical and mycologic aspects of tinea cruris in 598 patients with tinea cruris from January 1985 to December 1997 in Yeungnam University Hospital. RESULTS: The incidence of tinea cruris was 20.8% of 2,878 total dermatophytoses. The ratio of male to female patients was 23.9:1. And most of them were in their twenties and thirties. Most(82.1%) of them involved both sites of the groin. Concurrent dermatophytic infections of tinea cruris were noted in 29.4% of the cases and the most common one was tinea pedis(22.4%). Three hundred and thirty eight dermatophytes were isolated from 598 patients with tinea cruris. They were Trichophyton(T.) rubrum(95.3%), T. mentagrophytes(4.4%), Epidermophyton floccosum(1.2%), Microsporum canis(0.9%). CONCLUSION: Tinea cruris is a male predominant dermatophytosis, the most common causative organism is T. rubrum, and tinea pedis seems to be an important reservoir.
Arthrodermataceae ; Epidermophyton ; Female ; Groin ; Humans ; Incidence ; Male ; Microsporum ; Tinea Pedis ; Tinea*

Erythema dyschromicum perstans is a cutaneous pigmentary dermatosis of unknown etiology chararcterizd by asymptomatic macules of an ashy gray color which was first presented by Ramirez. We reported a case of Erythema dyschromicum perstans in 57 year old female patient. The skin lesion were characterized by the presence of discreated or confluented bluish-gray colored pigrnentation on the lateral surface of hoth upper extremities. Histologically, the lesion showed hydropic degeneration of the epidermis witb in continence of pigmcnt and an apperence of malanin-hearing macrophages in upper dermis which are compatible with Erythema dyschromicum perstans.
Dermis ; Epidermis ; Erythema* ; Female ; Humans ; Macrophages ; Middle Aged ; Skin ; Skin Diseases ; Upper Extremity

Drowning is one of the most common causes accidental death worldwide, but its diagnosis remains a challenging task in forensic pathology. Several authors have suggested that diatom analysis be conducted via an enzymatic digestion method that uses proteinase K to provide objective evidence for drowning; we employed this method in our study because of its superior applicability as compared to the conventional disorganization methods. The purpose of this study was to examine the reclaiming ratio of diatoms from experimentally drowned animal organs, which could be influenced by diatom morphology. The authors injected 3 diatoms species (Cyclotella striata, Navicula incerta, and Pleurosigma angulatum) into a rat's airway and compared the detection rate to investigate the factors that influence the sensitivity of diatom analysis. The results are as follows: (1) Average reclaiming ratio in the lungs was 81.07 for Navicula incerta, 48.26 for Cyclotella striata, and 5.35 for Pleurosigma angulatum. (2) The detection rates from the closed organs in 15 experimental animals were highest in the kidney (73%, 11/15), followed by the heart (67%, 10/15), brain (60%, 9/15), and liver (53%, 8/15). (3) Two Cyclotella striata was detected in the kidney of postmortem control group which suggest the possibility of contamination during laboratory procedure. In conclusion, the authors propose that diatom size could be a significant influencing factor for diatom extraction from the organs of drowned bodies; therefore, the results of diatom analysis must be interpreted after considering the diatom population of the drowning medium at the scene and the possibility of contamination during the laboratory procedure.
Animal Structures ; Animals ; Brain ; Diatoms ; Digestion ; Drowning ; Endopeptidase K ; Forensic Pathology ; Heart ; Kidney ; Liver ; Lung

Multiple lentigines syndrome is characterized by the presence of numerous dark brown macules on the skin but not mucous surfaces and known also by the mnemvnic "LEOPARD syndrome" are, besides the lentigines, electrocardiographic conduction defect, ocular hypertelorism, pulmonary stenosis, abnormalities of the genitalia consisting of gonadal or ovarian hypoplasia, retardation of growth, deafness and inherited by autosomal dominant trait. We experienced a case of multipIe lentigine syrrdrome in 20-year old woman. She had numerous pinhead to pea sized, dark brownish macules on the entire body skin a,nd had no associated anomalies of other organ. On laboratory examinations including the CBC, urinalysis., chest X-ray, EKG; EEG, Hormone assay was all normal except for the slight anemic finding. On histologic examina,tion of biopsied macular skin showed a slight elongation of rete ri.dges, an increase in the concentration of melanocyte in the basal layer and mild inflammatory infiltration in the upper dermis. Treatment was done by cryotherapy on the face with marked improvement.
Cryotherapy ; Deafness ; Dermis ; Electrocardiography ; Electroencephalography ; Female ; Genitalia ; Gonads ; Humans ; Hypertelorism ; Lentigo ; LEOPARD Syndrome* ; Melanocytes ; Peas ; Pulmonary Valve Stenosis ; Skin ; Thorax ; Urinalysis ; Young Adult

Digital polysomnography was developed to overcome the limitations of Rechtschaffen and Kales rule and to compensate the shortcomings of paper polysomnography. It enables easy access to and secure preservation of sleep records, and provides various displays of sleep data to enhance efficiency of visual scoring of sleep records. Rechtschaffen and Kales rule had been criticized for its ambiguity and lack of considerations in spatial information of EEG. As sleep records are acquired and processed in digital mode, they can be analyzed at microscopic and macroscopic levels. Digital analysis of sleep records provides the basis for development of new sleep measures. Sleep staging in digital polysomnography is based on the various analyses of EEG. Sleep apnea, hypopnea and periodic limb movement are detected automatically by digital analysis of respiratory signals and leg EMG. Digital polysomnography plays a complementary role to visual scoring and compensates the limitations of paper polysomnography. Digital polysomnography, including acquisition, processing and analysis of sleep records in digital mode, can be a great help in the development of sleep medicine, enabling the development of new sleep measures and the exchange of sleep records between sleep laboratories.
Brassica ; Electroencephalography ; Extremities ; Leg ; Polysomnography* ; Sleep Apnea Syndromes

No abstract available.
Constriction, Pathologic* ; Dilatation* ; Mitomycin*

Distinguishing epileptic seizure from non-epileptic seizure is a common diagnostic problem. Neurogenic or cardiac syncope can appear similar to atonic and even convulsive seizures. Classic migraine and transient ischemic attacks may also resemble epileptic seizures. Sleep disorders including REM sleep behavior disorder, nocturnal paroxysmal dystonia, and narcolepsy likewise simulate an epileptic seizure. Movement disorders such as paroxysmal dyskinesia can be misinterpreted as epileptic seizures (reflex epilepsy or myoclonic seizures). Psychogenic seizures are often misdiagnosed as an intractable epilepsy. Prior to the definitive diagnosis of epilepsy, possible non-epileptic seizures should be excluded. For the correct decision, a thorough and systematic history taking is important. In addition, EEG, pseudoseizure induction test, head-up tilt test, EKG, sleep studies, and video-EEG monitoring may be necessary. Misdiagnosis of non-epileptic seizures as epilepsy may result in unnecessary anti-epileptic drug use. At the same time, we should let the patients understand what the epilepsy is and that epilepsy is a treatable disease.
Chorea ; Diagnosis ; Diagnostic Errors ; Drug Resistant Epilepsy ; Electrocardiography ; Electroencephalography ; Epilepsy* ; Humans ; Ischemic Attack, Transient ; Linear Energy Transfer ; Migraine with Aura ; Movement Disorders ; Narcolepsy ; Nocturnal Paroxysmal Dystonia ; REM Sleep Behavior Disorder ; Seizures* ; Sleep Wake Disorders ; Syncope