Progressive supranuclear palsy (PSP) comprises psychiatric, neurological and physical complications. In the late stage, most patients with PSP are bed-bound because of motor disability. PSP manifests as predominantly axial abnormality in posture and abnormal muscle tone, resulting in cervical retroflexion and somatic pains. Severe retroflexion of the neck is frequently a cause of repeated aspiration pneumonia that affects survival expectancy. We injected botulinum toxin (BTX) for severe retroflexion using a CT-guided procedure to confirm the anatomical locations of paravertebral muscles and to localize the paravertebral target muscles for a patient with PSP who had repeated pneumonia caused by retroflexion-related dysphagia. BTX injection treatment markedly ameliorated the cervical dystonia and concomitant dysphagia. The patient has recovered and may be able to be discharged to home. There are few reports on the BTX injection technique, but BTX has analgesic effects and induces relaxation of abnormal muscle tension. Therefore, it may be applicable to other movement disorders at the late stage.

The purpose of this study was to evaluate the function of cardiac autonomic nervous activity and post-exercise vagal reaction during the menstrual cycle. The subjects were healthy young women (n=13, age 19.9±0.6 years) with normal menstrual cycles. Power spectral analysis of heart rate variability was used to examine cardiac autonomic nervous activity. In addition, the time con stant of heart rate decline for the first 30 sec (T₃₀) after exercise was used to examine post-exercise vagal reactivation.
Results show that the cardiac autonomic nervous activity changes during the menstrual cycle. Also, T₃₀ shows significant change during the menstrual cycle, especially T₃₀ retardation in the early luteal phase. These results suggest that an imbalance of estradiol and progesterone hormones may be responsible for these changes in cardiac autonomic nervous activity during the menstrual cycle.

‹Objective› In previous animal studies, it has been observed that ovarian hormones centrally alter baroreflex modulation of cardiovagal nervous control. If this central action of ovarian hormones is observed in human females, non-baroreflex modulation of cardiovagal nervous control should change with the menstrual cycle. The hypothesis in this study was that cardiovagal nervous response to facial cold stimuli (non-baroreflex modulation) changes throughout menstrual cycle.‹Subjects and methods› Eight young healthy women with a normal menstrual cycle participated in this study. The menstrual cycle was divided into 5 phases (menstrual, follicular, ovulatory, early luteal and late luteal) . Resing ECG RR intervals, cardiovagal nervous activity (by heart rate variability), RR intervals and cardiovagal nervous response to facial cold stimuli were measured during each menstrual phase. RR intervals and cardiovagal nervous response to facial cold stimuli were evaluated paying attention to the “quantity” and “quickness” of the changes.‹Results› There were no phase differences in resting RR intervals and cardiovagal nervous activity. Quantity of RR intervals and cardiovagal nervous response and quickness of. RR intervals to facial cold stimuli did not change throughout the menstrual cycle. The speed of cardiovagal nervous response to facial cold accelerated in the follicular phase, and to the contrary, slowed down in the early luteal phase, ‹Conclusion› These data suggest the speed of cardiovagal nervous response mediated non-baroreflex mechanism changes throughout the menstrual cycle.

The purpose of this study was to evaluate the change in dynamic and static balance ability during the menstrual cycle among young women. The subjects were young healthy women (n=12, age 20.4±1.2 years) with regular exercise and a normal menstrual cycle. The menstrual cycle was divided into 5 phases : Menstrual, Follicular, Ovulatory, Early luteal and Late luteal. Measurements were taken using the dynamic balance test, static balance test and looseness test. The dynamic balance test did not change during the menstrual cycle. Length Time within the static balance test increased in the late luteal phase compared to other menstrual cycle phases. The deviation of the mean of X within the static balance test increased in the follicular and late luteal phase and decreased in the ovulatory phase. Also, the deviation of the mean of X increased in the follicular phase compared to the menstrual phase and decreased in the menstrual and early luteal phases compared to the follicular and ovulatory. Left arm upper of laxity in hand on the back test within looseness test increased in the menstrual and early luteal phases compared to other menstrual cycle phases. These results suggest that static balance ability changes during the menstrual cycle.

[Objective] The aim of this investigation was to evaluate serum steroid hormone responses to acute resistance exercise. [Methods] Subjects were young healthy males (n=6) and females (n=6) . Each group performed three sets of 10 leg press and 10 bench press exercises at an intensity of their individual 10-repetition maximum (1ORM), with 1 min rest between sets. Blood samples were collected before (Pre-Ex) and immediately following the exercise (P0), 30 mm (P30), 60 mm (P60), and 24 hours (P24h) after the exercise. Levels of blood lactate, serum testosterone, dehydroepian drosterone sulfate (DHEAS) and cortisol were determined. [Results] The levels of blood lactate in males and females significantly increased at P0 and P30 compared with Pre-Ex (p<0.05) . In males, the serum level of testosterone significantly increased at PO (p<0.05), whereas in females, it significantly decreased at P0, P30, P60, P 24 h. (p<0.05) . The level of DHEAS significantly increased at P0 in both males and females (p<0.05) . [Conclusion] The change in the level of testosterone was different between males and females, but that of DHEAS showed a similar pattern for both sexes. The data suggest that DHEAS could be a useful indicator for evaluating the anabolic status of acute resistance exercise in females.

[Objective] The aim of this investigation was to evaluate salivary dehydroepiandrosterone (DHEA) responses during a competitive period among female football players.
[Methods] Subjects were college female football players (n=9) . Saliva and blood samples were collected at 18 : 00 (6 : 00 pm) and the profile of mood state (POMS) was recorded during a period of normal training (Pre), 3 days of competition (Competition), and a recovery period (Post) . Levels of salivary DHEA, cortisol, and serum creatin kinase (CK), urea nitorogen (UN), were determined.
[Results] The levels of salivary DHEA significantly increased during competition (2 nd days) compared with Pre (p<0.05), and significantly decreased after competition compared with Pre (p<0.05) . The levels of salivary cortisol significantly increased during the competition (2 nd and 3 rd days) compared with Pre (p<0.05) . Whereas it decreased after competition compared with Pre. The levels of serum CK significantly increased during the competition (2 nd days) compared with Pre (p<0.05) . The levels of serum UN did not change during the study. The fatigue score of POMS significantly increased during competition (2 nd days) compared with Pre (p<0.05) .
[Conclusion] These data suggest that DHEA could be a useful endocrinological indicator for evaluating training status in female athletes.

Five autopsy cases of poisoning by the weed killer paraquat (Gramoxone) are presented.
Case 1. A 33-year-old female swallowed about 150 ml of Gramoxone. She died after 11 hours of intoxication.
Abnormal post-mortem findings were confined to the lungs, the kidneys and the adrenals. Histologically, the lungs showed congestion and edema; the kidneys showed tubular' degeneration and necrosis; and the adrenals showed cortical degeneration and necrosis.
Case 2. A 74-year-old male swallowed about 20 ml of Gramoxone. He died on the 4th day of ingestion of Gramoxone.
Histologically, the lungs were congestive and there were a moderate degree of hyperplasia of alveolar septa.
Alveolar spaces contained edematous fluid containing fibrin. Some skeletal muscle fibers were variable in size, and showed degenerative changes including vacuolization. The adrenal cortex was atrophic.
Case 3. A 44-year-old female swallowed about 20 ml of Gramoxone. She died on the 8th day of ingestion. The lungs were both congestive and edematous. Alveolar spaces contained edematous fluid with a trace amount of fibrin. The kidneys showed tubular degeneration. The liver showed a moderate degree of fatty changes in the central zones.
Acute oesophagitis and acute ulcerative change in the stomach were noticed.
Case 4. A 45-year-old male swallowed about 90 ml of Gramoxone. He died after 12 hours of intoxication. Histologically, the lungs were remarkably congestive and edematous. There were fatty changes in the central areas of the liver. Acute gastritis were noticed.
Case 5. A 32-year-old female swallowed about 15 ml of Gramoxone. She died on the 28th day of ingestion. At post-mortem examination, the lungs were solid and atelectatic. Histologically, the lungs showed generalized, severe degree of fibrosis together with desquamative changes of alveolar epithelium and PAS-positive hyaline menbrane formations. The liver showed a moderate degree of fatty changes in the central areas. The skeletal muscle fibers were variable in size showing a moderate degree of vacuolar and targetoid changes.
Various amounts of Paraquat were detected in the lungs, the livers, the kidneys and the muscles of case 1 and 4, in the fatty tissues and the brain of case 1 using formalin-fixed specimens.
Degenerative changes of skeletal muscle fibers presented in this report may be ascribed to the effect of Praquat in the light of the literature.