No abstract available.
Humans ; Neurologic Examination* ; Physicians, Primary Care* ; Primary Health Care*

No abstract available.
Headache* ; Humans ; Physicians, Primary Care* ; Primary Health Care*

BACKGROUND & OBJECTIVES: Subacute combined degeneration (SCD) is a disease of spinal cord involving the posterior and lateral column due to vitamin B12 deficiency. The clinical and electrophysiologic findings of SCD are various. METHODS: From 1989 to 1996, 7 patients were diagnosed with SCD in our hospitals. The diagnosis was made by the neurologic and laboratory findings and electrophysiolgic studies such as nerve conduction studies(NCS) and evoked potential(EP). RESULT: Four patients received gastrectomy. Two had chronic atrophic, gastritis; one of them was assumed to have food-cobalamin malabsorrtion. The remaining one was a heavy drinker. The mean duration of neurologic symptoms was 35.7 months. The most common initial complaint was paresthesia (in 4) and impairment of cutaneous sensation was the most common neurologic sign At the time of diagnosis, 5 patients had myelopathy with was supported by EP in 3(60%). There were abnormal NCS findings in 5 f 6 patients with peripheral neuropathy. In one patient, there was no symptom and sign compatible with myelopathy but median nerve SEP showed bilateral central conduction delay. No one had visual symptoms but prolongation of P 100 was detected in 2 patients. Sural nerve biopsy was done in 2 case, which revealed chronic nonspecific neuropatby in one and chronic axonopathy in the other. Megaloblastic anemia was found in 4 cases and improved by cobalamin therapy in all the parents, in which the follow up hematologic data were available. There as a tendency that nonanemic patients had more severe neurologic symptoms than anemic ones. We could not find any relationship between the duration and severity of neurologic menifestations was best in the patients with the shortest duration of neurologic manifestations and hematologic feature festations. CONCLUSIONS: The authors suggest that early detection and treatment is very important for the improvement of symptoms in SCD.
Anemia, Megaloblastic ; Biopsy ; Diagnosis ; Follow-Up Studies ; Gastrectomy ; Gastritis ; Humans ; Median Nerve ; Neural Conduction ; Neurologic Manifestations ; Parents ; Paresthesia ; Peripheral Nervous System Diseases ; Sensation ; Spinal Cord ; Spinal Cord Diseases ; Subacute Combined Degeneration* ; Sural Nerve ; Vitamin B 12 ; Vitamin B 12 Deficiency

No abstract available.
Brain Stem* ; Hepatolenticular Degeneration*

The affiliations were published incorrectly.

No abstract available.
Classification* ; Humans ; Leukemia* ; Survival Rate*

Authors analyzed clinical and electrophysiological features of 35 patients with alcoholic neuropathy who had visited the Boramae City Hospital. All patients were men. Most of the cases drank alcohol everyday. The duration of alcohol consumption is from 2 to 47 years (mean, 17.8 years). Patients with relatively short history of alcohol consumption had a tendency to take more inadequate meals. Clinically we found two distinct separable categories ; one was sensorimotor peripheral neuropathy associated with other alcoholic complications, such as Wemicke and Pellagra disease, delirium tremens, liver disease etc(24 patients). The other had subacutely progressing prominent weakness with sensory change, especially in lower extremities(ll patients). Electrophysiological studies showed decreased amplitudes of sensory or motor compound action potentials with relative preservation of conduction velocity favoring axonal neuropathy. Among the electrophysiological parameters, abnormalities in F-wave(78.3%), H-reflex(86.4%) and sural nerve conduction studies(78.8%) were more frequently observed than in others, which were thought to be more sensitive parameters with early involvement. In terms of electrophysiological pattern there were no definite diffemeces between the two groups.
Action Potentials ; Alcohol Drinking ; Alcohol Withdrawal Delirium ; Alcoholic Neuropathy* ; Alcoholics* ; Axons ; Hospitals, Urban ; Humans ; Liver Diseases ; Male ; Meals ; Pellagra ; Peripheral Nervous System Diseases ; Sural Nerve

We have met 5 cases of cerebral sparganosis since 1984, including one which was reported by Hong et al. In 1985. We reviewed their medical records and clinical manifestations, possible etiologic histories, findings of brain CT and micro-ELISA done in all cases, and findings of brain biopsy done in 2 cases were discussed. 1. Initial manifestations were seizures (in 4 of 5) or limb weak-nesses (in 4 of 5), which were followed by symptoms and signs due to space occupying effects. 2. Raw snakes or raw frogs were ingested in 3 cases and estimated incubation periods in 2 cases were 2 and 5 years respectively. 3. Brain CT's showed widespread low density, usually in white matter area, ipsilateral ventricular dilatation and/or enhaneing nodules. 4. Micro-EILSA's showed that initial titers of sparganum-specific Ab were above criterion (0.22) except for serum of case 5, and F/U micro-ELISA'S done in 3 cases revealed negative conversion (decrease of Ab titer below criterion) only for CSF of case 5, in which surgical removal was successfully done, and otherwise variable changes of titers. 5. Brain biopsies done in 2 cases showed such findin-gs as degenerating worm, granuloma, tunnel formation, and calcospherules.
Biopsy ; Brain ; Dilatation ; Extremities ; Granuloma ; Medical Records ; Seizures ; Snakes ; Sparganosis*

BACKGROUND: Heparin salts induce negative proportional bias according to anticoagulant concentration for analysis of ionized calcium (iCa) However, D-phenylalanyl -L-prolyl- L-arginine chloromethyl ketone (PPACK), a selective thrombin inhibitor, do not bind to ionized calcium. Therefore, we evaluated PPACK as an alternative anticoagulant to lithium heparin (Li-Hep) for analysis of ira, blood gases and electrolytes. METHODS: The concentration of iCa in whole blood anticoagulated with heparin was compared with that in serum of patients admitted to Chungbuk National University Hospital (n=27). The blood gases, electrolytes and iCa according to each anticoagulant concentration (Ll-Hep or PFACK) were analyzed. The concentrations of anticoagulated whole blood (Li-Hep; 50 kIU/L, PPACK ; 75 mumol/L) were compared with those of nonanticoagulated whole blood for blood gases, electrolytes and iCa (n=17), RESULTS: The results were as follows; whole blood anticoagulated with Li-Hep demonstrated -0.28+/-0.15 mmol/L (26.6%) bias for ira compared with serum. No bias according to each anticoagulated concentrations were observed in analysis of blood gases, potassium and chloride. Negative proportional bias for iCa and sodium in serum anticoagulated with Li-HeP was observed. In comparison, no bias for ira and sodium was observed with PPACK. No bias was observed in analysis of blood gas or electrolytes with each anticoagulated whole blood except for sodium and chloride that had clinically nonsignificant bias. Whole blood anticoagulated with Li-Hep demonstrated a consistent -0.08+/-0.02 mmol/L (6.3%) bias for ira compared with nonanticoagulated whole blood. In comparison, no bias was observed with PPACK-anticoagulated whole blood for iCa. CONCLUSIONS: We concluded that PPACK is an ideal anticoagulant without bias for analysis of iCa, blood gases and electrolytes.
Arginine ; Bias (Epidemiology) ; Calcium* ; Chungcheongbuk-do ; Electrolytes* ; Gases ; Heparin* ; Humans ; Lithium ; Potassium ; Salts* ; Sodium ; Thrombin

PURPOSE: To determine whether prostate-specific antigen density(PSAD) and transition zone prostate-specific antigen density(TZ-PSAD) can predict the clinical response of patients with benign prostatic hyperplasia(BPH) to alpha-adrenergic blocker(terazosin). MATERIALS AND METHODS: From January 2000 to June 2002, 202 patients with BPH who were treated with alpha-adrenergic blocker(terazosin) were enrolled in this study. The peak flow rate(Qmax) and the International Prostate Symptom Score(IPSS) were compared prior to and 3 months following medication. We analyzed total prostate volume(TPV), transition zone volume(TZV), transition zone index(transition zone volume/total prostate volume, TZI), PSAD(PSA/total prostate volume), and TZ-PSAD (PSA/transition zone volume) as predictors of the response to alpha-adrenergic blocker (terazosin). RESULTS: At 3 months following medication with terazosin, a statistically significant improvement was shown in the IPSS and Qmax. There was no significant correlation between pretreatment TPV, TZV, TZI and the percent change in the IPSS and Qmax. However, there was a significant negative correlation between pretreatment PSAD (r=-0.632, p<0.001), TZ-PSAD (r=-0.599, p<0.001) and the percentage change in Qmax, while there was a positive correlation between pretreatment PSAD (r=0.620, p<0.001), TZ-PSAD(r=0.604, p<0.001) and the percentage change in the IPSS. Using the receiver operating characteristic curves to compare PSAD and TZ-PSAD for IPSS, the areas under the respective curves were 0.867 and 0.874(cut-off values were 0.04 and 0.1), and for the Qmax, the areas under the respective curves were 0.876 and 0.873(cut-off values were 0.04 and 0.1). CONCLUSIONS: Patients with a lower pretreatment PSAD and TZ-PSAD responded better to alpha-adrenergic blocker than those with a higher pretreatment PSAD and TZ-PSAD. PSAD and TZ-PSAD were predictors of the response to alpha-adrenergic blocker (terazosin) in patients with BPH.
Adrenergic alpha-Antagonists ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; ROC Curve