Ataxia is one of the most serious neurological symptoms in elderly The clarification of the related anatomical structures are necessary for the understanding of pathophysiologic mechanisms of ataxia. We have recently experienced a case of thalamic infarct in the territory of thalamogeniculate artery. The localization of lesion was based on CT and MR imaging. At first time, right hemiparesis and ataxia were prominent. Hemiparesis was transient but ataxia had been persistent for several months. It has been suspected that thalamus could be the part of neural circuits in balancing. Our case support this suggestion clinically. Based on clinical observations, a plausible extrapolation can be made to thalamic ataxia. It maybe related with dysfunction of dentatorubrothalamic and corticopontine pathway. Thus our case led us to conclude that thalamus could be engaged in balance control of human body.
Aged* ; Arteries ; Ataxia* ; Human Body ; Humans ; Magnetic Resonance Imaging ; Paresis ; Thalamus

A 71-year-old male initially presented with vocal cord palsy and underwent tracheostomy. After thorough examination, urogenital dysfunction, orthostatic hypotension, and Parkinsonism were found, which led to the diagnosis of multiple system atrophy (MSA). After the tracheostomy, bi-level positive airway pressure ventilation was required during the night due to nocturnal hypoxemia. Night-time hypoxemia is related to central sleep apnea, which is one of the manifestations of MSA. This is the first case of MSA manifested by bilateral vocal cord palsy as an initial sign in Korea. This case supports the notion that MSA should be taken into consideration when vocal cord paralysis is observed.
Aged ; Airway Obstruction ; Anoxia ; Diagnosis ; Humans ; Hypotension, Orthostatic ; Korea ; Male ; Multiple System Atrophy* ; Parkinsonian Disorders ; Sleep Apnea, Central ; Tracheostomy ; Ventilation ; Vocal Cord Paralysis*

There is increasing evidence that airway epithelial cells, when exposed to various gas-derived air pollutants, play an important role in airway inflammation by releasing inflammatory cytokines. However, there is little information on air pollutant-induced cytokine expression at the tissue level and on the role of sulfur dioxide (SO2), one of the major ambient air pollutants, in cytokine production. We studied whether or not a low concentration of sulfur dioxide induces an increase in tissue expression of interleukin-4 (IL-4), interleukin-8 (IL-8), and granulocyte/macrophage colony stimulating factor (GM-CSF). After exposing surgically obtained normal human nasal turbinates to 0.05 ppm SO2 for one hour, we conducted specific immunohistochemical staining to assess the tissue expression of each cytokine. We found that the percent expression of IL-8 and GM-CSF in the surface epithelium was significantly higher in each SO2-exposed tissue than in the matched control tissue. However, there was no significant difference in the number of submucosal IL-4-positive cells between exposed and control specimens. These results suggest that exposure to a low concentration of SO2 increases airway inflammation, apparently by inducing an increase in the expression of GM-CSF and IL-8.
Air Pollutants ; Colony-Stimulating Factors ; Cytokines ; Epithelial Cells ; Epithelium ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Humans ; Inflammation ; Interleukin-4* ; Interleukin-8* ; Mucous Membrane* ; Nasal Mucosa ; Sulfur Dioxide* ; Sulfur* ; Turbinates*

PURPOSE: Paragonimiasis is infectious disease occurred by Paragonimus Westermani, which invades into human body as a final host. Habitual eating the freshwater crab or crawfish unboiled is one of the reason of infection. Paragonimiasis raged in 1970s in Korea, Japan, China and other Asian countries but the incidence decreased rapidly. Once people eat infected second host, parasite penetrates the duodenal wall and migrates to the lung. During this migration period, the parasite can migrate to other organ, such as brain, spinal cord, liver and subcutaneous tissue, but the cases are rarely reported. The objective of our study is to present our experience of the ectopic migration of parasite to the subcutaneous tissue of the abdomen, which was easily treated with excision and Praziquantel medication. METHODS: A 59-year-old woman who likes eating unboiled freshwater crab was diagnosed as Paragonimiasis 15 months ago. Her symptoms were fever and cough, and she was treated with Praziquantel medication. 3 months after discharge, she visited our hospital with left pleuritic chest pain, cough with fever, and palpable mass formation on left lower quadrant of the abdomen. Wedge resection of the left lung and Praziquantel medication was maintained for a week. Nevertheless, fever persisted after the treatment. The patient received total excision of the abdominal soft tissue mass, and the fever was relieved. RESULTS: Pathologic findings of the mass showed multiple cyst and abscess formation with crystal structure which is suspicious parts of the parasite or calcified egg shells. Uncontrolled fever was relieved after the operation, and there was no evidence of recurrent Paragonimiasis and ectopic migration for 1 year follow up period. CONCLUSION: Ectopic migration of Paragonimus is rare, but multiple organ can be involved. Patient with Paragominiasis who was refractory in fever control after Praziquantel medication or surgical evaluation of the lung should be considered as ectopic migration of the Paragonimiasis.
Abdomen ; Abscess ; Animals ; Asian Continental Ancestry Group ; Brain ; Chest Pain ; China ; Communicable Diseases ; Cough ; Eating ; Egg Shell ; Female ; Fever ; Follow-Up Studies ; Fresh Water ; Human Body ; Humans ; Incidence ; Japan ; Korea ; Liver ; Lung ; Middle Aged ; Paragonimiasis ; Paragonimus ; Paragonimus westermani ; Parasites ; Praziquantel ; Rage ; Spinal Cord ; Subcutaneous Tissue

BACKGROUND AND OBJECTIVES: Young children response more readily to speech than to pure tone stimuli. Although there are several reports on modification of speech Reception Threshold Testing by picture identification in the States, none has been reported in Korea. MATERIALS AND METHODS: In this study, we investigated the testing of SRT-PI in 102 young children of normal development between 24 and 36 months. All subjects were tested not only with SRT-PI but also with play audiometry in the same condition. RESULTS: Overall success rate of SRT-PI was 80.3% while only 3.9% of subjects were successful in play audiometry. The success rate of SRT-PI was significantly higher in the 29-36 months group than in the 24-28 months group. Test time and threshold did not show significant differences between in sex and age of subjects with regard to SRT-PI. CONCLUSION: SRT-PI is a simple, efficient and very useful test battery for audiologic evaluation in young children.
Audiometry ; Child* ; Humans ; Korea ; Speech Reception Threshold Test

OBJECTIVE: The purpose of this research was to investigate the differences of symptoms and neurocognitive functions with good and poor social functioning schizophrenic outpatients. METHOD: 152 schizophrenic outpatients were divided to good social functioning group(n=26) and poor social functioning group(n=126) based on the instrumental role of workers or students. Neurocognitive functions of these patient groups were compared with normal control group, which was composed of 30 healthy persons without a history of psychiatric illness. Schizophrenic symptoms were assessed by the Positive and Negative Syndrome Scale(PANSS). Neurocognitive function tests include the sustained attention, sensory register, executive function, concentration and attention, and verbal memory and learning assessed with Degraded Stimulus Continuous Performance Test(DS-CPT), Span Apprehension Task(SAT), Wisconsin Card Sorting Test(WCST), Digit Span(DS), and Rey Auditory Verbal Learning Test(RAVLT). RESULTS: 1) No significant differences were noted in the symptom subtypes of PANSS between good and poor social functioning patient groups. 2) The poor social functioning patient group showed significant deficits in the sustained attention, sensory register, concentration and attention, and verbal memory and learning as manifested in the data of DS-CPT, SAT, DS, and RAVLT compared with normal control and good social functioning patient groups. But there were no differences in these neurocognitive functions between good social functioning patient group and normal control group. CONCLUSIONS: These results suggested that some neurocognitive deficits such as sustained attention, sensory register, concentration and attention, and verbal memory and learning may be more important factors than symptoms for social functioning in the stable schizophrenic outpatients.
Executive Function ; Humans ; Learning ; Memory ; Outpatients ; Schizophrenia ; Verbal Learning ; Wisconsin

It is well known that the inflammation of somatic tissues, bladder and colon can alter the sensitivity of primary afferents innervating these tissues. To see if uterine afferents also show altered sensitivity, we examined their responses to the algesic agent bradykinin before and after induction of uterine inflammation. Inflammation was induced by injecting the mustard oil into the uterine lumen of adult female rats. After induction of inflammation, the response latency to bradykinin did not change, but the duration and peak of the response and integrated impulse discharges during the response period increased significantly. Furthermore, after inflammation, the level of resting discharges of the afferents was much higher. These results are consistent with the idea that the inflammation can sensitize the uterine afferents.
Adult ; Animals ; Bradykinin* ; Colon ; Female ; Humans ; Inflammation* ; Mustard Plant* ; Nerve Fibers* ; Rats* ; Reaction Time ; Urinary Bladder ; Uterus

OBJECTIVES: Delirium is a common postoperative complication in old adults associated with adverse events including functional decline, longer lengths of stay, and risk of institutionalization. The purpose of this study is to evaluate the incidence, preoperative, intraoperative, and postoperative risk factors of postoperative delirium in spine surgery. METHODS: Seventy-nine patients who underwent spine surgery were included. Preoperative assessments included current medical illness, number of comorbid problems, and the number of medications by past medical history, medical record, and interview with patients and caregivers. Intraoperative risk factors were evaluated. Laboratory data were checked preoperatively and postoperatively. The presence of delirium was determined by the Korean version of Delirium Rating Scale (K-DRS). RESULTS: Postoperative delirium was found in patients (7.6%). There was an association suggested between older age and postoperative delirium in spine surgery (p<0.05). An association was suggested between increasing numbers of medical conditions and postoperative delirium (p<0.05). Preoperative hemoglobin, hematocrit, sodium, potassium, calcium, albumin levels and postoperative hemoglobin and total protein levels were in the delirium group was significantly lower than those in control group (p<0.05). CONCLSION: This study showed that the postoperative delirium in spine surgery is not rare and several preoperative and postoperative factors are involved in the development of delirium. This pilot study is the first prospective trial in the area of postoperative delirium in spine surgery with a small sample size and short-term period, so further research with large sample size will be necessary.
Adult ; Aged ; Calcium ; Caregivers ; Delirium* ; Hematocrit ; Humans ; Incidence ; Institutionalization ; Medical Records ; Pilot Projects* ; Postoperative Complications ; Potassium ; Prospective Studies ; Risk Factors ; Sample Size ; Sodium ; Spine*

BACKGROUND/AIMS: The purpose of this study was to discover the physiologic difference of a postprandial motor response in different segments of the colon between patients with irritable bowel syndrome and healthy subjects. METHODS: Irritable bowel syndrome patients are categorized into three groups according to their main symptoms; loose stool-dominant (A, n=5), abdominal pain-dominant (B, n=5), constipation-dominant (C, n=6) and the normal control group (n=5). The intraluminal pressure activity was measured with a colonoscopically positioned multilumen manometric catheter. The change of the colonic motility index (MI) is presented as a percent change (mean+/-SE%) over the basal period in response to a meal. RESULTS: 1) In the transverse, descending and sigmoid colon of healthy subjects, the percentage changes in the basal MI during the first 30 min after the meal are significantly increased (p < 0.05-0.01). 2) In the sigmoid colon, the percentage changes in the basal MI during the first 30 min after the meal were 62+/-18 in A, 29+/-18 in B, 12+/-8 in C and 306+/-102% in heathy subjects respectively, which shows a significant difference between the MI of control and healthy subjects (p < 0.05). 3) In B and C, the percentage changes in the basal MI during the first 30 min after the meal in the descending colon were 105+/-38, 11+/-7, respectively, which shows a significant difference between the two groups (p < 0.05). In A and C, the percentage changes in the basal MI during the first 30 min after the meal in the sigmoid colon was 62+/-18, 12+/-8, respectively, which shows a significant change between the two groups (p < 0.05). CONCLUSION: This study suggests that postprandial intraluminal pressure differences play a role in the pathophysiology of irritable bowel syndrome.
Catheters ; Colon* ; Colon, Descending ; Colon, Sigmoid ; Humans ; Irritable Bowel Syndrome* ; Meals ; Motor Activity*

Pseudoxanthoma elasticum (PXE)-like disorder with multiple coagulation factor deficiency is a genetic disease characterized by dystrophic mineralization of the connective tissue in multiple organs such as the skin, arteries, and retina. Patients with this disorder have excessive folding and sagging of the skin with loss of recoil, as well as coagulopathy. Crohn's disease is a chronic inflammatory condition of the gastrointestinal tract, which primary affects the small intestine, often leading to malnutrition. Here, we describe the case of a 25-year-old woman who presented with these diseases. We found that nutrient deficiency due to long-term Crohn's disease aggravated the coagulopathy associated with PXE-like disorder.
Adult ; Arteries ; Blood Coagulation Factors* ; Connective Tissue ; Crohn Disease* ; Female ; Gastrointestinal Tract ; Humans ; Intestine, Small ; Malnutrition ; Pseudoxanthoma Elasticum ; Retina ; Skin