Though the aetiology of transmissible spongiform encephalopathies (TSEs) remains uncertain, proteinase resistant prion protein (PrP-Sc), a converted form of the normal cellular prion protein (PrP-C), accumulates in the lysosome of cells of the nervous systems of animals with TSEs. In this study, clinical and epidemiological examinations of bovine spongiform encephalopathy (BSE) were conducted in Korea. During the investigated period, none of the cattle exhibited typical clinical signs of BSE, such as behavioral disturbances, high sensitivity, and abnormal locomotion. Immunohistochemical analysis and western immunoblotting were established to detect PrP-Sc in the brain tissue using monoclonal antibody (MAb) F89/160.1.5, produced by immunizing mice with a synthetic peptide which corresponds to bovine PrP residues 146-159, NH2-SRPLIHFGSDYEDRC-COOH. Although some BSE-like spongiform changes were observed in bovine brains randomly collected from Korean slaughterhouses from 1996 to 1999, no PrP-Sc was detected in those brains with the established immunohistochemistry and western immunoblotting assay. Also, no positive reaction was observed in bovine brains infected with rabies. These immunohistochemical and western immunoblotting methods using MAbs, specifically reactive with conserved epitopes on ruminant PrP, can be used for postmortem diagnosis of BSE. Further, the method can be applied to antemortem and the preclinical diagnosis of ovine scrapie by detecting PrP-Sc in lymphoid tissues, such as the tonsils, third eyelid or peripheral lymph nodes.
Abattoirs ; Animals ; Blotting, Western ; Brain/*pathology ; Brain Stem/pathology ; Cattle ; Encephalopathy, Bovine Spongiform/*epidemiology/pathology ; Immunohistochemistry ; Korea/epidemiology ; PrPSc Proteins/*analysis ; Sheep ; Sheep Diseases/*epidemiology/pathology

Propionic acidemia is an autosomal-recessive inborn error of branched-chain amino acid metabolism. It is caused by deficient activity of propionyl-coenzyme A carboxylase and is characterized by a spectrum of clinical and biochemical findings. It usually manifests in the neonatal period or early infancy. Since Childs et al first described the propionic acidemia of infants in 1961, it has rarely been reported. There have been no previous report of this organic acidemia in Korea. We present a case of propionic acidemia in a 4-day old male, who had poor feeding, dehydration, and hyperammonemia and died at 12 days of age. Diagnosis was established by gas chromatography and mass spectrometry, and this case is the first reported propionic acidemia in literature in Korea. A review of the related literature was included.
Child ; Chromatography, Gas ; Dehydration ; Diagnosis ; Diethylpropion* ; Humans ; Hyperammonemia ; Infant ; Korea ; Male ; Mass Spectrometry ; Metabolism ; Methylmalonyl-CoA Decarboxylase ; Propionic Acidemia*

It has been known that the usual findings of SPECT in patients with Todd's paralysis is the hypoperfusion of the corresponding hemisphere. We experienced a patient who developed transient hemiparesis after a seizure attack with hyperperfusion rather than hypoperfusion over the corresponding hemisphere on brain SPECT. A 36-year-old female presented with left hemiparesis after a secondarily generalized tonic seizure. No additional seizure-like attack was noted during admission. EEG showed intermittent focal slow waves over the right frontotemporal area on admission and returned to a normal pattern 72 hours after admission. Tc-99m ECD SPECT showed hyperperfusion on the right frontoparietal area in spite of the normalization of EEG. The degree of hyperperfusion was diminished as time passed for at least 72 hours. We report a patient who had Todd's paralysis associated with contralateral frontoparietal hyperperfusion. Todd's paralysis may be explained as the result of focal discharges that lead to local vasomotor changes.
Adult ; Brain ; Electroencephalography ; Female ; Humans ; Paralysis* ; Paresis ; Seizures ; Tomography, Emission-Computed, Single-Photon

The authors present a case of intracranial aneurysm with Takayasu's arteritis. A 10-year-old boy was admitted with complaints of sudden bursting headache and vomiting. Computed tomographic(CT) scan showed subarachnoid hemorrhage and measure blood pressures between in each side did differ significantly. Aortoangiogram showed narrowing of the abdominal aorta and stenosis at their origins of the renal arteries. An angiogram of the right carotid artery revealed a saccular aneurysm located at the proximal portion of the middle cerebral artery. Intracranial aneurysm with Takayasu's arteritis is a rare entity, even more in children.
Aneurysm ; Aorta, Abdominal ; Carotid Arteries ; Child* ; Constriction, Pathologic ; Headache ; Humans ; Intracranial Aneurysm* ; Male ; Middle Cerebral Artery ; Renal Artery ; Subarachnoid Hemorrhage ; Takayasu Arteritis* ; Vomiting

Recently there has been renewed interest in the use of highly concentrated saline solutions and colloidal fluid to resuscitate animals and humans from hypovolemic shock. In this study, effects of resuscitation with various fluids were compared in a cat model of acute hemorrhage. After anesthesia, the cat was exanguinated from the femoral artery, and an equivalent amount of fluid was injected through the femoral vein. Therefore this study was performed to evaluate the effects of gelatin in comparison with others. The results were as follows 1) Compared to crystalloid solution, colloidal soluions were more effective in restoring hemodynamic disturbance but there were no significant differences between Gelatin and Dextran group at same dosage level. 2) Mean arterial pressure was significantly increased in dextran and gelatin group after 30 minutes of fluid resuscitation(p<0.05). 3) Decreased hemoglobin due to plasma volume expansion was noticed in all group's(p<0.05) 4) After replacement of dextran and gelatin, central venous pressure was restored effectively(p < 0.05). 5) Decreased ETCO was recovered after replacement of fluid, but no difference among three groups. 6) Increased potassium level was redecreased 30 minutes after replacement of gelatin(p < 0.05). 7) Sodium level was decreased after hemorrhange in all three groups and after replacement of H/D and dextran, but no change in gelatin group(p<0.05). 8) Increased lactate after hemorrhage was decreased in gelatin and dextran group. 8) Decreased pH restored after replacement of dextran and gelatin.
Anesthesia ; Animals ; Arterial Pressure ; Cats* ; Central Venous Pressure ; Colloids ; Dextrans ; Femoral Artery ; Femoral Vein ; Gelatin* ; Hemodynamics ; Hemorrhage* ; Humans ; Hydrogen-Ion Concentration ; Lactic Acid ; Plasma Volume ; Potassium ; Resuscitation ; Shock ; Shock, Hemorrhagic ; Sodium

Propionic acidemia is an autosomal-recessive inborn error of branched-chain amino acid metabolism. It is caused by deficient activity of propionyl-coenzyme A carboxylase and is characterized by a spectrum of clinical and biochemical findings. It usually manifests in the neonatal period or early infancy. Since Childs et al first described the propionic acidemia of infants in 1961, it has rarely been reported. There have been no previous report of this organic acidemia in Korea. We present a case of propionic acidemia in a 4-day old male, who had poor feeding, dehydration, and hyperammonemia and died at 12 days of age. Diagnosis was established by gas chromatography and mass spectrometry, and this case is the first reported propionic acidemia in literature in Korea. A review of the related literature was included.
Child ; Chromatography, Gas ; Dehydration ; Diagnosis ; Diethylpropion* ; Humans ; Hyperammonemia ; Infant ; Korea ; Male ; Mass Spectrometry ; Metabolism ; Methylmalonyl-CoA Decarboxylase ; Propionic Acidemia*

Thirty four patients with diffuse axonal injury, defined as post-traumatic coma for over 24 hours with Glasgow Coma Scale(GCS) score of 8 or less following nonsurgical resuscitation, admitted to Inha Hospital from January to December 1991, were studied in order to identify clinical analysis. The aim of this study was to find out the effects of barbiturates or other intensive therapy or head elevation on the intracranial pressure(ICP), arteriovenous oxygen difference(AVDO2) and outcome. The results were as follows; The ratio of male to female was about 6 to 1. 2) In clinical signs at the emergency room, abnormal pupil size was shown 17 cases(61%) under 8-5 on the GCS, but all cases under 5 on the GCS showed abnormal pupil size. 3) Ventricular compression was shown in 29 cases(85%), 17 cases(50%) was showed the ventricular compression & cisternal obliteration. 4) Post-traumatic cerebral infarction was developed 59% of DAI and occurred in 88% of ventricular compression and cisternal obliteration. 5) On admission, above 5 ml/100 ml in AVDO2 was developed in 32 cases(94%) under 8 on the GCS, but in all cases under 5 on the GCS. Recording of ICP showed above 20 mmHg in 15 cases(44%). On coagulopathy, our cases showed that decrease of platelet was involved in 5 cases(15%), prothrombin time(PT) prolongation in 11 cases(32%), activated partial thromboplastin time(APTT) in 4 cases, fibrinogen in 5 cases. 6) The mean ICP was slightly lower when the patient's head was elevated at 30 degree than at 0 degree. The mean ICP was moderately lower when the patients were taken barbiturates therapy. ICP tends to increase from the 1st to 3rd day after injury. 7) The mean AVDO2 was significantly lower when the patients were taken barbiturates therapy, especially at the 1st day. 8) On the relation between Glasgow Outcome Scale(GOS) and Neurological grading(NG), GOS IV was developed in 8 cases(NG score 3-6), GOS III in 5 cases(NG score 7-9), GOS II in 2 cases(NG score 10). Total mortality rate was 56%.
Axons* ; Barbiturates ; Blood Platelets ; Cerebral Infarction ; Coma ; Coma, Post-Head Injury ; Diffuse Axonal Injury ; Emergency Service, Hospital ; Female ; Fibrinogen ; Head ; Humans ; Male ; Mortality ; Oxygen ; Prothrombin ; Pupil ; Resuscitation ; Thromboplastin

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*

A retrospective analysis of 36 cases of petrous pyramid fractures was studied clinically and radiographically during last 5 years. Of 503 patients with skull fractures admitted to the Inha University hospital, of which 7.1% involved the petrous pyramid. The most common mode of injury was a motor vehicle accident and the most common age group was the first decade. The anatomic location of fractures in the petrous pyramid were evaluated by high resolution computed tomography and it disclosed 20 longitudinal and 16 transverse fractures. The principal symptoms and signs, occurring alone or in combination, were a otologic problem, facial paralysis and CSF liquorrhea. The otologic problems were noted in almost every case. The facial palsy and CSF liquorrhea were present in 16 cases(36%) and 9 cases(25%), respectively. The anatomic type of fractures well corresponded to the principal symptoms and signs and the prognosis, the development rate of principal symptoms and signs of the transverse fracture was more higher and the prognosis of that was worse than the longitudinal fracture.
Facial Paralysis ; Humans ; Motor Vehicles ; Petrous Bone* ; Prognosis ; Retrospective Studies ; Skull Fractures

Endotracheal intubation has been widely used for general anesthesia and patency of airway. But intubation granuloma may be developed after intubation. From Feb. 1986 to Jun. 1993, the authors encountered 20 cases of intubation granuloma in Korea University Hospital and following results were obtained. 1) The incidence of intubation granuloma was 0.017%. 2) The age range was from 24 to 49 years. 3) The ratio of male to female was 1 to 19. 4) All cases located at posterior one third of vocal cord, 6 cases were bilateral, 14 were unilateral, of them 10 were in the right sides. 5) Eleven cases were occurred after caesarian section, and the ineidence of which was 0.134% . 6) Hoarseness was the main symptom in 18 cases. 7) The duration from intubation to development of symptom was 15 days to 4 months.
Anesthesia, General ; Female ; Granuloma* ; Hoarseness ; Humans ; Incidence ; Intubation* ; Intubation, Intratracheal ; Korea ; Male ; Vocal Cords