The knowledge about nutritional, toxic, and metabolic causes of dementia is particularly important, because they may be reversible. Central pontine myelinolysis(CPM) is one of these causes. CPM is a well known but rare metabolic disease of unknown etiology linked to overly aggressive correction of hyponatremia. We report a 74-year-old woman who developed disorientation, memory disturbance, and behavioral problem following intensive care unit management for pneumonia. Mini-mental status examination-Korean version(MMSE-K) study revealed severe cognitive dysfunction. Brain magnetic resonance imaging showed changes consistent with CPM and extrapontine myelinolysis. After supportive care, patient's clinical status was significantly improved. We suggest that a metabolic problem such as CPM should be considered in the diagnosis of acute or subacute cognitive deterioration in elderly patients.
Aged ; Brain ; Dementia ; Diagnosis ; Female ; Humans ; Hyponatremia ; Intensive Care Units ; Magnetic Resonance Imaging ; Memory ; Metabolic Diseases ; Myelinolysis, Central Pontine* ; Pneumonia ; Problem Behavior

BACKGROUND AND PURPOSE: Neurotrophic factors has been a subject of interest in the research of Parkinson's disease. In this experiment, intrastriatal 6-Hydroxydopamine(6-OHDA) injection was used to observe the effect of dopaminergic deafferentiation on the neurotrophic factor mRNA expression in the rat brain. METHODS: Male Sprague Dawley rats (250~300 gm) were treated to produce specific unilateral dopaminergic deafferentiation via injection of 6-OHDA at the right striatum without effect on the noradrenergic system. Treatment group (N=20) received same volume of vitamin C at the same site. The rats were sacrificed 3 hours, 12 hours, 24 hours, 3 days, 1 week, 2 weeks, 3 weeks, 4 weeks, after injection. The expression of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), tyrosine hydroxylase (TH), and enkephalin (ENK) mRNA were observed by in situ hybridization histochemistry in the hippocampus, striatum and substantia nigra. RESULTS: The expression of BDNF mRNA was increased in the cerebral cortex, dentate gyrus, and hippocampus. In the cerebral cortex, the increase of expression was peaked at 12 hours after 6-OHDA injection and confined to injection side. In the dentate gyrus, the expression was significantly increased in the injection side at 12 hours after injection, after that increased expression was observed in both side. The expression of NGF mRNA was increased in the dentate gyrus and cerebral cortex of lesion side at 3 hours and 12 hours after 6-OHDA injection. However, the expression of NT-3 mRNA was not changed. The expression of TH mRNA was gradually decreased in the substantia nigra compacta of injection side from 1 week to 4 weeks after 6-OHDA injection. The expression of enkephalin mRNA was increased from 24 hours, peaked at 1week, and returned to basal level at 4 weeks after injection in the injection side. CONCLUSION: From this results, it may suggest that the expression of neurotrophic factors in the cerebral cortex, dentate gyrus and hippocampus are closely related with the degeneration of dopaminergic neurons, not with the degeneration of noradrenergic neurons.
Adrenergic Neurons ; Animals ; Ascorbic Acid ; Brain* ; Brain-Derived Neurotrophic Factor ; Cerebral Cortex ; Dentate Gyrus ; Dopaminergic Neurons ; Enkephalins ; Hippocampus ; Humans ; In Situ Hybridization ; Male ; Nerve Growth Factor ; Nerve Growth Factors* ; Oxidopamine* ; Parkinson Disease ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Substantia Nigra ; Tyrosine 3-Monooxygenase

No abstract available in English.
Clinical Study ; Tibial Fractures

The authors have reviewed 119 cases of ligamentous injuries of the knee in 106 patients who were admitted and treated in the department of orthopedic surgery at Kyungpook National Universty Hospital during the period from 1974 to 1983. Patients were analyzed degree of injuries by clinical test, stress radiogram, double contrast radiogram and arthroscopy depend on the cases. Fifteen cases were treated conservatively and 104 cases were repaired the ruptured ligaments operatively, The results were as follows; 1. Ligamentous injuries of the knee were more prevalent in male 4 times than in female, and frequently occured in 3rd and 4th decade, 57 %. 2. Traffic accidents was most common causes, 77.4 % and athletic injuries was next, 15 %. 3. Medial collateral ligements were most commonly ruptured, 68 cases and its femoral attachment was ruptured most commonly, 32 cases. Single ligamentous rupture was most commonly appeared in medial collateral ligament in 36cases. Combined ligamentous rupture were more common in medial collateral ligaments and anterior cruciate ligaments in 15 cases. 4. On follow up examination, knee joint space was compared with both normal and injured knee. In single medial collateral ligamentous rupture, joint space was opened 0.1 mm more than normal side. In combined lesion of lateral collateral ligaments and both cruciate ligamentous rupture, joint space was opened 2.4 mm more than normal side. 5. Excellent and good results were obtained in 88 cases (81%) by operative treatment and 11 cases (73%) by conservative treatment. Early repair of the ligament, under the 2 weeks, gave much better results than later repair. 6. The results were more successful in single ligamentous injuries (55 cases, 87%) than multiligamentous injuries (38 cases, 68%).
Accidents, Traffic ; Anterior Cruciate Ligament ; Arthroscopy ; Athletic Injuries ; Clinical Study ; Collateral Ligaments ; Female ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Joints ; Knee Joint ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Male ; Orthopedics ; Rupture

No abstract available.

Huntington's disease is an autosomal dominant neurodegenerative disorder that usually begins in mid-life and is characterized by a progression of involuntary choreiform movements, personality change, and dementia. 4 specific unstable trinucleotide (CAG) repeat expansion in a gene on the short arm of chromosome 4 was recently identified as the pathogenic mutation for this disease. We have analysed the CAG expansion in peripheral leukocyte from a woman suspected with Huntington's disease and her family. A 40-year-old woman visited for the 6 years history of progressing intractable involuntary hyperkinetic movement and antagonistic personality. She showed bilateral caudate nucleus atrophy with mild enlargement of both frontal horn at brain MRI and showed the decrement of glucose metabolism in both basal ganglia at 18F-FDG PET scan. We also studied about the clinical manifestations of her family. Her younger brother also showed mild cognitive impairment and dysarthria. She and her relatives (n = 6) were tested for the existence of high risk allele of Huntington's disease by polymerase chain reaction method. The high risk allele (above 40 CAG repeat) in the 1715 gene was confirmed in 6 persons including the patient. The CAG repeat variance was 46 to 54. Only one person showed the normal range of CAG repeat.
Adult ; Alleles ; Animals ; Arm ; Atrophy ; Basal Ganglia ; Brain ; Caudate Nucleus ; Chorea ; Chromosomes, Human, Pair 4 ; Dementia ; Diagnosis* ; Dysarthria ; Female ; Fluorodeoxyglucose F18 ; Genes, vif ; Glucose ; Horns ; Humans ; Huntington Disease* ; Hyperkinesis ; Leukocytes ; Magnetic Resonance Imaging ; Metabolism ; Mild Cognitive Impairment ; Neurodegenerative Diseases ; Polymerase Chain Reaction* ; Positron-Emission Tomography ; Reference Values ; Siblings

To estimate the factors to the inclination of the criminal violence, the content of trace minerals and toxic metals in the scalp hair were measured during the period from May 1992 to october 1992. One hundred eleven violent and 89 nonviolent criminal inmates of Taegu correctional Institute were selected. The inmates of violent criminals were imprisoned by murder, robber, rape, injury and violent acts. Those of nonviolent criminals were swindle, larceny, and adultery and had no history of institutional violence. The contents of two toxic metals(cadmium, lead) and five trace minerals(Cu, Fe, Zn, Mg, Na) were determined by an atomic absorption spectrophotometer(lL. 551). The contents of cadmium and lead in hair of violent criminals were significantly higher as 0.56+/-0.14ppm, 11.53+/-3.32ppm, respectively, than 0.42+/-0.20ppm, 9.63+/-4.31ppm of nonviolent group (P<0.01). But the level of copper was significantly lower than nonviolent group (P<0.05). The factors that had a significant correlation with the inclination of violence in multiple logistic regression analysis were cadmium (odds ratio=98.09), unmarried (odds ratio=0.39), many times of criminal history (odds ratio=l.57) and residence of rural area (odds ratio=0.44). The results suggest that the sub-toxic contents of cadmium and lead in the hair may be of potential effect on behavior, and the mineral analysis may be an important adjunctive diagnostic procedure. Further studies into this problem are necessary.
Absorption ; Cadmium ; Copper ; Criminals* ; Daegu ; Extramarital Relations ; Hair* ; Homicide ; Humans ; Logistic Models ; Metals ; Minerals* ; Rape ; Scalp* ; Single Person ; Violence

BACKGROUND: Parkinson's disease is the primary degenerative disease characterized by rigidity, bradykinesia and resting tremor. Even though dopaminergic cell loss of the substantia nigra compacta is a main pathogenesis of the Parkinson's disease, the striatal dysfuntion is major pathophysiology of pakinsonian symptoms. METHODS: Since gene expression profile can explain the symptomatic varieties of Parkinson's disease, gene expression was investigated in the striatum of rat brain after lesioning of unilateral substantia nigra compacta with 6-hydroxydopamine using cDNA microarray technique for the first time. The expression patterns of 5,200 rat brain cDNAs were screened and clustered according to the function of gene. The expression patterns of enkephaline and substance-P mRNA were also studied for validation of animal preparation. RESULTS: Various genes involved in apoptosis, cytokines. cytoskeletal molecules, neurotrophic factors, receptors, intracellular Ca2+ metabolism, signal transduction, stress protein, cell cycle regulator protein, and expressed sequence tags(EST) have shown significant expression changes. CONCLUSIONS: These gene expressions provide the global assessment of the processes involved in secondary change of striatum afforded by dopaminergic denervation at molecular levels.
Animals ; Apoptosis ; Brain ; Cell Cycle ; Cytokines ; Denervation ; DNA, Complementary ; Enkephalins ; Gene Expression ; Hypokinesia ; Metabolism ; Models, Animal* ; Nerve Growth Factors ; Oligonucleotide Array Sequence Analysis ; Oxidopamine* ; Parkinson Disease ; Rats* ; RNA, Messenger ; Signal Transduction ; Substantia Nigra ; Transcriptome ; Tremor

A accidental spills of phenol(100%) to the river Nakdong with subsequent contamination of the tap water for about two million consumers in Taegu city of Korea were occurred in March 1991. A historical cohort study of 6,913 individuals was undertaken to determine the associated with illness. Population subjects were divided into two groups of exposed and unexposed. Exposed subjects were reported to be phenol associated symptoms significantly higher than those in a nearby unexposed area(39.6% vs 9.4%, p<0.01). Especially, in the related symptoms, highly significant differences were noted in the number of subjects reporting gastrointestinal illness such as nausea, vomiting, diarrhea, or abdominal pain. During the accident, study subjects who experienced peculiar taste or odor in the tap water were significantly higher in the exposed areas(92% vs 34.3%). Chlorophenols formed from chlorination of water may have aggravated the problem.
Abdominal Pain ; Chlorophenols ; Cohort Studies ; Daegu ; Diarrhea ; Drinking Water* ; Drinking* ; Equipment and Supplies* ; Halogenation ; Korea ; Nausea ; Odors ; Phenol* ; Rivers ; Vomiting ; Water

BACKGROUND: Drug-induced Parkinsonism(DIP) is the second commonest cause of Parkinsonism, after idiopathic Parkinson's disease(IPD). DIP is frequently produced by antipsychotic drugs. But the clinical characteristics of DIP did not get attention by neurologist. So we studied the clinical profiles of DIP patients. METHODS: We studied the clinical profiles of thirthone patients who showed parkinsonism after antipsychotic drug treatment. We compared the score of motor part of the Unified Parkinson's Disease Rating Scale(UPDRS) between trihexyphenidyl(n=15) & amantadine(n=16) monotherapy group(initial & 4 week after treatment). RESULTS: The mean age of patients was 45 years. Bradykinesia was the 1st symptom in 26 patients(94%), tremor in 5 patients(6%). In 25 patients(81%), the first symptom appeared within 1 week after sntipsychotic treatment. There was a statistical significant negative correlation between the dosage of antipsychotic drug and the symptom-onset interval following treatment with antipsychotic drugs(simple correlation analysis, p>0.01). Bradykinesia and rigidity were appeared in all DIP patients, symmetric distribution was more common(94%, 87%) Tremor occurred in 27 patients (87%). In patients with tremor, postural or action tremor was dominant in 15 patients(56%) asymmetric distribution was more common(16/27, 59%). There are no statistical difference in motor score of UPDRS between trihexyphenidyl & amantadine monotherapy group(student t-test, p<0.05) CONCLUSIONS: Bradykinesia was the most common 1st symptom in DIP patients. Asymmertrical postural or action tremor was relativelly common in DIP. Amantadine showed the same efficacy in the treatment of DIP compared to anticholinergics.
Amantadine ; Antipsychotic Agents ; Cholinergic Antagonists ; Humans ; Hypokinesia ; Parkinson Disease ; Parkinsonian Disorders* ; Tremor ; Trihexyphenidyl