A 41-year-old man was admitted due to altered mentality and confusion. He had showed progressive cerebellar ataxia, dysarthria, gait disturbance from his age of 33 years old. Brain MRI revealed high signal lesions in periaqueductal gray matter, mammillary bodies, median thalami and postcentral gyri bilaterally on T2-weighted images. Severe cerebellar atrophy was noted, too. We report a case of Wernicke's encephalopathy in a patient with probable multiple system atrophy. As far as we know, there have been no published report on this kind of case.
Adult ; Atrophy ; Brain ; Cerebellar Ataxia ; Dysarthria ; Gait ; Humans ; Magnetic Resonance Imaging ; Mamillary Bodies ; Multiple System Atrophy* ; Periaqueductal Gray ; Wernicke Encephalopathy*

OBJECTIVES: OSAS (obstructive sleep apnea syndrome) is a common disorder and its consequences are often serious. It is important to detect the disorder early in the course for proper treatment. This study is to grasp the snoring clinic visitors' knowledge level of OSAS. METHODS: One hundred and seventy-nine visitors at the of snoring clinic of Seoul National University Hospital were surveyed by questionnaire about reasons of visit and knowledge of treatment methods of snoring and OSAS, diagnostic method, OSAS-related symptoms, and complications. RESULTS: Most of the respondents (89.4%) "have already heard about OSAS" and the major sources of information was the mass media (58.1%) such as television and radio. More than half (60.3%) were aware that snoring is closely related to OSAS. More than half (59.8%) recognized that a nocturnal polysomnograpy was necessary for proper diagnosis. Two thirds (67%) of the respondents noted surgery as a treatment for snoring. More than half (55.9%) answered that they would follow the doctor's advice on the treatment choice. Only 12.3% of respondents "have heard about nCPAP". No one chose nCPAP (nasal continuous positive airway pressure) as a treatment for either snoring or OSAS. About one third (34.6%) of the respondents were aware that OSAS is related to hypertension. Only 12.8% noted that OSAS is related to diabetes mellitus. CONCLUSION: Visitors at the snoring clinic were found to have substantially limited knowledge of health risks and proper treatments of OSAS. We suggest that it is crucially important to educate patients and offer easy-to-understand information on snoring and OSAS. We predict that provision of educaiton and information to patients and general public will faciliate the diagnosis and treatment of snoring and OSAS and reduce the related disorders such as hypertension, stroke, and diabetes mellitus.
Diabetes Mellitus ; Hand Strength ; Humans ; Hypertension ; Mass Media ; Surveys and Questionnaires ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Snoring ; Stroke ; Television

The purposes of this study were (1) to understand how customers trade off one attribute against another when they choose a pizza restaurant, (2) to compare the importance of individual attributes with their relative importance and (3) to compare customers' brand choice patterns with the prediction of pizza restaurant operators. Empirical data for this study were collected from the customers (n = 307) and operators (n = 273) of four famous pizza franchise restaurants in Korea, Pizza Hut, Mister Pizza, Domino's Pizza and Pizza Mall. The attributes and attribute levels for the hypothetical profiles were decided from the focus group discussion. A total of 16 profiles was selected from fractional factorial designs. The SPSS conjoint procedure was used to calculate utility scores and simulate profiles. The overall group statistics showed the relative importance of all attributes compared with one other. Taste was the most important attribute (32.48%) in choosing a pizza restaurant, followed by service (21.87%), atmosphere (17.23%), price (15.17%) and speed of delivery (13.26%). There was a difference between the customers' ratings of the importance of the individual attributes and the ranking of the same attributes' relative importance as derived from the conjoint analysis. The operators rated service (26.54%) as also being important, as well as taste (27.76%), in choosing a pizza restaurant. The rankings of relative importance for pizza taste, service and price were statistically different in the customers' and operators' data (p < .001, p < .01, p < .05). Operators who want to differentiate themselves from their competitors should make decisions based on an increased understanding of their customers' brand choice decision process and measure the hidden needs of their customers.
Atmosphere ; Focus Groups ; Korea ; Restaurants*

No abstract available.
Paranasal Sinuses*

Hydranencephaly is a condition in which cerebral hemisheres are absent and reduced to fluid-filled sacs in a normal skull. Numerous causes have been proposed, but bilateral occlusion of the internal carotid arteries during early fetal development can explain most of the pathologic abnormalities. We evaluated a case of hydranencephaly by brain CT and magnetic resonance angiography. Magnetic resonance angiography showed flow within the vertebral and basilar arteries without internal carotid intracranial flow above the supraclinoid segment. A brief review of the related literature was given on this subject.
Basilar Artery ; Brain ; Carotid Artery, Internal* ; Fetal Development ; Hydranencephaly* ; Magnetic Resonance Angiography ; Skull

Prolonged ischemic-reperfusion induces cellular damages and apoptosis in rat skeletal muscle. Reactive oxygen species generated during reperfusion time induce expression of various genes and apoptosis. Among apoptosis-related gene products, Bcl-2 and Bax regulate the apoptotic response by inhibiting and promoting cell death, respectively. The purpose of this study was to observe the age-related alertation of expression profile of Bcl-2 and Bax in rat tibialis anterior muscle and soleus muscle following ischemia-reperfusion. 9 weeks, 30 weeks, and 65 weeks old male Sprague-Dawley rats were divided into control and ischemia groups. Ischemia group was divided into 3 subgroups based on reperfusion time. For ischemia, left commom iliac artery was occulded for 4 hours using rodent vascular clamps. The animals were sacrificed at hours 0, 3 and 24 after onset of reperfusion and tibialis anterior and soleus muscles were removed. Muscle tissues were embedded in paraffin and 6 micrometer sections were made. The expression level of Bcl-2 and Bax were examined using immunohistochemical methods. The results obtained were as follows; 1. In control group, immunoreactivities (IMRs) of Bcl-2 and Bax were weak or moderate in 30 weeks old rats and were trace in 9 and 65 weeks old rat. 2. In control group, IMRs of Bcl-2 and Bax in tibialis anterior muscle were more higher than those in soleus muscle, but not significantly. 3. In ischemia group, IMRs of Bax were increased with aging. 4. In ischemia group, IMR of Bax in tibialis anterior muscle was higher than that in soleus muscle. These results suggested that the increased IMR of Bax may be related to increasing of ischemic injury, and both old skeletal muscle and tibialis anterior muscle are susceptabile to ischemic injury of rat skeletal muscle.
Male ; Humans ; Rats ; Animals

Prolonged ischemic-reperfusion induces cellular damages and apoptosis in rat skeletal muscle. Such injury takes place in the phase of reperfusion following ischemia induction in part via regulating of apoptosis-related gene inductions. The present study was performed to examine the age-related alertation of expression of apoptosis in rat tibialis anterior and soleus muscles following ischemia-reperfusion. 9 weeks, 30 weeks, and 65 weeks old male Sprague-Dawley rats were divided into 2 groups such as controls and ischemia. For ischemia, left commom iliac artery was occulded for 4 hours using rodent vascular clamps. The tibialis anterior and soleus muscles were removed 0, 3, and 24 hours after onset of reperfusion. Muscle samples were embedded in paraffin and 6 micrometer sections were made. The apoptotic reactions was detected using TUNEL methods. The results obtained were as follows; 1. In control groups, the number of apoptosis was increased with aging, but not significantly. 2. In ischemia groups, the number of apoptosis was increased at 3 hours after ischemia, and decreased at 24 hours after ischemia. 3. In ischemia groups, the number of apoptosis was increased with aging. 4. In ischemia groups, the number of apoptosis in the tibialis anterior muscle was higher than that in soleus muscle. These results suggested that the ischemic injury of the rat skeletal muscle is increased with aging and that tibialis anterior muscle is more susceptabile to ischemic injury than soleus muscle.
Male ; Humans ; Rats ; Animals

Prolonged ischemic-reperfusion induces cellular damages and apoptosis in rat skeletal muscle. Such injury takes place in the phase of reperfusion following ischemia induction in part via regulating of apoptosis-related gene inductions. Among apoptosis-related gene products, Bcl-2 and Bax regulate the apoptotic response by inhibiting and promoting cell death, respectively. The present study was performed to examine the age-related alertation of expression of Bcl-2 and Bax along with apoptosis in rat tibialis anterior muscles following ischemia-reperfusion. 9 weeks, 30 weeks and more than 65 weeks old male Sprague-Dawley rats were divided into 2 groups such as controls, 4 hour ischemia. 4 hour ischemia group was divided into 3 subgroups based on reperfusion time. For ischemia, left commom iliac artery was occulded for 4 hours. The tibialis anterior muscles were removed 0, 3, and 24 hours after onset of reperfusion. Muscle samples were embeded in paraffin and 6 micrometer sections were made. The expression level of Bcl-2 and Bax were examed using immunohistochemical methods and apoptotic reactions was detected using TUNEL methods. The results obtained were as follows; 1. In control group, Bcl-2 and Bax were weakly immunostained in 9 weeks old rat tibialis anterior muscles. In 30 and 65 weeks old rat tibialis anterior muscles, Bcl-2 immunostaning was minimal. The level of Bax staining was increased in 30 and 65 weeks old rat tibialis anterior muscles, compared with those of 9 weeks old rats. The level of apopto-sis among different age groups were not altered. 2. In the 4 hour ischemia group, the level of Bax staining was correlated with the level of apoptosis in 9 weeks, 30 weeks and 65 weeks old rat tibialis anterior muscles. 3. The level of apoptosis was increased in older groups relative to younger groups in 4 hour ischemia. These results suggested that the level of apoptosis induced by ischemic-reperfusion in tibialis anterior muscle increase with ageing in rat tibialis anterior muscles, and that a increase of Bax expression is related to increased apoptosis.
Animals ; Apoptosis* ; Cell Death ; Humans ; Iliac Artery ; In Situ Nick-End Labeling ; Ischemia ; Male ; Muscle, Skeletal ; Muscles* ; Paraffin ; Rats* ; Rats, Sprague-Dawley ; Reperfusion

Superior oblique myokymia (SOM) is a rare disorder characterized by unilateral paroxysmal oscillopsia or diplopia. Recent studies revealed that SOM can be associated with neuro-vascular cross compression (NVCC) of the trunk of the trochlear nerve. Although it frequently occurs without any underlying systemic disease or concurrent neurologic sign, we need to consider this NVCC especially in cases with persistent disturbing symptoms. Hereby, we present two cases of SOM whose neuroimaging studies suggest NVCCs and, discuss recent update of the pathomechanism of SOM.
Diplopia ; Nerve Compression Syndromes ; Neuroimaging ; Neurologic Manifestations ; Trochlear Nerve ; Trochlear Nerve Diseases