Every word has its proper schwa which is produced through the mouth by the appropriately posed or positioned chin, tongue, and neck. This proper unaccentuated vowel or syllable for the certain languages is named as Juhn's anatomical schwa. In learning 2nd languages it can be very useful and much linguistic to teach how to voice the proper schwa. In linguistics the proper schwa has been expressed by International phonetic alphabet or phonography for a long time but Juhn's anatomical schwa is defined that the unaccentuated vowel or syllable is produced by the appropriately posed or positioned chin, tongue, and neck. After birth the child grows and develops the skull to the end and the baby teeth are lost to develop the permanent teeth and the jaw joints are to be firm gradually before the age of 7. For the 7 years the child learns the mother tongue so that his facial appearance becomes alike to his tribe who speaks the same language. The chewing and swallowing is alike with each other. The jaw joints become also firm to speak mother tongue easily. Thereafter the child can voice other language schwa not enough to speak it spontaneously. This is the first idea of the Juhn's locked chin. So we can postulate that the locked chin is made to be the jaw joints as soft as those the children under the age of 7 have for L2. This is the Juhn's unlocking rule and the solution for the Juhn's locked chin. Then we can move our chin and tongue to the next step producing the schwa for the second language.
Child ; Chin ; Deglutition ; Humans ; Jaw ; Joints ; Learning ; Linguistics ; Mastication ; Mothers ; Mouth ; Neck ; Parturition ; Skull ; Tongue ; Tooth ; Voice

Antihypertensive and beta-adrenoceptor blocking effect of long-acting propranolol were observed in the outpatient department, Department of Internal Medicine, National Medical Center during the period between December, 1981 and May, 1982. The clinical effects of long-acting propranolol were compared with those of conventional propranolol and following results were obtained. 1) Direct cross-over from conventional propranolol 20mg three times a day for several days to long-acting propranolol 160mg once daily was not accompanied by appreciable side effect and there was fairly good antihypertensive effect either in systolic or diastolic pressure. 2) Antihypertensive and bata-adrenoceptor blocking effect of long-acting propranolol 160mg once daily were comparable to those of conventional propranolol 40mg three or four times a day. The compliance of the patients to long-acting propranolol once daily was naturally better than that to conventional propranolol which must be taken three to four times daily. 3) In several cases of trial, the patients who tolerated the long-acting propranolol 160mg per day also well tolerated the regimen of long-acting propranolol 320mg per day, 4) The regimen of long-acting propranolol once daily was recommendable to those patients who were on beta-blocking agents for prolonged period of time for their indications such as hypertension and other chronic cardiovascular diseases, in view of the aspects of good patient compliance, good antihypertensive and beta-blocking effect.
Blood Pressure ; Cardiovascular Diseases ; Compliance ; Humans ; Hypertension ; Internal Medicine ; Outpatients ; Patient Compliance ; Propranolol*

To differentiate the postoperative changes from the recurrence of tumor and to evaluate MR imaging of early postoperative leptomeningeal seeding in medulloblastoma, We have retrospectively analysed 34 cases of MR images of 17 patients who were confirmed as medulloblastoma by histopathology. Noncontrast and postcontrast T1 weighted MR images were obtained in all patients. In 11 patients follow-up MR was done more than once (average:1.5 times) and average interval of MR imaging was 6 months. The timing of 34 MR images was as follow: 6 case within 2 months, 9 cases between 2 months and 1 year, 19 cases more than 1 year after surgery respectively. MR images within 2 month after surgery revealed contrast enhancement at operation site and adjacent meninges, hemorrhage, residual tumor. In patients who had no evidence of tumor recurrence, these early postoperative changes were markedly decreased within 6 month after sugery. MR images obtained more than 1 year after sugery showed no abnormal contrast enhancement or mild focal dural enhancement at operation site. Diffuse moderate dural enhancement was noted in one patient who had the history of post-surgical subdural hemorrhage. In six patients with tumor recurrences which were detected from as early as 9months to 6 years after surgery, the findings of recurrence included leptomeningeal enhancement of brain stem and cerebellar surface at early stage, variable sized enhancing leptomeningeal nodules, linear or irregular sulcus obliterating enhancing lesions, enhancing mass at primary or metastatic site. We have concluded that leptomeningeal enhancement detected after 6 months of surgery is an important MR finding suggesting the possibility of tumor recurrence. Small nodular and linear enhancement of leptomeninges at brainstem or cerebellar surface is considered as the early manifestation of intracranial tumor seeding.
Brain Stem ; Follow-Up Studies ; Hematoma, Subdural ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Medulloblastoma* ; Meninges ; Neoplasm, Residual ; Recurrence ; Retrospective Studies

The distal ulnar resection, Darrach operation, has been used for several conditions such as fracture about wrist joint, rheumatoid arthritis or ulno-carpal impingement syndrome. But, this operation could be led to have excessive unphysiologic increase radial loading on the radio-carpal joint and early osteoarthritis is thought to be inevitable in long-term follow-up. So, we performed various kind of reconstruction for 19 cases with dislocated distal radioulnar joint, and compared their radiologic and clinical results with that of the group for total 13 cases with distal ulnar resection. Through this study, we could find out that the preservation of normal relationship of dislocated distal radioulnar joint is considered as more desirable than that of removal of ulnar head.
Arthritis, Rheumatoid ; Dislocations ; Follow-Up Studies ; Head ; Joints ; Osteoarthritis ; Wrist Joint

The idiopathic calcinosis of the scrotum (Shapiro, 1970) is usually multiple, asymtomatic nodules of the scrotal skin which begins m childhood or early adult life, increase in the size and numbers, and sometimes breakdown to discharge chalky contents. Clinically they are most often misdiagnosed as cysts. The forty eight years old male patient visited our hospital on Oct. 14, 1980, because of multiple asymtomatic scrotal masses which are pin head to walnut sized. There is no family history of calcification, scrotal or otherwise. Histology shows naked amorphous masses in the dermis without any evidence of residual cysts, and is acicular clefts in the masses. Most of the tumors were surgically removed in 5 sessions.
Adult ; Calcinosis* ; Dermis ; Head ; Humans ; Juglans ; Male ; Scrotum* ; Skin

No abstract available.
Retroperitoneal Fibrosis*

Lichen sclerosus et atrophicus (LSA) is an uncommon condition of the skin with small white macular or atrophic plaques which predominantly affects the genital regions of middle aged and elderly women. We present an atypical case of LSA on a 58 year old woman. The patient had a brownish-black colored patch of 2.5 * 7.0 cm in size on the right clavicular area of one year's duration. The histopatholgy of the lesion disclosed classical findings of LSA. A marked incontinence of pigment is noted in the upper dermis which accounts for the clinical picture of the lesion. She was treated with topical hydrocortisone cream resulting in a marked diminution of pigmentation.
Aged ; Dermis ; Female ; Humans ; Hydrocortisone ; Lichen Sclerosus et Atrophicus* ; Lichens* ; Middle Aged ; Pigmentation ; Skin

Gold preparation had been used frequently in the past in the treatment of rheumatoid arthritis, tuberculosis and lupus erythematosua, etc. It is still used. when other more potent remedies, such as steroid, failed. We report a case of drug eruption following the use of gold preparation. A 38 year-old female was referred to our department from orthopedic surgery because of generalized, multiple, pin head sized, violaceous and flat topped papules of 1 x 2 mm in size and mucosal erosions and ulcers following gold therapy for rheumatoid arthritis. She had received 5 intramuscular injections of gold preparation (Myochrysine'), 220mg in total amounts. Our clinical impression was lichen planus like drug eruption, but histopathological picture disclosed nonapecific dermatitis. The eruption had disappeared gradually following oral administration of antihistaminics and prednisolone and daily starch tub baths.
Administration, Oral ; Adult ; Arthritis, Rheumatoid ; Baths ; Dermatitis ; Drug Eruptions* ; Female ; Head ; Humans ; Injections, Intramuscular ; Lichen Planus ; Orthopedics ; Prednisolone ; Starch ; Tuberculosis ; Ulcer

Magnetic resonance (MR) images of 14 consecutive patients with pathologically proven primary intracranial lymphoma were reviewed. All patients had a brain MR imaging before any treatment and were immunologically competent. MR images were acquired using 2.07 (n= 6) or 0.57 (n= 8) machine. The MR images were reviewed regarding the location, multiplicity, size, signal intensity, margin, shape, and the extent of surrounding edema of the lesion. Seven patients had multiple lesions, 2 to 4 in number. A total of 26 lesions was found; 25 were parenchymal lesions and one was dural lesion. The location of tumor was either central (r= 11) or peripheral (n= 14). The size of tumor was variable ranging from 0.6cm to 6.0cm in its maximal diameter. The tumors were isointense (n= 19) or hypointense (n= 7) relative to gray matter on T1-weighted images, isointense (n= 24) or hyperintense (n=2) on proton-density weighted images, and isointense (n= 21) or hyperintense (n= 5) on 78-weighted images. On gadolinium-enhanced T1-weighted images of 13 patients strong enhancement was seen in 22 of 23 lesions. Nineteen lesions showed smooth, well-defined margin, whereas remaining 7 lesions showed irregular, ill-defined margin. The shape of the tumor was diverse; round of ovoid (n= 15), lobulated (n= 9), or short linear (n= 2). These results suggest that one should consider the diagnosis of CNS lymphoma in cases with single or multiple masses that abut CSF space and show iso-or similar intensity to gray matter with strong enhancement on MR images.
Brain ; Diagnosis ; Edema ; Gray Matter ; Humans ; Lymphoma* ; Magnetic Resonance Imaging*

Three cases of chronic subdural hematoma superimposed on posttraumatic subdural hygroma are presented, with discussion of the development of the chronic subdural hematoma particularly. In all of these three cases the chronic subdural hematoma had occurred consequently to the posttraumatic subdural hygroma, but these diagnoses were done in variable periods of 20 days to 60 days. Therefore, it is suggested that the posttraumatic subdural hygroma have, at least, some relation to the genesis of the chronic subdural hematoma.
Diagnosis ; Hematoma, Subdural, Chronic* ; Subdural Effusion*