Twenty-two cases of idiopathic myocardiopathy were observed during the period of 1962 to 1971 and follow up clinical study was made in 5 cases. The criteria of diagnosis was based mainly on exclusive diagnosis in etiology unknown marked cardiomegaly. 1) Male and female ratio of idiopathic myocardiopathy was 1.1:1 and age of onset were distributed from first decade to fifth decade with similar number of cases. 2) Cardinal symptoms were dyspnea, palpitation, chest pain and cough. Common physical findings were protodiastolic gallop (in 2 cases), moist rales (in 3 cases) and hepatomegaly(in 3 cases). 3) Laboratory findings were normal except elevated T.T.T. in one case. 4) Electrocardiogram were abnormal in all cases. There were 3 cases of left ventricular hypertrophy, 3 cases of non-specific ST-T changes and one case of first degree A-V block, intraventricular conduction defect, abnormal Q wave and low valtage, respectively. 5) After medical treatment, symptoms were improved in 4 cases but heart size was reduced in only one case and E.C.G. abnormalities were unchanged in all cases.
Age of Onset ; Cardiomegaly ; Cardiomyopathies* ; Chest Pain ; Cough ; Diagnosis ; Dyspnea ; Electrocardiography ; Female ; Follow-Up Studies ; Heart ; Humans ; Hypertrophy, Left Ventricular ; Male ; Respiratory Sounds

We report two cass of HIV infection associated with condyeloma acuminatum. Two patients were healthy men who showed multiple pinkish verruc ous papules on the perianal area. Anti-HIV antibodies were detected in the patients' secatory particle agglutination test and confirmed by Western blot assay.
Agglutination Tests ; Antibodies ; Blotting, Western ; HIV Infections ; HIV* ; Humans* ; Male

BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder that often resolves spontaneously. It was long believed that the condition was caused by inorganic particles in the cupula of the posterior semicircular canal. Management of this condition includes medication, surgery, physical exercise and more recently particle repositioning maneuvers. Among the various therapies, exercise therapy (ET) reported by Brandt-Daroff was based on the theory of cupulolithiasis and is designed to treat BPPV through dispersion of the debris from the cupula. METHODS: Fifty four patients with BPPV were treated with ET to determine the effectiveness. Fifteen additional patients with BPPV were treated with only medication and served as a control group. RESULT: Forty eight of 54 cases (88.9%) treated with ET showed improvement after 2 weeks. With medication alone, 8 of the 15 cases (53.4%) showed improvement after 2 weeks. CONCLUSIONS: The most important benefit of this maneuver seemed to be more expedient recovery than that with medication alone.
Exercise ; Exercise Therapy* ; Humans ; Semicircular Canals ; Vertigo*

BACKGROUND: Generalized immune activation occurs early in the course of many infectious disease. Laboratory investigations have shown that immune activation can be quantified by the measurement of soluble immune activation products in serum. Soluble CD25, CD8, and CD4 are major immune activation products. Soluble CD8 and CD4 are indices of CD8+ T cell and CD4+T cell activity, respectively. OBJECTIVE: We estimated the concentrations of these molecules in patients with leprosy. METHODS: The study population consisted of 31 patients with tuberculoid leprosy and 71 patients with lepromatous leprosy(32 cases of M. leprae negative patients and 39 cases of M. leprae positive patients). Serum samples and clinical and laboratory data were collected form each patient and control. The levels of serum soluble CD25, CD8, and CD4 were measured by sandwich enzyme immunoassay. RESULTS: The levels of serum soluble CD25 were significantly raised in leprosy patients as compared to control and did not vary signficantly between tuberculoid and lepromatous leprosy. The soluble CD8 levels in the serum of patients with leprosy did not differ from the levels of the control. The levels of serum soluble CD4 were significantly decreased in the patients with lepromatous leprosy, but not in the patients with tuberculoid leprosy. However, there was no significant correlation between CD25, CD8, and cD4 and bacterial indices in patients with lepromatous leprosy. CONCLUSIONs: There data suggest that non-specific immune activation occurs the spectrum in leprosy, while CD4+ T cell activity is significantly decreased in patients with lepromatous leprosy.
Communicable Diseases ; Humans ; Immunoenzyme Techniques ; Leprosy* ; Leprosy, Lepromatous ; Leprosy, Tuberculoid

Measuring motor nerve conduction (MNC) in the hypoglossal nerve is an uncommon electrophysiologic study. However, this measurement can be easily performed with a wooden tongue depressor, to which a bipolar bar electrode is fixed by skin tape. We measured the MNC of the hypoglossal nerve in a patient with idiopathic unilateral weakness of the tongue. In the initial MNCs of the hypoglossal nerves, the CMAP amplitude was decreased and the latency was delayed in the lesion site when compared to the healthy site. In the follow-up study after 3 months, similar findings were found. Comparing the initial study with the follow-up one, however, the CMAP amplitude was increased and the latency was shortened in the lesion site. In conclusion, the MNC in the hypoglossal nerve is easy to measure and is useful for the evaluation of the hypoglossal nerve damage.
Electrodes ; Follow-Up Studies ; Humans ; Hypoglossal Nerve* ; Neural Conduction ; Surgical Tape ; Tongue*

BACKGROUND: This study aimed to evaluate the abilities of transcranial magnetic stimulations(TMS) and electrical stimulations(ES) in predicting clinical recovery in patients with Bell's palsy and to contribute to the understanding of the relations observed between the clinical and electrophysiological time courses of the disease. METHOD: We serially studied 22 patients(9 males, mean age 42) with Bell's palsy. Facial nerve function was graded according to the House-Brackmann grading system. RESULTS: A side-to-side comparison(amplitude ratio) of the amplitude of evoked responses between the initial and follow up studies showed a significant change except for the TMS on the stylomastoid foramen. With the TMS over the parieto-occipital area, the absence of a compound muscle action potential(CMAP) was observed in 19 patients during the early course of the disease. The reappearance(n=14) of evoked muscle potentials after an initial absence was observed in 14 patients with satisfactory recoveries at the last follow-up study. The amplitude ratio of ES and TMS during the early course of the disease correlated with the clinical outcome. CONCLUSIONS: Our findings indicate that TMS and ES can provide an early prediction for the outcome of the palsy. The presence of CMAP at the acute phase or the reappearance of CMAP after an initial absence with TMS suggests a rather good prognosis. Both TMS and ES were found to be useful methods for the assessment of facial palsy and as early predictors for the outcome in patients with Bell's palsy. Serial neurophysiologic studies were also important for evaluation of the prognosis of facial palsy.
Bell Palsy* ; Electric Stimulation ; Facial Nerve ; Facial Paralysis ; Follow-Up Studies ; Humans ; Male ; Paralysis ; Prognosis* ; Transcranial Magnetic Stimulation

BACKGROUND: The prognostic value of motor evoked potentials(MEP) by transcranial magnetic timulations(TMS) in acute stroke has not been well established. To determine the value of MEP as predictors of motor and functional recovery we examined correlations of neurophysiological measurements of central motor conduction time(CMCT) and functional assessments. METHOD: A longitudinal study was performed on 32 first-ever acute ischemic stroke patients. The cortical and cervical motor evoked potentials(MEPs) along with the degree of extremity weakness, the NIH stroke scale, and the Barthel index were performed in the period immediately following stroke and after 3-4 months of the onset. RESULTS: Five groups of patients were divided on the basis of MEP responses following the cortical stimulation; initial normal response following the normal one (group I; 11), initial delayed response following a normal or still delayed one (group II; 3/group III; 0), and an initial absent response with the reappearance of CMCT or still absent one (group IV; 8/group V; 10). Patients in group I,II and IV had consistently lower scores in motor weakness degree and NIH scale and higher scores in the Barthel index both at initial and follow-up studies, and achieved significantly better functional recovery(p<0.01). CONCLUSIONS: Discordant results of MEP in predicting the prognosis of stroke may result from the disregard of group IV, which had previously been considered as a poor outcome group solely because no cortical MEP responses were recorded at the initial study. As the MEP alone during the acute stage could not differentiate group IV from group V which had a persistent absence of cortical MEP responses, the evaluation of the neurological deficit at the same time is needed for better prediction of prognosis.
Evoked Potentials ; Evoked Potentials, Motor* ; Extremities ; Follow-Up Studies ; Humans ; Longitudinal Studies* ; Prognosis ; Stroke*

Authors observed the antihypertensive effect of debrisoquin sulfate in 35 cases of essential hypertension and following results were obtained. 1) Results of short term control of blood pressure with debrisquin in 35 hypertensive patients revealed good control in 74.3%, fair in 14.3%, poor in 5.7% and failure in 5.7% of cases. Significant reduction of blood pressure was achieved in 7 of 9 cases of hypertension with addition of hydrochlorthiazide to debrisoquin. 2) During long term therapy with debrisoquin (duration of average 3.9 months), good control cases were slightly reduced(good in 58.6%, fair in 24.1%, poor in 6.9%, failure in 10.3%). But average effective dose of debriioquin was not increased significantly. 3) Antihypertensive effect of debrisoquin was slightly reduced in the cases of severe hypertension, hypertension of over 10 years duration and complication of cerebrovascular accident. 4) The side effects during treatment with debrisoquin were dizziness in 31.4%, headache in 11.4%, dry mouth, blurred vision, general weakness, insomnia in 8.6% respectively. There were no side effects in 48.6% of cases.
Blood Pressure ; Debrisoquin* ; Dizziness ; Headache ; Humans ; Hypertension* ; Mouth ; Sleep Initiation and Maintenance Disorders ; Stroke

Postoperative hepaotoxicity may develope as a result of many causes. These poasble cau may include direct injury to the liver cella due to anesthetic drugs such as halothane, chronic liver disease, viral hepatitis, sepsis, severe burns, pregnancy, drug administration and transfusion. We had seven cases of acute hepatitis following surgery for the past 6 months. CASE 1: A 26-year-old male had an operation for maxillar fracture under isoflurane anesthesia. The preoperative liver enzyme (SGOT, SGPT) were elevated but other tests were within normal range. He developed high fever, marked elevation of SGOT, SGPT, upper abdominal pain and nausea on the 7th postoperative day. He died of acute respiratory and renal failure on the 23 rd postoperative day. CASE 2: A 55-year-old woman had an operation for cervical spondylosis under halothane anesthesia. She developed high fever, headache and leukocytosis on the 12th postoperative day. Liver function tests showed marked elevation of SGOT, SGPT, bilirubin and hypoalbuminemia on the 17th day. She died of acute respiratory failure on the 30th postoperative day. CASE 3: A 53-year-old woman had an operation for epidermal cyst under halothane anesthesia. On the 12th postoperative day she developed high fever, skin rash, marked elevation of SGOT, SGPT and leukopenia. She recovered gradually from hepatitis and went home in good health on the 30th postoperative day. CASE 4: A 68-year-old man had an operation for oral cancer under enflurane anesthesia. On the 16th postoperative day, liver function tests showed elevation of SGOT, SGPT and leukopenia, He gradually recovered on the 19th postoperative day. CASE 5: A 64-year-old woman had an operation for MCA aneurysm under enflurane anesthesia. He developed hypotension on the 20th postoperative day and respiratory difficult and marked elevation of SGOT, SGPT, BUN, creatinine, and generalized edema on the 22nd day. She recovered gradually and went home in good health on the 45th postoperative day. CASE 6: A 23-year-old woman had an operation for mandible fracture under enflurane anesthesia. The preoperative liver function tests showed a mild elevation of SGOT, SGPT, ALP. She recovered gradually and went home in good health on the 30th postoperative day. CASE 7: A 19-year-old woman had an operation for mandible fracture under halothane anesthesia. On the 30th postoperative day, she developed jaundice and marked elevation of SGOT, SGPT. She recovered gradually and went home in good health on the 55th postoperative day.
Abdominal Pain ; Adult ; Aged ; Alanine Transaminase ; Anesthesia ; Anesthesia, General* ; Anesthetics ; Aneurysm ; Aspartate Aminotransferases ; Bilirubin ; Burns ; Creatinine ; Edema ; Enflurane ; Epidermal Cyst ; Exanthema ; Female ; Fever ; Halothane ; Headache ; Hepatitis ; Humans ; Hypoalbuminemia ; Hypotension ; Isoflurane ; Jaundice ; Leukocytosis ; Leukopenia ; Liver ; Liver Diseases ; Liver Function Tests ; Male ; Mandible ; Middle Aged ; Mouth Neoplasms ; Nausea ; Pregnancy ; Reference Values ; Renal Insufficiency ; Respiratory Insufficiency ; Sepsis ; Spondylosis ; Young Adult

BACKGROUND: Cyclosporin A (CsA), a potent immunosuppressant, has been reported to be effective in the treatment of severe atopic dermatitis (AD). OBJECTIVE: The aim of this study was to evaluate the efficacy and side-effects of CsA in Korean patients with severe AD. MATERIALS AND METHODS: 16 patients with recalcitrant AD took CsA for at least 6 weeks. Among them, 11 patients were followed up for more than 16 weeks. Initial dose was 5mg/kg/day (maximum 300 mg/day) and the dose was reduced according to their therapeutic responses. SCORAD (Scoring AD) was used to evaluate clinical efficacy of CsA. During the 1st month of therapy, the therapeutic efficacy and side-effects were evaluated every 2weeks and after 1 month, every month. We checked blood pressure and laboratory abnormalities including liver function test, blood urea nitrogen (BUN), creatinine (Cr) and urinalysis at each visit in addition to observing clinical adverse effects. RESULTS: Significant reduction of SCORAD was noted in 15 patients after 6 weeks of CsA therapy. Only one patient stopped CsA therapy because of the elevation of blood pressure. Three patients showed albuminuria, which disappeared after CsA dose reduction. CONCLUSION: CsA can be used effectively and safely in severe Korean AD patients. Albuminuria seems to be a peculiar side-effect in Korean patients.
Albuminuria ; Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Cyclosporine* ; Dermatitis, Atopic* ; Humans ; Liver Function Tests ; Urinalysis