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

A clinical study was done on 29 cases of spontaneous pontine hemorrhage which were confirmed by brain CT scan at Keimyung university Dongsan hospital from Jan. 1981 to Feb. 1986. The results are summarized as follows. 1. The incidence of pontine hemorrhage was 7.4% of all spontaneous intracranial parenchymal hemorrhage. 2. The most prevalent age group were 40th and 50th decades and male to female ratio was 2.2:1. 3. The most common precipitating factor was hypertension and most of pontine hemorrhage occurred during daily routine or increased activities. 4. Symptoms on onset were headache, altered consciousness, vomiting, dizziness, motor weakness, dysarthria, sensory disturbance and generalized convulsion, in order of frequency. 5. Cardinal neurologic signs on admission were loss of consciousness, ocular signs e.g. Pinpoint or miotic pupil absent horizontal doll's eye movement ocular bobbing skew deviation MLF syndrome, motor weakness e.g. quadriparesis hemiparesis decerebrate rigidity, positive Babinski sign. 6. Mean size of hematoma on CT was 6.8cc and 44% was under 5cc. Hematoma of 4th ventricle was seen in 36% of pontine hemorrhage. 7. 25 cases of pontine hemorrhage were divided into 3 groups according to the location of hematoma on CT-basilar (2 cases), tegmental (15 cases), diffuse (8 cases). 8. All 29 cases of pontine hemorrhage were treated medically, 21% were improved, and 79% hopeless discharge or death. 9. Mild disturbance of consciousness on admission, small size (under 5cc) of hematoma and absence of hematoma in the 4th ventricle seem to be good prognostic indicators.
Brain ; Consciousness ; Decerebrate State ; Dizziness ; Dysarthria ; Eye Movements ; Female ; Headache ; Hematoma ; Hemorrhage* ; Humans ; Hypertension ; Incidence ; Male ; Neurologic Manifestations ; Ocular Motility Disorders ; Paresis ; Precipitating Factors ; Pupil ; Quadriplegia ; Reflex, Babinski ; Seizures ; Tomography, X-Ray Computed ; Unconsciousness ; Vomiting

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*

We studied 54 normal volunteers and 30 patients with Bell's palsy by magnetically and electrically evoked direct stimulations of facial nerve. A magnetic coil was placed tangentially to the parieto-occipital area and the stylomastoid foramen. Magnetic stimulation (MS) was less painful and able to excite deeper tying neural structures. Magnetically and electrically evoked direct stimulations of facial nerve showed the same characteristics in excitability and nerve conduction, but they could not be evaluated on the basis of the same normative data. We identified a locus of the impulse generation that might be closer to the exit of facial nerve from the brainstem. Compared with normal controls, MS-evoked CMAPS of patients with Bell's palsy had no responses, longer latencies, lower amplitudes, or disperses pattern. This study shown that MS at the stylomastoid foramen can not be used for the evaluation of the facial nerve conduction study in place of electrical stimulation(ES). As the transcranial MS can stimulate intracranial proximal portion of facial nerve directly and noninvasively, it can give additional information on the evaluation of facial nerve. Transcranial MS combined with ES may provide the means for assessing the entire facial nerve.
Bell Palsy ; Brain Stem ; Electric Stimulation* ; Facial Nerve* ; Healthy Volunteers ; Humans ; Neural Conduction

BACKGROUND: Many physiologic, pharmacologic and immunologic abnormalities were reported in atopic dermatitis but the cause and pathogenesis of the disease remain obscure. OBJECTIVE: This study was done to investigate the systemic immunologic abnormalities in atopic dermatitis. METHOD: To evaluate the cell mediated immunity, me quantified pei ipheral blood T lymphocytes and their subsets, using flow cytometery, and assessed plasma neopteiin levels by means of radioimmunoassay. To evaluate the abnormal humoral immunity, we assessed the serum IgE levels by means of enzyme-immunoassay. RESULTS: Mean proportions of peripheral blood T lymphocytes and, heir subsets in atopic Dermatitis patients were within normal limits. Hut the suppvessor/cytotoxic T lyrphocytes(T8) were significantly decreased in the group of se"ere atopic dermatitis compared with the group of mild atopic dermatitis(P<0.05). Plasma neopterin lervels in the group of atopic dermatitis were found to be significantly elevated as compared vith the control group(P<0.01), but no significant cifference was found between the mild and severe group of atcpic dermatitis(P>0.05). Mean serum IgE levels in the patients with atopic dermatitis were higher than reference value. But there was no significant difference between the mild and severe atopic dermatitis group. Serum IgE levels ivere negatiiely correlated with T8(r=-0.3774, P<0.05) and positively with T4/T8 ratio(r =0.5007, P<0.05). Conclusions : These data;uggest that the atopic der matitis has abr ormalities in cell mediated immunity as well as elevated IgE level.
Dermatitis, Atopic* ; Humans ; Immunity, Cellular ; Immunity, Humoral ; Immunoglobulin E ; Neopterin* ; Plasma* ; Radioimmunoassay ; Reference Values ; T-Lymphocyte Subsets* ; T-Lymphocytes