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

This study was performed to evaluate the usefulness of blink reflex(BR) and brainstem auditory evoked potential(BAEP) tests for the diagnosis of intrinsic and extribsic brainstem lesions and to observe the generator of blink reflex. BR and BAEP were recorded in 26 patierlts with various brainstern lesions(20 rnen and 6 women), arnong which were intrin sic brainstem lesions(12 pons, 6 rnedulla, 4 multilevel) and extrinsic brainstem lesions(3 cer ebellar hemisphere, 1 cerebellar verrnis) confirrned by neurological findings and CT or MRI lbe results were compared with those of age and sex rnatched normal control. Abnorrnal BR findings were detected in 16 cases(61.5%). There were significantly delayed in ipsilateral and contralateral late reflexes, and R /D ratios compared with those of norrnal control. In the abnorrnalities of BR according to sites of the lesions, early reflexes were significantly delayed in pontine and medullary lesions(p<0.01), and late reflexes were significantly delayed in all brainstem lesions compared with those of norrnal control(p<0.01). Abnorrnal BAEP findings were detected in 12 cases(46.2%). The absolute latencies of wave II, III, IV and V were significantly delayed in brainstem lesions cornpared with those of norrnal control(p<0.01). In the abnorrnalities of BAEP according to sites of the lesions, the re were significantly delayed in absolute latencies of wave m and IV in pontine lesion and of wave V in cerebellar lesion, and delayed in absolute latencies and interpeak latencies of all vwaves in multilevel brainstem lesion compared with those of norrnal control(p<0.01 or p<0. 05). In the results of 19 cases(7 pons, 5 medulla, 3 multilevel, 4 cerebellar) tested in acute stage(2 days to 2 weeks after attack) to observe the generator of blink reflex, early reflexes were rnainly delayed in pontine lesion(71%) and late reflexes were delayed in medullary lesion(80%).
Blinking* ; Brain Stem* ; Diagnosis ; Evoked Potentials, Auditory, Brain Stem* ; Magnetic Resonance Imaging ; Pons ; Reflex

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

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*

OBJECTIVE Present study was aimed to verify the effect of granulocyte macrophage-colony stimulating factor (GM-CSF) in the preimplantation development of mouse embryos and the involvement of the mitogen activated protein kiase (MAPK) in the GM-CSF signaling. METHODS: Two-cell embryos were cultured for 96 h in the presence or absence of GM-CSF (0, 0.4, 2, 10 ng/ml) and PD98059, a MEK inhibitor (10 muM). Morphological development, cell number per blastocyst, and apoptotic nuclei, were eamined. MAPK activity of embryonic immunoprecipitate by MAPK (ERK1/2) antibody was measured by in vitro phosphorylation of myelin basic protein. RESULTS: At post hCG 122 h the embryonic development among the experimental groups was significantly different (p=0.018). The rate of blastocyst development and cell number per embryo were the highest in 2 ng/ml GM-CSF treatment group. The percent of apoptotic cells of the GM-CSF-treated embryos was the lowest among the group. in blastocysts, GM-CSF treatment transiently increased MAPK activity. PD098059 attenuated the effect of GM-CSF on the morphological development, increase in cell number per blastocyst, down regulation of apoptosis, and upregulation of MAPK activity, suggesting that activation of MAPK cascade possibly mediated the embryotropic effect of GM-CSF. CONCLUSION: This result suggested that GM-CSF potentiated the development of preimplantation mouse embryos by activation of MAPK.
Animals ; Apoptosis ; Blastocyst ; Cell Count ; Down-Regulation ; Embryonic Development ; Embryonic Structures* ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocytes* ; Mice* ; Myelin Basic Protein ; Phosphorylation ; Pregnancy ; Up-Regulation

BACKGROUND: The thalamus is a subcortical gray-matter composed of several groups of nuclei. Though there are some characteristic clinical findings in thalamic stroke syndrome, it is not easy to identify their own function in each nuclei. We demonstrated this study to figure out the relationships between anatomic nucleus, sensory symptoms, and electrophysiologic findings in thalamic stroke. METHODS: Sixteen thalamic stroke patients were studied. Fifteen cases showed thalamic lacunar infarction by magnetic resonance imaging and one case showed thalamic hemorrhage by computed tomography. We compared their sensory symptoms and signs, somatosensory evoked potentials(SSEP), the size of lesions, and the location of lesions on imaging studies. RESULTS: There were 12 cases of a lesion on ventroposterolateral(VPL) nucleus(Group I) and 4 cases of a lesion on the other nuclei(Group II). All 8 cases which had a sensory deficit in Group I, and 2 cases - one with sensory deficit and the other without in Group II, showed abnormal SSEP findings. There were 9 cases in Group I and 3 cases in Group II with thalamic pain and there was no relationship between SSEP and thalamic pain. Five were pure sensory strokes in 6 patients with a small lesion(less than 0.5 cm), and pure sensory strokes were only 3 in 10 patients with relatively a large lesion (between 0.5 and 1.5 cm). CONCLUSION: There was significant relationship between sensory deficit and SSEP. SSEP can be used as a objective method in estimating the sensory deficit of thalamic stroke. We could ascertain the fact that other nuclei as well as VPL nucleus were associated with the development of pain in thalamic stroke, and there was significant relationship between the size of lesion and the clinical feature of stroke.
Evoked Potentials, Somatosensory* ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Stroke* ; Stroke, Lacunar ; Thalamus