We report a diabetic woman who developed paroxysmal hemichorea during an episode of non-ketotic hyper-glycemia. A MRI showed a high signal intensity on T1-weighted images and a low signal intensity on T2-weighted images in the contralateral putamen. SPECT on the 30th day after the onset revealed an increased blood flow in the contralateral striatum. Although these abnormalities in the left putamen are considered to be the cause of her involuntary movement, the exact pathophysiological mechanisms of these abnormalities are not yet clear and further investigations are needed.
Dyskinesias ; Female ; Humans ; Hyperglycemia* ; Magnetic Resonance Imaging ; Putamen ; Tomography, Emission-Computed, Single-Photon

The precise nature of the underlying disturbance responsible for TTP is unknown, but recent work suggests that abnormalities of sodium channels play an important role. There are only a few electrophysiologic studies reported during an attack of paralysis of TTP and the electrophysiologic studies during paralytic attack in our two patients showed the following results, different only in severity. 1.Nerve conduction studies were normal in all the tested sensory nerves. Motor nerves showed normal conduction velocities, but low amplitudes of CMAPs except for median nerve. 2.Needle EMG showed markedly decreased insertional activities, and lowamplitude, short-duration, and polyphasic MUAPS, The recruitment patterns on maximal efforts were markedly reduced. There were no spontaneous activities. 3.Repetitive nerve stimulation of ulnar nerve showed significant incremental responses on digiti quinti muscle, marked during the early phase of stimulation. The degree of incremental responses was proportional to the frequency of stimulation.
Humans ; Median Nerve ; Paralysis* ; Sodium Channels ; Ulnar Nerve

PURPOSE: To report the technique of modified Thompson quadricepsplasty with postoperative treatment using string tie and the results for stiff knees. MATERIALS AND METHODS: From June 1987 to June 1997, we evaluated the results of 20 knees of 19 patients who were managed with modified Thompson quadricepsplasty for the stiff knee and were followed up for an average of 29 months (range, 18 to 49 months). We performed modified Thompson quadricepsplasty, which included arthrolysis, anterolateral or lateral approach, transverse incision on tensor fascia lata, release of middle and distal third of quadriceps muslce. If the knee flexion was less than 130 degree, Z-plasty on distal tendinous portion of rectus femoris was performed. Postoperatively, the knees were flexed with string tie for 3 hours. And then the knees were extended for 3 hours. This periodic passive exercise was started by the 21st day after the surgery. RESULTS: The average gain in flexion from preoperative to postoperative was 74.7 degree+/-25.1 degree. At the latest follow-up, the average loss of range of motion from that obtained in the operating room was 5.3 degree+/-7.2 degree. According to Judet's assessment of results, there were 17 excellent and 3 good results. There was one wound infection but it resolved after wound care and intravenous antibiotics for 3 weeks. CONCLUSIONS: The modified Thompson quadricepsplasty and postoperative care with string tie provided good results for the stiff knee.
Anti-Bacterial Agents ; Fascia Lata ; Follow-Up Studies ; Humans ; Knee* ; Operating Rooms ; Postoperative Care ; Quadriceps Muscle ; Range of Motion, Articular ; Wound Infection ; Wounds and Injuries

The authors reported 100 cases of acute subdural hematomas confirmed by operation from Jan. 1972 to Sept. 1975. We discussed the relationship of the type of operation to mortality in acute subdural hematomas. The types of surgical operations were divided in 4 groups. The surgical mortality rate was 19% for frontotemporoparietal craniotomy, 29% for multiple burr holes technique, 42% for craniectomy and 48% for subtemporal decompression with burr holes and total over-all mortality was 36% in our cases. The authors reviewed the literatures described the surgical operative method and it's mortality and so we thought large frontotemporoparietal craniotomy is more valuable method for operation of the acute subdural hematomas.
Craniotomy ; Decompression ; Hematoma, Subdural, Acute* ; Mortality

Purpose: To predict the presence of tractional retinal detachment (TRD) in eyes with dense vitreous hemorrhage (VH) and proliferative diabetic retinopathy (PDR) by evaluating the status of posterior vitreous detachment (PVD) in fellow eyes using optical coherence tomography (OCT). Methods: A total of 44 eyes from 22 patients who underwent vitrectomy due to dense VH with PDR were enrolled. Using OCT, the PVD status in the fellow eye was divided into two groups (incomplete and complete PVD). The incomplete PVD group included eyes without PVD and eyes with partial PVD. B-scan ultrasonography was performed on eyes with dense VH to evaluate the presence of TRD. Both OCT and B-scan images were reviewed by four ophthalmologists (two novices and two experienced), and the interobserver agreement was evaluated. Results: There was a difference in the interobserver agreement regarding the presence of TRD in eyes with dense VH evaluated by B scan between novice and experienced ophthalmologists (novice, κ = 0.421 vs. experienced, κ = 0.814), although there was no difference between novice and experienced ophthalmologists in the interobserver agreement regarding the status of PVD in the fellow eye evaluated by OCT (novice, κ = 1.000 vs. experienced, κ = 1.000). All observed TRD during vitrectomy occurred in eyes with incomplete PVD in the fellow eye. Logistic regression analysis revealed a statistically significant relation between TRD and the age of the patient (odds ratio [OR], 0.874; p = 0.047), and between TRD and incomplete PVD in the fellow eye evaluated by OCT (OR, 13.904; p = 0.042). Conclusions Evaluation of the PVD status in the fellow eye using OCT may be a useful predictor for detecting the presence of TRD in eyes with dense VH and PDR.

BACKGROUND AND AIMS: This research was conducted in order to study the clinical usefulness and stability of the propofol used for sedation during upper gastrointestinal endoscopy. METHODS: The objective of this research was to study one hundred patients, who were chosen based upon their preference to be examined through diagnostic upper gastrointestinal endoscopy accompanied with propofol from July 1998 to August 1998, and who showed normality in the pulmonary function test and ECG. The elements observed were hemodynamic variations, injection dosage, injection time, recovery time and side effects. RESULTS: All patatints had no recollection of the procedure during gastrointestinal endoscopy. It was found that the older the patients were, the less amount of propofol sleep was indued. Systolic blood pressure, diastolic blood pressure and the mean arterial blood pressure were lowered noticeably after sleep, compared with those before the injection of propofol, while the heart rate hardly changed. CONCLUSIONS: Profopol is believed to be a useful sedative for upper gastrointestinal endoscopy. As blood pressre can be lowered however, a cautious attitude should be considered when injecting propofol in the elderly or in patients who have cardiovascular disease.
Aged ; Arterial Pressure ; Blood Pressure ; Cardiovascular Diseases ; Electrocardiography ; Endoscopy, Gastrointestinal* ; Heart Rate ; Hemodynamics ; Humans ; Propofol* ; Respiratory Function Tests

Technetium 99 M pertechnetate has become a valuable for the radioisotopic brain scan. This was introduced by Haper in 1963 and is now widely used in the medical field. The advantages are easy administration, high count rate with potential for high speed scanning, absence of beta radiation and decreasing time for test. We used Siemens Scintimat 2 Scanner with a 3x2 inch Na(T1) crystal and 151-hole collimator in our study. 10 mci Technetium 99 M was injected intravenously and obtained both lateral, anterior and posterior view in 80 cases of brain lesion from Mar. 75 to Sep. 76. The scans were classified as positive, negative and suspicious. The overall detection rate in 40 cases of brain tumors was 60%, especially high uptake in mengioma, malignant pituitary tumor, astrocytoma, metastatic brain tumor and acoustic neuroma. But in nontumors diseases of the brain including CVA, head injury and hydrocephalus the uptake rate was a little value.
Astrocytoma ; Beta Particles ; Brain Neoplasms ; Brain* ; Craniocerebral Trauma ; Hydrocephalus ; Neuroma, Acoustic ; Pituitary Neoplasms ; Sodium Pertechnetate Tc 99m ; Technetium

OBJECTIVE: In this experimental study, authors evaluated the effect of repeated graft of the fetal midbrain cells on rat model of hemiparkinsonism. MATERIALS AND METHODS: Following injection of the 6-hydroxydopamine into striatum, we examined the behavior (turning response to amphetamine and apomorphine) at 2, 4 and 8 weeks. Their turning behavior persisted until 8 weeks after lesion making. Only those with turning behavior of more than average 6.2turns/minute by amphetamine test were selected for transplantation. Three different methods of transplantation were assigned into three groups and compared with each other to evaluate their efficiencies in improving behavioral responses. In first method, the volume of the transplanted cells were equivalent to that of one fetal midbrain. The volume of the transplanted cells were twice as much as that of one fetal midbrain in a group with second method. The last group consisted of repeated transplantation. Here, we transplanted the same amount of fetal midbrain cells as the in group 2 with two divided doses in one month interval. RESULTS: The second and third group improved from amphetamine test significantly(p<0.05), whereas first group failed to show any significant improvement from same test. The results from second and third group were not significantly different from each other. CONCLUSION: This results suggest that transplantation of two volumes of the fetal midbrain is needed to improve the turning behavior of this model of parkinsonism. This volume can be tansplanted at once or it may be transplanted in two divided volumes with time interval, with similar effect.
Amphetamine ; Animals ; Mesencephalon ; Models, Animal* ; Oxidopamine* ; Parkinsonian Disorders ; Rats* ; Transplants*

PURPOSE: The purpose of this study is to identify nature of regenerated articular cartilage after microfracture surgery. MATERIALS AND METHODS: From Oct. 1997 to Nov. 1998, 40 knees were treated for osteoarthritis by arthroscopic microfracture technique. In the 18 knees, during the second arthroscopic procedure, biopsy specimens extending to the subchondral bone were taken and immunohistochemical staining was done to identify type of collagen. One patient was man and 17 patients were women. Average age of the patients were 58 years (range, 40-75 years). RESULTS: Type II collagen in articular cartilage appeared to be brown color with this staining. Degree of staining were +3 in 4 knees(22%), +2 in 2 knees(11%), +1 in 7 knees(39%) and trace in 5 knees(28%). CONCLUSION: Microfracture surgery restores the function of the joint by forming predominantly hyaline-like cartilage containing type II collagen. As analyzing amounts of type II collagen with an immunohistochemical staining in regenerated cartilage, we can presume the prognosis of regenerated cartilage tissue after microfracture surgery.
Biopsy ; Cartilage* ; Cartilage, Articular ; Collagen ; Collagen Type II* ; Female ; Humans ; Joints ; Knee ; Osteoarthritis ; Prognosis

BACKGROUND: There has been considerable progression in laboratory investigations of novel therapeutic approaches aimed at protecting the brain parenchyma in the setting of the acute ischemia. The zone of ischemia surrounding an area of infarction provides a target for neuroprotective agents. MK-801 is a well known non-competitive NMDA receptor antagonist and has a neuroprotective effect to ischemic penumbra zone. U-74389G is a compound of Lazaroid(21-Aminosteroid) and a free radical scavenger which has been investigated to a neuroprotective effect to ischemic penumbra zone. METHODS: The protective effects of single or combined pretreatment of U-74389G and MK-801 on the focal cerebral ischemia in the Sprague-Dawley rats were evaluated. The size of infarction after 2 hours occlusion-4 hours reperfusion of the left middle cerebral artery with modified Longa method was measured. The rats were given 3mg/Kg I.v. of MK-801 and U-74389G or 0.5ml of normal saline 30 minutes before middle cerebral artery occlusion. The size of infarction was described as the volume. RESULTS: U-74389G, MK-801, and combined U-74389G and MK-801 pretreatment reduced significantly the volume of infarction 55%, 64%, 24%, respectively compared with saline pretreatment (p<0.05) and the combined U-74389G and MK-801 pretreatment reduced significantly the volume of infarcted area compared with MK-801 or U-74389G pretreatment, 44%, 37%, respectively(p<0.05). There was no significant change of infarction volume between U-74389G and MK-801 pretreatment(p>0.05). CONCLUSIONS: These results show that single or combined pretreatment of U-74389G and MK-801 before 30 minutes of occlusion significantly reduced the volume of infarction compared with the control group in the focal cerebral occlusion-reperfusion of rats. And the combined pretreatment of U-74389G and MK-801 before 30 minutes of occlusion significantly reduced the volume of infarction compared with the single pretreatment of MK-801 or U-74389G in the focal cerebral occlusion- reperfusion of rats.
Animals ; Brain Infarction* ; Brain Ischemia ; Brain* ; Dizocilpine Maleate* ; Infarction ; Infarction, Middle Cerebral Artery ; Ischemia ; Middle Cerebral Artery ; Models, Animal* ; N-Methylaspartate ; Neuroprotective Agents ; Rats* ; Rats, Sprague-Dawley ; Reperfusion