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

No abstract available.
Animals ; Dopamine* ; Models, Animal* ; Parkinsonian Disorders* ; Rats* ; Receptors, Dopamine*

Fibrous hamartoma of infancy is an uncommon, benign fibroproliferative tumor arising from sub. cutaneous tissue during the First 2 years of life. We report a case of fibrous hamartoma of infancy in the scrotum. The clinical characteristics and management of this neoplasm are discussed with references.
Hamartoma* ; Scrotum*

Cytomegalovirus(CMV) rarely causes cutaneous rnanifestations. But since the recent development of organ transplants and the increased prevalence of AIDS, various skin manifestations of CMV infection such as varicelliform eruptions, perineal hulcerations, papular, purpurc and vesiculobllous lesions are increasing in immunocompromised subjects, Perineal ulceration is a typical cytomegalovirus-induced skin manifestation which exhibits similar morphology to herpes simplex viral infection. We describe a case of CMV-induced ulcer on labia majora in an AIDS patient, proven by histologic findings and immunohistochemistry. The patient was treated with ganciclovir and the lesion improved two months later.
Cytomegalovirus* ; Ganciclovir ; Herpes Simplex ; Humans ; Immunohistochemistry ; Prevalence ; Skin Manifestations ; Transplants ; Ulcer*

Although a vascular tumor of the spinal cord is a fairly common lesion, and is often asymptomatic, it was recently found more frequently by contrast myelography and selective spinal angiography. The first report on an angioma of the spinal cord was made by Hebold in 1885. They may be classified as malformation composed of masses of tortuous interlacing vessels. A benign vascular tumor of the spinal cord may occur at any level and within the structures of the spinal canal. The cord involved directly by portions of the varix, foci of infarction of the involved cord may be thrombosis of the vessels of the angioma. Vascular tumors of the cord are difficult to treatment. An attempt can be made to reduce the size of the angioma by ligation or resection, but it is imperative that the blood supply to the spinal cord or nerve roots should not be injured. Roentgen therapy may be of value. We have experienced in 3 patients with vascular tumor involving the spinal epidural space. They had paraparesis or paraplegia with sensory level and urinary difficulity. Roentgenograms show perpendicular striations in the vertebral body owing to coarse trabeculations surrounding the dilated vascular spaces. Myelogram shows subarachnoid blockade in the epidural space by a tumor mass. Total laminectomy was performed, and the vascular tumor mass was removed, thereafter the neurological signs were some improved.
Angiography ; Epidural Space ; Hemangioma ; Humans ; Infarction ; Laminectomy ; Ligation ; Myelography ; Paraparesis ; Paraplegia ; Spinal Canal ; Spinal Cord ; Spine* ; Thrombosis ; Varicose Veins