OBJECTIVE: The aim of the study is to evaluate the changes of the respiratory patterns associated with swallowing in the brain-injured patients. METHOD: Twenty brain-injured patients(6 bulbar lesions, 14 pseudobulbar lesions) and fifteen normal subjects were selected for this study. Each subject swallowed 5cc of water for ten times in a upright sitting position and a submental electromyography recording and respirography by pneumobelt on mid-abdomen were recorded simultaneously. RESULTS: 1) Most swallows occured during the late expiratory phase in both brain-injured patients and controls. 2) In brain-injured patients, the incidence of swallowing during inspiration was significantly higher than the controls(p<0.05). 3) In brain-injured patients, the postdeglutitive inspiration was significantly higher than the controls(p<0.05). 4) In patients with a bulbar lesion, the postdeglutitive inspiration was significantly higher than patients with a pseudobulbar lesion(p<0.01). 5) Postdeglutitive swallowing relatively correlates with the abnormalities in clinical findings and Video Fluoroscopic Swallowing Study(VFSS) findings. CONCLUSION: The respiratory patterns associated with the swallowing in brain-injured patients were different from that of the normal adults and the postdeglutitive inspiration could be the most valuable predictor of the aspiration.
Adult ; Deglutition* ; Electromyography ; Humans ; Incidence ; Swallows ; Water

Color developers(CD) have been noted to produce lichen planus like eruption as well as eczematous contact dermatitis. The chemicals involved are derivatives of paraphenylenediamine or aniline, i. e., Kodak CD 2, Kodak CD 3, Agfa TSS. We report a 28-year-old male who showed a feature of lichenoid contact dermatitis after exposure to color developer. Patch test revealed positive reactions to CD2, CD3 and CD4. Skin biopsy from a patch site showed lichen planus-like tissue reaction.
Adult ; Biopsy ; Dermatitis ; Dermatitis, Contact* ; Humans ; Lichen Planus ; Lichens ; Male ; Patch Tests ; Skin

In order to observe the arrhythmia which occured in early convalescent phase of acute myocardial infarction, a 24 hour ambulartory ECG monitiring was performed in 15 patients who is admitted at dept of Int Medicine, Ewha Womans University hospital from Aug. 1985 to Sept. 1986. during 7.5+/-3.4 days after admission. In all cases one or more of the following arrhythmias were observed;atrial premature beat, ventricular premature beat(VPB), transient paroxysmal ventricular thchycardia, atrial fibrillation, sinus arrest and junctional beat. Of 15 cases, 11(77.3%) had VPB's:Simple VPB's in 4 cases(26.7%) and complex VPB's(6.52+/-2.52)(P<0.05). But there were no difference of premature and abberancy index between complex VPB's and simple VPB's(P>0.1). In addition, we compaired the arrhythmias in CCU with those of early convalescent phase of acute myocardial infarction. But there was no correlation between them.
Arrhythmias, Cardiac* ; Atrial Fibrillation ; Cardiac Complexes, Premature ; Electrocardiography* ; Female ; Humans ; Myocardial Infarction*

Trauma to temporal bone is common in head injury. The causes of temporal bone trauma are traffic accident, falling down injury, assault and gunshot etc. The main symptoms and signs of temporal bone trauma are facial nerve paralysis, hearing loss, vertigo and cerebrospinal fluid leakage. To avoid or minimize the complication, the physicians have to perform precise diagnosis. The tools of diagnosis include the history and physical examination, radiologic examination, audiologic examination, vestibular function test and electrodiagnostic methods for facial nerve. The physicians have to decide the early proper intervention, for example surgery or medication, for the patients suffered from acute facial palsy, dizziness and cerebrospinal fluid leakage. In this study, the authors have reviewed the pathophysiology, classification, symptom, diagnosis and treatment of the temporal bone trauma.
Accidents, Traffic ; Cerebrospinal Fluid ; Classification ; Craniocerebral Trauma ; Diagnosis* ; Dizziness ; Facial Nerve ; Facial Paralysis ; Hearing Loss ; Humans ; Paralysis ; Physical Examination ; Temporal Bone* ; Vertigo ; Vestibular Function Tests

Amyloidosis is a disease complex associated with deposition of insoluble filbrillar protein in various tissues of the body. Cutaneous lesions are present in up to 40 % of patients with primary and myeloma associated systemic amyloidosis. We present a case of systemic amyloidosis associated with multiple myleoma occuring in 54-year-old male who had waxy papules with petechiae on nasola bial fold, postauricular area, and cheek. The diagnosis was confirmed by Congo red stain, electron microscope, immunelectrophoresis, Bence-Jones proteinuria, immunoperoxidase stain, and bone marow biopsy.
Amyloidosis* ; Biopsy ; Cheek ; Congo Red ; Diagnosis ; Humans ; Male ; Middle Aged ; Multiple Myeloma* ; Proteinuria ; Purpura

There are many different approaches to ultrasound-guided supraclavicular brachial plexus block (US-SCBPB), and each has a different success rate and complications. The most commonly performed US-SCBPB is the corner pocket approach in which the needle is advanced very close to the subclavian artery and pleura. Therefore, it may be associated with a risk of subclavian artery puncture or pneumothorax. We advanced the needle into the central part of the neural cluster after penetrating the sheath of the brachial plexus in US-SCBPB. We refer to this new method as the "central cluster approach." In this approach, the needle does not have to advance close to the subclavian artery or pleura. The aim of this study was to evaluate the clinical outcomes of the central cluster approach in US-SCBPB.
Brachial Plexus* ; Needles ; Pleura ; Pneumothorax ; Punctures ; Subclavian Artery ; Ultrasonography

Linear focal elastosis was first described by Burket et al. in 1989 in three elderly men with palpable striae-like yellow bands on their backs. Microscopic examination revealed many fine wavy bundles of elastic fibers separating the collagen in the mid to reticular dermis. The patients' ages range a from 17 to 87 years but this disease seems to be more common in younger age; men are more commonly affected. The cause of this disease has been suggested to be hereditary predisposition, unusual form of striae distensae or keloidal repair of striae distensae. We report linear focal elatosis with typical clinical and pathological features in a 15-year-old boy.
Adolescent ; Aged ; Collagen ; Dermis ; Elastic Tissue ; Humans ; Keloid ; Male ; Striae Distensae

Acoustic tumor is the most common tumor originating from cerebellopontine angle. Acoustic tumor is benign and main origin of this tumor is vestibular nerve. This tumor arises in Schwann cell (SC) and is encapsulated. Recently, the tumor is called vestibular schwannoma (VS). VS is classified to two type by epidemiology, sporadic form and neurofibromatosis type 2 (NF2). NF2 is autosomal dominant inherent disorder. This tumor is characterized bilateral VS, brain tumors such as meningioma and ependymoma, and spinal or cranial nerve schwannoma. Genetic studies suggested that NF2 is caused by abnormality or mutation of NF2 gene in chromosome 22q12. Both of them are known to develop the tumor by mutation of NF2 gene. Merlin is the cytoskeletal protein product of the NF2 tumor suppressor gene that mediates cell to cell contact information to regulate SC proliferation and survival. And merlin is highly homologous to ERM proteins. Merlin function is regulated by its conformation, adopting an inactive, growth permissive state following serine 518 (S518) phosphorylation. In NF2 patients, the precise mechanisms of developing the VS are unclear. But, the abnormalities of merlin are confirmed by many studies. And now, a lot of research about merlin function is progressing. In this study, the author would introduce about merlin (structure, function, molecular pathway, tumorigenesis and regulation) which leads to VS and molecular studies about merlin, and suggest the future direction of research.
Brain Neoplasms ; Cell Transformation, Neoplastic ; Cerebellopontine Angle ; Cranial Nerves ; Ependymoma ; Genes, Neurofibromatosis 2 ; Genes, Tumor Suppressor ; Humans ; Meningioma ; Neurilemmoma ; Neurofibromatosis 2 ; Neurofibromin 2 ; Neuroma, Acoustic ; Phosphorylation ; Proteins ; Serine ; Vestibular Nerve

No abstract available.

Venous angioma is a congenital disease of vascular malformation, which is a mass like lesion consisted of dilated medullary veins. It is generally a silent lesion since it is found in normal brain tissues and tends to have low blood flow and pressure. The venous angioma could be diagnosed with magnetic resonance imaging and angiography, but most of them are incidentally diagnosed, because it is usually asymptomatic. The patients with venous angioma have nonspecific symptoms, such as headache, nausea and vomiting, seizures, progressive neurological deficit and hemorrhage. In particular, the venous angioma in cerebellum could cause hearing disturbance, tinnitus and dizziness. We report a case of venous angioma in cerebellum that had been mistaken for peripheral vestibulopathy in a patient complaining of dizziness
Angiography ; Brain ; Central Nervous System Venous Angioma ; Cerebellum ; Dizziness ; Headache ; Hearing ; Hemangioma ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Nausea ; Seizures ; Tinnitus ; Vascular Malformations ; Veins ; Vomiting