BACKGROUND: Cervical dystonia is a focal dystonia characterized by painful spasmodic contractions of the neck muscles, that result in an abnormal posture of the head. Usually the pathogenesis of the disorder is unknown. Secondary cervical dystonia caused by intracranial lesions, involving the basal ganglia, thalamus or brainstem, is very rare. This is the first report of a focal cervical dystonia following cerebellar hemorrhage in Korea. CASE: We describe a 77 year-old woman presented with vertigo and vomiting followed by mild ataxia in the right extremities and cervical dystonia. She had a 25-year history of right hemiparesis due to a stroke. On physical examination, her neck turned to the right and tilted to the left shoulder. Polygraphic study revealed continuous muscular contraction of the left sternocleidomastoid and trapezius muscles without EEG changes. A brain CT scan showed right cerebellar hemorrhage and low density lesions in the left putamen. CONCLUSION: We reported a rare case of cervical dystonia associated with cerebellar hemorrhage. Because she had an old left putaminal lesion, it is suggested that cervical dystonia seen in our patient may be caused by additional dysfunction of dentatorubrothalamocortical pathway to the pre-existing damage to the striatopallidothalamocortical pathway.
Aged ; Ataxia ; Basal Ganglia ; Brain ; Brain Stem ; Dystonic Disorders ; Electroencephalography ; Extremities ; Female ; Head ; Hemorrhage* ; Humans ; Korea ; Muscle Contraction ; Neck ; Neck Muscles ; Paresis ; Physical Examination ; Posture ; Putamen ; Shoulder ; Stroke ; Superficial Back Muscles ; Thalamus ; Tomography, X-Ray Computed ; Torticollis* ; Vertigo ; Vomiting

OBJECTIVES: The previous genome-wide association studies have revealed several candidate genes for restless legs syndrome (RLS). The PTPRD (protein tyrosine phosphatase receptor type delta) gene is one of the candidate genes for RLS. The occurrence of antipsychotic-related RLS could also be attributable to differences in genetic susceptibility. This study aimed to investigate whether PTPRD polymorphism is associated with antipsychotic-related RLS in schizophrenia. METHODS: We assessed symptoms of antipsychotic-induced RLS in 190 Korean schizophrenic patients and divided the subjects into two groups according to the International Restless Legs Syndrome Study Group diagnostic criteria : (i) subjects that met all of the criteria (n=44) and (ii) the remaining subjects who were not considered to be RLS patients (n=146). PTPRD rs462664 was genotyped by PCR in 190 individuals. The chi2-test was performed to compare differences between two groups. RESULTS: The frequencies of genotype (chi2=1.31, p=0.519) of the PTPRD rs462664 did not differ significantly between schizophrenic patients with and without RLS. The difference of allele frequencies (chi2=1.30, p=0.25) of the PTPRD rs462664 between the schizophrenic patients with and without RLS were not significant. CONCLUSION: These results suggest that PTPRD gene polymorphism does not play a major role in susceptibility to antipsychotic-related RLS in schizophrenia. This finding suggests that antipsychotic-induced RLS may have a different pathogenesis compared to primary RLS.
Gene Frequency ; Genetic Predisposition to Disease ; Genome-Wide Association Study ; Genotype ; Humans ; Polymerase Chain Reaction ; Restless Legs Syndrome* ; Schizophrenia* ; Tyrosine*

BACKGROUND: Hemoptysis is a common clinical symptom, responsible for 11% of admission to the hospital chest service. Correct diagnosis, accurate localization of the bleeding source and proper management are imperative to reduce the risk of massive hemoptysis. We performed the study to define the optimal time of fiberoptic bronchoscopy in 63 patients with hemoptysis admitted to Kyung Hee University Hospital between Aug 1989 and Aug1992. METHODS: Retrospective analysis of medical records concerning the cause, amount, duration of hemoptysis and the timing of fiberoptic bronchoscopy in 63(M:F=36:27) patients. RESULTS: 1) The main causes of hemoptysis were pulmonary tuberculosis(52.4%) bronchiectasis(27.0%) and lung cancer(11.1%). 2) The bleeding sites were localized in 26 Patients(41.3%). 3) The rates of localization of bleeding site were not related to the amount and duration of hemoptysis. 4) The rates of localization of bleeding site were 61.8%(21/34) during hemoptysis,18.2%(122) within 24hr after resolution of hemoptysis, 14.3%(1/7) thereafter. CONCLUSION: Early bronchoscopy, especially during hemoptysis may show higher rates of successful localization than delayed bronchoscopy.
Bronchoscopy* ; Diagnosis ; Hemoptysis* ; Hemorrhage* ; Humans ; Lung ; Medical Records ; Retrospective Studies ; Thorax

Scrub typhus (Tsutsugamushi disease)is an acute febrile systemic illness caused by Rickettsia tsutsugamushi that is transmitted to humans by the bite of larval-stage trombiculid mites (chiggers). The authors analyzed chest radiographic findings of scrub typhus in 160 patients in Ulsan area. One hundred and eight (67.5%) of160 patients showed abnormal findings which included lung lesions in 108 patients (67.5%), cardiomegaly in 37 patients (23.1%), lymphadenopathy in 25 patients (15.6%) and pleural effusion in 11 patients (6.9%). Among the lung lesions, interstitial patterns were seen in 107 patients (66.9%), mostly fine or medium reticulonodular, and air-space patterns in 14 patients(8.8%) and combined interstitial and air-space patterns in 13 patients (8.1%). Sixty-four patients(40%) had combined chest radiographic findings. The typical chest radiographic findings of scrub typhus would be helpful in evaluation of the causes of acute febrile illness that occur during late fall in the endemic area.
Cardiomegaly ; Humans ; Lung ; Lymphatic Diseases ; Orientia tsutsugamushi ; Pleural Effusion ; Radiography, Thoracic* ; Scrub Typhus* ; Thorax* ; Trombiculidae ; Ulsan*

There are several methods for the reconstruction of partial urethral defect, including split-thickness skin graft, full-thickness skin graft, and preputial flap and free flap. Despite partial success using these methods, most results are unsatisfactory due to frequent complications such as postoperative infection, fistula formation, hair growth and stricture. There have been several pioneering experiments in this field using autogenous vein graft and the results have been controversial. However, the fact that the endothelial lining is replaced by natural urethral epithlium is generally accepted as a positive effect of this method. This experiment was designed to identify the possibility of using vein graft for the reconstruction of partial urethral defect. Two different types of vein graft method were performed in a total of 20 New Zealand White rabbits with partial urethral defect. Firth, for the patch-graft group, a 1 x 1 cm rectangular vein graft was sutured at a defective area of the same size. Second, for the tubed-graft group, a vein graft segment 1 cm long was replaced at a segmental urethral defect of the same length. Histologic study was performed at three and eight weeks postoperatively in each group. The process of transitional ell epithelial replacement within the grafted vein was uniformly observed in both experimental groups at three weeks postoperatively. At eight weeks postoperatively, the epithelial replacement was almost complete and histologically undistinguishable. In the retrograde urethrogram performed after 8 weeks, the urinary flow in the patch-graft group was normal and showed no stricture, and two of five rabbits in the tubed-graft group showed partial stricture at the graft site. In conclusion, natural urethral epithelium was restored in grafted venous segments irrespective of the type of graft. Partial stricture was observed in 40% of the tubed-graft group while complete reconstruction was possible in the patch-graft group.
Constriction, Pathologic ; Epithelium ; Fistula ; Free Tissue Flaps ; Hair ; Rabbits ; Skin ; Transplants* ; Veins*

No abstract available.
Histiocytosis, Langerhans-Cell*

The zinc finger protein ZBTB48 is a telomere-associated factor and renamed it as telomeric zinc finger-associated protein (TZAP). It binds preferentially to long telomeres competing with TRF1 and TRF2. However, its mutation in cancers has not been studied. In the present study, we analyzed TZAP mutation in 134 non-small cell lung cancers (NSCLCs). And its big data analysis was performed using COSMIC and TCGA data analysis. TZAP mutation was not found in 134 NSCLCs. And big data also showed that TZAP mutation was extremely low (0.59%, 15/2548). TCGA survival analysis showed no prognostic value of TZAP expression in lung adenocarcinoma (p = 0.185) and squamous cell carcinoma (p = 0.817). When stratified patients sorting as 25:25 (quarter), it has a significance (p = 0.003). This result suggested that genetic change of TZAP did not appear to be a possible molecular marker in lung cancer.

OBJECTIVE: To investigate the characteristics of the motor cortex map for abductor pollicis brevis muscle (APB) using transcranial magnetic stimulation (TMS) in normal subjects. METHOD: Ten adults without neurological disorder were studied. A piece of cloth which marked at 1 cm interval was fixed on the head of the subject. The motor cortex mapping for APB was done with butterfly magnetic stimulator, and then with round magnetic stimulator. RESULTS: The average optimal scalp position for left APB was located on lateral 6.2 cm, anterior 0.1 cm from Cz and that for right APB was located on lateral 6.0 cm, anterior 0.1 cm from Cz when stimulated with butterfly magnetic stimulator. The differences between hemispheres were less than 1 cm in the location of optimal scalp position and less than 10% in excitatory threshold (ET) irrespective of magnetic stimulator. The ipsilateral motor evoked potential (MEP) was not evoked in all subjects. The ET when stimulated with butterfly magnetic stimulator was higher to that when stimulated with round magnetic stimulator. CONCLUSION: We conclude that TMS using butterfly and round magnetic stimulator is useful for the motor cortex mapping.
Adult ; Butterflies ; Evoked Potentials, Motor ; Head ; Humans ; Motor Cortex* ; Nervous System Diseases ; Scalp ; Transcranial Magnetic Stimulation*

The diagnosis and treatment of pineal tumor has captivated the interest of neurosurgeons for decades. Reports indicated that the majority of these tumors were malignant and thereby couild not be surgically removed and decompressed without high mortality and morbidity. And the pineal tumor especially germinoma is one of the mosdt radiosensitive intracranial tumors. Therefore a regime of radiotherapy combined with ventricular shunting, to relieve hydrocephalus, was advocated. In addition, with development of C-T we make the diagnosis easily and assess the result of treatment. We report a pineal tumor which was treated completely by irradiation following ventriculo-atrial shunt.
Diagnosis ; Germinoma ; Hydrocephalus ; Mortality ; Pinealoma* ; Radiotherapy

Tuberculous bronchoesophageal fistula is a rare disease. We experienced a case of the tuberculous bronchoesophageal fistula, which was found by endoscopy and surgically confirmed. A sixty seven years old female patient complained of foreign body sensation in the throat and frequent aspiration, especially after liquid meal. Esophagoscopic ex- aminatian showed the orifice of the fistula in the midesophagus at the level of 28 cm from the incisors. Esophagogram showed bronchoesophageal fistula between midesophagus and the right intermediate bronchus. A bronchoscopy visualized fistulous tract with granulation in the right intermediate bronchus. Biopsy specimens obtained from the bronchus revealed the esophageal tissue with granulation and multinucleated giant cells. Fistulectomy with wrapping procedure was performed successfully. Surgical pathologic findings confirmed a small focal granuloma and chronic inflammations, compatible with tuberculosis. There was no evidence of malignancy at the specimens. She was treated with anti-tuberculous agents and became well.
Biopsy ; Bronchi ; Bronchoscopy ; Endoscopy ; Female ; Fistula* ; Foreign Bodies ; Giant Cells ; Granuloma ; Humans ; Incisor ; Inflammation ; Meals ; Pharynx ; Rare Diseases ; Sensation ; Tuberculosis