No abstract available.

No abstract available.

We report a patient who developed a Barrett,s esophageal ulcer 10 years after esophagomyotomy for achalasia. A-59-year-old female was admitted to the hospital with dysphagia for 2 months. In 1982, she had undergone a modified Heller esophagomyotomy for achalsia. After esophagogram, esophageal manometry, 24hr esophageal pH monitoring, esophagoscophy achalasia and Barrett,s esophageal ulcer was diagnosed. So, she had been treated with omeprazole and sucralfate and has been followed up in a asymtomatic state currently. In Barrett,s esophagus, there is a metaplasia of the normal stratified squamous mucosa to columnar epithelium, caused by the reflux of acid. It appears in approximately 10% of patients with chronic gastroesophageal reflux and is associated with increased probability of adenocarcinoma of the esophagus. Among the predis- posing factors of gastroesophageal reflux, there is treatment of esophageal achalsia by forceful dilatation or by the esophagomyotomy. The resultant ralaxation of lower esophageal sphinter, combined with deficient propulsive esophageal peristalsis, predisposed to gastroesophageal reflux. Actually an increased incidence of gastroesophageal reflux, esophagitis and stricture are well-known complications after esophagomyotomy. But in spite of higher risk of gastroesophageal reflux after esophagomyotomy the development of Barrett,s mucosa has been rarely reported and only recently recognized. Diagnosis of Barrett,s esophagus in such patients is difficult and the cumulative effects of achalasia and Barrett's esophagus predispose these patient to higher risk of developing esophageal carcinoma. So, high index of awareness and regular endoscopic surveillance are required.
Adenocarcinoma ; Barrett Esophagus ; Constriction, Pathologic ; Deglutition Disorders ; Diagnosis ; Dilatation ; Epithelium ; Esophageal Achalasia* ; Esophageal pH Monitoring ; Esophagitis ; Esophagus ; Female ; Gastroesophageal Reflux ; Humans ; Incidence ; Manometry ; Metaplasia ; Mucous Membrane ; Omeprazole ; Peristalsis ; Sucralfate ; Ulcer*

No abstract available.
Blood Platelets* ; Humans ; Platelet Aggregation* ; Plateletpheresis* ; Tissue Donors*

Authors presented the serial changes of brain MRI findings in two cases of cryptococcal meningitis. The MRI findings of the first patient (53-year-old female) consisted of dilated Virchow-Robin spaces, leptomeningeal enhancement, cryptococcomas and hydrocephalus. Dilated Virchow-Robin spaces were noted on the first MR obtained 33 days after symptom onset. The size and number of dilated Virchow-Robin space gradually decreased since 119 days after symptom onset (62 days after treatment). Faint leptomeningeal enhancement was found at cerebellar region on the first MRI, which became more distinct and intense on the day 119, probably due to improper treatment. The leptomeningeal enhancement decreased on the day 156. Mild hydrocephalus was noted on MRI obtained 70 days after symptom onset, which markedly aggravated on the day 119. It decreased after steroid therapy alone. Enhancing crytococcomas of variable size were noted at the right temporal lobe and cerebellum on MRI of the day 119, which decreased in size and number on the day 156. On the day 295 MRI showed nearly disppearance of the dilated Virchow-Robin space, but faint leptomeningeal enhancement, cerebellar crytococcomas and hydrocephalus still remained. The MRI findings of the second patient (36-year-old female) showed the findings similar to those of the first patient. Initial MRI obtained 18 days after symptom onset showed no abnormal findings. Dilated Virchow-robin spaces were noted on the day 36 (13 days after treatment onset), which nearly disappeared on the day 109. Enhancing cryptococcomas in both basal ganglia and cerebral cortex and leptomeningeal enhancement were noted on MRI of the day 136. Both cryptococcomas and leptomeningeal enhancement decreased in size and enhancing degree on the day 157. Hydrocephalus was noted on the day 109.
Basal Ganglia ; Brain ; Cerebellum ; Cerebral Cortex ; Follow-Up Studies* ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging* ; Meningitis, Cryptococcal ; Temporal Lobe

Authors presented the serial changes of brain MRI findings in two cases of cryptococcal meningitis. The MRI findings of the first patient (53-year-old female) consisted of dilated Virchow-Robin spaces, leptomeningeal enhancement, cryptococcomas and hydrocephalus. Dilated Virchow-Robin spaces were noted on the first MR obtained 33 days after symptom onset. The size and number of dilated Virchow-Robin space gradually decreased since 119 days after symptom onset (62 days after treatment). Faint leptomeningeal enhancement was found at cerebellar region on the first MRI, which became more distinct and intense on the day 119, probably due to improper treatment. The leptomeningeal enhancement decreased on the day 156. Mild hydrocephalus was noted on MRI obtained 70 days after symptom onset, which markedly aggravated on the day 119. It decreased after steroid therapy alone. Enhancing crytococcomas of variable size were noted at the right temporal lobe and cerebellum on MRI of the day 119, which decreased in size and number on the day 156. On the day 295 MRI showed nearly disppearance of the dilated Virchow-Robin space, but faint leptomeningeal enhancement, cerebellar crytococcomas and hydrocephalus still remained. The MRI findings of the second patient (36-year-old female) showed the findings similar to those of the first patient. Initial MRI obtained 18 days after symptom onset showed no abnormal findings. Dilated Virchow-robin spaces were noted on the day 36 (13 days after treatment onset), which nearly disappeared on the day 109. Enhancing cryptococcomas in both basal ganglia and cerebral cortex and leptomeningeal enhancement were noted on MRI of the day 136. Both cryptococcomas and leptomeningeal enhancement decreased in size and enhancing degree on the day 157. Hydrocephalus was noted on the day 109.
Basal Ganglia ; Brain ; Cerebellum ; Cerebral Cortex ; Follow-Up Studies* ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging* ; Meningitis, Cryptococcal ; Temporal Lobe

Ossification and calcification of the spinal ligaments frequently cause pressure upon the spinal cord andnerve roots. Authors reviewed 150 cases of C-spine CT, 80 cases of T-spine CT, and 725 cases of L-spine CT whichwere carried out a Pusan Natina University Hospital for 2 years from May 1983 to May 1985. We analysed 34 caseswhich showed ossification of posterior longitudinal ligament (OPLL) and ligamentum flavum (OLF) of these 955cases. The results are follows: 1. The male ot female ratio of spinal ligamentous ossification was 26:8. The 5thdecade group (24.41%) was the most prevalent age group. 4th decade(26.4%), 6th decade(23.52%), 7th decade(11.76),3rd decade (8.8%), and 8th decade(2.94%) in that order. 2. Of 955 cases of spine CT, the incidence of OPLL was 25cases(21.51%) and that of OLF was 10 ases(1.05%). 3. Regional incidence of spinal ligamentous ossification was asfollows. 1) In case of OPLL, cervical area was 19/150(12.67%) and lumbar area was 6/725 (0.83%). 2) In cases ofOLF, Thoracic area was 3/80(3.75%) and lumbar area was 8/725(1.10%). 4. The most frequent length of OPLL was 4body length (32%) and the most frequent locations are C4 and C5(68%). The types fo OPLL were 15 cases(60%) ofsegmental type, 8 cases(32%) of continuous type, and 2 cases(8%) of mixed type in that order. All segmental typeswere degree 1 or 2 and most continuous and mixed type (80%) were degree 2 or 3 dural sac effect. 5. The number ofinvolved interlaminar spaces in OLF was 1 to 5 interspaces and most of OLF were found at low thoracic and lumbararea. 6. There could be noted high correlation between the spinal ligamentous ossification and degenerative discdisease, The incidence of associated disc disease was 18/25(72%) in OPLL and 8/10(80%) in OLF.
Busan ; Female ; Humans ; Incidence ; Ligaments ; Ligamentum Flavum ; Male ; Ossification of Posterior Longitudinal Ligament ; Spinal Cord ; Spine

OBJECTIVE: To investigate the changes of gait patterns in subjects who use the ankle foot orthoses (AFOs) with a variable ankle joint stop. METHOD: Six young subjects without a known physical disability were involved in this study. Double upright AFOs with three kinds of ankle joint stops (eg. AFOs with 85o posterior stop, 90o posterior stop, and 95o posterior stop) were used for the right foot and a rigid shoe was used for the left foot. Gait patterns of the subjects using the AFOs with a variable ankle joint stop were evaluated with the three dimensional gait analysis system. RESULTS: The gait patterns of the subjects with a 85o posterior stop AFO showed a shorter duration of single support phase than the subjects with a 90o posterior stop or 95o posterior stop. They showed the increased maximal knee flexion angles, decreased knee extension angles and decreased ankle range of motions by the kinematics. These linear changes in parameters and kinematics were statistically significant. In kinetics, the gait patterns of the subjects using a AFO with 85o posterior stop had the largest maximal knee flexion moment and the gait patterns of the subjects using a AFO with 95o posterior stop had the largest maximal knee extension moment. However these results were not statistically significant. CONCLUSION: For the patients with uncontrolled ankle motion, the AFOs with 90o or 95o posterior stop would be more desirable than the AFOs with 85o posterior stop, for the clearance of foot and stability of knees but not for the correction of the knee hyperextension.
Ankle Joint* ; Ankle* ; Biomechanical Phenomena ; Foot Orthoses* ; Foot* ; Gait* ; Humans ; Kinetics ; Knee ; Shoes

Calcium-binding proteins in the nervous system are functioned in Ca2+ buffering and Ca2+ transport and regulation of various enzyme systems. They potentially have a number of different effects on cells includingaltering the duration of action potentials, promoting neuronal bursting activity and protecting cells against the damaging effects of excessive calcium influx. The present study has been designed to clarify the differential responding patterns of parvalbumin immunoreactive neurons in the rat retina following diabetic injury, for better understandings of role of parvalbumin in the retinal circuitry and in calcium homeostasis. Experimental diabetes was induced by a single intravenous injection of streptozotocin in a dose of 60 mg/kg body weight. Diabetic rats showing high blood glucose levels (above 300 mg/dL) were cared for 1, 4, 8, 12 and 24 weeks, respectively. The retinas at each time point were processed for immunohistochemistry and Western blotting using antiparvalbumin antibody. In the rat retina at normal, parvalbumin immunoreactivity appeared in AII amacrine cells, amacrine cells of a widefield type and displaced amacrine cells. A few bipolar cells are also showed the reactivity. During diabetes, the intensity of parvalbumin immunoreactivity is decreased especially in the AII amacrine cells. The cell number of parvalbumin immunoreactive neurons has showed no large changes throughout the diabetes, except that of bipolar cells. That population of parv immunoreactive of bipolar cells has increased remarkably at later diabetic periods. The protein levels of parvalbumin have showed transiently a slight increase at earlier diabetic periods, and then decreased to lower than that of normal. Parvalbumin immunoreactive bipolar cells at diabetes are co-localized not with PKC-alpha or recoverin, but with glutamate transporter Glt-1b. AII amacrine cell processes were joined with each other and with axon terminals of presumed cone bipolar cells by gap junction. These results suggest that the calcium buffering activity of parvalbumin is shifted from AII amacrine cells to a certain type of cone bipolar cells, in response to diabetes. This event may be occurred through electrically coupled gap junction in between these cell processes.
Action Potentials ; Amacrine Cells ; Amino Acid Transport System X-AG ; Animals ; Blood Glucose ; Blotting, Western ; Body Weight ; Calcium ; Calcium-Binding Proteins ; Cell Count ; Gap Junctions ; Homeostasis ; Immunohistochemistry ; Injections, Intravenous ; Nervous System ; Neurons ; Presynaptic Terminals ; Rats* ; Recoverin ; Retina* ; Retinaldehyde ; Streptozocin

No abstract available.
Cri-du-Chat Syndrome*