BACKGROUND AND OJBECTIVES: Nystagmus produced by static placement of the head in different orientations is termed positional nystagmus and in most instances the cause is a peripheral vestibular disorder, as in benign paroxysmal positioning vertigo (BPPV). However, the physiologic basis of the isolated positional downbeat nystagmus has not been fully understood. The goal was to find a possible pathomechanism of dizzy patients who showed isolated positional downbeat nystagmus (pDBN). MATERIALS AND METHOD: Twelve consecutive patients with isolated positional DBN and 50 normal volunteers underwent evaluation of spontaneous, head-shaking and positional nystagmus, smooth pursuit, saccades, and VOR. The patients with focal neurologic signs, abnormal hearing, caloric paresis or acute lesion on brain imaging were excluded. RESULTS: Positional downbeat nystagmus was developed during lying down, straight head-hanging and/or Dix-Hallpike position. Perverted head-shaking nystagmus was observed in seven patients (58.3%). Gait disturbance revealed in six patients. Other cerebellar manifestations including saccadic dysmetria and gaze-evoked nystagmus were not observed. The gains of VOR were increased than normal controls. However, the gains of visual enhancement and visual cancellation of the VOR were not different from controls and OKN/OKAN were normal. The mean VOR time constants did not differ between patients and normal controls. However, tilt suppression of the post-rotatory nystagmus was impaired in the patients (p<0.01). All patients showed normal findings in head thrust test, caloric response, BAEPs, and brain imaging. CONCLUSION: Isolated positional downbeat nystagmus (pDBN) in patients complained intermittent dizziness showed frequently accompanied perverted head-shaking nystagmus (HSN) and increased gain of VOR and impaired tilt suppression. This finding tells us that isolated positional downbeat nystagmus (pDBN) reflects pathologic central nystagmus results from cerebellar (uvulonodular) dysfunction.
Cerebellar Ataxia ; Deception ; Dizziness ; Gait ; Head ; Head Impulse Test ; Healthy Volunteers ; Hearing ; Humans ; Neuroimaging ; Neurologic Manifestations ; Nystagmus, Physiologic* ; Paresis ; Pursuit, Smooth ; Reflex, Vestibulo-Ocular ; Saccades ; Vertigo

BACKGROUND: This study aimed to investigate the practice effect of the 6-minute walk test (6MWT) after providing the subjects with knowledge of the results (KR). METHODS: Sixteen subjects with post-stroke hemiparesis volunteered to participate in this study. The 6MWT was performed by having the subjects take repeated walks along a 20-m walkway for 6 minutes; and the maximum distance walked was recorded. Two trials of the 6MWT were conducted under three conditions: no-KR, immediate-KR (providing knowledge of the time taken to complete each 20-m distance), and summary-KR (providing knowledge of the time taken to complete 60 m). RESULTS: The practice effects of all 3 conditions were determined by using the paired t-test, intraclass correlation coefficient (ICC) with <0.75, and the Bland-Altman plot. The findings of the paired t-test showed a significant difference under the immediate-KR condition only; however, no significant differences were noted under the no-KR and summary-KR conditions. In a data agreement analysis across the two trials using the ICC, none of the obtained values under the three conditions were in an acceptable range indicative of a practice effect. In the Bland-Altman plot, a greater data variation was observed under the immediate-KR condition than under the other two conditions. When comparing the conditions, the immediate-KR condition differed significantly from the no-KR condition. CONCLUSIONS: Our findings do not support the presence of a practice effect across the 6MWT. However, a practice effect seems to be clinically possible when the immediate-KR condition is incorporated into this test.
Gait ; Paresis ; Stroke

BACKGROUND: There have been many articles about the chemical peeling of Caucasian skin, but there have been few reports about postpeel results among Oriental people. OBJECTIVE: The purpose of this report is to evaluate the effects of chemical skin peeling on the facial skin of Korean individuals over a two year period and compare these results with those relating to Caucasian skin. METHOD: Using 15 to 50 per cent trichloroacetic acid (TCA), we have peeled 121 pationts with fine wrinking, irregular pigmentary deposits, superficial acne scars, and melasma, and observed them for 2 years. RESULTS: In contrast to melasma, fine wrinkling and irregular pigmentary deposits responded efficiently to TCA peeling. About 70 per cent of the patients showed satisfactory clinical results one year after treatment while 50 per cent of them did so two years after treatment. Postpeel hyperpigmentation and erythema lasted for 3.15 months and 6 weeks, respectively, on average. CONCLUSION: If we select a fair-skinned woman in her fifties, even though she is an Oriental. TCA peeling can treat the fine wrinkling or irregular pigmentary deposits to a satisfactory degree.
Acne Vulgaris ; Cicatrix ; Erythema ; Female ; Humans ; Hyperpigmentation ; Melanosis ; Methods ; Skin ; Trichloroacetic Acid*

No abstract available.
Cesarean Section* ; Cicatrix* ; Endometriosis* ; Female ; Pregnancy

No abstract available.
Mandibular Fractures

BACKGROUND: Endocrine pancreas tumor is a rare disease which incidence is less than 2% of all pancreatic tumors. But it comprises various types of tumor and usually secretes several hormones from one type of tumor although the patient with this tumor complains of sole symptom associated with only one hormone. The mechanism and clinical significance of multiple hormone secretion in the endocrine pancreas tumom are not yet clearly defined. METHODS: We analyzed retrospectively the clinicopathologic features of 20 cases which were operated at Seoul National University Hospital during the period between February 1989 and May 1998. RESULTS: The most common tumor was insulinoma (13 cases) and the second most common tumor was nonfunctioning tumor (6 cases). There was one case of somatostatinoma. Most of the patients with insulinoma complained of neuroglycopenic symptoms. There were 9 cases (45.0%) in which the tumors secreted more than two kinds of hormones, 7 cases in insulinoma, 2 cases in nonfunctioning tumors. Whether the tumor secreted multiple hormones was detected by the method of immunohistochemical staining. Though the tumors secreted more than two kinds of hormones, the patients with the tumors complained of symptoms which were associated with the cell type most strongly stained by immunohistochemical method. Whether or not the tumors secreted multiple hormones was not associated with the pathologic features such as tumor size, histologic patterns of the tumor, status of tumor cell differentiation and malignancy. CONCLUSION: From this results, we suggest that endocrine tumors of the pancreas secreted multiple hormones not by the mechanism of dedifferentiation from already differentiated endocrine cells but by the mechanism of neogenesis of multipotent islet stem cells. Since the relationship between the function of multiple hormone secretion in the endocrine pancreas tumors and islet stem cell would be significant, further study should be needed to find out the function of stem cells and application of stem cells to clinical use.
Cell Differentiation ; Endocrine Cells ; Humans ; Incidence ; Insulinoma ; Islets of Langerhans ; Pancreas* ; Rare Diseases ; Retrospective Studies ; Seoul ; Somatostatinoma ; Stem Cells

OBJECTIVE: To investigate whether the serum levels of IL-10 in patients with rheumatoid arthritis are different from those of normal controls and SLE patients and to find out any correlation with disease activity parameters of rheumatoid arthritis. METHODS: Sera from 20 healthy normal persons, 16 rheumatoid arthritis patients and 16 patients with systemic lupus erythematosus were collected and measured for IL-10 and IL-6. Various disease activity parameters were measured in RA patients. RESULTS: The serum level of IL-10 in RA patients was significantly elevated compared to normal controls but lower than those of SLE patients. In RA patients there was no definite correlation between the disease activity parameters and serum IL-10 levels. Despite significant improvements in terms of various disease activity parameters, there was no significant change of serum IL-10 levels after treatment in RA patients. In seropositive RA patients, positive correlation was found between serun IL-10 and rheumatoid factor levels. CONCLUSION: Our findings show that the serum IL-10 levels in patietns with RA are elevated compared to normal controls but lower than those of SLE patients. There was no correlation between serum IL-10 levels and disease acivity parameters of RA.
Arthritis, Rheumatoid* ; Humans ; Interleukin-10* ; Interleukin-6 ; Lupus Erythematosus, Systemic ; Rheumatoid Factor

The use of recombinant DNA technology to produce human growth hormone has resulted in a marked increase in availability of Growth Hormone(GH) to treat short stature due to GH deficiency and other conditions, such as Turner syndrome, familial short stature, chronic renal insufficiency and intrauterine growth retardation (IUGR). But, the GH therapy may result in the adverse events such as sodium and water retention, pseudotumor cerebri, slipped capital femoral epiphysis, growth of nevi, recurrence of tumor. We experienced a case of severe hypertension associated with GH therapy in a 14-year-old male who presented high blood pressure up to 190/100 mmHg and normalized at 2-3 weeks after discontinuation of GH. Therefore, we think that the blood pressure should be carefully monitored during GH therapy.
Adolescent ; Blood Pressure ; DNA, Recombinant ; Fetal Growth Retardation ; Growth Hormone* ; Human Growth Hormone ; Humans ; Hypertension* ; Male ; Nevus ; Noonan Syndrome ; Pseudotumor Cerebri ; Recurrence ; Renal Insufficiency, Chronic ; Slipped Capital Femoral Epiphyses ; Sodium

No abstract available.
Leukemia* ; Leukemia, Megakaryoblastic, Acute*

Excitatory amino acids have been implicated as one of the important putative cellular toxins in ischemic brain. Ketamine antagonizes the excitotoxic action of excitatory amino acids in the central nervous system. The present study was undertaken to determine whether ketamine anesthesia protect the formation of brain edema in the model of focal cerebral ischemia in rats. Forty adult male Sprague-Dawley rats weighing between 300gm and 400gm were used in this study. The animals were anesthetized with either halothane or ketamine, and then right middle cerebral artery occlusion were performed. After 4 hours of ischemia, the brain water and ion contents(Na+ and K+) were determined in the central, intermediate, and outer zones of each cortical mantle. In both halothane and ketamine anesthetized groups, there were significant brain edema in the ischemic central and intermediate zones. Ionic shifts were also observed in the ischemic central and intermediate zones to approximately same extent as the brain water content in both groups. However, there were no significant differences of brain edema between the two groups in the corresponding ischemic zones. These results suggest that ketamine anesthesia does not have significant protective effect on the formation of brain edema during the early stages of permanent incomplete cerebral ischemia.
Adult ; Anesthesia* ; Animals ; Brain Edema* ; Brain Ischemia ; Brain* ; Central Nervous System ; Excitatory Amino Acids ; Halothane ; Humans ; Infarction, Middle Cerebral Artery ; Ischemia* ; Ketamine* ; Male ; Rats* ; Rats, Sprague-Dawley