OBJECTIVE: This study was proposed to evaluate the electrophysiologic changes in central motor conduction and in silent period (SP) after paraspinal transcutaneous electrical stimulation near caudal area of the spinal cord. METHOD: Conditioning stimulation was applied to T12 paraspinal area for 20 minutes using interferential current therapy (80~100 Hz) in 11 healthy subjects. The amplitude and latency of central motor conduction and duration of SP were measured in motor evoked potential (MEPs) by using magnetic stimulator, before and after the conditioning stimulation. These variables were recorded in both tibialis anterior muscle, innervated from stimulated spinal area, and both abductor pollicis brevis, innervated from cervical cord not directly stimulated by electrical stimulation. RESULTS: After conditioning stimulation, the amplitudes of central motor conduction decreased (p<0.01), and the latencies did not change in both cervical and lumbar muscles in transcranial and spinal MEP studies, and the duration of SP was decreased in same manner (p<0.01). CONCLUSION: These results mean that the excitability of anterior horn cells decreases and the supraspinal inhibitory mechanism of the central motor conduction is suppressed by a certain conditioned electrical cutaneous stimulation in entire spinal cord.
Anterior Horn Cells* ; Electric Stimulation* ; Evoked Potentials, Motor ; Muscles ; Spinal Cord ; Transcutaneous Electric Nerve Stimulation

Multiple system atrophy (MSA) is an idiopathic neurodegenerative disorder involving many neuronal structures. It is a heterogeneous system disorder affecting extrapyramidal, cerebellar and autonomic nervous system. Only a minority of MSA patients are diagnosed before reaching the full blown stage. Its autonomic features like orthostatic hypotension, vocal cord paralysis are directly related to mortality. Up to now, rehabilitation of MSA patients had been rarely reported. Early, proper diagnosis and comprehensive rehabilitation for their heterogeneous clinical features are important. We experienced 54 year old hemiplegic paient who overlaps MSA. He showed some improvement in ADL and cerebellar symptoms after comprehensive rehabilitation programs.
Activities of Daily Living ; Autonomic Nervous System ; Diagnosis ; Humans ; Hypotension, Orthostatic ; Middle Aged ; Mortality ; Multiple System Atrophy* ; Neurodegenerative Diseases ; Neurons ; Rehabilitation ; Stroke* ; Vocal Cord Paralysis

Hodgkin's disease (HD) is a hematologic malignancy which shows common features regardless of race, but racial differences may be considered with certain clinical characteritcs. HD in Korea shows somewhat different characteristics when compared to cases in Western countries. We evaluated the clinical and histopathologic characteristics of HD, the outcomes of various chemotherapy regimens, and prognostic factors of HD in Korea. One hundred and five patients with initial histopathologic diagnosis of Hodgkin's disease were retrospectively reviewed 20 years after diagnosis at Yonsei University College of Medicine. Nodular sclerosis was the most common histopathogic subtype (41%) and mixed cellularity was nearly as common (40%). The overall complete remission rate (CR) was 87.6%. The disease-free survival (DFS) and overall survival (OS) rate were 79.2% and 84.8% at 5-years, 70% and 79.2% at 10- and 20-years. There were no significant differences in CR rate and DFS, but OS rates were significantly higher in m-BACOP and ABVD regimen. Univariate analysis revealed that age, B-symptom, ECOG scale, Ann Arbor stage, international prognostic index, and serum beta2-microglobulin level were significant prognostic factors for both DFS and OS. Multivariate analysis demonstrated that age, B symptoms, and ECOG scale were significant prognostic factors for OS only. In conclusion, the survival rates of HD patients in our center were superior to those of previous reports in Korea and Western countries. Considering the higher OS rate and decreased incidence of side effects, the ABVD regimen may be recommended for the initial treatment of Hodgkin's disease.
Treatment Outcome ; Remission Induction ; Prognosis ; Middle Aged ; Male ; Korea ; Humans ; Hodgkin Disease/mortality/*therapy ; Follow-Up Studies ; Female ; Disease-Free Survival ; Child, Preschool ; Child ; Antineoplastic Agents/*pharmacology ; Aged, 80 and over ; Aged ; Adult ; Adolescent

OBJECTIVE: To measure anterior displacement of the humeral head and to observe its relationship with clinical findings in the subluxed hemiplegic shoulders. METHOD: Seventeen hemiplegic patients, having the subluxed shoulder over one finger breadth were subjected. We measured shoulder pain, muscle power of the shoulder abductors, Brunnstrom stage and spasticity in the affected upper extremity. To measure the humeral displacement of the shoulder subluxation, the AP and transthoracic lateral views of simple radiologic picture were taken on both affected and unaffected shoulders, and repeated after donning three kinds of arm slings. RESULTS: Its anterior displacement as well as the inferior displacement occured in all subjects, and was significantly related with the value of shoulder pain and spasticity, and the inferior displacement with Brunnstrom stage and muscle power of the shoulder abductors in the subluxed hemiplegic shoulder (p<0.05). Correction of the humeral displacement occured significantly in anterior direction as well as inferior by use of all tested arm slings. CONCLUSION: Clinical implications of the shoulder subluxation were different according to direction of the humeral displacement, and anterior displacement will be considered for its symptom in hemiplegic shoulder.
Arm ; Fingers ; Hemiplegia ; Humans ; Humeral Head* ; Muscle Spasticity ; Shoulder Pain ; Shoulder* ; Upper Extremity

Nocardiosis is an acute, subacute, or chronic infection, most often beginning in the lung, and usually affects the immunocompromised host. Nocardial infections are not rare in the United States, 500 to 1000 cases are recognized each year, but rarely reported in Korea. Disorders associated with cellular immune dysfunction are the major risk factors for nocardiosis. We report one case of brain and retroperitoneal abscess caused by Nocardia asteroides in patient who has had a chronic lymphocytic leukemia and diabetes mellitus, with a review of the relevant literature.
Abscess ; Brain ; Diabetes Mellitus ; Humans ; Immunocompromised Host ; Korea ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Lung ; Nocardia asteroides ; Nocardia Infections* ; Risk Factors ; United States

OBJECTIVES: This study was conducted in order to investigate characteristics of temperament, depression, anxiety, attention, and impulsivity in adult males with Attention Deficit/Hyperactivity Disorder (ADHD) and internet addiction tendency. METHODS: The survey participants were 181 (121 patients and 60 healthy control subjects) adult males older than 19 years of age in Chung-Ang University Hospital and Gongju National Hospital. Subjects were divided according to ADHD with internet addiction tendency (AI), pure adults with ADHD (AD), and healthy control subjects (HC). All groups completed the Adult ADHD Scale (AADHD), Wender-Utah ADHD Rating Scale (WUADHD), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), the Korean Version of Young Internet Addiction Scale (YIAS-K), Barratt Impulsiveness Scale (BIS) and Temperament Character Inventory-Revised Short version for identification of relationship between ADHD and internet addiction tendency. RESULTS: AI groups were found to have higher AADHD, WUADHD, BDI, YIAS-K, and Novelty Seeking scores, compared to the AD and HC groups. The Cooperativeness score of the AI group was significantly lower than that of the AD group and HC group. The BAI and BIS scores of the AI group and AD group were significantly higher than those of the HC group. The Self-Directedness scores of the AI group and AD group were decreased, compared to the HC group. YIAS-K scores were partially related to BDI scores in the AI group. CONCLUSION: The results of this study indicate an association of higher score of BDI with internet addiction tendency in adult patients with ADHD. Management of temperament characteristics, depression, anxiety, attention, and impulsivity may be important for adults with ADHD and internet addiction tendency.
Adult* ; Anxiety ; Chungcheongnam-do ; Depression ; Humans ; Impulsive Behavior ; Internet* ; Male ; Temperament

BACKGROUND: Polycystic ovary syndrome (PCOS) is characterized by chronic anovulation and hyperandrogenism and this malady arises in 5~10% of reproductive women. There may be significant ethnic and racial variations in the clinical presentation of PCOS. The current study is aimed to define the clinical characteristics, including the metabolic features, of Korean women with PCOS. METHODS: We recruited 156 patients with PCOS and 252 healthy regular cycling women as controls between March 2003 and May 2006. The diagnosis of PCOS was made according to the criteria of the European Society of Human Reproduction and Embryology in 2003. The anthropometric measurements including weight, height, waist circumference, and physical examination for the modified Ferriman-Gallwey hirsutism scoring scale were performed. Reproductive hormones, blood lipids and standard 75g oral glucose tolerance tests were done to assess glucose tolerance and insulin sensitivity. RESULTS: Twenty six percent of the women with PCOS were obese and 6.4% of them had hirsutism. One of the 156 women (0.6%) with PCOS was newly diagnosed with diabetes mellitus and 25 of them (16.0%) had impaired glucose tolerance. The triglyceride levels and plasma glucose levels at 0, 30, 60, 90 and 120 minute and the plasma insulin levels at 30, 60, 90 and 120 minutes after initiating the oral glucose tolerance test in women with PCOS were significantly higher compared to those values for the controls. The HOMA-IR was significantly higher in the women with PCOS compared to the controls, even after adjusting for age and the body mass index. CONCLUSIONS: Obesity and clinical hyperandrogenism were not frequent in Korean women with PCOS, but this population did display distinct insulin resistance.
Anovulation ; Blood Glucose ; Body Mass Index ; Diabetes Mellitus ; Diagnosis ; Embryology ; Female ; Glucose ; Glucose Tolerance Test ; Hirsutism ; Humans ; Hyperandrogenism ; Insulin ; Insulin Resistance ; Obesity ; Physical Examination ; Plasma ; Polycystic Ovary Syndrome* ; Reproduction ; Triglycerides ; Waist Circumference

Hepatitis B virus (HBV) reactivation is the frequent complication after cytotoxic chemotherapy in HBsAg-positive non-Hodgkin's lymphoma (NHL) patients. Pre-chemotherapy viral load may be a risk factor and HBeAg-positive status is associated with increased viral load. The aim of this study was to investigate the long-term treatment outcome of lamivudine in preventing HBV reactivation and its associated morbidity according to HBeAg status. Twenty-four adult HBsAg-positive NHL patients were taken 100mg of lamivudine daily before the initiation of chemotherapy. The median duration of lamivudine therapy was 11.5 months (range: 1-54 months) and the median number of chemotherapy cycles was 6 (range: 1-16 cycles). The steroid containing chemotherapy regimens were used in 18 patients (75%), and the anti-CD20 monoclonal antibody containing chemotherapy regimen was used in 6 patients (25%). Four patients received autologous peripheral blood stem cell transplantation without resultant HBV reactivation. Hepatitis related to HBV reactivation was developed in 1 patient among 14 HBeAg-positive patients and no one among 10 HBeAg-negative. One patient developed HBV reactivation after lamivudine withdrawal, and 4 patients developed the YMDD (tyrosine-methionine-aspartate-aspartate) mutation during lamivudine therapy. There were no statistical differences in HBV reactivation rate during chemotherapy according to the HBeAg status. Our results demonstrate that lamivudine should be considered preemptively before the chemotherapy for all HBsAg-positive NHL patients to prevent HBV reactivation, regardless of pre-chemotherapy HBeAg status. Finally, compared with the chronic hepatitis B patients, similar rate of HBV reactivation after lamivudine withdrawal and development of YMDD mutation was observed in NHL patients.

Both Gitelman syndrome and Bartter syndrome are autosomal recessively inherited renal tubular disorders characterized by hypokalemic metabolic alkalosis, salt wasting and normal to low blood pressure. Gitelman syndrome is caused by mutations in the thiazide-sensitive Na- Cl cotransporter (NCCT) and distinguished from Bartter syndrome, which is associated with mutations of several genes, by the presence of hypomagnesemia and hypocalciuria. In most of the patients with Gitelman syndrome, the disease manifests with transient episodes of muscular weakness and tetany in the adult period, but, often, is asymptomatic. We report here an 11 years-old female with Gitelman syndrome who presented with aggravation of epileptic seizure. The diagnostic work-up showed typical clinical features of metabolic alkalosis, hypokalemia, hypomagnesemia and hypocalciuria. We also identified a heterozygote mutation(642CGC(Arg)>TGC(Cys)) and an abnormal splicing in the SLC12A3 gene encoding NCCT.
Adult ; Alkalosis ; Bartter Syndrome ; Child ; Epilepsy* ; Female ; Gitelman Syndrome* ; Heterozygote ; Humans ; Hypokalemia ; Hypotension ; Muscle Weakness ; Tetany

PURPOSE: The cause of aseptic meningitis remains mostly unknown because viral culture and identification is difficult. Thus, we report a study on 123 children with aseptic meningitis in Gyeongju in 2002 to identify the causing virus and the relationship with the clinical manifestation. METHODS: We prospectively investigated the patients, admitted to Dongguk University Hospital, into two groups between April and October 2002. Group 1 included 123 patients diagnosed as aseptic meningitis. Group 2, the adimssion control, included 120 patients, who suffered from none-enteroviral diseases. Specimens of CSF and stool were collected to perform reverse transcription polymerase chain reaction(RT-PCR), and enteroviral culuture was done in RT-PCR positive patients as well. RESULTS: The male to female sex ratio was 2.2:1 and the mean age was 6.2+/-3.7 years. The clinical manifestations were fever, headache and vomiting. The RT-PCR for enterovirus, performed in 58 cases of CSF in group 1, showed 5.2% positive results and negative result in viral culture. The RT-PCR for enterovirus used in stool specimens showed 89.3% and 41.1% of positive results in group 1 and group 2, respectively. Viral culture of stool specimens showed five cases of echovirus 13 and four cases of echovirus 6 in group 1, whereas three cases of echovirus 6 and one case of coxsackie B4 were detected in group 2. CONCLUSION: The etiologic viruses of the aseptic meningitis outbreak in Gyeongju in 2002 is presumed to be echovirus 13 and echovirus 6. Since echovirus 13 firstly appeared with various age distributions, the outbreak may have emerged due to a lack of acquisition of immunity to this virus.
Age Distribution ; Child ; Echovirus 6, Human ; Enterovirus ; Enterovirus B, Human ; Female ; Fever ; Gyeongsangbuk-do ; Headache ; Humans ; Male ; Meningitis, Aseptic* ; Prospective Studies ; Reverse Transcription ; Sex Ratio ; Vomiting