Objective　To study diagnostic significance of blink reflex(BR) in cranial Guillain-Barré Syndrome (cGBS). Methods　A comparative study was carried out on BR in 7 cGBS cases and 39 normal subjects.Results　As compared with controls,the cGBS group showed significant differences on latency and amplitude of R1,R2i, R2c component of BR,M wave and R1 conduction time (R1CT) inside the cranial part(P<0.001). Conclusion　The result suggested that BR and facial electromyogram were of great significance in the diagnosis of cGBS and might provide an objective index for clinical differential diagnosis.

Objective To investigate the effect of total sleep deprivation (TSD) shown in the electroencephalogram (EEG) power spectra in healthy young men. Method 20 healthy young male volunteers (19～22 years old) were subjected to 50 hours of TSD. EEGs were recorded 8 times (6 hours intervals) during TSD. EEG power was calculated for six bands at all 16 derivations.Results 50 hour TSD induced an increase in ? power at the other derivations except both occipitals ( P

Objective To investigate the role of Catbindin-D28k in the kidney on calcium metabolism.Methods VDR/CaBP-D28k double knockout(KO)mice was made.Body weight,diet intake and serum,urinary parameters and length,density of the long bones,histological staining of the tibia of WT,CaBP-D28(-/-),VDR(-/-)and VDR(-/-)/CaBP-D28k(-/-)mice were determined on regular and high Ca-Lac diet.Results On a regular diet,the double KO mice were growth-retarded more and smaller than VDR KO mice.Compared with VDR KO mice,the double KO mice had higher urinary calcium excretion and rachitic skeletal phenotype,which were manifested with higher serum parathyroid hormone levels,lower bone mineral density,and more distorted growth plate with mole osteoid formation in the trabecular region.On high calcium and high lactose diet,blood-ionized calcium levels were normal in both VDR KO and the double KO mice.However,in contrast to VDR KO mice,the skeletal abnormalities were not completely corrected in the double KO mice.Conclusion These results directly demonstrate that CaBP-D28k plays a critical role in maintaining calcium homeostasis and skeletal mineralization and suggest that its caleemic role can be mostly compensated by CaBP-D9k.

Cutis marmorata telangiectatica congenita(CMTC) is a rare congenital cutaneous vascular anomaly. The major skin findings are persistent, fixed cutis marmorata, telangiectasia, and phlebectasia. In approximately 50 % of patients, the disorder tends to be associated with various con-genital anomalies. We describe in this report a 4-month-old male infant with CMTC. The patient had red or violet marbled patches, telangiectases, and atrophy on the right arm present at birth. During the follow up period of 12 months, there was no change in the cutis marmorata pattern and telangiectases, whereas the atrophy has been less prominent than at the initial visit.
Arm ; Atrophy ; Follow-Up Studies ; Humans ; Infant ; Male ; Parturition ; Skin ; Telangiectasis ; Viola

A K+-channel blocker, 4-aminopyridine(4-AP) increases neurotransmitter release from motor nerve terminals and has been shown to restore neuromuscular transmission in the myasthenic syndrome. It has been reported that the intravenous injection of 4-AP in the myasthenic patients caused many central adverse effects including anxiety and restlessness, but did not affect the blood pressure. The aim of this study was to observe the effect of intracerebroventricularly administered 4-AP on the blood pressure and to elucidate the mechanism of the action in urethane-anesthetized rabbits. Intracerebroventricular(icv) 4-AP produced pressor effects in a dose-dependent fashion, but intravenous(iv) 4-AP of the same dose did not altered the blood pressure. Tetraethylammonium, a K+-channel blocker which differs from 4-AP structurally, had little effect on the blood pressure, but 3,4-diaminopyridine, another derivative of the aminopyridine, produced pressor effect similar to 4-AP. The pressor effect of icv 4-AP was not affected by the treatment with iv phenoxybenzamine and chlorisondamine, and in bilateral adrenalectomized rabbits. These results suggest that the 4-AP pressor effect is not related to the periphral sympathetic nerve nor adrenal gland. The pretreatment with icv phentolamine and prazosin did not altered the 4-AP pressor. However, the icv 4-AP pressor effect was significantly attenuated by the treatment with icv yohimbine, and significantly potentiated by the treatment with icv clonidine. The treatment with icv diltiazem markedly inhibited the icv 4-AP pressor effect. It is concluded that 4-AP-sensitive K+-channels in rabbit brain might play a role in the regulation of blood pressure and that the 4-AP pressor effect is closely related to the central alpha2-adrenoceptors and L-type calcium channels.
4-Aminopyridine* ; Adrenal Glands ; Anxiety ; Arterial Pressure* ; Blood Pressure ; Brain ; Calcium Channels, L-Type ; Chlorisondamine ; Clonidine ; Diltiazem ; Humans ; Injections, Intravenous ; Neurotransmitter Agents ; Phenoxybenzamine ; Phentolamine ; Prazosin ; Psychomotor Agitation ; Rabbits ; Tetraethylammonium ; Yohimbine

PURPOSE: Paraquat, a globally used herbicide, is highly toxic to human beings. Hence, we reviewed some cases of paraquat poisoning in Korea. METHODS: We analyzed the clinical and laboratory findings of 50 patients poisoned with paraquat retrospectively. The patients were admitted to the department of internal medicine in the Eumseong KeumWang hospital from January 2008 to December 2008. RESULTS: Among 50 cases of paraquat poisoning, 28 cases were male. Twenty-four cases (48%) were over 60 years old. Fourty-nine patients ingested paraquat on purpose as suicidal attempts, while 1 patient underwent accidental ingestion. Seven patients swallowed less than one mouthful of paraquat, of which 4 patients survived. Eleven patients swallowed two mouthfuls of paraquat, of which 8 patients survived. Thirty-two patients swallowed over three mouthfuls of paraquat and they all died. Thirty-one patients with leukocytosis died. Twenty-one patients with metabolic acidosis died. Increased levels of blood amylase and glucose were related to high mortality, and increased level of blood creatinine was related to severe mortality. Hemoperfusions were accomplished in 27 patients of paraquat poisoning, of which 12 patients survived. CONCLUSION: Paraquat is a highly toxic herbicide. When patients arrive at the hospital, laboratory findings, urine paraquat concentrations, arrival time, and the amount of paraquat consumed must be considered for treatment plan.
Acidosis ; Amylases ; Creatinine ; Dithionite ; Eating ; Glucose ; Hemoperfusion ; Humans ; Internal Medicine ; Korea ; Leukocytosis ; Male ; Mouth ; Paraquat ; Retrospective Studies

A case of a 21-year old female with Maffucci's syndrome is presented where the patient developed multiple cutaneous spindle-cell hemangioendotheliomas. She had multiple pea to walnut sized, non-tender, normal skin colored or slight bluish nodules and bony mass-like lesions on the left upper extremity and hand. A histological examination of the lesions showed that they were composed of irregularly dilated, thin walled cavernous blood spaces containing phleboliths and collapsed vascular spaces separated by spindled fibroblastic cells. Radiologically, the bony lesions showed radiolucent densities with calcified spots within the second proximal phalanx and metacarpal bone of the left hand, which were consistent with enchondromas.
Chondroma ; Female ; Fibroblasts ; Hand ; Hemangioendothelioma* ; Humans ; Juglans ; Peas ; Skin Pigmentation ; Upper Extremity

We report a case of infantile digital fibromatosis in a 34 month-old boy, who presented with a painless subcutaneous tumor on the medial aspect of the left third toe. A histological examination showed scattered small, round eosinophilic inclusion bodies in the cytoplasm of the tumor cells, which was consistent with infantile digital fibromatosis. A'immunohistochemical study revealed that desmin, a-smooth muscle actin, and vimentin were clearly positive in the cytoplasm of the tumor cells, but the inclusions themselves showed negative staining, thus indicating a hollow-like staining pattern. Electron microscopy showed either well-defined or ill-demarcated dense bodies in the cytoplasm of the tumor cells. In some areas, small vesicles and intracellular organells were observed' in the inclusions. In the course of conservative treatment, a new lesion developed on the lateral aspect of the left third toe, seven months after the appearance of the initial lesion.
Actins ; Cytoplasm ; Desmin ; Eosinophils ; Fibroma* ; Humans ; Inclusion Bodies ; Male ; Microscopy, Electron ; Negative Staining ; Toes ; Vimentin

BACKGROUND: Granuloma annulare is a chronic skin disease of unknown origin, that can present itself with diverse clinical and histopathologic findings. But no clinicopathological studies has been reported yet in Korea. OBJECTIVE: Our purpose was to investigate the clinicopathological findings of each type of granuloma annulare. METHODS: We observed twenty two cases of granuloma annulare and examined their clinical manifestations and histopathological findings. RESULTS: The incidence showed a bimodal peak between 3 to 4 years and 49 to 51 years in age and females were affected twice as much as males. The lesions are commonly located on the distal portion of the extremities. In histopathologic findings, perforating type was observed in 13.6% and subcutaneous type in 18.2%. In collagen alteration, fragmentation and hyalinization were observed in 72.7% and 81.8% respectively. Most infiltrated cells were epithelioid cells. In vascular changes, endothelial swelling and occlusion of vessels were common findings and vasculitis was shown in 36.4%. CONCLUSION: There were not epidemiologic differences from the reported studies in western patients. But the clinical manifestation and the histopathologic findings were so varied that differential diagnosis is important in diagnosis of granuloma annulare. Immunological and immunohistochemical studies may be necessary for differential diagnosis and elucidating pathogenesis of granuloma annulare.
Collagen ; Diagnosis ; Diagnosis, Differential ; Epithelioid Cells ; Extremities ; Female ; Granuloma Annulare* ; Granuloma* ; Humans ; Hyalin ; Incidence ; Korea ; Male ; Skin Diseases ; Vasculitis

We report a case of disseminated cutaneous metastatic carcinoma from stomach carcinoma in a 66-year-old male who complained chiefly of widespread cutaneous nodules. He had been admitted to the Department of Internal Medicine for stomach carcinoma. A radiological examination revealed a diffuse stomach wall thickening from the fundus to the antrum, and enlargement of paraaortic and pericaval lymph nodes during an abodominal CT scan. The clinical findings manifested above may suggest cutaneous metastasis from stomach carcinoma. A histological examination of the skin and stomach biopsies showed atypical cells with pleomorphic, hyperchromatic nuclei and bubble-like cytoplasm, which are consistent with poorly differentiated adenocarcinoma. Immunohistochemical stainings showed that these cells were positive for epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA) and low molecular weight cytokeratin.
Adenocarcinoma ; Aged ; Biopsy ; Carcinoembryonic Antigen ; Cytoplasm ; Humans ; Internal Medicine ; Keratins ; Lymph Nodes ; Male ; Molecular Weight ; Mucin-1 ; Neoplasm Metastasis ; Skin ; Stomach* ; Tomography, X-Ray Computed