The diagnosis of OPCA could be made clinically with important aid of brain CT scanning, although the definite and conclusive diagnosis only by postmortem pathological determination. We reviewed, clinically and with brain CT examination, 12 cases of patients with OPCA who were admitted to the Yeungnam University Hospital for a recent 5 years. The result were as following: 1. The distribution of age is from 49 to 72, mainly 50 to 60. Man is more frequent than women at the 4.5 times. 2. The interval period from Sx. Onset to diagnosis is 1 year to 6 years. 3. The usual initial Sxs. Were dizziness (58%), ataxia (33%), and other less frequent Sxs. Were weakness of low extremities, dysarthria, headache and urinary incontinence. The clinical manifestations at the initial diagnosis were cerebellar disturbance (100%), dysarthria (83%), and increased deep tendon reflexes (58%). 4. The results of brain CT finding are like this: the width of cerebellar sulci is more than 1mm, other 4 cases more than 2mm. the width of cerebellar pontine cistern of the patient if usually 3 to 4mm, other 2 cases extended to the 5 mm. the A. P and lateral lengths of 4th. ventricle is 4 mm and 4 to 8 mm respectively. 6 cases of whole patients show coincidentally cerebral atrophy.
Ataxia ; Atrophy ; Brain ; Clinical Study* ; Diagnosis ; Dizziness ; Dysarthria ; Extremities ; Female ; Headache ; Humans ; Olivopontocerebellar Atrophies* ; Reflex, Stretch ; Tomography, X-Ray Computed ; Urinary Incontinence

One and a half syndrome is an ipsilateral gaze paresis or palsy combined with and internuclear ophthalmoplegia on contralateral gaze. The lesion site is at the paramedian pontine reticular formation and the adjacent MLF. The common causes are unilateral pontine infarction and multiple sclerosis. We experienced a case of one and a half syndrome which has a suspected small pontine infarct.
Infarction ; Multiple Sclerosis ; Ocular Motility Disorders ; Paralysis ; Paresis ; Pontine Tegmentum

The author studied 20 healthy adults (20 hands) as a control and 30 patients (40 hands) with carpal tunnel syndrome to evaluate the clinical usefulness of measuring nerve conduction velocity after wrist flexion in diagnosis of carpal tunnel syndrome. The median nerve conduction velocity over wrist to finger segment was measured before and after wrist flexion for 1, 2 and 5 minutes, using belly-tendon method for motor nerve distal latency (MNDL) and antidromic method for sensory nerve conduction velocity (SNCV). The results were as follows: 1. In control group, MNDL increased in 1 hand and SNCV decreased in 2 hands after wrist flexion. In patient group, MNDL increased in 2 hands and SNCV decreased in 3 hands after wrist flexion. 2. In both control and patient group, there were no significant changes in mean values of SNCV and MNDL between before and after wrist flexion. 3. Phalen's wrist flexion test was positive in 5 percent of control and 60 percent of patient group. 4. Tinel's sign was present in 10 percent of control and 33 percent of patient group.
Adult ; Carpal Tunnel Syndrome* ; Diagnosis ; Fingers ; Hand ; Humans ; Median Nerve ; Methods ; Neural Conduction* ; Wrist*

No abstract available.
Epidermis* ; Urocanic Acid*

We herein describe a 70-year-old woman who presented with respiratory failure due to extensive lung adenocarcinoma. Despite advanced disease, care in the intensive care unit with ventilator support was performed because she was a newly diagnosed patient and was considered to have the potential to recover after cancer treatment. Because prompt control of the cancer was needed to treat the respiratory failure, empirical treatment with an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor was initiated before confirmation of EGFR-mutant adenocarcinoma, and the patient was successfully treated. Later, EGFR-mutant adenocarcinoma was confirmed.
Adenocarcinoma* ; Aged ; Female ; Humans ; Intensive Care Units ; Lung* ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Respiration, Artificial ; Respiratory Insufficiency* ; Ventilators, Mechanical ; Erlotinib Hydrochloride

We present three neuropathologically-verified and two clinically-probable cases of Creutfeldt Jakob disease. All five had nonspecific prodromal complaints or symptoms prior to overt neurological signs and showed striking progressive neurologic deterioration, especially cognitive decline and cerebellar dysfunction. Myoclonic involuntary movements and complete decapitated states followed in one or two months. The characteristic even pathognomonic in proper clinical settings, features of electroencephalography, magnetic resonance imaging and positron emission tomography and pathologic findings are presented.
Cerebellar Diseases ; Creutzfeldt-Jakob Syndrome* ; Dyskinesias ; Electroencephalography ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Strikes, Employee

No abstract available.
Barotrauma* ; Lung Injury* ; Lung* ; Respiration, Artificial*

BACKGROUND: In order to investigate the usefulness and safety of Natural Stent, we performed this study in a canine model of tracheal stenosis induced using Nd-YAG laser. METHODS: After tracheal stenosis was induced in 12 Mongrel dogs using Nd-YAG laser, either Dumon (n=6) or Natural (n=6) stent was inserted into the trachea. To assess the degree of stent migration and mucostasis, bronchoscopy was performed every week for 4 weeks, after which all stents were removed. One week after stent removal, tracheal stenosis was evaluated by bronchoscopy. RESULTS: The degree of stent migration was not different between the dogs with Dumon stent (3.0+/-0.8) and those with Natural (2.0+/-1.0), nor was the degree of mucostasis, at Dumon (1.7+/-0.5) and Natural Stent (1.5+/-0.6), respectively. One week after stent removal, the degree of tracheal stenosis was not different between the Dumon (1.5+/-0.5) and the Natural group (1.0+/-0.4). In addition, there was no death and the degree of tracheal stenosis remained always within the safe limit (less than 2.0) in all animals. CONCLUSION: In a canine model of tracheal stenosis induced using Nd-YAG laser, the usefulness and safety of Natural Stent were similar to those of Dumon Stent. A clinical trial is necessary to document the usefulness and safety of Natural Stent in patients with tracheal stenosis.
Animals ; Bronchoscopy ; Dogs ; Humans ; Lasers, Solid-State ; Stents* ; Trachea ; Tracheal Stenosis*

BACKGROUND: Tracheal stenosis is an urgent but uncommon disease. Therefore, primary care clinicians have limited clinical experience. Animal models of a tracheal stenosis can be used conveniently for the learning, teaching, and developing new diagnostic and therapeutic modalities for tracheal stenosis. Recently, a canine model of a tracheal stenosis was developed using a Nd-YAG laser. To describe the methods and results of developed animal model, we performed this study. METHODS: Six Mongrel dogs were generally anesthetized and the anterior 180 degree of tracheal cartilage of the animal was photo-coagulated using a Nd-YAG laser. The animals were bronchoscopically evaluated every week for 4 weeks and a pathologic evaluation was also made. RESULTS: Two weeks after the laser coagulation, the trachea began to stenose and the stenosis progressed through 4 weeks. All animals suffered from shortness of breath, wheezing, and weight loss in the 3 weeks after the laser treatment, and two died of respiratory failure just before the fourth week. The gross pathologic findings showed the loss of cartilage and a dense fibrosis, which resulted in a fibrous stricture of the trachea. Microscopy also showed that the fibrous granulation tissue replaced destroyed cartilage. CONCLUSION: The canine model can assist in the understanding and development of new diagnostic and therapeutic modalities for tracheal stenosis.
Animals ; Bronchoscopy ; Cartilage ; Constriction, Pathologic ; Dogs ; Dyspnea ; Fibrosis ; Granulation Tissue ; Laser Coagulation ; Lasers, Solid-State* ; Learning ; Microscopy ; Models, Animal ; Primary Health Care ; Respiratory Insufficiency ; Respiratory Sounds ; Trachea ; Tracheal Stenosis* ; Weight Loss

PURPOSE: Tracheal restenosis due to excessive granulation tissue around a silicone stent requires repeated bronchoscopic interventions in patients with post-tuberculosis tracheal stenosis (PTTS). The current study was conducted to identify the risk factors for granulation tissue formation after silicone stenting in PTTS patients. MATERIALS AND METHODS: A retrospective study was conducted between January 1998 and December 2010. Forty-two PTTS patients with silicone stenting were selected. Clinical and radiological variables were retrospectively collected and analyzed. RESULTS: Tracheal restenosis due to granulation tissue formation were found in 20 patients (47.6%), and repeated bronchoscopic interventions were conducted. In multivariate analysis, tracheal wall thickness, measured on axial computed tomography scan, was independently associated with granulation tissue formation after silicone stenting. Furthermore, the degree of tracheal wall thickness was well correlated with the degree of granulation tissue formation. CONCLUSION: Tracheal wall thickening was associated with granulation tissue formation around silicone stents in patients with post-tuberculosis tracheal stenosis.
Adult ; Bronchoscopy/methods ; Female ; Granulation Tissue/*pathology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Silicones ; Stents/*adverse effects ; Tomography, X-Ray Computed ; Trachea/*pathology ; Tracheal Stenosis/etiology/*pathology ; Tuberculosis/*complications