The determination of motor nerve conduction velocity is an important part to electrodiagnosis. Its value as neurophysiologic investigative procedure has been known for many years, and recently it has been utilized as a chinical diagnostic technic. Its most valuable role is differentiating between those conditions which affect the axon primarily and those which affect the anterior horn cell. Many factors such as temperature in the vicinity of the nerve, diameter of the axon, degree of myelinization, age of the patient, local environment of the nerve and intensity of electrical stimulation have been demonstrated to affect the rate of propagation of impulses along motor fibers. Pathologic conditions affecting the axon usually alter the excitability along involved segments and, therefore, result in reduced conduction velocity. The purpose of this study was to determine the normal data of the motor nerve conduction velocities of median, ulnar, tibial and peroneal nerves in Korean. 1. The motor nerve conduction velocities of median, ulnar, peroneal and tibial nerves were 61.54±6.95 (46.7–94.2) m/sec, 61.74±7.28 (45.6–95.0)m/sec, 48.80±5.54 (38.8–69.9) m/sec, 47.39±4.85 (36.2–64.2 m/sec respectively. 2. The condition velocity in the upper extremities has been found 13.5 m/sec faster than in the lower extremities. 3. A significant decline in motor nerve conduction velocities was noted in the over 60 year old age group. 4. There were significant differences between the sexes.
Anterior Horn Cells ; Axons ; Electric Stimulation ; Electrodiagnosis ; Humans ; Lower Extremity ; Myelin Sheath ; Neural Conduction ; Peroneal Nerve ; Tibial Nerve ; Upper Extremity

This study aimed to investigate the existence of GABA receptor and the mechanisms of action of GABA and diazepam of the trachealis muscle isolated from dog. Horizontal muscle strips of 2mm×15mm were prepared from canine trachea, and isometric myography in isolated muscle chamber bubbled with 95/5%-O₂/CO₂ at 36℃, at the pH of 7.4 was performed. Muscle strips contracted responding to the electrical field stimulation (ESP) by 2~20 Hz, 20 msec, monophasic square wave of 60 VDC. GABA and diazepam suppressed the EFS-induced contractions to the similar extent, significantly. (p<0.05). Bicuculline, a GABA(A) receptor antagonist blocked both GABA- and diazepam-inhibitions; but DAVA, a GABA(B) receptor antagoinst did not affect either of them. These results suggest than in the canine trachealis muscle, there may be only GABA(A) receptor, and GABA and diazepam inhibit the contractility via GABA(A) receptor.
Animals ; Bicuculline ; Diazepam ; Dogs ; gamma-Aminobutyric Acid* ; Hydrogen-Ion Concentration ; Myography ; Receptors, GABA ; Receptors, GABA-A ; Trachea

BACKGROUND: Recentry, the prevalence of HBsAg in children has been gradually decreased in Korea may be due to extensive vaccination. The object of this study is to identify the HbsAg positive rate in 6 to 7 year-old school children in Seoul and to outline the surveilance status of the HBsAg positive subjects. METHODS: We analyzed HBV mass screening results of 120,106 6 to 7-year-old school children in Seoul. For 188 HBsAg positive children who complied with the follow up visit, we tested HBeAg, LFT and interviewed their parents. We also compared the questionnaire results of HbsAg positive group with those of 694 random-sampled HBsAg negative controls. RESULTS: The overall HBsAg positive rate was 0.79%(0.81% in boys and 0.76% in girls). Children in poverty area showed significantly higher rate(1.04%) of HBsAg positivity than those in non-poverty area(0.77%). Among HbsAg positive children, 86.7% was also HBeAg positive and had higher ALT levels than those with negative HBeAg. More than 70% of parents of HBsAg positive children was not aware of their children's HBsAg status before the screening and 28.7% of mothers did not know their own HbsAg status. The complete vaccination rate of the HBsAg positive and HBsAg negative group were 75.5% and 77.4% respectively, which shows no significant difference. Having family history of HBV infection was significantly associated with HBsAg positive status(OR=32. 8). CONCLUSIONS: The HBsAg positive rate in 6- to 7-year-old school children has decreased in Korea compared to the data from previous studies. However in the aspects of public awareness and health care compliance, there are much room for quality improvement. Above all, more rigorous and continuous surveilance system is required for antenatal and postpartum care.
Child* ; Compliance ; Delivery of Health Care ; Follow-Up Studies ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis* ; Humans ; Korea ; Mass Screening ; Mothers ; Parents ; Pilot Projects* ; Postnatal Care ; Poverty Areas ; Prevalence ; Quality Improvement ; Seoul* ; Vaccination ; Surveys and Questionnaires

Authors report the first autopsy case of acquired immune deficiency syndrome in Korea. The patient was a 26 years old Korean male who died of respiratory failure due to mixed pulmonary infections. He had history of homosexual contacts with partners of both domestic and foreign nationalities. Initial presentation was unexplained fever for two months. Serological test and western blot test for anti-HIV were positive and T-cell subset analysis revealed T3/T4/T8 to be 73/8/67%. Pulmonary tuberculosis with mediastinal lymphadenopathy and esophagonadal fistula and oral candidiasis were presented. Respiratory infection progressed gradually and he died seven months after the initial symptom. Autopsy findings were generalized severe lymphoid cell depletion, especially of T-cell population and mixed pulmonary infections with Pneumocystis carinii and cytomegalovirus (CMV). The CMV infection involved lungs and adrenals. Oral candidiasis was also demonstrated.
AIDS-Related Complex/complications/diagnosis/pathology ; Acquired Immunodeficiency Syndrome/complications/*diagnosis/pathology ; Adult ; Autopsy ; Candidiasis/complications/diagnosis/pathology ; Humans ; Male ; Pneumonia, Pneumocystis/complications/diagnosis/pathology ; Tuberculosis, Pulmonary/complications/diagnosis/pathology

PURPOSE: A transurethral incision of the ureterocele offers several advantages. This study investigated the clinical efficacy of a transurethral incision in a ureterocele. MATERIALS AND METHODS: Twenty two children, 5 boys and 17 girls, received a transurethral incision as the primary treatment for their ureteroceles. Of the children, 12 had intravesical and 10 had ectopic ureteroceles. The initial presentations were abnormal findings in prenatal ultrasonography in 9 cases, fever in 7, UTI in 2, and others in 4. The median patient's age at the transurethral incision of the ureterocele was 3.3 months (range 0.2month to 4.1years). A cold knife or a 3-french Bugbee electrode was used. Their clinical courses were evaluated with a radiological and laboratory examinations. RESULTS: The transurethral incision resulted in the decompression of the ureterocele in 19 (86%), reflux to the upper moiety in 15 (68%), UTI in 2 (9%) and incontinence in 1 (4.5%). Eighteen patients (82%), 8 patients with an intravesical ureterocele and all 10 patients with an ectopic ureterocele, required secondary operations. A transurethral incision proved to be a definitive treatment for 4 (33.3%) patients with an intravesical ureterocele. Secondary operations were performed at 7.3 7.1months postoperatively. CONCLUSIONS: An endoscopic incision may be advocated as a definitive treatment modality for some patients with an intravesical ureterocele. Furthermore, by safely delaying reconstructive surgery, the majority of children can benefit from an endoscopic incision of the ureterocele.
Child ; Decompression ; Electrodes ; Female ; Fever ; Humans ; Ultrasonography, Prenatal ; Ureterocele*

Cerebral rete mirabile is a unusual form of chronic cerebrovascular occlusive disease characterized usually by bilateral stenosis of distal internal carotid arteries and their vicinity, by a hazy network of collateral circulation at the base of brain called moyamoya vessels and clinically by recurring hemispheric ischemic attack in children. We have reported here 2 cases of cerebral rete mirabile in children and performed newly developed operative procedure which we think is an ideal surgical method for treatment of this disease in children and is compared with other surgical treatment.
Brain ; Carotid Artery, Internal ; Child* ; Collateral Circulation ; Constriction, Pathologic ; Humans ; Ischemia ; Surgical Procedures, Operative

OBJECTIVE: To analyze the indications, clinical features, cytogenetic results and complications of amniocentesis and to determine the efficacy of antenatal genetic amniocentesis. METHODS: We analyzed retrospectively maternal age, gestational age, indications, transplacental puncture, frequency, discoloration of amniotic fluid, karyotype and complications in 325 cases of prenatal genetic amniocentesis performed at Chungnam National University Hospital from January 2000 to December 2002. RESULTS: The most common age group was from 30 to 34 (31.4%) and mean age was 32.7 years old. 85.3% of cases were performed at 16th-20th gestational weeks. Abnormal maternal serum markers were the most common indication of amniocentesis (56.0%) and the second most common indication was maternal age over 35 (33.2%). Abnormal karyotypes were found in 12 cases (3.6%) and normal variants were 21 cases (6.5%). Numerical aberration were 9 cases (2.7%) and structural aberration were 3 cases (0.3%). Among the autosomal aberrations, Down syndromes were 5 cases and Edward syndrome was 1 case. Among the sex chromosomal aberrations, 47,XXX were 2 cases and Turner syndrome was 1 case. As the increasing maternal age, the incidence of abnormal karyotype was increased. Procedure-related complications occurred in 11.7% of cases and fetal loss rate was 7.4%. No significant associations were found between procedure-related complications and maternal age, gestational age, transplacental puncture, frequency, discoloration of amniotic fluid, and antibiotic treatment. CONCLUSION: Amniocentesis is useful for prenatal genetic diagnosis in pregnancies with increasing risk of chromosome aberrations, such as advanced maternal age, abnormal maternal serum markers or abnormal US findings. Further studies are necessary to identify risk factors of complications after invasive procedure.
Abnormal Karyotype ; Amniocentesis* ; Amniotic Fluid ; Biomarkers ; Chromosome Aberrations ; Chungcheongnam-do ; Cytogenetic Analysis* ; Cytogenetics* ; Diagnosis ; Female ; Gestational Age ; Humans ; Incidence ; Karyotype ; Maternal Age ; Pregnancy ; Pregnancy Trimester, Second* ; Punctures ; Retrospective Studies ; Risk Factors ; Turner Syndrome

OBJECTIVE: Endometriosis is a very common gynecological condition in which tissue similar to endometrium proliferates at sites outside the uterine cavity. Although it generally remain a benign condition, malignant transformation has been documented, and it is commonly found in association with endometrioid subtype ovarian carcinoma. In order to identify the genomic change in those areas possibly involved in the pathogenesis of endometriosis, we performed LOH analysis. METHODS: Twenty seven cases of endometriosis were analyzed for the detection of LOH using 5 microsatellite markers. LOH analysis was performed by PCR, capillary electrophoresis and gene scan analysis using DNA from sections of tumor and normal tissue pairs. RESULTS: Twenty two of 27 (81.5%) cases demonstrated LOH at one or more loci. The frequency of LOH was 37.0% (D18S69), 25.9% (D22S274), 14.8% (D22S283), 7.4% (D6S286), 7.4% (D13S160). CONCLUSION: The frequencies of LOH was increased in higher stage of endometriosis. Most notable findings were found at chromosome 18 and 22 loci (D18S69, D22S274). These region might involve the some candidate genes closely related with the pathogenesis of endometriosis.
Chromosomes, Human, Pair 18 ; DNA ; Electrophoresis, Capillary ; Endometriosis* ; Endometrium ; Female ; Loss of Heterozygosity* ; Microsatellite Repeats ; Polymerase Chain Reaction

Experinece in the management of 74 patients with delayed traumatic intracranial hemorrhage(DTICH) of 474 head injury from January 1996 to December 1996 is poresented with emphasis on the incidence, occurring time, risk factors and outcome. The incidence of DTICH was 15.6% of all hospitalized head-injury patients. After an injury, every patient had an immediate computerized tomography(CT) scan to diagnose intracranial pathology and then CT follow-up was carried out according to intial CT finding and reurological deficit. The lesion was almost occurred in patients with initial abnormal CT finding(85.1%). 82.4% of DTICH were noted within 72 hours after injury. The delayed epidural hematoma and intracerebral hemorrhage were almost noted in first 72 hours(>90%), but the delayed subdural hemorrhage was found after a time interval varying from 6 hours to 10 days. So we strongly recommend CT follow-up in 4-8hour, 24-72hour, and then 7th day after head injury, especially in patients with initial abnormal CT findings. The risk factor of the delayed lesion was not hypotension, hypoxia, and consciousness level, but age of patients and the initial CT finding. The development of DTICH was not heralded by neurological deterioration. The prognosis of DTICH was not worse than non-DTICH. The patient with delayed subdural hemorrhage was better than the patient with non-delayed lesion(including hemorrhage and normal CT finding).
Anoxia ; Cerebral Hemorrhage ; Consciousness ; Craniocerebral Trauma* ; Follow-Up Studies ; Head* ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Hypotension ; Incidence ; Intracranial Hemorrhages* ; Pathology ; Prognosis ; Risk Factors

BACKGROUND: Paradoxical embolism through the patent foramen ovale (PFO) is a well-recognized mechanism for otherwise unexplained ischemic stroke. Although transthoracic contrast echocardiography (TCE) has been used frequently for noninvasive diagnosis of right to left shunt through PFO, its diagnostic accuracy appears limited, especially in patients with poor acoustic window. Since harmonic imaging (HI) can enhance the definition of contrast microbubbles, theoretical advantages of HI in the detection of right to left shunt through PFO using microbubbles can be considered. However, there are few data regarding the diagnostic efficacy of HI in the detection of right to left shunt through PFO. The purpose of this study was to compare the diagnostic value of transthoracic HI in the detection of right to left shunt through PFO in patients with stroke with that of fundamental imaging (FI). Methods: One hundred thirty-six consecutive patients with stroke (82 male, mean age:9) underwent TCE in both HI and FI and transesophageal echocardiography (TEE) during rest and Valsalva maneuver with intravenous administration of agitated saline. PFO was judged to be present if microbubbles appeared in the left atrium within 3 cardiac cycles of their appearance in the right atrium. TEE was regarded as the gold standard for assessing the diagnostic accuracy of TCE. Results: Right to left shunt through PFO was detected in 40 of 136 patients by TEE (29.4%). FI of TCE detected shunt through PFO in only 9 of 136 patients (6.6%). In contrast, HI detected shunt through PFO in 25 of 136 patients (18.4%). The overall sensitivity and specificity of FI and HI for detection of right to left shunt through PFO were 22.5%, 62.5% (p<0.05) and 100%, 100%, respectively. Valsalva maneuver during HI significantly increased the detection rate of shunt through PFO (during rest in 9 and during Valsalva maneuver in 25, p<0.05). CONCLUSION: HI with contrast microbubble injection significantly enhanced the detection of right to left shunt through PFO in patients with ischemic stroke compared with FI by transthoracic approach.
Acoustics ; Administration, Intravenous ; Diagnosis ; Dihydroergotamine ; Echocardiography* ; Echocardiography, Transesophageal ; Embolism, Paradoxical ; Foramen Ovale, Patent* ; Heart Atria ; Humans ; Male ; Microbubbles ; Sensitivity and Specificity ; Stroke ; Valsalva Maneuver