No abstract available.
Fever* ; Mucous Membrane* ; Tongue*

No abstract available.
Laryngectomy* ; Rehabilitation* ; Voice*

No abstract available.
Esophageal Atresia* ; Tracheoesophageal Fistula*

BACKGROUND AND PURPOSE: For diagnosis of acquired autoimmune myasthenia gravis (MG), single fiber electromyography (SFEMG) is known to be much more sensitive than repetitive nerve stimulation test (RNST) in demonstrating the electrophysiological defects of neuromuscular transmission. Neuromuscular blocking in SFEMG is presumed to have the same physiologic basis with decremental response in RNST. The authors performed the study to know the correlations between the electrophysiological parameters of the RNST (decremental response) and the SFEMG (jitter and blocking) and to understand the basic physiological mechanisms in MG. METHODS: In 28 patients with definite MG (12 : ocular MG, 16 : generalized MG), RNST and SFEMG tests were done in orbicularis oculi and abductor digiti quinti and in extensor digitorum communis, respectively. The correlations between several factors, such as maximum decremental response (%) in RNST, mean value of mean consecutive differences (MCD's) (?sec) and blocking pairs (%) were analyzed. RESULTS: In 12 ocular MG patients, RNST and SFEMG abnormalities were found in 4 (33.3%) and in 10 (83.3%), respectively. In 16 generalized MG patients, abnormal decremental responses were found in 13 (81.3%) and increased jitters in 15 (93.8%). SFEMG showed significant correlations between blockings and mean MCD's (R=0.54, p<0.01). When the correlation between RNST and SFEMG was analyzed, increased percentage of blockings in extensor digitorum communis were correlated with maximum degree of decremental responses in abductor digiti quinti or orbicularis oculi (R=0.60, p<0.001). The degree of mean MCD's was poorly correlated with maximum decremental responses (R=0.23, p=0.229). But the correlation became significant (R=0.43, p<0.05) by analyzing mean MCD's and maximum decremental responses only from abductor digiti quinti, reflecting that blockings have similar electrophysiological meanings with increased mean MCD's. CONCLUSION: The good correlation between decremental response in RNST and blocking or mean MCD's in SFEMG was found. Therefore the authors concluded that the parameters of the RNST and the SFEMG show similar electrophysiologic phenomena of the abnormal neuromuscular transmission in MG.
Diagnosis ; Electromyography* ; Electrophysiological Phenomena ; Humans ; Myasthenia Gravis* ; Neuromuscular Blockade

It has been reported that pupillary paralysis is rare findings in typical Guillain-Barre syndrome(GBS). We experienced a 56-year-old male with fulminant GBS who pupillary paralysis. He showed quadriplegia, total paresis of motor cranial nerves including bilateral ptosis and complete opthalmoplegia. Pupils were dilated up to 8mm and fixed. After a one year follow up, his pupil slowly constricted to light. The instillation of 0.1% pilocarpin caused both pupillary constriction. These results pointed to postganglionic involvement of pupillary parasympathetic nerves.
Constriction ; Cranial Nerves ; Follow-Up Studies ; Guillain-Barre Syndrome* ; Humans ; Male ; Middle Aged ; Paresis ; Pilocarpine ; Pupil ; Pupil Disorders* ; Quadriplegia

BACKGROUND: Skin thickness for parameter of skin aging has been analysed with various methods. Skin thickness variations between the young and the old has been studied with various methods such as biopsies, calipers, micrometers, computer tomography, ultrsonography. But none of these methods evaluates skin thickness exactly. OBJECTIVE: For the evaluation of age-dependent skin thickness changes, we compared the skin thickness of an old-aged group and a young group with 20MHz-ultrasonography. METHODS: In order to identify the skin thickness variation between different age groups, 60 subjects, 30 aged 23-33, and 30 over 60, were studied with 20MHz-high frequency ultrasonogrphy (Dermascan C, Cortex Technology, Hadsund, Denmark) on fourteen skin sites. This machine was designed to measure the thickness from the top of the epidermis to the bottom of the dermis. After storage of cross-sectional skin imaging, skin thickness was calculated with a computer assisted image-analysis program. Skin thickness of the old was analysed by age, sex, height and weight.
Biopsy ; Dermis ; Epidermis ; Humans ; Skin Aging ; Skin* ; Ultrasonography*

The effect of 1% atropine solution and 1% atropine ointment on healing of corneal epithelium in 20 rabbits was studied. Corneal epithelium was removed by #15 blade in central area of 7mm in diameter under topical anesthesia with 0.5% pontocaine. 1% atropine solution was applied three times daily to Rt. eyes, and 1% atropine ointment to Lt. eyes. Progress of epithelial healing was observed by fluorescent staining of the wound. At the end of 24 hours, fluorescent staining area was 46.90% in average for Rt. eyes, and 51.90% in average for Lt. eyes. At the end of 48 hours, it was 7.83% for Rt. eyes, and 11.0% for Lt. eyes. At the end of 72 hours, All of Rt. eyes did not stain, but 2 of 10 Lt. eyes were faintly stained. Difference between ophthalmic solution and ointment on the effect of corneal epithelial healing was not significant.
Anesthesia ; Atropine ; Epithelium, Corneal* ; Rabbits ; Tetracaine ; Wounds and Injuries*

The purpose of this study is to evaluate the course and prognosis of secondary glaucoma due to silicone encircling surgery for retinal detachment. The experiment was performed by observing the changes of elevated intraocular pressure and electroretinogram produced by silicone encircling in 20 rabbits. The rabbits were divided into 4 groups according to the elevattd level of intraocular pressure which was obtaintd by tightening of #240 silicone bands around the equator of the eyeball. The intraocular pressure was measured with a Schiotz tonometer and electroretinogram was recorded with a set of preamplifier, (freqwoncy reSponse 0.3-240 Hz, gain 80 decibel). Tektronix 5A18N dual trace amplifier, 5B12N dual time base, and 5103N oscilloscope. From the experiments, fo1lowing findings were obtained. 1. The effect on intraocular pressure. a) The elevated intraocular pressure returned to the preoperative level within 5-15 minutes in 35-45 mmHg group, 3-4 hours in 55-65 mmHg group, 4-6 hours in 75-85 mmHg group, and 7-8 hours in 95-105 mmHg group. b) In all the groaps, rapid fall of the intraocular pressure was observed within 10 minutes and relatively slow decrease was followed. From the second postoperative day, the intraocular pressure was maintained at a lower level than the preoperative intraocular pressure. 2. The effect on electroretinogram. a) In 35-45 mmHg group, supernormal wave was recorded during the 3 postoperative hours and then the wave returned to the preoperative amplitude. b) In 55-65 mmHg group, the electroretionogram reduced immediately after operation to 70% of the preoperative amplitude in 'a' wave and to 60% of the preoperative amplitude in 'b' wave' The reduced amplitude recovered to the preoperative level on the postoperative 1-2 days. c) In 75-85 mmHg group, both 'a' and 'b' wave were abolished immediately after the operation. The 'a' wave started to recover when the intraocular pressure decreased to 57.6-67.2 mmHg and 'b' wave started to recover when the intraocular pressure decreased to 49.9-57.6 mmHg. d) In 95-105 mmHg group, both 'a' and 'b' wave were abolished immediately after the oreration. The 'a' wave started to recover when the intraocular pressure decreased to 49.9-66.2 mmHg and 'b' wave started to recover when the intraocular pressure decreased to 37.2-40.2 mmHg. Consequently, it was found that the intraocular pressure over 75 mmHg caused irreversible damage to the function of retina, though the increased intraocular pressure due to silicone encircling returned to the preoperative level within 8 hours, and the visual cell layer of retina was more resistant to the increased intraocular pressure than the inner nuclear layer of retina.
Glaucoma ; Intraocular Pressure* ; Prognosis ; Rabbits ; Retina ; Retinal Detachment ; Silicones*

A 38-year-old female patient presented dystrophic nail changes on her all finger and toe nails for 10 years. On examination, nails were uniformly affected with longitudinal ridging, loss of normal luster and brownish discoloration. This patient has not had any inflammatory skin diseases or systernic illness for the past 10 years. Biopsy examination from the dystrophic nail showed non-specific eczematous changes. The clinical and histologic features of this yatient was considered as the consistent findings with the ty enty-nail dystrophy, occured on the idiopathic base, coined by previous authors.
Adult ; Biopsy ; Female ; Fingers ; Humans ; Numismatics ; Skin Diseases ; Toes

Among the enzymes which are responsible for basement membrane breakdown, matrix metalloproteinases (MMP) form a family of neutral proteases that are regulated at the levels of gene transcription, proenzyme activation by the cleavage of protein, and the inhibition of the active enzyme by tissue inhibitors of matrix metalloproteinases (TIMP). Recent reports have demonstrated that the expression of these proteolytic enzymes are elevated in several solid tumors and that it can be associated with invasiveness and poor prognosis. We examined the expression of MMP-2, MMP-9, TIMP-1 and TIMP-2 by immunohistochemistry in 160 cases of infiltrating ductal carcinoma. And we compared these data with the established prognostic parameters - tumor size, nodal status, clinical stage, hormonal receptor status, microvessel density, and TGF-beta1 expression in order to evaluate how MMP and TIMP expression are associated with breast cancer progression and prognosis. Microvessel density in invasive breast carcinoma was significantly correlated with tumor size and recurrence (p<0.05). The immunohistochemical expression of TGF-beta1 was significantly associated with tumor size, lymph node metastasis, and clinical stage (p<0.05). The microvessel density was significantly correlated with TGF-beta1 expression in more than 50% of tumor cells. The immunohistochemical expression of MMP-2 and MMP-9 were significantly correlated with nodal metastasis and absence of immunoreactivity for estrogen and progesterone receptors. The immunohistochemical expression of TIMP-1 was inversely correlated with clinical stage and microvessel density while that of TIMP-2 was inversely correlated with clinical stage (p<0.05). Small size of tumor, presence of progesterone receptor, highly differentiated histologic grade, and absence of immunoreactivity for MMP-9 were significantly associated with higher survival rate, but in multivariate analysis only tumor size and MMP-9 expression appeared to affect survival independently.
Basement Membrane ; Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Estrogens ; Humans ; Immunohistochemistry ; Lymph Nodes ; Matrix Metalloproteinases ; Microvessels ; Multivariate Analysis ; Neoplasm Metastasis ; Peptide Hydrolases ; Prognosis ; Receptors, Progesterone ; Recurrence ; Survival Rate ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2 ; Transforming Growth Factor beta1