OBJECTIVES: This study was conducted in order to evaluate the effects of inhalants on color vision impairment. METHODS: The inhalation group consisted of 81 neurotoxic chemical substance abusers at Bugok National Hospital and Institute of Forensic Psychiatry, Ministry of Justice. The control group consisted of 41 employees of Bugok National Hospital. The Lanthony D-15 desaturated hue test was administered to both groups. For the qualitative analysis, we classified the results by the morphological characteristics of color vision impairment. For the quantitative analysis, we calculated the total color distance score (TCDS) and the color confusion index (CCI) and determined that the individual was abnormal if the TCDS was over 65.0 or the CCI was over 1.25. RESULTS: The TCDS of the inhalation group was 75.58+/-21.07 and the CCI was 1.34+/-0.37 in the right eye, and 75.47+/-23.63 and 1.34+/-0.42, respectively in the left eye. These results are higher than those found for the control group. In regards to the TCDS, 50 (61.8%) of the abusers in the inhalation group had color vision impairment in the right eye and 48 (59.2%) had impairment in the left eye. 11 (26.8%) of the employees in the control group had color vision impairment in the right eye and 13 (31.7%) had impairment in the left eye. In regards to the CCI, 38 (46.9%) of the abusers in the inhalation group had color vision impairment in the right eye and 35 (43.2%) had impairment in the left eye. 4 (9.8%) of the employees in the control group had color vision impairment in the right eye and 7 (17.0%) had impairment in the left eye. The results of multiple logistic regression analysis for acquired color vision impairment showed that the inhalation period (OR=1.20, 95% CI: 1.03~1.40) was the significant variable. CONCLUSIONS: These findings indicate that the inhalation of neurotoxic substances may impair the color vision, and the period inhaled with neurotoxic substances is significant variable affecting on the acquired color vision impairment.
Color Vision ; Eye ; Forensic Psychiatry ; Inhalation ; Logistic Models ; Social Justice

Acute multiple cranial neuropathies are considered as variant of Guillain-Barre syndrome, which are immune-mediated diseases triggered by various cases. It is a rare disease which is related to infectious, inflammatory or systemic diseases. According to previous case reports, those affected can exhibit almost bilateral facial nerve palsy, then followed by bulbar dysfunctions (cranial nerves IX and X) accompanied by limb weakness and walking difficulties due to motor and/or sensory dysfunctions. Furthermore, reported cases of the acute multiple cranial neuropathies show electrophysiological abnormalities compatible with the typical Guillain-Barre syndromes (GBS). We recently experienced a patient with a benign infectious disease who subsequently developed symptoms of variant GBS. Here, we describe the case of a 48-year-old male patient who developed multiple symptoms of cranial neuropathy without limb weakness. His laboratory findings showed a positive result for anti-GQ1b IgG antibody. As compared with previously described variants of GBS, the patient exhibited widespread cranial neuropathy, which included neuropathies of cranial nerves III-XII, without limb involvement or ataxia.
Ataxia ; Bulbar Palsy, Progressive ; Communicable Diseases ; Cranial Nerve Diseases* ; Cranial Nerves ; Extremities* ; Facial Nerve ; Guillain-Barre Syndrome* ; Humans ; Immunoglobulin G ; Male ; Middle Aged ; Paralysis ; Rare Diseases ; Walking

OBJECTIVE: To clarify the relationship of the initial radiologic and a biomechanical parameter at first clinical visit, and define the effectiveness of modified insole, following insole fitting in children with flexible flatfoot. METHODS: Children aged less than 13 years with flexible flatfoot were enrolled. The total number of subjects was 66 (33 boys, 33 girls). The subjects were divided into 5 subgroups, based on age: 1–2, 3–4, 5–6, 7–9, and 10–12 years. The mean time period between the initial & final examination for their resting calcaneal stance position angle (RCSPA) was 24 months. Radiography quantified the deformity by measuring angles, including the talometatarsal angle, the metatarsal angle, and the calcaneal pitch angle. RESULTS: From the angles measured on radiographs, only the talometatarsal angle showed a statistically significant correlation to the initial RCSPA (r=-0.578 for right side, r=-0.524 for left side; p<0.01). The mean RCSPA improved in all subgroups of subjects following insole fitting. Moreover, in children younger than 7 years, the improvement in RCSPA from the insole fitting was greater compared to children aged 7 years and older. CONCLUSION: The insole has additionally beneficial effects in all populations younger than 13 years. However, there might exist a hidden effect of normal structural pedal alignment during growth accompanied with bony maturation and developmental process. To date, it is controversial whether the treatment of flexible flatfoot is necessary in the vast majority of cases, or simple observation and advice to parents would suffice.
Child* ; Congenital Abnormalities ; Flatfoot* ; Humans ; Metatarsal Bones ; Parents ; Radiography

OBJECTIVE: To evaluate whether an initial complete impairment of spinal cord injury (SCI) contributes to the functional outcome prediction, we analyzed the relationship between the degree of complete impairment according to the American Spinal Injury Association impairment scale (AIS), the posterior tibial nerve somatosensory evoked potential (PTSEP) and the changes of functional indices. METHODS: Sixty subjects with SCI were studied who received rehabilitative management for over 2 months. The degree of completeness on basis of the initial AIS and PTSEP were evaluated at the beginning of rehabilitation. Following treatment, several functional indices, such as walking index for spinal cord injury version II (WISCI II), spinal cord independence measure version III (SCIM III), Berg Balance Scale (BBS), and Modified Barthel Index (MBI), were evaluated until the index score reached a plateau value. RESULTS: The recovery efficiency of WISCI and BBS revealed a statistically significant difference between complete and incomplete impairments of initial AIS and PTSEP. The SCIM and MBI based analysis did not reveal any significant differences in terms of the degree of AIS and PTSEP completeness. CONCLUSION: AIS and PTSEP were highly effective to evaluate the prognosis in post-acute phase SCI patients. BBS and WISCI might be better parameters than other functional indices for activities of daily living to predict the recovery of the walking ability in post-acute SCI.
Activities of Daily Living ; Evoked Potentials, Somatosensory ; Humans ; Postural Balance ; Prognosis ; Rehabilitation ; Spinal Cord ; Spinal Cord Injuries* ; Spinal Injuries ; Tibial Nerve ; Walking

Mucinous cholangiocarcinoma, characterized by large quantities of mucin production, is a rare subtype of peripheral cholangiocarcinoma and usually shows rapid progression and a fatal outcome. We report here a case of mucinous cholangiocarcinoma in a 69 year-old man, who was infected with Clonorchis sinensis. Histologically, the tumor was an adenocarcinoma with extensive intracellular and extracellular mucin production, up to 70% of the tumor mass and there was frequent lymphovascular invasion of the tumor cells. The liver adjacent to the mass contained eggs of Clonorchis sinensis in the bile duct lumen and showed ductal epithelial hyperplasia, mucinous metaplasia and adenomatous proliferation of intramural glands. The patient was treated with a right hepatectomy. Four months after the surgery, the tumor recurred in the soft tissue of the right flank.
Aged ; Bile Duct Neoplasms/*complications/secretion ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*complications/secretion ; Clonorchiasis/*complications ; English Abstract ; Humans ; Male ; Mucins/secretion

Acetylcholine provocation test was performed in 54 patients who were admitted to Seoul National University Hospital between August, 1989 and October, 1990 with chest painn and normal or near normal(narrowin of less than 30%) coronary arteries on baseline coronary angiogram. 1) After provocation with intracoronary acetylcholine, 19 patients showed coronary artery constriction of less than 50%, 5 patients showed constriction of 50 to 74%, 21 patients showed constriction of 75 to 99% and 5 patients showed total occlusion. patients with typical symptoms of variant angina showed coronary artery constriction of more than 50% in 81% of cases while those without such symptoms showed constriction of more than 50% in only 28%. 2) We classified the coronary artery constriction over 50% after acetylcholine provocation into focal, diffuse, combined type and total occlusion. 3) Branches of coronary artery on which constriction was provoked by acetylcholine were right coronary, left anterior descending and left circumflex in the decreasing order of frequency. 4) In patients with focal constriction less than 50%, there was neither ECG change nor development of chest pain, and out of 13 patients with focal constriction of more than 75%, 11 patients showed both chest pain and ST segment change and 2 of them showed either chest pain or ST sement change. 5) In 4 patients with diffuse constriction of less than 75%, we could not observe ECG change and chest pain and in 11 patients with diffuse constriction of more than 75%, six showed chest pain and ST segment change, four showed chest pain without ECG change and one showed neither chest pain nor ECG change. 6) In 5 patients with total occlusion, 3 of them showed both chest pain and ST segment change and 2 of them showed only chest pain. 7) Patients with coronary artery constriction of more than 75% showed significant difference in occurrence of chest pain and ST segment change in comparison with patients with coronary artery constriction of less than 75%(p<0.01). It is suggested that dynamic coronary artery constriction of more than 75% after acetylcholine provocation can be considered as positive test regardless of the morphologic feature of the lesion, whether it is diffuse or focal.
Acetylcholine* ; Chest Pain ; Constriction ; Coronary Vessels* ; Electrocardiography ; Humans ; Seoul ; Spasm* ; Thorax

Acetylcholine provocation test was performed in 54 patients who were admitted to Seoul National University Hospital between August, 1989 and October, 1990 with chest painn and normal or near normal(narrowin of less than 30%) coronary arteries on baseline coronary angiogram. 1) After provocation with intracoronary acetylcholine, 19 patients showed coronary artery constriction of less than 50%, 5 patients showed constriction of 50 to 74%, 21 patients showed constriction of 75 to 99% and 5 patients showed total occlusion. patients with typical symptoms of variant angina showed coronary artery constriction of more than 50% in 81% of cases while those without such symptoms showed constriction of more than 50% in only 28%. 2) We classified the coronary artery constriction over 50% after acetylcholine provocation into focal, diffuse, combined type and total occlusion. 3) Branches of coronary artery on which constriction was provoked by acetylcholine were right coronary, left anterior descending and left circumflex in the decreasing order of frequency. 4) In patients with focal constriction less than 50%, there was neither ECG change nor development of chest pain, and out of 13 patients with focal constriction of more than 75%, 11 patients showed both chest pain and ST segment change and 2 of them showed either chest pain or ST sement change. 5) In 4 patients with diffuse constriction of less than 75%, we could not observe ECG change and chest pain and in 11 patients with diffuse constriction of more than 75%, six showed chest pain and ST segment change, four showed chest pain without ECG change and one showed neither chest pain nor ECG change. 6) In 5 patients with total occlusion, 3 of them showed both chest pain and ST segment change and 2 of them showed only chest pain. 7) Patients with coronary artery constriction of more than 75% showed significant difference in occurrence of chest pain and ST segment change in comparison with patients with coronary artery constriction of less than 75%(p<0.01). It is suggested that dynamic coronary artery constriction of more than 75% after acetylcholine provocation can be considered as positive test regardless of the morphologic feature of the lesion, whether it is diffuse or focal.
Acetylcholine* ; Chest Pain ; Constriction ; Coronary Vessels* ; Electrocardiography ; Humans ; Seoul ; Spasm* ; Thorax

OBJECTIVETo assess the clinical evidence for and against acupuncture as a treatment for Bell's palsy.

METHODSWe conducted a literature search of 15 databases from their inception to December 2010 without language restrictions. We included all randomized clinical trials (RCTs) regardless of their controls. Methodological quality was evaluated using the Cochrane risk of bias assessment tool.

RESULTSOf the 3 474 articles, only eight RCTs met our inclusion criteria. Four RCTs tested the effects of acupuncture against drug therapy on disease response rate. The meta-analysis of these data showed significant improvements in the acupuncture group [n=463, risk ratio (RR)=1.07, 95% CI: 1.02 to 1.13; P=0.006, I(2)=0%]. Six RCTs tested the effects of acupuncture plus drug therapy versus drug therapy alone. The meta-analysis of this set of RCTs also showed the favorable effects of acupuncture on disease response rate (n=512, RR=1.11, 95% CI: 1.05 to 1.17; P=0.001, I(2)=13%).

CONCLUSIONSThe evidence supporting the effectiveness of acupuncture for treating Bell's palsy is limited. The number and quality of trials are too low to form firm conclusions. Further rigorous RCTs are warranted but need to overcome the many limitations of the current evidence.

Bronchogenic cysts are rare developmental anomalies of the primitive foregut that occur during embryogenesis. They may arise in the mediastinum or within pulmonary parenchyma and, less frequently, below or within the diaphragm. Presenting signs may vary from multiple symptomatic to asymptomatic. A 9-year-old boy was coincidentally found to have a round-shaped mass in chest X-ray which he did not possess during neonatal period. Computer tomography showed a round, homogeneous mass in posterior mediastinum which was adhered to the esophagus. The mass was surgically excised and pathologically confirmed bronchogenic cyst. We hereby present the case with review of literature.
Bronchogenic Cyst* ; Child* ; Diaphragm ; Embryonic Development ; Esophagus ; Female ; Humans ; Male* ; Mediastinum ; Pregnancy ; Thorax

Acute transverse myelitis (ATM) is an upper motor neuron disease of the spinal cord, and concomitant association of peripheral polyneuropathy, particularly the axonal type, is rarely reported in children. Our cases presented with ATM complicated with axonal type polyneuropathy. Axonal type polyneuropathy may be caused by acute motor-sensory axonal neuropathy (AMSAN) or critical illness polyneuropathy and myopathy (CIPNM). These cases emphasize the need for nerve and muscle biopsies to make the differential diagnosis between AMSAN and CIPNM in patients with ATM complicated with axonal polyneuropathy.
Axons* ; Biopsy ; Child* ; Diagnosis, Differential ; Humans ; Motor Neuron Disease ; Muscular Diseases ; Myelitis, Transverse* ; Polyneuropathies* ; Spinal Cord