Paroxysmal choreoathetosis(dyskinesia) is classified into two subtypes: paroxysmal kinesigenic choreoathetosis(PKC) and paroxysmal dystonic choreoathetosis(PDC). PDC consist of attacks of dystonia and /or choreoathetosis during which the patients are dysarthric or anarthric, have irregular clonic movement and dystonic posturing of extremities, and these not precipitated by sudden movement but rather by alocohol, coffee and stress. Attacks are longer (2ninute-4hours), but less frequently(3-4times/day) than PKC, they are not responsive to anticonvulsants(eg, phenytoin, carbamazepine) but controlled by clonazepam.This disease is rare, in the reported families, the transmission was clearly autosomal dominant with high penetrance.
Coffee ; Dystonia ; Extremities ; Humans ; Penetrance ; Phenytoin

Hereditary progressive dystonia develope in the first decade of ?life and is characterized by marked diurnal fluctuation of symptoms(dystonic postures and movements), i.e.symptoms aggrevated towards evening and alleviated after sleep. These symptoms and signs responded dramatically to levodopa. With the high incidence of familial cases this disorder is considers to be hereditary, but inheritance is not clear yet. Segawa regarded this disorder as a dystonia different from Parkinson's disease and other types of dystonic movement disorders, thereafter it has been reported under name of hereditary progressive dystonia with marked diurnal fluctuation.
Dystonia* ; Incidence ; Levodopa ; Movement Disorders ; Parkinson Disease ; Posture ; Wills

We treated a 66 year-old-male patient with non-traumatic spontaneous E. coli meningitis, whose cerebrospinal fluid showed turbid, and from which E. coli was cultured, and who had urinary tract infection and fatty liver disease which were thought to be predisposing factors to the meningitis. Gram-negative bacillary meningitis is a very rare condition after the neonatal period, and may be complicated by penetrating cranial injuries, neurosurgical interventions or such debilitating diseases as diabetes, liver cirrhosis, urinary tract infection, malignancy and alcholism, etc. It has a high mortality rate in spite of using various antibiotics.
Adult* ; Anti-Bacterial Agents ; Causality ; Cerebrospinal Fluid ; Fatty Liver ; Humans ; Liver Cirrhosis ; Meningitis* ; Mortality ; Urinary Tract Infections

Curcumin exerts a protective effect in cerebral ischemia through its anti-oxidant and anti-inflammatory activities. gamma-enolase is a glycolytic enzyme expressed in neurons that is known to exerts a neuroprotective effect. We investigated whether curcumin regulates gamma-enolase expression in focal cerebral ischemic injury in rats. Middle cerebral artery occlusion (MCAO) was performed to induce focal cerebral ischemia. Adult male rats were injected intraperitoneally with either vehicle or curcumin (50 mg/kg) 1 h after MCAO and cerebral cortex tissues were isolated 24 h after MCAO. We found that MCAO-induced injury resulted in a reduction in gamma-enolase expression in vehicle-treated animals using a proteomics approach. However, this reduction was attenuated in animals with MCAO treated with curcumin. Reverse-transcription PCR and Western blot analyses also showed that curcumin treatment prevented the MCAO injury-induced reduction in gamma-enolase expression. The results of this study suggest that curcumin exerts its neuroprotective function in focal cerebral ischemia by regulating the expression of gamma-enolase.
Adult ; Animals* ; Blotting, Western ; Brain Ischemia ; Cerebral Cortex ; Curcumin* ; Humans ; Infarction, Middle Cerebral Artery ; Male ; Middle Cerebral Artery* ; Models, Animal* ; Neurons ; Neuroprotective Agents ; Phosphopyruvate Hydratase* ; Polymerase Chain Reaction ; Proteomics ; Rats

BACKGROUND AND OBJECTIVES: Hyperhomocyt(e)inemia is known to be one of independent risk factors for the ischemic heart diseases recently, but the role of hyperhomocysteinemia in restenosis after coronary intervention is unclear. The relationship between plasma homocysteine level and restenosis after coronary intervention was evaluated in Korean patients. MATERIALS AND METHOD: Eighty three patients underwent successful percutaneous coronary intervention (PCI) and follow-up coronary angiography were divided into two groups according to restenosis, and the level of plasma homocysteine was compared between groups with restenosis (n=5, M:F=7:8, 60.6+/-13.5 years) and without restenosis (n=8, M:F=0:8, 60.3+/-12.8 years). RESULTS: The clinical manifestation, atherosclerosis risk factors except for hypertension, and coronary angiographic findings were not significantly different in patients with or without restenosis(P=S). The value of homocysteine was 9.3+/-3.1 micromol/L in 35 patients with restenosis and 8.4+/-2.5 micromol/L in 48 patients without restenosis(P=S). All of 8 patients whose values of plasma homocysteine were more than 13 micromol/L, had angiographic restenosis. Plasma homocysteine was not an independent risk factor of restenosis by means of logistic regression analysis. CONCLUSION: Plasma homocysteine is not a potential risk factor of restenosis after percutaneous coronary intervention.
Atherosclerosis ; Coronary Angiography ; Follow-Up Studies ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Hypertension ; Logistic Models ; Myocardial Ischemia ; Percutaneous Coronary Intervention* ; Plasma ; Risk Factors

BACKGROUND AND OBJECTIVES: Since 1987, coronary stents have changed the pattern of practice of interventional cardiology, by reducing the complications and improving the clinical outcomes. However, coronary stent restenosis still remains a significant clinical problem in the field of interventional cardiology. The aim of this trial was to compare the clinical efficacy of a rotational atherectomy (ROTA), with that of a plain old balloon angioplasty (POBA), in patients with coronary stent restenosis. SUBJECTS AND METHODS: One hundred and three patients (men 80, 58.4+/-10.3 years of age), diagnosed with coronary stent restenosis, at Chonnam National University Hospital, between January 1999 and December 2000, were analyzed. The clinical end-points were the occurrence of major adverse cardiac events (MACE): death, myocardial infarction and target lesion revascularization (TLR) during the one-year clinical follow-up. RESULTS: The baseline clinical and angiographic characteristics were similar between the two groups. Before the percutaneous coronary intervention (PCI), the diameter of stenosis of the POBA and ROTA groups were 81.9+/-14.0 and 82.9+/-10.0%, respectively, which decreased to 25.5+/-15 and 22.7+/-12% after treatment. At the one-year clinical follow-up, the TLR rates were 7.0 and 6.3% in the POBA and ROTA groups, respectively. The MACE results were not different between the two groups (7.0 and 9.4% in the POBA and ROTA groups, respectively). CONCLUSION: There was no significant long-term clinical benefit of a rotational atherectomy prior to a POBA, compared with a POBA alone, for the treatment of coronary stent restenosis.
Angioplasty ; Angioplasty, Balloon* ; Atherectomy, Coronary* ; Cardiology ; Constriction, Pathologic ; Follow-Up Studies* ; Humans ; Jeollanam-do ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Stents*

Transduction of cytokine gene into tumor cells is a promising method of tumor therapy, but the value is limited by accompanying side effects. To focus antitumor immune response to tumor antigen-specific CTL, we developed an antitumor vaccine by transfecting modified IL-2 gene in a membrane-bound form (mbIL-2) into B16F10 melanoma cells. The mbIL-2 clone showed reduced tumorigenicity and metastatic ability, and inhibited metastasis and prolonged the survival of mice against B16F10 cells. The inhibition of B16F10 metastasis by mbIL-2 was accompanied by the increment of CD8+ T cells. The metastasis of mbIL-2 clone was significantly increased in the CD8+ T cell-depleted mice, but not in CD4+ T cell depleted mice. Spleen cells immunized with the mbIL-2 clone showed higher CTL activity towards B16F10 cells than those immunized with control cells. The size of CD8+ T cell population in the lung of mice injected with the mbIL-2 clone was markedly greater than that of mice injected with B16F10 cells, but there was no detectible change in CD4+ and CD8+ T cell populations of lymph nodes and spleen. These results suggest that when the mbIL-2 clone is introduced into the blood stream, it migrates mainly to lung and activates CD8+ T cells in situ, possibly by direct priming. Such a tumor vaccine may ameliorate the toxic side effects encountered with conventional cytokine gene therapy.
Animals ; CD4-Positive T-Lymphocytes ; CD8-Positive T-Lymphocytes/immunology ; Cancer Vaccines/*immunology ; Female ; *Genetic Engineering ; Interleukin-2/*genetics/metabolism ; Lung Neoplasms/*immunology/secondary/therapy ; Lymphocyte Activation ; Melanoma, Experimental/genetics/*immunology/*prevention & control ; Mice ; Mice, Inbred C57BL ; Research Support, Non-U.S. Gov't ; Spleen/immunology ; Survival Rate ; T-Lymphocytes, Cytotoxic/immunology ; Vaccination

PURPOSE: We examined the effects of 3 months of intensive education (IE) after hospital discharge compared to conventional education (CE) on nutritional status and quality of diet and life among South Korean gastrectomy patients. METHODS: The study was conducted among 53 hospitalized gastrectomy in-patients (IE group, n = 28; CE group, n = 25) at Kyung Hee University Hospital at Gangdong. Baseline data were collected from electronic medical records and additional information was gathered via anthropometric measurements, assessment of nutritional status through a patient-generated, subjective global assessment (PG-SGA), diet assessment, and measures of self-efficacy and satisfaction with meals for 3 months following hospital discharge. RESULTS: Total PG-SGA scores were significantly higher in the CE group than in the IE group at 3-week post-discharge (5.2 in the IE group vs. 10.4 in the CE group, P < 0.001), with higher scores indicating a greater severity of malnutrition. Energy intake over the 3 months increased in both the IE group (from 1,390 to 1,726 kcal/day) and the CE group (from 1,227 to 1,540 kcal/day). At 3-week post-discharge, the IE group had significantly higher daily protein and fat intake (P < 0.05). Self-efficacy improved in each category (P < 0.001), except for 'difficulty eating adequate food'. When assessing satisfaction with meals, there was a difference in the 'satisfaction with the current meal size' (P < 0.001) and 'satisfaction with the menu content' (P < 0.001). CONCLUSION: Nutritional status among gastrectomy patients in the IE group improved. Relative to the CE control, the IE group demonstrated improved self-efficacy and meal satisfaction 3-week post-discharge.
Diet ; Eating ; Education* ; Electronic Health Records ; Energy Intake ; Gastrectomy ; Humans ; Malnutrition ; Meals ; Nutrition Assessment ; Nutrition Therapy ; Nutritional Status* ; Quality of Life* ; Stomach Neoplasms

Recent increase in the incidence of lung cancer often makes it difficult to differentiate between lung cancer and tuberculosis (TB), due to their radiologic similarities. Fine needle aspiration biopsy (FNAB) has been widely employed for the diagnosis of lung cancer and TB, but the diagnostic accuracy of TB is not high enough. As a rapid screening test for tuberculosis, we evaluated serological tests using Mycobacterium tuberculosis PPD and lipoarabinomannan (LAM) antigens. A total of 95 patients with indication of FNAB cytology from initial CT findings were enrolled. 25 patients had TB, 76 thoracic malignancy, and six (7.9%) of the lung cancer patients also had TB, indicating much higher prevalence of TB in thoracic tumor patients. Antibodies to PPD were elevated in 18 (72.0%) of 25 TB patients and in 22 (31.4%) of 70 patients with thoracic malignancy. In contrast, only 3 (4.7%) of 64 healthy controls aged 40 or above were seropositive to PPD antigen. The prevalence of anti-PPD antibodies in thoracic tumor patients was therefore significantly greater than that amongst the healthy controls (p 0.001, chi-square test). However, no significant difference in the prevalence of anti-LAM antibodies was found between study subjects and controls. This study demonstrates that thoracic tumor patients have significantly elevated antibodies to PPD; therefore, high anti-PPD seroreactivity in thoracic tumor patients should be cautiously interpreted. A longitudinal investigation on seropositive thoracic tumor patients is required to determine the role of the serological test for TB in lung cancer patients.
Adult ; Aged ; Aged, 80 and over ; Antibodies, Bacterial/*analysis ; Biopsy, Needle ; Female ; Human ; Lipopolysaccharides/*immunology ; Lung Neoplasms/complications/diagnosis/*microbiology ; Male ; Middle Age ; Mycobacterium tuberculosis/*immunology ; Seroepidemiologic Studies ; Tuberculin/*immunology ; Tuberculosis, Pulmonary/complications/diagnosis

Henoch-Shonlein purpura(HSP) is a systemic small-vessel vasculitis that primarily affects the skin, gastrointestinal tract, joints, and kidneys. The nervous system may be involved, less commonly than other organs. When the central nervous system(CNS) was involved, headache, changes in mental status, seizures, and focal neurologic deficits have been reported. Hypertension, uremic encephalopathy, metabolic abnomalities, electrolyte abnormalities, or cerebral vasculitis were suggested as possible causes of the neurologic manifestation. Diagnosis of vasculitic involvement of CNS is difficult. Magnetic resonance imaging of the brain is the modality of choice for the evaluation of the CNS disease. Steroid or plasmapheresis are used in treatment of cerebral vasculitis. We experienced a case of 9-year-old boy who had presented with Henoch-Schonlein purpura nephritis complicating encephalopathy accompanied by hypertension and cerebral vasculitis. Brain MRI showed multiple small nodular-linear pattern enhancing lesions in whole cerebral hemispheres and focal increased T2 signal in the right basal ganglia. We used intravenous immunoglobulin in treatment of cerebral vasculitis. We report this case with a brief review of related literature.
Basal Ganglia ; Brain ; Brain Diseases, Metabolic ; Central Nervous System Diseases ; Cerebrum ; Child ; Diagnosis ; Gastrointestinal Tract ; Headache ; Humans ; Hypertension* ; Immunoglobulins ; Joints ; Kidney ; Magnetic Resonance Imaging ; Male ; Nephritis* ; Nervous System ; Neurologic Manifestations ; Plasmapheresis ; Purpura, Schoenlein-Henoch* ; Seizures ; Skin ; Vasculitis ; Vasculitis, Central Nervous System*