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

Neurobehavioral deficits, especially in cognition, are often the cause of significant disability after traumatic brain injury (TBI). A thorough evaluation of cognitive function is needed before an effective cognitive rehabilitation. Common cognitive changes that follow TBI include impaired attention, psychomotor slowing, executive dysfunction, and impairment in working memory. The Seoul Neuropsychological Screening Battery (SNSB), the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) and the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-cog) can be used to evaluate the multiple cognitive domains in TBI. Wisconsin Card Sorting Test, Frontal Assessment Battery, Trail making test, Digit-symbol test and symbol-digit test are useful to detect mild cognitive impairment in the TBI patients who have subjective cognitive impairment and no abnormality on routine neuropsychological tests. Tests of psychomotor speed and executive function are sensitive to TBI. Computerized neurocognitive testing can be administered to measure relatively mild degrees of neurocognitive impairment in TBI.

Diffuse aspiration bronchiolitis is defined as a clinical entity characterized by a chronic inflammation of bronchioles caused by recurrent aspiration of foreign particles. Clinical symptoms are bronchorrhea, bronchospasm, and dyspnea, and chest radiographs show the presence of regional or disseminated srnall nodular shadows and hyperlucency. Chest CT should help in detecting diffuse nodular shadows of bronchiolitis. Pathologic findings of diffuse aspiration bronchiolitis are characterized by localization of chronic mural inflammation with foreign body reaction in bronchioles. Recurrence of small amounts of aspiration might play an important role in the pathogenesis of diffuse aspiration bronchiolitis. We report a case of diffuse aspiration bronchiolitis in a 4-month- old female infant who had recurrent aspiration due to dysphagia and presented with recurrent fever, dyspnea and wheezing. She showed typical radiologic and histologic findings compatible to diffuse aspiration bronchiolitis. She was improved with treatment of nasogastric tube feeding. We emphasize the importance of recognizing this disease entity and differentiating it from pulmonary diseases associated with bronchospasm. (J Korean Pediatr Soc 2000;43:842-845)
Bronchial Spasm ; Bronchioles ; Bronchiolitis* ; Deglutition Disorders ; Dyspnea ; Enteral Nutrition ; Female ; Fever ; Foreign-Body Reaction ; Humans ; Infant* ; Inflammation ; Lung Diseases ; Radiography, Thoracic ; Recurrence ; Respiratory Sounds ; Tomography, X-Ray Computed

BACKGROUND: The functional dyspepsia gives rise to such a symptom similar to peptic ulcer without showing a noticeable lesion(e.g, gastric or duodenal ulcer) by endoscopy or upper GI serises, and it has been known that this is about twice as many as the peptic ulcer. However, there is no exact theory about its pathophysiology and it is suggested that multiple factors including genetic, physiologic, psychologic, environmental factors are engaged. Especially, in respect to the occurrence of functional dyspepsia and psychological factors, there have been many clinical studies over the world. But, we still need more studies in this country, therefore, this study has been initiated to give help patients of functional dyspepsia, invest.igating their characteristic traits through MMPI. METHODS: From March to September in 1996, the patients who visited the family medicine out-patients department of St. Marys hospital of Catholic Medical College were sampled in this study. There were 46 patients having a similar symptoms to peptic ulcer without showing pathologic lesions by endoscopy. Through an interview and some basic tests, the 41 controls who had no dyspeptic symptoms and were not affected to a noticeable physical or physiological disorders were selected for the normal reference group. The standardized MMPI of our country was applied to the whole object groups to get a result. Then each average value of the measure(mean T-score) was calculated, and the differences of the average value were analyzed by the t-test and chi-square test. And the psychological pattern analysis was done. RESULTS: In demographic aspects, there were no significant differences between the two groups. The mean T score for each measure of the two groups falls within the normal ranges with their values being of between 30 to 70. And the average of L, F, and K measure, known as the validity measure, did not give a significant differences between the two groups. The measure of Hs, D, and Hy have appeared significantly high in the patients group(p<0.01) and the Pd measure, too(p<0.05). While Mf, Pa, and Ma measure have not shown a significant differences, Pt, Sc, and Si measure have very significant differences(p<0.01). CONCLUSIONS: In the patient group with the functional dyspepsia, the measures of Hs, D, and Hy where they indicate a neurotic pattern have shown a very significantly high point as well as those of Pd, Pt, Sc, and Si where they indicate a psychotic pattern. This reveals that in the group of the functional dyspepsia neurotic or psychotic trends to attribute. However, it is very hard to define the characteristics of a group with just one test, so further study with more variable test will be necessary.
Dyspepsia* ; Endoscopy ; Humans ; MMPI* ; Outpatients ; Peptic Ulcer ; Psychology ; Reference Values

No abstract available.
Head* ; Neck*

Cognitive function, behavioral symptoms, and activities of daily living (ADL) are all evaluated for a diagnosis of dementia. The Samsung Dementia Questionnaire (SDQ), the Short form-SDQ (S-SDQ), and the Korean Dementia Screening Questionnaire (K-DSQ) are all useful tools in the evaluation of cognitive function. The mini-mental state examination (MMSE) is the most popular tool for the measurement of general cognitive function. Objective cognitive impairment needs to be defined using neuropsychological tests. ADLs are evaluated by interview and an ADL scale such as the Korean Instrumental ADL (K-IADL) or the Seoul-IADL. Abnormal behavioral symptoms can be efficiently evaluated using the Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI). The severity of dementia can be evaluated using the Clinical Dementia Rating scale or the Global Deterioration Scale. To determine the cause of dementia, neurologic examination, structural brain imaging, and blood testing, including VDRL, Vitamin B12, folate, and thyroid function tests, are administered. The new diagnosis of dementia due to Alzheimer's disease (AD) by the National Institute on Aging-Alzheimer's Association was centered on a clinical core of insidious onset and worsening of episodic memory impairment, but biomarker evidence was also integrated into the diagnosis of AD dementia for use in research setting.
Activities of Daily Living ; Alzheimer Disease ; Behavioral Symptoms ; Dementia ; Folic Acid ; Hematologic Tests ; Mass Screening ; Memory, Episodic ; Neuroimaging ; Neurologic Examination ; Neuropsychological Tests ; Surveys and Questionnaires ; Thyroid Function Tests ; Vitamin B 12

The incidence of uterine prolapse during pregnancy is rare. A 34-year-old G3P1 was initially presented at 16 weeks 5days of gestation with a prolapse of the uterine cervix. The cervix was edematous and protruding beyond introitus. Management included bed rest, and the patient was discharged after several days with a vaginal pessary to help maintain cervical placement. At 35 weeks of gestation, the patient did not experience any further prolapse after the removal of the pessary. Pregnancy progressed to term with no further prolapse. She was readmitted at 38weeks 5days of gestation with spontaneous labor. She delivered a 3.36kg male with an Apgar score at 1 minute and at 5 minutes of 7 and 8 respectively. The patient's cervix remained prolapsed in the early postpartum period; however it was easily reduced prior to discharge. After puerperium, the patient's cervix remained prolapsed. She was fitted with a vaginal pessary for uterine support. We reported this case with related literature.
Adult ; Apgar Score ; Bed Rest ; Cervix Uteri ; Female ; Humans ; Incidence ; Male ; Pessaries ; Postpartum Period ; Pregnancy* ; Prolapse ; Uterine Prolapse*

OBJECTIVES: The aim of the present study was to evaluate the effect of fluoride mouthrinse with low pH on the surface microhardness of artificial incipient carious enamel. METHODS: Firstly, the concentration of sodium fluoride and pH values were measured in commercially available mouthrinse. Secondly, DOCTOR Clean & Fresh(R) (Jang In Pharm, co., LTD. KOREA) with 0.02% sodium fluoride and pH value below pH 4.0 was selected as the experimental group, 0.02% sodium as the positive control group and distilled water as the negative control group. Enamel samples of n vine teeth (n=36) were divided into the three groups respectively and treated with the mouthrinse solutions for 3 and 20 minutes. The surface microhardness (Vickers hardness number, VHN) was measured with microhardness tester before and after the treatments. RESULTS: The average pH of DOCTOR Clean & Fresh(R) was 3.45+/-0.00, and it was acidic enough to cause tooth erosion. The difference of surface microhardness (DeltaVHN) before and after the 20 minute treatment was statistically significant among the groups: DOCTOR Clean & Fresh(R) (12.77+/-2.25 DeltaVHN), distilled water (0.24+/-0.75 DeltaVHN), 0.02% sodium fluoride solution (-0.62+/-1.62 DeltaVHN) (P<0.05). The DOCTOR Clean & Fresh(R) group with low pH showed greater changes on the surface microhardness of the carious enamel than those of other groups (P<0.05). CONCLUSIONS: It is suggested that the mouthrinse with low pH can reduce the surface microhardness of incipient carious enamel.
Dental Enamel ; Fluorides ; Hardness ; Hydrogen-Ion Concentration ; Sodium ; Sodium Fluoride ; Tooth ; Tooth Erosion ; Water

To evaluate the oral glutamine (GLN) on the luminal microbes and bacterial translocation (BT) in short bowel, 45 Wistar rats were utilized in three groups; A (control), and B and C (short bowel, 85% of small bowel resected). The group A was fed with elemental diet (EmD), B with EmD+2% glycine, and C with EmD+2% GLN. The groups B and C were isocaloric and isonitrogenous. Wet weight, DNA, protein, and histomorphometry of the mucosa and parallel microbial culture from cecal contents, caval blood, and tissue blocks of the liver, spleen, and mesenteric lymph nodes were performed on the 5th, 10th, and 15th day. Mucosal growth was higher in group C than B. Colony forming units (CFU) from cecal contents increased more in group B than in C. BTs in A, B, and C were 7/15, 8/15, and 2/15, respectively. Total CFUs in blood and tissues were 5.8X10(4)/g, 5.5X10(6)/g, and 1.8X10(4)/g, respectively. As for BT, the most frequent organism was Klebsiella in A (79.3%), but E. coli in B and C (94.2% and 55.6%). GLN seems to suppress luminal microbes, and reduces BT in short bowel due to enforced barrier function and proliferation of the mucosa.
Animals ; Anti-Infective Agents/therapeutic use ; Body Weight/drug effects ; DNA/metabolism ; Glutamine/*therapeutic use ; Intestine, Small/drug effects/microbiology/*surgery ; Male ; Rats ; Rats, Wistar ; Stem Cells ; Time Factors

The frequency of stab wounds is gradually increasing and patients with stab wounds visit the hospital through the emergency room. Management options for patients with stab wound include mandatory exploration and selective observation, but recently many authors have emphasized the importance of selective conservation with development of diagnostic procedure and controversy still exists concerning the management of patients with stab wounds. We retrospectively analysed the clinical data of 78 patients with stab wounds who visited the emergency room of St. Paul's Hospital over 5 years from January 1 1992 to December 31 1996. The following results were obtained. 1) The most prevalent age group were the twenties & the thirties(58.9% of patient) and then most patients were of young age. The male to female ratio was 2.9: 1. 2) Most injuries occurred at night between 8p.m. and 4a.m.(61.5%) and during September injuries were most frequent. 3) The most common causes of stab wound were fighting(55.1%) followed by suicide (21.8%), then accidents including traffic accidents(16.7%) and robbery(6.4%). 4) The instruments most commonly used were knives(53.8%) and broken glass(28.2%). 5) Half of patients were drunk from alcohol and in 3 cases from an antipsychotic drug. 6) In 11 cases(14.1%), there were multiple wound sites and in 8 cases(10.3%) superficial wounds into subcutaneous fatty tissue. 7) According to stab wound sites, the extremities were wounded in 36 cases(46.2%), chest in 21 cases(26.9%), abdomen in 15 cases(19.2%) and neck in 7 cases(9.0%). 8) Emergency explorations were performed in 43 cases(55.1%) under general or regional anesthesia, which included neck in 4 cases(9.3%), chest in 3 cases(7.0%), abdomen in 11 cases(25.6%) and extremity in 25 cases(58.1%). In exploratory laparotomy, negative exploration rate was 18.2%. 9) Death occurred in 2 cases(2.6%). One died due to sepsis with multiple colon perforation and the other due to hypovolemic shock with Superior Vena Cava injury.
Abdomen ; Adipose Tissue ; Anesthesia, Conduction ; Colon ; Emergencies ; Emergency Service, Hospital ; Extremities ; Female ; Humans ; Laparotomy ; Male ; Multiple Trauma ; Neck ; Retrospective Studies ; Sepsis ; Shock ; Suicide ; Thorax ; Vena Cava, Superior ; Wounds and Injuries ; Wounds, Stab*