BACKGROUND: The oral ulcer is a common oral disorder, but the precise etiology remains elusive despite of intensive clinical, immunological, hematological and microbiological investigations. OBJECTIVE: The purpose of this study was to examine oral ulcers for the detection of HSV DNA by using PCR and to characterize clinical features of HSV DNA positive cases. METHODS: Specimens collected with cotton swabs and saliva from 48 cases of oral ulcers were examined for HSV DNA by PCR and Southern blot hybridization. RESULTS: 1. HSV DNA was detected in 8 of 48(16.7%) cotton swabbed specimens of oral ulcers and saliva by PCR and Southern blot hybridization. 2. Clinical features of HSV DNA positive oral ulcers were a. predominently located in buccal mucosa. b. mall sized(<3mm), multiple(> or =5) lesions. 3. In Behcet's disease, 2 of 7(28.6%) cases of oral ulcers were positive for HSV DNA CONCLUSION: PCR is an useful and accurate method for the detection of HSV DNA from cotton swabbed specimens of oral ulcers.
Blotting, Southern ; DNA ; Herpes Simplex* ; Mouth Mucosa ; Oral Ulcer* ; Polymerase Chain Reaction* ; Saliva ; Simplexvirus*

BACKGROUND: Brain-derlved neurotrophic factors(BDNF) is critically involved in development and maintenance of the central and peripheral nervous system and the expression of its mRNA increases after various insults such as ischemia. If one takes the protective role of BDNF into consideration, it would be important to understand the mechanism of induction in BDNF mRNA. Although previous reports suggested the relationship between activation of N-methy]-D-aspartate(NMDA) receptor and induction of BDNF mRNA following ischemic insult, the mechanism is not clearly understood. METHODS: In this experiment, in situ hybridization was used to study expression of mRNA for c-fos, heat shock protein 72, and brain-derived neurotrophic factor in the gerbil brain after 15 minutes of forebrain ischemia as well as with MK801 pretreatment before ischemia. RESULTS: Transient ischemic insult caused the induction of c-fos and heat shock protein 72 mRNA expression which partially blocked by MK801 within 24 hours after reperfusion. From 30 minutes to 4 hours after the reperfusion, the level of brain-derived neurotrophic factor mRNA was increased in the granule cells of the dentate gyrus. In addition, the increase of BDNF mRNA was not influenced by NMDA receptor antagonist, MK801. CONCLUSIONS: The expression of BDNF mRNA after acute ischemia could be induced not by NMDA receptor related intracellular calcium change, but by some other factors which requires further effort to be solved. Finally, if the changes of mRNA expression lead to alterations in the relative availability of BDNF, this might influence functional outcome and necrosis following ischemia.
Animals ; Brain ; Brain-Derived Neurotrophic Factor* ; Calcium ; Dentate Gyrus ; Dizocilpine Maleate ; Gerbillinae* ; HSP72 Heat-Shock Proteins ; In Situ Hybridization ; Ischemia ; Mice* ; N-Methylaspartate ; Necrosis ; Peripheral Nervous System ; Prosencephalon ; Reperfusion ; RNA, Messenger*

A 4-year-old boy visited the hospital with exotropia after brain hemorrhage caused by trauma. He had undergone decompressive craniectomy and cranioplasty 18 months prior to presentation at our hospital. An alternate prism cover test showed more than 50 prism diopters (PD) of left exotropia when he was fixing with the right eye and 30 PD of right exotropia when he was fixing with the left eye at near and far distance. On the Hirschberg test, 60 PD of left exotropia was noted in the primary position. Brain computerized tomography imaging performed 18 months prior showed hypodense changes in the right middle cerebral artery and anterior cerebral artery territories. Subfalcian herniation was also noted secondary to swelling of the right hemisphere. The patient underwent a left lateral rectus muscle recession of 7.0 mm and a left medial rectus muscle resection of 3.5 mm. Three weeks after the surgery, the Hirschberg test showed orthotropia. On alternate prism cover testing, 8 PD of left exotropia and 8 PD of right esotropia were noted at distance. We report a patient who developed dissociated horizontal deviation after right subfalcian subdural hemorrhage caused by trauma.
Brain Injuries/*complications ; Child, Preschool ; Decompressive Craniectomy/*adverse effects ; Esotropia/*etiology/surgery ; Exotropia/*etiology/surgery ; Hematoma, Subdural/etiology/radiography/*surgery ; Humans ; Male ; Oculomotor Muscles/*surgery ; Tomography, X-Ray Computed ; Treatment Outcome

BACKGROUND: The current various case-finding instruments for detecting depression in Korea are too cucumbersome and time-consuming for routine use in primary care or student and soldier groups because of too many questions. We carried out this study in order to investigate the validity of the two-question case-finding instrument for detecting depression easily in the primary care or the mentioned groups. METHODS: We selected one boy high school in Seoul and 155 sophomer students answered the questionnaire by self-report. The questionnaire included two questions about depressed mood and anhedonia: (1) "During the past month, have you often been bothered by feeling down, depressed or hopeless?" (2) "During the past month, have you often been bothered by little interest or pleasure in doing things(e.g., studying, playing or talking with friends) ?". And then a resident of family medicine interviewed them and made a diagnosis for depression using the diagnostic criteria of DSM-IV. Simultaneously we compared the test characteristics of a two-question case-finding instrument with those of a previously validated Beck Depression Inventory as a currently world-wide used screening instrument for depression. RESULTS: The prevalence of major depression as determined by the interview was 6.6%(10 of 151). The two-question case finding instrument had a Cronbach's alpha of 0.663-internal consistency, a sensitivity of 100%, a specificity of 54.6%, a positive likelihood ratio of 2.20 and a negative predictive value of 1.00.(A "yes" answer to either of the two questions was considered a positive test.) And the BDI had a sensitivity of 90%, a specificity of 68.1%, a positive likelihood ratio of 3.63 and a negative predictive value of 0.99(cut-off point=15). Area under the ROC curves of the two-question case-finding instrument was 0.882, greater than that of the BDI, 0.834. CONCLUSIONS: The test characteristics of a two-question case-finding instrument were higher compared to those of BDI for major depression. Therefore, the two-question case-finding instrument is a useful measure for detecting depression and less time-consuming in primary care and certain groups.
Adolescent ; Anhedonia ; Depression* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea ; Male ; Mass Screening* ; Military Personnel ; Pleasure ; Prevalence ; Primary Health Care ; ROC Curve ; Sensitivity and Specificity ; Seoul ; Surveys and Questionnaires

BACKGROUND: Headache is one of the most common disorders, and shows ethnic or geographic diversities. Moreover, the prevalence and epidemiologic characteristics of headache, especially in people living in an island area, is lacking. Therefore, we investigated the prevalence and subtypes of headache in an island area of Korea. METHODS: We collected the demographic and clinical data of all residents living in the survey island area. A neurologist interviewed 352 respondents in a face-to-face method. The specific headache diagnosis was based on the diagnostic criteria of the International Headache Society. RESULTS: The survey island area represented a typical aging society like that of a rural area in Korea. Tension-type headache was the most common type. The prevalence of migraine, tension-type headache, and other headache were 4.0%, 7.1%, and 1.7%, respectively. Migraine with aura occupied 1.7% and migraine without aura occupied 2.3%. Episodic tension-type headache occupied 6.5% and chronic tension-type headache occupied 0.6%. Migraine showed a peak prevalence below the third decade of age and tension-type headache showed a peak prevalence above the sixth decade. CONCLUSIONS: This study showed a characteristic pattern of the prevalence of headache in an island area of Korea. We thought this low prevalence of headache might be due to not only subject age but also social-environmental factors. This study may be helpful in understanding headaches and can provide some basic information for future studies.
Aging ; Surveys and Questionnaires ; Diagnosis ; Epidemiology ; Headache* ; Korea* ; Migraine Disorders ; Migraine with Aura ; Migraine without Aura ; Prevalence ; Tension-Type Headache

BACKGROUND: Based on a recent study showing that the reactivation of HSV-1 may be one of the possible pathogenesis of idiopathic facial mononeuropathy, antiviral therapy has been suggested as a good treatment modality. However, the efficacy of antiviral therapy is still controversial. This argument may be caused by the absence of a reliable system of grading facial nerve paralysis. We performed this study to investigate the therapeutic effects of an antiviral agent and possible prognostic factors using the Sunnybrook scale. METHODS: Patients with idiopathic facial mononeuropathy were divided as two groups according to the treatment regimens (Acyclovir & Steroid vs. Steroid only). Clinical efficacy was evaluated using the House-Brackmann grading system and Sunnybrook scale. Electrodiagnostic studies including the blink reflex, facial nerve conduction study, and facial nerve excitability test were performed. The clinical improvement rate between the two groups and the usefulness of the electrodiagnostic studies as prognostic factors were analyzed. RESULTS: No significant differences of the clinical improvement rate was revealed with a 70% improvement rate for the Acyclovir treatment group and 84% for the steroid only group. Among electrodiagnostic studies, the compound muscle gamma action potential (CMAP) amplitude (=0.637, p=0.000) and nerve excitability =0.688, gamma test (p=0.000) on 2 weeks showed significant correlations to the final Sunnybrook score. There is good correlation between the two facial nerve grading systems. CONCLUSIONS: Acyclovir may not be effective in the recovery of idiopathic facial mononeuropathy. CMAP amplitude and nerve excitability tests on 2 weeks may provide valuable prognostic factors. The Sunnybrook scale may be useful as a facial grading system.
Action Potentials ; Acyclovir* ; Blinking ; Facial Nerve ; Herpesvirus 1, Human ; Humans ; Mononeuropathies* ; Paralysis

OBJECTIVE: The aim of this study was to evaluate the relationship between motor evoked potentials (MEPs) or somatosensory evoked potentials (SSEPs) and the recovery of function in acute or subacute stroke patients. METHOD: Twenty one hemiplegic stroke patients were examined with MEPs of extensor carpi radialis, abductor pollicis brevis, tibialis anterior and abductor hallucis and SSEPs of median and tibial nerves. A separate score was defined for upper and lower extremities within the Fugl-Meyer assessment and Korean-modified Barthel index. Motor performances were evaluated simultaneously with the evoked potential assessments and at 2 weeks after the first examination. RESULTS: The second motor function of upper extremity was significantly higher in patients with the presence of MEP or SSEP (p<0.05). The improvement of self care was correlated with the responsiveness in SSEP. Motor function of lower extremity was significantly associated with the responsiveness in MEP or SSEP (p>0.05). MEP in tibialis anterior or tibial SSEP were correlated with the mobility. CONCLUSION: MEP in tibialis anterior is useful in predicting in mobility after stroke. SSEP is predictive for activities in daily living after stroke.
Activities of Daily Living ; Evoked Potentials ; Evoked Potentials, Motor ; Evoked Potentials, Somatosensory ; Humans ; Lower Extremity ; Recovery of Function ; Self Care ; Stroke ; Tibial Nerve ; Upper Extremity

A few patients with Parkinson's disease (PD) crave large amounts of levodopa therapy far beyond those needed to alleviate their symptoms, even in the state of overdose complication. Such harmful pattern of compulsive dopaminergic drug use is called as dopamine dysregulation syndrome (DDS). We report a chronic stage PD patient presenting with high fever and altered mentality, who had the DDS as well as the Parkinsonism hyperpyrexia syndrome (PHS).
Dopamine* ; Fever ; Humans ; Levodopa ; Parkinson Disease ; Parkinsonian Disorders*

No abstract available.

Secondary osteoporosis resulting from specific clinical disorders may be potentially reversible, and thus continuous efforts to find and adequately treat the secondary causes of skeletal fragility are critical to ameliorate fracture risk and to avoid unnecessary treatment with anti-osteoporotic drugs. Among the hyperfunctional adrenal masses, Cushing's syndrome, pheochromocytoma, and primary aldosteronism are receiving particularly great attention due to their high morbidity and mortality mainly by increasing cardiovascular risk. Interestingly, there is accumulating experimental and clinical evidence that adrenal hormones may have direct detrimental effects on bone metabolism as well. Thus, the present review discusses the possibility of adrenal disorders, especially focusing on pheochromocytoma and primary aldosteronism, as secondary causes of osteoporosis.
Cushing Syndrome ; Hyperaldosteronism ; Metabolism ; Mortality ; Osteoporosis ; Pheochromocytoma