Hypoglycemia sometimes manifests as focal neurologic deficits simulating cerebrovascular disease. Symptoms are usually resolved by glucose infusion, but persistent hemiplegia is rarely reported. A 68-year-old diabetic woman on oral hypoglycemic agent(OHA) was admitted with right hemiplegia and global aphasia. Blood glucose level was 29 mg/dl on admission. No evidence of cerebral infarct or underlying brain disease could be found on initial brain CT and follow up MRI. Focal stenosis or occlusion was also absent on MR angiography. Hemiplegia and aphasia were not improved despite adequate therapy. Hypoglycemic hemiplegia should be suspected in all diabetic patients using insulin or OHA with stroke-like episode, and we suggest that prolonged hypoglycemia may be related to persistence of neurologic deficits.
Aged ; Angiography ; Aphasia ; Blood Glucose ; Brain ; Brain Diseases ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Glucose ; Hemiplegia* ; Humans ; Hypoglycemia ; Insulin ; Magnetic Resonance Imaging ; Neurologic Manifestations

The confirmatory diagnosis of Moyamoya disease has been obtained by invasive angiographic examination. We report the results of MRI and transcranial doppler sonography of three cases ol Moyamoya disease, which ws disgnosed by clinical and angiography. We think that the diagnosis of Moyamoya disease can be made by noninvasive MRI and transcranial doppler sonography without conventional invasive angiography.
Angiography ; Diagnosis ; Magnetic Resonance Imaging* ; Moyamoya Disease* ; Ultrasonography, Doppler, Transcranial*

BACKGROUND & OBJECTIVE: Huntington disease(HD) is clinically diagnosed by the triad of autosomal dominant inheritance, involuntary movements mainly chorea and dementia. The phenotype of HD is variable and other diseases can have same phenocopy. Therefore gene diagnosis of HD becomes essential for confirmatory diagnosis. Recent discovery of an expanded CAG trinucleotide repeat at the telomeric position of chromosome 4p made the gene diagnosis possible even in sporadic cases. We examined the length of CAG repeat in Huntington gene locus by PCR method in clinically diagnosed HB patients to make a confirmatory diagnosis. METHODS: Three patients with chorea, dementia and family history were tested. All laboratory tests including MRI had been normal so far. Genomic DNA was extracted from their WBC, and PCR was done on Huntington gene locus using primers modified from HD Collaboratory Group. Agarose gel electrophoresis to examine the rough degree of expansion, polyacrylamide gel electrophoresis to determine repeat length, and sequencing of the expanded allele were done. As a second step, three choreic patients without family history, one patient with tardive dyskinesia and one whole HD family were tested. RESULTS: Three choreic patients with family history showed expansion of CAG repeats in the amplified site. Two sporadic choreic patients, and one asymptomatic member in a HD family had increased CAG repeats. CONCLUSION: We confirmed expansion of CAG repeats in Huntington gene locus in clinically diagnosed HD. None of the patients had caudate atrophy, which has been considered an early finding. Sporadic choreic patients could be diagnosed as HD by gene study. Presymptomatic case was found in a family screening, and will need to be followed. Gene analysis offers a critical tool to make a confirmatory diagnosis of HD, and will be a powerful tool in genetic counseling.
Alleles ; Atrophy ; Chorea ; Dementia ; Diagnosis ; DNA ; Dyskinesias ; Electrophoresis, Agar Gel ; Electrophoresis, Polyacrylamide Gel ; Genetic Counseling ; Humans ; Huntington Disease* ; Magnetic Resonance Imaging ; Mass Screening ; Movement Disorders ; Phenotype ; Polymerase Chain Reaction ; Trinucleotide Repeats ; Wills

No abstract available.
Alopecia* ; Minoxidil*

Etretinate(Ro 10-9359), an aromatic analogue of vitamin A acid, has been known to be effective in the treatment of psoriasis, Darier's disease, pityriasis rubra pilaris, ichthyosis, and palmoplantar keratoderma when administered orally. In this experiment, we compared the therapeutic and side effects between a group with high dose therapy(initially 75mg of etretinate a day) and an another group with low dose therapy(initially 40mg of etretinate a day). We also observed whether the pretreatment followed by combined treatment with vitamin E could potentiate the therapeutic effect as well as reduce the side effects of oral etretinate. This experiment comprised 102 moderate to severe psoriatic patients. The following results were obtained from this experiment. 1. Fifty-six among 92 patients(61%) who were treated with etretinate for more than 4 weeks showed good to excellent therapeutic effect. 2 The high dose therapy was more effective, but showed more side effects than low dose therapy. 3 Vitamin E did not potentiate the effect of etretinate. In low dose therapy, the pretreatment followed by combined treatment with vitamin E showed a tendency to reduce the side effects of etretinate.
Acitretin* ; Darier Disease ; Etretinate* ; Humans ; Ichthyosis ; Keratoderma, Palmoplantar ; Pityriasis Rubra Pilaris ; Psoriasis* ; Tretinoin ; Vitamin E* ; Vitamins*

OBJECTIVE: The biomechanical stabilities between the anterior plate fixation after anterior discectomy and fusion (ACDFP) and the posterior transpedicular fixation after ACDF(ACDFTP) have not been compared using human cadaver in bilateral cervical facet dislocation. The purpose of this study is to compare the stability of ACDFP, a posterior wiring procedure after ACDFP(ACDFPW), and ACDFTP for treatment of bilateral cervical facet dislocation. METHODS: Ten human spines(C3-T1) were tested in the following sequence: the intact state, after ACDFP(Group 1), ACDFPW(Group 2), and ACDFTP(Group 3). Intervertebral motions were measured by a video-based motion capture system. The range of motion(ROM) and neutral zone(NZ) were compared for each loading mode to a maximum of 2.0Nm. RESULTS: ROMs for Group 1 were below that of the intact spine in all loading modes, with statistical significance in flexion and extension, but NZs were decreased in flexion and extension and slightly increased in bending and axial rotation without significances. Group 2 produced additional stability in axial rotation of ROM and in flexion of NZ than Group 1 with significance. Group 3 provided better stability than Group 1 in bending and axial rotation, and better stability than Group 2 in bending of both ROM and NZ. There was no significant difference in extension modes for the three Groups. CONCLUSION: ACDFTP(Group 3) demonstrates the most effective stabilization followed by ACDFPW(Group 2), and ACDFP(Group 1). ACDFP provides sufficient strength in most loading modes, ACDFP can provide an effective stabilization for bilateral cervical facet dislocation with a brace.
Braces ; Cadaver ; Diskectomy ; Dislocations* ; Humans ; Spine

During experimental Eimeria infections in chickens, facilities are often contaminated by fecal oocysts known to be highly resistant to both chemical and enzymatic treatments. Thus, studies using experimental Eimeria infections have been limited due to the difficulty of complete elimination of residual oocysts from both cages and facilities. To overcome this limitation, simple, inexpensive, and disposable cages were constructed from cardboard boxes and tested during experimental Eimeria maxima infections. The cages were used in animal rooms with only a 1.7% evidence of coccidia contamination between adjacent cages. No significant differences in fecal oocyst output and body weight gain were noted between animals housed in disposable cages and animals housed in wire control cages. This cage design is a useful means for preventing oocyst contamination during experimental conditions, suggesting that this disposable cage design could be used for other avian infectious disease studies.
Animals ; Chickens ; Coccidiosis/transmission/*veterinary ; Disposable Equipment/*utilization ; Eimeria/*isolation & purification ; *Environmental Microbiology

Helicobacter pylori-eliminating effects of FEMY-R7, composed of fucoidan and evening primrose extract, were investigated in mice and humans. Male C57BL/6 mice were infected with the bacteria by intragastric inoculation (1x10(9) CFU/mouse) 3 times at 2-day intervals, and simultaneously, orally treated twice a day with 10 or 100 mg/kg FEMY-R7 for 2 weeks. In Campylobcter-like organism-detection test, FEMY-R7 markedly reduced the urease-positive reactivity. In a clinical sudy, human subjects, confirmed to be infected with Helicobacter pylori, were orally administered twice a day with a capsule containing 150 mg FEMY-R7 for 8 weeks. FEMY-R7 significantly decreased both the Delta over baseline-value in urea breath test and the serum pepsinogens I and II levels. The results indicate that FEMY-R7 not only eliminates H. pylori from gastric mucosa of animals and humans, but also improves gastric function.
Animals ; Bacteria ; Breath Tests ; Gastric Mucosa ; Helicobacter ; Helicobacter pylori ; Humans ; Male ; Mice* ; Oenothera biennis* ; Pepsinogen A ; Pepsinogens ; Urea

Blastic natural killer (NK) cell lymphoma is a rare neoplasm characterized by blastoid tumor cells expressing CD4 and CD56, with predominant skin involvement. Although this tumor has been regarded as a neoplasm related to NK cell, recent studies suggested that it is derived from plasmacytoid dendritic cells, but not from NK cell. Herein we report 4 cases of CD4+CD56+ lineage marker- blastic NK cell lymphomas with a review of literatures. The patients were 3 men and one woman. Three of them were young (17, 18, and 22 yr old). Three patients had skin lesions, at initial presentation in two patients and during the course of disease in other patient. Histologically, tumors consisted of monotonous medium to large blastoid cells showing no necrosis, angiocentric growth or epidermotrophism. All four tumors were CD4+ and CD56+. Three expressed CD68 antigen. Lineage specific markers for B- and T cell were negative. All tumors did not express myeloperoxidase. T-cell receptor gene rearrangement, EBV, CD13 and CD33 were negative. In one patient, tumor cells arranged in Homer-Wright type pseudorosette and expressed terminal deoxynucleotidyl transferase(TdT). Despite the standard lymphoma chemotherapy, the tumors, except one lost during follow-up, progressed and relapsed. The patients died 8-60 months after diagnosis.
Adolescent ; Antigens, CD4/*analysis ; Antigens, CD56/*analysis ; Cell Lineage ; Female ; Humans ; Killer Cells, Natural/immunology/*pathology ; Lymphoma, T-Cell/immunology/*pathology ; Male ; Middle Aged