OBJECT: There have been some controversies about the nature of peripheral neuropathy in patients with subacute comblned degeneration. Mayer concluded that the neuropathy was essentially demyelinating. And other reports which were based on pathologic or electrophyslological filldings have been saying axonopathy. We tried to find the nature of perlpheral neuropathy by doing conventional nerve conduction studies in 19 patients with subacute combined degeneration. SUBJECT AND METHOD: We included 19 patients with subacute combined degeneration, who were diagnosed by decreased serum vitamin B12(200pg/ml) and abnormal neurologic symptoms and/or signs. The patients were between 26 and 86 years of age. Eleven of them were male. We performed conventional nerve conduction studies Including H-reflex, When nerve conduction parameters deviated by more than 2SD from the normal mean value, they were consider as abnormal. RESULTS: nerve conduction studies were abnormal in 13/19. 11/13 with abnormal nerve conduction studies showed the pattern of peripheral polyneuropathy. Ten of them showed decreased amplitudes of sensory nerve action potentials or compound nerve action potentials with/wlthout mild slowing of nerve condcution. The abnormalities of the three patients with nerve conduction parameters of demyelinating range were confined to the distal segments of the median nerves. CONCLUSION: We thought that the results of the nerve conduction studies of our cases were compatible with axonopathy rather than demyelinopathy as a principal ]esion of the peripheral nervous system.
Action Potentials ; H-Reflex ; Humans ; Male ; Median Nerve ; Neural Conduction* ; Neurologic Manifestations ; Peripheral Nervous System ; Peripheral Nervous System Diseases ; Polyneuropathies ; Subacute Combined Degeneration ; Vitamins

Eating the meat of pheasants which was killed by potassium cyanide, a 27 year old man developed several symptoms of minor intoxication. A few days later, the patient became mute, apathy, somnelent and indifferent but without any parkinsonia features or dementia. On CT brain scan, bilateral symmetrical and non-enhancing focal low densities are noticed in basal ganglia, similar to the carbon monoxide intoxication.
Adult ; Apathy ; Basal Ganglia ; Brain* ; Carbon Monoxide ; Dementia ; Eating ; Humans ; Meat ; Potassium Cyanide

This study was undertaken for the clinical analysis and evaluation on 121 patients with incompetent internal os of the cervix, who were admitted and treated with McDonald operation or Shirodkar operation at the Soonchounhyang Medical Center from January 1991 to December 1995. The results of this study were as follows : 1. The incidence of this IIOC was 1.1% of 11,116 cases of total delivery. 2. The mean age of IIOC was 31.7 years old. 3. The average number of gravida was 3.2. 4. The most common contributary factor was previous history of artificial abortion (51.2 %), and midtrimester abortion (17.4 %), cervical laceration due to previous vaginal delivery (8.3 %) etc. was followed. 5. The success rate of operation was 76 %, and the highest success rate (85.7 %) was reveald with period from 15th weeks to 16th weeks of gestation. 6. When cervical dilatation was abscent or small, the success rate of operation was high. 7. The factors of failed operation were preterm labor (58.7 %), PROM (34.5 %), and PIH, bleeding. 8. The delivery method after operation was vaginal delivery in 83 cases (68.6%) and cesarean section in 38 cases (31.4 %).
Cervix Uteri* ; Cesarean Section ; Female ; Hemorrhage ; Humans ; Incidence ; Labor Stage, First ; Lacerations ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Second

Repetitive nerve stimulation (RNS) test was systematically performed in proximal and distal muscles of 142 cases with myasthenia gravis (MG) and 45 norrnal controls and then analyzed qualitatively. Diagnostic sensitivity was 75% based on abnorrnal decremental response in at least one muscle. The sensitivity increased from 56% in ocular MG to 96% in type Iib MG according to severity of disease. Higher diagnostic yield was noted in the orbiculans oculi in ocular MG and in the trapezius in gereralized MG. RNS test on proximal muscle showed a higher positive rate than that on distal muscles. When distal muscle testing was negative, there was an additional increase of 24% in proximal muscle testing. The posttetanic exhaustion (PTE) enhanced diagnostic sensitivitY as much as 8% in generalized MG. The posttetanic facilitation(PTF) and PTE were observed in 50% and 38% of generalized MG and were most prominent in MG with moderate severity. Five patterns on RNS findings were classified according to test paramcters. The most common response was the pattern which showed normal arnplitude of compound muscle action potential, decremental response at low rate stimulation, and PTF without PTE.
Action Potentials ; Muscles ; Myasthenia Gravis* ; Superficial Back Muscles

Repetitive nerve stimulation test (RNS) is an easy and non-invasive test which provides objective for the presence of a myasthenic neuromuscular defect and for monitoring possible improvement through various therapeutic measures, and makes the differentiation of neuromuscular junction disorders. Analysing the RNS test of 45 normal controls and 146 patients with myasthenia gravis quantitatively, the following results obtained. 1. At low rate stimulation, the decremental response upto 2 standard deviation in normal control are 7.1% in orbicularis oculi(~), 7.6% in flexor carpi ulnaris (FCU) and 5.4% in abductor digiti guinti muscle(ADQ). There are two kinds of facilitation noticed: incremental responses at repetitive low stimulation (13.3-14.9%) immediately after tetanic stimulationy and increased mean amplitudes of compound muscle action potentials after exercise(l3-17%). Four minutes after the tetanic stimulation, the decremental responses at low rate stimulation become accentuated slightly even in normal control group. 2. At low rate stimulation. There are singificant decremental decremental responses in patients with myasthenia gravis, but statistically no significant differences are seen in the quantity of decremental responses among 2, 3 and 5/sec rate of stimulation. 3. The pattern and severity of decremental responses at low rate stimulation are depending on the clinical type of generalized myasthenia gravis. There are no decremental responses in FCU or ADQ in ocular type. The decremental responses of oo are greater than that of FCU in mild generalize myasthenia, but the reverse is true in moderate generalized type. 4. Statistically significant post-tetanic facilitation and exhaustion are noticed in patients with generalized myasthenia gravis.
Action Potentials ; Humans ; Myasthenia Gravis* ; Neuromuscular Junction Diseases

Repetitive nerve stimulation test (RNS) is an easy and non-invasive test which provides objective for the presence of a myasthenic neuromuscular defect and for monitoring possible improvement through various therapeutic measures, and makes the differentiation of neuromuscular junction disorders. Analysing the RNS test of 45 normal controls and 146 patients with myasthenia gravis quantitatively, the following results obtained. 1. At low rate stimulation, the decremental response upto 2 standard deviation in normal control are 7.1% in orbicularis oculi(~), 7.6% in flexor carpi ulnaris (FCU) and 5.4% in abductor digiti guinti muscle(ADQ). There are two kinds of facilitation noticed: incremental responses at repetitive low stimulation (13.3-14.9%) immediately after tetanic stimulationy and increased mean amplitudes of compound muscle action potentials after exercise(l3-17%). Four minutes after the tetanic stimulation, the decremental responses at low rate stimulation become accentuated slightly even in normal control group. 2. At low rate stimulation. There are singificant decremental decremental responses in patients with myasthenia gravis, but statistically no significant differences are seen in the quantity of decremental responses among 2, 3 and 5/sec rate of stimulation. 3. The pattern and severity of decremental responses at low rate stimulation are depending on the clinical type of generalized myasthenia gravis. There are no decremental responses in FCU or ADQ in ocular type. The decremental responses of oo are greater than that of FCU in mild generalize myasthenia, but the reverse is true in moderate generalized type. 4. Statistically significant post-tetanic facilitation and exhaustion are noticed in patients with generalized myasthenia gravis.
Action Potentials ; Humans ; Myasthenia Gravis* ; Neuromuscular Junction Diseases

OBJECTIVE: The aim of this study was to assess the relationship between disease progression and expression of c-erbB-2 and S-100 protein positive dendritic cells in Cervical cancer. STUDY DESIGN: Tissues were analyzed from 100 patients. Each of them had invasive carcinoma(44), microinvasive(12), CIS(33), CIN(II) before treatment, c-erbB-2 oncoprotein expression and S-100 protein positive dendritic cell were confirmed by immunohistochemical staining. (Avidin-biotin complex method) RESULTS: C-erbB-2 immunostaining was significantly associated with disease progression (p<0.05). In case of CIN I, there was not noted stained specimen but in case of invasive carcinoma, 24 cases of stained specimen were noted. S-100 protein positive dendritic cell was not associated with disease progression of cervical carcinoma.(p>0.05) CONCLUSIONS: According to our results, c-erbB-2 is possible factor in Carcinogenesis of cervical carcinoma with progression of it. and S-100 protein positive dendritic cell was not associated with disease progression of cervical carcinoma.
Carcinogenesis ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Dendritic Cells* ; Disease Progression ; Female ; Humans ; S100 Proteins* ; Uterine Cervical Neoplasms

Symmetrical bilateral thalamic infarction is a rare cerebrovascular disease, caused by occlusion of the paramedian thalamic arteries. The clinical manifestations of this disease are much different from classical thalamic syndrome, with disturbance of consciousness, memory, eye movement and behavior. Observing two cases of bilateral symmetrical thalamic infarction on CT scan with characteristic clinical findings in Medical Center, pertinent literature were reviewed.
Arteries ; Consciousness ; Eye Movements ; Infarction* ; Memory ; Thalamic Diseases ; Tomography, X-Ray Computed

We measured serum levels of CA-125 and Tissue polypeptide antigen(TPA) in 135 patients with pelvic tumors(129 benign pelvic tumors and 6 malignant ovarian tumors) preoperatively. Each tumor marker was measured by immunoradiometric assay. Serum CA-125 levels of 35.0U/ml, 65.0U/ml and TPA levels of 80.0U/ml, 100.0U/ml were determined as cut-off values. The results were evaluated by each tumor marker and two tumor markers coincidently. The results were as follows : (continue)
Humans ; Immunoradiometric Assay ; Biomarkers, Tumor

Fishbones are the most common upper aerodigestive and esophageal foreign body found in adults. Usually these bones pass, but when complications arise, they can be catastrophic and may include neck abscesses, mediastinitis, and esophago-aortic or esophagocarotid fistulas. We report the radiologic findings of fishbone injury occurring in a 48-year-old man in whom a globefish bone had penentrated the hypopharynx and migrated to the sternocleidomastoid muscle.
Abscess ; Adult ; Fistula ; Foreign Bodies ; Humans ; Hypopharynx ; Mediastinitis ; Middle Aged ; Neck