OBJECTIVE: To evaluate the effect of a transcranial magnetic stimulation on reciprocal inhibition of the human leg. METHOD: Twenty healthy human subjects who showed significant inhibition of soleus H reflex after conditioning electrical stimulation of tibialis anterior at a conditioning-test interval of 2 ms were included in this study. Changes in the amount of reciprocal inhibition by conditioning electrical stimulus were compared after transcranial magnetic stimulation of tibialis anterior. RESULTS: Approximately 12% inhibition of H reflex was produced by motor threshold stimulation, and 14% inhibition by maximum stimulation of common peroneal nerve. When a submotor threshold cortical shock was given with test-conditioning interval 0 ms, this inhibition was not significantly changed. There was no significant change of H reflex amplitude ratio by conditioning electrical stimulation after delivering supramotor threshold cortical shock. Amplitude of H reflex was enhanced by transcranial magnetic stimulation at each same conditioning electrical stimulation. CONCLUSION: We conclude that TMS can produce excitatory effects on spinal motor neurons rather than Ia inhibitory interneuron and there is no evidence for convergence onto Ia inhibitory interneurons from the fiber systems excited by magnetic stimulation over the cortex.
Electric Stimulation ; H-Reflex* ; Humans ; Interneurons ; Leg ; Motor Neurons ; Muscle, Skeletal* ; Peroneal Nerve ; Shock ; Transcranial Magnetic Stimulation*

Asperigillous osteomyelitis of the spine has quite rarely been reported. We present a 57-year-old man with old pulmonary tuberculosis who developed cough, sputum and back pain followed by paraplegia. Magnetic resonance imaging of the thoracic spine showed the destruction of the vertebral body through the level of T4-5 and epidural abscess. Decompressive surgery was carried out under the presumptive diagnosis of tuberculous spondylitis. However, the pathologic findings were aspergillous infection showing acute angle hyphae. To the best of our knowledge, this is the first report of aspergillous spondylitis producing compressive myelopathy in Korea.
Aspergillus* ; Back Pain ; Cough ; Diagnosis ; Epidural Abscess ; Humans ; Hyphae ; Korea ; Magnetic Resonance Imaging ; Middle Aged ; Osteomyelitis ; Paraplegia ; Spinal Cord Compression* ; Spine* ; Spondylitis ; Sputum ; Tuberculosis, Pulmonary

A 50-year-old man who had suffered from chronic indigestion complained of upper abdominal pain and vomiting which had persisted for 4 days. Consequently, he had eaten two persimmons before sleeping detected each day for five days. An irregular multinodular villous filling defect was in the duodenal bulb on, the UGI series, which had its location and changed its position. It was difficult to differentiate a papillary gastric polyp or villous tumor from the duodenal bezoar, but the patient's history of having eaten persimmons was helpful. The endoscopic and pathologic study confirmed a phytobezoar which was located in the normal duodenal bulb. Subsequently we are reporting this case having reviewed the related literature of the phytobezoar which was found in the normal duodenal bulb.
Abdominal Pain ; Bezoars* ; Diospyros ; Duodenum ; Dyspepsia ; Humans ; Middle Aged ; Polyps ; Vomiting

Chlorfenapyr is a widely used, moderately hazardous pesticide. Previous reports have indicated that chlorfenapyr intoxication can be fatal in humans. We reported the first non-fatal case of chlorfenapyr-induced toxic leukoencephalopathy in a 44-year-old female with resolution of extensive and abnormal signal intensities in white matter tracts throughout the brain, brain stem, and spinal cord on serial magnetic resonance imaging.
Adult ; Brain/*radiography ; Brain Stem/radiography ; Female ; Humans ; Insecticides/*toxicity ; Leukoencephalopathies/*etiology/radiography ; *Magnetic Resonance Imaging ; Pyrethrins/*toxicity ; Spinal Cord/*radiography ; White Matter/radiography

No abstract available.
Diagnosis*

OBJECTIVE: To evaluate the effects of etidronate disodium on bone and soft tissue, especially on bone mineral density, and mucosal changes of the aorta and esophagus. METHOD: Male Sprague-Dawley rats were randomly divided into 2 separate groups: one with etidronate disodium and one without etidronate disodium. Bone mineral density (BMD) in lumbar vertebrae, femur, and a simple X-ray of the whole body were obtained. The abdominal aorta and esophagus were assessed histopathologically in post treatment. RESULTS: In post treatment for 12 weeks, the extent of decrease in BMD of the group with etidronate disodium was less than that of the group without etidronate disodium (p<0.05). There was no evidence of aorta and heart valve calcification in the simple X-ray, nor was there intima-media thickening, atheroma formation and calcification in aorta and esophageal irritation findings in pathologic examinations in both groups. CONCLUSION: The results suggested that etidronate disodium had an inhibitory effect on bone mineral loss and had the esophageal tolerability and safety, but no difference in aorta calcification and antiarthrogenic effects, including aorta wall thickness in this study.
Aorta ; Aorta, Abdominal ; Bone Density ; Esophagus ; Etidronic Acid* ; Femur ; Heart Valves ; Humans ; Lumbar Vertebrae ; Male ; Plaque, Atherosclerotic ; Rats, Sprague-Dawley

The purpose of this study was to detect where the center of pressure in foot would be located at the end point of loading response and the terminal stance by the dynamic plantar pressure measurement. Seventeen adults who had the usual feet without a pathologic gait were evaulated simultaneously by the motion analysis using VICON 370, and the plantar pressure measurement using EMED-SF. Two devices were set in the 60 Hz frame. The foot was divided into 3 different zones; hindfoot, midfoot, and forefoot. The end point of loading response was located at the 1.92+/-1.46 frame distal to the hindfoot- midfoot borderline. The end point of terminal response was located at the 2.27+/-1.96 frame distal to the maximal pressure points of metatarsal head. Authors could differentiate each period of stance phase; the initial contact, loading response, mid-stance, terminal stance, and preswing, using the analysis of center of pressure by the dynamic plantar pressure measurement.
Adult ; Foot* ; Gait* ; Head ; Humans ; Metatarsal Bones

No abstract available.
Quetiapine Fumarate ; Stroke

A pyogenic liver abscess (PLA) mostly occurs in association with biliary tract disease, but some PLAs have no apparent underlying cause, i.e., they are cryptogenic. The authors experienced three cases of PLA or liver cyst infection after colon polypectomy without other distinct etiologies. These cases suggest that colonoscopic polypectomy can cause a mucosal defect that provides a route for bacteria to invade the portal system or spread intraperitoneally to the liver. Colonoscopic polypectomy should be considered as a procedure that might cause PLA. Moreover, clinicians should be aware of this possibility if a patient complains of fever or abdominal pain after a colonoscopic polypectomy.

Massive hemoptysis represents a major medical emergency that is associated with high mortality. The causes of hemoptysis are various and include pulmonary and cardiovascular disorders and trauma. The causes of pulmonary disorder are tuberculosis, bronchiectasis, abscess, malignancy, bronchitis, and fungal infection. The causes of cardiovascular disorder are mitral stenosis, pulmonary embolism, and congestive heart failure. A fistula between an aortic aneurysm and the pulmonary parenchyma is one of the causes of hemoptysis, but it is a rare. However, if undiagnosed, it is a uniformly fatal cause of massive hemoptysis. This is a case of bleeding from a fistula between an aortic arch aneurysm and a lung parenchyma in a patient with an aortic arch aneurysm who presented with massive hemoptysis. He had suffered intermittent hemoptysis since he was diagnosed with an aortic arch aneurysm three years before. A high clinical suspicion must be maintained when a history of intermittent hemoptysis is obtained in patients with an aortic aneurysm or prior aortic graft surgery.
Abscess ; Aneurysm* ; Aorta, Thoracic* ; Aortic Aneurysm ; Bronchiectasis ; Bronchitis ; Emergencies ; Fistula* ; Heart Failure ; Hemoptysis ; Hemorrhage ; Humans ; Lung ; Mitral Valve Stenosis ; Mortality ; Pulmonary Embolism ; Transplants ; Tuberculosis