We report a case of decreased cerebrospinal fluid glucose with lymphocytic pleocytoisis in a patient with herpes zoster meningoencephalitis. The finding was likely to be confused with that of tuberculous meningoencephalitis. The concentration of CSF glucose is a critical point in the differential diagosis of various causes of nervous system infection. Although the herpes zoster meningoencephalitis isa well recognized, cases with markedly low, level of CSF glucose has been rare. We reviewed such unusual cases in the literature that were accompanied by hypoglycorrhachia. The duration of hypoglycorrhachia was transient. This suggests a differential point from that of tuberculous meningitis.
Cerebrospinal Fluid ; Encephalitis, Varicella Zoster* ; Glucose* ; Herpes Zoster* ; Humans ; Meningoencephalitis ; Nervous System ; Tuberculosis, Meningeal

Subacute sensory neuropathies associated with primary Sjogren's syndrome have been reported rarely. We describe a woman with primary Sjogren's syndrome who developed a widespread, pure sensory neuropathy with a subacute onset. An electrophysiological study showed the typical absence or decreased amplitude of sensory nerve action potentials (SNAPs). A sural nerve biopsy showed a loss of large myelinated fibers and axonal degeneration without inflammation. The clinical course of long-standing subacute sensory neuropathy, the biopsy-documented axonal degeneration, and the neurophysiological findings suggest involvement of the dorsal root ganglia.
Action Potentials ; Axons ; Biopsy ; Female ; Ganglia, Spinal ; Humans ; Inflammation ; Myelin Sheath ; Peripheral Nervous System Diseases ; Sjogren's Syndrome* ; Sural Nerve

BACKGROUND AND OBJECTIVES: The utility of Doppler mitral flow pattems for the indirect assessment of left ventricular diastolic function is valid and widely used. One of the most common variables affecting mitral flow is heart rate. The aim of this study was to compare between mitral flow and mitral annulus velocity by Doppler tissue imaging (DTI) according to increment of heart rate. MATERIALS AND METHODS: 17 healthy volunteers (M: F=10: 7, mean age 27+/-2 years) comprised this study. They were free of any acute or chronic illness. The heart rate was elevated by increments of 10 beats (baseline, 80, 90, 100, 110, 120) by transesophageal atrial pacing. We measured mitral flow parameters (E and A velocity, E/A ratio, IVRT, DT of E) and mitral annulus velocity by DTI (e and a velocity, e/a ratio, RIVRT). We gave the score of visual estimation at baseline and each heart rate. The definition of the score was as follows, 1: well visualization of each envelope 2: summation of velocity wave forms 3: no differentiation, completely fused. RESULTS: 1) The E of mitral flow was significantly increased from 100 to 120 BPM and A velocity was significantly increased from 80 to 100 BPM (p<0.05). E/A ratio was significantly decreased from 90 to 100 BPM than baseline (p<0.05). 2) The e and e/a ratio of mitral annulus velocity were significantly increased from above 110, 100 BPM than baseline, respectively (p<0.05). But a velocity was little changed. 3) The score was all significantly higher in mitral annulus velocity pattern by DTI than mitral flow at each heart rate. CONCLUSIONS: The mitral annulus velocity by DTI is less affected by heart rate and visualized better than mitral fiow in increased heart rate. Therefore the assessment of mitral annulus velocity may be helpful for evaluating diastolic function during heart rates of physiologic range.
Chronic Disease ; Healthy Volunteers ; Heart Rate* ; Heart*

BACKGROUND/AIMS: The aims of this study were to determine subgoups of functional dyspesia and to evaluate the short-term effect of cisapride in patients with functional dyspepsia in Korea. METHODS: 1025 patients, with a mean age of 42.6 years, with symptoms of functional dyspepsia, were recruited consecutively and upper gastrointestinal symptoms were investigated by interview in 41 hospitals in Korea. In an open, multicenter trial, 1025 patients received Smg of cisapride three times a day (TID) for at least .2 weeks for the treatment of symptoms of functional dyspepsia. When necessary, the dose of cisapride was increased to 10mg TID and the duration of therapy was extended to 4 weeks. RESULTS: The most frequently reported symptoms of functional dyspepsia were epigastric discomfort or fullness (85%), bloating (70%), belching (53%), early satiety (52%) and epigastric pain (46%) retrospectively. Subgroups of functional dyspepsia were as follows; dysmotility-like 73.5%, ulcer-like 39.7%, reflux-like 13.0%, and unspecified dyspepsia 14.0%. However, 33.2% of subjects with functional dyspepsia could be classified into more than one subgroup. Upper gastrointestinal symptoms were decreased to average 50.3% (range; 42.2 to 59.2%) after 2 weeks of cisapride treatment and to 25% (19.2 to 29.9%) after 4 weeks. cisapride therapy resulted in good or excellent improvement in 59.0% of the patients after two weeks, in 75% of patients after 4 weeks. Adverse events were occurred in 52 patients (5.8% of all patients), most commonly, loose stools or diarrhea (3.5%), abdominal pain (1.1%), and dizziness (0.3%). The majority of adverse events was mild and transient in nature and led to premature discontinuation of treatment in 4 patients. CONCLUSIONS: Although the majorities of patients with functional dyspepsia have dysmotility like symptoms in Korea, there is such overlap among the dyspepsia subgroups. Most patients responded well to a short therapeutic trial with cisapride without significant side effects.
Abdominal Pain ; Cisapride* ; Diarrhea ; Dizziness ; Dyspepsia* ; Eructation ; Humans ; Korea* ; Retrospective Studies