Creutzfeldt-Jakob disease(CJD) is characterized clinically by rapidly progressive dementia with pyramidal, extrapyramidal, and cerebellar symptoms and signs, and histologically by spongiform change, neuronal loss and reactive gliosis. We have experienced 2 cases of CJD. Case 1 was a 36-year-old male who had suffered from myoclonus and cerebellar symptoms including sluggish speech, gait and balance disturbance. Case 2 was a 70-year-old female who had showed cognitive dysfunction, ataxic gait and disturbance of extraocular movement. Both patients, underwent brain biopsy. Case 1 revealed marked cortical atrophy, 2mm in thickness, with neuronal loss and astrocytic proliferation extending into white matter. The spongiform change, made up of many small, usually rounded or oval, vacuoles was noted mainly in the neuropil. Case 2 revealed remarkable spongiform change throughout the cortex and cytoplasmic vacuoles compressing the nuclei of neuronal cells were numerous. Neuronal loss and gliosis were also found without considerable change in the white matter. On double immunostaining against GFAP and PrP(Prion Protein), there was a weak positive reaction for PrP in the perinuclear cytoplasm in case 1, and a strongly positive reaction in case 2. The electron microscopic examination showed numerous membrane-bound vacuoles in neuropil and perikarya of neurons. The majority of the vacuoles were multiseptated by thin membranous structures. They demonstrated curled, or disrupted membrane, that had foldings and protrusions into the vacuolar clear spaces. There were neither identifiable virus-like particles nor amyloid deposition.
Female ; Male ; Humans

Though the incidence of paragonimiasis has been remarkably decreased since 1970, it is still not a rare disease in Korea. Major problems in the diagnosis of pulmonary paragonimiasis on chest radiography are its differentiation from pulmonary tuberculosis and lung cancer. Chest radiographic findings have been described in detail, but little have been reported on CT findings. We reviewed CT findings of 10 patients with pulmonary paragonimiasis. The characteristic CT findings were similar to those on chest radiography, such as air-space consolidation (70%), nodular mass (50%), pleural effusion (40%), cystic lesion (30%), small low density within the mass (30%), linear density (20%), pneumothorax(20%), and burrow track (20%). CT depicted the cystic lesions and the burrow tracks more clearly and showed the small worm-retaining cysts within the mass that were not detectable on chest radiography. In conclusion, all of these CT findings are useful in the diagnosis of pulmonary paragonimiasis especially when differentiation from tuberculosis or lung canceris difficult on chest radiography.
Diagnosis ; Humans ; Incidence ; Korea ; Lung ; Lung Neoplasms ; Paragonimiasis* ; Pleural Effusion ; Radiography ; Radiography, Thoracic ; Rare Diseases ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

No abstract available.
Dermatitis, Atopic ; Pyroglyphidae

For the evaluation of exercise induced R wave amplitude changes in lead V5 (big up tri, openR) and multiple leads(summation operatorR), we studied 20 normal subjects and 21 ischemic heart disease patients with positive exercise test. All underwent submaximal, multiple leads multistage treadmill exercise testing. 14 to 20 normal subjects(70%) there were decreased R wave amplitude in multiple leads on treadmill exercise testing. 16 of 21 patients(76%) there were increased R wave amplitude on treadmill exercise testing. In normal group, R wave amplitude between rest and exercise was significantly decreased in lead V5 and multiple leads. In patients grous, R wave amplitude between rest and exercise was significantly increased in lead V5 and multiple leads. It is suggested exercise induced R wave amplitude changes probably enhance the diagnostic reliability by ST segment changes on treadmill exercise testing.
Exercise Test* ; Humans ; Myocardial Ischemia

BACKGROUND AND OBJECTIVES: A rotation chair test has been used to evaluate the function of the horizontal semicircular canals. Currently, two chair systems according to the presence of cylindrical darkroom are used in a clinic setting. However, it has not been thoroughly investigated whether one system is superior to the other system or not. In this study, we aimed to compare test outcomes and subject convenience between two systems. SUBJECTS AND METHODS: Twenty subjects with no history of otologic disease were enrolled. Subjects were tested with two systems: system [A] with a cylindrical chamber and system [B] with no chamber. The results of sinusoidal harmonic acceleration (SHA), step velocity (SV), and visual fixation (VFX) tests were compared between the systems. Subject convenience was assessed with a questionnaire survey and results were compared between the systems. RESULTS: There were no significant differences in gain or asymmetry in SHA test between the systems. However, the phase of system [A] was significantly lower than that of system [B] at 0.16 Hz. There was no significant difference between the systems in directional preponderance (DP) gain or DP time constant. Regarding the VFX test, gain was higher in system [A] than system [B]. Subjects reported less stuffiness and less anxiety with system [B] than system [A], while preferring the system [A] goggles. CONCLUSIONS: A rotation chair system without a darkroom can provide a more comfortable experience for subjects in terms of stuffiness and anxiety, while showing comparable results in SHA and SV tests with a darkroom system.
Acceleration ; Anxiety ; Ear Diseases ; Eye Protective Devices ; Semicircular Canals

BACKGROUND AND PURPOSE: The occurrence of PWD in neurodegenerative disease is very rare, and this is the first report of it being related to early-onset AD. We describe a patient with early-onset Alzheimer's disease (AD) who presented with pure word deafness (PWD). CASE REPORT: The patient had experienced PWD for 2 years, followed by other cognitive deficits suggestive of parietotemporal dysfunction. Brain imaging including 18FDG-PET and [11C] PIB-PET supported the diagnosis of AD. CONCLUSIONS: Our case highlights the clinical variability that characterizes early-onset AD.
Alzheimer Disease ; Aphasia, Primary Progressive ; Deafness ; Humans ; Neurodegenerative Diseases ; Neuroimaging

Gastric bezoars are collection of indigestible material in the stomach, and these can be classified into five broad categories: phytobezoar, trichobezoar, pharmacobezoar, lactobezoar and miscellaneous materials such as sand, stone and concrete (gypsum). The treatment of gastric bezoars has recently changed from surgical management to such nonsurgical interventions as enzymatic dissolution, nasogastric suctioning and endoscopic removal by polypectomy snare and basket. Up to the present, electrohydraulic lithotripsy has been a well established method for the treatment of urinary and hepatobiliary stones. We report here on a patient who had a huge gastric bezoar that was formed by the ingestion of gypsum, and this was treated with endoscopic electrohydraulic lithotripsy.
Bezoars* ; Calcium Sulfate* ; Eating* ; Endoscopy ; Humans ; Lithotripsy* ; Silicon Dioxide ; SNARE Proteins ; Stomach ; Suction

We present three neuropathologically-verified and two clinically-probable cases of Creutfeldt Jakob disease. All five had nonspecific prodromal complaints or symptoms prior to overt neurological signs and showed striking progressive neurologic deterioration, especially cognitive decline and cerebellar dysfunction. Myoclonic involuntary movements and complete decapitated states followed in one or two months. The characteristic even pathognomonic in proper clinical settings, features of electroencephalography, magnetic resonance imaging and positron emission tomography and pathologic findings are presented.
Cerebellar Diseases ; Creutzfeldt-Jakob Syndrome* ; Dyskinesias ; Electroencephalography ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Strikes, Employee

BACKGROUND AND PURPOSE: The closing-in phenomenon is the tendency to draw near or on the target when copying figures, which has been found mostly in patients with Alzheimer's disease (AD). We attempted to quantify the degree of closing-in and to compare it between patients with AD and vascular dementia (VaD). METHODS: The subjects (55 AD, 39 VaD and 38 normal controls) were asked to copy the figure of alternating square and triangle, starting at the designated point and continuing from left to right. The patients with AD and VaD did not differ in age, education, severity of dementia or Rey Complex Figure Test copy score. The proximity (Y-axis) of the subject's drawing to the target was plotted at intervals of 2 mm along the X-axis and the degree of closing-in was computed from the slope of the regression line. RESULTS: The AD and VaD patients showed a steeper slope than the controls. There was no significant difference, however, in the magnitude of closing-in of the AD and VaD patients. When closing-in was defined as a slope that was greater than the mean+2SD of the slope observed for the controls, 32.7% of the AD and 25.6% of the VaD patients showed closing-in. CONCLUSIONS: Our study, using a new method of measuring the degree of closing-in, suggests that this phenomenon is not specific to AD.
Alzheimer Disease* ; Dementia ; Dementia, Vascular* ; Education ; Humans

PURPOSE: E-cadherin (ECD) plays a pivotal role in integrating the normal tissue architecture and the suppression of cancer invasion, including stomach cancer. The epidemiology of stomach cancers is noticeably different according to the site of the index tumor, even though the stomach cancers all have similar gross shapes. In this study, the relation between the expression of ECD, along with the clinicopathologic parameters and recurrence or survival, were investigated for patients with gastric adenocarcinoma according to the tumor location. METHODS: We examined formalin-fixed, paraffin-embedded archival tissues from 50 surgically resectable gastric adenocarcinomas, which were grouped by the index tumor site as follows: distal (antrum) versus proximal (mid and upper body). To elucidate the correlation between the ECD expression and the site of the stomach cancer with the other clinicopathologic factors, we examined the ECD tissue status via performing immunohistochemistry. To compare the rates of recurrence and survival among subgroups, the patients were followed up for an average of 42 months. RESULTS: Among the 50 tumors examined, 28 (56%) tumors showed various degrees of a ECD expression. The gender, age, size, depth of invasion, lymph node metastasis, stage, lymphatic invasion and vascular invasion were not related with the ECD expression. The Lauren classification was cor-related with the ECD expression in the mid and upper body stomach cancer, but not in the antral stomach cancer (P=0.042). The expression of ECD was not related with the survival rate (P=0.223). There was no significant difference in the recurrence rate between the subgroups with and without an abnormal expression of ECD (P=0.588). CONCLUSION: For the mid and upper body stomach cancer, the expression of E-cadherin correlated with the diffuse type of cancer, according to the Lauren classification, but not with the survival rate.
Adenocarcinoma ; Cadherins* ; Classification* ; Epidemiology ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Stomach Neoplasms* ; Stomach* ; Survival Rate