BACKGROUND AND OJBECTIVES: Nystagmus produced by static placement of the head in different orientations is termed positional nystagmus and in most instances the cause is a peripheral vestibular disorder, as in benign paroxysmal positioning vertigo (BPPV). However, the physiologic basis of the isolated positional downbeat nystagmus has not been fully understood. The goal was to find a possible pathomechanism of dizzy patients who showed isolated positional downbeat nystagmus (pDBN). MATERIALS AND METHOD: Twelve consecutive patients with isolated positional DBN and 50 normal volunteers underwent evaluation of spontaneous, head-shaking and positional nystagmus, smooth pursuit, saccades, and VOR. The patients with focal neurologic signs, abnormal hearing, caloric paresis or acute lesion on brain imaging were excluded. RESULTS: Positional downbeat nystagmus was developed during lying down, straight head-hanging and/or Dix-Hallpike position. Perverted head-shaking nystagmus was observed in seven patients (58.3%). Gait disturbance revealed in six patients. Other cerebellar manifestations including saccadic dysmetria and gaze-evoked nystagmus were not observed. The gains of VOR were increased than normal controls. However, the gains of visual enhancement and visual cancellation of the VOR were not different from controls and OKN/OKAN were normal. The mean VOR time constants did not differ between patients and normal controls. However, tilt suppression of the post-rotatory nystagmus was impaired in the patients (p<0.01). All patients showed normal findings in head thrust test, caloric response, BAEPs, and brain imaging. CONCLUSION: Isolated positional downbeat nystagmus (pDBN) in patients complained intermittent dizziness showed frequently accompanied perverted head-shaking nystagmus (HSN) and increased gain of VOR and impaired tilt suppression. This finding tells us that isolated positional downbeat nystagmus (pDBN) reflects pathologic central nystagmus results from cerebellar (uvulonodular) dysfunction.
Cerebellar Ataxia ; Deception ; Dizziness ; Gait ; Head ; Head Impulse Test ; Healthy Volunteers ; Hearing ; Humans ; Neuroimaging ; Neurologic Manifestations ; Nystagmus, Physiologic* ; Paresis ; Pursuit, Smooth ; Reflex, Vestibulo-Ocular ; Saccades ; Vertigo

Monosymptomatic enuresis(bed-wetting without other symptoms) is a common problem in children, affecting 15% of five-year-olds and occurring more frequently in boys than in girls. Because it is usually caused by a physiologic maturational delay, the prevalence decreases with age. Children with enuresis have a small bladder capacity. Failure to awake to the micturition urge is not necessarily related to being a "deep sleeper", and children with enuresis may pass urine involuntarily because of the immature central nervous pathways. As the CNS pathways matures with age, most children are more easily aroused from sleep. There is strong evidence of a genetic predisposition for enuresis. Children with enuresis must be evaluated to reveal any underlying physiologic conditions or disease states, such as urinary tract infection or structural abnormality. Once these are ruled out, the goal is to stop the bed-wetting while preserving the child's self-esteem. However, before treatment of enuresis, concurrent problems, such as daytime enuresis and urgency or chronic constipation, should be managed. For the treatment of enuresis, the child wears a moisture alarm-a small, portable, transistorized device-to bed. The alarm sounds or vibrates when wet, awakening the child. Drug therapy for enuresis includes desmopressin, which decreases the urine volume, and imipramine and oxybutynin, which inhibit bladder contraction. Both delayed urinary control and current enuresis are associated with a markedly increased risk of behavioral, emotional, and academic problems.
Child ; Constipation ; Deamino Arginine Vasopressin ; Drug Therapy ; Enuresis* ; Female ; Genetic Predisposition to Disease ; Humans ; Imipramine ; Prevalence ; Problem Behavior ; Urinary Bladder ; Urinary Tract Infections ; Urination

According to the need for objectivity and convenience the whole planning process is devided into a secries of 8 systematic stages. But it is an unending upward spiral of incremented efforts toward improvement. So many activities should be carried out concurrently, providing a mutual supportive flow back and forth between various stages of the process depending on local conditions and requirements. The eight stages are : (1) Planning the Planning and Developing Planning competence, (2) Statements of Policy and Broad Goals, (3) Data Gathering, (4) Priority Statement, (5) Statement of Major Alternative Proposals, (6) Development of Detailed Plan, (7) Implementation as a Part of the Planning Process, (8) Evaluation. The frame and function of the planning machinery must be adjusted to local conditions, and also flexibility is desirable, especially at the start, when adaptations are more necessary and more frequent.
Mental Competency ; Pliability ; Regional Health Planning*

No abstract available.
Chungcheongnam-do* ; Family Planning Services* ; Humans

Medical images wit high resolution are coded to be archived communicated in PACS. In this pater, we have studied on coding of Cardio-Angiography. Our coding technique is method is Subband-Vector Quantization. This technique is irreversible coding method. This technique's objects are removing blocking artifact and edge degradation, adapting for drastic image change because of dye injection, and fast decoding, We achieved good results for Cardio-Angiography data, but the study on more sophisticated motion estimation techniques and VQ techniques must be performed.
Artifacts ; Clinical Coding* ; Statistics as Topic

No abstract available.
Child* ; Hepatitis* ; Humans

Ischemic colitis still remains largely underdiagnosed despite the fact that it is one of the most common disorders of the large bowel. The aims of the present study were to evaluate the variable histologic findings of ischemic colitis and to find out helpful histopathological features in diagnosis. Retrospective review of the clinical symptoms, underlying diseases, endoscopic findings of 23 patients, and the histologic features of 37 biopsies was done. We analyzed the significant pathologic features in the histologically diagnosed ischemic colitis group and compared the biopsy time between the histologically diagnosed ischemic colitis group and the non-diagnosed group. Comparison of the endoscopic biopsy time between the group that showed significant histologic features and the group that showed no significant histologic features was also done. The age of the patients ranged from 27 to 87 years. Most patients had abdominal pain, hematemesis, and melena. Endoscopic differential diagnoses included ischemic colitis, ulcerative colitis, infectious colitis, tuberculous colitis, Crohn's disease, and pseudomembranous colitis. Histologic features and diagnoses were also variable. The coagulative necrosis of mucosa and the epithelial desquamation were frequently detected in the group pathologically diagnosed as ischemic colitis. The most pathognomonic finding was coagulative necrosis of the mucosa that was almost always detected within seven days after the onset of clinical symptoms. Recognition of variable patterns of ischemic colitis in a biopsy specimen will direct the clinician to evaluate the vascular system. Early endoscopic biopsy is essential for the precise diagnosis of ischemic colitis.
Abdominal Pain ; Biopsy* ; Colitis ; Colitis, Ischemic* ; Colitis, Ulcerative ; Crohn Disease ; Diagnosis ; Diagnosis, Differential ; Enterocolitis, Pseudomembranous ; Hematemesis ; Humans ; Melena ; Mucous Membrane ; Necrosis ; Retrospective Studies

Helicobacter pylori infection has been shown to be associated with gastric carcinoma. However, despite the frequent detection of seropositivity for H. pylori and histologic detection in biopsy specimen, histologic detection rate of H. pylori in surgical specimens has been low. In this study, we investigated the prevalence of H. pylori infection in gastrectomy specimens bearing gastric adenocarcinoma and compared it with both endoscopic biopsy and serologic results. H. pylori infection was identified by Giemsa stain in the mucosa stripped from the tumor, body, and antrum in 61 gastrectomy specimens. We evaluated the effect of H. pylori infection on gastric mucosal cell proliferation by using monoclonal antibody for Ki-67. H. pylori detection rate using Giemsa stain was higher in gastrectomy specimens (67.3%) compared to that (48.1%) of biopsy specimens (p=0.006). The detection rate was higher in body than that of antrum or tumor site in the same patients (p=0.001). The H. pylori seropositivity was 60.5% and relatively nonspecific. The mean value of Ki-67 labeling index in the H. pylori-positive group was higher than that in the H. pylori-negative group (p<0.05). The increase in gastric epithelial cell proliferation was not influenced by the location of the tumor or the site of the specimen. The results suggest that the actual prevalence of H. pylori infection in patients with gastric carcinoma is considerably higher than that evaluated on endoscopic biopsy specimens. In addition, the increased cell proliferation in the H. pylori-positive group suggests some evidence that H. pylori may be involved in gastric carcinogenesis.
Adenocarcinoma* ; Azure Stains ; Biopsy ; Carcinogenesis ; Cell Proliferation ; Epithelial Cells ; Epithelium* ; Gastrectomy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Mucous Membrane ; Prevalence

Melanocytes were identified by the dopa reaction, and counted in vertical sections of 183 specimens of normal skin and 218 specimens of patients with pigmentary disorders. The incidence of dopa-positive cells in the basal layer was determined. One cell in 9 in the basal layer was dopa-positive in normal specimens. There was no significant difference in the incidence of dopa-positive cells between male and female and between adult and children. Specimens from face, neck and prepuce revealed comparatively high incidence of dopa-positive cells. Among pigmentary disorders, vitiligo and halo area of halo nevus were characterized by an abscence or marked reduction in the number of dopa-positive cells, but lentigo and cafe-au-lait spot were characterized by an increase in their number In tuberous sclerosis, tinea versicolor and idiopathic guttate hypomelanosis, there wasn't any change of the melanocyte population between lesional skin and normal skin. The significance of these findings in vertical skin sections was discussed.
Adult ; Cafe-au-Lait Spots ; Child ; Dihydroxyphenylalanine* ; Female ; Humans ; Hypopigmentation ; Incidence ; Lentigo ; Male ; Melanocytes ; Neck ; Nevus, Halo ; Skin* ; Tinea Versicolor ; Tuberous Sclerosis ; Vitiligo

No abstract available.
Carcinoma, Papillary* ; Thyroid Gland*