Astasia-abasia refers to the inability to stand or walk despite possessing good motor strength and conserved voluntary coordination. Although it is usually regarded as a psychogenic disorder, organic causes have been reported. Herein we describe a patient who presented with alcohol-induced episodic astasia-abasia. Interestingly, SPECT performed during an episode showed hyperperfusion in the dorsal brainstem and subthalamic region. These areas roughly coincide with the mesencephalic locomotor region and subthalamic locomotor region, respectively, and it is conceivable that abnormal neural activity in these areas is related to the symptoms in our patient.

Ever since transplant surgery became a common procedure. The early diagnosis of irreversible cessation of cerebral function has become an important need We analysed the findings of transcranial doppler of five cases. Two was diagnosed brain death by currently accepted criteria. Two cases showed absence of intracranial blood flow and normal to disturbed flow status of the cervical carotid artery. Three cases showed reverberating flow pattern with reflux phenomenon. Transcranial doppler investigation seems to provide a practical, non-invasive. And reliable disgnostic evidence for the arrest of cerebral circulation.
Brain Death* ; Brain* ; Carotid Arteries ; Diagnosis* ; Early Diagnosis

Although most of the known pathogenic mutations in the progranulin gene (PGRN) are null mutations leading to a reduction in the serum PGRN protein levels, missense mutations also have been identifi ed in patients with frontotemporal lobar degeneration and in patients with Alzheimer disease. Among these, p.R564C mutation was identifi ed in a late-onset AD patient with a reduced serum PGRN level. However, recently, we found the p.R564C mutation in a healthy control subject raising doubts whether this is a pathogenic mutation. In this report, we measured the serum PGRN levels in 20 subjects without the p.R564C mutation and in one subject with the p.R564C mutation, to determine whether the p.R564C mutation is associated with reduced serum PGRN levels. We found that the serum PGRN level in the subject with the p.R564C mutation was not reduced compared to the subjects without the p.R564C mutation. Our result reiterates that p.R564C may not be a pathogenic mutation.

The Pill Questionnaire (PillQ) has been proposed as a simple way to evaluate cognitive deficits and their impact on the daily lives of those with Parkinson’s disease (PD) by asking patients or caregivers about whether patients can independently manage their pills. We used the PillQ to investigate the association of ability to manage medication with cognition and activities of daily living (ADLs) in patients with PD. Patients were divided into two groups based on PillQ scores. The no-impact group was able to take their antiparkinsonian medication independently, and the impact group exhibited problems describing their treatment or taking their drugs independently. A total of 208 participants (93 men) were included. 111 patients (53.4%) were included in the no-impact group, and 97 (46.6%) were included in the impact group. The impact group showed significantly lower cognitive functioning, difficulties with the performance of ADLs, and severe motor dysfunction. PillQ scores were significantly correlated with Mini-Mental State Examination and the Montreal Cognitive Assessment, and Clinical Dementia Rating scores. Management of medication by PD patients is associated with cognitive function, and the PillQ is an easy and useful test for detecting cognitive impairment and its impact on daily life.

Background and Objectives: This study aimed to examine factors of poor outcome by analyzing the outcomes of bilateral subthalamic deep brain stimulation in Parkinson’s disease after 3 years. Methods: We assumed that patients who could not manage independent life in their best stimulationon/medication-on condition after a defi ned period might not have been a good surgical candidate. A poor outcome is defi ned as a failure to maintain functional independence at three years during a stimulation-on/medication-on state. Results: A total of 84 patients underwent bilateral subthalamic deep brain stimulation and all were followed up for 3 years. We excluded one patient who had intracranial hemorrhage. Twenty-one patients of the 83 patients could not keep up independent life even during their best condition for the following reasons: freezing in 15 patients, dementia in 5, depression in 3, musculoskeletal problems in 7, and cancer in one patient. Conclusions: Many patients could not keep up independent life during their best condition as early as three years after deep brain stimulation. Musculoskeletal problems were one major cause of disabilities, as were freezing and dementia. We emphasize that musculoskeletal problems need more attention in the preoperative screening of deep brain stimulation candidates and during the follow up.

Many factors including social rejection, family problems, loss of educational opportunity, fear, prejudice and ignorance of leprosy compound the inherent psychologicaI stress of leprosy. In light of these problems we have undertaken a study to evaluate the psychological status of several selected groups of leprasy patients. We first studied 340 leprosy patients living in resettlement villages and 304 healthy people living in similar isolated areas. We used a self report symptom inventory, SCL-90 (symptom check list-90), and compared the two-groups. (countinued..)
Humans ; Leprosy* ; Prejudice ; Self Report ; Social Distance

Background & Objective: The MAPT H1 haplotype and SNCA single nucleotide polymorphism (SNP) rs356219 have been reported to have a synergistic effect on the risk of Parkinson’s disease (PD). Because the H1/H1 genotype has been reported to predominate in Korean population, we investigated the polymorphism of rs356219 in 878 PD patients and 559 controls. Methods: The SNCA SNP rs356219 was analyzed in 878 PD patients and in 559 healthy Korean subjects. Results: The G allele of SNCA SNP rs356219 was found to contribute to PD susceptibility with odds ratios (ORs) similar to those reported previously. However, the ORs were not as large as that of the SNCA rs356219 plus MAPT H1/H1 combination reported in the literature, which cast doubt on the existence of a synergistic effect between the two genotypes in our population. Conclusions: This study supports that the G allele of the SNCA SNP rs356219 contributes to PD susceptibility as reported previously, but it does not support the presence of a synergistic interaction between SNCA and MAPT.

PURPOSE: In normal tissue, MUC2 mucin gene is expressed predominantly in goblet cells, while MUC3 is expressed in both goblet cells and columnar absorptive cells of small intestine and colon. MUC5 mucin genes are expressed predominantly in the surface epithelial cells, while MUC6 is expressed mainly in the mucus neck cells of gastric glands and pyloric glands of stomach. In this paper, we determined any changes of mucin in drug-resistant cell lines from those parental cells, and we evaluated the altered regulation of mucin production in drug-resistant cells. MATERIALS AND METHODS: In the study of 17 day postconfluent parental HT29 (HT29) and methotrexate-resistant HT29 (HT29-MTX) colon cancer cell lines were examined for the expression of MUC2, 3, 5 and 6 mucin polypeptide (apomucin) by Northern blot and slot blot analysis, and also by immunoblot analysis. RESULTS: The level of MUC2 expression was unchanged, while there was increase in MUC3 expression in HT29-MTX compared to HT29. Interestingly there was a marked increase in the expression of MUC5 mRNA in HT29-MTX. The densitometric readings expressed as HT29-MTX/HT29 at 17th day after the cells were confluent are MUC2 (1.1), MUC3 (1.3), MUC5 (>70), MUC6 (1.0) with RNA slot blot. Immunoblot analysis was consistent with these data. CONCLUSION: Marked induction in MUC5 but not MUC6 gastric mucin gene was found in MTX resistance in HT29 colon cancer cells. The possible biological consequences of altered regulation of mucin genes in drug resistant colon cancer cells require further investigation.
Adenocarcinoma* ; Blotting, Northern ; Cell Line* ; Colon* ; Colonic Neoplasms ; Drug Resistance ; Epithelial Cells ; Gastric Mucins ; Gastric Mucosa ; Gene Expression* ; Goblet Cells ; HT29 Cells ; Humans* ; Intestine, Small ; Methotrexate* ; Mucins* ; Mucus ; Neck ; Parents ; Reading ; RNA ; RNA, Messenger ; Stomach

Autoimmune hemolytic anemia was diagnosed in a 60-year-old male without underlying disorder. He had complained of headache and exertional dyspnea. Laboratory studies revealed hemoglobin 4.9 g/dL, reticulocyte count 30%, total serum bilirubin 2.6 mg/dL, and haptoglobin 10 mg/dL. The peripheral blood smear showed marked spherocytosis. The bone marrow examination showed marked erythroid hyperplasia. The direct antiglobulin test was 2+ positive with anti-IgG and negative for C3d while indirect antiglobulin test was 1+ positive. The anti-E was identified in his serum and eluate from his red blood cells (RBCs). His blood group was group A, CcDEe. He had no transfusion history and autocontrol was positive. The adsorbed serum with ZZAP-treated RBCs did not react with a panel of reagent RBCs. These findings indicated that the antibody was autoanti-E. After transfusions of E-negative RBCs, the hemoglobin increased to 8.4 g/dL, and hemolytic transfusion reaction was not noted after transfusions. Treatment with prednisolone was effective in controlling the hemolytic anemia, but a splenectomy was performed to achieve permanent remission. After splenectomy the patient had normal hemoglobin and reticulocyte count lasting for three years without subsequent medical therapy.
Anemia, Hemolytic ; Anemia, Hemolytic, Autoimmune* ; Bilirubin ; Blood Group Incompatibility ; Bone Marrow Examination ; Coombs Test ; Dyspnea ; Erythrocytes ; Haptoglobins ; Headache ; Humans ; Hyperplasia ; Male ; Middle Aged ; Prednisolone ; Reticulocyte Count ; Splenectomy

The peripheral neuroepithelioma is a primitive neuroectodermal tumor arising from peripheral nerve. This tumor is exceedingly rare and various authorities have estimated its incidence as less than 1% of all malignant tumors of peripheral nerve. As far as our knowledge is concerned, no report on the peripheral neuroepithelioma has been published in Korea. In June, 1985, we experienced a case of peripheral neuroepithelioma that arose in scalp in a 56 year old female. Clinical data and histopathological findings with light and electron microscope of the case were discussed and a brief review of the literature on this entity was made.
Female ; Humans ; Incidence