Ataxia is one of the most serious neurological symptoms in elderly The clarification of the related anatomical structures are necessary for the understanding of pathophysiologic mechanisms of ataxia. We have recently experienced a case of thalamic infarct in the territory of thalamogeniculate artery. The localization of lesion was based on CT and MR imaging. At first time, right hemiparesis and ataxia were prominent. Hemiparesis was transient but ataxia had been persistent for several months. It has been suspected that thalamus could be the part of neural circuits in balancing. Our case support this suggestion clinically. Based on clinical observations, a plausible extrapolation can be made to thalamic ataxia. It maybe related with dysfunction of dentatorubrothalamic and corticopontine pathway. Thus our case led us to conclude that thalamus could be engaged in balance control of human body.
Aged* ; Arteries ; Ataxia* ; Human Body ; Humans ; Magnetic Resonance Imaging ; Paresis ; Thalamus

No abstract available.

Atropine is a commonly used eye drug due to the effect of mydrasis and cycloplegia. The true allergic contact dermatitis to atropine is rarely reported. A case of allergic contact dermatitis due to atropine sulfate in a 35-year-old woman was confirmed by the patch test.
Adult ; Atropine* ; Dermatitis, Allergic Contact* ; Female ; Humans ; Patch Tests

We conducted this cohort analytic study to determine whether women with unexplained elevations of maternal serum hCG at 15-18 weeks' gestation are at increased risk for pregnancy complications and adverse perinatal outcomes. The inclusion criteria were a singleton gestation, a confirmed gestational age, and an hCG level greater than 2.0 multiples of the median (MoM). The exclusion criteria were fetal anomalies, an abnormal karyotype, molar pregnancy, and an MSAFP level greater than 2.5 multiples of the median (MoM). A group of randomly selected women with hCG levels under 2.0 MoM served as controls. Patients with elevated levels of hCG had a significantly higher risk for PIH (17.9% versus 4.5%; P <.05) and preterm delivery (17.9% versus 3.5%; P<, 05) than control. But no significant differences were observed in the incidence of intrauterine growth restriction and low birth weight and in the newborn weight. We suggested that pregnancies with unexplained elevated hCG levels should be regarded as high-risk pregnancies. And these patients require careful monitoring with adequate obstetric management.
Abnormal Karyotype ; Chorionic Gonadotropin* ; Cohort Studies ; Female ; Gestational Age ; Humans* ; Hydatidiform Mole ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome* ; Pregnancy* ; Pregnancy, High-Risk

Coenzyme Q is concentrated in Golgi apparatus membranes and mitochondria, but not in other membranes. Although it is difficult to prove the metabolic action of coenzyme Q administered exogenously in clinical cases, the effect of this substance can be evaluated by criteria based on clinical findings. In an attempt to evaluate the effect of coenzyme Q for the treatment of 67 patients(male 26 cases, female 41 cases) of congestive heart failure, we administered Coenzyme Q1030mg daily for 4 to 8 weeks. Most of them were valvular heart disease(74.6%) and hypertension (14.9%). Clinical effects were evaluated at least 4 weeks later by the criteria using a scoring method of severity of congestive heart failure which was devised by Ishiyama, etc. In summary, a definite effect was found in 13 cases(19%) and a mild effect was observed in 46 cases(69%). During treatment there were no significant side effects, and also no significant changes in heart rate and blood pressure.
Blood Pressure ; Estrogens, Conjugated (USP)* ; Female ; Golgi Apparatus ; Heart ; Heart Failure* ; Heart Rate ; Humans ; Hypertension ; Membranes ; Mitochondria ; Research Design ; Ubiquinone

BACKGROUND: Diabetic ketoacidosis(DKA) is serious acute metabolic complication and the most important cause of high morbidity and mortality of diabetes. The object of this study is to examine the clinical characteristics of patients with DKA who had a prior history of diabetes or not. METHOD: Authors reviewed retrospectively the medical records of 49 cases adimitted to Kyungpook National University Hospital from January 1991 to June 1997 with a diagnosis of DKA and classified cases as type I, type II and newly diagnosed diabetics according to prior history of diabetes. RESULTS: 1. Of 49 cases of DKA, 24(49%) were classified as type I, 17(35%) as type II from data available in the medical records, and 8(16%) had DKA as the initial manifestation of the disease. 2. The male to female ratio was 0.5 : 1 in type I, 1.1 : 1 in type II and 1.7 : 1 in newly diagnosed diabetics, and the mean age was 24.4 in type I, 57.9 in type II and 23.9 years old in newly diagnosed diabetics. 3. The mean duration between initial diagnosis of diabetes and the occurrence of DKA was 2.6 in type I and 6.9 years in type II diabetes. The occurrence of DKA within 2 years of initial diagnosis of diabetes was 54% in type I and 18% in type II diabetes, but the occurrence of DKA after 5 years of initial diagnosis of diabetes was 17% in type I and 47% in type II diabetes. 4. The precipitating factors of DKA were identified in 88% in type I, 76% in type II and 38% in newly diagnosed diabetics, and the most common precipitating factor was omission of treatment in both type I and type II(type I: 56%, type II: 35%). 5. The altered mental status was correlated with increased osmolality (p<0.05), but not with other laboratory values such as pH, bicabonate, glucose, anion gap and dehydration status(p>0.05). CONCLUSION: It is necessary to conduct early aggressive evaluation for early diagnosis and proper treatment of DKA, because DKA occurs in patients with prior history of type II diabetes and without prior diabetic history as well as patients with prior history of type I diabetes.
Acid-Base Equilibrium ; Dehydration ; Diagnosis ; Early Diagnosis ; Female ; Glucose ; Gyeongsangbuk-do ; Humans ; Hydrogen-Ion Concentration ; Male ; Medical Records ; Mortality ; Osmolar Concentration ; Precipitating Factors ; Retrospective Studies

PURPOSE: To recanalize the occlusive lesion of superficial femoral artery at origin site by retrograde approach via popliteal artery. MATERIALS AND METHODS: 15 patients, who were poor surgical candidates due to coronary artery disease and who had severe occlusive lesion of superficial femoral artery close to its origin with good distal runoffs to popliteal artery, were selected. Patients were all~men and range of age were from 53 years to 66 years (mean age:63 years). Range of lesion length were from 15cm to 30cm (mean length:22.4cm). Localization of popliteal artery was done with Doppler stethoscope or "road-map" DSA. The method of recanalization were transluminal endarterectomy catheter (TEC), TEC and angioplasty, thrombolysoangioplasty (TLA). RESULT: Retrograde puncture of popliteal artery were done in 15 patients successfully. TEC & PTA was performed in 9 patients, TEC only in 2 patients, and TLA & PTA in 2 patients. During the follow-up period of 5 months to 2 years reocclusion did not occurr in 10 patients except for 1 patient with poor cardiac output in whom it occured 1 day later. Remained 4 patients were lost in follow up. Any neurologic or vascular complication did not occur. CONCLUSION: Retrograde approach of superficial fernoral artery via popliteal artery in patients with difficult vascular intervention by common method provides a useful, alternative recanalization method.
Angioplasty ; Arteries ; Cardiac Output ; Catheters ; Coronary Artery Disease ; Endarterectomy ; Femoral Artery* ; Follow-Up Studies ; Humans ; Popliteal Artery* ; Punctures ; Stethoscopes

We observed the levels of serum cholesterol, triglyceride and HDL-cholesterol in 28-hyperlipidemic patients after treatment with procetofene(Lipanthyl(R)), a new hypolipidemic agent. The results were as follows. 1. The hyperlipidemic patients were 7 cases of pure hypercholesterolemia, 12 cases of mixed hyperlipidemia and 9 cases of pure hypertriglyceridemia. 2. All the patients were treated with daily dose of 200 to 400mg, usually 300mg, and duration of more than 12 weeks. 3. The serum cholesterol decreased significantly at the rate of 29% in pure hypercholes terolemia and 29% in mixed hyperlipidemia after treatment for 12 weeks. 4. The serum triglyceride decreased significantly at the rate of 58% in mixed hyperlipidemia and 42% in pure hypertriglyceridemia after treatment for 12 weeks. 5. The serum HDL-cholesterol increased at the rate of 10% in pure hypercholesterolemia, 14% in mixed hyperlipidemia and 26% in pure hypertriglyceridemia after treatment for 12 weeks, but the increase rate was statistically significant only in pure hypertriglyceridemia. 6. Transient epigastric discomfort was complained by 2 patients, but subsided spontaneously with continuous treatment. 7. In view of these results, procetofene appears to be an effective and well tolerated agent for the treatment of all the types of hyperlipidemia.
Cholesterol ; Fenofibrate ; Humans ; Hypercholesterolemia ; Hyperlipidemias ; Hypertriglyceridemia ; Triglycerides

BACKGROUND: The purpose of this study is to assess the range of shoulder motion using an indirect evaluation method without physical examinations of patients based on questionnaires regarding several specific arm postures referenced by patient's own body parts. METHODS: Nine criteria of specific shoulder motion including 4 forward flexion, 2 external rotation, and 3 internal rotation were decided as reference position which can represent a certain shoulder motion. Flexion contains postures such as lifting arm to waist-height, shoulder-height, eye-height, and raising arm above head with arm touching ears. External rotation comprises grasping ears and placing hands on back of the head. Vertebral height in internal rotation is determined by calculating the samples' motions, which are holding on to trouser belts, opposite-elbow, and scapula. These postures are included in questionnaires for patients to evaluate the validity and effectiveness of this indirect method. RESULTS: The range of flexion was 77degrees (60degrees to 100degrees), 96degrees (87degrees to 115degrees), 135degrees (115degrees to 150degrees), and 167degrees (150degrees to 175degrees) when arms go up to waist, shoulder, eye, and high vertically. Range of external rotation was 39.6degrees (30degrees to 50degrees) when grasping ears and 69.2degrees (60degrees to 80degrees) with the hands on the back of the head. Range of internal rotation was L4 when placing trouser belts, T12 for holding opposite elbow, and T9 for reaching scapula. The mismatch rates of flexion, external rotation, and internal rotation were 11.6%, 9.6%, and 7.8%. CONCLUSIONS: The range of shoulder motion using this method is expected to be applied to an established shoulder scoring system which included shoulder motion evaluation item.
Arm ; Ear ; Elbow ; Hand ; Hand Strength ; Head ; Human Body* ; Humans ; Lifting ; Physical Examination ; Posture ; Range of Motion, Articular ; Scapula ; Self-Assessment ; Shoulder Joint ; Shoulder* ; Telephone ; Surveys and Questionnaires

BACKGROUND: Trisomy 16 in mice is considered to be an animal model for Down's syndrome in human. We studied the morphologic characteristics of the heart and the edema, and their significance to the teratogenesis in this animal model. METHODS: A total of 30 dams were sacrificed to bear 125 (61.9%) normal fetuses 35 (17.3%) abnormal fetuses and 42 (20.8%) resorptions. Cytogenetic study and morphological examination were performed using microdissection agar-mount sectioning histologic examination and scanning electron microscope. RESULTS: The crown-rump length was significantly shorter in abnormal (trisomic fetuses) than the normal (eusomic) fetuses. Trisomic fetuses showed massive edema at the back from the vertex to the lumbar area. Four-chamber view section of the agar-mount and histologic section showed a common atrioventricular valve bridging the left and the right atrioventricular junction. Scanning electron microscopic examination on atrioventricular valves showed three types of atrioventricular valves:five cases with common atrioventricular orifice, three cases with partitioned atrioventricular orifice and two cases with atresia of the right atrioventricular orifice. CONCLUSION: This study confirmed the presence of massive edema and cardiac anomalies in the mouse with trisomy 16. But there was morphologic diversity of cardiac anomaly in this model.
Animals ; Crown-Rump Length ; Cytogenetics ; Down Syndrome ; Edema* ; Endocardial Cushion Defects ; Fetus* ; Heart ; Humans ; Hydrops Fetalis ; Mice ; Microdissection ; Models, Animal ; Pathology* ; Teratogenesis ; Trisomy*