Acute ataxic sensory neuronopathy resulting from podophyllin intoxication.
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Biomedical subjects
Publications and source records attributed to K P Lin.
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The term "congenital muscular dystrophy (CMD)" is used for a group of diseases with heterogeneous clinical and cranial CT scan manifestations. Recently, a distinct subtype, characterized by white matter hyperlucency on CT scan but normal or nearly normal intellectual function, has been recognized in Western peoples and has even been named "occidental-type cerebromuscular dystrophy." Here, we described two Chinese siblings with this type of CMD.
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Bajiaolian (Dysosma pleianthum), one species in the Mayapple family, has been widely used as a general remedy and for the treatment of snake bite, weakness, condyloma accuminata, lymphadenopathy and tumours in China for thousands of years. However, the textbooks of traditional Chinese medicine mention little about the toxicity of Bajiaolian. Within 1 year, the authors saw five people who manifested nausea, vomiting, diarrhoea, abdominal pain, thrombocytopenia, leucopenia, abnormal liver function tests, sensory ataxia, altered consciousness and persistant peripheral tingling or numbness after drinking infusions made with Bajiaolian. The herb was recommended by either traditional Chinese medical doctors or herbal pharmacies for postpartum recovery and treatment of a neck mass, hepatoma, lumbago and dysmenorrhoea. Podophyllotoxin is one of the main ingredients of the Bajiaolian root. The clinical manifestations observed in our patients were consistent with podophyllum intoxication. Podophyllotoxin intoxication usually results from the accidental ingestion or topical application of podophyllum resin. However, these cases of Bajiaolian intoxication were iatrogenic and results from 'therapeutic doses' of Bajiaolian cited in the textbooks of traditional Chinese medicine.
We applied somatosensory and motor evoked potential studies to investigate patients with cervical spondylotic myelopathy (CSM) diagnosed clinically and roentgenographically. There were 32 consecutive cases collected, including 25 males and 7 females, at an average age of 62 +/- 8.2 (49-75) years. A control group consisted of 30 healthy subjects matched in body height and age with patients. The normal values of head-to-neck and head-to-lumbar region central motor conduction times (CMCTs) were 7.04 +/- 0.60 (6.1-8.2) and 15.94 +/- 1.23 (14.0-18.7) ms, which were not affected by body height. The somatosensory evoked potential (SEP) findings were related to clinical posterior column signs, levels of cord lesion, and nerves tested. The abnormality rate of median nerve SEP was relatively low, 53% (17/32), particularly for the lesion below C5-6 level in which median nerve SEP was usually normal. The abnormality rates of ulnar and tibial nerve SEPs were up to 84.5% (27/32) and 90.6% (29/32) respectively. However, median, ulnar and tibial nerve SEPs were normal in 3 (9.4%) patients showing normal posterior column function clinically. Only 18 (56.3%) patients had recordable motor evoked potential (MEP) from abductor digiti minimi (ADM) to head stimulation. The head-to-neck CMCT, 9.12 +/- 1.53 (6.3-12.7) ms, was significantly prolonged. Of these 18 cases there were 9 cases of delayed CMCT with reduced MEP amplitude, 4 of delayed CMCT, 3 of reduced MEP amplitude, and 2 of normal CMCT and MEP amplitude. The remaining 14 cases (43.7%) showed absent MEP from ADM to head stimulation. The overall abnormal rate of MEP from ADM was 93.8% (30/32). MEP from tibialis anterior (TA) to head stimulation was recorded only in 6 patients in whom the responses were all abnormal. There was no response recorded from TA in the remaining 26 CSM patients.(ABSTRACT TRUNCATED AT 250 WORDS)
This communication proposes a method called linear prediction (a high performant technique in digital speech processing) for analyzing digital ECG signals. There are several significant properties indicating that ECG signals have an important feature in the residual error signal obtained after processing by Durbin's linear prediction algorithm. This communication also indicates that the prediction order need not be more than two for fast arrhythmia detection. The ECG signal classification puts an emphasis on the residual error signal. For each ECG's QRS complex, the feature for recognition is obtained from a nonlinear transformation which transforms every residual error signal to a set of three states pulse-code train relative to the original ECG signal. The pulse-code train has the advantage of easy implementation in digital hardware circuits to achieve automated ECG diagnosis. The algorithm performs very well in feature extraction in arrhythmia detection. Using this method, our studies indicate that the PVC (premature ventricular contraction) detection has at least a 92 percent sensitivity for MIT/BIH arrhythmia database.