A Cas e of Bilateral Lateral Medullary Syndrome due to Two Cons ecutive Medullary Infarcts

Lateral medullary syndrome is one of the most well known and best characterized vascular syndromes of the vertebrobasilar circulation. This syndrome is most often caused by unilateral occlusive disease of the ipsilateral vertebral artery or its posterior inferior cerebellar artery branch. Bilateral lateral medullary syndromes are rare and the prognosis of this condition is grave. A 70-year-old hypertensive, diabetic woman developed sudden dizziness and gait ataxia. On neurologic examination, she had dysarthria, hoarseness, nystagmus, absent gag reflex, sensory changes on the right hemibody, and left limb and gait ataxia. Brain MRI revealed left middle and inferior lateral medullar infarction. Brain MR angiography revealed occlusion of the right vertebral artery and mild stenosis at the origin of the left vertebral artery with distal occlusion. Seven months later, she developed right lateral medullary syndrome. Repeated brain MRI revealed right upper lateral medullar and cerebellar infarction. We report a case of bilateral lateral medullary syndromes due to two consecutive medullary infarcts.

The Association between C-reactive Protein and Obesity among Korean Men

BACKGROUND: C-reactive protein (hereinafter CRP) is a substance that is elevated in large quantities when there is an abnormal metabolic reaction or an inflammatory condition. Many researches have identified the substance as a prognostic and an independent risk factor responsible for cardiovascular disease. More recently, many studies have shown that obesity is associated with low-grade systemic inflammation. This study was attempted to illustrate the relationship between obesity and CRP regarding Korean men who were applied by different standards of obesity. METHODS: The subjects included 15,353 men who had visited one health promotion center from May, 2001 to December, 2001, were randomly selected as the total addressable population. We excluded 389 men who were observed to have inflammatory conditions, according to the results of the general chemical and physical diagnosis. Among 15,353 Korean men 14,964 were examined. CRP was quantitatively analyzed by the method of Nephelometry as high sensitivity-CRP. CRP values in relation to age, BMI, clustering of metabolic risk factors were studied, and multiple logistic regression analysis was conducted to identify correlation between obesity and CRP value. RESULTS: We compared the median values of CRP of each group divided by age, BMI, and clustering of metabolic risk factors. As a matter of the fact, the more age, BMI, and clustering of metabolic risk factors increased, the more the value of CRP significantly increased (P<0.0001). We operationally defined incremented CRP value as CRP of 0.22 mg/dl or more, and conducted multiple logistic regression analysis with the parameters of age, BMI, and obesity related diseases. Consequently, when fasting blood glucose and total cholesterol were high or HDL was low, the risk of CRP increasing was significantly high. Also, when the age was more than 60 or BMI was greater than 25 kg/m2, which was categorized as obese, the risk regarding increase in CRP was significantly high. CONCLUSION: Obesity is independently related to increase in CRP in Korean men. Which suggests that low-grade systemic inflammation exists in obese people. Furthermore, our study showed that old age, high level of blood glucose, high level of cholesterol, and low level of HDL have correlation with increase in CRP.

Prediction of Adolescence Overweight from Childhood Body Mass Index 7 Year Retrospective Study of Suburban School Children

BACKGROUND: Childhood and adolescent obesity, not only increases the risk of obesity into adulthood but also is a significant culprit affecting health in general. The purpose of this study was to examine the trend in body mass index (BMI) and to investigate the prediction of adolescence overweight from childhood weight status by retrospectively tracking for seven years. METHODS: The subjects, 520 adolescents aged 14 and 15 years, were recruited from a junior high school that is located in Guri-city. The subjects' height and weight measurements were extracted from the school records of annual physical examination. We assessed their BMI over a period of seven years starting at age seven. Other baseline data were obtained by questionnaires which were completed by both the subjects and their parents in 2001. RESULTS: The prevalence of overweight, according to the Korean Pediatric Society guideline, increased at age 7 through 14. The overweight adolescents of age 14 were more likely to have an obese mother. The results showed that 84% of males and 47% of females who were overweight in childhood continued to remain overweight in adolescence. Compared to the non-overweights, the relative risk of becoming an overweight adolescent among overweight boys was 5.7 (95% CI: 4.1~8.1) and among overweight girls was 6.3 (95% CI: 3.4~11.4). CONCLUSION: Approximately 70% of the overweight children continued to remain overweight as adolescents. Therefore, prevention and effective management of obesity during childhood and adolescence are essential.