1.Diabetes mellitus as a predictor for late recovery of vestibular neuritis
Kang Min Park ; BongSoo Park ; Kyong Jin Shin ; Sam Yeol Ha ; JinSe Park ; Sung Eun Kim
Neurology Asia 2014;19(4):393-397
The time course of recovery in vestibular neuritis varies between individuals. The aim of this study was
to identify the predictors for the early or late recovery of vestibular neuritis. The inclusion criteria were
patients 1) who had an acute onset of vertigo lasting at least 24 hours, 2) with a horizontal-torsional
unidirectional spontaneous nystagmus, and 3) with a canal paresis of 20% or more on the bithermal
caloric tests. The primary endpoint for this study was an early or late recovery of vestibular neuritis as
a dependent variable. A functional level scale was used to define the late recovery (5 or more points) at
seven days after the symptom onset. The secondary endpoint was the duration of hospitalization. One
hundred twenty eight patients met the inclusion criteria for this study, and among them, 71 patients
had an early recovery. Multiple logistic regression analysis showed that diabetes mellitus was the only
independent significant variable for the prediction of a late recovery of vestibular neuritis. In addition,
the diabetes mellitus was a predicting variable for long duration of hospitalization. Diabetes mellitus
was a predictor for a late recovery of vestibular neuritis.
2.A Case of Erythrodermic Form of Mycosis Fungoides.
Moo Kyu SUH ; Yeol Oh SUNG ; Ki Seong YOON ; Kyoung Yim HA ; Jung Ran KIM ; Yeon Hee OH ; Sam KWON
Korean Journal of Dermatology 1998;36(1):111-115
We report a case of an erythrodermic form of mycosis fungoides in a 68-year-old male, who showed generalized erythroderma with scales for 3 months. Lymphadenopathies in the inguinal and neck areas were present. Histopathological findings showed epidermotropism, perivascular atypical lymphocyte infilteration in the upper dermis, and dermatopathic lymphadenopathy in the inguinal lymph node. T cell markers were positively stained in the immunohistochemical study. These clinicopathological features were consistent with an erythrodermic form of mycosis fungoides(TNM IIl). The patient was treated with PUVA therapy and low dose chemotherapy.
Aged
;
Dermatitis, Exfoliative
;
Dermis
;
Drug Therapy
;
Humans
;
Lymph Nodes
;
Lymphatic Diseases
;
Lymphocytes
;
Male
;
Mycosis Fungoides*
;
Neck
;
PUVA Therapy
;
Weights and Measures
3.Mechanical Solitaire Thrombectomy with Low-Dose Booster Tirofiban Injection.
Duck Ho GOH ; Sung Chul JIN ; Hae Woong JEONG ; Sam Yeol HA
Neurointervention 2016;11(2):114-119
PURPOSE: Mechanical thrombectomy using a Solitaire stent has been associated with a high recanalization rate and favorable clinical outcome in intra-arterial thrombolysis. To achieve a higher recanalization rate for mechanical Solitaire thrombectomy, we used an intra-arterial low-dose booster tirofiban injection into the occluded segment after stent deployment. We report the safety and recanalization rates for mechanical Solitaire thrombectomy with a low-dose booster tirofiban injection. MATERIALS AND METHODS: Between February and March 2013, 13 consecutive patients underwent mechanical Solitaire thrombectomy with low-dose booster tirofiban injection. The occlusion sites included the proximal middle cerebral artery (5 patients), the internal carotid artery (5 patients), the top of the basilar artery (2 patients) and the distal middle cerebral artery (M2 segment, 1 patient). Six patients underwent bridge treatment, including intravenous tissue plasminogen activator. Tirofiban of 250 µg was used in all patients except one (500 µg). All occluded vessels were recanalized after 3 attempts at stent retrieval (1 time, n=9; 2 times, n=2; 3 times, n=2). RESULTS: Successful recanalization was achieved in all patients (TICI 3, n=8; TICI 2b, n=5). Procedural complications developed in 3 patients (subarachnoid hemorrhage, n=2; hemorrhagic transformation, n=1). Mortality occurred in one patient with a basilar artery occlusion due to reperfusion brain swelling after mechanical Solitaire thrombectomy with low-dose booster tirofiban injection. Favorable clinical outcome (mRS≤2) was observed in 8 patients (61.5%). CONCLUSION: Our modified mechanical Solitaire thrombectomy method using a low-dose booster tirofiban injection might enhance the recanalization rate with no additive hemorrhagic complications.
Basilar Artery
;
Brain Edema
;
Carotid Artery, Internal
;
Hemorrhage
;
Humans
;
Methods
;
Middle Cerebral Artery
;
Mortality
;
Reperfusion
;
Stents
;
Thrombectomy*
;
Tissue Plasminogen Activator
4.Steroid-Responsive Recurrent Encephalopathy Associated with Subacute Thyroiditis.
Yun Jae CHUNG ; Kwang Yeol PARK ; Jihyun AHN ; Sam Yeol HA ; Young Chul YOUN
Journal of Clinical Neurology 2008;4(4):167-170
BACKGROUND: Steroid-responsive encephalopathy associated with subacute thyroiditis has, to our knowledge, not been reported previously. CASE REPORT: A 49-year-old woman was found collapsed and brought to our institution with decreased mentality, dysarthria, and gait disturbance. Brain magnetic resonance imaging and angiography were normal but blood tests revealed thyroid-autoantibody-negative thyrotoxicosis. Results of a (99m)technetium-pertechnetate scan were compatible with the thyrotoxic phase of subacute thyroiditis. 14-3-3 proteins were detected in cerebrospinal fluid. Her mental status began to improve from the day following steroid administration. Recurrent encephalopathy was found 2 months after the initial admission, which was also effectively treated with steroid. CONCLUSIONS:We speculate that steroid-responsive recurrent encephalopathy associated with subacute thyroiditis is a subtype of Hashimoto's encephalopathy, and consider that steroid treatment should not be delayed in suspected patients.
14-3-3 Proteins
;
Angiography
;
Brain
;
Brain Diseases
;
Dysarthria
;
Female
;
Gait
;
Hashimoto Disease
;
Hematologic Tests
;
Humans
;
Magnetic Resonance Imaging
;
Middle Aged
;
Thyroiditis, Subacute
;
Thyrotoxicosis
5.Prolonged Corrected QT Interval in Patients with Myotonic Dystrophy Type 1.
Kang Min PARK ; Kyong Jin SHIN ; Sung Eun KIM ; Jinse PARK ; Sam Yeol HA ; Byoung Joon KIM
Journal of Clinical Neurology 2013;9(3):186-191
BACKGROUND AND PURPOSE: Sudden cardiac death is one of the leading causes of death in patients with myotonic dystrophy type 1 (DM1). It has been proposed that a prolonged QT interval is associated with sudden cardiac death in several neurological diseases, including multiple system atrophy, idiopathic Parkinson's disease, and diabetic autonomic neuropathy. However, analyses of the corrected QT (QTc) interval in DM1 patients are rare in the literature. The purposes of this study were to determine the association between the QT interval and DM1, and the affecting factors. METHODS: Thirty-nine patients diagnosed with DM1 through genetic testing were enrolled. The QTc interval (calculated using Bazett's formula: QTc=QT/radicalRR) was compared between these patients and 39 normal healthy controls. The clinical and laboratory factors affecting QTc interval in the patient group were investigated. RESULTS: The QTc interval was significantly longer in the DM1 group (411.2+/-44.7 msec, mean+/-SD) than in the normal control group (355.6+/-20.6 msec). Intragroup analysis revealed that a prolonged QTc interval in DM1 patients was associated with being female and older, having a longer disease duration, and exhibiting abnormal electrocardiography findings. CONCLUSIONS: The higher incidence of sudden cardiac death in the DM1 population is associated with the observed prolonged QTc interval in those patients.
Cause of Death
;
Death, Sudden, Cardiac
;
Diabetic Neuropathies
;
Electrocardiography
;
Female
;
Genetic Testing
;
Humans
;
Incidence
;
Multiple System Atrophy
;
Myotonic Dystrophy
;
Parkinson Disease
6.Unexpected Detachment of Solitaire Stents during Mechanical Thrombectomy.
Sung Tae KIM ; Sung Chul JIN ; Hae Woong JEONG ; Jung Hwa SEO ; Sam Yeol HA ; Hae Wook PYUN
Journal of Korean Neurosurgical Society 2014;56(6):463-468
OBJECTIVE: Unexpected Solitaire stent detachment can occur during mechanical Solitaire thrombectomy. The purpose of this study was to retrospectively evaluate the influencing factors causing unexpected Solitaire stent detachment and the clinical outcomes. METHODS: Between October 2011 to December 2013, 232 cases of mechanical Solitaire thrombectomy for acute ischemic stroke were performed in 3 stroke centers. During this period, we encountered unexpected Solitaire stent detachments during mechanical Solitaire thrombectomies in 9 cases. RESULTS: Solitaire stents unexpectedly detached in 9 cases (3.9%) during the retrieval of Solitaire stents. The median patient age was 76 years. The occlusion sites of the unexpected stent detachment were the proximal middle cerebral artery (MCA) in 7 cases and the internal carotid artery in 2 cases. The sizes of the stents that unexpectedly detached were 6x30 mm in 7 cases, 5x30 mm in 1 case, and 4x20 mm in 1 case. Four patients had unexpected detachment at the first retrieval, 1 patient at the second, 3 patients at the third, and 1 patient at the fifth. In all of the cases of unexpected detachment at the first retrieval, the stent deployment site was the proximal MCA. After detachment, a proximal marker of the Solitaire stent was observed in 3 patients. However, no marker was visible in the remaining 6 patients. CONCLUSION: Unexpected Solitaire stent detachment should be considered in the first instance of stent retrieval for a relatively large-diameter stent, especially in elderly patients with MCA occlusions.
Aged
;
Carotid Artery, Internal
;
Humans
;
Middle Cerebral Artery
;
Retrospective Studies
;
Stents*
;
Stroke
;
Thrombectomy*
7.A Case of Anaplastic Astrocytoma Presented with Symptoms of the Brain and Spinal Cord as a First Manifestation.
Sam Yeol HA ; Dong Sun SHIN ; Young Chul YOON ; Oh Sang KWON ; Tae Jin LEE
Journal of the Korean Neurological Association 2003;21(5):543-547
A 34-year-old woman complained of left facial palsy and numbness on the left thigh that began two weeks prior with headaches. Brain MRI revealed ill-defined patchy T2 weighted high signal intensities in the right medial temporal lobe and thalamus without contrast enhancement. Ten days later, when she complained of sensory symptoms below the 7th thoracic cord, we found an enhancing lesion in the lower cervical cord on the MRI. The result from the brain biopsy was consistent with anaplastic astrocytoma.
Adult
;
Astrocytoma*
;
Biopsy
;
Brain*
;
Facial Paralysis
;
Female
;
Headache
;
Humans
;
Hypesthesia
;
Magnetic Resonance Imaging
;
Spinal Cord*
;
Temporal Lobe
;
Thalamus
;
Thigh
8.A Case of Anaplastic Astrocytoma Presented with Symptoms of the Brain and Spinal Cord as a First Manifestation.
Sam Yeol HA ; Dong Sun SHIN ; Young Chul YOON ; Oh Sang KWON ; Tae Jin LEE
Journal of the Korean Neurological Association 2003;21(5):543-547
A 34-year-old woman complained of left facial palsy and numbness on the left thigh that began two weeks prior with headaches. Brain MRI revealed ill-defined patchy T2 weighted high signal intensities in the right medial temporal lobe and thalamus without contrast enhancement. Ten days later, when she complained of sensory symptoms below the 7th thoracic cord, we found an enhancing lesion in the lower cervical cord on the MRI. The result from the brain biopsy was consistent with anaplastic astrocytoma.
Adult
;
Astrocytoma*
;
Biopsy
;
Brain*
;
Facial Paralysis
;
Female
;
Headache
;
Humans
;
Hypesthesia
;
Magnetic Resonance Imaging
;
Spinal Cord*
;
Temporal Lobe
;
Thalamus
;
Thigh
9.A Case of Atypical Isolated Nodular Infarction: Nystagmus with a Reverse Direction.
Kang Min PARK ; Kyong Jin SHIN ; Sam Yeol HA ; Jin Se PARK ; Sung Eun KIM
Korean Journal of Stroke 2012;14(3):163-165
A cerebral infarction involving the nodulus usually produce contralateral lateropulsion and ipsilateral spontaneous nystagmus to the lesion. Here, we report a case of atypical isolated nodular infarction showed ipsilateral lateropulsion and contralateral spontaneous nystagmus to the lesion with a normal head impulse test. A right-handed 70-year-old man developed sudden vertigo with an unsteady gait. Neurologic examination revealed spontaneous left-beating nystagmus with a torsional component. He also displayed imbalance of walking and axial lateropulsion to the right side. Head impulse test was normal. Magnetic resonance imaging indicated acute infarction in the right nodulus on diffusion-weighted images.
Cerebral Infarction
;
Gait Disorders, Neurologic
;
Head
;
Infarction
;
Magnetic Resonance Imaging
;
Neurologic Examination
;
Vertigo
;
Vestibular Neuronitis
;
Walking
10.A Case of Metastatic T-cell Lymphoma Involving Both Temporal Lobe.
Hyung Geun OH ; Sam Yeol HA ; Young Chul YOON ; Oh Sang KWON ; Tae Jin LEE
Journal of the Korean Neurological Association 2001;19(4):417-422
In the metastatic CNS lymphoma, parenchymal involvement, especially in both temporal lobes, is rare. A 54-year-old man complained of memory impairment and personality changes that began two weeks prior. He had ulcerated skin lesions and multiple subcutaneous nodules. Brain MRI revealed a diffuse low in T1WI, high in T2WI, and contrast-enhancement in both temporal lobes. Treatment was done with acyclovir and dexamethasone, and symptoms were improved. One week later, symptoms were aggravated and a brain biopsy was performed. The result was a peripheral T-cell lymphoma. (J Korean Neurol Assoc 19(4):417~422, 2001)
Acyclovir
;
Biopsy
;
Brain
;
Dexamethasone
;
Humans
;
Lymphoma
;
Lymphoma, T-Cell*
;
Lymphoma, T-Cell, Peripheral
;
Magnetic Resonance Imaging
;
Memory
;
Middle Aged
;
Skin
;
T-Lymphocytes*
;
Temporal Lobe*
;
Ulcer