Although cerebrospinal fluid leakage is suggested as one of the causes of spontaneous intracranial hypotension, on]y a few cases with direct evidence of cerebrospinal fluid leakage on radionuclide cisternography have been reported in the literature Indirect evidences of cerebrospinal fluid leakage such as early visualization of the soft tissue and bladder or delayed migration of radiotracer have been observed in most patients with spontaneous intracranial hypotension. We report a case of spontaneous intracranial hypotension in which cerebrospinal fluid leakage was directly demonstrated by early dynamic imaging of spine on radionuclide cisternography. We suggest that early dynamic imaging of spine is an important adjunctive procedure in detecting cerebrospinal fluid leakage in patients with spontaneous intracranial hypotension.
Cerebrospinal Fluid* ; Humans ; Intracranial Hypotension* ; Spine ; Urinary Bladder

Although transesophageal echocardiography (TEE) is known to be useful in detecting a possible embolic source in patients with ischemic stroke, its usefulness in various stroke subtypes remains still uncertain. We reviewed the clinical findings and TEE records of 191 patients with various stroke subtypes. We classified them into four stroke subtypes- cardiac embolism, lacunar infarct, large artery disease and stroke of unclear etiology. TEE parameters such as left atrial thrombus, spontaneous echo contrast, atrial septal aneurysm, interatrial shunts, ventricular thrombus or aneurysm, myxomatous mitral valve or mitral valve prolapse and atheromatous plaque on ascending aorta or aortic arch were compared among different stroke subtypes. The yield of TEE was subtantial in all stroke subtypes. Left atrial thrombi and spontaneous echo contrast were frequent in patients with high-risk cardiac embolism-21.4% and 42.9%, respectively, whereas only one patient had spontaneous echo contrast in other subtypes. Interatrial shunt was common in all stroke subtypes and was found more frequently in stroke of unclear etiology (42. 9%) compared to other subtypes (27. 2%) (P=O.02, X2). Other parameters were detected in only a few patients. TEE seems to be a useful procedure in patients with high-risk cardiac embolism, and the clinical significance of interatrial shunt in patients with stroke of unclear etiology remains to be determined.
Aneurysm ; Aorta ; Aorta, Thoracic ; Arteries ; Echocardiography* ; Echocardiography, Transesophageal ; Embolism ; Humans ; Mitral Valve ; Mitral Valve Prolapse ; Stroke* ; Stroke, Lacunar ; Thrombosis

We present one case report of anterior urethral diverticulum in a male with giant calculi. The patient was a 56-year-old male with the complaints of base-ball sized palpable scrotal mass and post-void dribbling for 15-16 years. The diverticulum was filled with multiple whitish-yellow stones. The largest one was 8X7X6cm in size.
Calculi* ; Diverticulum* ; Humans ; Male* ; Middle Aged

PURPOSE: To evaluate the efficacy and safety of silodosin 8 mg once daily in a 12-week treatment of subjects with severe lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A total of 100 subjects from 10 urology centers in Korea were included in this study. The inclusion criteria were as follows: age > or =50 years, International Prostate Symptom Score (IPSS) > or =20, quality of life (QoL) score > or =3, urine volume > or =120 mL and maximal urinary flow rate (Qmax) <15 mL/s, and postvoid residual volume (PVR) <100 mL. We assessed the improvement of LUTS with change in IPSS, QoL score, Qmax, PVR, and adverse events at baseline and 4 and 12 weeks after treatment with silodosin 8 mg once daily. RESULTS: The IPSS values were 23.27+/-3.34, 15.89+/-6.26, and 13.80+/-6.31 at baseline, 4, and 12 weeks, respectively, with significant improvements (p<0.0001, p=0.0214, respectively). QoL scores were 4.44+/-0.85, 3.38+/-1.20, and 3.04+/-1.20 at baseline, 4, and 12 weeks, respectively, and the differences were statistically significant (p<0.0001). There was a significant difference in Qmax between baseline and 12 weeks (p<0.0001) but not in PVR (p=0.9404) during the clinical trial. The most frequent adverse event in this study was ejaculation failure with 13 cases. However, no subject dropped out because of ejaculation failure, and in 12 of the 13 cases it was fully resolved without further treatment. CONCLUSIONS: Silodosin 8 mg once daily may be effective and safe in Korean patients with severe LUTS associated with BPH.
Ejaculation ; Humans ; Korea ; Lower Urinary Tract Symptoms* ; Male ; Prospective Studies* ; Prostate ; Prostatic Hyperplasia* ; Quality of Life ; Residual Volume ; Urology

Plasma cell Granuloma (PCG) is a form of idiopathic inflammatory pseudotumor (IPT). It is a rare entity character-ized by a nonneoplastic proliferation of inflammatory cells dominated by a polyclonal expansion of the plasma cells. This lesion has been discovered in many parts of the body including the central nervous system. We now report two cases of plasma cell granuloma involving the brain. The first case was a 42-year-old man who presented a right hemi-paresis. He had a lesion in the convexity of the left parietal region. The second case was a 58-year-old woman who was expressed confusion and a frontal-temporal headache. She had a lesion in the convexity of the left temporal region and mastoid bone. The diagnosis of PCG was confirmed by pathological and immunohistochemical studies revealing pre-dominant plasma cells in the affected tissues.
Adult ; Brain ; Central Nervous System ; Diagnosis ; Female ; Granuloma, Plasma Cell* ; Headache ; Humans ; Mastoid ; Middle Aged ; Plasma Cells* ; Plasma* ; Rabeprazole

Intracranial hemorrhage is a rare complication of amphethamine abuse, and cerebral vasculitis as a cause of the hemorrhage has been demonstrated by arteriography or autopsy findings. We report a 22-year-old female, an occasional methamphetamine abuser over 1 to 2 months, who presented with the sudden onset of bifrontal headache, nausea and vomiting immediately after an intravenous injection of methamphetamine. Imaging studies demonstrated intracerebral hemorrhage and subdural hemorrhage associated with cerebral vasculitis. To our knowledge, this entity has not been previously reported in Korea.
Angiography ; Autopsy ; Cerebral Hemorrhage ; Female ; Headache ; Hematoma, Subdural ; Hemorrhage ; Humans ; Injections, Intravenous ; Intracranial Hemorrhages* ; Korea ; Methamphetamine* ; Nausea ; Vasculitis, Central Nervous System* ; Vomiting ; Young Adult

Intracranial hemorrhage is a rare complication of amphethamine abuse, and cerebral vasculitis as a cause of the hemorrhage has been demonstrated by arteriography or autopsy findings. We report a 22-year-old female, an occasional methamphetamine abuser over 1 to 2 months, who presented with the sudden onset of bifrontal headache, nausea and vomiting immediately after an intravenous injection of methamphetamine. Imaging studies demonstrated intracerebral hemorrhage and subdural hemorrhage associated with cerebral vasculitis. To our knowledge, this entity has not been previously reported in Korea.
Angiography ; Autopsy ; Cerebral Hemorrhage ; Female ; Headache ; Hematoma, Subdural ; Hemorrhage ; Humans ; Injections, Intravenous ; Intracranial Hemorrhages* ; Korea ; Methamphetamine* ; Nausea ; Vasculitis, Central Nervous System* ; Vomiting ; Young Adult

The major causes of small bowel obstruction are postoperative adhesion, hernia, intussusception and malignancies. However, in cases of uncommon causes of small bowel obstruction, surgeons are in a dilemma because the preoperative diagnosis and making a decision to operate are frequently difficult and delayed. Phytobezoars are unusual cause of small bowel obstruction. They are mostly due to ingestion of stringent immature fruits following gastric surgery. They are usually formed in stomach and do not migrate to the other intestinal tract, but can lead to the serious complication of acute small bowel obstruction. We are reporting a case of acute small bowel obstruction due to phytobezoar about 2x2x3 cm3 size in a 90 year old female.
Aged* ; Aged, 80 and over ; Bezoars ; Diagnosis ; Eating ; Female ; Fruit ; Hernia ; Humans ; Intestinal Obstruction* ; Intussusception ; Stomach

Malignant biliary or pancreatic duct stricture is dilatated using dilatating catheter or balloon catheter but a high grade stricture is difficult to dilate by general dilatating methods. Using Soehendra stent retriever is an effective method for exchanging an impacted stent. Recently, high grade malignant biliary strictures have been dilatated by Soehendra stent retriever. We report 3 cases of successful biliary drainage in high grade malignant biliary strictures using 7 Fr Soehendra stent retriever.
Catheters ; Constriction, Pathologic* ; Drainage* ; Pancreatic Ducts ; Stents*

This is a case of a boy with autosomal dominant cerebellar ataxia (SCA type 2), which was confirmed by DNA analysis. A 9-year-old boy had been suffering from tremor in both arm and leg for 5 years. After traffic accident, a year ago, the symtoms were more aggravated, and he visted our hospital. The boy showed slow saccades, decreased DTR, ataxic gait and limb ataxia. We analyzed DNA repetition, which revealed positive for the SCA2 expanded repeat.
Accidents, Traffic ; Arm ; Ataxia ; Cerebellar Ataxia ; Child ; DNA ; Gait ; Humans ; Leg ; Male ; Saccades ; Spinocerebellar Ataxias* ; Tremor ; Trinucleotide Repeats