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

BACKGROUND AND PURPOSE: Hypertension and alcohol consumption are well known independent risk factors of spontaneous intracerebral hemorrhage (ICH). However, it is uncertain whether controlling of them reduces the volume of ICH. Furthermore, it remains also unkown whether other factors such as age, sex, education level, smoking, diabetes mellitus, and previous history of stroke are related to the volume of ICH. This study was designed to evaluate the relations of those things with the volume of ICH. METHODS: We prospectively assessed above items in 103 consecutive patients with ICH aged 33 to 87 years (mean age : 64 years, 50 men and 53 women ). We divided the volume of ICH with the use of CT scan into small (<10cc, n=71) and large (>=l0cc, n=32) groups. RESULTS: The patients with previous history of stroke significantly have a smaller volume of ICH compared to those without (p=0.04). However, the other factors (age, sex, education level, antihypertensive medication, alcohol consumption, smoking, and diabetes mellitus) were not significantly correlated with the volume of ICH to multivariate analysis. The patients with previous history of stroke tended to receive more regular antihypertensive medication than these without (p-0.06). CONCLUSION: The patients with previous history of stroke have a smaller volume of ICH possibly due to adequate antihypertensive treatment. However, the other factors which we evaluated were not significantly correlated with the volume of ICH.
Alcohol Drinking ; Cerebral Hemorrhage* ; Diabetes Mellitus ; Education ; Female ; Humans ; Hypertension ; Male ; Multivariate Analysis ; Prospective Studies ; Risk Factors ; Smoke ; Smoking ; Stroke ; Tomography, X-Ray Computed

Isolated cranial neuropathies involving the facial nerve are very rare manifestations of pontine infarction, and have not been described in paramedian pontine infarction. We report a 67-year-old woman who developed sudden and long-lasting right facial nerve paralysis accompanied by transient ipsilateral abducens nerve palsy. Brain magnetic resonance imaging showed two discrete simultaneous infarctions in the right inferior paramedian pontine area, which seemed to correspond to the facial nerve fascicle and the abducens nerve fascicle, respectively. Paramedian pontine infarction can be one of the causes of facial nerve palsy and present as an isolated or predominant sign.
Abducens Nerve Diseases* ; Abducens Nerve* ; Aged ; Brain ; Cranial Nerve Diseases ; Facial Nerve ; Female ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Paralysis

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

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*

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

Ocular disturbances related to cranial nerve lesion or increased intracranial pressure are well known in cryptococcal meningitis, but internuclear ophthaloplegia is very rare and only two cases have been reported to our knowledge. We report the third patient of internuclear ophthalmoplegia in cryptococal meningitis. The internuclear ophthalmoplegia in our case persisted for one year with a demonstrable lesion in brain MRI, in contrast to the other cases in which intranuclear ophthalmoplegia was transient and no responsible lesion was observed.
Brain ; Cranial Nerves ; Cryptococcosis* ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Cryptococcal ; Ocular Motility Disorders ; Ophthalmoplegia