No abstract available.

Objectives: . The aim of this study was to investigate whether preserved vestibular function in the high-frequency range influences the prognosis of patients with bilateral vestibulopathy (BVP) after vestibular rehabilitation. Methods: . Twenty-four patients followed up with vestibular rehabilitation were recruited. The enrolled patients were divided into two groups according to the preservation of the high-frequency vestibulo-ocular reflex (VOR) based on the video head impulse test (vHIT). The results of computerized dynamic posturography and the Dizziness Handicap Inventory (DHI) survey collected at baseline and at the 6-month follow-up after vestibular rehabilitation therapy were analyzed. Results: . Both groups showed significantly increased composite and DHI scores after follow-up with vestibular rehabilitation. The group with preserved high-frequency VOR showed a better composite score (p=0.064) and vestibular score (p= 0.008) than the group with lost high-frequency VOR at the 6-month follow up. The DHI score significantly decreased only in the group with lost high-frequency VOR (p=0.047). Among the three vestibular function tests (caloric test, rotary chair test, and vHIT) used to diagnose BVP, only vHIT showed a significant correlation (p=0.015) with a favorable prognosis (composite score ≥70). Conclusion . Better treatment outcomes are likely in patients with BVP with preserved vestibular function in response to high-frequency stimulation, as measured by the vHIT.

Objectives: . The aim of this study was to investigate whether preserved vestibular function in the high-frequency range influences the prognosis of patients with bilateral vestibulopathy (BVP) after vestibular rehabilitation. Methods: . Twenty-four patients followed up with vestibular rehabilitation were recruited. The enrolled patients were divided into two groups according to the preservation of the high-frequency vestibulo-ocular reflex (VOR) based on the video head impulse test (vHIT). The results of computerized dynamic posturography and the Dizziness Handicap Inventory (DHI) survey collected at baseline and at the 6-month follow-up after vestibular rehabilitation therapy were analyzed. Results: . Both groups showed significantly increased composite and DHI scores after follow-up with vestibular rehabilitation. The group with preserved high-frequency VOR showed a better composite score (p=0.064) and vestibular score (p= 0.008) than the group with lost high-frequency VOR at the 6-month follow up. The DHI score significantly decreased only in the group with lost high-frequency VOR (p=0.047). Among the three vestibular function tests (caloric test, rotary chair test, and vHIT) used to diagnose BVP, only vHIT showed a significant correlation (p=0.015) with a favorable prognosis (composite score ≥70). Conclusion . Better treatment outcomes are likely in patients with BVP with preserved vestibular function in response to high-frequency stimulation, as measured by the vHIT.

Purpose: To evaluate the dynamic range of retinal nerve fiber layer (RNFL) and optic nerve head (ONH) parameters measured using optical coherence tomography (OCT) in conditions ranging from nonglaucomatous status to advanced glaucoma by longitudinal observation. Methods: A total of 15 eyes from 12 participants with glaucoma progression from a nonglaucomatous status to advanced glaucoma were included. The RNFL and ONH parameters were compared between the nonglaucomatous and advanced stages within the same eye. The absolute and relative changes in OCT parameters were analyzed. Results: The median highest intraocular pressure was 42.5 mmHg (interquartile range, 37.5 to 54.5 mmHg), and the final mean deviation of the visual field test was –24.68 dB (interquartile range, –23.93 to –31.13 dB). The median relative changes in RNFL thickness were –40.6% in the overall area, and –51.9%, –21.4%, –51.1%, and –41.8% in the superior, nasal, inferior, and temporal quadrants, respectively (all p < 0.05). Relative changes in the rim area, disc area, average cup to disc ratio, vertical cup to disc ratio, and cup volume were –56.64%, 0.59%, 62.10%, 66.0%, and 337.90%, respectively (all p < 0.05, except for disc area with a p-value of 0.753). Conclusions The dynamic range of the RNFL thickness ranged from 40.6% to 51.9%, and the dynamic range of the ONH parameters ranged from 56.64% to 337.90%. During the course of glaucoma progression, the cup volume showed the widest dynamic range. However, the disc area did not show significant changes.

In 1992, Brugada described clinical features of patients with aborted sudden cardiac death who showed no demonstrable heart disease and a peculiar ECG pattern consisting of right bundle branch block and ST-segment elevation in right precordial leads. Recently, We experienced two cases with aborted sudden cardiac death and similar ECG pattern. Physical examination, routine laboratory tests including serum electrolytes, echocardiography, myocardial thallium SPECT, MRI and MIBG scans were within normal limit. Arrhythmias were not induced in treadmill exercise test, and signal averaged ECGs revealed positive late potentials. Coronary angiography showed normal coronary artery with no evidence of induced vasospasm. Polymorphic ventricular tachycardia and ventricular fibrillation were induced by ventricular stimulation. Intravenous administration of flecainide, procainamide augmented ST segment elevation in one patient, and isoproterenol reduced ST segment elevation in the other patient. For prevention of sudden death, ICDs were implanted in the two patients. Ventricular fibrillations occurred in one patient 12 and 13 months after the implantation and were successfully terminated by ICD.
3-Iodobenzylguanidine ; Administration, Intravenous ; Arrhythmias, Cardiac ; Bundle-Branch Block* ; Coronary Angiography ; Coronary Vessels ; Death, Sudden ; Death, Sudden, Cardiac* ; Echocardiography ; Electrocardiography ; Electrolytes ; Exercise Test ; Flecainide ; Heart Diseases ; Humans ; Isoproterenol ; Magnetic Resonance Imaging ; Physical Examination ; Procainamide ; Tachycardia, Ventricular ; Thallium ; Tomography, Emission-Computed, Single-Photon ; Ventricular Fibrillation

A 60 year old male patient with a medical history of pulmonary tuberculosis presented with severe headaches and general weakness. Radiological studies revealed mass lesions both in the right using and the right cerebellar hemisphere. Clinically metastatic brain tumor and tuberculoma were highly suspected. The cerebella mass was totally excised and an unusual pathologic result was reported as botryomycosis. According to literatures reviewed, botryomycosis is a chronic bacterial infectious lesion resembling actinomycosis and mycotic abscess and it has been frequently reported in the skin, subcutaneous lesions and other visceral organs, but the cases of brain involvement were extremely rare. This article is a case report of a cerebellar botryomycosis. The pathologic characteristics and the differential diagnosis of botryomycosis are discussed.
Abscess ; Actinomycosis ; Brain ; Brain Neoplasms ; Diagnosis, Differential ; Headache ; Humans ; Male ; Middle Aged ; Skin ; Tuberculoma ; Tuberculosis, Pulmonary

OBJECTIVES: Few disciplines in medicine encompasses such wide diagnostic and treatment modalities as cardiology. A traditional text and education system is limited in its efficacy to convey such variety. In order to address this problem, a comprehensive computer-aided education system that compiles and links the current knowledge of cardiovascular diseases is proposed. An availability of such system through CD-ROM and world wide web will contribute undoubtedly to the promotion and betterment of current understandings of cardiology all over the world. METHODS AND RESULTS:1) The information about the cardiovascular diseases has been complied and organized. Multimedia medical information includes text, audio features that allow the users to study actual sounds, and visual aids (slides, real-time demonstration, and schematic illustrations).2) Cardiology education system can be approached according to "Disease module" or "Laboratory test module". One can readily look up the disease of interest and see the results of different tests. Or one can choose the laboratory test or physical examination and study the differences among the diseases. "Self test module" is also available to help user's self assessment of his/her understanding of cardiovascular diseases.3) This cardiology education program is conveniently stored in CD-ROM and can also be accessible through the world wide web (http://med.chungbuk.ac.kr/~mccho/ web-cardiology/alogo.html). CONCLUSION: A multimedia approach for the study of cardiovascular diseases has been developed and is now avaliable in CD-ROM. The same information can be obtained from our home page through the world wide web.
Audiovisual Aids ; Cardiology* ; Cardiovascular Diseases ; CD-ROM ; Education* ; Internet* ; Multimedia ; Physical Examination ; Self-Assessment

We treated 8 patients with large pituitary adenomas(4 females, 4 males) with bromocriptine. In all patients the level of prolactin was decreased to within the normal range and in most patients the size of tumor was decreased remarkably, high cure rate of large pituitary tumor fallowing operation after pretreated bromocriptine was obtained.
Bromocriptine* ; Female ; Humans ; Pituitary Neoplasms* ; Prolactin ; Reference Values

The provocation test of variant angina are known as ergonovine test, hyperventilation, acetylcholine, exercise and cold pressor test, but beta-blocker provocation test has not been reported as a case. So, this paper reports on the diagnosis of variant angina by beta-blocker provocation test and the case of subendocardial infarcion induced by this test. This study reports with literature and investigation about the following case : A 45-year-old man with a history of recurrent episode of typical angina on the early morning for the past 20 days. He was administrated beta-blocker given by oral route, and on the next morning there was chest pain as same degree as before, Holter EKG displayed ST segment elevation and ventricular tachycardia. It was confirmed focal spasm on coronary angiography, ST segment elevation on EKG, and newly developed hypokinesia on left ventriculogram and followed-up echocardiagraphy. When the chest pain is absent, EGK was normal. And we confirmed that elevation of cardiac enzyme was absent as a result of serial follow up study.
Acetylcholine ; Chest Pain ; Coronary Angiography ; Diagnosis ; Electrocardiography ; Ergonovine ; Follow-Up Studies ; Humans ; Hyperventilation ; Hypokinesia ; Infarction* ; Middle Aged ; Spasm ; Tachycardia, Ventricular

Cerebrovascular complications are of the most frequent intracranial complications of bacterial meningitis. Most of the previous reports suggest that the prognosis for the pafients with cerebrovascular complications was unfavorable. We recently experienced a case of meningococcal meningitis with fulminant meningococcemia associated with multifocal non-enhancing lesions on, initial brain MRI. These lesions were hyperintense on T2weighted image and were located in left basal ganglia, both medial thalami, periventricular white matter, left cerebellar hemisphere, and right midbrain and were considered to be resulted from small vessel involvement. Gram negative diplococci were detected by Gram staining of specimens from skin lesion. After antimicrobial therapy and glucocorticoid replacement the patient was recovered without any neurologic sequelae. After one month, follow-up MRI showed resolution of all the ischemic lesions except in midbrain. Additionally there was a small focal hemtoma formation in left basal ganglia. The small hematoma was considered to be resulted from rupture of microaneurysm and disappeared on follow up MRI performed after 3 months. This case suggests that the cerebrovascular complications in meningococcal mningitis might be treated successfully.
Basal Ganglia ; Brain ; Follow-Up Studies ; Hematoma* ; Humans ; Magnetic Resonance Imaging ; Meningitis* ; Meningitis, Bacterial ; Meningitis, Meningococcal ; Mesencephalon ; Prognosis ; Rupture ; Skin