Anterograde amnesia in Behcet's disease is a rare occurrence. A 50-year-old man presented with anterograde amnesia. He had been suffering multiple oral aphthous ulcers and genital ulcers with erythema nodosum. A neurological examination revealed prominent anterograde memory disturbance. Brain MRI revealed high signal intensity lesions involving the anterior thalamus, posterior part of the basal ganglia and the mesial temporal lobe. We report a rare case of Behcet's disease manifesting severe anterograde amnesia resulting from thalamic and mesial temporal lesions.
Amnesia, Anterograde* ; Basal Ganglia ; Brain ; Erythema Nodosum ; Humans ; Magnetic Resonance Imaging ; Memory ; Middle Aged ; Neurologic Examination ; Stomatitis, Aphthous ; Temporal Lobe ; Thalamus ; Ulcer

diopathic facial nerve paralysis after surgery is not common but has clinical significance. We report a case of facial nerve paralysis in the immediate postanesthetic period after cervical spine surgery. A 41-year-old man with cervical herniated disc was scheduled for cervical laminectomy. After uneventful surgery, he suffered from left facial numbness and weakness. Imaging study and audiogram couldn't reveal any anatomic abnormality except Thornwaldt cyst. Conservative treatment with steroids and antivirals resolved his symptoms until 16th day after surgery.
Adult ; Anesthesia, General ; Antiviral Agents ; Facial Nerve ; Facial Paralysis ; Humans ; Hypesthesia ; Intervertebral Disc Displacement ; Laminectomy ; Paralysis ; Spine ; Steroids

PURPOSE: In order to prevent tuberculosis transmission early, it is important to diagnose and treat tuberculosis infection by investigating people who have contact with patients with active tuberculosis. METHODS: From July 2014 to June 2017, the intrafamilial childhood contacts of the patients who were diagnosed with active tuberculosis at Chungnam National University Hospital were investigated for the presence of tuberculosis infection. We also retrospectively analyzed the treatment status of children treated with latent tuberculosis infection (LTBI) during the same period. RESULTS: Among the 269 children who had intrafamilial contact with active tuberculosis patient, 20 (7.4%) did not receive any screening. At the first screening, one (0.4%) was diagnosed with pulmonary tuberculosis, seven (2.8%) had a previous history of tuberculosis infection, and 42 patients (16.9%) were diagnosed with LTBI. At the second screening, 29 patients (11.6%) were diagnosed with LTBI, and 61 patients did not finish the investigation. Only 188 (69.9%) out of 269 patients completed the investigation. Ninety patients received treatment for LTBI and 83 patients (92.2%) completed the treatment, of which 18 patients had side effects such as rash, fatigue, and gastrointestinal symptoms. However, there were no serious side effects requiring treatment discontinuation. CONCLUSIONS: The completion rate of childhood tuberculosis contact investigation was low, but the completion rate of LTBI treatment was high in children without serious side effects. In order to prevent and manage the spread of tuberculosis, active private-public partnership efforts and education of the patient and guardian are needed.
Child ; Chungcheongnam-do ; Disease Transmission, Infectious ; Education ; Exanthema ; Fatigue ; Humans ; Latent Tuberculosis ; Mass Screening ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: Chronic constipation is not uncommon even in children. Recently biofeedback treatment (BT) is considered as a useful modality in the treatment of various types of constipation. The aim of this study was to evaulate the effectiveness of BT in children with chronic constipation. METHODS: We reviewed 24 cases of childhood constipation (17 boys, 7 girls) who visited the Jinju Hakmoon colorectal surgery clinic and GNUH1 between April, 2001 and September, 2002. Balloon-mediated anorectal manometry system was used for BT. The effects of therapy was assessed by bowel movement, defecation time, fecal soiling and balloon evacuation test in the early course of therapy. The long term follow up survey was done by telephone interview at January 2003 and the effects of therapy was assessed by bowel movement, defecation time, fecal soiling and parents' satisfaction. RESULTS: Patients received the BT for the three times on average, and as the result of the therapy, 20 patients experienced disappearance of symptoms (87%) or at least improvement of symptoms. In terms of manometric values, the mean resting pressure was 113.4 mmHg before the BT, but decreased to 86.3 mmHg after the BT (P=0.0012). Mean pushing pressure dropped to 85.98 mmHg from 130.45 mmHg (P=<0.0001). Mean sensitivity decreased from 55 ml to 35 ml (P=0.0053). Mean compliance decreased from 20.28 H2O/cm to 4.21 H2O/cm (P=0.0015). 13 patients (76%) showed disappearance or improvement of symptoms in the long term follow up. CONCLUSIONS: The Balloon mediated biofeedback therapy is effective in children with chronic constipation. It is safe, easy to administer and also improve symptoms and objective parameters of anorectal function. Balloon mediated biofeedback therapy could be the first-line therapy in child patient with chronic constipation who failed conservative management.
Biofeedback, Psychology* ; Child* ; Colorectal Surgery ; Compliance ; Constipation* ; Defecation ; Follow-Up Studies ; Gyeongsangnam-do ; Humans ; Interviews as Topic ; Manometry ; Soil

BACKGROUND: Platelets play a key role in many occlusive vascular disorders and anti-platelet agents are the most important therapeutic strategy in preventing the recurrence of cerebral infarction. In order to know the platelet aggregability according to the strategy of anti-platelet agents, we measured platelet aggregability in patients who were taking anti-platelet agents for cerebral infarction. METHODS: Platelet aggregability in response to adenosine diphosphate (ADP) or collagen was measured in whole blood samples from 175 patients (48 females and 137 males). It was analyzed according to the type of cerebral infarction, vascular risk factors, and each anti-platelet agent. RESULTS: Platelet aggregability induced by ADP or collagen was significantly increased in patients with large artery atherosclerotic infarction compared to those with small vessel disease. Among anti-platelet regimens, combined therapy with aspirin and clopidogrel decreased platelet aggregability most effectively. CONCLUSIONS: These findings suggest that anti-platelet treatment should be tailored to the vascular status of each patient, and that combination therapy with aspirin and clopidogrel can effectively modulate platelet aggregability in preventing the recurrence of cerebral infarction.
Adenosine Diphosphate ; Arteries ; Aspirin ; Atherosclerosis ; Blood Platelets* ; Cerebral Arterial Diseases ; Cerebral Infarction* ; Collagen ; Female ; Humans ; Infarction ; Recurrence ; Risk Factors

BACKGROUND: Although massive use of live attenuated mumps virus vaccines successfully reduced the incidence of mumps virus infection worldwide, mumps outbreaks have not been completely eliminated, even in vaccinated populations. In recent years, the incidence of mumps has been remarkably increased in Korea. This study was designed to evaluate the recent seroprevalence rate of mumps IgG among children in Kyonggi province at 1996 and 1999. METHODS: Study population included students from 8 elementary schools in Kyonggi province. Serum samples were collected twice at 1996 and 1999 and tested for mumps-specific antibody by enzyme-linked immunosorbent assay (ELISA). We also conducted a questionnaire survey on the parents and collected the records including history of vaccination and mumps infection. RESULTS: The seropositive rates against mumps were 89.47% and 89.74% at 1996 and 1999, respectively, and they were not significantly different when compared to age, sex, and region. Although the first vaccination rates were 92.17% and 92.25% at 1996 and 1999, respectively, the second vaccination rates were only 37.89% and 38.03% at 1996 and 1999, respectively. Infection rate showed no significant difference between vaccinated groups and nonvaccinated groups. Seropositive rate of infected group was higher than that of noninfected group but it was not significantly different between the vaccinated and the nonvaccinated. CONCLUSIONS: This study showed the seropositive rate and vaccination against mumps in children. There were no significant relationships between vaccination and infection. Therefore, it seems likely that the vaccination is not fully protective against mumps infection. This study will be helpful for the establishment of guideline for prevention and treatment of mumps in Korea.
Child* ; Disease Outbreaks ; Enzyme-Linked Immunosorbent Assay ; Gyeonggi-do* ; Humans ; Immunoglobulin G* ; Incidence ; Korea ; Mumps virus ; Mumps* ; Parents ; Seroepidemiologic Studies ; Vaccination ; Vaccines ; Surveys and Questionnaires

BACKGROUND: The clinical and pathological heterogeneity of progressive supranuclear palsy (PSP) is well established. Even with a well-defined clinical phenotype and a thorough laboratory workup, PSP can be misdiagnosed, especially in its early stages. CASE REPORT: A 52-year-old woman, who we initially diagnosed with a behavioral variant of frontotemporal dementia developed parkinsonian features, which then progressed to gait instability and gaze abnormality. CONCLUSIONS: We report herein a pathologically confirmed case of PSP presenting with behavioral changes including agitation and irritability, which eventually led to the cardinal symptoms of progressive supranuclear palsy.
Dihydroergotamine ; Female ; Frontotemporal Dementia ; Gait ; Humans ; Middle Aged ; Parkinsonian Disorders ; Phenotype ; Population Characteristics ; Supranuclear Palsy, Progressive

Purpose: We aimed to assess the real-world efficacy of nab-paclitaxel in metastatic breast cancer patients. Materials and Methods: This is a retrospective study performed in two tertiary referral hospitals in Korea. Patients with metastatic breast cancer treated with nab-paclitaxel (Abraxane®) between March 2016 and March 2020 were enrolled. Results: A total of 102 patients with metastatic breast cancer were included. Patients were heavily pre-treated with a median of four prior lines of chemotherapy (5 lines when including endocrine therapy in hormone-receptor-positive patients), and 66 patients (64.7%) were exposed to taxanes in the metastatic setting. According to St. Gallen molecular subtypes, 36 patients (35.3%) were luminal A, 28 (27.5%) were luminal B, 18 (17.7%) were human epidermal growth factor receptor 2–positive and 20 (19.6%) had triple-negative disease. Fifty patients (49.0%) were treated with a 3-weekly regimen (260 mg/m2 on day 1 every 3 weeks), and 52 (51.0%) were treated with a weekly regimen (100 mg/m2 every week). Objective response rate was 22.9%. After a median follow-up of 22.0 months, median progression-free survival (PFS) was 4.0 months (95% confidence interval [CI], 2.6 to 4.8) and median overall survival was 8.7 months (95% CI, 7.5 to 11.2). Patients treated with weekly regimen had longer PFS compared to 3-weekly regimen (5.5 vs. 2.3 months, p < 0.001). Multivariate analysis revealed the treatment regimen as an independent prognostic factor for PFS. There was no grade 3 or 4 hypersensitivity reaction. Conclusion This real-world data shows that nab-paclitaxel is a reasonable treatment option in heavily pre-treated and/or taxane-exposed metastatic breast cancer patients.

Purpose: Endocrine therapy is a standard treatment for hormone receptor-positive breast cancer, which accounts for 60%–75% of all breast cancer. Hormone receptor positivity is a prognostic and predictive biomarker in breast cancer. Approximately 50%–80% of breast cancer is also positive for androgen receptor (AR), but the prognostic and predictive value of AR expression in breast cancer is controversial. Here, we investigated AR expression and its prognostic value in patients with surgically resected breast cancer in Korea. Methods: We retrospectively reviewed the medical records of patients who had surgically resected breast cancer to collect AR expression data and other clinicopathological data. The optimal cut-off for AR positivity was determined using a receiver operating characteristic curve analysis. Results: We reviewed 957 patients with surgically resected breast cancer from June 2012 to April 2013. The median follow-up was 62 months, and relapse events occurred in 101 (10.6%) patients. Unlike the cut-off value of 1% or 10% in previous reports, 35% was determined to be best for predicting relapse-free survival (RFS) in this study. At the cut-off value of 35%, 654 (68.4%) patients were AR-positive. AR expression was more prevalent in luminal A (87.6%) and luminal B (73.1%) types than in human epidermal growth factor receptor 2-positive (56.2%) or triple-negative (20.6%) types. AR expression of ≥ 35% was significantly related to longer RFS in a multivariate analysis (hazard ratio, 0.430; 95% confidence interval, 0.260–0.709; p = 0.001). Conclusion We propose a cut-off value of 35% to best predict RFS in patients with surgically resected breast cancer. AR expression was positive in 68.4% of patients, and AR positivity was found to be an independent prognostic factor for longer RFS.