Blindness or serious visual impairment is a common and well known sequela of methanol intoxication in man, while other manifestations such as focal neurological deficits and abnormal brain CT scan are reported rarely. We experienced a case of acute methanol intoxication, which showed not only visual impairment but also bulbar symptoms and characteristic bilateral symmetrical hypodensity area in basal ganglia, especially putamen on brain CT scan. We tried 'pulse therapy'-continuouis dripping of methyl prednisolone (Solumedrol 1gm/day) for 5 days-with transient improvement of visual impairment, but bulbar symptoms were stationary. One month later, visual impairment was recurred, and the 'pulse therapy' was tried again but without benefit. On follow-up brain CT scan, the size of previous hypodensity area in basal ganglia was decreased.
Basal Ganglia ; Blindness ; Brain* ; Bulbar Palsy, Progressive* ; Follow-Up Studies ; Methanol* ; Prednisolone ; Putamen ; Tomography, X-Ray Computed* ; Vision Disorders

The Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder of neuromuscular transmission that is frequently associated with malignancy, particulary small cell carcinoma of the lung. To our knowledge, there was no report of LEMS in Korean listeratures and this might be the first case in this country. The patient is a 55 year old man with muscle weakness and fatigability of proximal lower limbs for 2 months. Bronchogenic carcinoma is confirmed radiologically and pathologically. The electrophysiological studies suppert the clinical diagnosis of LEMS with (1) low amplitude of evoked compound muscle potential to a single supramaximal stimulus on nerve, (2) significant decremental response at low rates of stimulation and (3) marked incremental response at high rates of stimulation.
Carcinoma, Bronchogenic ; Carcinoma, Small Cell ; Diagnosis ; Humans ; Lambert-Eaton Myasthenic Syndrome* ; Lower Extremity ; Lung ; Middle Aged ; Muscle Weakness

Paroxymal nocturnal hemoglobinuria is a kind of intravascular hemolytic anemia due to acquired corpscular defects, and is not rare in this country. The corpscular defect is originated from hematopoietic stem cells, and white blood cells and platelets are also involved. Consequently, the major complications which might affect mortality and morbidity include thrombotic phenomena, especially hepatic and cerebral venous thrombosis. This is a case report of cerebral venous thrombosis with hemiparesis, seizure and change of consciousness in paroxysmal nocturnal hemoglobinuria accompanied by intravascular hemolysis. The diagnosis is confirmed by CT brain scan and cerebral angiography and the patient is effectively treated with antiplatelets, anticonvulsants and steroids.
Anemia, Hemolytic ; Anticonvulsants ; Brain ; Cerebral Angiography ; Consciousness ; Diagnosis ; Hematopoietic Stem Cells ; Hemoglobinuria ; Hemoglobinuria, Paroxysmal* ; Hemolysis ; Humans ; Leukocytes ; Mortality ; Paresis ; Seizures ; Steroids ; Venous Thrombosis*

A typical case of gelinerazed cutalineous lichen amyloidosus is reported. A 62-year-old female had had brownish papular lesions on the lower legs, hands, and shoulders for about 8 years. Three years later, the papular lesions extended through the whole body surface. She complained of severe itching and tingling sensation. Physical findings were confined to the skin. The skin lesions were diffusely distributed. The size of the lesion was from pin-head to rice, The color was dark brownish. The papules were over generalized skin except for the face, palms, and sole.. Diagnosis was made by the characteristic clinical manifestations and histopathologic findings of the skin. However, the specimens of the liver and rectal biopsies did not show amyloid deposits. Based on these findings, authors concluded that this is a case of generalized cutaneous lichen amvloidosus and this is the second case in the literature in Korea. Even though the subjective symptom such as itching is getting decrease, the clinical course of this disease could not be aliernated by classical and conventional therapeutic regimens.
Biopsy ; Diagnosis ; Female ; Hand ; Humans ; Korea ; Leg ; Lichens* ; Liver ; Middle Aged ; Plaque, Amyloid ; Pruritus ; Sensation ; Shoulder ; Skin

To investigate the drug effect of topical Mitomycin C in various concentrations combined with steroid, we used 30 rabbits whose corneal epitheliums were abraded intentionally. They were divided into 5 groups. Using MMC in various concentrations and steroids, we instilled them into right eyes and saline into left eyes as control. We measured the healing rate at a interval of 12 hours. Three months later, we sacrificed one of them and examined the pathological changes from various ocular tissues. We found many complications such as corneal edema, ulcer, opacity and definite delay of wound healing when the concentration higher than 0.04%MMC was used. There were also decreased fibroblast cells in H-E staining. The steroids seemed not to pose any influence on the effect of MMC. In conclusion, we must take the great care in the use of MMC, and the concentration should be low when used. In addition, we still think there ought to be more studies as to the effect of steroids according to MMC levels.
Cornea* ; Corneal Edema ; Epithelium, Corneal ; Fibroblasts ; Intention ; Mitomycin* ; Ophthalmic Solutions* ; Rabbits ; Steroids ; Ulcer ; Wound Healing

To investigate the drug effect of topical Mitomycin C in various concentrations combined with steroid, we used 30 rabbits whose corneal epitheliums were abraded intentionally. They were divided into 5 groups. Using MMC in various concentrations and steroids, we instilled them into right eyes and saline into left eyes as control. We measured the healing rate at a interval of 12 hours. Three months later, we sacrificed one of them and examined the pathological changes from various ocular tissues. We found many complications such as corneal edema, ulcer, opacity and definite delay of wound healing when the concentration higher than 0.04%MMC was used. There were also decreased fibroblast cells in H-E staining. The steroids seemed not to pose any influence on the effect of MMC. In conclusion, we must take the great care in the use of MMC, and the concentration should be low when used. In addition, we still think there ought to be more studies as to the effect of steroids according to MMC levels.
Cornea* ; Corneal Edema ; Epithelium, Corneal ; Fibroblasts ; Intention ; Mitomycin* ; Ophthalmic Solutions* ; Rabbits ; Steroids ; Ulcer ; Wound Healing

Ischemia is a rare cause of the optic chiasmal syndrome and is sometimes hard to define. The present report describes a 73 year ~ old male with abruptly developed visual field defect involving bitemporal hemianopsia and inferior binasal quadrantanopsia. The MRI study revealed focal anterior hypothalarnic atrophy which might be due to focal infarction. These findings are suggesting common blood supply of superior chiasmal circulation and anterior inferior hypothalamus.
Atrophy ; Hemianopsia ; Humans ; Hypothalamus ; Infarction* ; Ischemia ; Magnetic Resonance Imaging ; Male ; Optic Chiasm* ; Visual Fields

Nevus lipomatosus cutaneus superficialis is a very rare skin disease which appears at birth or within the firat two decades of life. This uncommon condition is due to collections of ectopic fat cells within the upper and mid-dermis. There are two clinical forms. The first form is a lesion of zonal distribution, present from birth or childhood, usually on the buttocks or the lower back. The second form, a dome or sessile, papule, begins in adult life and is less restricted in distribution, and occurs also on the limbs Coalescence of soft, yellowish papules tends to form cerebriform plaques. The authors experienced two cases of typical nevus lipomatosus cutaneus superficialis. The first case was a 23-year male who had asymptomatic, soft, skin colored, and pea sized confluent nodules on the right lower back area since at birth. The second case was a 35-year female who had asymptomatic, multiple, soft, skin colored from rice to walnut sized confluent nodules on the coccygeal area which developed at the age of 27. Diagnosis was confirmed by clinical and histopathological findings.
Adipocytes ; Adult ; Buttocks ; Diagnosis ; Extremities ; Female ; Fluconazole ; Humans ; Juglans ; Male ; Nevus* ; Parturition ; Peas ; Skin ; Skin Diseases

Tuberculomas in the spine are estimated to be 15 to 50 times less common than those occurring in the cranium. We experienced a case of intramedullary spinal tuberculoma and brain tuberculoma associated with pulmonary tuberculosis. A 39-year-old male was referred to the National Medical Center via emergency room because of urinary difficulty and lower limb weakness for 3 days. He had been treated with anti-tuberculosis regimens against pulmonary tuberculosis for 20 days. Spinal MRI revealed intradural intramedullary tuberculoma at T5. On the 21st day at the hospital, a generalized seizure attacked him. Brain MRI revealed multiple tuberculoma in both hemispheres, brainstem and cerebellum. He was treated anti-tuberculosis regimens and corticosteroids for 9 months. His condition improved clinically and radiologically. We report this case with a review of the literature.
Adrenal Cortex Hormones ; Adult ; Brain Stem ; Brain* ; Cerebellum ; Emergency Service, Hospital ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Seizures ; Skull ; Spine ; Tuberculoma* ; Tuberculosis, Pulmonary*

No abstract available.
Accidents, Traffic* ; Emergencies* ; Emergency Service, Hospital* ; Injury Severity Score*