Vestibular neuronitis is characterized by sudden onset of vertigo, horizonto-rotatory spontaneous nystagmus, loss of caloric response on the affected side with normal otoscopic findings, normal hearing and no other neurological deficit. The pathogenesis of the disease is still unproven, though the viral origin is strongly considered. Herpes simplex virus-type 1, Mumps virus, Rubella virus, Cytomegalovirus, Ebstein-Barr virus may have a role in the disease. Mumps virus is among the other rare causes, so we introduce a case of 13-year old girl who developed sudden vertigo with spontaneous nystagmus, nausea, and vomiting preceded by mumps in her left parotid one week ago. She was diagnosed as a vestibular neuronitis clinically, and serum IgM Ab of mumps virus was detected positive. This case supports the possible role of mumps virus in the etiology of vestibular neuronitis.
Cytomegalovirus ; Hearing ; Herpes Simplex ; Humans ; Immunoglobulin M ; Methylmethacrylates ; Mumps ; Mumps virus ; Nausea ; Parotitis ; Polystyrenes ; Rubella virus ; Vertigo ; Vestibular Neuronitis ; Viruses ; Vomiting

Otosclerosis is a primary metabolic bone disease of the otic capsule and ossicles. It is one of the causes of acquired hearing loss, with clinical manifestations occurring in approximately 1% of individuals in some populations in the Western countries. Although the cause of otosclerosis is undetermined, the disease has a well established hereditary predisposition, with approximately half of all affected individuals having family members known to be affected. Many genetic studies of otosclerosis support an autosomal dominant mode of inheritance with penetrance in the range of 20-40%. There have been a few reports of the clinically suspicious otosclerosis cases in Korea, but otosclerosis having familial forms have not been reported. We report one case of familial otosclerosis.
Bone Diseases, Metabolic ; Hearing Loss ; Humans ; Korea ; Otosclerosis* ; Penetrance ; Wills

Pheochromocytoma is derived from the chromaffin tissue. The typical finding of pheochromocytoma is paroxysmal hypertension accompanied with various signs and symptoms that are due to the excess of catecholamines or other bioactive substances. Yet the diagnosis is sometimes difficult to make because its clinical presentation is quite variable. Especially, hemoptysis is a very rare symptom, so the diagnosis is often missed or delayed. Without making the correct diagnosis and then subsequently administering treatment, the condition may be fatal. We herein report on a 68 year-old woman who was admitted because of abdominal pain and hemoptysis. The initial radiologic findings suggested pulmonary edema with alveolar hemorrhage. The urine catecholamine levels were elevated and she developed catecholamine-induced cardiomyopathy. We performed bronchial arterial embolization and we administered alpha blocker medication for controlling the hemoptysis and hypertension. After the temporary symptomatic improvement, her clinical course was aggravated by pneumonia and pulmonary edema. In spite of performing definitive surgery for pheochromocytoma, she died of postoperative hemodynamic instability.
Abdominal Pain ; Cardiomyopathies ; Catecholamines ; Female ; Hemodynamics ; Hemoptysis ; Hemorrhage ; Humans ; Hypertension ; Pheochromocytoma ; Pneumonia ; Pulmonary Edema

OBJECTIVE: Huntington's disease (HD) is a genetic neurodegenerative disease that is caused by abnormal CAG expansion. Altered microRNA (miRNA) expression also causes abnormal gene regulation in this neurodegenerative disease. The delivery of abnormally downregulated miRNAs might restore normal gene regulation and have a therapeutic effect. METHODS: We developed an exosome-based delivery method to treat this neurodegenerative disease. miR-124, one of the key miRNAs that is repressed in HD, was stably overexpressed in a stable cell line. Exosomes were then harvested from these cells using an optimized protocol. The exosomes (Exo-124) exhibited a high level of miR-124 expression and were taken up by recipient cells. RESULTS: When Exo-124 was injected into the striatum of R6/2 transgenic HD mice, expression of the target gene, RE1-Silencing Transcription Factor, was reduced. However, Exo-124 treatment did not produce significant behavioral improvement. CONCLUSION: This study serves as a proof of concept for exosome-based delivery of miRNA in neurodegenerative diseases.
Animals ; Cell Line ; Exosomes ; Huntington Disease* ; Methods ; Mice ; MicroRNAs ; Neurodegenerative Diseases ; Transcription Factors

Actinomycosis is a rare form of disease that is caused by Actinomyces such as A. israelii and A. bovis, which may take the form of chronic, purulent inflammation of deep tissue evolves with necrosis, formation of sinuses and fibrotic mass. This disease arises in the head and neck area mainly in 55% and other places like that chest and the gastrointestinal tract occurs in 45%. Actinomycosis can present in a variety of forms and may mimic other infections or even neoplasms. Our case was 44-year-old man having painful indurated mass in his left TMJ area, otorrhea in his left ear and trismus. He was treated with surgical excision and biopsy confirmed actinomycosis. And after that, he was cured successfully with antibiotic therapy. We report this case of actinomycosis that developed in the left TMJ area with review articles.
Actinomyces ; Actinomycosis* ; Adult ; Biopsy ; Ear ; Gastrointestinal Tract ; Head ; Humans ; Inflammation ; Neck ; Necrosis ; Temporomandibular Joint* ; Thorax ; Trismus

Ankylosing spondylitis (AS) is a systemic inflammatory disorder that affects the axial skeleton. It often involves the extra-articular organs. Cardiovascular involvement is one of the extra-articular manifestations, which is mostly represented by aortic root, valvular heart disease, and conduction disturbances. An aortic sclerosing inflammatory process induces aortic root thickening and rigidity. An aortic aneurysmal change is a rare complication that often leads to life threatening conditions. A few cases regarding aortic aneurysm have been reported, but there are no reported cases in Korea. We report the first case of descending thoracic and abdominal aortic aneurysm in a patient with ankylosing spondylitis.
Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Heart Valve Diseases ; Humans ; Korea ; Skeleton ; Spondylitis, Ankylosing*

BACKGROUND AND OBJECTIVES: A possible link between Meniere's disease (MD) and headache was originally suggested by Prosper Meniere. We aimed to analyze the clinical manifestation of headache in definite MD compared with benign paroxysmal positional vertigo (BPPV) as a control group. MATERIALS AND METHODS:We examined headache in 67 patients with definite MD according to the criteria of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). Sex- and age-matched 67 patients with BPPV served as a control group. Information was obtained concerning the prevalence, localization, severity, character, sequence of headache and response to therapy. RESULTS: Altogether 60 MD patients (90%) and 47 BPPV patients (70%) was reply the questionnaire. 46 MD patients (69%) and 15 BPPV patients (22%) reported headache. Headache was moderate to severe in 39 MD patients (85%) and as a whole more severe than that of the BPPV patients (P<0.05). Temporal area was the most frequently involved region in MD group, whereas posterior neck area was most frequent in BPPV group. The sequence of headache and vertigo attack was pre-(23%), intra-(33%), after-(44%). The 39 patients (89%) of headache in MD was response to the vestibular suppressants, diuretics, calcium channel blocker. CONCLUSION: It is concluded that high incidence of headache and migraine in combination with MD seems to common pathophysiology with migraine. Therefore, our results could provide predictive value in the treatment and follow up of MD patients with headache.
Calcium Channels ; Diuretics ; Follow-Up Studies ; Headache* ; Humans ; Incidence ; Meniere Disease* ; Migraine Disorders ; Neck ; Prevalence ; Surveys and Questionnaires ; Vertigo

Miliary brain metastasis from the lung is uncommon and has a poor therapeutic response. We report a case of pulmonary adenocarcinoma combined with multiple brain cystic lesions that were initially misdiagnosed as neurocysticercosis. A 53-year-old male who never smoked was admitted to our hospital with complaints of agitation and cognitive impairment. Brain magnetic resonance imaging showed innumerable, small nodular lesions with a central, low signal intensity in whole brain parenchyma. His symptoms were not improved by the empirical praziquantel medication for disseminated neurocysticercosis. After a transbronchial biopsy from the right middle lobe, we could diagnose the primary lung adenocarcinoma with a single nucleotide polymorphism in the epidermal growth factor receptor exon 20 at codon 787 (Q787Q). His neurologic symptoms and imaging findings have been gradually improving with a first-line Gefitinib treatment for five months. We recommend a more active diagnostic approach including biopsy in case of atypical imaging findings.
Adenocarcinoma ; Biopsy ; Brain ; Codon ; Dihydroergotamine ; Exons ; Humans ; Lung ; Lung Neoplasms ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Metastasis ; Neurocysticercosis ; Neurologic Manifestations ; Polymorphism, Single Nucleotide ; Praziquantel ; Quinazolines ; Receptor, Epidermal Growth Factor ; Smoke

BACKGROUND AND OBJECTIVES: Canalith repositioning procedure (CRP) provides rapid and long-lasting relief of symptoms in most patients with benign paroxysmal positional vertigo (BPPV). However, some patients express nonspecific symptoms such as anxiety or discomfort after CRP, even after the disappearance of nystagmus and vertigo. The purpose of this study is to assess the residual symptoms after CRP in patients with BPPV using questionnaire. SUBJECTS AND METHOD: CRP was performed in 135 patients until nystagmus and vertigo disappeared, and the patients were asked to complete the Dizziness Handicap Inventory (DHI) before and five to seven days after treatment. For the control group, 135 normal volunteers were selected, and cross matched according to the age and sex with the patient group. The DHI were compared among pre CRP, post CRP and control group. RESULTS: There were statistically significant differences between the pre-CRP and post-CRP DHI scores and also between the post-CRP and control group. Comparison between the pre and post-CRP DHI scores, and post-CRP and control group both showed incomplete improvement with respect to some items. CONCLUSION: Even after the successful CRP, DHI scores indicated incomplete recovery and residual subjective symptoms was presented. Thus, additional follow up and management may be needed.
Anxiety ; Dizziness ; Humans ; Surveys and Questionnaires ; Vertigo

BACKGROUND: Lung cancer has been the leading cause of cancer death in South Korea since 2000. This study examined the clinical characteristics of lung cancer patients diagnosed in a community hospital from the year 2000 to 2005, and compared these results with previously reported statistical data. METHOD: The lung cancer data in a form of an electronic medical record was downloaded from the hospital medical information system. The clinical characteristics of the 1,509 patients with lung cancer were analyzed retrospectively. RESULT: The mean age of the patients was 63.7 years. 82.5% and 74.5% of the patients were men and smokers, respectively. Squamous cell carcinoma (41.6%) was the most common pathology type followed by adenocarcinoma(32.3%) and small cell carcinoma(13.9%). When 604 patients who were diagnosed from 2000 to 2003 were compared with 905 patients diagnosed from 2004 to 2005, the age of patients increased significantly (61.5 years vs. 65.1 years; p<0.001) and the proportion of adenocarcinomas was significantly higher(29.3% vs. 34.4%; p=0.046). CONCLUSION: Among the major histology types of lung cancer, the incidence of adenocarcinoma has been increasing recently. The age of the lung cancer patients at diagnosis is getting older. This is despite the fact that the distributions of the initial anatomic stages have not changed significantly.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Diagnosis ; Electronic Health Records ; Hospitals, Community ; Humans ; Incidence ; Information Systems ; Jeollanam-do* ; Korea ; Lung Neoplasms* ; Lung* ; Male ; Pathology ; Retrospective Studies