Intravascular lymphomatosis (IL) is a variant of non-Hodgkin's lymphoma with an predilection for the CNS. Most cases are not diagnosed until postmortem. IL is characterized by neoplastic proliferation of lymphoid cells within the lumen of small veins and arteries with minimal involvement of the parenchyma. We experienced a 62-year-old woman who presented with seizure and fever associated with anemia, elevated LDH and beta 2-microglobulin without systemic involvement. This report illustrates the diagnostic challenge of this rare disorder with a grave prognosis. (J Korean Neurol Assoc 19(4):413~416, 2001)
Anemia ; Arteries ; beta 2-Microglobulin ; Central Nervous System* ; Female ; Fever ; Humans ; L-Lactate Dehydrogenase ; Lymphocytes ; Lymphoma, Non-Hodgkin ; Middle Aged ; Prognosis ; Seizures ; Veins

BACKGROUND: It is well known that a lacunar infarction has characteristic clinical features and a relatively good prognosis. However, the significance of lesions in the parent artery of patients with lacunar syndrome as regard to the prognosis remains unsettled. METHODS: Using the data of consecutive patients with their first ischemic stroke and were followed longer than 1 year, were divided the patients by their clinical features and the results of the work-up was as follows; (1) mismatching [MM] group; lacunar syndrome and the presence of parent arterial lesion, (2) large artery artherosclerosis [LAD]; non-lacunar syndrome and the presence of parent arterial lesion, (3) no determined etiology [NE]; non-lacunar syndrome without parent arterial lesion, and (4) small artery disease [SAD]; lacunar syndrome without parent arterial lesion. Patients with a potential source of embolism were excluded from this study. The prognosis and recurrence rate of patients with the MM group were compared with those of other groups. RESULTS: A total of 176 patients were included; 56 LAD, 62 SAD, 22 MM and 36 NE groups. An unstable hospital course was more frequently found in LAD than in the other groups. The recurrence rate of the MM group (23%) was significantly higher than that of SAD (2%), but was similar to that of patients with non-lacunar syndrome (LAD 16%, NE 28%). CONCLUSIONS: Among patients with lacunar syndrome, the prognosis of those with parent arterial lesions was different from those without lesions. Therefore, a systematic work up of the stroke mechanism may be important in patients with lacunar syndrome.
Arteries ; Embolism ; Humans ; Parents* ; Prognosis ; Recurrence ; Stroke ; Stroke, Lacunar*

BACKGROUND: Exposure to organic solvents becomes a common problem to workers of heavy industries in Korea. A number of volatile organic solvents which are frequently used in painting can cause various derangements of the nervous system, especially cognitive impairments and peripheral neuropathy. METHODS: This study was carried out on 190 workers as a control group who had never been exposed to organic solvents and on 674 spray painters with long-term exposure to organic solvent mixtures. The major components of organic solvent mixtures were determined. All subjects underwent neurological examination as well as routine physical check-up after completing questionnaires on general, musculoskeletal, neuropsychiatric and neurological systems. Subjects with abnormal findings on neurological examination related with the exposure of organic solvent mixtures took further neuropsychological and neurophysiological tests. RESULTS: The prevalence rates of cognitive impairments and of peripheral neuropathy in the exposed group were significantly higher than the control group (9.5% vs 2.1% and 2.1% vs 0%, respectively). High exposure group (more than 2.64 of cumulative exposure index, CEI) showed also higher prevalence of cognitive impairments and of peripheral neuropathy than low exposure group (cognitive impairments; 12.3% vs 6.4%, peripheral neuropathy; 2.3% vs 1.8%). Most common cognitive impairments were attentional deficit, and abnormal sense on the extremities or face was most common symptom of the peripheral nervous system. CONCLUSION: This study is the first large-scale, case-control study extensively evaluating cognitive impairments and peripheral neuropathy related with volatile organic solvent mixtures in spray painters working in a shipbuilding industry in Korea. The results show that the prevalence rates of cognitive impairments and of peripheral neuropathy are relatively low, but clearly related with the exposure extent of organic solvents.
Case-Control Studies ; Extremities ; Korea ; Metallurgy ; Nervous System ; Neurologic Examination ; Paint ; Paintings ; Peripheral Nervous System ; Peripheral Nervous System Diseases* ; Prevalence ; Surveys and Questionnaires ; Solvents*

Though congitive functions of a man decline in normal aging and memory decline is the most common complaint of an elderly, the status of quantitive and qualitative estimates of these are rare in Korea. To assess the qualitative and quantitive aspect of changes of memory in aging, neuropsychological tests about memory functions were performed and the results were.analyzed in healthy adult volunteers of 20 to 9 year-old, having no evidence-of organic brain dysfunction. The scores of each tests.are lower than that of English-speaking countries, but memory functions declined significantly in normal aging and the qualitative aspect of these are characteristics. Contrary to the western reports. The visuospatial memory declined significantly before the age of 50 and the verbal memory after 50 in aging. So we should take care in screening and diagnosis of dementia and amnesia using these neuropsychological test in Korea.
Adult* ; Aged ; Aging* ; Amnesia ; Brain ; Child ; Dementia ; Diagnosis ; Humans ; Korea ; Mass Screening ; Memory* ; Neuropsychological Tests ; Volunteers

No abstract available.
Postural Orthostatic Tachycardia Syndrome* ; Syncope

No abstract available.
Lymphadenitis*

An extra-ovarian teratoma has been reported in a few cases of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. A 25-year-old woman presented with psychiatric symptoms. We did not find an ovarian teratoma on initial examination, and her initial simple chest X-ray was normal. We incidentally found an abnormality on follow-up simple chest X-ray and diagnosed an anterior mediastinal teratoma. Therefore, in patients with suspected anti-NMDAR encephalitis, even if simple chest X-ray is normal, chest computed tomography should be performed to investigate a hidden teratoma.
Adult ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis ; Encephalitis ; Female ; Follow-Up Studies ; Humans ; Teratoma ; Thorax

No abstract available.
Magnetic Resonance Imaging* ; Magnetic Resonance Spectroscopy* ; Neoplasms, Neuroepithelial*

BACKGROUND: The efficacy of sumatriptan(SMN) in acute management of migrane has been well established. In Korea, however, a clinical study comparing the utility of oral(PO) and subcutaneous(SQ) regimen had not been conducted yet. This study was directed to compare the two regimens of SMN in terms of the efficacy as well as the adverse events in a singed-out Korea patient group. METHODS: The 91 migrane patients were recruited and randomly assigned to either PO or SQ regimen as the initial treatment of acute migrane attack. Then, they were forwarded to the other regimen as an open cross-over trial. The treatment responses and adverse events were assessed and rated by the subjects. RESULTS: Eighty one patient successfully tried at least one regimen of SMN. Overall, the proportion of excellent treatment response was 90.7%(PO) and 94.1%(SQ), with the occurrence of adverse events being 67.4%(PO) and 76.5%(SQ) respectively. In 18 patients who were able to complete cross-over procedure, the efficacy was 94.4% both in PO and SQ regimen, with the occurrence of adverse events 72.2% in both of two regimen. Although the SQ regimen tends to induce faster treatment response regardless of the cross-over completion, it bears no statistical significance. CONCLUSION: We conclude that the PO and SQ regimens of SMN show very comparable clinical utility in achieving therapeutic responses as well as in producing adverse events. The treatment efficacy was excellent but higher occurrence of side effects in this study, although mostly in mild degree, suggests that optimal dose adjustment strategy needs to be elaborated in Korea.
Humans ; Korea ; Migraine Disorders* ; Sumatriptan* ; Treatment Outcome

Situs inversus totalis is a rare anomaly in which the abdominal and thoracic cavity structures are opposite their usual positions. A 41-yr-old woman, who had an ulcerating cancer on the rectum, was found as a case of situs inversus totalis. We present an overview of the operative technique for the first documented laparoscopic total mesorectal excision of a rectal cancer in the patient with situs inversus totalis. Careful consideration of the mirror-image anatomy permitted a safe operation using techniques not otherwise different from those used for the general population. Therefore, curative laparoscopic surgery for rectal cancer in this patient is feasible and safe.
Adult ; Female ; Humans ; Laparoscopy/*methods ; Mesocolon/*surgery ; Rectal Neoplasms/diagnosis/*surgery ; Rectum/*surgery ; Situs Inversus/*complications/*surgery