No abstract available.
Cutaneous Fistula ; Glomerulonephritis, Membranous* ; Humans ; Sarcoma, Kaposi*

A 71-year-old male initially presented with vocal cord palsy and underwent tracheostomy. After thorough examination, urogenital dysfunction, orthostatic hypotension, and Parkinsonism were found, which led to the diagnosis of multiple system atrophy (MSA). After the tracheostomy, bi-level positive airway pressure ventilation was required during the night due to nocturnal hypoxemia. Night-time hypoxemia is related to central sleep apnea, which is one of the manifestations of MSA. This is the first case of MSA manifested by bilateral vocal cord palsy as an initial sign in Korea. This case supports the notion that MSA should be taken into consideration when vocal cord paralysis is observed.
Aged ; Airway Obstruction ; Anoxia ; Diagnosis ; Humans ; Hypotension, Orthostatic ; Korea ; Male ; Multiple System Atrophy* ; Parkinsonian Disorders ; Sleep Apnea, Central ; Tracheostomy ; Ventilation ; Vocal Cord Paralysis*

No abstract available.
Folliculitis* ; Herpesvirus 3, Human ; Scalp*

Post-traumatic fat embolism was first reported by Zenker in 1862, Von Bergmann reported the first clinical diagnosis of the fat embolism syndrome in 1873. Fat embolism has been associated with traumatic or non-traumatic disorders. Fat embolization after long bone trauma is probably common as a subclinical event. The diagnosis of fat embolism syndrome is based on the patient's history, is supported by clinical signs of pulmonary, cerebral, and cutaneous dysfunction, and is confirmed by the demonstration of arterial hypoxemia in the abscence of other disorders. Two different mechanisms cause fat to embolize: direct entry of deposit fat into the blood stream and agglutination of endogenous or exogenous plasma fat. MRI can detect a cerebral fat embolism with a higher sensitivity than cerebral CT. We report a case of post-traumatic cerebral fat embolism without pulmonary involvement, and we present a review of the literature. A 16-year girl had a traffic accident and pelvic bone fracture. Forty eight hours later severe trauma become stuporous without a focal neurological deficit. The patient received supportive therapy, and her condition improved throughout her hospital course. She was discharged with good condition after a 30-day hospital stay.
Accidents, Traffic ; Agglutination ; Anoxia ; Diagnosis ; Embolism, Fat* ; Female ; Humans ; Length of Stay ; Magnetic Resonance Imaging ; Pelvic Bones ; Plasma ; Rivers ; Stupor

Posthypoxic myoclonus is poorly controlled with current treatments. Based on clinical experience, valproate and benzodiazepines have been used to treat myoclonic seizures. Rarely, some antiepileptic drugs may exacerbate myoclonic seizures. Although lamotrigine is controversial for treatment in myoclonic seizures, we experience a case of posthypoxic myoclonus improved with lamotrigine add-on therapy.
Anticonvulsants ; Benzodiazepines ; Myoclonus* ; Seizures ; Valproic Acid

Brain infarction restricted to the unilateral hypothalamus is known to be very rare because of the abundant blood supply from the circle of Willis. We report a case of right hypothalamic infarction. A 63-year-old woman developed hyperphagia, hypersomnolence and hemihyperhidrosis limited to the left half of the face. Brain MRI revealed a high signal intensity at the right anteromedial hypothalamus.
Brain ; Brain Infarction ; Circle of Willis ; Disorders of Excessive Somnolence* ; Female ; Humans ; Hyperphagia ; Hypothalamus ; Infarction* ; Magnetic Resonance Imaging ; Middle Aged

Cutis marmorata telangiectatica congenita (CMTC) is a rare congenital vascular disorder. The skin lesions associated with CMTC include persistent, reticulated vascular patches and telangiectasia, and they are sometimes associated with underlying atrophy and ulceration. The condition is present at birth and tends to improve with age, although some skin lesions remain unchanged throughout life. We encountered two patients with CMTC: a 12-day-old infant and a 21-year-old woman with a history of CMTC since birth. Both patients had localized reticulated purpuric patches with atrophy. During follow-up, although the purpuric patches improved in both patients, there were no changes in the skin atrophy in either patient. Herein, we present these cases showing the changes in the cutaneous features of CMTC over time and demonstrate that CMTC at birth may persist throughout life.
Atrophy ; Female ; Follow-Up Studies ; Humans ; Infant ; Parturition ; Skin ; Telangiectasis ; Ulcer ; Young Adult

Sternomastoid tumor has long been recognized as a peculiar fibrous growth of the sternocleidomastoid muscle that usually appears during first several weeks of life. Sternomastoid tumor has often been referred to as "congenital torticollis" or "congenital muscular torticollis" because it is often associated with muscular torticollis. Some authors prefer to discuss them separately as either "sternomastoid tumor" when mass is palpable, or "muscular torticollis" when only tightness of sternomastoid muscle is present. Although it is disputed whether sternomastoid tumor will lead to muscular torticollis, 1/4-1/3 numbers of sternomastoid tumor does progress to muscular torticollis. However, muscular torticollis may occur in children without history of a mass in the sternocleidomastoid muscle. We present two cases of sternomastoid tumor that is combined with torticollis, one case was treated by physiotherapy and the other by surgery.
Child ; Humans ; Torticollis

Behcet's disease is an inflammatory disorder of unknown etiology with multi-organ involvement. Although it rarely involves the heart, once the heart is involved the results can be devastating. However, since cardiac involvement has various manifestations, diagnosis is challenging. The clinical features and echocardiographic findings of cardiac Behcet's may mimic culture-negative infective endocarditis. A correct diagnosis is usually made postoperatively. Here, we report the case of a 55-year-old male who was initially diagnosed with infective endocarditis that caused metastatic vertebral osteomyelitis. He underwent immediate cardiac surgery and received empirical antibiotics, but all culture findings were negative; however, he had a sustained fever and elevated inflammatory marker levels. After reviewing the results of pathologic and imaging studies, a final diagnosis of cardiac Behcet's disease was made. He was successfully treated with a high dose of corticosteroids. This report demonstrates a rare case of cardiac Behcet's disease mimicking culture-negative infective endocarditis.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Behcet Syndrome ; Diagnosis ; Echocardiography ; Endocarditis* ; Fever ; Heart ; Humans ; Male ; Middle Aged ; Osteomyelitis ; Spondylitis ; Thoracic Surgery

Malrotation is a congenital anomaly that becomes symptomatic more frequently during infancy. The indication for surgical treatment at that age is straightforward. In older children, the diagnosis may be more difficult because of chronic and vague complaint. The aim of this study is to compare the symptoms, rate of volvulus and surgical findings in children younger and older than one year. A retrospective study of 40 patients in a a single medical center diagnosed with malrotation from April 1996 to May 2010 was performed. There were 20 (50%) boys and 20 (50%) girls. At the time of operation, 27 (67.5%) patients were younger and 13 (32.5%) were older than 1 year. Vomiting was seen in 20 cases (74.1%) of the younger group compared to 2 cases (15.4%) of the older group. Abdominal sonography and upper gastrointestinal series showed a sensitivity of 100%. Operative findings: 12 (44.4%) of the younger group presented with volvulus compared to none of the older group. The Ladd's procedure was routinely performed with appendectomy in all cases and bowel resection was requires when volvulus included bowel necrosis or other anomalies were found. After definite procedures, surgical correction for adhesive obstruction was necessary in 5 menbers (18.5%) of the younger group and 1 patient (7.7%) in the older group. There was 1 death due to respiratory failure and pneumonia. Abdominal pain was more frequent symptom and bilious vomiting was less frequent. Volvulus did not occur in the older group. Malrotation should be diagnosed promptly in children over 1 year of age by upper gastrointestinal series and abdominal ultrasonography even though symptoms are not as clear cut as in infants.
Abdominal Pain ; Adhesives ; Appendectomy ; Child ; Humans ; Infant ; Intestinal Volvulus ; Necrosis ; Pneumonia ; Respiratory Insufficiency ; Retrospective Studies ; Vomiting