1.Generalized Chorea-Ballismus Associated with Nonketotic Hyperglycemia in Diabetes Mellitus: A Case Report.
Hyun Ran SHIN ; Ji Hoon KIM ; Mee Young PARK
Yeungnam University Journal of Medicine 2002;19(2):136-143
Even though the nonketotic hyperglycemia is a metabolic disorder, it complicates hemic- horea-hemiballism rarely. Moreover, generalized chorea-ballism associated with nonketotic hyperglycemia in diabetes mellitus is very rare, so it has not been reported in Korean literature. Although the precise pathophysiologic mechanisms of these disorders are still poorly understood, deficiency of gamma aminobutyric acid (GABA) in nonketotic hyperglycemia or reduced GABAnergic inhibition by striatal lesion may increase inhibitory output to subthalamic nucleus. These result loss of pallidal inhibition and produce contralateral hemichorea-hemiballism. The striatal lesions, such as transient ischemia with reactive astrocytosis or small amount of petechial hemorrhage, are related with changes of magnetic resonance image (MRI) findings presumably. We report a diabetic old woman who developed generalized chorea-ballismus as a very rare complication of nonketotic hyperglycemia. Her brain MRI showed high signal intensity in left lentiform nucleus and right pallidum on T1 weighted images and low signal intensity in bilateral putamen on T2 weighted images with highly enhanced corresponding lesions on T1 weighted enhancement images.
Brain
;
Corpus Striatum
;
Diabetes Mellitus*
;
Female
;
gamma-Aminobutyric Acid
;
Gliosis
;
Hemorrhage
;
Humans
;
Hyperglycemia*
;
Ischemia
;
Magnetic Resonance Imaging
;
Putamen
;
Subthalamic Nucleus
2.Fibroadenoma with Formation of Epidermal Cyst: A case report.
Jong Jae JUNG ; Ji Shin LEE ; Seung HYUN
Korean Journal of Pathology 2000;34(7):537-539
Epidermal cyst in the fibroadenoma of the breast is very rare. A 29-year-old woman presented with a lump in the upper outer quadrant of the right breast. Clinically it was a fibroadenoma and the excisional specimen showed an encapsulated, firm lobulated lesion with a cystic area on cut surface. The cystic area showed squamous metaplasia of the ductal epithelium and keratinous cyst formation in the fibroadenoma. We report this unusual case with review of literatures.
Adult
;
Breast
;
Epidermal Cyst*
;
Epithelium
;
Female
;
Fibroadenoma*
;
Humans
;
Metaplasia
3.Expression of hMSH2, hMLH1 Protein in Sporadic Colorectal Cancer and Corresponding Normal Tissue.
Jae Young JUNG ; Dong Kook PARK ; Ji Hyun SHIN
Journal of the Korean Society of Coloproctology 1998;14(4):709-718
PURPOSE: DNA mismatch repair gene is responsible for hereditary nonpolyposis colorectal cancer. But it is not well known its role in sporadic colorectal cancer patients. We analysed normal hMSH2, hMLH1 protein expression in colorectal adenocarcinoma tissues and corresponding normal tissues to find out the role of mismatch repair gene in sporadic colorectal cancer by Western blotting. METHODS: Normal hMSH2 and hMLH1 protein expression was studied on 25 colorectal cancer and corresponding normal tissue by Western blot with hMSH2 and hMLH1 monoclonal antibody. Normal protein band was expressed on 100 kD in hMSH2 and 87 kD in hMLH1. SW480 and LoVo cell line was used as positive and negative control for hMSH2 and LoVo and SW480 as positive and negative for hMLH1. And we analysed the relation between the hMSH2, hMLH1 protein expression and clinicopathological parameters. RESULTS: It was 2 cases (8%) that both hMSH2 and hMLH1 protein expression was not observed. Three cases (12%) were negative for hMSH2 and 2 cases (8%) for hMLH1. One or both hMSH2, hMLH1 protein expression was not observed in 7 cases (28%) in total. There was no correlation for proximal occurrence (25% vs 35%), young age (37.5% vs 23.5%) and lymph node metastasis (50% vs 47%). But poorly and mucinous differentiation was regarded as having relation with negative expression of hMSH2 and hMLH1 (50% vs 17.6%) but not significant statistically. CONCLUSION: Sporadic colorectal cancer with negative expression of normal hMSH2 and hMLH1 protein showed no relation to younger age, proximal site preference and lymph node metastasis. But it was suggested that mismatch repair gene protein was involved in cancer cell differentiation in sporadic colorectal cancer.
Adenocarcinoma
;
Blotting, Western
;
Cell Differentiation
;
Cell Line
;
Colorectal Neoplasms*
;
Colorectal Neoplasms, Hereditary Nonpolyposis
;
DNA Mismatch Repair
;
Humans
;
Lymph Nodes
;
Mucins
;
Neoplasm Metastasis
6.The Effect of Antenatal Corticosteroid on Perinatal Outcomes of Preterm Births.
In Sik LEE ; Shin Myung SHIN ; Ji Ahn KANG ; Hye Sung WON ; Pyl Ryang LEE ; Ahm KIM ; Joo Hyun NAM
Korean Journal of Obstetrics and Gynecology 2000;43(5):863-870
OBJECTIVES: To determine the effectiveness and clinical utility of antenatal corticosteroids in the reduction of neonatal morbidity and mortality on preterm birth Material and method: Neonatal outcomes of 312 preterm babies were evaluated retrospectively. One hundred and two preterm babies(study group) were given dexamethasone more than 1 dose antenatally and 210 preterm babies(control group) were not given dexamethasone antenatally. Antenatal steroids were administered in the form of four 5mg intramuscular doses of dexamethasone 12 hours apart. Maternal and neonatal outcomes of study group were compared with those of control group. Student t- test, x2 test, Fisher's exact test, and logistic regression analysis were used where appropriate. p-value< 0.05 was considered significant. RESULTS: Antentenatal corticosteroid significantly decreased the incidence of RDS(OR:0.47, 95% CI:0.25-0.86), IVH/PVL(OR : 0.32, 95% CI : 0.12-0.86), necrotizing enterocolitis(OR : 0.49, 95% CI : 0.25-0.98), and neonatal death(OR: 0.30, 95% CI: 0.10 - 0.89) in preterm delivery. In the presence of PROM, antenatal corticosteoid seemed to have no protective effect on the neonatal complications such as RDS, IVH/PVL, NEC, PDA, and neonatal death. CONCLUSIONS: Antenatal administration of corticosteroids was effective to decrease the incidence of neonatal morbidity and neonatal mortality in the preterm neonates with no apparent maternal complications.
Adrenal Cortex Hormones
;
Dexamethasone
;
Humans
;
Incidence
;
Infant
;
Infant Mortality
;
Infant, Newborn
;
Logistic Models
;
Mortality
;
Premature Birth*
;
Retrospective Studies
;
Steroids
7.Effects of Intravenous Fluid and Diuretics on Stone Fragmentation and Passage during Extracorporeal Shock Wave Lithotripsy (ESWL) of Upper Ureteral Stone.
Korean Journal of Urology 2003;44(2):129-133
PURPOSE: A prospective randomized controlled trial was performed to investigate the effects of intravenous hydration, both with and without diuretics, on the fragmentation and passage of an upper ureteral stone during ESWL. MATERIALS AND METHODS: We analyzed 65 patients with upper ureteral stones, primarily treated with piezoelectric LT-02 lithotripter, between November, 2001 and March, 2002. The patients were divided in 3 groups; the 20 patients in group A were injected with 500ml of normal saline for intravenous hydration, and 20mg of furosemide for diuretic effect during the ESWL; the 20 patients in group B were injected with normal saline without furosemide, and the remaining 25, group C, were used as controls. The same energy settings for the shockwaves in one session were equally applied to all the patients during the ESWL, with a 4Hz shockwave frequency, 100% power, a 50 minute treatment and 43 minute storage time. After 2 weeks, the degrees of stone fragmentation, and the residual fragments, were evaluated on the post-ESWL KUB and compared with the pre-ESWL KUB. RESULTS: After a single ESWL treatment, the stone-free rate was 70% (14 of 20 patients) in group A, 60% (12 of 20 patients) in group B and 28% (7 of 25 patients) in group C (p<0.05). The stone-free rates of groups A and B were significantly higher than that of group C, but there was no statistical difference between groups A and B. The stone-free rates, after a single session, according to the stone size was higher in groups A (77.8%) and B (73.3%) than in group C (38.9%) for stones smaller than 10mm (p<0.05), but they were similar between the three groups for stones larger than 10mm (p>0.05). CONCLUSIONS: Intravenous hydration with normal saline, both with and without a furosemide injection for diuretic effect, during ESWL would be an effective method to facilitate the fragmentation and passage of upper ureteral stones smaller than 10mm.
Diuretics*
;
Furosemide
;
Humans
;
Lithotripsy*
;
Prospective Studies
;
Shock*
;
Ureter*
;
Ureteral Calculi
8.Atypical Ocular and Optical Coherence Tomographic Findings With Presumed Miliary Tuberculosis.
Journal of the Korean Ophthalmological Society 2011;52(1):107-111
PURPOSE: To report clinical features and optical coherence tomographic findings of presumed atypical ocular tuberculosis associated with tuberculosis lymphadenitis and encephalomeningitis. CASE SUMMARY: A 28-year-old female with lymphadenitis in the axillary area presented with a fever and headache of a one week duration. CSF study and MRI findings implied tuberculosis encephalomeningitis, and presumed tuberculosis uveitis manifested with visual disturbance after five days. Ocular symptoms were aggravated and showed anterior iridocyclitis, vitritis, macular edema, and multifocal retinitis with miliary granuloma that was distinct from choroiditis or typical tuberculosis granuloma. After the patient received anti-tuberculosis medication and systemic corticosteroids, significant improvements in visual acuity, ocular findings and OCT results were observed. CONCLUSIONS: Ocular tuberculosis can present with various clinical findings, and caution should be taken so as not to misdiagnose based on these characteristics. In the present case, anti-tuberculosis medication and systemic steroids resulted in the resolution of inflammation. In such cases, monitoring the posterior pole lesion via OCT may be helpful in determining improvement.
Adrenal Cortex Hormones
;
Adult
;
Choroid
;
Choroiditis
;
Female
;
Fever
;
Granuloma
;
Headache
;
Humans
;
Inflammation
;
Iridocyclitis
;
Lymphadenitis
;
Macular Edema
;
Meningitis
;
Meningoencephalitis
;
Retinitis
;
Steroids
;
Tuberculosis
;
Tuberculosis, Miliary
;
Tuberculosis, Ocular
;
Uveitis
;
Visual Acuity
9.A Case of CHAP Syndrome.
Man Wook SEO ; Ji Sung KIM ; Seong Yong YU ; Byeung Soo SHIN ; Young Hyun KIM
Journal of the Korean Geriatrics Society 2001;5(4):348-353
CHAP syndorme consists of choreoathetosis, orofacial dyskinesia, affective change, hypotonia, and pseudobulbar signs. CHAP syndrome was firstly des- cribed with onset 1 to 7 days after induced profound hypothermia and complete circulatory arrest for con- genital heart lesion repair. Since then, only a few cases have been reported until now. Case We report a patient who demonstrated all of the elements of the CHAP syndrome in severe cachexic state. Brain SPECT(99mTC-ECD) shows decreased perfusion in left fronto-parieto-temporal lobe. Comments The pathogenesis of CHAP syndrome is obscure. However our case led us to suggest that more essential component pre- disposing to the CHAP syndrome is hypoxia rather than hypothermia. Furthermore, it seems to be related with circulatory insufficiency in extrapyramidal nervous systems.
Anoxia
;
Brain
;
Heart
;
Humans
;
Hypothermia
;
Movement Disorders
;
Muscle Hypotonia
;
Nervous System
;
Perfusion
10.Granular Cell Tumor on the Scalp.
Ji Yeon SHIN ; Hei Sung KIM ; Sang Hyun CHO ; Jeong Deuk LEE
Korean Journal of Dermatology 2012;50(7):658-659
No abstract available.
Granular Cell Tumor
;
Scalp