No abstract available.
Diabetic Neuropathies* ; Lumbosacral Plexus* ; Magnetic Resonance Imaging*

There are several causes developing diplopia after cataract surgery. Among these causes, central fusion disruption may be developed in longstanding unilateral traumatic cataract and uncorrected aphakia. The pathophysiology is unknown, but time interval between sensory deprivation and optical correction is an important factor. The characteristic signs and symptoms are exotropic, hypotropic or excyclotropic deviation, and intractable diplopia with vertical bobbing movement of non-fixing eye, particularly near the angle of superimposition with prism or haploscopic device. The authors report two cases of central fusion disruption in longstanding unilateral traumatic cataract and uncorrected aphakia.
Aphakia ; Cataract ; Diplopia ; Sensory Deprivation

Senile entropion is caused by following pathophysiologic changes ; disinsertion or weakness of lower lid retractor, upward migration and overriding of the preseptal orbicularis oculi muscle over pretarsal orbicularis muscle, horizontal lid laxity, and relative enophthalmos from absorption of orbital fat. There have been numerous procedures to correct senile entropion, but the difficulty of adequate and concurrent correction of all of the underlying defect result in high recurrence rate. Therefore, authors performed a combined procedure including reattachment of disinserted lower lid retractor or tucking of weakened lower tarsus, and the extirpation of overriding preseptal orbicularis oculi muscle. At the same time we performed the correction of the lower lid laxity using lateral tarsal strip procedure of full-thickness wedge resection. Authors performed this method in 21 cases of 17 patients and the cosmetic and functional result were satisfactory.
Absorption ; Ankle ; Enophthalmos ; Entropion* ; Humans ; Orbit ; Recurrence

Optic nerve evulsion is a visually devastating and rare manifestation resulting in sudden visual loss after ocular trauma. The several hypothesis of mechanism include penetrating orbital injury causing a backward pull on the optic nerve, extreme rotation and forward displacement of the globe, and sudden increase in intraocular pressure causing rupture of the lamina cribrosa. The authors report a case of optic nerve evulsion in a 25- year old man who was struck in the right eye with a umbrella. The diagnosis was made by fundoscopic findings, fluorescein angiography, visual evoked potential, electroretinography, orbit computed tomography and magnetic resonance image.
Diagnosis ; Electroretinography ; Evoked Potentials, Visual ; Fluorescein Angiography ; Intraocular Pressure ; Optic Nerve* ; Orbit ; Rupture

Thrombotic thrombocytopenic purpura (TTP) is frequently associated with small cortical and subcortical infarcts. However, major intracranial artery occlusion is rare. We report a case of progressive middle cerebral artery (MCA) infarction in a patient with TTP. A 76-year-old woman with hypertension was admitted due to right hemiparesis and transcortical motor aphasia. On laboratory findings, she had microangiopathic hemolytic anemia and thrombocytopenia. Brain MRI showed left subcortical multiple infarction, and MR angiogram revealed severe stenosis of left MCA main stem. She was treated with heparin and steroid but a few days later, there was neurologic deterioration attributed to progressive occlusive stroke in the left MCA territory. Follow-up brain CT demonstrated left malignant MCA infarction. TTP may be associated with progressive occlusion of large cerebral artery.
Aged ; Anemia, Hemolytic ; Aphasia, Broca ; Arteries ; Brain ; Cerebral Arteries ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Heparin ; Humans ; Hypertension ; Infarction ; Infarction, Middle Cerebral Artery* ; Magnetic Resonance Imaging ; Middle Cerebral Artery* ; Paresis ; Purpura, Thrombotic Thrombocytopenic* ; Stroke ; Thrombocytopenia

Pseudotumor cerebri is a syndrome of increased intracranial pressure, and may be a rare complication of cyclosporine treatment. We report a 26-year-old woman with pseudotumor cerebri which developed after cyclosporine medication for kidney transplantation. Regular examinations of the fundi are required in patients taking oral cyclosporine, especially when they report headache or blurred vision.
Adult ; Cyclosporine ; Female ; Headache ; Humans ; Intracranial Pressure ; Kidney ; Kidney Transplantation ; Pseudotumor Cerebri

Chordoid meningioma, an uncommon subtype of meningioma, occurs rarely in the spine. In this case report, the authors present a case of spinal chordoid meningioma in a young female patient, and include a detailed description of imaging findings and a literature review.
Female ; Humans ; Meningioma ; Spine

BACKGROUND AND PURPOSE: Serial nerve conduction studies (NCSs) are recommended for differentiating axonal and demyelinating Guillain-Barré syndrome (GBS), but this approach is not suitable for early diagnoses. This study was designed to identify possible NCS parameters for differentiating GBS subtypes. METHODS: We retrospectively reviewed the medical records of 70 patients with GBS who underwent NCS within 10 days of symptom onset. Patients with axonal GBS and acute inflammatory demyelinating polyneuropathy (AIDP) were selected based on clinical characteristics and serial NCSs. An antiganglioside antibody study was used to increase the diagnostic certainty. RESULTS: The amplitudes of median and ulnar nerve sensory nerve action potentials (SNAPs) were significantly smaller in the AIDP group than in the axonal-GBS group. Classification and regression-tree analysis revealed that the distal ulnar sensory nerve SNAP amplitude was the best predictor of axonal GBS. CONCLUSIONS: Early upper extremity sensory NCS findings are helpful in differentiating axonal-GBS patients with antiganglioside antibodies from AIDP patients.
Action Potentials ; Antibodies ; Axons* ; Classification ; Diagnosis ; Early Diagnosis ; Electrodiagnosis ; Guillain-Barre Syndrome* ; Humans ; Medical Records ; Neural Conduction ; Retrospective Studies ; Ulnar Nerve ; Upper Extremity*

OBJECTIVE: To evaluate the clinical feasibility and obtain useful parameters of 31P magnetic resonance spectroscopy (MRS) study for making the differential diagnosis of brain tumors. MATERIALS AND METHODS: Twenty-eight patients with brain tumorous lesions (22 cases of brain tumor and 6 cases of abscess) and 11 normal volunteers were included. The patients were classified into the astrocytoma group, lymphoma group, metastasis group and the abscess group. We obtained the intracellular pH and the metabolite ratios of phosphomonoesters/phosophodiesters (PME/PDE), PME/inorganic phosphate (Pi), PDE/Pi, PME/adenosine triphosphate (ATP), PDE/ATP, PME/phosphocreatine (PCr), PDE/PCr, PCr/ATP, PCr/Pi, and ATP/Pi, and evaluated the statistical significances. RESULTS: The brain tumors had a tendency of alkalization (pH = 7.28 +/- 0.27, p = 0.090), especially the pH of the lymphoma was significantly increased (pH = 7.45 +/- 0.32, p = 0.013). The brain tumor group showed increased PME/PDE ratio compared with that in the normal control group (p = 0.012). The ratios of PME/PDE, PDE/Pi, PME/PCr and PDE/PCr showed statistically significant differences between each brain lesion groups (p < 0.05). The astrocytoma showed an increased PME/PDE and PME/PCr ratio. The ratios of PDE/Pi, PME/PCr, and PDE/PCr in lymphoma group were lower than those in the control group and astrocytoma group. The metastasis group showed an increased PME/PDE ratio, compared with that in the normal control group. CONCLUSION: We have obtained the clinically applicable 31P MRS, and the pH, PME/PDE, PDE/Pi, PME/PCr, and PDE/PCr ratios are helpful for differentiating among the different types of brain tumors.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Astrocytoma/diagnosis/*metabolism ; Brain Abscess/diagnosis/*metabolism ; *Brain Chemistry ; Brain Neoplasms/diagnosis/*metabolism/secondary ; Case-Control Studies ; Diagnosis, Differential ; Feasibility Studies ; Female ; Humans ; Hydrogen-Ion Concentration ; Lymphoma/diagnosis/*metabolism ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy/*methods ; Male ; Middle Aged ; Phosphorus/diagnostic use ; Prospective Studies ; Young Adult

BACKGROUND AND PURPOSE: Multifocal seeding of the leptomeninges by malignant cells, which is usually referred to as leptomeningeal carcinomatous metastasis, produces substantial morbidity and mortality. The diagnosis of leptomeningeal metastasis is usually established by cerebrospinal fluid (CSF) investigation, including cytology, cell counts, protein, glucose, and a tumor marker such as carcinoembryonic antigen (CEA). This study examined the diagnostic value of CEA in the CSF. METHODS: We measured the CSF CEA level in 32 patients with leptomeningeal metastasis. The control group consisted of 19 cancer patients without leptomeningeal metastasis. CEA was measured by the chemiluminescent emission method. RESULTS: The CEA level was significantly higher in patients with leptomeningeal metastasis than in the control group (p<0.005). The level of CSF protein was higher and that of CSF glucose was lower in patients with leptomeningeal metastasis than in the control group (p<0.005). CONCLUSIONS: The CSF CEA level is useful for diagnosing leptomeningeal carcinomatous metastasis. The CSF levels of protein and glucose are also useful in the diagnosis.
Carcinoembryonic Antigen ; Cell Count ; Glucose ; Humans ; Neoplasm Metastasis ; Seeds