No abstract available.
Hemangioma, Cavernous* ; Urinary Bladder*

Seizure induced transient brain CT or MRI abnormalities following status epilepticus have previously been reported. However, focal transient imaging abnormalities involving hippocampus or mesial temporal lobe as a consequence of seizure are rare findings. We report 2 patients with transient mesial temporal abnormalities on MRI associated with partial seizure of temporal lobe origin. A 59-year-old man with a 4-month history of occasional epigastric rising sensation had developed frequent olfactory hallucination 7 days prior to presentation. On brain MRI, T2 signal was increased in the right mesial temporal region, and the lesion showed mild mass effects and partial enhancement after gadolinium injection. Interictal spikes were noted from right nasopharyngeal electrode, but there was no clinical or electrical evidence of status epilepticus during prolonged scalp/sphenoidal EEG monitoring. His seizures were successfully controlled by phenytoin. T2 high signal was markedly decreased and prior enhancement was no longer seen on brain MRI done 5 weeks later. A 33-year old woman with a 6 month history of occasional vacant staring and oral automatism with amnesia complained progressive memory impairment. Right amygdala and hippocampal head was enlarged and showed T2 high signal without contrast enhancement. EEG with sphenoidal electrodes showed right sphenoidal spikes. Her seizures were controlled by carbamazepine and brain MRI became unremarkable 6 weeks later. Suggested mechanisms and significance of the transient imaging abnormalities following seizures will be briefly reviewed.
Adult ; Amnesia ; Amygdala ; Automatism ; Brain ; Carbamazepine ; Electrodes ; Electroencephalography ; Female ; Gadolinium ; Hallucinations ; Head ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Memory ; Middle Aged ; Phenytoin ; Seizures* ; Sensation ; Status Epilepticus ; Temporal Lobe*

PURPOSE: To verify the stability and effect of OcuLarsol(R), which was newly developed for irrigating solution, by evaluating influence on cornea. METHODS: In vivo study group, after an irrigation and aspiration instrument was put into rabbit's anterior chamber: one eye was irrigated with OcuLarsol(R) for 15 minutes, and the other eye with the balanced salt solution (BSS(R), Alcon, USA). After the operation, corneal changes were observed for a week. In vitro study group, after enucleating of rabbits' eyeballs, corneas were mounted in a dual chambered specular microscope and perfused with glutathione bicarbonate Ringer's solution (GBR) for one hour: one cornea of the pair was perfused with OcuLarsol(R) and the other cornea was perfused with BSS(R) for 2-3 hours. After perfusion, corneal swelling rates and endothelial permeability were measured. RESULTS: In vivo study group, central corneal thickness measurement and endothelial cell count showed that there was no significant difference between the two groups on the day of operation, and 1st, 3rd and 7th day after the operation (p>0.05). Corneal endothelial observation with Alizarin red S, HandE stain, and scanning electron microscope detected no difference in cell shape and density. In vitro study group, corneal swelling rates and endothelial permeability showed no significant difference between OcuLarsol(R) and BSS(R) group and transmission electron microscope showed endothelial cells with normal organelles in all groups. CONCLUSIONS: There was no significant difference between the two irrigating solutions, BSS(R) and OcuLarsol(R), in terms of effect and side effects.
Anterior Chamber* ; Cell Shape ; Cornea ; Corneal Pachymetry ; Endothelial Cells* ; Glutathione ; Hand ; Organelles ; Perfusion ; Permeability

BACKGROUND: Microalbuminuria predicts cardiovascular events in diabetic and non-diabetic patients. But, few studies have addressed the relationship between microalbuminuria and cerebral infarction. We determined the incidence of microalbuminuria in non-diabetic subjects with cerebral infarction and investigated the relationship between urinary albumin excretion and risk factors of the stroke. METHODS: Urinary albumin excretion rate, 24 hours blood pressure monitoring, fasting serum lipid profiles, fibrinogen, fasting glucose, insulin and c-peptide were evaluated in 50 non-diabetic patients with acute cerebral infarction and matched 48 controls. RESULTS: Microalbuminuria was detected in 23 of 50(46%) patients with acute cerebral infarction and 4 of 48(8%) control subjects. Hypertension was present in 13 of 23(57%) microalbuminuric patients and 9 of 27(33%) non-microalbuminuric patients. In the microalbuminuric patients with cerebral infarction, diastolic blood pressure and fasting glucose were significantly greater than the control group. But, no difference in systolic blood pressure, lipid level, fibrinogen, fasting insulin and c-peptide level. CONCLUSIONS: The prevalence of microalbuminuria in patients with cerebral infarction was higher than controls and it was associated with increased diastolic blood pressure(DBP) and fasting blood glucose(FBS). Therefore, microalbuminuria is associated with thrombogenic cerebral infarction and it was partly mediated by DBP and FBS.
Blood Pressure ; Blood Pressure Monitors ; C-Peptide ; Cerebral Infarction ; Fasting ; Fibrinogen ; Glucose ; Humans ; Hypertension ; Incidence ; Insulin ; Prevalence ; Risk Factors ; Stroke

Ocular complications of HIV-related cryptococcal meningitis are reasonably common, but complete binocular blindness as the first manifestation of HIV is extremely rare. A 58-year-old man presented with binocular blindness. He experienced blurred vision for 3 days before the blindness. Mild pleocytosis was present in the cerebrospinal fluid, from which Cryptococcus neoformans was cultured. Serology revealed positivity for HIV antibody. He was treated with antifungal and antiretroviral therapy. This case indicates that HIV-related cryptococcal meningitis should be taken into consideration when determining the cause of unexpected sudden binocular blindness.
Blindness* ; Cerebrospinal Fluid ; Cryptococcus neoformans ; HIV ; Humans ; Leukocytosis ; Meningitis, Cryptococcal* ; Middle Aged ; Telescopes*

Elevated levels of aspartate aminotrasferase(AST), alanine aminotransferase(ALT) and bilirubin were noted incidentally after laparoscopic cholecystectomy(LC). This study was attempted to investigate the elevation of AST, ALT and bilirubin after laparoscopic cholecystectomy without bile duct injury and it,s clinical significance. Bile duct injury is most feared complication of laparoscopic cholecystectomy. Increased liver enzymes and bilirubin levels may be indicative of this complication. But, these parameters have not been investigated in patients who had laparoscopic cholecystectomy and in whom no damage to the bile duct was noted. 906 patients with normal results of preoperative liver function test were entered into the study. Blood was collected at 24 hours, 48-72 hours and 6-8 days after laparoscopic cholecystectomy, and AST, ALT, Alkaline phosphatase(AlkP) and bilirubin levels were observed. In AST, a mean 2.33-fold increase was observed. In ALT, a mean 2.10-fold increase was observed. A mean 1.42-fold and a mean 1.73-fold increase were observed in total and direct bilirubun levels. But, AlkP was not increased. In many patients a significant increase in AST, ALT and bilirubin levels occured after laparoscopic cholecystectomy. But they returned to normal values within several days without any specific treatments. These elevations of AST & ALT without increasing of AlkP, and slight elevation of bilirubin without increasing of AlkP appear to have no obvious clinical significance, the exact cause of these elevations is unclear, and need further investigation.
Alanine ; Aspartic Acid ; Bile Ducts ; Bilirubin* ; Cholecystectomy, Laparoscopic* ; Humans ; Liver Function Tests ; Liver* ; Reference Values

To evaluate the effect of anabolic steroid(AS) on body composition and protein metabolism in malnourished CAPD patients, 7 CAPD patients who were proved to be malnourished by subjective global assessment received 200mg of AS, nandrolone decanoate, by intramuscular route monthly for 5 months. We analyzed the body composition, biochemical nutritional markers, plasma and dialysate amino acids(AA) before and after administration of AS. The mean age was 53.6+/-11.5 years, the sex ratio was 2:5, and the duration of CAPD was 28.5+/-18.7 months. Two patients were diabetics. Five months after AS administration, %lean body mass seemed to increase from 52.6+/-11.7 to 57.3+/-11.0%(P>0.05), but there were no significant changes in body weight and body mass index. Serum insulin-like growth factor-I (172.4+/-88.5 vs. 204.1+/-85.8ng/ml, P<0.05) and transferrin(213.6+/-55.4 vs. 239.0+/-55.3mg/dl, P<0.05) were significantly increased, and serum total CO2(31.1+/-4.5 vs. 25.9+/-2.5mM/L, P<0.05) were significantly decreased. Urea nitrogen appearance(4.0+/-2.0 vs. 3.6+/-1.6g/ day) seemed to be decreased. Both plasma essential AA(EAA) level(738.3+/-206.5 vs. 492.5+/-187.2micromol/L, P<0.05) and peritoneal EAA loss(565.0+/-186.1 vs. 377.4+/-113.9micromol/day, P<0.05) decreased significantly after administration. Plasma total and non- essential amino acids(NEAA) level tended to be increased and peritoneal total and NEAA loss seemed to be decreased without statistical significance. In conclusion, AS seems to have anabolic effect and be useful in the correction of malnutrition in CAPD patients.
Amino Acids ; Anabolic Agents ; Body Composition* ; Body Mass Index ; Body Weight ; Humans ; Malnutrition ; Metabolism* ; Nandrolone ; Nitrogen ; Peritoneal Dialysis, Continuous Ambulatory* ; Plasma ; Sex Ratio ; Urea

BACKGROUND/AIMS: An ectopic opening of the common bile duct (CBD) into the duodenal bulb is known to cause biliary tract diseases or peptic ulcer. Yet such a case is extremely rare and the clinical significance of this malformation has not yet been clarified. METHODS: Ten patients with an ectopic opening in the duodenal bulb and who were treated at 4 hospitals in the Chungcheong province area were enrolled. Their clinical and radiographic features and the treatment for their combined biliary diseases were retrospectively analysed. RESULTS: The mean age of the ten patients was 73 years (range: 38~84 years, 8 men, 2 women) Eight of 10 patients had clinical signs and symptoms (RUQ abdominal pain: 5, epigastric pain: 3, fever: 3, Melena: 1). The two patients without symptoms were incidentally found to have an ectopic orifice during the evaluation for bile duct dilatation and a regular health check-up, respectively. Nine had duodenal ulcer scars or bulb deformities. Four had active duodenal ulcers and one of them had bleeding from the active duodenal ulcer, which was treated by endoscopic sclerotheraphy. Six of the 10 patients (60%) had biliary tract diseases (CBD stones: 4, cholangitis without CBD stone: 1, IHD stone: 1). Cholangiography was used for evaluation in 9 patients, and it showed dilatation of the CBD or IHD in 7 (78%), a tapered common bile duct at the distal CBD in 7 (78%) and a hook-shaped distal CBD in 8 (89%). Six patients' biliary tract diseases were treated endoscopically (ERCP: 4, PTCS: 2). Duodenal perforation occurred in 1 (10%), who was successfully managed by medical treatment. CONCLUSIONS: An ectopic opening of the CBD in the duodenal bulb is frequently associated with recurrent duodenal ulcer and biliary tract disease. Combined biliary tract disease can be successfully treated endoscopically.
Bile Ducts ; Biliary Tract Diseases ; Cholangiography ; Cholangitis ; Cicatrix ; Common Bile Duct ; Congenital Abnormalities ; Dilatation ; Duodenal Ulcer ; Hemorrhage ; Humans ; Male ; Peptic Ulcer ; Retrospective Studies

OBJECTIVE: To analyze the effects of speech therapy between children with specific language impairment (SLI) and mild intellectual disability (ID). METHOD: Fourteen children with SLI and thirteen children with mild ID who had received speech therapy for more than 1 year were enrolled. The language function and cognitive function of all subjects were assessed before and after speech therapy. RESULTS: Improvement of receptive and expressive language development were shown in 78.5% and 71.4% of children with SLI, respectively. However improvement of receptive and expressive language development was shown in only 30.7% of children with ID. Improvement of verbal intelligence which had appeared in the SLI group was not shown in the ID group. CONCLUSION: Effects of speech therapy were different in children with SLI and mild ID and more favorable outcomes were demonstrated in children with SLI.
Child ; Humans ; Intellectual Disability ; Intelligence ; Language Development ; Speech Therapy

BACKGROUND: Ischemic stroke occurring during sleep is still an unexplored area of cerebrovascular event. As the exact onset time of stroke while sleeping (SWS) cannot be determined, these patients are generally excluded from the thrombolytic therapy of acute ischemic stroke. The aim of this study was to know whether differences in clinical features exist between patients suffering a SWS and those with stroke while awake (SWA). METHODS: We reviewed the medical records of acute ischemic stroke patients consecutively registered in Hallym Stroke Databank between January 1999 and June 2007. We compared the risk factors and clinical features between the SWS and SWA groups. RESULTS: A total of 2,962 patients were included in the study, of which 821 (27.7%) were SWS. No differences between SWS and SWA were identified with regard to baseline clinical characteristics and risk factors except a history of smoking. In stroke subtype, small vessel occlusions were more frequently in SWS group than SWA group. Intravenous rt-PA treatments were performed frequently in the SWA group. Clinical outcomes at discharge were better in SWA group than SWS group. CONCLUSION: This study suggest that no major differences were exist in clinical characteristics between SWS and SWA patients, except the history of smoking. Clinical outcomes of patients with ischemic stroke within 6 hours after stroke onset were poor in SWS group. In SWS group, relatively little chances of thrombolysis might be the explanation of these finding.
Glycosaminoglycans ; Humans ; Medical Records ; Risk Factors ; Smoke ; Smoking ; Stress, Psychological ; Stroke ; Thrombolytic Therapy