Global aphasia without other focal neurologic lateralizing signs (GWLS) is an uncommon stroke syndrome. The pathogenesis of GWLS has been thought as the result of multiple cardioembolism. However, a few cases of GWLS with a single lesion have been reported. We report an unusual case of GWLS with a single left superior temporal infarction. A 73-year-old right handed man was admitted with receptive and expressive language impairment without other focal neurologic lateralizing signs. The patient's global aphasia symptom has being 4 weeks after symptom onset. Brain CT showed only one lesion of left superior temporal lobe. Our case notes that the multiple lesions of the speech area are not only necessary to produce GWLS, and it is not necessarily imply a double lesion or an embolic causes.
Aged ; Aphasia* ; Brain ; Hand ; Humans ; Infarction ; Stroke ; Temporal Lobe

Two patients with moyamoya disease are reported whose initial and predominant manifestations were choreic movements. Choreic movements were recurrent and were often tnggered by excitement, emotional tension, or insomnia There were occurred unilaterally Moyamoya disease must be considered in the differential diagnosis of acquired chorea in young adults.
Chorea* ; Diagnosis, Differential ; Humans ; Moyamoya Disease* ; Sleep Initiation and Maintenance Disorders ; Young Adult

Ventricular performance was evaluated in 21 patients with uncomplicated acute transmural myocardial infarction (10 anterior and 11 inferior). Left ventricular global and regional ejection fraction, ejection rate and right ventricular ejection fraction were assessed using radionuclide ventriculography. The results were as follows : 1) In anterior infarction, left ventricular global ejection fraction was more significantly depressed than in inferior infarction(mean+/-SD : 33. 0+/-15.4% versus 48.6+/-7.0%, P<0.01). 2) In inferior infarction, right ventricular global ejection fraction was more depressed than in anterior infarction(33.3+/-9.8% versus 45.0+/-13.2%, P<0.05). 3) Regional ejection fraction of septal, apico-inferior and posterolateral wall were found to be depressed in anterior infarction than in inferior infarction, but no significant differences were present. It is concluded that the magnitude of right and left vnetricular dysfunction was affected by the location of acute transmural infarction.
Humans ; Infarction ; Myocardial Infarction* ; Radionuclide Ventriculography ; Stroke Volume

No abstract available.
Lipoprotein(a)* ; Risk Factors*

Onychomycosis is a common infection of the nail, with its prevalence estimated at 20 percent. However, a significant proportion of patients, perhaps as high as 20~40%, is classified as treatment failures and/or relapse following treatment. Several factors such as antifungal resistance, dermatophytoma, preexisting nail dystrophy, reinfection from the surrounding infected tissue can influence the success of a particular monotherapy. Therefore, the combination of antifungal drugs to produce synergistic activity is one possible advance towards achieving higher cure rates. The combination therapies have been known to increase antifungal spectrum and potency of drugs, facilitate drug delivery and reduce fungal load in nail plate. Their final goals are to increase a tolerance and maximize the therapeutic efficacy. Considering the special circumstance of the nail, the oral/topical combination is the most appropriate, for it increases drug concentration in the nail plate by mutual complementary cooperation. Treatment of onychomycosis requires long-term systemic medication of antifungal agent, and its complete cure rates were only 30~50%. Clinical success rate is determined by patients compliance which depends on treatment method and period. In practice, compliance of long-term treatment was very low, possibly attributable to longer treatment duration. Another challenge was relapse and/or reinfection after cure. The authors have attempted to address the issue concerning the method of treatment and duration of action for oral antifungal agents commonly used in practice today, and whether there is a statistically significant difference among those drugs, based on the studies analyzing patient compliance.
Antifungal Agents ; Compliance* ; Humans ; Onychomycosis* ; Patient Compliance ; Prevalence ; Recurrence ; Treatment Failure

Herpes zoster may be associated with a number of neurological complication. Herper zoster ophthalmicus and delayed contralateral hemiparesis is a well-described entity. We report a patient who had acute cerebral infarction 8 weeks after herpes zoster ophthalrnicus. Brain CT disclosed large cerebral infarction in the right middle cerebral artery territory. Decompressivecraniectomy was perforrned because of the impending uncal herniation on the 4th admission day. Pathological finding of resected brain parenchyrna and meninges showed the early cerebral infarction without evidence of vasculitis or er;cephalitis. Postoperatively the patient was improved.
Brain ; Cerebral Infarction ; Herpes Zoster* ; Humans ; Meninges ; Middle Cerebral Artery ; Paresis* ; Vasculitis

The generally accepted taste pathway in an animal projects ipsilaterally from the solitary nucleus. However, the path-way of gustatory fibers in the human brainstem has not been sufficiently clarified. A 57-year-old hypertensive man was admitted with sudden dizziness and hemiageusia. A neurological examination revealed also a diminution of taste on the left half of his tongue. A MRI showed a high signal intensity in the right lower pontine area. This case suggests that the unilateral lesion of the pons may lead to contralateral taste disturbances.
Ageusia ; Animals ; Brain Stem ; Cerebral Infarction ; Dizziness ; Facial Nerve ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Examination ; Pons ; Solitary Nucleus ; Tongue

No abstract available.
Pheochromocytoma*

Pulmonary asbestosis is defined as bilateral diffuse interstitial fibrosis of the lungs caused by exposure to asbestos. Many occupations are at risk for asbestos exposure, particularly in the mining, milling, manufacturing, construction, shipbuilding, and automotive industries. Therefore, the prevalence of asbestosis should be fairly widespread. The diagnosis of asbestosis can be made on either clinical or pathological grounds. We recently encountered one case of asbestosis which was confirmed histologically. On HRCT, there was ground-glass opacity with irregular linear shadows, subpleural curvilinear lines and parenchymal bands. Neither plaque nor calcification were noted. The histologic findings observed on open-lung biopsy specimen were well in accord with those in HRCT. Many asbestos-coated bodies were present along with black dust.
Asbestosis/radiography* ; Asbestosis/pathology* ; Biopsy ; Case Report ; Human ; Male ; Middle Age ; Radiography, Thoracic ; Tomography, X-Ray Computed

A 57-year-old man complained of sudden hearing loss and vertigo as sole initial symptoms. Pure tone audiometry revealed severe bilateral sensorineural hearing loss. Brain MRI demonstrated multiple scattered small acute infarctions in the bilateral thalami, occipital lobe, cerebellum and ventral upper pons, however, none in the level of vestibulocochlear nuclei. Cerebral angiography revealed vertebrobasilar occlusion with collateral circulation. On the seventh day of the patient's hospital stay, he developed dysarthria, dysphagia and ataxia. Five months later, his hearing loss persisted, but other neurologic deficits improved substantially.
Ataxia ; Audiometry ; Brain ; Cerebellum ; Cerebral Angiography ; Collateral Circulation ; Deafness ; Deglutition Disorders ; Dysarthria ; Hearing Loss ; Hearing Loss, Bilateral* ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Humans ; Infarction ; Length of Stay ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Manifestations ; Occipital Lobe ; Pons ; Vertebrobasilar Insufficiency ; Vertigo*