No abstract available.

A 34-year-old male patient was first admitted to our Department on October 16, 1965. He complained of frontal headaches especially in the morning and ild right hemiparesis over the previous 6 months, which were progressively more severe as time went by. On examination, he was mentally clear ut slightly dysphasic: there were mild right hemisparesis and marked bilateral papilledema. Angiogram showed a left posterior frontal vascular tumor. At operation on November 3, 1965, total excision of a posterior frontal parasagittal tumor was performed. To the naked eye, this seemed to be a meningioma; the tumor was egg-sized, round but somewhat lobulated, graysish white in color, firm and fibrotic appearance, and it attached to the superior longitudinal sinus, involving without occluding it. Histologically. It was considered a meningioma of firbrolastic type, containing small amount of capillaries and some areas of collegen deposition around the fibroblasitc cell masses with foci of meningoendothelial cluster; though some doubt was expressed over its innocence. He tolerated the resection of frontal tumor well, and remained in relatively good health for 7 years, as to do his usual farmer work with minimal right hemiparesis. There were some episodes of generalized seizure during there periods. The patients was readmitted on December 25, 1972, however, because of frontal headaches and vomiting over recent 6 months and dysphasia, mental confusion developing rapidly over the previous 3 months. Urinary incontinence was also complained of. On examination he was drowsy, apathetic and mentally confused, more so than when first admitted. There was a goose-egg sized tense bulging in the left frontotemporal region, previously operated. Central-typed right facial palsy, right hypoglossal palsy and bilateral marked papilledema were noted. There were spastic hemiparesis, greater in the upper extremity, and long tract signs on the right side. Angiogram revealed a posterior frontal parasagittal vascular tumor, much as before. At operation on January 5, 1973, subtotal resection of tumor was performed, remaining the deep-seated parasagittal posterior frontal mass. The gross appearance of tumor was necrotic partially on the surfaces, potato-shaped with nodularith and pinkish white in color. On sectioning cut surface was slightly myxoid with cystic degeneration in the center. There was also patchy degeneration, showing yellow tinge in the cut surface. Microscopically, there were prominent hypercellularity with many mitoses, atypism, pleomorphism and degenerative process. Vascutar reaction with amyloid-like infiltration in perivascular area was also demonstrated as with focal pseudocartilagenous degeneration and partial hemorrhage; overall findings were highly suggestive of recurrent memingioma with malignant change (sarcomatous change) in left posterior frontal parasagittal region.
Adult ; Aphasia ; Capillaries ; Facial Paralysis ; Headache ; Hemorrhage ; Humans ; Male ; Meningioma* ; Mitosis ; Muscle Spasticity ; Papilledema ; Paralysis ; Paresis ; Seizures ; Superior Sagittal Sinus ; Tolnaftate ; Transcutaneous Electric Nerve Stimulation ; Upper Extremity ; Urinary Incontinence ; Vomiting

Trigeminal neurinoma is a rare condition arising from the gasserian or trigeminal nerve root. It comprises 0.2% of all brain tumors, and usually affects middle life, but about 10% of it appears in adolescents. Middle fossa syndrome, symptoms and signs of cerebellopontine angle tumor and mixture of these may be developed through the extension of the tumor. Symptoms and signs of cerebellar and midbrain compression may also be elicited in some stage of the tumor. Erosion of the Anteromedial portion of the petrous apex and defect of the flow of the middle fossa contribute to the diagnosis. Air studies and cerebral antiography have been used, and recently pantopaque basal cisternography has been introduced. The route of operation depends upon the main localization of the tumor, but transtemporal approach with tentorial section is widely used for dumbbell-shaped tumor. A case of cerebellopontine angle tumor which had been postoperatively proved to be a trigeminal neurinoma is reported.
Adolescent ; Brain Neoplasms ; Diagnosis ; Humans ; Iophendylate ; Mesencephalon ; Neurilemmoma* ; Neuroma, Acoustic ; Puberty* ; Trigeminal Nerve

Trigeminal neurinoma is a rare condition arising from the gasserian or trigeminal nerve root. It comprises 0.2% of all brain tumors, and usually affects middle life, but about 10% of it appears in adolescents. Middle fossa syndrome, symptoms and signs of cerebellopontine angle tumor and mixture of these may be developed through the extension of the tumor. Symptoms and signs of cerebellar and midbrain compression may also be elicited in some stage of the tumor. Erosion of the Anteromedial portion of the petrous apex and defect of the flow of the middle fossa contribute to the diagnosis. Air studies and cerebral antiography have been used, and recently pantopaque basal cisternography has been introduced. The route of operation depends upon the main localization of the tumor, but transtemporal approach with tentorial section is widely used for dumbbell-shaped tumor. A case of cerebellopontine angle tumor which had been postoperatively proved to be a trigeminal neurinoma is reported.
Adolescent ; Brain Neoplasms ; Diagnosis ; Humans ; Iophendylate ; Mesencephalon ; Neurilemmoma* ; Neuroma, Acoustic ; Puberty* ; Trigeminal Nerve

OBJECTIVES: Paroxetine is known to have fewer cognitive side effects than older antidepressants such as amitriptyline. To confirm this objectively, we compared the effects of paroxetine on the psychomotor performance with those of amitriptyline in 10 healthy volunteers. METHOD: Paroxetine and amitriptyline were administered orally in a double-blind, two-way, single dose, crossover design. Assessments of psychomotor performances were carried out before and 2 and 6 hours after administration of single dose of paroxetine (40mg) or amitriptyline (50mg). Each treatment day was separated by 1 week of washout period. The psychomotor performances were measured using Vienna Determination Unit, Vienna Reaction Time, Vienna Signal Detection, Grooved Pegboard Test and Finger Tapping Test. The data were analyzed using two-way, repeated measures ANOVA on a crossover model. RESULTS: The results showed that paroxetine 40mg produced no significant performance decrements on the every test of psychomotor performances, whereas amitriptyline 50mg produced markedly impaired performance on most of the psychomotor tests. CONCLUSION: This study confirmed pervious findings that paroxetine is generally devoid of adverse side effects on psychomotor performance.
Amitriptyline* ; Antidepressive Agents ; Cross-Over Studies ; Fingers ; Healthy Volunteers* ; Paroxetine* ; Psychomotor Performance ; Reaction Time

A61-year-old head-injured patient exhibited acute onset of paraplegia during hospital in-care. Review of radiographs showed an occult linear transverse fracture line between the T11 and T12 vertebrae. An MRI scan performed after paraplegia showed compression of the spinal cord by a bony fragment. This case report presents a rare but devastating complication of an occult fracture at the T-L junction in patient with ankylosing spondylitis which was considered less significant due to more severe head injury. Thorough clinical and roentgenographic examination of the entire vertebral column is recommended in patients with ankylosing spondylitis who have sustained injury. Even if minor spinal trauma occurs in such clinical setting, the condition should be managed as a spinal fracture with potentially serious neurologic complications.
Craniocerebral Trauma ; Fractures, Closed* ; Humans ; Magnetic Resonance Imaging ; Paraplegia ; Spinal Cord ; Spinal Fractures ; Spine ; Spondylitis, Ankylosing*

Candida exists in the oral cavity as normal flora, which is cultured in 7% of the population. And the development of candidiasis is usually related to the systemic or local immunosuppressed status such as diabetes, long-term antibiotics, steroid, radiation therapy or chemotherapy. However, isolated laryngeal candidiasis in immunocompetent patients is a rare entity with fewer than 40 cases reported in the world. Symptoms of laryngeal candidiasis are variable such as hoarseness, dysphagia, or odynophagia according to its extent, but it has clinical importance because of its resemblance with laryngeal premalignant or malignant lesions. Diagnosis is made by biopsy under direct laryngoscopy with special staining to identify the hyphae. In this article, we report a case of laryngeal candidiasis presented as leukoplakia localized on vocal fold with literature reviews.
Anti-Bacterial Agents ; Biopsy ; Candida ; Candidiasis* ; Deglutition Disorders ; Diagnosis ; Drug Therapy ; Hoarseness ; Humans ; Hyphae ; Laryngoscopy ; Larynx ; Leukoplakia* ; Mouth ; Vocal Cords

A 44-year-old Korea woman was admitted to our department on March 5, 1973 with complaints of low back pain and radiating leg pain on the right side which have persisted for past 4 years. Howeve , the patient had a history of radiating leg pain on the left side about 8 years ago. Physical examination revealed paravertebral muscle spasm on both sides, limited backward bending, normal straight leg raising test, decreased ankle jerk on both sides and mild sensory change in the right L5 dermatome. Plain radiograms of the lumbar spine showed decreased normal lumbar lordosis and narrowing of L4-5 and L5-S1 interspaces. Myelogram demonstrated partial obstruction by marked bilateral indentation filling defect at L4-5 level, narrowing of dye column below that level, and abnormal root sleeves. Under the impression of herniated L4-5 intervertebral disc, total laminectomies of the 4th and 5th lumbar vertebrae were performed and found relatively hypertrophic limagentum flavum and bilaterally conjoined roots commonly originating from dural sac. Following decompression that would was closed routinely. Postoperatively all symptoms were improved.
Adult ; Animals ; Ankle ; Decompression ; Female ; Humans ; Intervertebral Disc ; Korea ; Laminectomy ; Leg ; Lordosis ; Low Back Pain ; Lumbar Vertebrae ; Physical Examination ; Spasm ; Spine

BACKGROUND: Hyperhomocysteinemia plays an important role in atherosclerosis resulting from endothelial dysfunction and injury followed by platelet activation and thrombus formation. We evaluated the prevalence and determinants of hyperhomocysteinemia in patients with chronic renal failure(CRF) and relationship between hyperhomocysteinemia and cardiovascular diseases. METHODS: We evaluated the prevalence of hyperhomocysteinemia in CRF patients and hemodialysis patients. Fasting plasma homocysteine, vitamin B12, vitamin B6, creatinine, fibrinogen, lipoprotein(a), glucose, total cholesterol, HDL cholesterol, and TG levels were assessed in 69 patients. RESULTS: Hyperhomocysteinemia was detected 5% in controls, 86% in CRF groups, and 85% in hemodialysis group. Serum folate value in hemodialysis group was significantly higher than normal controls (10.7+/-4.8 vs. 15.3+/- 5.4nmoL/L; p<0.05). Plasma homocysteine concentration negatively correlated with serum folate level in hemodialysis patients(r=-0.42, p<0.05). Cardiovascular diseases were deteceted 14% in CRF patients and 25% in hemodialysis patients. Matched odds ratios(with 95% confidence intervals) were respectively 118.75, 107.7 for homocysteine in CRF and hemodialysis patients compaired with control group. CONCLUSION: Plasma homocysteine level correlated negatively with serum folate level in hemodialysis patients. In univariate analysis, determinant of plasma homocysteine concentration in hemodialysis patients is plasma folate concentration. We considered that hyperhomocysteinemia is also an independent risk factor of cardiovascular diseases.
Atherosclerosis ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Creatinine ; Fasting ; Fibrinogen ; Folic Acid ; Glucose ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Kidney Failure, Chronic* ; Lipoprotein(a) ; Plasma ; Platelet Activation ; Prevalence* ; Renal Dialysis ; Risk Factors ; Thrombosis ; Vitamin B 12 ; Vitamin B 6

Castleman disease is a relatively rare disorder of lymphoid tissue that involves the gastrointestinal tract in a variety of clinical and pathologic manifestations. A submucosal location has never been described in the medical literature. We report a case of esophageal Castleman disease involving thesubmucosal layer in a 62-year-old man, which was confirmed on pathology. Esophagography and CT demonstrated an intramural tumor, and a leiomyoma or leiomyosarcoma was suspected based on the known incidence of such tumors.
Mucous Membrane/*pathology ; Middle Aged ; Male ; Humans ; Giant Lymph Node Hyperplasia/*diagnosis ; Esophageal Diseases/*diagnosis ; Endoscopy ; Diagnosis, Differential