Cycloserine is a broad spectrum antibiotic used as a second drug for treatment of drug resistant tuberculosis. Inappropriate usage in excessive doses can give rise to neurological problems. We report a case who developed aphasia, anxiety and seizure during anti-tuberculosis medication. MRI of the brain showed reversible cytotoxic edema in dentate nuclei. Clinical and MRI findings were consistent with cycloserine toxicity.

Meningioma is a common neoplasm of the central nervous system; however, primary extracranial meningioma of the paranasal sinus, especially the maxillary sinus, is rare. We report a case of primary extracranial meningioma (fibrous type) of the maxillary sinus and present a literature review of the imaging features that correlate with fibrous meningioma.

The incidence of skull tuberculosis is very rare, with only a few cases reported as a result of a simple radiography and computed tomographic findings. In this study, we report the magnetic resonance image (MRI) findings of a case of skull tuberculosis, which was confirmed histologically.
Frontal Bone ; Incidence ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Skull ; Tuberculosis ; Tuberculosis, Osteoarticular

The two distinct types of axonal degeneration that occur after neuronal injury include Wallerian degeneration (WD) and transneuronal degeneration. The most commonly recognizable cause of secondary degeneration is cerebral infarction, but may also include a variety of conditions including hemorrhage, trauma, necrosis, and focal demyelination. Herein, we present a rare case of WD of the cerebellar peduncles accompanied by unilateral hypertrophic olivary degeneration following pontine hemorrhage.

PURPOSE: We wanted to analyze the mammographic and clinical findings of the non-mass image-forming low echoic areas seen on breast ultrasonography (US) and investigate their pathologic results. MATERIALS AND METHODS: Sixty-nine patients with 72 non-mass image-forming low echoic areas seen on breast US and who had undergone mammography and biopsy were included in this study. The mammographic findings were divided into 2 groups: 1) the negative or probably benign group and 2) the suspicious for malignancy group. The US findings were divided into 3 groups: focal, segmental and diffuse distributions. The clinical findings were divided into 2 groups: the non-palpable and palpable groups. We investigated the pathologic results according to each group. RESULTS: Of the 72 lesions, 49 (68.1%) were benign and 23 (31.9%) were malignant. On the mammography, 42 (93.3%) of the 45 negative or probably benign findings and 7 (25.9%) of 27 suspicious for malignancy findings were pathologically benign (p < 0.001). On the US, 38 (76%) of the 50 focal distributions and 11 (52.4%) of 21 segmental distributions were benign (p = 0.090). Thirty (73.2%) of the 41 nonpalpable lesions and 19 (61.3%) of the 31 palpable lesions were benign (p = 0.609). CONCLUSIONS: A non-mass image-forming low echoic area seen on breast US was malignant at a higher rate when it was found in conjunction with suspicious mammographic finding. There was no significant correlation between the distribution of the non-mass image-forming low echoic areas on US or their palpability and the pathologic results.
Biopsy ; Breast ; Humans ; Mammography ; Ultrasonography, Mammary

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant inherited disease characterized by epistaxis, telangiectases and visceral arteriovenous malformations (AVMs). The involvement of the gastrointestinal tract, liver, lung and cerebrum for HHT has been described, whereas little is known about AVMs of the spleen. We report here the radiological findings of a case of a splenic AVM manifested by thrombocytopenia in HHT.
Arteriovenous Malformations ; Cerebrum ; Epistaxis ; Gastrointestinal Tract ; Liver ; Lung ; Spleen ; Telangiectasia, Hereditary Hemorrhagic ; Telangiectasis ; Thrombocytopenia

BACKGROUND/AIMS: The purpose of this study was to assess the value of acoustic radiation force impulse (ARFI) for predicting the extent of radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) by correlating the elasticity of HCC and peritumoral parenchyma (as measured by ARFI) with the extent of ablation determined by computed tomography (CT). METHODS: From September 2009 to June 2011, 158 patients underwent RFA ablation for HCC (single, < or =3 cm). We evaluated the data of a total of 38 prospectively enrolled patients who underwent both ARFI imaging and contrast-enhanced CT after one session of 12 minutes of RFA without a change in needle position. The ARFI imaging indices, including the mean shear wave velocity (SWV) of HCC, mean SWV of the peritumoral parenchyma and tumor size, were evaluated to determine the statistical correlation with RFA extent after one session of 12 minutes of RFA. RESULTS: A stiffer liver parenchyma in patients with cirrhosis results in a smaller ablation zone. CONCLUSIONS: SWV of ARFI in liver parenchyma was well correlated with RFA extent. After evaluating the correlation between ARFI and RFA extent, we suggest that the SWV in liver parenchyma might be a non-invasive supplementary tool for predicting the extent of RFA.
Acoustics ; Carcinoma, Hepatocellular ; Elasticity ; Elasticity Imaging Techniques ; Fibrosis ; Humans ; Liver ; Needles ; Prospective Studies

This case is about 68-years old male patients who was exposed to hexavalent chromic acid on whole body. After the accident, he was transferred to burn center and received massive fluid resuscitation. Despite of the resuscitation, renal failure had pro -gressed and pulmonary dysfunction happened subsequently. Pulmonary dysfunction had aggravated that ECMO was required on hospital day 3, the patient had been transferred to other hospital that could manage the condition of the patient. Soon after the transfer, the patient died. We report this case because the acute chromic acid poisoning lead to multiple organ failure including renal impairment.

BACKGROUND: Thyroid function depends on ethnic and environmental factors. North Korean refugees have the same genetic background as South Koreans, but they have been exposed to different environments. This study examines the prevalence and pattern of thyroid disorders in North Korean women living in South Korea, focusing on subclinical hypothyroidism (SCH). METHODS: The intended sample was a total of 327 North Korean women residing in Seoul. Health questionnaires and medical examinations, including serum thyrotropin (thyroid stimulating hormone, TSH), free thyroxine, and thyroid autoantibodies, were conducted. RESULTS: The prevalence of SCH was 9.4%. In logistic regression analysis, smoking, menopause, length of stay in South Korea, body mass index, history of thyroid disease, and metabolic syndrome were not associated with the risk of SCH. Whereas, the positivity of autoantibodies were associated with a high risk for SCH (odds ratio [OR], 4.840; 95% confidence interval [CI], 1.80-13.017; P = 0.002), and age was associated with a low risk for SCH (OR, 0.94; 95% CI, 0.888-0.994; P = 0.031). The serum TSH levels also decreased with increasing age, and in particular, there was significant difference between 30-39 years, and over 60 years (2.33 +/- 1.51 microIU/mL vs. 1.54 +/- 0.73 microIU/mL, P = 0.028). CONCLUSION: In North Korean women, the positivity of autoantibodies was associated with a high risk for SCH. But interestingly, a younger age was associated with a high risk for SCH. Considering that they suffered from severe famine at the period of growth, and this led to malnutrition, their thyroid dysfunction might be associated with the peculiar environment that they experienced.
Autoantibodies ; Body Mass Index ; Female ; Humans ; Hypothyroidism ; Length of Stay ; Logistic Models ; Malnutrition ; Menopause ; Prevalence ; Refugees ; Republic of Korea ; Smoke ; Smoking ; Starvation ; Thyroid Diseases ; Thyroid Gland ; Thyrotropin ; Thyroxine ; Surveys and Questionnaires

A clinical practice guideline for patients in the dying process in general wards and their families, developed through an evidence-based process, is presented herein. The purpose of this guideline is to enable a peaceful death based on an understanding of suitable management of patients’ physical and mental symptoms, psychological support, appropriate deci-sion-making, family care, and clearly-defined team roles. Although there are limits to the available evidence regarding medical issues in patients facing death, the final recommendations were determined from expert advice and feedback, considering values and preferences related to medical treatment, benefits and harms, and applicability in the real world. This guideline should be applied in a way that takes into account specific health care environments, including the resources of medical staff and differences in the available resources of each institution. This guideline can be used by all medical institutions in South Korea.