BACKGROUND AND OBJECTIVES: The human vestibule is known to be able to induce cervical muscle potential secondary to strong acoustic stimulations. This reflex is assumed to originate in the saccule, and is called "vestibular evoked myogenic potentials" (VEMP). The responses consist of alternatively positive and negative successive waves (p13-n23). This study was designed to evaluate the clinical significance of VEMP. MATERIALS AND METHOD: We studied the difference among the latencies of p13, n23 and the amplitudes among the 10 normal volunteers, 5 patients with sudden sensorineural hearing loss and 10 patients with vestibulopathy. And we compared the result of the caloric test and VEMP in patients with vestibulopathy. RESULTS: In the normal group, VEMP was detected in all and all of the sudden sensorineural hearing loss patients showed VEMP both in the affected and unaffected side. In unilateral vestibulopathy patients, VEMP were present in the unaffected side but not in the affected side. The difference between the amplitudes and latencies were not found in those cases where VEMP was detected. In vestibulopathy patients, VEMP were well correlated with the result of the caloric tests. CONCLUSION: We confirmed that VEMP is originated from the vestibule, not from cochlea. VEMP could provide itself as an addition method for testing the vestibule.
Acoustics ; Caloric Tests ; Cochlea ; Healthy Volunteers ; Hearing Loss, Sensorineural ; Humans ; Reflex ; Saccule and Utricle

Hemorrhage associated with an intracranial neoplasm is a rare event and can produce a serious outcome. Most of the intracranial hemorrhages in brain tumors are in the subarachnoid, intracerebral, or subdural area and cases of intratumoral or intraventricular hemorrhage are relatively rare. The authors report two cases of brain tumors associated with intratumoral and intraventricular hemorrhage which occurred during the preoperative embolization. The diagnoses were petro-clival hemangiopericytoma and suspected intraventricular meningioma. There was no specific precipitating factor for the bleeding. We discuss the possible mechanisms of intracranial hemorrhage in these cases, and stress the unexpected complication when performing preoperative embolization.
Brain Neoplasms* ; Brain* ; Diagnosis ; Hemangiopericytoma ; Hemorrhage ; Intracranial Hemorrhages* ; Meningioma ; Precipitating Factors

No abstract available.
Cerebral Ventricles* ; Hydrocephalus*

Angiosarcoma is very rare but highly malignant soft tissue tumor derived from the vascular endothelium. This tumor is most commonly found in the skin and subcutaneous tissues. Angiosarcoma is known to cause early and widespread metastasis leading to a very poor prognosis of less than 24 months. We report a case of angiosarcoma developed in the temporoparietal scalp of a 84-year-old man. The patient was referred for us consultation after failed systemic antibiotic treatment, incision drainage treatment for "cellulitis" by the general physician. We performed excision and biopsy. The histologic finding of the lesion showed that irregular, complex vascular channels in dermis. The tumor cells were positive for Factor VIII-related antigen. The lesion was confirmed as cutaneous angiosarcoma. We recommended a radical surgery and reconstruction followed by adjuvant radiation, but the patient refused. The patient was expired 2 months thereafter because of a massive hemorrhagic pleural effusion by suspicious distant metastasis. Authors reported important aspects of clinical findings, histologic features and therapeutic options of the scalp angiosarcoma.
Aged, 80 and over ; Biopsy ; Dermis ; Drainage ; Endothelium, Vascular ; Hemangiosarcoma* ; Humans ; Neoplasm Metastasis ; Pleural Effusion ; Prognosis ; Scalp* ; Skin ; Subcutaneous Tissue ; von Willebrand Factor

Mondor's disease is also called thrombophlebitis and it is not a common condition. The characteristics finding of Mondor's disease is a subcutaneous cord that is tender and tense. This disease commonly occurs in the breast and abdomen. The etiology of Mondor's disease is unknown, but the generally agreed on causes are trauma, excessive exercise and breast surgery. On rare occasions, this disease is related to malignancy, pregnancy, filariasis and so on. This disease is self limiting and it is usually treated conservatively and symptomatically. We treated one woman who had Mondor's disease on the anterior side of the left elbow. This is a very rare location for Mondor's disease and so clinicians need to be aware about the possibility of this unusual presentation for this disease.
Abdomen ; Breast ; Elbow ; Female ; Filariasis ; Humans ; Pregnancy ; Thrombophlebitis ; Transcutaneous Electric Nerve Stimulation

Cerebral sparganosis is a rare parasitic CNS disease. Recently we have experienced a case of sparganosis involving bilateral cerebral hemispheres. The brain CT scan and MRI with administration of the contrast material demonstrated an intensely enhanced lesion in the left parietal area, and low density lesions in the right parieto-occipital area and left occipital area with cerebromalacia. The titer of the anti-spargasnum IgG antibody in serum and CSF was high. The parasitic granulation capsule and inflammatory tissue were removed from the left parietal area using the Cosman-Roberts-Wels stereotactic guide.
Brain ; Central Nervous System Diseases ; Cerebrum* ; Encephalomalacia ; Immunoglobulin G ; Magnetic Resonance Imaging ; Rabeprazole ; Sparganosis* ; Tomography, X-Ray Computed

PURPOSE: To investigate the role of the posterior vitreous detachment as a factor affecting visual acuity after laser treatment on macular edema in eyes with branch retinal vein occlusion (BRVO). METHODS: We retrospectively studied the medical records of 55 BRVO patients who were treated with argon laser photocoagulation for macular edema. The eyes were classified as those with posterior vitreous detachment (PVD, group I, 21 eyes) and those with no or partial PVD (group II, 34 eyes). The visual acuity before and after laser treatment was compared according to the posterior vitreous status. RESULTS: The eyes with visual acuity gaining two or more lines, final visual acuity of 0.5 or better, and mean change of visual acuity after laser treatment were 66.0%, 38.1%, and 1.8 lines in group I and 41.2%, 32.4%, and 1.6 lines in group II, respectively (p>0.05). Factors responsible for no change or decrease of visual acuity after laser treatment were macular ischemia, macular degeneration or exudate, and epiretinal membrane. CONCLUSIONS: PVD can be a prognostic factor for macular edema with BRVO. We should carefully examine for the presence of PVD in eyes with BRVO.
Argon ; Epiretinal Membrane ; Exudates and Transudates ; Humans ; Ischemia ; Light Coagulation ; Macular Degeneration ; Macular Edema* ; Medical Records ; Retinal Vein Occlusion ; Retrospective Studies ; Visual Acuity ; Vitreous Detachment

We report a case of multiple cerebral infarcts, which developed after intra-arterial(IA) carboplatin therapy in a patient with glioblastoma who had received surgery with conventional and intraoperative radiation therapy (IORT). A 31-year-old male patient presented with one-month history of worsening headaches and visual dimness. Seven years previously, he had been subjected to a subtotal resection of anaplastic astrocytoma in the right occipital lobe, followed by external radiation therapy with a total dose of 5580cGy. Carboplatin was given at an initial dose of 300mg/m2. Before and after the infusion of carboplatin, solumedrol(500mg/day) was given for seven days, with the dosage being gradually reduced over the next five days. In addition, 20% mannitol(100ml) was infused over a 15-minute period before chemotherapy, and the fluid volume of electrolyte was adjusted to maintain an optimal urine output. The patient underwent five cycles of IA carboplatin therapy. Careful attention should be given during IA carboplatin chemotherapy to patients who are also being treated with IORT.
Adult ; Astrocytoma ; Carboplatin* ; Drug Therapy ; Glioblastoma ; Headache ; Humans ; Male ; Occipital Lobe

STUDY DESIGN: Prospective observational study. OBJECTIVES: The aim of this study was to examine the usefulness of a fentanyl matrix patch in the management of chronic low back pain. SUMMARY OF LITERATURE REVIEW: Chronic low back pain is a significant disabling disease with high medical costs and socioeconomical effects. Oral medication is a fundamental tool for conservative treatment. The fentanyl matrix patch is currently regarded as an alternative method for oral medication, however, the usefulness of the fentanyl matrix patch has not been fully evaluated. MATERIALS AND METHODS: From September 2008 to May 2009, a multicenter, open, prospective observational study was conducted. The inclusion criteria included chronic pain patients that did not respond to conservative pain management. The clinical usefulness was evaluated with pain intensity, and the KEQ-5D (Korean version of Euro QoL-5 dimension). RESULTS: Overall, 538 patients were included in this study. The pain intensity decreased about 1.84 +/- 1.91 at the second visit and further decreased by about 2.52 +/- 2.34 at the third visit (p<0.0001). The KEQ-5D score decreased about 0.12 +/- 0.18 at the second visit, and decreased further to 0.18 +/- 0.24 at the third visit (p<0.0001). The number of patients with adverse effects was 121 (22.49%). CONCLUSIONS: The fentanyl matrix patch improves the pain and disability in patients with chronic low back pain. It is a useful alternative method for the management of chronic low back pain.
Chronic Pain ; Fentanyl* ; Humans ; Low Back Pain* ; Observational Study ; Pain Management ; Prospective Studies

Hypertension is a rare but well-documented manifestation of neuroblastoma. This is a case in which a hypertensive 8 month-old male with a large left adrenal mass was diagnosed as pheochromocytoma and prepared for surgery with alpha adrenergic blockers and beta adrenergic blockers. Vital signs prior to induction of anesthesia and during surgery also mimicked pheochromocytoma but pathologic examinations revealed neuroblastoma. Laboratory findings also supported pheochromocytoma taking into account the fact that hypertension is rare in neuroblastomas.
Adrenergic alpha-Antagonists ; Adrenergic beta-Antagonists ; Anesthesia ; Child* ; Humans ; Hypertension* ; Infant ; Male ; Neuroblastoma* ; Pheochromocytoma ; Vital Signs