Although some cases of benign positional vertigo are associated with a chronic ipsilateral sensorineural hearing loss, an association with simultaneous ipsilateral sudden deafness is rare. We report a 53-year old woman with sudden deaf-ness with simultaneous positional vertigo in the same ear characterized by benign paroxysmal positional vertigo of pos-terior semicircular canal type. After a modified Epley particle-repositioning maneuver, the patient's vertigo was resolved. Clinical and neuro-otologic evaluations suggested that the lesion responsible for this patient was probably located within inner ear rather than within the vestibulocochlear nerve. (J Korean Neurol Assoc 19(4):410~412, 2001)
Ear ; Ear, Inner ; Female ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden* ; Humans ; Middle Aged ; Semicircular Canals ; Vertigo* ; Vestibulocochlear Nerve

A 44-year-old man showed recurrent paroxysmal amnesic attacks following viral encephalitis which, despite antiepileptic treatment, developed into status epilepticus. Interestingly, the amnesic attacks mainly consisted of amnesia for retrograde events. After recovery from status, he showed a persistent amnesia which was characterized as disproportionate retrograde amnesia for the past 20 years. We attribute the amnesic attacks in the acute stage to a transient epileptic amnesia and the profound retrograde amnesia in the chronic stage to status- or infection-related focal brain damage.
Adult ; Amnesia ; Amnesia, Retrograde* ; Brain ; Encephalitis, Viral* ; Humans ; Status Epilepticus

No abstract available.
Encephalitis, Viral* ; Histiocytic Necrotizing Lymphadenitis*

Acute changes of the bilateral basal ganglia shown in the brain MRI a diabetic uremic patient have been rarely reported. We report a 52-year-old diabetic uremic patient who had neurological disturbances. At admission, axial diffusion-weighted images and T2-weighted images showed high signal intensities in the bilateral basal ganglia, and axial T1-weighted images visualized low signal intensities in same area. The underlying mechanism may be associated with metabolic as well as vascular factors.
Basal Ganglia* ; Brain ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Uremia

We experienced 3 cases of food-borne botulism within a family. They presented with progressive ptosis, dysphonia, dysarthria and limb weakness, which had started about 12 hours after ingestion of vacuum-packed sausage. Two cases progressed to respiratory failure. Botulinum toxin A was detected from the stool sample of one case. Conservative treatment with mechanical ventilation was done and they recovered from respiratory failure over a 30-70 days period. This is the first case report of food-borne botulism in Korea.
Botulinum Toxins ; Botulism* ; Dysarthria ; Dysphonia ; Eating ; Extremities ; Humans ; Korea ; Respiration, Artificial ; Respiratory Insufficiency

PURPOSE: We performed 65 cases of posterior fusion surgery for cervical and/or high thoracic lesions using a polyaxial screw-rod system. PATIENTS AND METHODS: A total of 486 screws were implanted in 65 patients. RESULTS: Fixation of the screws was carried out over an average of 2.9 spinal segments. Upon evaluation by postoperative CT scans, twelve (2.5%) screws had suboptimal trajectories but two of these revealed radiculopathy in one patient and required screw repositioning. No vascular sequelae resulted. There has been no segmental motion in any of the cases to date. As for other complications, there was one case of dural tearing and two cases of lateral mass fractures. There were no infections or other wound healing problems or hardware failures. No patients had neurological deterioration after surgery. There were statistically significant improvements in the mean Neck Disability Index (NDI) scores and Visual Analogue Scale (VAS) scores in the preoperative and late postoperative follow-up evaluations. Although further studies are required to establish the long-term results of fusion rates and clinical outcomes. CONCLUSION: We cautiously suggest that the posterior polyaxial screw-rod system can be safely used as a primary or additional fusion method in this risky region. The successful and safe use of this method is dependent on a precise preoperative surgical plan and tactics for ensuring safe screw fixation.
Adult ; Aged ; Aged, 80 and over ; *Bone Screws ; Cervical Vertebrae/radiography/*surgery ; Female ; Humans ; Male ; Middle Aged ; Recovery of Function ; Reproducibility of Results ; Spinal Diseases/physiopathology/*surgery ; Spinal Fusion/instrumentation/*methods ; Thoracic Vertebrae/radiography/surgery ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome

A pregnane steroid, 3α-hydroxy-pregn-7-ene-6,20-dione (1), was isolated from a Hydractinia-associated Cladosporium sphaerospermum SW67 by repetitive column chromatographic separation and highperformance liquid chromatography (HPLC) purification. The planar structure of 1 was elucidated from the analysis of the spectroscopic data (1D and 2D NMR spectra) and LC-MS data. The absolute configuration of 1 was determined by interpretation of ROESY spectrum of 1, together with the comparison of reported spectroscopic values in previous studies. To the best of our knowledge, this is the first report of the identification of the pregnane scaffold from C. sphaerospermum, a natural source. Compound 1 was evaluated for its effects on lipid metabolism and adipogenesis during adipocyte maturation and showed that compound 1 substantially inhibited lipid accumulation compared to the control. Consistently, the expression of the adipocyte marker gene (Adipsin) was reduced upon incubation with 1. Further, we evaluated the effects of 1 on lipid metabolism by measuring the transcription of lipolytic and lipogenic genes. The expression of the lipolytic gene ATGL was significantly elevated upon exposure to 1 during adipogenesis, whereas the expression of lipogenic genes FASN and SREBP1 was significantly reduced upon treatment with 1. Thus, our findings provide experimental evidence that the steroid derived from Hydractinia-associated C. sphaerospermum SW67 is a potential therapeutic agent for obesity.

PURPOSE: It is known that serum thyroid hormones and lipid profiles are affected by the different biotransformation pathways of antiepileptic drugs (AEDs). The aim of this study was to evaluate thyroid functions and lipids in epileptic patients taking AEDs. METHODS: We prospectively examined serum thyroid hormone concentrations and lipid profiles in 45 patients with epilepsy and compared them with 45 healthy age- and sex-matched controls. We measured serum free T4 (FT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPO-ab), thyroid globulin antibody (TG-ab), total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL) and triglycerides (TG). To analyze, the patient groups were divided into two groups:36 patients using hepatic enzyme inducing AEDs and 9 patients using non-enzyme-inducing AEDs. RESULTS: Mean age, sex and body mass index (BMI) were not different in both groups. The serum free T4 level of all patients was lower than that of the control group (p<0.05). The serum free T4 level of the patients taking hepatic enzyme inducing AEDs was lower than that of the control group. TSH, TPO-ab and TG-ab levels were not different in both groups. There was no correlation between free T4 levels and the duration of therapy in the patient group. For lipids, LDL, HDL, TG and total cholesterol, levels were not different in both groups. CONCLUSIONS: Hepatic enzyme inducing AEDs led to a decrease in free T4 levels but the TSH level remained normal. These findings seem to be not only due to liver enzyme induction but also hypothalamic interference of regulation of thyroid hormone production by the drugs. Lipid profiles were not significantly influenced by AEDs but further evaluation should be needed.
Anticonvulsants* ; Biotransformation ; Body Mass Index ; Cholesterol ; Enzyme Induction ; Epilepsy ; Humans ; Iodide Peroxidase ; Lipoproteins ; Liver ; Prospective Studies ; Thyroid Gland* ; Thyroid Hormones* ; Thyrotropin ; Triglycerides

Ictal vomiting is a rare clinical manifestation of temporal lobe epilepsy. This manifestation is considered a clinical lateralizing sign pointing toward seizure activity within the nondominant temporal lobe. However, we have experienced a case of ictal vomiting associated with temporal lobe epilepsy within the dominant hemisphere. The ictal vomiting occurred early in the course of the seizure when rhythmic discharges predominantly involved the left temporal lobe. This patient underwent a left anterior temporal lobectomy and experienced markedly reduced seizure frequency for more than 2 years.
Anterior Temporal Lobectomy ; Epilepsy ; Epilepsy, Temporal Lobe* ; Humans ; Seizures ; Temporal Lobe* ; Vomiting*

BACKGROUND: Bone mineral density (BMD) is influenced by genetic, hormonal, and environmental factors. Long-term antiepileptic drug (AED) use also causes osteopenia or osteoporosis that have been most extensively described in institutionalized patients. But, the mechanism of these abnormalities is unclear. The objective of this study is to determine the effect of AED on bone density and to explain the pathophysiologic mechanisms by analyzing bone related factors. METHODS: We prospectively examined BMD by dual-energy X-ray absorptiometry in 45 patients with epilepsy. We measured the serum calcium, phosphorus, protein, alkaline phosphatase (ALP), bone specific ALP, vitamin D and osteocalcin to analyze the factors that influence bone metabolism. RESULTS: BMD was significantly lower in the patient group than in the control group (p<0.05). 13% of patients had osteopenia and 3% of patients had osteoporosis. The level of bone specific ALP was higher in the patient group, but the level of vitamin D was not different, implying that BMD is decreased by the direct effect of antiepileptic drugs. There was a weak negative correlation and marginal significance between BMD and the duration of therapy in the patient group (r=-0.407, p<0.05). CONCLUSIONS: Long-term antiepileptic drug therapy in patients who have seizures causes significant bone loss in the lumbar spine even in the absence of vitamin D deficiency. In addition, the degree of bone mineral density was weakly related with the therapeutic duration of antiepileptic drugs. The regular evaluation of BMD in patients with long-term antiepileptic drugs might be helpful to prevent decreases in BMD.
Absorptiometry, Photon ; Alkaline Phosphatase ; Anticonvulsants* ; Bone Density* ; Bone Diseases, Metabolic ; Calcium ; Drug Therapy ; Epilepsy ; Humans ; Metabolism* ; Osteocalcin ; Osteoporosis ; Phosphorus ; Prospective Studies ; Seizures ; Spine ; Vitamin D ; Vitamin D Deficiency