BACKGROUND: Drug-induced Parkinsonism(DIP) is the second commonest cause of Parkinsonism, after idiopathic Parkinson's disease(IPD). DIP is frequently produced by antipsychotic drugs. But the clinical characteristics of DIP did not get attention by neurologist. So we studied the clinical profiles of DIP patients. METHODS: We studied the clinical profiles of thirthone patients who showed parkinsonism after antipsychotic drug treatment. We compared the score of motor part of the Unified Parkinson's Disease Rating Scale(UPDRS) between trihexyphenidyl(n=15) & amantadine(n=16) monotherapy group(initial & 4 week after treatment). RESULTS: The mean age of patients was 45 years. Bradykinesia was the 1st symptom in 26 patients(94%), tremor in 5 patients(6%). In 25 patients(81%), the first symptom appeared within 1 week after sntipsychotic treatment. There was a statistical significant negative correlation between the dosage of antipsychotic drug and the symptom-onset interval following treatment with antipsychotic drugs(simple correlation analysis, p>0.01). Bradykinesia and rigidity were appeared in all DIP patients, symmetric distribution was more common(94%, 87%) Tremor occurred in 27 patients (87%). In patients with tremor, postural or action tremor was dominant in 15 patients(56%) asymmetric distribution was more common(16/27, 59%). There are no statistical difference in motor score of UPDRS between trihexyphenidyl & amantadine monotherapy group(student t-test, p<0.05) CONCLUSIONS: Bradykinesia was the most common 1st symptom in DIP patients. Asymmertrical postural or action tremor was relativelly common in DIP. Amantadine showed the same efficacy in the treatment of DIP compared to anticholinergics.
Amantadine ; Antipsychotic Agents ; Cholinergic Antagonists ; Humans ; Hypokinesia ; Parkinson Disease ; Parkinsonian Disorders* ; Tremor ; Trihexyphenidyl

No abstract available
Dermatitis, Atopic* ; Eczema* ; Humans ; Nipples*

The idiopathic long-QT syndrome is an infrequent inherited disorder, characterized by prolonged QT interval and by the occurrence of life-threatening tachyarrhythmia, particularly in association with emotional or physical stree. In its characteristic presentation, with obvious QT prolongation and stree induced syncope with torsades de points, the diagnosis is straightforward for physicians aware of the disease. But sometimes in cases of borderline QT prolongation and vague symptom, a correct diagnosis is delayed and frequently misdiagnosed as a seizure disorder. The mortality of untreated symptomatic patients with LQTS exceeds 20% in the year after their first syncopal episode and aapproaches 50% within 10 years. But this high mortality rate has been significantly reduced by the use of pharmacological or surgical antiadrenergic therapy or both. So early detection of the disease and antiadrenergic treatment sympathetic innervation to the heart. Second, there was intrinsic gene abnormality in the mechanisms responsible for cardiac repolarization. We report one case of LQTS in a 24 years old female patient who had been suffering from stree related syncope. Her initial EKG had prologed QT interval(588msec) and increased QT intrval dispersion(200msec). In the Holter monitor, long and short cycle sequence induced (pause-dependent) torsades de pointes was detected. She has been treated by beta-blocker and has maintained her condition without recurrence of the symptoms.
Diagnosis ; Electrocardiography ; Epilepsy ; Female ; Heart ; Humans ; Long QT Syndrome ; Mortality ; Recurrence ; Syncope ; Tachycardia ; Torsades de Pointes ; Young Adult

BACKGROUND: The possible role of apolipoprotein E (APOE for gene, apoE for protein) allele in atherosclerotic diseases is not clearly understood. For the putative role of APOE genotypes, we examined APOE polymorphism among patients with stroke. METHODS: A total of 202 ischemic stroke patients were involved in this study. The genotype DNA was isolated from whole blood and the APOE alleles were determined by polynicrase chain reaction. RESULTS: The genotype of APOE epsilon3/3 was the most common allele in the stroke group and the control group. The frequencies of APOE epsilon2, epsilon3, epsilon4 allele in stroke group were 0.052, 0.851, and 0.097, respectively. There was no significant difference in APOE genotypes between the stroke group and the control group. No significant associations lions were found for the APOE genotypes and the serum lipid profiles. CONCLUSION: These findings suggest that APOE was not related to the stroke,
Alleles ; Apolipoprotein E2 ; Apolipoproteins E ; Apolipoproteins* ; DNA ; Genotype ; Humans ; Lions ; Stroke

In full-thickness defects of the nasal alar rim, to achieve projection and maintain airway patency, cartilage graft is frequently needed. However, cartilage graft presents a challenge in considerations such as appropriate donor site, skeletal shape and size, and healing of the donor area. To avoid these demerits, we tried primary closure of alar rim defects by also making the contralateral normal ala smaller. We treated two patients who had a full-thickness nasal alar defect after tumor excision. Cartilage graft was considered for the reconstruction. However, their alar rims were overly curved and their nostril openings were large. To utilize their nasal shape, we did primary closure of the defect rather than cartilage graft, and then downsized the contralateral nasal ala by means of wedge resection to make the alae symmetric. Both patients were satisfied with their aesthetic results, which showed a smaller nostril and nearly straight alar rims. Moreover, functionally, there was no discomfort during breathing in both patients. We propose our idea as one of the reconstruction options for nasal alar defects. It is a simple and easy-to-perform procedure, in addition to enhancing the nasal contour. This method would be useful for patients with a large nostril and an overly curved alar rim.
Cartilage ; Humans ; Nose Deformities, Acquired ; Reconstructive Surgical Procedures ; Respiration ; Tissue Donors ; Transplants

Gastrointestinal hemangiomatosis is a rare benign vascular lesion, which can produce massive or persistent blood loss. Numerous lesions, usually of the cavernous type, involve stomach, small bowel, and colon. The diagnosis of hemangiomatosis is difficult. It is diagnosed usually by endoscopic study or barium enema for bleeding or anemia evaluation in childhood. A 17-year-old female was admitted to our hospital with anemia and dizziness for several months. She was diagnosed as diffuse intestinal hemangiomatosis by gastroduodenoscopy and colonoscopy. Gastroduodenosocpic findings showed multiple, small, mound-like, reddish-purple hemangiomas on the lower body, fundus and prepyloric area of the stomach. Colonoscopic findings showed similar lesions on the ascending and descending colon. The polypoid lesion on the ascending colon was ligated by detachable snare due to bleeding. No other hemangioma was detected by ultrasonography, abdominal angiography or small bowel series. We report a case of diffuse hemangiomatosis, largely distrubuted in the stomach and colon, but without involvement of skin or other solid organ. The bleeding hemangioma on the ascending colon was treated by endoscopic ligation, and the anemia of the patient was improved.
Adolescent ; Anemia* ; Angiography ; Barium ; Colon ; Colon, Ascending ; Colon, Descending ; Colonoscopy ; Diagnosis ; Dizziness ; Endoscopy* ; Enema ; Female ; Hemangioma ; Hemorrhage ; Humans ; Ligation ; Skin ; SNARE Proteins ; Stomach ; Ultrasonography

Central nervous system cryptococcosis is common in the AIDS patients with reported incidences ranging from 1.9% to 11.0%. Cryptococcosis may be the initial manifestation of HIV infection or occur simultaneously with other opportunistic infections. HIV-infected patients with central nervous system cryptococcosis complain of fever, headache, nausea and vomiting, and cognitive dysfunction. Meningeal signs and photophobia are less common than in HIV-negative patients. Focal neurologic signs and seizures are uncommon. Disseminated cryptococcosis is often concomitantly found at the time of central nervous system cryptococcosis. We report a case of 49 year-old Korean female with HIV infection who died of disseminated cryptococcosis with autopsy findings.
Autopsy* ; Central Nervous System ; Cryptococcosis* ; Female ; Fever ; Headache ; HIV Infections ; Humans ; Incidence ; Middle Aged ; Nausea ; Neurologic Manifestations ; Opportunistic Infections ; Photophobia ; Seizures ; Vomiting

Clinically, multiple system atrophy is difficult to differentiate from other basal ganglia disorders such as idiopathic Parkinson's disease or other types of cerebellar ataxia. The "hot cross bun"sign is a radiological sign which, it has been claimed, is highly specific for multiple system atrophy, and we describe four cases in which this sign occurred. In one patient, multiple system atrophy was clinically diagnosed, but in the other three, the respective clinical diagnosis was spinocerebellar ataxia type 1, type 2 (genetically), and old cerebellar hemorrhage. We therefore suggest that the hot cross bun sign reflects degeneration of transverse pontocerebellar fibers and is not a pathognomic sign of multiple system atrophy.
Basal Ganglia Diseases ; Cerebellar Ataxia ; Diagnosis ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Movement Disorders* ; Multiple System Atrophy ; Parkinson Disease ; Spinocerebellar Ataxias

Rhinocerebral mucormycosis is the most common fungal infection and is frequently seen in patients with poorly controlled diabetes mellitus. We report a rare case of cavernous sinus mucormycosis in a 70-year-old man with insulin-dependent diabetes mellitus. An endoscopic surgical removal of the mucocele was performed. The histopathologic examination revealed characteristic aseptate branching hyphae with invasion of blood vessels, which is consistent with zygomycosis. The patient was administered high-dose amphotericin B therapy. While undergoing amphotericin-B treatment, the patient developed a left-sided hemiparesis. Magnetic resonance imaging and magnetic resonance angiography revealed acute infarction in the right hemisphere and occlusion of the right internal carotid artery in the right cavernous sinus. The patient was managed with conventional medical treatment for acute cerebral infarction and additional amphotericin B infusion. The patient survived, but with severe neurologic sequelae despite extensive medical therapy, including complete-visual loss, leftsided hemiparesis, impairment of cognitive function, dysphagia, and neuropathic pain on the left side of the body. We report herein the clinical course and treatment of a patient with cerebral complications due to mucormycosis and also present a brief literature review.
Aged ; Amphotericin B ; Blood Vessels ; Carotid Artery, Internal ; Cavernous Sinus ; Caves ; Cerebral Infarction ; Deglutition Disorders ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Humans ; Hyphae ; Immunosuppression ; Infarction ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Mucocele ; Mucormycosis ; Neuralgia ; Paresis ; Zygomycosis

We report a rare case that showed aggravation of neurological symptoms due to expansion of the synovial cyst at C7/T1 after several month of trauma and present the consideration of proper prevention and management. A 64-year old male was admitted by right arm weakness(GIV+) after a pedestrian traffic accident. According to computed tomography(CT) scan and electromyography(EMG), a brachial plexus injury was diagnosed and he was treated conservatively. After 7 months, he was re-admitted by the left side weakness(GIV-) with severe pain and magnetic resonance image(MRI) revealed the expanded cystic lesion at C7/T1 level which compressed the cord from left side. After administration of steroid, surgical resection was performed via posterior approach and partial laminectomy. The dural expansion was observed after total removal of cyst which was diagnosed as a pathologist and symptoms were completely recovered. Because of its possibility of expansion of the synovial cyst and critical myelopathic symptoms can be induced in cervical spine, immobilization should be in consideration for acute period of post-trauma, especially, in old-aged patients with degenerative facet joints. And surgical procedure should not be delayed if symptoms developed.
Accidents, Traffic ; Arm ; Brachial Plexus ; Humans ; Immobilization ; Laminectomy ; Magnetic Resonance Spectroscopy ; Male ; Spine ; Synovial Cyst ; Zygapophyseal Joint