Progressive Supranuclear Palsy (PSP) is a rare degenerative disease showing supranuclear ophthalmoplegia, rseudobulbar palsy and several parkinsonian features. This is , as far as the author's knowledge, the first case in this country. The patient is a 55 year old female with slowly progressive disturbances in walking, swallowing, speech and behaviors. The most characteristic finding is the prominent external ophthalmoplegia, especially vertical and downward gaze, which can be easily overcome by the oculocephalic reflexes (Doll's eye movements). The dyspagia, dysarthria and emotional lability may suggest the pseudobulbar palsy. General hyper-reflexia and Babinski sign are noted. There are several features of parkinsonism, but the rigidity is more severe in the trunk than in the extremities and the posture is rather hyperextended than scooped. There is no tremor. The disease is slowly progressive and the medical treatment for Parkinson's disease is not effective.
Deglutition ; Dysarthria ; Extremities ; Female ; Humans ; Middle Aged ; Ophthalmoplegia ; Paralysis ; Parkinson Disease ; Parkinsonian Disorders ; Posture ; Pseudobulbar Palsy ; Reflex ; Reflex, Babinski ; Supranuclear Palsy, Progressive* ; Tremor ; Walking

Since the EEG study is without harm and pain, it has often been applied to headache sufferers,and many articles have been reported on the findings therefrom in other countries, but rare in Korea. An analysis of clinical and EEG features in 980 headache subjects in National Medical Center is presented. 1. In 980 cases of headache, 542 cases are female and about two thirds of the patients are between 20 and 49 years of age. 2. The distribution of patients contains functional headache (368 cases), tension headache (221 cases). Vascular headache (201 cases) and headache by organic brain diseases (93 cases) in orders. 3. The incidence of EEG abnormalities is 15.1% (147 cases) and most of the findings are dysrrhythmia I or II. The generalized abnormality is more common than focal. 4. Abnormal EEG findings are most common in patients with headache with seizure disorder (54.7%), followed by organic brain diseases (47.3%), and vascular headache (15.3%). In contrast, functional headache and tension headache reveal very low occurrence of EEG abnormalities. 5. There is a tendency of reverse relationship between symptom duration and incidence of EEG abnormalities but no close relationship between the characters of headache and EEG findings.
Brain Diseases ; Electroencephalography* ; Epilepsy ; Female ; Headache* ; Humans ; Incidence ; Korea ; Tension-Type Headache ; Vascular Headaches

Eating the meat of pheasants which was killed by potassium cyanide, a 27 year old man developed several symptoms of minor intoxication. A few days later, the patient became mute, apathy, somnelent and indifferent but without any parkinsonia features or dementia. On CT brain scan, bilateral symmetrical and non-enhancing focal low densities are noticed in basal ganglia, similar to the carbon monoxide intoxication.
Adult ; Apathy ; Basal Ganglia ; Brain* ; Carbon Monoxide ; Dementia ; Eating ; Humans ; Meat ; Potassium Cyanide

No abstract available.
Observer Variation*

Blindness or serious visual impairment is a common and well known sequela of methanol intoxication in man, while other manifestations such as focal neurological deficits and abnormal brain CT scan are reported rarely. We experienced a case of acute methanol intoxication, which showed not only visual impairment but also bulbar symptoms and characteristic bilateral symmetrical hypodensity area in basal ganglia, especially putamen on brain CT scan. We tried 'pulse therapy'-continuouis dripping of methyl prednisolone (Solumedrol 1gm/day) for 5 days-with transient improvement of visual impairment, but bulbar symptoms were stationary. One month later, visual impairment was recurred, and the 'pulse therapy' was tried again but without benefit. On follow-up brain CT scan, the size of previous hypodensity area in basal ganglia was decreased.
Basal Ganglia ; Blindness ; Brain* ; Bulbar Palsy, Progressive* ; Follow-Up Studies ; Methanol* ; Prednisolone ; Putamen ; Tomography, X-Ray Computed* ; Vision Disorders

Thymectomy is considered as one of the important therapy for patients with myasthenia gravis(MG) for reducing the symptoms and hasting the time of remission. However, the efficacy of thymectomy in previous studies were not in concordant with each others. This study was designed to assess the effects of thymectomy in 84 MG patients. The patients were divided into two groups according to their medications before thymectomy : the patients who had been treated with anticholinesterase(ACE group) and the others who had been treated with both anticholinesterase and steroid(steroid group). The outcomes of thymectomy were divided into two group : ""success"" and ""failure"". The ""success"" outcomes included the patients with remission or improvements and the ""failure"" outcomes included the patients with improvement by immunosuppressive agents, unimprovement, and death. To find factors which might influence on the prognosis after thymectomy, the following variables were considered for statistics; The onset age of MG, gender, myasthenic crisis before operation, the clinical symptoms at the time of operation, and the pathologic findings of thymus. The results were as follows. Sixty-six patients were included in ACE group and 18 in steroid group. The success were occurred in 37 patients among ACE group(56%) and in 8 patients among steroid group(44.4%). In ACE group, the success more frequently occurred in the patients with thymic follicular hyperplasia(79.3%) than in those with thymoma(36%), and normal or atrophic thymus(41.7%). The Patients who had mild clinical symptoms at the operation also showed higher success rate. However, gender, the age of onset, and the presence of myasthenic cirsis before the operation did not influences on the results of the operation. In steroid group, the success rate was higher in the patients with shorter duration of steroid treatment before thymectomy(< 6 month) and follicular hyperplasia. In addition, the immunosuppressive treatments also gave symptomatic improvements in most patients with failure outcomes after thymectomy. In conclusion, thymectomy demonstrated beneficial effects in about half of MG patients. Follicular hyperplasia and mild symptoms at the operation were considered to be factors for predicting better results after thymectomy. Our findings also suggest that the longstanding steroid treatment before thymectomy may negatively affect on the successful thymectomy, especially on remission.
Age of Onset ; Humans ; Hyperplasia ; Immunosuppressive Agents ; Myasthenia Gravis* ; Prognosis ; Thymectomy* ; Thymus Gland

Symmetrical bilateral thalamic infarction is a rare cerebrovascular disease, caused by occlusion of the paramedian thalamic arteries. The clinical manifestations of this disease are much different from classical thalamic syndrome, with disturbance of consciousness, memory, eye movement and behavior. Observing two cases of bilateral symmetrical thalamic infarction on CT scan with characteristic clinical findings in Medical Center, pertinent literature were reviewed.
Arteries ; Consciousness ; Eye Movements ; Infarction* ; Memory ; Thalamic Diseases ; Tomography, X-Ray Computed

BACKGROUNDS: Though K-ADL was developed and validated, weighting each item of K-ADL is needed to evaluate the severity of functional disability as a whole. METHODS: Nominal group technique was used to weight individual items of K-ADL. Relevant experts were recruited; one specialist in geriatrics, one expert in elderly health service, one doctor expert in questionnarie, one nurse and two social welfare workers and one caregiver who work in nursing home for elderly, one nurse working at dementia care center. At the first round, each expert assigned the weights of each item. At the second round, those experts met, discussed, and re-evaluated each weighting. Using the newly developed weighted score, we measured its validity compared to brain-disability grade and three experts' decision of severe dysfunction. RESULTS: For inability to perform task, 7 points were given to 'dressing'and 'washing face', 6 points to 'bathing', 9 points to 'feeding', 8 points to 'transfer and toileting'. If any assistance is needed, 7 points were scored to 'dressing', 4 points were scored to 'washing face', 'feeding', 'transfer' and 'toileting', 2 points were scored to 'dressing'. Correlation coefficient between weighted K-ADL sum and brain-disability grade was -0.665(p=0.000). CONCLUSIONS: We assigned differential weighting to each of K-ADL and found that summing weighted K-ADL was excellent in some validity test.
Aged ; Caregivers ; Dementia ; Geriatrics ; Health Services ; Humans ; Nursing Homes ; Social Welfare ; Specialization ; Weights and Measures

A 29 year old woman came to the hospital due to headache, facial edema, amenorrhea and galactorrhea. On the lahoratory studies, not only hyperprolactinemia and pituitary enlargement, but also primary hypothyroidism were found. Symptomatic and radiological resolution could be achieved by the thyroid hormone replacement only. This case emphasizes the need for evaluation of thyroid status in patients vith presumptive prolacin producing pituitary tumors before initiation of the therapy for hyperprolactinemia.
Adult ; Amenorrhea ; Edema ; Female ; Galactorrhea ; Headache ; Humans ; Hyperprolactinemia* ; Hypothyroidism* ; Pituitary Neoplasms ; Pregnancy ; Thyroid Gland

Primary transitional cell carcinoma of ovary has been recently recognized as a separate subtype of epithelial cancer. It is unusual tumor and in which definite urothelial features are present, but no benign Brenner component is identified. These tumor are more aggressive and tend to present at a higher stage than malignant Brenner tumors, but they appear to respond better to chemotherapy than other type of ovarian epithelial cancer. We have experienced two cases of ptimary transitioaal cell carcinoma of ovary. So we report these cases with a brief review of literature.
Brenner Tumor ; Carcinoma, Transitional Cell* ; Drug Therapy ; Female ; Ovary*