Wilson's disease typically presents symptoms associated with liver damage or neuropsychiatric disturbances, while endocrinologic abnormalities are rare. We report an unprecedented case of hypopituitarism in a patient with Wilson's disease. A 40-year-old woman presented with depression, general weakness and anorexia. Laboratory tests and imaging studies were compatible with liver cirrhosis due to Wilson's disease. Basal hormone levels and pituitary function tests indicated secondary hypothyroidism and adrenal insufficiency due to hypopituitarism. Brain MRI showed T2 hyperintense signals in both basal ganglia and midbrain but the pituitary imaging was normal. She is currently receiving chelation therapy along with thyroid hormone and steroid replacement. There may be a relationship between Wilson's disease and hypopituitarism. Copper deposition or secondary neuronal damage in the pituitary may be a possible explanation for this theory.
Adrenal Insufficiency/diagnosis/etiology ; Adult ; Brain/diagnostic imaging ; Depression/etiology ; Female ; Hepatolenticular Degeneration/*complications ; Humans ; Hypopituitarism/complications/*diagnosis/drug therapy ; Hypothyroidism/diagnosis/etiology ; Liver Cirrhosis/complications/diagnostic imaging ; Magnetic Resonance Imaging ; Steroids/therapeutic use ; Thyrotropin-Releasing Hormone/therapeutic use

Wilson's disease typically presents symptoms associated with liver damage or neuropsychiatric disturbances, while endocrinologic abnormalities are rare. We report an unprecedented case of hypopituitarism in a patient with Wilson's disease. A 40-year-old woman presented with depression, general weakness and anorexia. Laboratory tests and imaging studies were compatible with liver cirrhosis due to Wilson's disease. Basal hormone levels and pituitary function tests indicated secondary hypothyroidism and adrenal insufficiency due to hypopituitarism. Brain MRI showed T2 hyperintense signals in both basal ganglia and midbrain but the pituitary imaging was normal. She is currently receiving chelation therapy along with thyroid hormone and steroid replacement. There may be a relationship between Wilson's disease and hypopituitarism. Copper deposition or secondary neuronal damage in the pituitary may be a possible explanation for this theory.
Adrenal Insufficiency/diagnosis/etiology ; Adult ; Brain/diagnostic imaging ; Depression/etiology ; Female ; Hepatolenticular Degeneration/*complications ; Humans ; Hypopituitarism/complications/*diagnosis/drug therapy ; Hypothyroidism/diagnosis/etiology ; Liver Cirrhosis/complications/diagnostic imaging ; Magnetic Resonance Imaging ; Steroids/therapeutic use ; Thyrotropin-Releasing Hormone/therapeutic use

Carcinoma of the prostate is a common malignancy affecting elderly men. Lung metastasis from prostate cancer occurs frequently, but tumor metastasis to the central bronchi that clinically mimics primary bronchogenic carcinoma are very rare. We report a 73-year old man with endobronchial metastasis from prostatic carcinoma presented with respiratory symptom cough. Diagnosis of issues taken from materials which were used for bronchoscopic biopsy and prostate biopsy and immunohistochemical staining for prostate specific antigen(PSA) confirmed a case of endobronchial metastasis from prostatic carcinoma. Hormonal therapy(LHRH agonist) was applied to this patient.
Aged ; Biopsy ; Bronchi ; Carcinoma, Bronchogenic ; Cough ; Diagnosis ; Humans ; Lung ; Male ; Neoplasm Metastasis* ; Prostate ; Prostatic Neoplasms

Myxedema coma is a severe life-threatening form of hypothyroidism that is associated with a high mortality rate. It is known to be common in the elderly, and is mainly accompanied with cardiogenic shock, respiratory failure, central nervous system dysfunction, and body temperature regulation defects. Thus, immediate management is required in order to prevent fatal complications in myxedema coma. However, early detection is difficult and further, it is easily misdiagnosed due to its low incidence rate and nonspecific symptoms. We report a case of myxedema coma which was misdiagnosed for heart failure. The patient was successfully treated with intensive care and oral low dose levothyroxine.
Aged ; Body Temperature Regulation ; Central Nervous System ; Coma* ; Heart Failure ; Humans ; Hypothyroidism ; Hypoventilation ; Incidence ; Critical Care ; Mortality ; Myxedema* ; Respiratory Insufficiency ; Shock, Cardiogenic ; Thyroxine*

Background: The digits-in-noise (DiN) test is a speech-in-noise test to measure speech recognition threshold in noise adaptively. Herein, we aimed to develop the Korean version of the DiN test to provide a useful hearing screening tool for clinical as well as research purposes.Method: Spoken monosyllabic digits from 0 to 9 were recorded by a female speaker. The test list was constructed such that each digit was placed in three different positions. An optimization procedure was conducted to equate the audibility of each digit. After the optimization, the smartphone application for the Korean DiN (K-DiN) test was developed. For the adaptive measurement procedure, 180 new DiN triplets separated into six lists of 30 were created. Mean speech recognition threshold values for each list and session were measured to examine the test-retest and training effects of the test materials. In addition, speech recognition threshold values measured by different devices were compared to determine whether the speech recognition threshold levels differed. Results: Optimization results showed that the mean speech recognition threshold and slope were −11.55 dB signal-to-noise ratio and 10.21%/dB, respectively, which are comparable to levels shown in different-language versions of the DiN test. The results of the test-retest and training effects revealed no significant differences among the test sessions and lists. Additionally, the mean speech recognition threshold values measured by four different devices were not different, indicating the reliability of the test materials. Conclusion We believe this study is the first to attempt to develop a K-DiN test. Our results indicate that this test can be used as a potentially reliable hearing screening tool.

Linear and whorled nevoid hypermelanosis(LWNH) is characterized by macules in streaks and whorls along Blaschko's lines, that are not preceded by inflammation. LWNH can present with various findings such as neurologic, musculoskeletal, ophthalmologic, facial and cardiac abnormalities. Intracranial lipoma is very rare condition, with an incidence of less than 1% of all intracranial tumors. We recently experienced a case of LWNH with intracranial lipoma of corpus callosum. We report this case with a brief review of the related literature.
Corpus Callosum ; Hyperpigmentation* ; Incidence ; Inflammation ; Lipoma*

Ovarian pregnancy is a rare form of ectopic pregnancy that is often difficult to diagnose. The diagnostic criteria were described in 1878 by Spiegelberg, which comprise that the pregnancy is in the ovary and does not involve the tube. Ovarian pregnancy occurs in the corpus luteum, and is usually accompanied with the rupture of the ovary and massive hemoperitoneum. It presents as a hemorrhagic ovary and frequently misdiagnosed as a ruptured corpus luteum. We have experienced a case of ovarian pregnancy and reviewed it briefly.
Corpus Luteum ; Female ; Hemoperitoneum ; Ovary ; Pregnancy ; Pregnancy, Ectopic* ; Rupture

Traditionally, early appendectomy has been the cornerstone of therapy for acute appendicitis. However, once appendiceal perforation and abscess formation occurs, the optimal means of treatment and the timing of operation is controversial. Recently, it was reported that radiologically guided percutaneous abscess drainage and antibiotic therapy, as an initial nonoperative management, was effective and safe. Recent experience with endoscopic transmural drainage of pancreatic pseudocysts or even pancreatic abscesses prompted us to use the similar technique for the primary treatment of peri-appendiceal abscess. We report a case of peri-appendiceal abscess complicating acute appendicitis which was successfully treated by colonoscopic transmural internal drainage.
Abscess* ; Appendectomy ; Appendicitis* ; Colonoscopy ; Drainage* ; Pancreatic Pseudocyst

OBJECTIVES: The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. METHODS: Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. RESULTS: Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. CONCLUSION: The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.
Anxiety ; Attention Deficit and Disruptive Behavior Disorders ; Checklist ; Child Behavior ; Child* ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea ; Nocturnal Enuresis* ; Parents ; Psychopathology ; Social Problems

Neurofibroma in gastrointestinal tract are presented as localized forms or in associated with neurofibromatosis. Previous reported cases were presented as relatively large sized esophageal mass and treated by surgical resection. However, a neurofibroma was found incidentally during endoscopy in this case. It was presented as palisade like solitary nodules with or without connecting mucosal bridges in lower esophagus. It was treated by mucosectomy and followed up without recurrence.
Endoscopy ; Esophagus* ; Gastrointestinal Tract ; Neurofibroma* ; Neurofibromatoses ; Recurrence