Therapeutic irradiation may produce a variety of adverse side effects on the central and the peripheral nervous systems. These adverse effects are divided into two main groups; transient and permanent. Four major clinical syndromes have been described in relation to permanent radiation injury of the nervous system: encephalopathy, cranial neuropathy, myelopathy, and peripheral neuropathy. Among them, delayed encephalopathy represents the major hazard in CNS irradiation. The characteristic MR imaging pattern of radiation induced delayed necrotizing leukoencephalopathy is symmetric, high-signal foci on T2WI in the periventricular white matter. We report a case of suspected post-irradiation leukoencephalopathy showed progressive mental change, quadriparesis, and urinary incontinence with characteristic MR findings who had taken therapeutic irradiation 12 months ago.
Cranial Nerve Diseases ; Leukoencephalopathies* ; Magnetic Resonance Imaging ; Nervous System ; Peripheral Nervous System ; Peripheral Nervous System Diseases ; Quadriplegia ; Radiation Injuries ; Spinal Cord Diseases ; Urinary Incontinence

No abstract available.
Mesenteric Artery, Superior*

BACKGROUND & OBJECTIVES: There are few reports of affecting factors of the longterm prognosis after acute ischemic stroke. The aim of this prospective study was to determine which variables, of those easily measurable during the first 24 hours after stroke onset, would be predictors of longterm outcome. METHOD: Ninety-eight patients with an acute ischemic stroke were evaluated within 24 hours after symptom onset. The following potential affecting factors of outcome were prospectively collected : demographic datas, socioeconomic factors, risk factors of cerebrovascular accidents, clinical f indings as measured by the National Institute of Health (NIH) scale, laboratory findings and premorbid varibles rated according to modified Rankin score (mRS). We evaluated the outcome, assessed with mRS as good (mRS 3 or less) and poor (mRS 4, 5 or death) and follow up was undertaken at 6, 12, 18 and 24 months after onset. The statistical analysis was performed by means of SPSS/PC+package to determine the longterm prognostic factors. RESULTS: The multiple stepwise regression analysis revealed that the outcome depend on NIH scale(p<0.001), age (p<0.01), previous stroke(p<0.01), loss of consciousness (LOC) at onset (p Follow-Up Studies ; Humans ; Paresis ; Prognosis ; Prospective Studies ; Risk Factors ; Socioeconomic Factors ; Stroke ; Unconsciousness

We report a 18 years old man of brainstem encephalitis with acute ataxia, areflexia and gaze evoked vertical and horizontal nystagmus which is mimicking Miller Fisher syndrome. He had evidences of both peripheral neuropathy in nerve conduction studies and a brainstem encephalitis in MR findings. The possible relationship of the Miller Fisher syndrome and brainstem encephalitis are discussed with brief review of literature.
Adolescent ; Ataxia ; Brain Stem* ; Encephalitis* ; Humans ; Miller Fisher Syndrome* ; Neural Conduction ; Nystagmus, Pathologic ; Peripheral Nervous System Diseases

High dose intravenous immunoglobulin (IVIg) therapy can improve the clinical course of several immune mediciated diseases. We evaluated clinical effects and side effects of IVIg in Guillain-Barre syndrome (GBS). 19 Patients with GBS were studied prospectively in a placebo-controlled trial. 11 Patients were received high dose IVIg (400mg/kg for 5 days) and controls received only conservative treatment. The disability scores using modified Rankin scores before and after treatment of each group were compared. Four weaks later, mean Rankin Score of IVIg group was 2.5 + 0.7 and control group was 3.3+ 0.5which showed significant difference(p<0.05). There were no serious advers effer of promote early improvement with safety in acute phase of Guillan-Barre syndrome.
Guillain-Barre Syndrome* ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Prospective Studies

The benign mesenchymoma, in which fibrous tissue is accompanied by two or more mesencymal components, occurs very rarely in the head and neck area. The majority appear in patients under 25 years of age, most commonly in the subcutaneous scalp, cheek, or tongue. There is a 20% recurrence rate. Wide surgical excision is the treatment of choice. We report a case of mesenchymoma in the nasopharynx which was removed by transpalatine approach with a brief review of literature.
Cheek ; Head ; Humans ; Mesenchymoma* ; Nasopharynx ; Neck ; Recurrence ; Scalp ; Tongue

Because most of modern peoples are busy with many their task according to specialization and complexity of society, it is impportant to determine optimal and comfortable time of colonoscopy. So this study was designed to compare efficacy of colonic cleansing and patient acceptance according to the time of colonoseopy. Among 140 peoples who underwent colonoscoyy in Busan St. Benedict Hospital between March 1995 to August 1995, two groups of 70 peoples were randomly assigned to undergo colonoscopy either at A.M. or ~P.M. The results were as follows: 1) In view of efficacy rate of colonic cleansing, the group at P.M, was superior to the group at A.M.. 2) In view of patients acceptance and side effects, the group at P.M. showed better acceptance and less side effects than the group at A.M.. In conclusion, this study showed that the colonoscopy at P.M. is better than at A.M., especially when patient is poor systemic condition or low acceptance to colonoscopic cleansing preparation. However, it may be also acceptable undergoing colonoscopy at A.M. if patient condition is good and patient is busy with his task.
Busan ; Colon* ; Colonoscopy* ; Humans ; Prospective Studies*

Purpose: Preoperative tumor size is associated with clinical stage, treatment plan and even survival rate of patient. We investigated the accuracy of tumor size estimation between magnetic resonance imaging (MRI) and ultrasonography (US) findings, comparing these with pathologic tumor size in the diagnosis of early breast carcinoma. Methods: Between 2011 and 2016, 136 patients with early breast cancer were analyzed and their tumor size on US and MRI findings were compared with their pathologic tumor size retrospectively. The background parenchymal enhancement of MRI was categorized as minimal, mild, moderate, and extreme. The patients who underwent neoadjuvant chemotherapy, had positive resection margins, underwent excisional biopsy for cancer diagnosis, and had non-mass lesions on MRI scans, were excluded. Results: In all, 83.1% of the cases showed concordance between MRI findings and pathologic tumor size within 0.5cm. MRI overestimated the findings by 10.3% and underestimated them by 6.6%; 78.7% showed concordance between US findings and pathologic tumor size within 0.5cm. US overestimated the findings by 5.9% and underestimated them by 15.4%. The tumor size on MRI (r=0.87) showed a stronger correlation to the pathologic tumor size than that on US (r=0.64) in early breast cancer patients. US had a tendency to underestimate the tumor size. The degree of breast parenchyma did not affect the accuracy of the measurement of preoperative tumor size. Conclusion MRI is relatively more accurate than US for assessing preoperative tumor size in breast cancer patients. US tends to underestimate tumor size.

We describe a 28 year-old woman who had fever, general myalgia, tender erythematous subcutaneous nodules on whole body skin, and acute pleuritis after influenza vaccination. Temporal association between vaccination and her symptoms and skin biopsy result are in agreement with our diagnosis as leukocytoclastic vasculitis. A review found that there were a few similar cases involving the skin, kidney, and rarely nervous system, mostly with good prognoses. Our patient was treated by a short course of corticosteroid and no recurrence has been observed for five months. Although there is a possibility of an infection, the temporal association, the false-positive HCV ELISA test, and the increased serum IgE were interesting findings, which might account for this leukocytoclastic vasculitis after influenza vaccination.
Adult ; Biopsy ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Fever ; Humans ; Immunoglobulin E ; Influenza, Human* ; Kidney ; Myalgia ; Nervous System ; Pleurisy ; Prognosis ; Recurrence ; Skin ; Vaccination* ; Vasculitis*

Gastric bezoars are collection of indigestible material in the stomach, and these can be classified into five broad categories: phytobezoar, trichobezoar, pharmacobezoar, lactobezoar and miscellaneous materials such as sand, stone and concrete (gypsum). The treatment of gastric bezoars has recently changed from surgical management to such nonsurgical interventions as enzymatic dissolution, nasogastric suctioning and endoscopic removal by polypectomy snare and basket. Up to the present, electrohydraulic lithotripsy has been a well established method for the treatment of urinary and hepatobiliary stones. We report here on a patient who had a huge gastric bezoar that was formed by the ingestion of gypsum, and this was treated with endoscopic electrohydraulic lithotripsy.
Bezoars* ; Calcium Sulfate* ; Eating* ; Endoscopy ; Humans ; Lithotripsy* ; Silicon Dioxide ; SNARE Proteins ; Stomach ; Suction