Kyoung Min Kim

CT Colonography of pneumatosis cystoides intestinalis

Pneumatosis cystoides intestinalis (PCI) is an unusual condition that is characterized pathologically by multiple thin-walled, noncommunicating, gas-filled cysts in the submucosal or subserosal layer of the gastrointestinal wall. This paper describes the interesting CT colonographic findings of two patients with PCI, showing multiple gas-filled cysts in the colonic wall.

Charcot-Marie-Tooth Disease Masquerading as Acute Demyelinating Encephalomyelitis-Like Illness

X-linked Charcot-Marie-Tooth disease (CMTX1) is a clinically heterogeneous hereditary motor and sensory neuropathy with X-linked transmission. Common clinical manifestations of CMTX1 disease, as in other forms of Charcot-Marie-Tooth (CMT) disease, are distal muscle wasting and weakness, hyporeflexia, distal sensory disturbance, and foot deformities. Mutations in the connexin-32 gene (gap junction protein β1 [GJB1]) are responsible for CMTX1 disease. In this report, we describe a patient with CMTX1 disease presenting with recurrent attacks of transient and episodic acute demyelinating encephalomyelitis (ADEM)–like symptoms without previous signs of lower extremity weakness or foot deformities; the patient, as well as his asymptomatic mother, exhibited a novel GJB1 mutation (p.Met1Ile). Differential diagnosis of recurrent and transient ADEM-like illness, if unexplained, should include the possibility of CMTX1 disease.

Gray Scale and Power Doppler Study of Biopsy-Proven Kikuchi Disease

Kikuchi disease is a benign, self‐limiting cause of cervical lymphadenopathy. It can show sonographic features similar to those of other common causes of lymphadenopathy. The purpose of this study was to characterize the sonographic features of Kikuchi disease that can contribute in differentiating between Kikuchi disease and other diseases causing cervical lymphadenopathy.

Evaluation of uncompensated unilateral vestibulopathy using the modified clinical test for sensory interaction and balance

Objective To compare the results of the Modified Clinical Test for Sensory Interaction and Balance (mCTSIB) and the Sensory Organization Test (SOT) of computerized dynamic posturography (CDP) to better understand the role and limitations of the mCTSIB in the diagnosis and rehabilitation of patients with uncompensated unilateral vestibulopathy. Study Design Prospective blind study. Setting Tertiary referral center. Interventions Ninety-eight patients with uncompensated unilateral vestibulopathy were enrolled. After diagnosis was established through ocular motor studies, head roll and Dix–Hallpike tests, caloric testing, and pure tone audiometry, the mCTSIB and SOT were administered simultaneously. Main Outcome Measure Composite or comprehensive scores and equilibrium scores. Results When composite or comprehensive scores were used to classify subjects as normal or abnormal, the mCTSIB and SOT showed significant agreement (p > 0.256). SOT condition 2 (eyes closed on a firm surface) showed a greater degree of correlation than did other conditions; the foam-surface or eyes-open conditions yielded poor correlation coefficients. Conclusion The mCTSIB can be used instead of the SOT in screening to distinguish normality from abnormality in dizzy patients with unilateral vestibulopathy. However, the degree of dizziness assessed by SOT condition was poorly correlated with mCTSIB results, especially in conditions with the eyes open and those using a foam surface.

Correlating the head shake-sensory organizing test with dizziness handicap inventory in compensation after vestibular neuritis.

Objective Despite complaints of dizziness, some patients with unilateral compensated vestibular weakness show normal results on Sensory Organization Test (SOT), which is being widely used for the evaluation of vestibular function compensation. The head shake-sensory organization test (HS-SOT) has been suggested to increase the sensitivity of SOT. In HS-SOT, the patient is required to shake head under Conditions 2 and 5 of traditional SOT. However, the sensitivity of HS-SOT remains unelucidated in patients with vestibular neuritis. The aim of this study was to determine the sensitivity of HS-SOT and SOT and compare them with the Dizziness Handicap Inventory (DHI) in detecting balance problems in patients with vestibular neuritis complaining of dizziness. Setting Tertiary referral center. Patients A prospective analysis was conducted on all vestibular neuritis patients between September 2009 and April 2011. Thirty-two patients with uncompensated vestibular neuritis were enrolled in this study. Patients with acute symptoms of dizziness, orthopedic problems, or any other severe underlying conditions were excluded. Main Outcome Measures Equilibrium and vestibular scores of SOT and equilibrium score ratios of HS-SOT and DHI were obtained from each patient after 1 week and 1, 2, and 6 months of the first attack of vestibular neuritis. Results HS-SOT is more correlated with the DHI than SOT by periods. One month after vestibular neuritis, the correlation between DHI and SOT, HS-SOT Conditions 2 and 5 were −0.301, −0.385, and −0.625, respectively. Six months after vestibular neuritis, the correlation between DHI and SOT, and HS-SOT Conditions 2 and 5 were −0.053, −0.337, and −0.394, respectively. Conclusion HS-SOT was more sensitive than SOT during the compensation of vestibular neuritis. Specifically, during the compensation of vestibular neuritis, HS-SOT Condition 5 was more correlated with DHI than HS-SOT Condition 2. The results suggest that HS-SOT provides more useful measures for the evaluation of vestibular compensation in vestibular neuritis.

Multiple myeloma with isolated plasmacytoma in temporal bone.

Plasma cell tumors are characterized by a monoclonal neoplastic proliferation of immunoglobulin-secreting plasma cells. Multiple myeloma (MM) is the disseminated form of a malignant plasma cell disorder and is characterized by multiple lytic bone lesions, monoclonal protein in the serum or urine, and pathologic fractures. Typically, MM shows multiple lytic lesions of the cranium, whereas plasmacytoma manifests as a mass lesion. Plasmacytoma may involve the cranial vault, cranial base, brain parenchyma (1), and rarely, the temporal bone. We report a case of MM with isolated plasmacytoma in the temporal bone.