BackgroundHemophagocytic lymphohistiocytosis (HLH) is a rare multisystem disorder that frequently involves the central nervous system (CNS). We compared the clinical characteristics, treatment, and prognosis of patients with HLH according to the degree of CNS involvement.MethodsThe clinical manifestations, initial laboratory data, treatment, and outcomes for 50 patients diagnosed with HLH and treated at Asan Medical Center between January 1995 and August 2011 were retrospectively reviewed and analyzed. CNS involvement was defined as the presence of neurological symptoms or an elevated white blood cell (WBC) count in the cerebrospinal fluid (CSF).ResultsAmong these 50 patients, 23 (46%) developed CNS disease. Among patients with CNS disease, 19 had neurological symptoms, including seizures, altered consciousness, facial palsy, dysarthria, and dysphagia. Four patients had elevated CSF WBC counts without neurological symptoms. Twelve patients had abnormal brain imaging results, including high signal intensity lesions on T2-weighted magnetic resonance imaging (MRI) findings, ventriculomegaly, hemorrhage, atrophy, and leptomeningeal enhancement. Patients with CNS disease had lower ferritin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels as well as reduced 5-year survival as compared to those without CNS disease.ConclusionCNS involvement is common among patients with HLH. Overall, patients with CNS disease achieve poorer outcomes than patients without CNS involvement. To improve outcomes, physicians must carefully monitor the neurological manifestations in patients with HLH and administer the appropriate course of intensified chemotherapy to patients with CNS disease.

Addiction can be largely divided into two categories. One is called medium addiction in which medium itself causes an addiction. Another is called cause addiction that brings addiction through combination of sensitive self and latent personal action. The medium addiction involves addiction phenomena directly caused by illegal drugs, alcohol and various other chemicals. The cause addiction is dependent on personal sensitivities as a sensitive problem of personal and includes cyber addictions such as shopping, work, game, internet, TV, and gambling. In this paper we propose two-dimensional addiction model that are equivalent to using an R-L-C series circuit of Electrical circuit and a Spring-Damper-mass of mechanical system. We also organize a Duffing equation that is added a nonlinear term in the proposed two-dimensional addiction model. We represent periodic motion and chaotic motion as time series and phase portrait according to parameter's variation. We confirm that among parameters chaotic motion had addicted state and periodic motion caused by change in control coefficient had pre-addiction state.

Bitemporal hemianopia is a significant pathological hallmark of a pituitary lesion; however, binasal hemianopia is rarely reported, except for its known association with other ocular diseases rather than with brain lesions. We report a 24-year-old male with binasal hemianopia caused by pneumosinus dilatans of the sphenoid sinuses.