PURPOSE: To investigate the clinical features and risk factors of ischemic third, fourth, sixth cranial nerve palsy. METHODS: Retrospectively, we reviewed the medical records of 46 eyes of 46 patients who were diagnosed with ischemic third, fourth, sixth nerve palsy alone such as age of onset, risk factors, recovery rate and recovery time. RESULTS: The mean age of onset was 64.9 years. Of the 46 patients, 15 patients (32.6%) in third cranial nerve palsy group, 15 patients (32.6%) in fourth cranial nerve palsy group, 16 patients (34.8%) in sixth cranial nerve palsy group. The risk factor of hypertension in 30 patients (65.2%) was the most common than other risk factors such as diabetes, hyperlipidemia, elevated blood hematocrit, ischemic heart disease, left ventricular hypertrophy, smoking. The mean number of risk factors was 2.3 +/- 0.5 in third cranial nerve palsy group, 1.6 +/- 1.1 in sixth cranial nerve palsy group, 1.4 +/- 1.1 in fourth cranial nerve palsy group. Of the 46 patients, 42 patients (91.3%) were recovered. There was no significant difference in recovery rate by cranial nerve palsy. Recovery time of intracranial abnormalities group (10.5 +/- 2.9 weeks) in brain imaging study was late as compared with that of no intracranial abnormalities group (7.5 +/- 5.1 weeks). CONCLUSIONS: The overall recovery rate of isolated ischemic third, fourth, sixth cranial nerve was high. But if there are intracranial abnormalities in imaging study, it took a long time to recover. Also ischemic third cranial nerve palsy had multiple risk factors characteristically.
Abducens Nerve ; Abducens Nerve Diseases ; Age of Onset ; Cranial Nerve Diseases* ; Hematocrit ; Humans ; Hyperlipidemias ; Hypertension ; Hypertrophy, Left Ventricular ; Medical Records ; Myocardial Ischemia ; Neuroimaging ; Oculomotor Nerve ; Paralysis ; Prognosis* ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking ; Trochlear Nerve Diseases

PURPOSE: To investigate the clinical features and risk factors of ischemic third, fourth, sixth cranial nerve palsy. METHODS: Retrospectively, we reviewed the medical records of 46 eyes of 46 patients who were diagnosed with ischemic third, fourth, sixth nerve palsy alone such as age of onset, risk factors, recovery rate and recovery time. RESULTS: The mean age of onset was 64.9 years. Of the 46 patients, 15 patients (32.6%) in third cranial nerve palsy group, 15 patients (32.6%) in fourth cranial nerve palsy group, 16 patients (34.8%) in sixth cranial nerve palsy group. The risk factor of hypertension in 30 patients (65.2%) was the most common than other risk factors such as diabetes, hyperlipidemia, elevated blood hematocrit, ischemic heart disease, left ventricular hypertrophy, smoking. The mean number of risk factors was 2.3 +/- 0.5 in third cranial nerve palsy group, 1.6 +/- 1.1 in sixth cranial nerve palsy group, 1.4 +/- 1.1 in fourth cranial nerve palsy group. Of the 46 patients, 42 patients (91.3%) were recovered. There was no significant difference in recovery rate by cranial nerve palsy. Recovery time of intracranial abnormalities group (10.5 +/- 2.9 weeks) in brain imaging study was late as compared with that of no intracranial abnormalities group (7.5 +/- 5.1 weeks). CONCLUSIONS: The overall recovery rate of isolated ischemic third, fourth, sixth cranial nerve was high. But if there are intracranial abnormalities in imaging study, it took a long time to recover. Also ischemic third cranial nerve palsy had multiple risk factors characteristically.
Abducens Nerve ; Abducens Nerve Diseases ; Age of Onset ; Cranial Nerve Diseases* ; Hematocrit ; Humans ; Hyperlipidemias ; Hypertension ; Hypertrophy, Left Ventricular ; Medical Records ; Myocardial Ischemia ; Neuroimaging ; Oculomotor Nerve ; Paralysis ; Prognosis* ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking ; Trochlear Nerve Diseases

Recoverin is a member of the large family of EF-hand calcium binding proteins (Baimbridge et al., 1992), and it is thought to be involved in the regulation of phosphodiesterase in photoreceptors and in the phosphorylation of activated rhodopsin (Polans et al., 1996). Although the functional significance of recoverin in cone bipolar cells is not fully understood, the antiserum against recoverin has been widely used to identify a certain population of cone bipolar cells (Milam et al., 1993; Sasso's Pognetto et al., 1994; Euler & W sle, 1995). GABA is well known to act as major neurotransmitters in the mammalian central nervous system including retina. This study was conducted to identify the development process of recoverin-labeled cone bipolar cells, and the timing points of synaptic formation of the labeled bipolar cells and GABAergic amacrine cells in the rat retina. The results were as follows; In the adult rat retina, recoverin-labeled cone bipolar cells were subdivided into twotypes; type 2 cells with axon terminal stratified in sublamina a of the inner plexiform layer (IPL), and type 8 cells with axon terminals stratified in sublamina b of the IPL. Recoverin-labeled cone bipolar cells began to appear from postnatal day 5. The axon terminals of recoverin-labeled type 2 cone bipolar cells stratified at postnatal day 10, while those of type 8 cone bipolar cells stratified at postnatal day 13. The axon terminals of type 2 cone bipolar cells made ribbon synapses onto GABAergic amacrine cells in the IPL at postnatal day 10. These results demonstrate that recoverin-labeled type 2 cone bipolar cells differentiate earlier than recoverin-labeled type 8 cone bipolar cells, and suggest that GABAergic amacrine cells may play important roles in visual processing of recoverin-labeled type 2 cone bipolar cells by making synapse onto these cells at early stage. Synapses between type 2 cone bipolar cells and GABAergic amacrine cells are formed about the time of postnatal day 10 for visual processing.
Adult ; Amacrine Cells* ; Animals ; Calcium-Binding Proteins ; Central Nervous System ; gamma-Aminobutyric Acid ; Humans ; Neurotransmitter Agents ; Phosphorylation ; Presynaptic Terminals ; Rats* ; Recoverin* ; Retina* ; Rhodopsin ; Synapses

Hepatoma is one of the most common malignant disease among cancers that occur in Korea. Recently, according ta developing imaging diagnostic technology and non surgical treatment the hepatoma is easily detected in early diagnosis and appropriate treatment. From this point of view, the histologic pattern of hepatoma is markedly important. This is the first reported case of sclerosing hepatocellular carcinoma, which is characterized by intense fibrosis, in which the tubular neoplastic structures are embedded. The incidence of sclerosing hepatocellular carcinoma is very rare. Therefore the rare histologic pattern of hepatoma might be introduced by many studies and reports. We recently experienced a case of sclerosing hepatocellular carcinoma.
Carcinoma, Hepatocellular ; Early Diagnosis ; Fibrosis ; Incidence ; Korea

BACKGROUND: Memory impairment results from various neurologic disorders. Among them, the memory loss associated with stroke is called amnesic stroke. Involved regions in the amnesic stroke are medial temporal lobe, thalamus, basal forebrain, retrosplenial region, and subcortical regions. Unilateral amnesic stroke is posterior cerebral artery territory including thalamus. Isolated infarction of hippocampal region has been rarely reported because hippocampus has dual blood supply from anterior choroidal cerebral artery and posterior cerebral artery. CASE REPORT: A 61-year old male with a history of diabetes for 6 years and hypertension for 13 years, was admitted with acute memory loss occurring 6 days before admission. He could not remember the exact date, place and recent events but could remember remote events about his personal and familial affairs. Brain MRI revealed an infarction in left hippocampal region and cerebral angiography showed multiple focal stenosis and luminal irregularity on left anterior choroidal, middle cerebral, basilar and both posterior cerebral arteries. COMMENTS: We report unilateral amnesic stroke only confined to left hippocampal region with literature review.
Amnesia ; Brain ; Cerebral Angiography ; Cerebral Arteries ; Choroid ; Constriction, Pathologic ; Hippocampus ; Humans ; Hypertension ; Infarction* ; Magnetic Resonance Imaging ; Male ; Memory Disorders* ; Memory* ; Middle Aged ; Nervous System Diseases ; Phenobarbital ; Posterior Cerebral Artery ; Prosencephalon ; Stroke ; Temporal Lobe ; Thalamus

Cerebrovascular complications are of the most frequent intracranial complications of bacterial meningitis. Most of the previous reports suggest that the prognosis for the pafients with cerebrovascular complications was unfavorable. We recently experienced a case of meningococcal meningitis with fulminant meningococcemia associated with multifocal non-enhancing lesions on, initial brain MRI. These lesions were hyperintense on T2weighted image and were located in left basal ganglia, both medial thalami, periventricular white matter, left cerebellar hemisphere, and right midbrain and were considered to be resulted from small vessel involvement. Gram negative diplococci were detected by Gram staining of specimens from skin lesion. After antimicrobial therapy and glucocorticoid replacement the patient was recovered without any neurologic sequelae. After one month, follow-up MRI showed resolution of all the ischemic lesions except in midbrain. Additionally there was a small focal hemtoma formation in left basal ganglia. The small hematoma was considered to be resulted from rupture of microaneurysm and disappeared on follow up MRI performed after 3 months. This case suggests that the cerebrovascular complications in meningococcal mningitis might be treated successfully.
Basal Ganglia ; Brain ; Follow-Up Studies ; Hematoma* ; Humans ; Magnetic Resonance Imaging ; Meningitis* ; Meningitis, Bacterial ; Meningitis, Meningococcal ; Mesencephalon ; Prognosis ; Rupture ; Skin

No abstract available.
Animals ; Dopamine* ; Models, Animal* ; Parkinsonian Disorders* ; Rats* ; Receptors, Dopamine*

Plasma cell Granuloma (PCG) is a form of idiopathic inflammatory pseudotumor (IPT). It is a rare entity character-ized by a nonneoplastic proliferation of inflammatory cells dominated by a polyclonal expansion of the plasma cells. This lesion has been discovered in many parts of the body including the central nervous system. We now report two cases of plasma cell granuloma involving the brain. The first case was a 42-year-old man who presented a right hemi-paresis. He had a lesion in the convexity of the left parietal region. The second case was a 58-year-old woman who was expressed confusion and a frontal-temporal headache. She had a lesion in the convexity of the left temporal region and mastoid bone. The diagnosis of PCG was confirmed by pathological and immunohistochemical studies revealing pre-dominant plasma cells in the affected tissues.
Adult ; Brain ; Central Nervous System ; Diagnosis ; Female ; Granuloma, Plasma Cell* ; Headache ; Humans ; Mastoid ; Middle Aged ; Plasma Cells* ; Plasma* ; Rabeprazole

PURPOSE: Reexpansion pulmonary edema (REPE) is a rare but potentially lethal complication of treatment for pneumothorax. This study was designed to compare the frequency of REPE after treatment of primary spontaneous pneumothorax (PSP) with 6 French (Fr) small bore catheterization and 14-20 Fr chest tube thoracostomy. METHODS: The medical records of PSP patients treated with thoracostomy from January 2010 to May 2015 were reviewed retrospectively. We compared the group treated using a 6 Fr small bore catheter with the group treated using a 14-20 Fr chest tube for clinical and demographic factors. The main outcome was the frequency of REPE between the two groups. RESULTS: A total of 196 patients were enrolled. No significant differences in catheter indwelling time, lengths of hospital stay, and treatment failures were observed between the two groups. REPE developed in 21 patients (10.7%). The frequencies of REPE after 6 Fr small bore catheter and 14-20 Fr chest tube were 6.0% (7 of 114 patients) and 17.1% (14 of 82 patients), respectively (p=0.015). In logistic regression analysis, drainage via 14-20 Fr chest tube showed significant correlation with the occurrence of REPE (odds ratio=3.03, p=0.038). CONCLUSION: A 6 Fr small bore catheter offers a safe and effective alternative to a chest tube for treatment of pneumothorax. We suggest that drainage via a small bore catheter should be considered as the initial treatment of choice for PSP patients in terms of frequency of development REPE.
Catheterization* ; Catheters* ; Chest Tubes* ; Demography ; Drainage ; Humans ; Length of Stay ; Logistic Models ; Medical Records ; Pneumothorax* ; Pulmonary Edema* ; Retrospective Studies ; Thoracostomy* ; Thorax* ; Treatment Failure

There are several methods with which 6-hydroxy-dopamine is injected into the nigrostriatal pathway in rats for making models of Parkinson's disease. One is a complete lesion model in which A9 and A10 dopamine cells are destroyed, and the other one is a partial lesion model in which only A9 dopamine cells are destroyed. The aim of this study is to establish the model most suitable for transplantation of neural tissue. First, the behavioral change was investigated after dopamine releasing(amphetamine) or dopamine agonist(apomorphine) substances were injected. And then, immunohistochemical staining for tyrosine hydroxylase(TH) of the striatum and the substantia nigra was performed. Sixteen complete lesion models of Brundin, 4 complete lesion models of Perese, and 5 partial lesion models of Perese were made. The rotation response to amphetamine injection(5mg/kg, intraperitoneally) was checked 2 weeks after lesion making. For 6 rats, which showed rotation more than 7 turns/minute with amphetamine, the rotation response to subcutaneous injection of apomorphine was examined. Five complete lesion model of Brundin, 1 partial lesion model of Perese and 4 complete lesion model of Perese demonstrated rotation above 7 turns/minute in amphetamine test. Immunohistochemical staining of substantia nigra and corpus striatum for TH was faint on the lesioned side in rats which showed rotation above 7 turns/min in amphetaine-induced rotation test, irrespective of the kinds of model, while those ares of the normal side showed dense staining for TH. However, the results of immunohistochemical staining did not coincide with the results of rotation test by apomorphine.
Amphetamine ; Animals ; Apomorphine ; Corpus Striatum ; Dopamine ; Injections, Subcutaneous ; Models, Animal* ; Oxidopamine* ; Parkinson Disease* ; Rats* ; Substantia Nigra ; Tyrosine