We report a 71 years old woman with transient periodic limb movement disorder and myoclonus that appeared after acute gastrointestinal bleeding. The abnormal movements dissolved as the blood loss was restored. The woman was later found to have an asymptomatic spine meningioma. Iron defi ciency due to acute bleeding may be the trigger resulting in the abnormal movements in this patient with subclinical spinal meningioma

Background and Objectives: This study aimed to describe the ischemic stroke subtypes and risk factors in young Korean adults, focusing mainly on traditional risk factors and management of ischemic stroke. Methods: The study patients were the fi rst-ever acute cerebral ischemic infarction age 49 years or below admitted to the Kyung Hee University Medical Centre from September 2003 to June 2009, with ischaemic stroke patients >50 years as control. The stroke subtypes was categorized according to Trial of Org 10172 in Acute Stroke Treatment classifi cation. The traditional risk factors of ischemic stroke were examined. For those known to have hypertension and diabetes prior to onset of stroke, their adherence to treatment of hypertension and diabetes was also assessed. Results: Close to half of the patients ≤49 years were due to premature atherosclerosis from small vessel occlusion and large artery atherosclerosis. The most common risk factor in declining order was hypertension, smoking, dyslipidemia and obesity. On logistic regression analysis, hypertension, dyslipidemia, and obesity were strongly associated with small vessel occlusion. In patients who were known to have hypertension and diabetes prior to the onset of stroke, the younger patients were less adherent to the treatment as primary prevention than the older stroke patients. Conclusion: This study suggests that premature atherosclerosis from small vessel occulusion is the most common cause of ischaemic stroke among young adults in Korea. Non-adherence to primary preventive treatment of hypertension and diabetes is common.

No abstract available.
Dystonia

Background: This study aimed to investigate the dietary habit problems related to lifestyle by analyzing health behaviors and dietary habits in Korean young adults. Methods: Adults aged 20≥ and ≥39 years single-person households who participated in the survey were included in the study. Subjects were classified into food related lifestyle. Subsequently, characteristics, health behaviors, dietary habits were analyzed. Results: The participants of the study were classified into five types: a ‘taste-type’, an ‘economy-type’, a ‘convenience-type’, a ‘health-type’, and a ‘safety-type’. As a result of comparing eating habits by food-related lifestyles, the ‘economy-type’ showed the highest dietary assessment with a score of 3.18, while the ‘safety-type’ ranked the lowest, a score of 2.54. The ‘economy-type’ scored highest they ate out less, cooked more, suggesting a need for nutritious cooking classes. The ‘health-type’, with more men and price-conscious individuals, sought healthier convenience options. The ‘taste-type’ preferred food delivery and dining out, needing balanced menus. In contrast, the ‘convenience-type’ overate, scoring low in habits, emphasizing the need for healthier menus and support. The ‘safety-type’ which has a high percentage of jobs in the service industry and high school graduates, showed the need for policy support for better diet. Conclusions Young single-person households have different dietary problems depending on their food-related lifestyle. Therefore, we recommended for the customized dietary education considering the characteristics of each type.

A 45-year-old female visited our clinic due to sudden right leg weakness and sensory loss. Brain and spinal cord magnetic resonance imaging showed widespread cavernous malformations. Cavernous malformation in L1 spine area was accompanied by a subacute stage hematoma with perilesional edema. Sensory loss subsided after corticosteroid therapy. Usually, neurologic deficit by spinal cavernous malformation appears more chronically in the adults compared to children. Treatment options are difficult to establish in a case with multiple cavernous malformations. Identifying hemorrhagic lesions by extensive neuroimaging evaluation could be helpful to select the treatment target for cavernous malformation.
Adult ; Brain ; Central Nervous System* ; Child ; Edema ; Female ; Hematoma ; Hemorrhage ; Humans ; Leg ; Magnetic Resonance Imaging ; Middle Aged ; Neuroimaging ; Neurologic Manifestations* ; Spinal Cord ; Spine

OBJECTIVES: The purpose of this study was to investigate the involvement of TRPA1 in the cinnamaldehyde-induced pulpal blood flow (PBF) change in the feline dental pulp. MATERIALS AND METHODS: Mandibles of eight cats were immobilized and PBF was monitored with a laser Doppler flowmetry at the mandibular canine tooth. To evaluate the effect of cinnamaldehyde on PBF, cinnamaldehyde was injected into the pulp through the lingual artery at a constant rate for 60 seconds. As a control, a mixture of 70% ethanol and 30% dimethyl sulfoxide (DMSO, vehicle) was used. To evaluate the involvement of transient receptor potential ankyrin 1 (TRPA1) in PBF change, AP18, a specific TRPA1 antagonist, was applied into the pulp through the Class V dentinal cavity followed by cinnamaldehyde-administration 3 minutes later. The paired variables of experimental data were statistically analyzed using paired t-test. A p value of less than 0.05 was considered as statistically significant. RESULTS: Administration of cinnamaldehyde (0.5 mg/kg, intra-arterial [i.a.]) induced significant increases in PBF (p < 0.05). While administration of a TRPA1 antagonist, AP18 (2.5 - 3.0 mM, into the dentinal cavity [i.c.]) caused insignificant change of PBF (p > 0.05), administration of cinnamaldehyde (0.5 mg/kg, i.a.) following the application of AP18 (2.5 - 3.0 mM, i.c.) resulted in an attenuation of PBF increase from the control level (p < 0.05). As a result, a TRPA1 antagonist, AP18 effectively inhibited the vasodilative effect of cinnamaldehyde (p < 0.05). CONCLUSIONS: The result of the present study provided a functional evidence that TRPA1 is involved in the mechanism of cinnamaldehyde-induced vasodilation in the feline dental pulp.
Animals ; Ankyrins ; Arteries ; Cats ; Cuspid ; Dental Pulp* ; Dentin ; Dimethyl Sulfoxide ; Ethanol ; Laser-Doppler Flowmetry ; Mandible ; Vasodilation

A 59-year old man was admitted for drowsiness and stiff neck. CSF examination showed lymphocytic pleocytosis and PCR for herpes simplex virus (HSV)-1 was positive in CSF. Brain MRI revealed enhanced lesions in left temporal lobe. His symptom improved with acyclovir. Follow-up studies showed red blood cells in CSF and a hematoma in the left temporal lobe. There was no additional symptom related to the hematoma. He was discharged after conservative care. Although rare, hematoma can develop in HSV-1 meningoencephalitis.
Acyclovir ; Brain ; Encephalitis, Herpes Simplex* ; Erythrocytes ; Follow-Up Studies ; Hematoma* ; Herpes Simplex* ; Herpesvirus 1, Human ; Leukocytosis ; Magnetic Resonance Imaging ; Meningoencephalitis ; Neck ; Polymerase Chain Reaction ; Simplexvirus ; Sleep Stages ; Temporal Lobe

PURPOSE: Recent observational studies have found that vitamin D deficiency is associated with respiratory tract infections. However, randomized controlled trials (RCTs) regarding the efficacy of vitamin D in childhood respiratory tract infection (RTI) have yield inconsistent results. We performed a systematic review and meta-analysis to evaluate the association between vitamin D supplementation and the risk of RTI. METHODS: A comprehensive search was conducted using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trial. Randomized controlled trials of vitamin D supplementation for prevention of RTI in children were included for the analysis. Cochrane Collaboration's tool for assessing the risk of bias was used to assess the quality of the studies. Pooled risk ratios with 95% confidence intervals (CIs) were meta-analyzed using Review Manager 5.3. RESULTS: A total of seven RCTs were included in the meta-analysis. According to a random-effects model, the risk ratio for vitamin D supplementation was 0.82 (95% CI: 0.69-0.98) and I2=62% for heterogeneity. On subgroup analysis, heterogeneity decreased in the subgroup with follow-up less than 1 year, participants ≥5 years of age, patients subgroup, and subgroup with dosing daily. Funnel plot showed that there might be publication bias in the field. CONCLUSIONS: The present meta-analysis supports a beneficial effect of vitamin D supplementation for the prevention of RTI in children. However, the result should be interpreted with caution due to limitations including a small number of available RCTs, heterogeneity among the studies, and potential publication bias.
Bias (Epidemiology) ; Child* ; Follow-Up Studies ; Humans ; Odds Ratio ; Population Characteristics ; Publication Bias ; Respiratory System* ; Respiratory Tract Infections* ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

No abstract available.
Head* ; Humans ; Parkinsonian Disorders*

PURPOSE: To report a rare case of Aspergillus endophthalmitis as a preceding symptom of central nervous system (CNS) lymphoma. CASE SUMMARY: A 66-year-old female was admitted to our clinic with mental change for 3 days. Seven months earlier, she had been diagnosed with retinal vasculitis in an ophthalmology clinic because of blurred vision in both eyes and was administered steroid therapy. Three months earlier, because of progressive symptoms, vitreous fluid culture had been performed and showed Aspergillus endophthalmitis. She was treated with intravitreous voriconazole injection and oral voriconazole. Initial brain magnetic resonance imaging (MRI) and cerebrospinal fluid study was normal. Two months later, a second MRI showed multiple enhancing lesions, which were aggravated on the third MRI at admission to our clinic. Although brain biopsy was not performed due to the poor condition of the patient, CNS lymphoma was suspected based on the neuroimaging. After steroid pulse therapy and whole brain radiation, follow-up neurologic examination showed improved mental state, and follow-up MRI showed remarkable shrinkage of multiple lesions. CONCLUSIONS: As Aspergillus endophthalmitis is an opportunistic infection in those with an immune-compromised state and the orbit is near the central nervous system, the clinician should be alert to concomitant disorders in CNS. For a prompt and accurate diagnosis of CNS disorder, early evaluation of neurologic symptoms beyond symptoms of endophthalmitis and neuroimaging is essential.
Aged ; Aspergillus* ; Biopsy ; Brain ; Central Nervous System* ; Cerebrospinal Fluid ; Diagnosis ; Endophthalmitis* ; Female ; Follow-Up Studies ; Humans ; Lymphoma* ; Magnetic Resonance Imaging ; Neuroimaging ; Neurologic Examination ; Neurologic Manifestations ; Ophthalmology ; Opportunistic Infections ; Orbit ; Retinal Vasculitis