No abstract available.
Infarction

Coronavirus disease 2019 (COVID-19) is a new type of epidemic infectious disease that threatens the world after it first broke out in Wuhan, China, in December 2019. By early March, Korea had the second largest number of confirmed cases of COVID-19 in the world after China, among which about 90% of patients reported in Daegu and Gyeongsangbuk-do province. As a neurologist, the author experienced various neurological diseases while working at hub-hospitals for COVID-19 in Daegu. I would like to describe the role of a neurologist in the emerging outbreak of infectious diseases, along with my experience working at the hub-hospital for Middle East Respiratory Syndrome (MERS) in 2015.

PURPOSE: The treatment of children mandibular condyle fracture that is severely displaced is controversial. The conservative treatment of it may lead to complications- mandibular deficiency, asymmetry, malocclusion and temporomandibular joint dysfunction. Moreover, open reduction carries risks for growth retardation, facial nerve injury, scarring and joint stiffness. The aim of this article is to present an alternative technique of the treatment by using a threaded Kirschner wire and external rubber traction. METHODS: From November 2005 to May 2008, three patients underwent the management by using a threaded Kirschner wire and external rubber traction. A threaded Kirschner wire was inserted in the condylar segment by using a C-arm. We applied the external rubber traction, and we reducted the segment progressively until complete reduction. The mandibular-maxillary fixations were removed after 3 weeks, and patients were sent to training for mouth opening. RESULTS: The technique didn't result in complications- joint dysfunction, facial nerve injury, sore, infection and nonunion during follow-up period. Radiologic follow-up examinations revealed correct reduction in all patients. In all cases, we found restoration of preinjury occlusion and temporomandibular joint function. CONCLUSION: Closed reduction of children mandibular condyle fracture by using a threaded Kirschner wire and external rubber traction did achieve anatomic reduction and restore mandibular height. This alternative technique is simple, effective, inexpensive, easy to apply and minimally invasive.
Child ; Cicatrix ; Facial Nerve Injuries ; Follow-Up Studies ; Humans ; Joints ; Malocclusion ; Mandibular Condyle ; Mouth ; Rubber ; Temporomandibular Joint ; Traction

No abstract available.
Encephalitis, Herpes Simplex ; Herpes Simplex ; Methylmethacrylates ; Neurosyphilis ; Polystyrenes

Thymoma occurs in about 20% of patients with myasthenia gravis (MG), but the recurrence of thymoma has rarely been reported. A 68-year-old man presented with ptosis and weakness of the neck muscles. He had undergone thymectomy for ocular MG with invasive thymoma 20 years previously. Chest computed tomography revealed recurrence of the thymoma. This 20-year period is, to our knowledge, the longest reported interval for recurrence of an MG-associated thymoma. The literature on the optimal follow-up duration after thymectomy is reviewed.
Aged ; Follow-Up Studies* ; Humans ; Myasthenia Gravis* ; Neck Muscles ; Recurrence* ; Thorax ; Thymectomy* ; Thymoma*

Objectives: Now, coronavirus disease (COVID-19) is worldwide threatening. Medical staff’s efforts and sacrifices against COVID-19 are still ongoing. The purpose of this study was to investigate the mental health of the medical staff who have fought against the COVID-19 in hub hospitals. Methods: The medical staff underwent an evaluation of psychiatric and sleep status between March 23rd and April 3rd, 2020. Based on the evaluation, we retrospectively analyzed depression, anxiety, and sleep quality of the medical staff, who worked more than 7 days for fighting against the COVID-19. Results: This study included a total of 101 medical staff. Approximately 1/4 of the medical staff showed depressive mood and low quality of sleep, and more than 1/3 reported anxiety. The nurses reported more severe psychiatric symptoms and poorer sleep quality. Conclusions This study demonstrated the mental and sleep status of the medical staff against COVID-19. Medical and social support should be considered for them.

Background: Intravenous recombinant tissue plasminogen activator (IV rtPA) is the mainstay of treatment for acute ischemic stroke to recanalize thrombosed intracranial vessels within 4.5 hours. Emergency carotid artery stenting for the treatment of acute stroke due to stenoocclusion of the proximal internal carotid artery (ICA) can improve symptoms, prevent neurological deterioration, and reduce recurrent stroke risk. The feasibility and safety of the combination therapy of IV rtPA and urgent carotid artery stenting have not been established. Methods: From November 2005 to October 2020, we retrospectively assessed patients who had undergone emergent carotid artery stenting after IV rtPA for hyperacute ischemic stroke due to steno-occlusive proximal ICA lesion. Hemorrhagic transformation, successful recanalization, modified Rankin Scale (mRS) score at 90 days, and stent patency at 3 and 12 months or longer were evaluated. Favorable outcome was defined as a 90-days mRS score of ≤ 2. Results: Nineteen patients with hyperacute stroke had undergone emergent carotid artery stenting after IV rtPA therapy. Their median age was 70 (67.5–73.5) years (94.7% men).Among 15 patients with an additional intracranial occlusion after flow restoration in the proximal ICA, a modified TICI grade ≥ 2b was achieved in 11 patients (73.3%). Hemorrhagic transformation occurred in five patients (26.3%); mortality rate was 5.7%. Eleven patients (57.9%) had favorable outcomes at 90 days. Stent patients (94.1%) maintained stent patency for ≥ 12 months. Conclusion We showed that emergent carotid artery stenting after IV rtPA therapy for hyperacute stroke caused by atherosclerotic proximal ICA steno-occlusion was feasible and safe.

PURPOSE: This study was performed to determine the relationship between PTEN and vascular endothelial growth factor (VEGF) expression and to assess their roles in the tumor-induced angiogenesis and tumor progression in non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Formalin-fixed, paraffin-embedded tissues, from 96 patients diagnosed with NSCLC, were evaluated for VEGF and PTEN expression using immunohistochemical methods. The results of the expression pattern of VEGF alone, or in combination with PTEN expression, were compared with clinicopathological parameters. RESULTS: VEGF expression was seen in 54 (56.3%) of the 96 NSCLCs evaluated, and was significantly correlated with histological type, and seen more frequently in adenocarcinomas compared to the other histological types (p<0.05). There were no significant associations between VEGF expression and tumor size, lymph node metastasis and stage. The microvessel density (MVD) determined by CD34 staining were significantly higher in tumors with VEGF expression (62.9+/-21.8) than those without (55.1+/-15.1). Loss of PTEN expression was seen in 33 (34.4%) of the 96 NSCLCs evaluated. VEGF expression was more frequently detected in the tumors with loss of PTEN expression (69.7%) than in those with PTEN expression (49.2%). When the combined VEGF/ PTEN phenotypes were divide into two groups; group I (VEGF-/PTEN+) and group II (VEGF-/ PTEN-, VEGF+/PTEN+, VEGF+/PTEN-), a significant correlation was also seen between the groups and the histologic types. There was a trend for the tumors in group II to show more frequent lymph node metastasis (50.0%) than those in group I (31.5%), although there was no statistical significance. The MVDs were significantly higher in group II (63.1+/-20.7) than in group I (53.4+/-17.2). CONCLUSION: These findings demonstrate an inverse correlation between the expressions of PTEN and VEGF. It is possible that PTEN may repress VEGF expression, and modulate VEGF-mediated angiogenesis, which suggests further analysis of the complex phenomenon of neo-angiogenesis in NSCLC is essential.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Chromosomes, Human, Pair 10 ; Humans ; Lymph Nodes ; Microvessels ; Neoplasm Metastasis ; Phenotype ; Vascular Endothelial Growth Factor A*

PURPOSE: The aim of this sutdy was to evaluate the feasibility of 3-[131I]Iodo-O-methyl-L-a-methyltyrosine ([131I]OMINT) as an agent for tumor image. MATERIALS AND METHODS: After synthesis of 4-O-methyl-L-a-methyltyrosine (OMAMT), OMAMT was labeled with 131I using Iodogen method. In viro cellular uptake study was performed using 9 L gliosarcoma cells at various time points upto 4 hr. The biodistribution (five rats implanted with the 9 L gliosarcoma cells per group) was evaluated at 30 min, 2 hr, 24 hr after iv injection of 3.7 MBq [131I]OMIMT or L-3-[131I]iodo-a-methyltyrosine ([131I]IMT). Gamma camera images were obtained at 30min, 2 hr, and 24 hr. RESULTS: [131I]OMINT uptake was 3.3 times and 2.5 times higher than [131I]IMT uptake at 30 min and 60 min, respectively and same after 2 hr in in vitro sutdy using 9L gliosarcoma cells. Maximum accumulation in tumor occurred at 30 min for both [131IOMINT and [131I]IMT in tumor bearing rats. The tumor uptake of [131I]OMINT was significantly higher than that of [131I]IMT in tumor bearing rats. The tumor uptake of [131I]OMIMT was significantly higher than that of [131I]IMT at early time point studied (3.74 +/- 0.48 vs 0.38 +/- 0.17% ID/g at 30 min and 2.40 +/- 0.17 vs 0.24 +/- 0.03% ID/g at 2 hr, respectively, p<0.01). However, the tumor uptake of both radiolabels were not significantly different at 24 hr (0.04 +/- 0.01 vs 0.05 +/- 0.01% ID/g). Tumor was visualized as early as at 30 min in gamma camera images. CONCLUSION: These data suggested that [131I]OMIMT might be a useful tumor imaging agent and has more advantage for the tumor imaging compared to [131I]IMT.
Animals ; Gamma Cameras ; Gliosarcoma ; Rats*