No abstract available.
Korea* ; Moyamoya Disease*

No abstract available.
Stevens-Johnson Syndrome*

No abstract available.
Kasabach-Merritt Syndrome*

Tibialis anterior muscle hernia is the most common hernia among lower extremity muscles. This condition can be diagnosed by physical examination and radiologic findings, especially by dynamic ultrasonography. There are surgical methods of treatment for muscle hernia, including direct repair, fasciotomy, fascial patch grafting using autologous fascia lata or synthetic mesh. We report a case of tibialis anterior muscle hernia treated with local periosteal rotational flap. Because there are several advantages to the local periosteal rotational flap, such as lack of donor site morbidity, lack of skin irritation, low cost, simplicity, and an easy approach, this technique could be an option for tibialis anterior muscle hernia.
Fascia Lata ; Hernia ; Humans ; Lower Extremity ; Muscle, Skeletal ; Muscles ; Physical Examination ; Skin ; Tissue Donors ; Transplants

Anti-N-methyl D-aspartate receptor (anti-NMDAR) encephalitis, recently recognized as a form of paraneoplastic encephalitis, is characterized by a prodromal phase of unspecific illness with fever that resembles a viral disease. The prodromal phase is followed by seizures, disturbed consciousness, psychiatric features, prominent abnormal movements, and autonomic imbalance. Here, we report a case of anti-NMDAR encephalitis with initial symptoms of epilepsia partialis continua in the absence of tumor. Briefly, a 3-year-old girl was admitted to the hospital due to right-sided, complex partial seizures without preceding febrile illness. The seizures evolved into epilepsia partialis continua and were accompanied by epileptiform discharges from the left frontal area. Three weeks after admission, the patient's seizures were reduced with antiepileptic drugs; however, she developed sleep disturbances, cognitive decline, noticeable oro-lingual-facial dyskinesia, and choreoathetoid movements. Anti-NMDAR encephalitis was confirmed by positive detection of NMDAR antibodies in the patient's serum and cerebrospinal fluid, and her condition slowly improved with immunoglobulin, methylprednisolone, and rituximab. At present, the patient is no longer taking multiple antiepileptic or antihypertensive drugs. Moreover, the patient showed gradual improvement of motor and cognitive function. This case serves as an example that a diagnosis of anti-NMDAR encephalitis should be considered when children with uncontrolled seizures develop dyskinesias without evidence of malignant tumor. In these cases, aggressive immunotherapies are needed to improve the outcome of anti-NMDAR encephalitis.
Anti-N-Methyl-D-Aspartate Receptor Encephalitis* ; Antibodies ; Anticonvulsants ; Antihypertensive Agents ; Cerebrospinal Fluid ; Child* ; Child, Preschool ; Cognition ; Consciousness ; D-Aspartic Acid ; Diagnosis ; Dyskinesias ; Encephalitis ; Epilepsia Partialis Continua* ; Female ; Fever ; Humans ; Immunoglobulins ; Immunotherapy ; Korea* ; Methylprednisolone ; Rituximab ; Seizures ; Virus Diseases

Objective: The purpose of this study was to verify the validity and reliability of Korean elderly by translating the Hayling Test, a test that measures semantic inhibition ability among executive functions. Methods: Total 91 participants were recruited in accordance with inclusion criteria and exclusion criteria for each group. Within them, 34 were normal from Dongjak-gu, Seoul, 29 were mild cognitive impairment (MCI) from clinics located in Seoul, and 28were Alzheimer’s disease (AD) from clinics located in Seoul, respectively. The one-way analysis of covariance, the Bonferroni veri-fication, the receiver operating characteristic (ROC) curve analysis, and the Brain Imaging analysis of voxel-based morphometrywere conducted in order to compare and analyze performance of demographics characteristics of each group, Hayling Test results, and The Continuous Performance Test-X (CPTX) results. Results: The comparison analysis showed the Hayling Test is more valid methodology than the CPTX test in discriminating nor-mal, MCI, and AD. Furthermore, ROC curves between normal and AD groups also demonstrated higher sensitivity (88%) and specificity (73%) of Hayling Test, and confirmed its diagnostic validity. In line with the above, brain imaging analysis displays sig-nificant positive correlation between temporal & frontal brain regions through the Hayling Test scores, however, this correlationwas not found for CPTX. Conclusion It is expected that the Haling Test, which measures language inhibition function, can be used simply and usefully in diagnosing dementia.

A previously healthy 52-year-old man presented to the emergency room with acute onset left hemiparesis and dysarthria. Brain computed tomography and magnetic resonance examinations revealed acute cerebral infarction in the right middle cerebral artery territory and a sphenoid ridge meningioma encasing the right carotid artery terminus. Cerebral angiography demonstrated complete occlusion of the right proximal M1 portion. A computed tomography perfusion study showed a wide area of perfusion-diffusion mismatch. Over the ensuing 48 hours, left sided weakness deteriorated despite medical treatment. Emergency extracranial-intracranial bypass was performed using a double-barrel technique, leaving the tumor as it was, and subsequently his neurological function was improved dramatically. We present a rare case of sphenoid ridge meningioma causing acute cerebral infarction as a result of middle cerebral artery compression.
Brain ; Carotid Arteries ; Cerebral Angiography ; Cerebral Infarction* ; Dysarthria ; Emergencies ; Emergency Service, Hospital ; Humans ; Meningioma* ; Middle Aged ; Middle Cerebral Artery ; Paresis ; Perfusion

The authors describe a case of choriocarcinoma that metastasized to the cerebral cortex, vertebral body, and intramedullary spinal cord. A 21-year-old woman presented with sudden headache, vomiting and a visual field defect. Brain computed tomography and magnetic resonance examinations revealed an intracranial hemorrhage in the left temporo-parietal lobe and two enhancing nodules in the left temporal and right frontal lobe. After several days, the size of the hemorrhage increased, and a new hemorrhage was identified in the right frontal lobe. The hematoma and enhancing mass in the left temporo-parietal lobe were surgically removed. Choriocarcinoma was diagnosed after histological examination. At 6 days after the operation, her consciousness had worsened and she was in a state of stupor. The size of the hematoma in the right frontal lobe was enlarged. We performed an emergency operation to remove the hematoma and enhancing mass. Her mental status recovered slowly. Two months thereafter, she complained of paraplegia with sensory loss below the nipples. Whole spine magnetic resonance imaging revealed a well-enhancing mass in the thoracic intramedullary spinal cord and L2 vertebral body. Despite chemotherapy and radiotherapy, the patient died 13 months after the diagnosis.
Brain ; Cerebral Cortex ; Choriocarcinoma ; Consciousness ; Emergencies ; Female ; Frontal Lobe ; Headache ; Hematoma ; Hemorrhage ; Humans ; Intracranial Hemorrhages ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Neoplasm Metastasis ; Nipples ; Paraplegia ; Pregnancy ; Spinal Cord ; Spine ; Stupor ; Visual Fields ; Vomiting ; Young Adult

Twin-to-twin transfusion syndrome (TTTS) is one of the complications showing high mortality rate in monochorionic twins with vascular communication in the placenta. Clinical manifestations of TTTS are usually characterized by polyhydramnios, circulatory overload, cardiac failure and fetal hydrops in the recipient twin and symmetrical fetal growth restriction, oligohydramnios, hypovolemia and anemia in the donor twin. TTTS occurres in 10-35% of monochorionic twins. We report three cases of TTTS with fetal hydrops in which amnioreduction was serially attempted and maternal digoxin treatment was tried for the therapeutic purpose.
Anemia ; Digoxin ; Female ; Fetal Development ; Fetal Therapies ; Fetofetal Transfusion* ; Heart Failure ; Humans ; Hydrops Fetalis ; Hypovolemia ; Mortality ; Oligohydramnios ; Placenta ; Polyhydramnios ; Pregnancy ; Tissue Donors

BACKGROUND: We are continually exposed to low-dose radiation (LDR) in the range 0.1 Gy from natural sources, medical devices, nuclear energy plants, and other industrial sources of ionizing radiation. There are three models for the biological mechanism of LDR: the linear no-threshold model, the hormetic model, and the threshold model. OBJECTIVE: We used keratinocytes as a model system to investigate the molecular genetic effects of LDR on epidermal cell differentiation. METHODS: To identify keratinocyte differentiation, we performed western blots using a specific antibody for involucrin, which is a precursor protein of the keratinocyte cornified envelope and a marker for keratinocyte terminal differentiation. We also performed quantitative polymerase chain reaction. We examined whether LDR induces changes in involucrin messenger RNA (mRNA) and protein levels in calcium-induced keratinocyte differentiation. RESULTS: Exposure of HaCaT cells to LDR (0.1 Gy) induced p21 expression. p21 is a key regulator that induces growth arrest and represses stemness, which accelerates keratinocyte differentiation. We correlated involucrin expression with keratinocyte differentiation, and examined the effects of LDR on involucrin levels and keratinocyte development. LDR significantly increased involucrin mRNA and protein levels during calcium-induced keratinocyte differentiation. CONCLUSION: These studies provide new evidence for the biological role of LDR, and identify the potential to utilize LDR to regulate or induce keratinocyte differentiation.
Blotting, Western ; Cell Differentiation ; Keratinocytes* ; Molecular Biology ; Nuclear Energy ; Polymerase Chain Reaction ; Radiation, Ionizing ; RNA, Messenger