In early thrombolytic therapy for acute focal ischemic stroke, the start of treatment within therapeutic time window is one of the most important thing. Recently, new imaging modalities such as SPECT, transcranial doppler, diffusion/ perfusion-weighted MRI, and MR anglography have been implicated to avoid time consumption and delayed therapy. Of these, MR angiography is nomnvasi and rapid technique to visualize large and medium-sized arteries. We explored the usefulness of MR angiography in early thrombolytic therapy. Arterial occlusion of three patients with severe ischemic stroke were demonstrated on MR anglography and wluch were treated with Urokmase (10, 000-20, 000 units/kg) by intravenous infusion within 2-4 hours after symptom onset. Recanalization and brain lesion was assessed by repeated MR angiography and MRI or CT 24 hours later. Clinical improvement was observed in two patients 5-24 hours after initiation of treatment. In one patient hemorrhagic infarction without clinical deterioration was detected by follow-up computed tomography. Recanalization was documented on repeated MR angiography of three patients. MR angiography can document occlusion of stroke-related vasculature without delay of thrombolytic therapy and repeated MR anglography can reveal whether recanalization has occurred.
Angiography ; Arteries ; Brain ; Follow-Up Studies ; Humans ; Infarction ; Infusions, Intravenous ; Magnetic Resonance Angiography* ; Magnetic Resonance Imaging ; Stroke ; Thrombolytic Therapy ; Tomography, Emission-Computed, Single-Photon

BACKGROUND: To clarify the clinicoradiological correlation and prognosis of acute ischemic stroke involving para-median territory of pons. METHODS: We studied 37 patients with first-ever ischemic stroke involving paramedian terri-tory of pons and divided them based on the shape and level of lesion shown in their MRI. The clinical features, MRI findings, and prognosis were assessed. RESULTS: The paramedian infarctions extending to the basal surface were found in 28 patients (76%), and small infarctions separated from the basal surface were found in 9 patients (24%). In patients with infarction extending to the basal surface, 23 patients (82%) had progressive or fluctuating onset, whereas all patients with small infarction separated from the basal surface had non-progressive onset. In the group with upper pon-tine lesion (14 patients), dysarthria-clumsy hand syndrome was found in 4 patients, ataxic hemiparesis (AH) in 3, pure motor hemiparesis (PMH) in 2, and pure sensory stroke in 1. In the group with middle and lower pontine lesion (22 patients), PMH was found in 9, AH in 3, and sensory motor stroke in 2. The mean Modified Rankin Disability Scale scores on admission and after follow-up (mean 29 months) of the group with upper pontine lesion were 2.36 +/-0.50 and 1 . 0 0 +/-0.55, those with mid-lower pontine lesions, 3.48 +/-0.51 and 1.17 +/-0.49 (P<0.01 and P>0.05 respectively). CONCLUSIONS: Paramedian pontine infarction extending to the basal surface usually presents with progressive onset. Paramedian pontine infarction most often produces classic lacune syndrome of which PMH is the most common. In our study, patients with mid-lower paramedian pontine infarction had more severe initial neurological deficits than those with upper paramedian pontine infarction. However, a late outcome was found to be favorable in both groups.
Follow-Up Studies ; Hand ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Paresis ; Pons ; Prognosis* ; Stroke

Marchiafava-Bignami disease(MBD), characterized by the primary degeneration of the corpus callosum, is a rare complication of chronic alcoholism. Recently, a few cases of MBD with reversible neuro-imaging abnormalities were reported. A 58-year-old, chronic alcoholic man was admitted with mental change, dysarthria, and a seizure attack. A T2-weighted Brain magnetic resonance imaging demonstrated high signal intensities in the body and splenium of the corpus callosum, multiple white matter, and cortical gray matter. Treatment with a multiple vitamin complex resulted in a near complete recovery of neurological manifestation. A brain MRI obtained four weeks after admission revealed a dramatic resolution of previous imaging abnormalities. We report a case of Marchiafava-Bignami disease with reversible neuro-imaging abnormalities.
Alcoholics ; Alcoholism ; Brain* ; Corpus Callosum ; Dysarthria ; Humans ; Magnetic Resonance Imaging* ; Marchiafava-Bignami Disease* ; Middle Aged ; Neurologic Manifestations ; Seizures ; Vitamins

We reviewed 27 patients wlth cerebellar infarction which was demonstrated by brain CT and/or MRI. Infarction occurred in the territory of posterior inferior cerebellar artery (PICAj in 16 patients, and the territory of the superior cerebellar artery(SCA) was involved in 5 patients. Antenor inferior cerebellar artery(AICA) infarcts occurred in 3 patients. Both PICA and SCA temtories were involved in 2 patients. In the remaining 1 patient, the infarct encompassed the borderzone between the SCA and PICA territories. The main symptoms and signs were sudden onset of vertigo, dizziness, nausea, vomiting, dysmetria, ataxia, nystagmus, and headache. There were signs of associated brain stem infarction or occipitotemporal infarction; rostral basilar artery syndrome, classic SCA syndrome, Wallenberg syndrome, internuclear ophthalmoplegia, facial palsy, hearing impairment. Presumed cerebral embolism was the main stroke mechanism in the SCA terntories. Six patients with brainstem compression or brainstem involvement showed consciousness deterioration, and only one of them died as a result of extensive cerebellar infarctions involving both SCA and PICA territories Cerebellar infarction may run a more benign course than previously thought.
Arteries ; Ataxia ; Basilar Artery ; Brain ; Brain Stem ; Brain Stem Infarctions ; Cerebellar Ataxia ; Consciousness ; Dizziness ; Facial Paralysis ; Headache ; Hearing Loss ; Humans ; Infarction* ; Intracranial Embolism ; Lateral Medullary Syndrome ; Magnetic Resonance Imaging ; Nausea ; Ocular Motility Disorders ; Pica ; Stroke ; Vertigo ; Vomiting

No abstract available.
Aluminum* ; Onychomycosis* ; Yttrium*

Background and Objectives: Many preclinical studies have been conducted using animal disease models to determine the effectiveness of human mesenchymal stem cells (hMSCs) for treating immune and inflammatory diseases based on the belief that hMSCs are not immunogenic across species. However, several researchers have suggested xenogeneic immune responses to hMSCs in animals, still without detailed features. This study aimed to investigate a xenogeneic humoral immune response to hMSCs in mice in detail. Methods: and Results: Balb/c mice were intraperitoneally injected with adipose tissue-derived or Wharton’s jelly-derived hMSCs. Sera from these mice were titrated for each isotype. To confirm specificity of the antibodies, hMSCs were stained with the sera and subjected to a flow cytometic analysis. Spleens were immunostained for proliferating cell nuclear antigen to verify the germinal center formation. Additionally, splenocytes were subjected to a flow cytometric analysis for surface markers including GL-7, B220, CD4, CD8, CD44, and CD62L. Similar experiments were repeated in C57BL/6 mice. The results showed increased IgG 1 and IgG 2a titers in the sera from Balb/c mice injected with hMSCs, and the titers were much higher in the secondary sera than in the primary sera. These antibodies were specifically stained the hMSCs. Germinal centers were observed in the spleen, and flow cytometric analysis of the splenocytes showed higher frequencies of centroblasts (B220 ＋ GL7 ＋ ) and memory T cells (CD62L ＋ CD44 ＋ ) both in CD4 ＋ and CD8 ＋ subsets. Similar results were obtained for C57BL/6 mice. Conclusions hMSCs induced a humoral immune response in mice, with characters of T cell-dependent immunity

Background: A precise anatomical understanding of the adductor canal (AC) and its neural components is essential for discerning the action mechanism of the AC block. We therefore aimed to clarify the detailed anatomy of the AC using micro-computed tomography (micro-CT), histological evaluation, and immunofluorescence (IF) assays. Methods: Gross dissections of 39 thighs provided morphometric data relevant to injection landmarks. Serial sectional images of the AC were defined using micro-CT and ultrasonography. The fascial and neural structures of the AC proper were histologically evaluated using Masson’s trichrome and Verhoeff-Van Gieson staining, and double IF staining using choline acetyltransferase (ChAT) and neurofilament 200 antibodies. Results: The posteromedial branch insertion of the nerve to vastus medialis (NVM) into the lateral border of the AC proper was lower (14.5 ± 2.4 cm [mean ± SD] above the base of the patella) than the origin of the proximal AC. The AC consists of a thin subsartorial fascia in the proximal region and a thick aponeurosis-like vastoadductor membrane in the distal region. In the proximal AC, the posteromedial branch of the NVM (pmNVM) consistently contained both sensory and motor fibers, and more ChAT-positive fibers were observed than in the saphenous nerve (27.5 ± 11.2 / 104 vs. 4.2 ± 2.6 / 104 [counts/µm2], P < 0.001). Conclusions Anatomical differences in fascial structures between the proximal and distal AC and a mixed neural component of the neighboring pmNVM have been visualized using micro-CT images, histological evaluation, and IF assays.

BACKGROUND AND PURPOSE: Among the many factors having influence on seasonal incidence of thrombotic disease, we studied the seasonal variation of fibrinolytic activity, which might be thought to have influence on seasonal incidence of thrombotic disease. SUBJECT AND METHOD: Seasonal plasma tissue type plasminogen activator (t-PA) and euglobulin fibrinolytic activity (EFA) were measured in 18 male and 22 female normal volunteers during a year. RESULT: The level of t-PA was higher in winter than in spring (p<0.05), but was not significantly different in the other couples of four seasons. The level of EFA was higher in winter than in summer and in autumn (p<0.01), and was slightly higher in winter than in spring without significance. The level of EFA was higher in spring than in summer (p<0.05). There was no correlation between the level of t-PA and that of EFA in any of the seasons. CONCLUSION: The fibrinolytic activity is higher at lower temperature than at higher temperature. Thus, it seems that a rise in fibrinolytic activity in cold weather counters certain changes which make a thrombotic event.
Family Characteristics ; Female ; Healthy Volunteers ; Humans ; Incidence ; Male ; Plasma ; Seasons* ; Tissue Plasminogen Activator ; Weather

Eosinophilic gastroenteritis is a rare clinicopathologic entity of an unknown etiology with a variety of digestive symptoms. The clinical features depend on the site of eosinophilic infiltration and affected layer of intestinal wall. Diagnostic criteria include demonstration of eosinophilic infiltration of the affected bowel wall, lack of evidence extra-intestinal disease, and exclusion of various disorders that could mimic similar conditions. We experienced a 54-year-old man with 6 months history of severe intermittent abdominal colic associated with malnutrition and weight loss. Abdominal computed tomography showed mass like lesion at terminal ileum, which caused partial small bowel obstruction. So, we carried out laparotomy, and then segmental resection and ileo-ascending colostomy were done because of small bowel obstrucion. We diagnosed the case as transmural type of eosinophilic gastroenteritis. We report this case with a brief review of the literatures.
Colic ; Colostomy ; Eosinophils* ; Gastroenteritis* ; Humans ; Ileum ; Laparotomy ; Malnutrition ; Middle Aged ; Weight Loss

Hepatitis C virus (HCV) is one of the main causes of liver disease. 1~2% of the Korean people has been reported to be infected by HCV. Although HCV is less infectious than hepatitis B virus (HBV), it is more prone to develop chronic infection (~ 80%) which may link to cirrhosis and hepatocellular carcinogenesis. In addition, prevalence of hepatitis caused by HCV infection is gradually increased every year in Korea. Recently, a large number of clinical trials using direct-acting antiviral (DAA) drugs have been shown efficient therapeutic results for chronic HCV infections and some of them are on the market. However, there is still a concern on viral evasion to the DAAs and the effective mechanisms of immunological clearance of HCV remains to be elucidated. Here, we introduce the recent findings on the role of Th17-Treg axis which may play a critical role of the viral pathogenesis and/or immunological defense against HCV infection. The underlying regulatory mechanisms of Th17-Treg axis might be a potential candidate for the better control of HCV chronic infections.
Axis, Cervical Vertebra ; Carcinogenesis ; Fibrosis ; Hepacivirus* ; Hepatitis B virus ; Hepatitis C* ; Hepatitis* ; Interleukin-17 ; Korea ; Liver Diseases ; Prevalence