We have noticed that several sentences in a review article by Drs. Jung and Roh published in J Clin Neurol [Circulating endothelial progenitor cells in cerebrovascular disease, J Clin Neurol 2008;4(4):139-147] are identical from those in an article by Dr. Rouhl et al. published in Stroke [Endothelial progenitor cell research in stroke: a potential shift in pathophysiological and therapeutical concepts, Stroke 2008;39(7):2158-2165]. The text of the Jung and Roh article neither mentions nor cites the article by Rouhl and colleagues. A review of this case by the editorial committee of Journal of Clinical Neurology concluded that Drs. Jung and Roh plagiarized the paper by Rouhl and colleagues. Drs. Jung and Roh have acknowledged the plagiarism in the original manuscript and given clear credit for the work of Dr. Rouhl and colleagues in a letter published in this issue as an "Apology". I regret that this has happened and that this plagiarism was not identified prior to publication.
Neurology ; Plagiarism ; Publications ; Stem Cells ; Stroke

Young adult stroke is not rare disease and have diverse causes. We studied 135 young adults aged 15 - 45 years who had been admitted to Severance Hospital with a diagnosis of cerebral infarction from January 1990 to June 1995. The results are as follows. 1. The diverse causes of earshot infarction in young adults have been found in most patients(88.2%). The major causes of cerebral infarction in young adults were atherosclerosis(32.6%) and cardioembolism(32.6%). The causes were significantly different between younger(15 - 30 years old) and older(31 - 45 years old) patients. 2. The major risk factors of atherosclerotic cerebral infarction were hypertension(29 patients), smoking(14 patients), and hyperlipidemia(11 patients). 3. The major causes of cardioembolism were valvular heart disease(21 patients) and prosthetic valve(I0 patients). The mitral valve prolapse was discovered only in one patient. 4. Fourteen patients had non-atherosclerotic vasculopathies. The moyamoya disease was the most common cause of them. 5. The other causes of cerebral infarction were found in 17 patients and the major causes were alcohol intoxication and postoperative thromboembolism. 6. The cerebral infarction occurred mostly in the carotid artery territory(95 patients) and the distribution of the involved vascular territory was not different between younger and older age groups. 7. The clinical outcomes were good in most patients (86, 7%). From the above results, we demonstrated that young adults with cerebral infarction had various causes and showed favorable clinical outcomes. We also found that the causes of cerebral infarction varied between younger and older groups. Our findings suggest that careful and thorough case-by-ease evaluation may be mandatory to clarify the causes of cerebral infarction in young adults.
Carotid Arteries ; Cerebral Infarction* ; Diagnosis ; Heart ; Humans ; Infarction ; Mitral Valve Prolapse ; Moyamoya Disease ; Rare Diseases ; Risk Factors ; Stroke ; Thromboembolism ; Young Adult*

Painful ophthalmoplegia is not common and may be due to variety of causes, of which distant metastsis of malignant lymphoma is rare. This is a case of painful ophthalmoplegia who has looked like Tolosa-Hunt syndrome at first showing normal CSF findings, increased erythrocyte sedimentation rate and some response to steroid. About 2 months later, however, pelvic malignant lymphoma (diffuse undifferentiated according to Rappaport classification) was found, followed by lymphomatous meningitis. The symptoms of pain and ophthalmoplegia were markedly improved after systemic and intrathecal chemotherapy and radiotherapy of whole brain for the metastatic malignant lymphoma.
Blood Sedimentation ; Brain ; Drug Therapy ; Lymphoma* ; Meningitis ; Ophthalmoplegia* ; Radiotherapy ; Tolosa-Hunt Syndrome

To get a better insight into the clinical differentiation between vertigo of cerebrovascular origin and of aural origin, we investigated radiologically proven stroke patients who presented with vertigo as an initial clinical manifestation. Of 154 stroke patients, 30 patients with vertigo (20%) had the relevant lesion, demonstrated with the initial computerized tomographic scan (13 patients) or the follow-up magnetic resonance imaging (MRI) study (17 patients) of the brain. Every lesion was in the vertebrobasilar arterial territory; 19 in the cerebellum, 8 in the pons, and 3 in the medulla oblongata. Although 12 of the 30 patients (40%) presented with vertigo in isolation at the onset of stroke, eight patients (27%) developed additional neurologic abnormalities from four hours to seven days later. Patients with isolated vertigo (13%) had the small lesion exclusively in the cerebellum of the PICA medial branch territory. The most frequent accompanying neurological sign was swaying in the cerebellar and medullary lesion, and dysarthria in the pontine lesion. The direction of nystagmus or swaying did not match the lesion side in some patients. Our findings suggest that cerebellar stroke may commonly manifest isolated vertigo or vertigo with swaying mimicking labyrinthine disorder, particularly at the onset of the disease. MRI study and tests for truncal ataxia and lateropulsion may be crucial for the detection of vertigo of cerebrovascular origin.
Adult ; Cerebrovascular Disorders/complications/*radiography ; Diagnosis, Differential ; Female ; Human ; Male ; Nervous System Diseases/etiology ; Nystagmus, Pathologic/etiology ; Prospective Studies ; Sensation Disorders/*diagnosis ; *Tomography, X-Ray Computed ; Vertigo/complications/*radiography

Diphenylbydantoin-induced movement disorders have been rarely reported. They include choreoathetosis, orofacial dyskinesia, asterixis, dystonia, and ballismus. A patient with epllepsy, who showed orofacial dyskinesia with toxic cerebellar syrnptoms after longterm use of diphenylhydantoin is presented. The involuntary movement rapidily disappeared with a reduction of diphenylhydantoin dose.
Dyskinesias ; Dystonia ; Humans ; Movement Disorders* ; Phenytoin

Painful ophthalmoplegia is an unusual presentation of malignant lymphoma. Moreover, spontaneous remission and exacerbation of it has quite rarely been reported. We present a patient who showed spontaneous remission and exacerbation of the painful ophthalmoplegia. Brain MR imagings showed infiltrating, iso-intensity mass a, TlWl and T2WI, and strong enhancement with gadolinium on TIWI in parasellar area. Malignant lymphoma of diffuse large cell type was found in cervical lymph node biopsy.
Biopsy ; Brain ; Gadolinium ; Humans ; Lymph Nodes ; Lymphoma* ; Ophthalmoplegia* ; Remission, Spontaneous*

BACKGROUND AND OBJECTIVES: Stroke onset is known to vary by several factors. Although it has been known that stroke may develop most frequently in the morning, its association with the type of activity has quite rarely been described. METHODS: We prospectively investigated by interview the time of and the activity during or before the onset of stroke in patients with acute cerebral infarction from Aug. 1995 to Mar. 1996. The activities were subdivided into basal metabolic rate state, sedentary, light, moderate, and heavy movements based on the caloric expenditure. RESULTS: One hundred-twenty five patients were enrolled. The time of day when ischemic stroke most frequently occurred was from 8:00 AM to noon. The type of activity was significantly associated with stroke onset in that it developed most commonly during and just after sleep or resting. The relationship between the onset of stroke and such patterns of onset time and the activity was found only in the atherothrombotic infarction, but not in the other stroke types. CONCLUSION: We demonstrated that stroke has clear diurnal variation. Our observations also suggested that the activity may be significantly associated with stroke onset. These findings may be useful for better understanding of the pathogenesis and prevention of ischemic stroke.
Basal Metabolism ; Cerebral Infarction* ; Health Expenditures ; Humans ; Infarction ; Prospective Studies ; Stroke

Recurrent zoster myelitis is quite rare. We present a previously healthy 27-year-old woman who developed recurrent attacks of myelopathy shortly after the characteristic skin rashes of herpes zoster. Magnetic resonance imaging studies demonstrated each lesion in the spinal cord at the same segments as the skin lesions. She had two attacks at opposite sites at the same spinal cord level and complete recovery after being treated with intravenous acyclovir. We suspect that direct invasion of varicella zoster virus was the cause of recurrent myelopathy in our patient.
Adult ; Case Report ; Female ; Herpes Zoster/complications* ; Human ; Magnetic Resonance Imaging ; Myelitis/virology* ; Myelitis/diagnosis ; Recurrence

Aseptic meningitis may rarely occur with the use of OKT3 murin monoclonal antibody, which is an immunosuppressive agent for the prevention and treatment of acute rejection in solid transplantation. We present a patient with aseptic meningitis, developed during OKT3 therapy, who shows characteristic clinical features and CSF findings consistent with OKT3 associated aseptic meningitis.
Humans ; Meningitis, Aseptic* ; Muromonab-CD3*

With the development of electrophysiologic technique, a more detailed topographical organizations of motor cortex, especially hand area have been introduced in animal experiment. To the best our knowledge, in cerebral infarction, only one patient with isolated weakness of intrinsic hand muscles has been reported. We present two patients with cerebral infarction who showed isolated weakness in their intrinsic hand. Patient 1; A 76-year-old woman with coronary artery obstructive disease developed abrupt weakness in flexion of right thumb, index, middle finger and in adduction of thumb. Brain MRI showed a small discrete lesion in the posterior bank of left precentral gyrus. An angiography revealed an occlusion of left central sulcus artery. Prominent thumb adduction weakness was remained 11 days later. Patient 2; A 57-year-old hypertensive man was admitted because of recurrent TIA and decreased grasp power of right hand, especially flexion and adduction of thumb, index finger and middle finger. Brain MRI showed focal lamina necrosis in left precentral gyrus. An angiography revealed an occlusion of left internal carotid artery. Findings in our patients suggest that the similar arrangement of efferent zone for cortical hand area found in monkeys also may exist in human beings.
Aged ; Angiography ; Animal Experimentation ; Arteries ; Brain ; Carotid Artery, Internal ; Cerebral Infarction ; Coronary Vessels ; Female ; Fingers ; Hand Strength ; Hand* ; Haplorhini ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Middle Aged ; Motor Cortex ; Muscles* ; Necrosis ; Thumb