The authors reviewed the clinical findings and treatment results of 12 cases of spinal meningeal cysts which were detected in MRI of low back patients. In these lesions, large cysts without CSF communication can compressed the nerve roots within spinal canal and it is difficult to confirm the cause of symptom whether it is originated from cysts or from associated spinal disorders. The terms and classifications of spinal meningeal cysts were very confusing. Among 12 cases, we excised 3 cases of large cysts with gluteal and perianal pains that were caused by compressed sacral nerve roots. All three cases were type 2 cyst (classified by Nabors) and located in sacral canal. In one case associated with isthmic spondylolisthesis, posterolateral fusion and pedicle screw fixations were combined with cyst excision. In other two cases, there were not any spinal pathologic findings that compressed sacral nerve roots except mild degenerative changes and intervertebral disc herniation in lower lumbar and sacral levels All 3 excised cases showed good prognosis in more than one year follow up. The other cases were treated conservatively for the associated spinal disorders.
Classification ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging ; Prognosis ; Radiculopathy ; Spinal Canal ; Spondylolisthesis

PURPOSE: Even though Malassezia yeast may play an important role in the exacerbation of atopic dermatitis (AD), only a few studies of Malassezia infection have been conducted in children with AD. Thus, we compared each of clinical findings, including the severity of head and neck dermatitis and laboratory results depending on specific IgE against Malassezia furfur. METHODS: This cross-sectional study was carried out on 121 children aged 3 months to 18 years between April and July of 2014. Retrospective data was collected using the medical records, and patients were divided into 2 groups according to the presence of Malassezia sensitization. RESULTS: Specific IgE against Malassezia (group 1) was observed in 28 of all patients (23.1%). Group 1 children were at an older age (9.1+/-6.9 vs. 2.1+/-3.7, P<0.001). Group 1 children had a higher SCORing Atopic Dermatitis (SCORAD) index (46.4+/-21.0 ng/mL vs. 37.2+/-13.4 ng/mL, P=0.001), and total IgE (1,324.2+/-1,166.0 IU/mL vs. 209.5+/-532.5 IU/mL, P<0.001) compared to group 2 children (Malassezia-). In the group 1, the correlation between the Malassezia-specific IgE and 25-hydroxyvitamin D3 was negatively weak (r=-0.106) and not statistically significant (P=0.246). Furthermore, Malassezia-specific IgE and the SCORAD index (r=0.281, P=0.002) or total IgE (r=0.380, P<0.001) were positively correlated. CONCLUSION: The results of this study suggest that specific IgE against M. furfur may be helpful in assessing the severity of prepubertal children and early adolescents with AD involving the head and neck.
Adolescent ; Calcifediol ; Child* ; Cross-Sectional Studies ; Dermatitis* ; Dermatitis, Atopic ; Head* ; Humans ; Immunoglobulin E* ; Malassezia ; Medical Records ; Neck* ; Retrospective Studies ; Yeasts

BACKGROUND: Resistance of Mycobacterium tuberculosis to anti-tuberculosis (TB) drugs is almost exclusively due to spontaneous chromosomal mutations in target genes. Rapid detection of drug resistance to both first- and second-line anti-TB drugs has become a key component of TB control programs. Technologies that allow rapid, cost-effective, and high-throughput detection of specific nucleic acid sequences are needed. This study was to develop a high-throughput assay based on allele-specific primer extension (ASPE) and MagPlex-TAG microspheres to detect anti-TB drug resistance mutations. METHODS: DNA samples from 357 M. tuberculosis clinical isolates and H37Rv were amplified by multiplex PCR using four primer sets, followed by multiplex ASPE using 23 TAG-ASPE primers. The products were sorted on the TAG-ASPE array and detected by using the Luminex xMAP system. Genotypes were also determined by sequencing. RESULTS: Genetic drug susceptibility typing by the TAG-ASPE method was 100% concordant with those obtained by sequencing. Compared with phenotypic drug susceptibility testing (DST) as a reference method, the sensitivity and specificity of the TAG-ASPE method were 83% (95% confidence interval [CI], 79-88%) and 97% (95% CI, 90-100%) for isoniazid. For rifampin testing, the sensitivity and specificity were 90% (95% CI, 86-93%) and 100% (95% CI, 99-100%). Also, the sensitivity and specificity were 58% (95% CI, 51-65%) and 86% (95% CI, 79-93%) for ethambutol. CONCLUSIONS: This study demonstrated the TAG-ASPE method is suitable for highly reproducible, cost-effective, and high-throughput clinical genotyping applications.
DNA ; Drug Resistance* ; Ethambutol ; Genotype ; Isoniazid ; Microspheres ; Multiplex Polymerase Chain Reaction ; Mycobacterium tuberculosis ; Rifampin ; Tuberculosis ; Viperidae

OBJECTIVE: To find the characteristics of stroke in colorectal cancer patients. METHOD: We retrospectively analyzed 32 patients of stroke in colorectal cancer who were operated from January 2001 to December 2002 by reviewing their charts and brain CTs or MRIs. The type, risk factor, localization and origin of stroke and the stage of colorectal cancer were analyzed. RESULTS: The mean age was 69.2 years. TNM stage II (41%) was the most common. Twenty-three cases were ischemic stroke, four were hemorrhagic stroke and the others were unidentified. Diabetes (63%), hypertension (53%), cardiac disease (19%), and family history of stroke (9%) were observed in patients. The main cause of ischemic stroke was arterial thrombosis, and lacunar and middle cerebral infarction were more common in ischemic stroke. CONCLUSION: Several common risk factors between colorectal cancer and stroke were observed, and these risk factors are associated with the atherosclerosis of cerebral vascular system. To reduce the incidence of cerebrovascular disease and colorectal cancer, we may need to control those risk factors.
Atherosclerosis ; Brain ; Cerebral Infarction ; Colorectal Neoplasms ; Heart Diseases ; Humans ; Hypertension ; Incidence ; Prevalence ; Retrospective Studies ; Risk Factors ; Stroke ; Thrombosis

BACKGROUND: Small proportions of all the elderly stroke patients receive recombinant tissue plasminogen activator (r-tPA) therapy, although old age is not a proven contraindication to intravenous thrombolytic therapy for acute ischemic stroke. The purpose of this study was to identify reasons for exclusion from r-tPA therapy and factors associated with the decision of r-tPA use in elderly patients with acute ischemic stroke. METHODS: From the acute stroke registries of 22 domestic university hospitals taking the r-tPA therapy from January 2007 to May 2010, we extracted data of all acute ischemic stroke patients who were aged 80 or over and arrived within onset 3 hours. For all patients, we assessed the eligibility of r-tPA therapy using National Institute of Neurological Disorders and Stroke (NINDS) r-tPA trial criteria. For eligible patients, we compared all clinical variables between patients who were treated with r-tPA and those who were not, and analyzed potential factors related to the decision of r-tPA use. RESULTS: A total of 494 patients were included in this study. 255 patients (51.6%) were excluded by NINDS r-tPA trial criteria and the major reasons for exclusion were minor neurological deficit (53.7%) and clinical improvement (17.3%). Among 239 patients who were eligible for r-tPA, 162 (32.8%) patients received r-tPA and 77 (15.6%) did not. Multivariable analysis showed that younger age, shorter time-delay from onset to admission, non-smoker, no history of prior stroke, good pre-stroke functional status and severe initial neurological deficit were independently associated with the decision of r-tPA use in the elderly stroke patients predictors for r-tPA treatment. CONCLUSION: In very elderly patients, mild neurological deficit on arrival and rapid clinical improvement in neurological symptoms were the main reasons for exclusion from thrombolytic therapy.
Aged ; Hospitals, University ; Humans ; National Institute of Neurological Disorders and Stroke ; Registries ; Stroke ; Thrombolytic Therapy ; Tissue Plasminogen Activator

Background: and Purpose: Blood pressure (BP) control is strongly recommended, but BP control rate has not been well studied in patients with stroke. We evaluated the BP control rate with fimasartan-based antihypertensive therapy initiated in patients with recent cerebral ischemia. Methods: This multicenter, prospective, single-arm trial involved 27 centers in South Korea. Key inclusion criteria were recent cerebral ischemia within 90 days and high BP [systolic blood pressure (SBP) >140 mm Hg or diastolic blood pressure (DBP) >90 mm Hg]. BP lowering was initiated with fimasartan. BP management during the follow-up was at the discretion of the responsible investigators. The primary endpoint was the target BP goal achievement rate (<140/90 mm Hg) at 24 weeks. Key secondary endpoints included achieved BP and BP changes at each visit, and clinical events (ClinicalTrials.gov Identifier: NCT03231293). Results: Of 1,035 patients enrolled, 1,026 were included in the safety analysis, and 951 in the efficacy analysis. Their mean age was 64.1 years, 33% were female, the median time interval from onset to enrollment was 10 days, and the baseline SBP and DBP were 162.3±16.0 and 92.2±12.4 mm Hg (mean±SD). During the study period, 55.5% of patients were maintained on fimasartan monotherapy, and 44.5% received antihypertensive therapies other than fimasartan monotherapy at at least one visit. The target BP goal achievement rate at 24-week was 67.3% (48.6% at 4-week and 61.4% at 12-week). The mean BP was 139.0/81.8±18.3/11.7, 133.8/79.2±16.4/11.0, and 132.8/78.5±15.6/10.9 mm Hg at 4-, 12-, and 24-week. The treatment-emergent adverse event rate was 5.4%, including one serious adverse event. Conclusions Fimasartan-based BP lowering achieved the target BP in two-thirds of patients at 24 weeks, and was generally well tolerated.

Background: and Purpose: Blood pressure (BP) control is strongly recommended, but BP control rate has not been well studied in patients with stroke. We evaluated the BP control rate with fimasartan-based antihypertensive therapy initiated in patients with recent cerebral ischemia. Methods: This multicenter, prospective, single-arm trial involved 27 centers in South Korea. Key inclusion criteria were recent cerebral ischemia within 90 days and high BP [systolic blood pressure (SBP) >140 mm Hg or diastolic blood pressure (DBP) >90 mm Hg]. BP lowering was initiated with fimasartan. BP management during the follow-up was at the discretion of the responsible investigators. The primary endpoint was the target BP goal achievement rate (<140/90 mm Hg) at 24 weeks. Key secondary endpoints included achieved BP and BP changes at each visit, and clinical events (ClinicalTrials.gov Identifier: NCT03231293). Results: Of 1,035 patients enrolled, 1,026 were included in the safety analysis, and 951 in the efficacy analysis. Their mean age was 64.1 years, 33% were female, the median time interval from onset to enrollment was 10 days, and the baseline SBP and DBP were 162.3±16.0 and 92.2±12.4 mm Hg (mean±SD). During the study period, 55.5% of patients were maintained on fimasartan monotherapy, and 44.5% received antihypertensive therapies other than fimasartan monotherapy at at least one visit. The target BP goal achievement rate at 24-week was 67.3% (48.6% at 4-week and 61.4% at 12-week). The mean BP was 139.0/81.8±18.3/11.7, 133.8/79.2±16.4/11.0, and 132.8/78.5±15.6/10.9 mm Hg at 4-, 12-, and 24-week. The treatment-emergent adverse event rate was 5.4%, including one serious adverse event. Conclusions Fimasartan-based BP lowering achieved the target BP in two-thirds of patients at 24 weeks, and was generally well tolerated.