No abstract available.
Nucleopolyhedrovirus* ; Sequence Analysis*

Herpes zoster involving noncontiguous dual dermatomes is very rare in both immunocompetent and immunocompromised persons. This unique presentation has been referred to as zoster duplex unilateralis or bilateralis, depending whether one or both halves of the body are involved. A 22-year-old woman, who had been treated for acute leukemia, congestive heart failure and chronic disseminated candidiasis, was referred to our department for painful papulovesicular eruptions on the right side of the anterior chest and upper back for 2 days, and the left buttock for 1 day. Tzanck smear revealed multinucleated giant cells with intranuclear inclusion bodies. We report a rare case of zoster duplex bilateralis.
Buttocks ; Candidiasis ; Female ; Giant Cells ; Heart Failure ; Herpes Zoster* ; Humans ; Intranuclear Inclusion Bodies ; Leukemia ; Thorax ; Young Adult

Cystic natured pelvic mass in males are very rare condition in the field of urology. Recently, we experienced a cystic pelvic mass in a 24-year old male, so we report this case with brief review of literature.
Humans ; Male ; Urology ; Young Adult

PURPOSE: Intraductal papilloma (IDP) is a benign breast disease with malignant potential, for which complete surgical excision is usually recommended. The aim of the present study was to investigate predictive factors for upgrading patients with a benign papillary lesion (BPL). METHODS: This study was an observational study using a prospectively collected cohort. In total, 13,049 patients who underwent a core needle biopsy (CNB) for a breast lesion between January 2009 and May 2015 were enrolled. We reviewed all patients with pathologically confirmed BPL from a CNB. RESULTS: Surgical treatment was performed for 363 out of a total of 592 lesions. According to the pathological differences, the lowest upgrade rate was shown in IDP without atypia (without atypia, 6.0%; with atypia, 26.8%; papillary neoplasm, 31.5%; p<0.001). The univariate analysis showed that, in IDP without atypia, the age at diagnosis, size of BPL on ultrasonography, and density on mammography were associated with upgrading. The multivariate analysis revealed that age >54 years and lesion size >1 cm were significantly associated with upgrade to malignancy (odds ratio [OR]=4.351, p=0.005 and OR=4.236, p=0.001, respectively). CONCLUSION: The indications for surgical treatment can be defined as age >54 years and mass size >1 cm, even in IDP without atypia in the CNB results; this also includes cases of IDP with atypia or papillary neoplasm. Therefore, we suggest that close observation without surgery is sufficient for younger women with a small IDP without atypia.
Biopsy ; Biopsy, Large-Core Needle* ; Breast Diseases ; Breast Neoplasms ; Breast* ; Cohort Studies ; Diagnosis ; Female ; Humans ; Mammography ; Multivariate Analysis ; Observational Study ; Papilloma, Intraductal ; Prospective Studies ; Ultrasonography

Epilepsy is a chronic neurological disorder manifesting recurrent unprovoked epileptic seizures. About 20~30% of epilepsy patients are resistant to antiepileptic medications. These patients suffer from high risk of physical injury, unemployment, marital problem, and psychological stress. Epilepsy surgery is the firstly recommended treatment modality for the patients with medically intractable epilepsy. Presurgical evaluation is the most important process for performing epilepsy surgery. The ultimate goal of the presurgical evaluation in patients with medically refractory partial seizures is the localization of the epileptogenic zone and the resection of which is also both necessary and sufficient to render the patient seizure-free. The localization of the epileptogenic zone derives from a hierarchical synthesis of localizing data independently obtained from clinical, electrographic, neuroimaging, and neuropsychological examination. In addition, closely related to the goal of localizing the epileptogenic zone is the significant need for anticipating the risks of functional deficits that could derive from the surgical resection. Mesial temporal lobe epilepsy (TLE) is the best candidate for epilepsy surgery. Anterior temporal lobectomy with amygdalohippocampectomy is a surgical treatment method for mesial TLE and its seizure-free rate (SFR) is 60~90%, whereas one-year SFR of antiepileptic drug treatment for mesial TLE is 10~20%. Cortisectomy is a surgical method for extratemporal epilepsy and its SFR is about 40~70%. Corpus callosotomy is a partial or complete division of corpus callosum for preventing seizure propagations between right and left hemispheres and is effective for controlling atonic seizures. The variation of postsurgical seizure outcomes is related to the qualities of epilepsy surgery program, presurgical evaluation and surgical techniques. For the good surgical outcome, the epilepsy surgery program should include neurologist, neurosurgeon, neuropsychologist, neuro-radiologist and neuro-nuclear medicine specialist for a comprehensive team approach.
Anterior Temporal Lobectomy ; Corpus Callosum ; Epilepsy* ; Epilepsy, Temporal Lobe ; Humans ; Nervous System Diseases ; Neuroimaging ; Seizures ; Specialization ; Stress, Psychological ; Unemployment

Objectives: The diagnosis of hypersomnia may be changed by the repeated multiple sleep latency test (MSLT). We investigated the long-term reliability of MSLT in the diagnosis of narcolepsy type 1(NT1) and 2 (NT2). Methods: We reviewed the data of patients with NT1 and NT2 who underwent MSLT at least twice between 2008 and 2020. The clinical information and polysomnography/MSLT data were thoroughly assessed, and two sleep experts evaluated the consistency and reliability of diagnosis independently. Results: Eighty patients (38 with NT1 and 42 with NT2 as a final diagnosis) were included in this study. Of the 80 patients, 20 (nine with NT1 and 11 with NT2) underwent the 3rd MSLT. No significant differences were found in the sleep data and Epworth Sleepiness Scale at baseline. During the 2nd MSLT, 18.4% (n=7) patients with NT1 and 47.6% (n=20) patients with NT2 did not satisfy the diagnosis of narcolepsy. At the 3rd MSLT, six out of nine patients with NT1 and seven of 11 patients with NT2 were not suitable for narcolepsy. Two of the initial NT1 (5.2%) and 10 of the initial NT2 (23.8%) patients were found to be normal. Three patients who were confirmed to have NT1 through consecutive MSLTs had significantly shorter sleep latency and more number of sleep-onset rapid eye movements than the other patients. Conclusions The reliability of MSLT were not robust in the diagnosis of NT1 and NT2 in this long-term follow-up study. The MSLT results should be interpreted with careful consideration based on elaborate preparations.

Objectives: The diagnosis of hypersomnia may be changed by the repeated multiple sleep latency test (MSLT). We investigated the long-term reliability of MSLT in the diagnosis of narcolepsy type 1(NT1) and 2 (NT2). Methods: We reviewed the data of patients with NT1 and NT2 who underwent MSLT at least twice between 2008 and 2020. The clinical information and polysomnography/MSLT data were thoroughly assessed, and two sleep experts evaluated the consistency and reliability of diagnosis independently. Results: Eighty patients (38 with NT1 and 42 with NT2 as a final diagnosis) were included in this study. Of the 80 patients, 20 (nine with NT1 and 11 with NT2) underwent the 3rd MSLT. No significant differences were found in the sleep data and Epworth Sleepiness Scale at baseline. During the 2nd MSLT, 18.4% (n=7) patients with NT1 and 47.6% (n=20) patients with NT2 did not satisfy the diagnosis of narcolepsy. At the 3rd MSLT, six out of nine patients with NT1 and seven of 11 patients with NT2 were not suitable for narcolepsy. Two of the initial NT1 (5.2%) and 10 of the initial NT2 (23.8%) patients were found to be normal. Three patients who were confirmed to have NT1 through consecutive MSLTs had significantly shorter sleep latency and more number of sleep-onset rapid eye movements than the other patients. Conclusions The reliability of MSLT were not robust in the diagnosis of NT1 and NT2 in this long-term follow-up study. The MSLT results should be interpreted with careful consideration based on elaborate preparations.

Localization of epileptogenic zone in central epilepsy is difficult because of extent and rapidity of ictal spread. Epilepsy surgery in central region is challenging because of the risk of sensorimotor deficitsrelated to excision of eloquent areas. We present a case of 27- year-old woman with a successful surgical treatment for intractable epilepsy from the central region.
Epilepsy ; Female ; Humans

The cause of primary spontaneous pneumothorax (PSP) is obvious. Recently, the FLCN mutation was suggested to be a causal factor in PSP. A 47-year-old Korean male patient with chief complaint of repetitive PSP had numerous emphysematous bullae and multiple large cysts based upon high resolution computer tomography. Here we report a case of PSP with an FLCN c.468_470delTTC mutation.
Blister ; Humans ; Male ; Middle Aged ; Pneumothorax ; Sequence Deletion

BACKGROUND AND PURPOSE: There is growing interest in high-frequency oscillations (HFO) as electrophysiological biomarkers of the epileptic brain. We evaluated the clinical utility of interictal HFO events, especially their occurrence rates, by comparing the spatial distribution with a clinically determined epileptogenic zone by using subdural macroelectrodes. METHODS: We obtained intracranial electroencephalogram data with a high temporal resolution (2000 Hz sampling rate, 0.05-500 Hz band-pass filter) from seven patients with medically refractory epilepsy. Three epochs of 5-minute, artifact-free data were selected randomly from the interictal period. HFO candidates were first detected by an automated algorithm and subsequently screened to discard false detections. Validated events were further categorized as fast ripple (FR) and ripple (R) according to their spectral profiles. The occurrence rate of HFOs was calculated for each electrode contact. An HFO events distribution map (EDM) was constructed for each patient to allow visualization of the spatial distribution of their HFO events. RESULTS: The subdural macroelectrodes were capable of detecting both R and FR events from the epileptic neocortex. The occurrence rate of HFO events, both FR and R, was significantly higher in the seizure onset zone (SOZ) than in other brain regions. Patient-specific HFO EDMs can facilitate the identification of the location of HFO-generating tissue, and comparison with findings from ictal recordings can provide additional useful information regarding the epileptogenic zone. CONCLUSIONS: The distribution of interictal HFOs was reasonably consistent with the SOZ. The detection of HFO events and construction of spatial distribution maps appears to be useful for the presurgical mapping of the epileptogenic zone.
Biomarkers ; Brain ; Electrodes ; Electroencephalography ; Epilepsies, Partial ; Epilepsy ; Humans ; Neocortex ; Seizures