Sweet's syndrome, or acute febrile neutrophilic dermatosis, is an unusual disease characterized by fever, leukocytosis, and distinctive skin lesions. Common complications include arthralgia, arthritis, conjunctivitis, and iridocyclitis. However, the involvement of the central nervous system in this disease, termed `neuro-Sweet syndrome' is rarely reported. We present a patient with recurrent encephalitis for 15 years, accompanied with neutrophilic dermatosis, and characterized by HLA-B54 and Cw1, with good responsiveness to corticosteroid.
Arthralgia ; Arthritis ; Central Nervous System ; Conjunctivitis ; Encephalitis ; Fever ; Humans ; Iridocyclitis ; Leukocytosis ; Neutrophils ; Skin ; Skin Diseases ; Sweet Syndrome

Osmotic myelinolysis syndrome in central nervous system is classified into central pontine myelinolysis(CPM) and extrapontine myelinolysis(EPM). The former can cause a spastic quadriplegia, pseudobulbar palsy, and varying degree of mental disorder, but the latter a movement disorder(tremor, dystonia, parkinsonism, and chorea, etc), behavior change(mood instability, personality change, agitated delirium, and disinhibition, etc), and cognitive dysfunction. Although a few cases of asymptomatic CPM have been reported, asymptomatic EPM were rare. A 67-year-old woman with diabetes mellitus and old cerebral infarction has suffered from the common bile duct stone. She had hyponatremia(Na=126mEq/L) on admission and was corrected rapidly. Incidental findings of her brain MRI showed EPM. We experienced a case of bilateral middle cerebellar peduncle myelinolysis incidentally without neurological presentations and report a rare case of asymptomatic EPM recoverd in diabetic woman after rapid correction of hyponatremia.
Aged ; Brain ; Central Nervous System ; Cerebral Infarction ; Chorea ; Common Bile Duct ; Delirium ; Diabetes Mellitus ; Dihydroergotamine ; Dystonia ; Female ; Humans ; Hyponatremia ; Incidental Findings ; Magnetic Resonance Imaging ; Mental Disorders ; Myelinolysis, Central Pontine* ; Parkinsonian Disorders ; Pseudobulbar Palsy ; Quadriplegia

OBJECTIVES: People at ultra-high risk for psychosis have heterogenous character and different long-term outcomes. We divided ultra-high risk subjects into two subgroups by presence of familial history and tried to find different pattern of functional connectivity of the default mode network (DMN) between the two groups in order to examine the effects familial loading. METHODS: Eleven subjects at clinical-high risk (CHR) group with familial history of psychiatric illness and nineteen subjects of CHR group without familial history were recruited. All the subjects were scanned using resting-state functional magnetic resonance imaging. A posterior cingulate cortex was the seed region of the analysis, and the DMN of the both high risk group were analyzed with voxel-wise two sample T test. RESULTS: The CHR group with familial history showed greater functional connectivity in the precuneus area in contrast with the other high risk subjects (peak-level t=5.49, p<0.001). There were no significant differences in total score on the Positive and Negative Syndrome Scale and Scales of Psychosis-risk Syndrome between the two groups. CONCLUSION: The study suggests that the abnormalities of functional connectivity between precuneus and posterior cingulate area may be associated with the genetic vulnerability of high risk trait.
Gyrus Cinguli ; Magnetic Resonance Imaging ; Pilot Projects ; Psychotic Disorders ; Seeds ; Weights and Measures

OBJECTIVES: Tetrasodium pyrophosphate (TSP) is used in processed meat products, as an emulsifier in cheese, and as a color preservative in soybean paste. However, little is known about its toxicity. This study was conducted to investigate the potential acute and repeated dose toxicity of TSP in Spraque Dawley (SD) rats. METHODS: In the acute study, animals were administered with oral or dermal doses of 2,000 mg/kg TSP. In the repeated dose study, animals were administered doses of 0, 250, 500, and 1,000 mg/kg by oral gavage five times a week for 90 days. RESULTS: In acute toxicity studies, no dead animals or abnormal necropsy findings were found in the control or treated group. In the repeated dose toxicity study, there were no significant changes in body weight in the 1,000 mg/kg treatment group, or food consumption, urinalysis, and hematology in any group. With regards serum biochemistry, the levels of total protein, albumin, A/G ratio, triglyceride, calcium and inorganic phosphate were altered at doses of 500 and 1,000 mg/kg. However, no changes were observed at the dose of 250 mg/kg. With regards histopathological findings, cortical tubular basophilia of the kidney increased at the dose of 1,000 mg/kg, but not at doses of 250 and 500 mg/kg. No significant changes were observed in other organs at doses of 250, 500, and 1,000 mg/kg. CONCLUSIONS: Based on the results, TSP is unclassified according to the Globally Harmonization System, with an LD50 value of over 2,000 mg/kg. The no observed effect level (NOEL) and no observed adverse effect level (NOAEL) were 250 and 500 mg/kg /day respectively and the target organ appears to be the kidney.
Animals ; Biochemistry ; Body Weight ; Calcium ; Cheese ; Diphosphates ; Hematology ; Kidney ; Lethal Dose 50 ; Meat Products ; No-Observed-Adverse-Effect Level ; Rats ; Soybeans ; Urinalysis

PURPOSE: To tabulate underlying disease and to assess the clinical significance of CT-diagnosed spontaneouspneumonediastinum. MATERIALS AND METHODS: We retrospectively reviewed CT scans and medical records of 11consecutive patients with spontaneous pneumomediastinum, and analyzed their clinical history and course, and infive cases, pulmonary function. CT scans of 126 patients with idiopathic pulmonary fibrosis (IPF) collected whilethe 11 consecutive patients were being treated were analyzed for the prevalence of pneumomediastinum. We analyzedCT findings with respect to the amount and distribution of air in the mediastinum, and the presence or absence ofair outside the mediastinum. RESULTS: In the 11 patients, underlying diseases were IPF (n=4), bronchiolitisobliterans organizing pneumonia (BOOP)(n=2), bronchiectasis (n=2), tuberculous tracheal stenosis (n=1), andpulmonary tuberculosis with bullous emphysema (n=1); there was one without associated disease. Of the 126 patientswith IPF, four (3.2%) showed spontaneous pneumomediastinum. All ten with underlying diseases had severe dyspnea.In five patients, a pulmonary function test showed marked impairment. Two of four patients with IPF and both withBOOP died within 2 months of CT scanning, whereas the remaining six showed clinical improvement. The detectionrate of pneumomediastinum on plain chest radiograph was 82% (9/11). CT showed that mediastinal air was mostfrequently found in the retrosternal space. There were four cases of pneumothorax and two of subcutaneousemphysema. CONCLUSION: Spontaneous pneumomediastinum might be associated with idiopathic pulmonary fibrosis andmight be a poor prognostic factor in patients with IPF or BOOP.
Bronchiectasis ; Cryptogenic Organizing Pneumonia ; Emphysema ; Humans ; Idiopathic Pulmonary Fibrosis ; Mediastinal Emphysema* ; Mediastinum ; Medical Records ; Pneumonia ; Pneumothorax ; Prevalence ; Radiography, Thoracic ; Respiratory Function Tests ; Retrospective Studies ; Tomography, X-Ray Computed ; Tracheal Stenosis ; Tuberculosis

PURPOSE: To compare the CT findings of mycobacterial infection other than tuberculosis (MOTT) with those of tuberculosis (TB). MATERIALS AND METHODS: The chest CT scans of 30 immunocompetent patients with culture-proven pulmonary MOTT (M:F=11:19; mean age, 51.2 yrs.) and of 24 patients with active tuberculosis (M:F=12:12; mean age, 42.5 yrs.) were analyzed by two radiologists; decisions were reached by consensus. RESULTS: Common findings for both MOTT and TB included bronchogenicaly-spread bronchogenic spread nodular lesion (93.3% for MOTT, 100 % for TB), bronchiectasis (90%, 83.3%), bronchial wall thickening (66.7%, 54.2%), granuloma (63.3%, 75%), parenchymal scarring (53.3%, 54.2), and mediastinal lym-phadenopathy (50%, 37.5 %). Less commonly observed findings were emphysema (46.7%, 29.7%), atelectasis (36.7%, 29.2%), narrowing of a major airway (23.3%, 25%), consolidation (23.3 %, 29.2 %), and pleural disease (16.7%, 29.2%). Except for cavity (30%, 53.3%; p< .05), the frequencies of each finding were not right middle lobe (40%, 16.7%), right lower lobe (63.3%, 33.3%) and lingula division (53.3 %, 25%) was sig-nificantly more common in MOTT than in TB (p < .05). The number of lobes in which bronchiectasis and bronchial wall thickening were involved was greater in MOTT(3.20) than in TB(2.04) (p=.011). CONCLUSION: Although the CT findings of MOTT and TB overlap considerably, cavities are more common in TB, while in MOTT, bronchiectasis in the lower lung zone is more common and bronchiectasis tends to be more extensive.
Bronchiectasis ; Cicatrix ; Consensus ; Emphysema ; Granuloma ; Humans ; Lung ; Pleural Diseases ; Pulmonary Atelectasis ; Tomography, X-Ray Computed ; Tuberculosis*

To investigate the characteristics of incidental pituitary microadenomas, we examined 120 pituitary glands from Korean forensic autopsy cases, from which eight tumors were identified (incidence 6.7%). The average age of the affected subjects was 50 yr (range: 33-96 yr) with a female predominance. The maximum diameters of the tumors ranged from 0.4 to 5.4 mm (mean: 2.8 mm). Immunohistochemical analysis of pituitary hormones revealed three growth hormone-secreting adenomas, one prolactin-producing adenoma, one gonadotropin-producing adenoma, one plurihormonal adenoma, and two null cell adenomas. MIB-1 staining for Ki-67 antigen showed no positive expression. The microvessel density (MVD) of the pituitary microadenomas ranged from 2.3 to 11.6% (mean: 5.3%) and was significantly lower than that of nonneoplastic pituitary glands (11.9-20.1%, mean: 14.8%). Our study provides reference data on incidental pituitary microadenomas in the Korean population.
Adenoma/blood supply/epidemiology/metabolism/*pathology ; Adult ; Aged ; Aged, 80 and over ; Autopsy ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen/metabolism ; Korea/epidemiology ; Male ; Microcirculation/pathology ; Middle Aged ; Pituitary Hormones/metabolism ; Pituitary Neoplasms/blood supply/epidemiology/metabolism/*pathology

No abstract available.
Lichen Planus ; Lichens

Alveolar soft-part sarcoma is a rare soft tissue sarcoma of young adults with unknown histogenesis, and the organ most frequently involved in metastasis is the lung. We report the CT findings of three patients of pulmonary metastases of alveolar soft-part sarcoma, which manifested as clearly enhanced pulmonary nodules or masses. On enhanced scans, some of the masses were seen to contain dilated and tortuous intratumoral vessels.
Adult ; Case Report ; Female ; Human ; Lung Neoplasms/blood supply/*radiography/*secondary ; Male ; Sarcoma, Alveolar Soft Part/blood supply/*radiography/*secondary ; *Tomography, X-Ray Computed

Deep vein thrombosis and pulmonary embolism are serious and fatal complications in orthopedic surgery. Most cases of symptomatic pulmonary embolism in knee surgery have been reported after total knee arthroplasty, but rarely after patella fracture. We report on a case of symptomatic pulmonary embolism after surgical treatment of a patella fracture in a 42-year-old female patient.
Adult ; Arthroplasty ; Enclomiphene ; Female ; Humans ; Knee ; Patella* ; Pulmonary Embolism* ; Venous Thrombosis