No abstract available.
Congenital Abnormalities*

Objective: Recently, the lipid profile of atherogenic dyslipidemia has become important in cerebrovascular diseases. Atherogenic index of plasma (AIP), an index that reflects this lipid profile as a single number, has been proposed, but there are still few related studies in cerebrovascular disease. In this study, we evaluated the relationship between AIP and cerebral small vessel disease (cSVD) in health check-up participants. Methods: We assessed consecutive health check-ups participants between 2006 and 2013. cSVD was measured including the following three subtypes: white matter hyperintensity (WMH), lacuens, and cerebral microbleeds (CMBs). WMH quantitatively measured the volume, and lacunes and CMBs qualitatively evaluated the presence. AIP was calculated according to the following formula based on blood test results: AIP=log [triglyceride (mg/ dL)/high-density lipoprotein cholesterol (mg/dL)]. Results: A total of 3,170 participants were evaluated (mean age: 56.5 years, male sex: 53.8%). In multivariable linear regression analysis, AIP (β=0.129, 95% confidence interval [CI]=0.003–0.255) was associated with WMH. Age, hypertension, diabetes, lipid-lowering agents, and intracranial atherosclerosis were also associated with WMH volume. In multivariable logistic regression analysis, AIP (adjusted odds ratio=1.72 1.79, 95% CI=1.03– 2.90) showed close association with lacunes. Age and intracranial atherosclerosis were also related to lacunes. CMBs did not show a statistically significant association with AIP. Conclusion High AIP was associated with cSVD in health check-up participants. Since this close relationship was only seen in WMH and lacunes, these subtypes may have arisen from a more atherosclerosis-related pathology.

Systemic lupus erythematosus (SLE) is a disease of unknown etiology in which tissues and cells are damaged by pathogenic autoantibodies and immune complexes. Skin manifestations of SLE include malar rash, discoid rash, photosensitivity, oral ulcer, panniculitis, urticaria, bullae, erythema multiforme and lichen planus-like lesions. It has long been recognized that dystrophic soft tissue calcification may occur in association with certain connective tissue disorders such as scleroderma or dermatomyositis. Soft tissue calcification in a patient with SLE has been rarely reported. We have experienced a patient with SLE who presented with diffuse subcutaneous tissue calcification on face, chest, abdomen and all extremities.
Abdomen ; Antigen-Antibody Complex ; Autoantibodies ; Connective Tissue ; Dermatomyositis ; Erythema Multiforme ; Exanthema ; Extremities ; Humans ; Lichens ; Lupus Erythematosus, Systemic* ; Oral Ulcer ; Panniculitis ; Skin Manifestations ; Subcutaneous Tissue* ; Thorax ; Urticaria

No abstract available.
Bone Density* ; Estrogens* ; Female ; Humans

BACKGROUND: It has been well known that absolute and interpeak latencies of brainstem auditory evoked potentials (BAEP) are usually prolonged in diabetics. However, Its etiology is still controversial. We tried to identify whether the cause is structural or metabolic in origin by performing BAEP and brain MRI in the diabetic patients. METHODS: BAEP were performed in both the diabetic patients (DM) group (16 males and 15 females) and the normal control group (25 males and 33 female). A brain MRI was performed in the DM group on those who showed abnormal BAEP and com-pared the results of BAEP of the DM group with those of the control group. RESULTS: 7 patients (22.6%) showed abnor-mal BAEP (male; 6, female; 1, unilateral; 4, bilateral; 3) when abnormal BAEP was defined as being larger than two and a half standard deviations of the control group BAEP results. Two males of the DM group who showed abnormal structural lesions of the pons in their brain MRI were not included in the statistical analysis. The remaining 14 diabetic male patients (mean age: 58.7 +/-9.1 years, mean disease duration: 6.1 +/-4.7 years, mean hemoglobin (Hb) A1C: 7.7 +/- 2.0%) and 15 diabetic female patients (mean age: 60.6 +/-10.8 years, mean disease duration: 5.4 +/-5.1 years, mean HgA1C: 7.8 +/-2.1%) were stastistically analyzed. Interpeak latencies of I-III, III-V, and I-V were found to be signifi-cantly prolonged in the DM group. The prolongation of interpeak latencies of I-III and I-V were found to be signifi-cantly correlated with the disease duration only in the diabetic female patients, but not with age and HbA1c. CONCLUSIONS: These findings suggest that both metabolic derangement and structural lesion contribute to prolonging the central conduction time on BAEP pathway in diabetics.
Brain ; Brain Stem* ; Diabetes Mellitus ; Evoked Potentials, Auditory, Brain Stem* ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Pons

Auditory agnoia is defined as a disability to recognize spoken languages and/or nonverbal environmental sounds and music despite adequate hearing while spontaneous speech, reading and writing are preserved. Usually, either bilateral or unilateral temporal lobe especially transverse gyral lesions are responsible for auditory agnosia. Subcortical lesions without cortical damage else rarely causes auditory agnosia. We pesent a 65-year-old right-handed male with generalized auditory agnosia caused by bilateral subcorcal lesions. After the two attacks of stroke, he could not understand and recognize spoken words and meet of non verbal sounds. Repetition and dictation were impossible but spontaneous speech was fluent and comprehensible even though mild paraphasic error was noted. Naming was normal. He could understand and read aloud the written words and phrases. Clinical examination of the ears was normal as were audiometry and brainstem auditory evoked potential. Brain magnetic resonance images showed a large cavitary lesion due to an old intracerebral hematoma in right subcortical temporoparietal lobe with preserved superior temporal gyrus and a slit like subcortical lesion in the left insula.
Aged ; Agnosia* ; Audiometry ; Brain ; Ear ; Evoked Potentials, Auditory, Brain Stem ; Hearing ; Hematoma ; Humans ; Male ; Music ; Stroke ; Temporal Lobe ; Writing

Epidermoid cysts occur rarely on the palms and soles, where hair is not present. These cysts have long been assumed to arise from traumatic implantation of epidermal fragment, but the pathogenesis is still controversial. Recently, with microscopic findings, immunohistochemical features, and molecular studies, the epidermoid cysts of the sole may be induced by the human papillomavirus. We report two cases of epidermoid cysts of the sole with the discussion of the pathogenesis.
Epidermal Cyst* ; Hair ; Humans*

Intradural extramedullary tuberculoma of the spinal cord (IETSC) is an uncommon disease which can occurs secondary to tuberculous meningitis. A 31-year-old woman was diagnosed as tuberculous meningitis after mental disorientation. Her mentality was recovered after antituberculous therapy. After 7 months of antituberculous therapy, paraplegia has developed. Magnetic resonance imaging (MRI) revealed a mass lesion between the T1 and T12 spinal levels with arachnoid thickening which results in the development of tuberculoma. She received surgical resection of IETSC followed by antituberculous therapy and neurological function has been improved. The two years after surgical treatment, spinal MRI showed syringomyelia between T1 to L1. But, her neurological outcome was not aggravated.
Adult ; Arachnoid ; Female ; Humans ; Magnetic Resonance Imaging ; Paraplegia ; Spinal Cord* ; Syringomyelia ; Tuberculoma* ; Tuberculosis, Meningeal*

No abstract available.
Multiple Organ Failure* ; Sepsis*

We described the findings of fine needle aspiration cytology of the lung from a patient with Wegener's granulomatosis. Early diagnosis and prompt treatment of the patients with Wegener's granulomatosis is essential for a better prognosis. However, the variety of clinical presentations and nonspecific radiologic infiltrates of Wegener's granulomatosis frequently make the diagnosis difficult. Although an open lung biopsy is required for a firm diagnosis, fine needle aspiration cytology & biopsy preparation can also provide an adequate tissue sample, when the findings of fine needle aspiration are considered with clinical manifestations and ANCA value in the serum. The cytologic smears showed scattered necrotic tissue fragments entrapping many neutrophils and occasional epithelioid cells. Multinucleated giant cells were infrequently observed. Ziehl-Neelsen stain for acid fast bacilli was negative. All the cytologic features recapitulated the histopathologic findings of purulent and necrotizing granulomatous inflammation seen in Wegener's granulomatosis.
Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Biopsy, Fine-Needle* ; Diagnosis ; Early Diagnosis ; Epithelioid Cells ; Giant Cells ; Humans ; Inflammation ; Lung ; Neutrophils ; Prognosis ; Wegener Granulomatosis*