No abstract available.
Pneumonia*

Distinct from migraine with aura or hemiplegic migraine, a rare clinical entity of migraine-like headache, transient focal neurologic deficit and CSF pleocytosis (HaNDL) has been known. Although the etiology or pathogenesis is unknown, possibility of viral infection or inflammation has been suggested. We report a 25-year-old man diagnosed as HaNDL with literature review. (J Korean Neurol Assoc 19(3):302~304, 2001)
Adult ; Aphasia ; Headache* ; Humans ; Inflammation ; Leukocytosis* ; Migraine Disorders ; Migraine with Aura ; Neurologic Manifestations*

No abstract available.
Encephalitis* ; Glioma* ; Recurrence*

BACKGROUND: Intracerebral hemorrhage (ICH) is associated with a considerable proportion of stroke and head injuries, but except for supportive care, there is no medical therapy available. Transplantation of human neural stem cells (NSCs) can be used to reduce behavioral deficit in experimental ischemic infarct model. However, effect of stem cell transplantation in experimental intracerebral hemorrhage (ICH) is unknown. We hypothesized that NSCs could migrate and differentiate into neurons or glial cells, and improve functional outcome in ICH. METHODS: Experimental ICH was made by intrastriatal administration of bacterial collagenase in adult rats. Animals were randomized to receive intravenously either immortalized Lac-Z positive human NSCs (5x1 06 in 500microL, n=15) or same volume of saline (n=12) on the following day. Animals were evaluated for 8 weeks after surgery with behavioral test battery. After 8 weeks, animals were sacrificed and the brains were sectioned. Transplanted NSCs were detected by X-gal histochemistry or beta-gal immunohistochemistry, and differentiation of grafted NSCs were evaluated by double labeling of GFAP, NeuN, or neurofilament. RESULTS: Transplanted NSCs migrated to the side of peri-hematomal areas, and differentiated into neurons and astrocytes. NSCs injection group showed improved performances on rotarod test after 2 weeks and on limb placing test after 5 weeks compared with control group (p<0.05) and these effect persisted up to 8 weeks. CONCLUSIONS: Intravenously injected NSCs enter rat brain with ICH, and differentiate into astrocytes or neuronal cell, which lead to functional recovery. These findings show the possibility that NSCs can be used to reduce neurological deficits in the experimental ICH.
Adult ; Animals ; Astrocytes ; Brain ; Cerebral Hemorrhage* ; Collagenases ; Craniocerebral Trauma ; Extremities ; Humans* ; Immunohistochemistry ; Neural Stem Cells* ; Neuroglia ; Neurons ; Rats ; Rotarod Performance Test ; Stem Cell Transplantation ; Stroke ; Transplants

BACKGROUND AND PURPOSE: Hypertrophic pachymeningitis (HP) is a rare disease caused by autoimmunity in the meninx that causes various neurologic symptoms, including headache, seizures, weakness, paresthesia, and cranial nerve palsies. Although the first-line therapy for HP is steroids, many HP cases are refractory to steroids or recur when the steroids are tapered. Here we report three HP cases that were successfully treated with rituximab (RTX). METHODS: From an institutional cohort recruited from April 2012 to July 2016, three HP cases that were identified to be steroid-refractory were treated with RTX (four weekly doses of 375 mg/m²). Clinical improvement was assessed by the number of relapses of any neurologic symptom and the largest dural thickness in MRI. RESULTS: All three patients were recurrence-free of neurologic symptoms and exhibited prominent decreases in the dural thickness after RTX treatment. No adverse events were observed in the patients. CONCLUSIONS: We suggest RTX as a second-line therapy for steroid-refractory HP. Further studies are warranted to confirm this observation in a larger population and to consider RTX as a first-line therapy.
Autoimmunity ; Cohort Studies ; Cranial Nerve Diseases ; Headache ; Humans ; Magnetic Resonance Imaging ; Meningitis* ; Neurologic Manifestations ; Paresthesia ; Rare Diseases ; Recurrence ; Rituximab* ; Seizures ; Steroids

Neurological disorders induced by long-term exposure to organic solvents typically have a slowly progressive clinical course, which may be arrested or even reversed following discontinuation of exposure. We report an unusual case of rapidly progressive toxic leukoencephalomyelopathy in a 29-year-old man who had worked at a chemical factory that used toluene for the manufacture of nylon 66 for 5 years. He presented with progressive weakness of legs, recurrent seizures, and cognitive decline. Widespread white-matter changes in the brain and spinal cord, and myelodysplastic syndrome were noted. He died 6 months after the onset of his symptoms, and autopsy showed discrete multifocal demyelination and necrosis in the central nervous system, and dysplastic cells of erythroid, myeloid, and megakaryotic lineages in blood vessels. The co-occurrence of leukoencephalomyelopathy and myelodysplastic syndrome highlights the vulnerability of the white matter and bone marrow to injury from organic solvents. Intravascular congestion of dysplastic hematopoietic cells might have led to his unusually rapid progression of leukoencephalomyelopathy.
Adult ; Autopsy ; Blood Vessels ; Bone Marrow ; Brain ; Central Nervous System ; Demyelinating Diseases ; Estrogens, Conjugated (USP) ; Humans ; Leg ; Myelodysplastic Syndromes* ; Necrosis ; Nervous System Diseases ; Nylons ; Seizures ; Solvents ; Spinal Cord ; Toluene

Rheumatoid arthritis (RA) is an autoimmune disease involving the synovial membrane of peripheral joints. T cells specific for self antigens may play a critical role. Identification of T cell receptors (TCR) of such specific T cell clones is very important for treatment, prevention and identification of relevant autoantigens. To identify specific T cells, TCR V beta family repertoire and the clonal expansion of T cells were analyzed in this study. The percentage of V beta 5+ or V beta 8+ cells in the synovial fluid mononuclear cells (SFMCs) was similar to that in the peripheral blood mononuclear cells (PBMCs). However, the percentage of DR+ T cells in the SFMCs was higher (p< 0.01). Analyzing the clonality of T cells in 8 V beta families (V beta 1, V beta 5, V beta 8, V beta 14, V beta 16, V beta 17, V beta 18, V beta 20), clonal expansions in CD8+ T cells from the SFMCs were found more frequently than in the PBMCs. The patterns of clonal expansions were discrepant between the SFMCs and the PBMCs even in the same patient, which suggests several inflamed tissue specific T cell clonal expansions in the SFMCs. These T cell clones might be activated by autoantigens which are not identified yet and responsible for the RA pathogenesis.
Arthritis, Rheumatoid/*metabolism/pathology ; Base Sequence ; Blood Cells/*metabolism ; Clone Cells ; Female ; Human ; Male ; Molecular Probes ; Molecular Sequence Data ; Polymerase Chain Reaction ; Receptors, Antigen, T-Cell/genetics/*metabolism ; Support, Non-U.S. Gov't ; Synovial Fluid/cytology/*metabolism ; T-Lymphocytes/*metabolism

BACKGROUND: Pneumonia is a common medical complication after acute stroke, and makes a considerable influence on the prognosis. It is potentially preventable or treatable if early recognized. Thus, the identification of which patients are at risk for the development of pneumonia is clinically significant. METHODS: A total of 240 patients with an acute stroke who were consecutively admitted to a Seoul National University Hospital were studied. The following prognostic factors were accounted for in the statistical analyses: age, sex, hypertension, diabetes, cardiac disease, smoking, recurrent stroke, NIHSS, modified Rankin scale (mRS), the presence of dysphagia, blood pressure, body temperature, white blood cell count, blood sugar, fibrinogen, Levin tube insertion, Foley catheter insertion, and subtype of stroke. RESULTS: Pneumonia was diagnosed in 36 (17.0%) patients during the acute stage of stroke, particularly within 2 weeks. Average admission stay of patients with pneumonia was 38.7 days, whereas it was 19.3 days for those without pneumonia. By multivariate analysis, Levin tube insertion, body temperature, recurrent stroke, and mRS were significant predictor of pneumonia development. Forty percent of patients with four or five points of mRS developed pneumonia, compared to 6% in less than four points. CONCLUSIONS: Our results show that the patients who have Levin tube, high mRS, or recurrent stroke tend to develop pneumonia after acute stroke. It is important for early detection and prevention of pneumonia in patients with high mRS.
Blood Glucose ; Blood Pressure ; Body Temperature ; Catheters ; Deglutition Disorders ; Fibrinogen ; Heart Diseases ; Humans ; Hypertension ; Leukocyte Count ; Multivariate Analysis ; Pneumonia* ; Prognosis ; Seoul ; Smoke ; Smoking ; Stroke*