OBJECTIVE: To evaluate the relationship of high sensitivity C-reactive protein (hs-CRP), fibrinogen and homocysteine to carotid intima-media thickness (IMT) in acute ischemic stroke. METHODS: Subjects were 347 patients with acute cerebral infarction. The carotid arterial wall thickness was measured using high resolution B-mode ultrasound. The serum levels of hs-CRP, fibrinogen and homocysteine were measured by latex-enhanced turbidimetric immunoassay, clot scattering method, and chemiluminescence immunoassay respectively. Univariate regression analysis was performed to evaluate the relationship between these levels and carotid IMT. RESULTS: In patients with acute ischemic stroke, carotid IMT was significantly correlated with increased serum levels of hs-CRP and fibrinogen (P < 0.05, P < 0.01, respectively). However association between serum homocysteine and carotid IMT was not statistically significant. CONCLUSIONS: Increased serum levels of hs-CRP and fibrinogen may be correlated with carotid IMT. Measurement of serum hs-CRP and fibrinogen may be helpful for predicting degrees of atherosclerosis in acute ischemic stroke.
Atherosclerosis ; C-Reactive Protein ; Carotid Intima-Media Thickness ; Cerebral Infarction ; Fibrinogen ; Homocysteine ; Humans ; Immunoassay ; Luminescence ; Stroke

BACKGROUND AND PURPOSE: Stroke is common among cancer patients. However, risk factors and biomarkers of stroke in cancer patients are not well established. This study aimed to investigate risk factors and biomarkers as well as etiology of ischemic stroke in cancer patients. METHODS: A retrospective review was conducted in cancer patients with ischemic stroke who were admitted to a general hospital in Busan, Korea, between January 2003 and December 2012. The risk factors and biomarkers for stroke and stroke subtypes in cancer patients were compared with age- and sex-matched noncancer patients with ischemic stroke who were admitted to the same hospital during the same period. RESULTS: One hundred fifty-six cancer patients with ischemic stroke were identified. Cancer patients with ischemic stroke were found to have a significantly lower proportion of hypertension, atrial fibrillation, hyperlipidemia, and ischemic heart disease than noncancer patients with ischemic stroke. However, stroke biomarkers, such as erythrocyte sedimentation rate and high-sensitivity C-reactive protein, fibrinogen, pro-brain natriuretic peptide, and D-dimer levels, were significantly increased in cancer patients with ischemic stroke than in noncancer patients. Large-artery atherosclerosis and stroke of undetermined cause were more common in cancer patients with ischemic stroke than in noncancer patients with ischemic stroke. CONCLUSIONS: Cancer patients with ischemic stroke showed different risk factors, stroke biomarkers, and stroke etiology compared with noncancer patients with ischemic stroke.
Atherosclerosis ; Atrial Fibrillation ; Biomarkers* ; Blood Sedimentation ; Busan ; C-Reactive Protein ; Fibrinogen ; Hospitals, General ; Humans ; Hyperlipidemias ; Hypertension ; Korea ; Myocardial Ischemia ; Retrospective Studies ; Risk Factors* ; Stroke*

Calcium deposits in the basal ganglia and in the other areas of the brain may occur as idiopathic disease or secondary to metabolic disturbances including hypoparathyroidism. Fahr's syndrome is characterized by secondary cerebral calcification and variable clinical manifestations of movement disorder, cognitive impairment, and behavioral changes. We report a 48 year-old man with Fahr's syndrome due to idiopathic hypoparathyroidism who presented with recurrent epileptic seizures. Brain CT showed multiple calcifications of the Fahr type in the basal ganglia, thalami, cerebellar white matter and dentate nuclei, and centrum seiovale. Brain MRI diffusion-weighted image showed high signal intensity in the right anterior temporal region.
Basal Ganglia ; Brain ; Calcium ; Epilepsy ; Humans ; Hypoparathyroidism ; Movement Disorders

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by the human polyomavirus JC virus. PML mainly occurs in immunocompromised patients. A 36-year-old man with no evidence of immunosuppresion presented seizures. MRI scans of brain showed multifocal lesions in the cerebral white matters. JC virus DNA was positive in the cerebrospinal fluid examined by JC virus PCR. We report a rare case of PML presenting as viral encephalitis that occurred in a healthy adult person.
Adult ; Brain ; Central Nervous System ; Demyelinating Diseases ; DNA ; Encephalitis, Viral ; Humans ; Immunocompromised Host ; JC Virus ; Leukoencephalopathy, Progressive Multifocal ; Magnetic Resonance Imaging ; Polymerase Chain Reaction ; Seizures ; Viruses

PURPOSE: Controversy exists over the preoperative risk factors for postoperative urinary retention after the midurethral sling procedure for stress urinary incontinence (SUI). We intended to analyze the effect of preoperative flow rate on postoperative urinary retention after the transobturator tape (TOT) operation. MATERIALS AND METHODS: A total of 322 patients who underwent TOT from June 2006 to May 2012 were included in this retrospective study. All patients were preoperatively investigated for urinary symptoms and underwent preoperative urodynamic studies including urine flow rate. Postoperative urinary retention, voiding difficulty, and uroflowmetry were checked. Urinary retention was defined as the need for additional catheterization longer than 1 day. Patients were divided by preoperative peak flow rate (Qmax) of 15 mL/s (low Qmax group and normal Qmax group). RESULTS: There were 3 cases of postoperative urinary retention (0.9%) and 52 cases of voiding difficulty (16.1%). The low Qmax group included 40 patients (12.4%) and the normal Qmax group included 282 patients (87.5%). Between the two groups, there were no significant differences in age, previous pelvic surgery history, or past medical history. The low Qmax group had higher scores for voided volume and detrusor pressure at Qmax. However, there was no significant difference in postoperative voiding difficulty between the two groups. Furthermore, three patients who experienced postoperative retention showed high flow rates preoperatively. CONCLUSIONS: Our results suggest that voiding difficulty in the group with low preoperative flow was tolerable and the treatment success rate was comparable to that in patients in the normal flow group. According to our analysis, patients with a low flow rate preoperatively can be safely treated with TOT for SUI.
Catheterization ; Catheters ; Humans ; Retrospective Studies ; Risk Factors ; Suburethral Slings* ; Urinary Incontinence ; Urinary Incontinence, Stress ; Urinary Retention ; Urodynamics

Alzheimer's disease (AD) is the most common cause of age-related dementia. The neuropathological hallmarks of AD include extracellular deposition of amyloid-beta peptides and neurofibrillary tangles that lead to intracellular hyperphosphorylated tau in the brain. Soluble amyloid-beta oligomers are the primary pathogenic factor leading to cognitive impairment in AD. Neural stem cells (NSCs) are able to self-renew and give rise to multiple neural cell lineages in both developing and adult central nervous systems. To explore the relationship between AD-related pathology and the behaviors of NSCs that enable neuroregeneration, a number of studies have used animal and in vitro models to investigate the role of amyloid-beta on NSCs derived from various brain regions at different developmental stages. However, the Abeta effects on NSCs remain poorly understood because of conflicting results. To investigate the effects of amyloid-beta oligomers on human NSCs, we established amyloid precursor protein Swedish mutant-expressing cells and identified cell-derived amyloid-beta oligomers in the culture media. Human NSCs were isolated from an aborted fetal telencephalon at 13 weeks of gestation and expanded in culture as neurospheres. Human NSCs exposure to cell-derived amyloid-beta oligomers decreased dividing potential resulting from senescence through telomere attrition, impaired neurogenesis and promoted gliogenesis, and attenuated mobility. These amyloid-beta oligomers modulated the proliferation, differentiation and migration patterns of human NSCs via a glycogen synthase kinase-3beta-mediated signaling pathway. These findings contribute to the development of human NSC-based therapy for AD by elucidating the effects of Abeta oligomers on human NSCs.
Amyloid beta-Peptides/*pharmacology ; Animals ; Apoptosis ; Cell Aging ; Cell Movement ; Cell Proliferation ; Culture Media, Conditioned/chemistry/pharmacology ; Fetus/cytology ; Glycogen Synthase Kinase 3/*metabolism ; HEK293 Cells ; Humans ; Mice ; Mice, Inbred C57BL ; Neural Stem Cells/*drug effects/metabolism/physiology ; Signal Transduction ; Telomere Shortening

Serratia marcescens causes various diseases. Skin ulcer is one of S. marcescens related diseases, but it is rare clinical syndrome. We experienced a case of skin ulcer caused by S. marcescens in a woman with alcohol induced cirrhosis. After exposure to fresh water while trimming the codfish, she developed deep ulcer on her right hand and bacteremia by S. marcescens. S. marcescens should be considered as a specific etiology of skin infection presenting after fresh water exposure.
Abscess ; Bacteremia ; Female ; Fibrosis ; Fresh Water ; Hand ; Humans ; Liver Diseases, Alcoholic ; Serratia ; Serratia marcescens ; Skin ; Skin Ulcer ; Ulcer

Renal vein thrombosis (RVT) is not an uncommon condition amongst patients with nephrotic syndrome or malignancy. Septic pulmonary embolism (SPE) is associated with risk factors such as intravenous drug use, pelvic thrombophlebitis, and suppurative processes in the head and neck. However, acute pyelonephritis is a rare cause of RVT and SPE. Case reports on RVT and SPE due to acute pyelonephritis are rare. In most of the earlier cases, patients had underlying conditions such as diabetes mellitus, renal carcinoma, calyceal stones, and hyperhomocysteinemia. We report a case of acute pyelonephritis complicated by RVT and SPE that occurred in a patient without any predisposing risk factors for thromboembolism. RVT and SPE were diagnosed using computed tomography and ventilation/perfusion scan. The patient recovered with antibiotics and anticoagulation therapy without any surgical interventions.
Anti-Bacterial Agents ; Diabetes Mellitus ; Head ; Humans ; Hyperhomocysteinemia ; Neck ; Nephrotic Syndrome ; Pulmonary Embolism ; Pyelonephritis ; Renal Veins ; Risk Factors ; Thromboembolism ; Thrombophlebitis ; Thrombosis

Serratia marcescens causes various diseases. Skin ulcer is one of S. marcescens related diseases, but it is rare clinical syndrome. We experienced a case of skin ulcer caused by S. marcescens in a woman with alcohol induced cirrhosis. After exposure to fresh water while trimming the codfish, she developed deep ulcer on her right hand and bacteremia by S. marcescens. S. marcescens should be considered as a specific etiology of skin infection presenting after fresh water exposure.
Abscess ; Bacteremia ; Female ; Fibrosis ; Fresh Water ; Hand ; Humans ; Liver Diseases, Alcoholic ; Serratia ; Serratia marcescens ; Skin ; Skin Ulcer ; Ulcer

Renal vein thrombosis (RVT) is not an uncommon condition amongst patients with nephrotic syndrome or malignancy. Septic pulmonary embolism (SPE) is associated with risk factors such as intravenous drug use, pelvic thrombophlebitis, and suppurative processes in the head and neck. However, acute pyelonephritis is a rare cause of RVT and SPE. Case reports on RVT and SPE due to acute pyelonephritis are rare. In most of the earlier cases, patients had underlying conditions such as diabetes mellitus, renal carcinoma, calyceal stones, and hyperhomocysteinemia. We report a case of acute pyelonephritis complicated by RVT and SPE that occurred in a patient without any predisposing risk factors for thromboembolism. RVT and SPE were diagnosed using computed tomography and ventilation/perfusion scan. The patient recovered with antibiotics and anticoagulation therapy without any surgical interventions.
Anti-Bacterial Agents ; Diabetes Mellitus ; Head ; Humans ; Hyperhomocysteinemia ; Neck ; Nephrotic Syndrome ; Pulmonary Embolism ; Pyelonephritis ; Renal Veins ; Risk Factors ; Thromboembolism ; Thrombophlebitis ; Thrombosis