BACKGROUND: Several population- and clinic-based studies have investigated the clinical characteristics of migraine with aura in Western countries. However, migraine with aura has not been investigated in Korea or other Asian countries. The aim of this study was to determine the frequency and characteristics of migraine with aura in Korea. METHODS: We consecutively recruited patients with migraine from 2010 to 2014 in the Eulji Headache Clinic. Migraines with and without aura were diagnosed according to the International Classification of Headache Disorders-II criteria based on a clinical interview and structured questionnaire. RESULTS: In total, 97 (35% males and 65% females) and 649 (12% males and 88% females) patients were diagnosed as migraines with and without aura, respectively. Visual aura was the most common type of aura (94%) among patients with migraine with aura, followed by sensory aura (6%) and then speech aura, retinal aura, and brainstem aura (each 3%). The most frequently accompanying headache type was migraine (77%), followed by nonmigraine headache (17%), with no headache presenting in 6% of patients. Migraine without aura was the most common headache (61%) outside of migraine with aura, followed by nonmigraine headache (14%). CONCLUSIONS: Only 13% of migraineurs have aura symptoms. Nonvisual aura symptoms are rare in Korean patients with migraine with aura.
Asian Continental Ancestry Group ; Brain Stem ; Classification ; Epilepsy ; Headache ; Humans ; Korea ; Male ; Migraine Disorders* ; Migraine with Aura* ; Migraine without Aura ; Retinaldehyde

BACKGROUND: Mizoribine (MZR) is an imidazole nucleoside isolated from Eupenicillium brefeldianum. MZR is currently in clinical use for patients who have undergone renal transplantation. Therapeutic efficacy of MZR has also been demonstrated in rheumatoid arthritis and lupus nephritis. MZR has been shown to inhibit the proliferation of lymphocytes by interfering with inosine monophosphate dehydrogenase. Since the exact mechanism by which MZR benefits rheumatoid arthritis (RA) is not clear, we investigated the ability of MZR to direct its immunosuppressive influences on other antigen presenting cells, such as macrophages. METHODS: Mouse macrophage RAW264.7 cells were stimulated with lipopolysaccharide in the presence of MZR. To elucidate the mechanism of the therapeutic efficacy in chronic inflammatory diseases, we examined the effects of MZR on the production of pro-inflammatory cytokines, nitric oxide (NO) and prostaglandin E2 (PGE2) in macrophages. RESULTS: MZR dose-dependently decreased the production of nitric oxide and pro- inflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha), interleukins 1beta (IL-beta) and IL-6 PGE2. Examination of gene expression levels showed that the anti-inflammatory effect correlated with the down-regulation of inducible nitiric oxide synthase expression, cycloxygenase-2 expression and TNF-alpha gene expression. CONCLUSION: In this work, we resulted whether MZR (1.25~10 microgram/ml) inhibited macrophage activation by inhibiting secretion of pro-inflammatory cytokines, NO and PGE2. These findings provide an explanation for the therapeutic efficacy of MZR in chronic inflammation- associated diseases.
Animals ; Antigen-Presenting Cells ; Arthritis, Rheumatoid ; Cytokines* ; Dinoprostone* ; Down-Regulation ; Eupenicillium ; Gene Expression ; Humans ; Inosine Monophosphate ; Interleukin-6 ; Interleukins ; Kidney Transplantation ; Lupus Nephritis ; Lymphocytes ; Macrophage Activation ; Macrophages* ; Mice ; Nitric Oxide ; Oxidoreductases ; Tumor Necrosis Factor-alpha

BACKGROUND: Dendritic cells (DCs) play a critical role not only in the initiation of immune responses, but also in the induction of immune tolerance. In an effort to regulate immune responses through the modulation of antigen presenting cell (APC) function of DCs, we searched for and characterized APC function modulators from natural products. METHODS: DCs were cultured in the presence of propolis components, WP and CP, and then examined for their ability to present exogenous antigen in association with major histocompatibility complexes (MHC). RESULTS: WP and CP inhibited class I MHC-restricted presentation of exogenous antigen (cross-presentation) in a DC cell line, DC2.4 cells, and DCs generated from bone marrow cells with GM-CSF and IL-4. The inhibitory activity of WP and CP appeared to be due not only to inhibition of phagocytic activity of DCs, but also to suppression of expression of MHC molecules on DCs. We also examined the effects of WP and CP on T cells. Interestingly, WP and CP increased IL-2 production from T cells. CONCLUSION: These results demonstrate that WP and CP inhibit MHC-restricted presentation of exogenous antigen through down-regulation of phagocytic activity and suppression of expression of MHC molecules on DCs.
Antigen Presentation ; Biological Products ; Bone Marrow Cells ; Cell Line ; Dendritic Cells* ; Down-Regulation ; Granulocyte-Macrophage Colony-Stimulating Factor ; Immune Tolerance ; Interleukin-2 ; Interleukin-4 ; Major Histocompatibility Complex* ; Propolis* ; T-Lymphocytes

OBJECTIVE: The Gynecologic Cancer Lymphedema Questionnaire (GCLQ) was designed to identify gynecologic cancer patients with lower limb lymphedema (LLL). The questionnaire consists of 20 items distributed over 7 symptom clusters. The present study aimed to develop an abridged form of the GCLQ for simpler screening and more effective follow-up of LLL. METHODS: Data that had been collected for the development and validation of the Korean version of the GCLQ (GCLQ-K) were used in this study. Receiver-operating characteristic (ROC) curves were drawn according to the individual items of the GCLQ-K. Based on discrimination ability, the candidate items were selected in each symptom cluster. After combining the items, the best model was identified and named GCLQ-7. The area under the ROC curve (AUC) was compared between the GCLQ-7 and the original GCLQ-K. RESULTS: In total, 11 candidate items were selected from the original GCLQ-K. Among the models made with the candidate items, GCLQ-7, the best model, was constructed with 7 items as follows: 1) limited knee movement, 2) general swelling, 3) redness, 4) firmness/tightness, 5) groin swelling, 6) heaviness, and 7) aching. This model exhibited an AUC of 0.945 (95% confidence interval [CI], 0.900–0.991), which is comparable with that of the original GCLQ-K (AUC, 0.867; 95% CI, 0.779–0.956). The best cutoff value was 2 points, at which the sensitivity and specificity were 97.0% and 76.5%, respectively. CONCLUSION: The newly developed short version model, GCLQ-7, showed acceptable discrimination ability as compared with the original GCLQ-K.
Area Under Curve ; Discrimination (Psychology) ; Endometrial Neoplasms ; Female ; Follow-Up Studies ; Genital Neoplasms, Female ; Groin ; Humans ; Knee ; Lower Extremity ; Lymphedema* ; Mass Screening ; Ovarian Neoplasms ; ROC Curve ; Sensitivity and Specificity ; Surveys and Questionnaires ; Uterine Cervical Neoplasms

BACKGROUND: The decreased estimated glomerular filtration rate (eGFR) levels at admission in patients with stroke have been associated with more severe clinical deficits and with worse outcomes; however, the relationship between eGFR levels and volumetric measurement of cerebral infarct size on neuroimaging has not been studied, to our knowledge. METHODS: Consecutive patients who presented within 48h of ischemic stroke and underwent brain diffusion-weighted imaging (DWI) over a 55-month period were studied. Patients with ischemic stroke of large artery atherosclerosis (LAA), small vessel occlusion (SVO), or cardioembolism (CE) etiologies were included. Those who were treated with thrombolysis and disabled before index stroke were excluded. Infarction volumes were log transformed to approximate normality. Chronic kidney disease (CKD) was defined as an eGFR < 60 mL/min per 1.73 m2. Subjects were categorized into two groups: CKD or no CKD. The relationship between CKD and DWI infarct volumes was examined using an analysis of covariance. RESULTS: Of the included 405 patients (mean age, 68 years; female, 60.2%; LAA, 60.0%; SVO, 16.5%; CE, 23.5%), 108 patients had CKD. Infarct volumes (mL, median [interquartile range]) were not significantly different between stroke patients with CKD and those without CKD in any stroke subtype (LAA, 0.77 [0.01-2.97] vs. 0.96 [0.01-5.22]; SVO, 0.18 [0.02-0.21] vs. 0.27 [0.01-0.52]; CE, 8.91 [0.04-28.54] vs. 5.22 [0.05-42.39]). Adjustment for possible confounders did not change the associations. CONCLUSIONS: Renal impairment is not associated with cerebral infarct volume among acute ischemic stroke patients.
Arteries ; Atherosclerosis ; Brain ; Female ; Glomerular Filtration Rate ; Humans ; Infarction ; Neuroimaging ; Renal Insufficiency, Chronic ; Stroke*

Hashimoto's encephalopathy (HE) is a rare autoimmune disorder characterized by a nonspecific encephalopathy with high titers of serum anti-thyroid antibody in the absence of other defined causes. A 54-year-old woman was admitted due to recurrent seizures and confusion. Her serum anti-thyroid antibody level was elevated, and brain MRI showed multiple instances of vasogenic edema. Her symptoms disappeared after treatment with high-dose steroids and antiepileptic drugs. We propose that HE should be considered in the differential diagnosis of multiple vasogenic edema on brain imaging.
Anticonvulsants ; Brain* ; Diagnosis, Differential ; Edema* ; Female ; Humans ; Magnetic Resonance Imaging* ; Middle Aged ; Neuroimaging ; Seizures ; Steroids

Hashimoto's encephalopathy (HE) is a rare autoimmune disorder characterized by a nonspecific encephalopathy with high titers of serum anti-thyroid antibody in the absence of other defined causes. A 54-year-old woman was admitted due to recurrent seizures and confusion. Her serum anti-thyroid antibody level was elevated, and brain MRI showed multiple instances of vasogenic edema. Her symptoms disappeared after treatment with high-dose steroids and antiepileptic drugs. We propose that HE should be considered in the differential diagnosis of multiple vasogenic edema on brain imaging.
Anticonvulsants ; Brain* ; Diagnosis, Differential ; Edema* ; Female ; Humans ; Magnetic Resonance Imaging* ; Middle Aged ; Neuroimaging ; Seizures ; Steroids

Ceftazidime is a widely used third-generation cephalosporin. We report a case of ceftazidime-induced nonconvulsive status epilepticus in a patient with renal failure. A 56-year-old man experienced the gradual development of altered mentation after a diabetic foot ulcer was treated with ceftazidime. Rhythmic sharply contoured triphasic waves were evident in all electroencephalography leads. The clinical and electrographical seizures ceased after introducing antiepileptic drugs and discontinuing ceftazidime. This case demonstrates that altered mentality and nonconvulsive status epilepticus can be caused by ceftazidime in patients with renal dysfunction.
Anticonvulsants ; Ceftazidime ; Diabetic Foot ; Electroencephalography ; Humans ; Middle Aged ; Renal Insufficiency ; Seizures ; Status Epilepticus* ; Ulcer

Ceftazidime is a widely used third-generation cephalosporin. We report a case of ceftazidime-induced nonconvulsive status epilepticus in a patient with renal failure. A 56-year-old man experienced the gradual development of altered mentation after a diabetic foot ulcer was treated with ceftazidime. Rhythmic sharply contoured triphasic waves were evident in all electroencephalography leads. The clinical and electrographical seizures ceased after introducing antiepileptic drugs and discontinuing ceftazidime. This case demonstrates that altered mentality and nonconvulsive status epilepticus can be caused by ceftazidime in patients with renal dysfunction.
Anticonvulsants ; Ceftazidime ; Diabetic Foot ; Electroencephalography ; Humans ; Middle Aged ; Renal Insufficiency ; Seizures ; Status Epilepticus* ; Ulcer