Giant cavernous malformations (GCMs) occur very rarely and little has been reported about their clinical characteristics. The authors present a case of a 20-year-old woman with a GCM. She was referred due to two episodes of generalized seizure. Computed tomography and magnetic resonance image demonstrated a heterogeneous multi-cystic lesion of 7 x 5 x 5 cm size in the left frontal lobe and basal ganglia, and enhancing vascular structure abutting medial portion of the mass. These fingings suggested a diagnosis of GCM accompanying venous angioma. After left frontal craniotomy, transcortical approach was done. Total removal was accomplished and the postoperative course was uneventful. GCMs do not seem differ clinically, surgically or histopathologically from small cavernous angiomas, but imaging appearance of GCMs may be variable. The clinical, radiological feature and management of GCMs are described based on pertinent literature review.
Basal Ganglia ; Caves ; Craniotomy ; Female ; Frontal Lobe ; Gas Chromatography-Mass Spectrometry ; Hemangioma ; Hemangioma, Cavernous ; Humans ; Magnetic Resonance Spectroscopy ; Seizures ; Young Adult

Cavernous malformations (CMs) arising from the optic nerve and chiasm are extremely rare. The authors present a case of 39-year-old woman with CMs of the optic chiasm. She was referred due to sudden onset of bitemporal hemianopsia and headache, the so-called 'chiasmal apoplexy'. MRI findings suggested a diagnosis of hemorrhage and vascular malformation of the optic chiasm. Pterional craniotomy revealed an intrachiasmatic cavernous malformation with hemorrhage. The malformation was totally excised, but field deficits remained unchanged after surgery.
Adult ; Caves ; Craniotomy ; Female ; Headache ; Hemianopsia ; Hemorrhage ; Humans ; Optic Chiasm ; Optic Nerve ; Stroke ; Vascular Malformations

Ocular flutter is a relatively rare eye movement disorder that refers to occasional bursts of involuntary horizontal oscillation around the point of fixation, characterized by rapid, repetitive, horizontal, symmetrical and sinusoidal oscillation without inter- saccadic interval. It is known to be associated with disorders of the cerebellum and brainstem resulting from various pathological conditions, but it's anatomical and pathophysiological basis remains unclear. Here, we present the case of a patient who had severe ocular flutter associated with Merkel cell carcinoma.
Brain Stem ; Carcinoma, Merkel Cell* ; Cerebellum ; Humans ; Ocular Motility Disorders ; Paraneoplastic Syndromes

BACKGROUND: Proliferation and survival of dentate granule cells are influenced by epileptic seizures. Dentate granule cells might play an important role in the pathogenesis of temporal lobe epilepsy. However, most studies have used the rat model. We investigated the neurogenesis of dentate granule cells by the kainic acid (KA)-induced seizure model in ICR mice. METHODS: Seizures were chemically induced by intraperitoneal injections of KA (30 mg/kg) and seizure behavior grades were evaluated. Bromodeoxyuridine (BrdU, 50 mg/kg) was subsequently administered once a day for 6 consecutive days, starting at 24 hours after KA or saline treatment. Mice were sacrificed 7 days after KA administration. The number of BrdU-positive cells in the hippocampus were counted in every seventh section in a series of 30 micrometer coronal sections. We examined the long-term fate of BrdU-labeled cells after KA-induced seizures by double-labeled immunofluorescence with confocal microscopy, 28 days after the last injection of BrdU. RESULTS: After KA administration, every seizure behavior was graded II or more. Quantitative analysis of BrdU labeling revealed a significantly increased proliferation rate of neural precursor cells after seizures. BrdU-positive cells were increased at least 2-fold in KA injection (83.38+/-44.33, n=5) compared to the controls (35.61+/-17.87, n=6). Most of the newborn cells migrated into the granule cell layer from the subgranular zone after KA-induced seizures (n=6, respectively). The majority of these mitotic cells (89%) were differentiated into neurons. CONCLUSIONS: Our results indicated that mitotic activity in the about hippocampus was enhanced after KA-induced seizures in ICR mice, and that the majority of all BrdU-positive cells showed the phenotypic differentiation to neuronal cells.
Animals ; Bromodeoxyuridine ; Epilepsy ; Epilepsy, Temporal Lobe ; Fluorescent Antibody Technique ; Hippocampus ; Humans ; Infant, Newborn ; Injections, Intraperitoneal ; Kainic Acid ; Mice* ; Mice, Inbred ICR ; Microscopy, Confocal ; Models, Animal ; Neurogenesis* ; Neurons ; Seizures*

As the number of dementia patients increases due to rapid aging, the burden of dementia becomes a big social problem. In response to this, various policies have been introduced in Korea. In particular, as the new policy of national responsibility for dementia care has been implemented in 2017, detailed plans for improving health care and long-term care support for dementia patients and their caregivers have been introduced. The most important thing in carrying out the comprehensive government plan will be securing sufficient the professional health and social care workforce. However, the number of neurologists to play an important role in the management of dementia will be more and more insufficient. Therefore, the need to supply an adequate number of neurologists in Korea should be discussed.
Aging ; Caregivers ; Delivery of Health Care ; Dementia ; Humans ; Korea ; Long-Term Care ; Social Problems

Eosinophilic abscess is a rare disease of stomach that consists of many eosinophils in submucosa and muscle layers of stomach. Eosinophilic abscess is usually observed in liver after parasite infestation such as hepatic fascioliasis or in intradermal lesion of pemphigus. A 67-year-old female was admitted due to epigastric pain and indigestion. Endoscopic finding suggested early gastric cancer type IIc with the depth of invasion to mucosal layer at the lesser curvature of lower body. Histologic examination of endoscopic biopsy proved to be signet ring cell type adenocarcinoma. On endoscopic ultrasonography, the tumor was imaged as a slightly elevated mass with 15 mm in diameter. The lesion was localized from the first layer to the fourth layer which correspond to the mucosa and the proper muscle layer, The lesion consisted of low echoic and isoechoic densities. The lower echoic lesion ranging from the third layer to the fourth layer was thought to be necrotic or hemorrhagic portion within the tumor. Subtotal gasterectomy was performed. We compared the endoscopic and endosonographic features with the histologic findings of the resected stomach. Histologic examination showed signet ring cell carcinoma in mucosal layer and eosinophilic abscess in submucosal and proper muscle layer. We concluded that the endosonographic depth of invasion was overestimated because of the eosinophilic abscess.
Abscess* ; Adenocarcinoma ; Aged ; Biopsy ; Carcinoma, Signet Ring Cell ; Dyspepsia ; Endosonography* ; Eosinophils* ; Fascioliasis ; Female ; Humans ; Liver ; Mucous Membrane ; Parasites ; Pemphigus ; Rare Diseases ; Stomach ; Stomach Neoplasms*

BACKGROUND AND PURPOSE: To estimate clinical roles of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) versus angiography and ultrasonography in carotid plaque characterization. METHODS: We characterized two groups of patients with recently (<1 month) symptomatic (n=14; age=71.8+/-8.6 years, mean+/-SD) or chronic (n=13, age=68.9+/-9.0 years) carotid stenosis using a battery of imaging tests: diffusion magnetic resonance (MR) imaging, MR or transfemoral angiography, duplex ultrasonography (DUS), and carotid FDG-PET/computed tomography. RESULTS: The degree of angiographic stenosis was greater in patients with recently symptomatic carotid plaques (67.5+/-21.5%) than in patients with chronic carotid plaques (32.4+/-26.8%, p=0.001). Despite the significant difference in the degree of stenosis, lesional maximum standardized uptake values (maxSUVs) on the carotid FDG-PET did not differ between the recently symptomatic (1.56+/-0.53) and chronic (1.56+/-0.34, p=0.65) stenosis groups. However, lesional-to-contralesional maxSUV ratios were higher in the recently symptomatic stenosis group (113+/-17%) than in the chronic stenosis group (98+/-10%, p=0.017). The grayscale median value of the lesional DUS echodensities was lower in the recently symptomatic stenosis group (28.2+/-10.0, n=9) than in the chronic stenosis group (53.9+/-14.0, n=8; p=0.001). Overall, there were no significant correlations between angiographic stenosis, DUS echodensity, and FDG-PET maxSUV. Case/subgroup analyses suggested complementarity between imaging modalities. CONCLUSIONS: There were both correspondences and discrepancies between the carotid FDG-PET images and DUS or angiography data. Further studies are required to determine whether FDG-PET could improve the clinical management of carotid stenosis.
Angiography ; Atherosclerosis ; Carotid Stenosis ; Constriction, Pathologic ; Diffusion ; Fluorodeoxyglucose F18 ; Humans ; Magnetic Resonance Spectroscopy ; Molecular Imaging ; Positron-Emission Tomography

Sacroiliitis is a prototyical feature of the seronegative spondyloarthropathies. It has been reported rarely in patients with systemic lupus erythematosus. We report a case of bilateral sacroiliitis in a 26 year-old female who presented 5 out of 11 ARA criteria for systemic lupus erythematosus. She complained of right low back pain since 1 week after delivery. Plain roentgenogram, computed tomogram and magnetic resonance imaging revealed no evidence of subluxation or pyogenic infection that may be possibly related to delivery, but bilateral sacroiliitis especially more severe in the right side that showed concordantly increased uptake on bone scan. Also she had neither HLA DR-3 nor B-27 antigens and had no other clinical findings of limitation of motion of spine and chest expansion, which suggest that there is a less likelihood of coexistent ankylosing spondylitis. In this case, we suggested that sacroiliitis may be a infrequent manifestation of systemic lupus erythematosus.
Adult ; Female ; Humans ; Low Back Pain ; Lupus Erythematosus, Systemic* ; Magnetic Resonance Imaging ; Sacroiliitis* ; Spine ; Spondylarthropathies ; Spondylitis, Ankylosing ; Thorax

Atrial flutter occurs most often in patients with organic heart disease. It appears that chronic atrial flutter is associated with a remarkably high risk of clinically apparent thromboembolism and effective anticoagulation appears to reduce this risk, but acute or recent onset, postoperative atrial flutter may have a lower risk of thromboembolism than those with chronic atrial flutter. In chronic atrial flutter or fibrillation with organic heart disease, anticoagulation is generally justified but there is some debate about anticoagulation in paroxysmal atrial flutter. The spontaneous echo contrast is generally accepted one of the major risk factor of thromboembolism and usually occurred in mitral stenosis, dilated cardiomyopathy, and enlarged left atrium, but rarely observed in apical hypertrophic cardiomyopathy. We experienced a patient with apical hypertrophic cardiomyopathy, who visited to emergency medical center due to dizziness and suffered from cerebral thromboembolism after restoration of sinus rhythm. In transesophageal echocardiography, there was moderate to severe spontaneous echo contrast in left atrium. This patient showed that transesophageal echocardiography evaluation of left atrium might be mandatory in patients with paroxysmal atrial flutter and organic heart disease.
Atrial Flutter* ; Cardiomyopathies* ; Cardiomyopathy, Dilated ; Cardiomyopathy, Hypertrophic ; Dizziness ; Echocardiography, Transesophageal ; Emergencies ; Heart Atria ; Heart Diseases ; Humans ; Mitral Valve Stenosis ; Risk Factors ; Thromboembolism*

A seven months old, tiger shovelnose catfish was referred to the veterinary medical teaching hospital of the college of veterinary medicine, Konkuk university because of suspecting a foreign body in the stomach. By physical and radiologic examinations, the catfish revealed abdominal enlargement, vomiting, inactivity and radiopaque foreign bodies in the stomach. Under general anesthesia with dilute isoflurane solution, celiotomy was performed. Stomach was atonic, and three foreign bodies were palpated in the stomach. In this process, three stones came out through mouth. Abdominal muscles were closed with a simple continuous suture pattern, and skin was closed with a simple mattress suture pattern. Sutured site was covered with glue and mucous taken from allogenic skin. On the second day after surgery, the patient recovered to normal condition, showing increased appetite and activity.
Animals ; Catfishes/*surgery ; Foreign Bodies/pathology/*surgery ; Gastroscopy/veterinary ; Stomach/*surgery