Cerebral air embolism (CAE) is a rare complication of various medical procedures. It manifests with symptoms similar to those of typical acute cerebral infarction, however the treatment is quite different. We present a case of arterial CAE that was associated with a disconnected central venous catheter and appeared as punctate dark signal intensities with aliasing artifacts on the susceptibility-weighted filtered phase magnetic resonance image. The susceptibility-weighted filtered phase image can be helpful for diagnosing CAE and the magnetic resonance imaging reflects the pathophysiology of CAE.
Artifacts ; Central Venous Catheters ; Cerebral Infarction ; Embolism, Air ; Intracranial Embolism ; Magnetic Resonance Imaging

No abstract available.
Alexander Disease*

A subarachnoid hemorrhage (SAH) is caused by rupture of an intracranial aneurysm. SAHs have significant morbidity and mortality worldwide. Since the 1970s, clipping of intracranial aneurysms has been the standard treatment for SAHs. In the 1990s, a detachable platinum coil device was introduced. This device led to the development of endovascular techniques and reduced the risk of further rupture without a craniotomy. Thus, endovascular coiling has become widely used in patients with ruptured and unruptured intracranial aneurysms (UIAs). Regardless of the treatment technique (clipping or endovascular coiling), the goal of occluding aneurysms is the prevention of rebleeding in ruptured aneurysms and rupture in UIAs. These two treatment techniques have advantages and disadvantages. The question of which technique is more effective in patients with intracranial aneurysms remains controversial. The objective of this article is to provide a comprehensive review of the effect of coiling versus clipping of intracranial aneurysms.
Aneurysm ; Aneurysm, Ruptured ; Comprehension ; Craniotomy ; Endovascular Procedures ; Humans ; Intracranial Aneurysm ; Platinum ; Rupture ; Subarachnoid Hemorrhage

Background: Regardless of countries, the myth that rain makes the body ache has been worded in various forms, and a number of studies have been reported to investigate this. However, these studies, which depended on the patient’s experience or memory, had obvious limitations. Google Trends is a big data analysis service based on search terms and viewing videos provided by Google LLC, and attempts to use it in various fields are continuing. In this study, we endeavored to introduce the ‘value as a research tool’ of the Google Trends, that has emerged along with technological advancements, through research on ‘whether toothaches really occur frequently on rainy days’. Methods: Keywords were selected as objectively as possible by applying web crawling and text mining techniques, and the keyword “bi” meaning rain in Korean was added to verify the reliability of Google Trends data. The correlation was statistically analyzed using precipitation and temperature data provided by the Korea Meteorological Agency and daily search volume data provided by Google Trends. Results: Keywords “chi-gwa”, “chi-tong”, and “chung-chi” were selected, which in Korean mean ‘dental clinic’, ‘toothache’, and ‘tooth decay’ respectively. A significant correlation was found between the amount of precipitation and the search volume of tooth decay. No correlation was found between precipitation and other keywords or other combinations. It was natural that a very significant correlation was found between the amount of precipitation, temperature, and the search volume of “bi”. Conclusion Rain seems to actually be a cause of toothache, and if objective keyword selection is premised, Google Trends is considered to be very useful as a research tool in the future.

PURPOSE: Kiwi fruit allergy in children has scarcely been reported. This study focused on the clinical characteristics of kiwi fruit allergy and value of kiwi specific Immunoglobulin E (IgE) antibodies in Korean children. METHODS: The study was based on a data analysis of 18 patients, who were diagnosed with clinical kiwi fruit allergy at Ajou University Hospital from June 2005 to June 2012. Clinical details were collected by medical history and telephone survey. Sera from all children were analyzed for kiwi specific IgE (ImmunoCAP) and patients with negative result were further evaluated by an enzyme linked immunosorbentassay test (ELISA) using our own made kiwi fruit extracts. RESULTS: The subjects were 10 male and 8 female with a median aged 25 months. Twelve out of 18 (66.7%) were diagnosed with angioedema or urticaria, 4 (22.2%) were diagnosed with oral allergy syndrome, 1 was presented with dyspnea, and 1 was diagnosed with anaphylaxis. Oral route of exposure (88.9%) was most common and majority of patients (88.9%) experienced clinical symptoms at the first exposure to kiwi fruit. Six out of 12 patients with urticaria showed negative result in specific IgE by ImmunoCAP, but specific IgE were detected in 2 of 6 by ELISA with our own made kiwi extract. CONCLUSION: Systemic reactions to kiwi fruit were common in Korean children, and the symptoms were frequently developed at the first time of exposure. Additional diagnostic methods would be needed for evaluation of IgE sensitization in kiwi allergic patients with negative result by ImmunoCAP.
Aged ; Anaphylaxis ; Angioedema ; Antibodies ; Child ; Dyspnea ; Enzyme-Linked Immunosorbent Assay ; Female ; Fruit ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Male ; Statistics as Topic ; Telephone ; Urticaria

PURPOSE: To investigate the association of carotid intraplaque hemorrhage (IPH) with acute cerebral ischemic events and progression of stenosis using magnetic resonance (MR) imaging. MATERIALS AND METHODS: From April 2014 to December 2016, 53 patients underwent carotid plaque MR imaging, including magnetization-prepared rapid acquisition with gradient-echo (MPRAGE) sequence. A total of 66 carotid arteries in 53 patients had carotid stenosis, and they were included in this study. Carotid arteries were classified according to the presence of IPH, the age of hemorrhage, and degree of stenosis. We assessed ipsilateral cerebrovascular event rates and progression of stenosis between the IPH and no-IPH groups. RESULTS: Of the 61 carotid arteries assessed, 34 (56%) had IPH, and 27 (44%) had no IPH. Acute cerebral ischemic events were more frequent in the IPH group (47% vs. 22%, P = 0.045), especially in the < 30%-stenosis group (100% vs. 0%, P = 0.028). However, there was no significant difference in the incidence of ischemic events according to the age of hemorrhage (50% vs. 44%, P = 0.492). Among the 61 carotid arteries, 20 carotid arteries had previously undergone carotid artery imaging and were evaluated for plaque progression. The trend for progression of stenosis favored the IPH group versus the no-IPH group, with a marginal P-value (20% ± 12.7 vs. 9.6% ± 5.7, P = 0.063). CONCLUSION: IPH was associated with an increased incidence of acute ischemic events, especially in the mild-stenosis group and it was also associated with progression of stenosis. Evaluation of the carotid IPH by carotid plaque MR could improve discrimination of carotid plaques that cause ischemic events and progression of stenosis.
Carotid Arteries ; Carotid Stenosis ; Constriction, Pathologic* ; Discrimination (Psychology) ; Hemorrhage* ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Stroke

No abstract available.
Larynx* ; Pharmacology ; Succinylcholine* ; Vecuronium Bromide*

Fetal thymus may be the organ for NK cell maturation, but the in vivo evidences are few, Here, by analyzing NK cell receptor, we present that NK cells develop in fetal thymus and fetal liver and that NK cell receptor appears earlier than the expression CD16 or CD56. Moreover, the finding that the repertoire of NK cell receptor is different between fetal thymus and fetal liver lymphocytes suggests that the environmental factors may influence the NK cell receptor repertoire during NK cell maturation.
Killer Cells, Natural* ; Liver* ; Lymphocytes* ; Thymocytes* ; Thymus Gland

PURPOSE: The immunological characteristics of young Korean children with walnut (WN) allergy and the influence of different cooking methods on WN proteins have not been evaluated to date. This study aimed to evaluate the major WN allergens identified among Korean children, together with changes in WN antigenicity caused by common cooking methods. METHODS: We enrolled children under the age of 13 years with WN serum-specific immunoglobulin (Ig) E concentrations. The protein fractions of dry-fried and boiled WN extracts were compared with those of raw WNs using sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), 2-dimentional gel electrophoresis (2DE) and a proteomic analysis using electrospray ionization (liquid chromatography-mass spectrometry [LC-MS]). An immunoblotting analysis was conducted to examine IgE reactivity toward raw WNs using serum samples from 6 children with a clinical WN allergy. To determine the processed WN proteins with IgE-binding capacity, a 2D-immunoblotting analysis was performed using the pooled sera of 20 WN-sensitized children. RESULTS: Protein bands from raw WNs were identified at 9, 16, 28, 52, 58, and 64 kDa via SDS-PAGE. The 9- and 16-kDa protein bands were enhanced by boiling, whereas the 52- and 64-kDa bands were considerably diminished. On LC-MS analysis, of the 66 IgE-binding proteins present in raw WNs, 57 were found in dry-fried WNs, but only 4 in boiled WNs. The sera of 5 out of 6 participants reacted with the 52-kDa protein bands and those of 4 out of 6 participants reacted with the 16- and 28-kDa protein bands, respectively. Meanwhile, a 2D-immunoblotting result confirmed the presence of different binding patterns among children who consumed cooked WNs. CONCLUSIONS: The protein profile of boiled WNs is substantially different from that of raw WNs. However, 4 proteins including prolamins remained stable after dry-frying or boiling. Further studies are needed to evaluate the clinical relevance of these findings.
Allergens ; Child* ; Cooking ; Electrophoresis ; Electrophoresis, Polyacrylamide Gel ; Humans ; Hypersensitivity ; Immunoblotting ; Immunoglobulin E ; Immunoglobulins* ; Juglans* ; Prolamins ; Sodium Dodecyl Sulfate ; Spectrum Analysis

Metabolic encephalopathy is a critical condition that can be challenging to diagnose. Imaging provides early clues to confirm clinical suspicions and plays an important role in the diagnosis, assessment of the response to therapy, and prognosis prediction. Diffusion-weighted imaging is a sensitive technique used to evaluate metabolic encephalopathy at an early stage.Metabolic encephalopathies often involve the deep regions of the gray matter because they have high energy requirements and are susceptible to metabolic disturbances. Understanding the imaging patterns of various metabolic encephalopathies can help narrow the differential diagnosis and improve the prognosis of patients by initiating proper treatment regimen early.