PURPOSE: The purpose of this study was to evaluate the phenomenon of diaschisis in the cerebellum and cerebral certex in patients with pure basal ganglia hemorrhage using cerebral blood flow SPECT. MATERIALS AND METHODS: Twelve patients with pure basal ganglia hemorrhage were studied with Tc-99m ECD brain SPECT Asymmetric index (AI) was calculated in the cerebellum and cerebral cortical regions as |CR-CL|/(CR-CL)x200, where CR and GL and the mean reconstructed counts for the right and left ROIs, respectively. Hypoperfusion was considered to be present when AI was greater than mean+2 SD of 20 control subjects. RESULTS: Mean AI of the cerebellum and cerebral cortical regions in patients with pure basal ganglia hemorrhage was significantly higher than normal controls (p<0.05): Cerebellum (18.68+/-8.94 vs 4.35+/-0.94, mean+/-SD), thalamus (31.91+/-10.61 vs 2.57+/-1.45), basal ganglia (35.94+/-16.15 vs 4.34+/-2.08), parietal (18.94+/-10.69 vs 3.24+/-0.87), frontal (13.60+/-10.8 vs 4.02+/-2.04) and temporal cortex (18.92+/-11.95 vs 5.13+/-1.69). Ten of the 12 patients had significant hypoperfusion in the contralateral cerebellum. Hypoperfusion was also shown in the ipsilateral thalamus (n=12), ipsilateral parietal (n=12), frontal (n=6) and temporal cortex (n=10). CONCLUSION: Crossed cerebellar diaschisis (CCD) and cortical diaschisis may frequently occur in patients with pure basal ganglia hemorrhage, suggesting that CCD can develop without the interruption of corticopontocerebellar pathway.
Basal Ganglia Hemorrhage* ; Basal Ganglia* ; Brain ; Cerebellum ; Humans ; Rabeprazole ; Thalamus ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Female ; Humans ; Ovary*

Septo-optic dysplasia, as first described by de Morsier, is a rare developmental anomaly of absent or hypoplastic septum pellucidum, a primitive optic vesicle, and dysplasia of the optic nerve, chiasm, and optic tracts. It is a common cause of hypopituitarism in children and has variable hypothalamic-pituitary dysfunction. We experienced a case of septo-optic dysplasia in 5 month old female baby who presented with developmental delay and seizure. A magnetic resonance imaging of the brain showed absence of the septum pellucidum and the fundoscopic examination disclosed the absence of left optic disc and atrophy of right optic disc.
Atrophy ; Brain ; Child ; Female ; Humans ; Hypopituitarism ; Infant ; Magnetic Resonance Imaging ; Optic Nerve ; Seizures ; Septo-Optic Dysplasia* ; Septum Pellucidum ; Visual Pathways

A 49-year-old Caucasian male patient suffered from fever general weakness and diffuse hair loss on the scalp for 3 days. Skin lesions showed erythematous scaly patches with pustules and erosions on the lower extremities and perianal region, and multiple ulcerations on the labial mucoas. A complete blood cell count revealed thrombocytopenia and leukopenia, which gradually worsened day after day (platelet: 29, 000/mm², WBC: 1,000/mm³). Candida albicans was isolated from the lesions of the oral cavity and lower extremities. Twelve days prior to the visit, he had taken etretinate Tegison®) P.O.25mg/day, prednisolone P.O. 50mg1dy and methotrexate P.O. 15mg/day for 5 days for the treatment of psoriasis. We presume that these adverse reactions may be synergistic adverse reactions, probably due to methotrexate and etretinate in consideration of the patient's history.
Acitretin* ; Blood Cell Count ; Candida albicans ; Etretinate* ; Fever ; Hair ; Humans ; Leukopenia ; Lower Extremity ; Male ; Methotrexate* ; Middle Aged ; Mouth ; Prednisolone ; Psoriasis* ; Scalp ; Skin ; Thrombocytopenia ; Ulcer

We report a case of mycosis fungoides in a 37 year-old male patient who had relatively well defined, irregular, erythematous plaques covered with acales on the buttock, lower extremities, anterior chest and back. Histopathological findings showed epidermotropism and Pautrier microabscesses in the epidermis and infiltration of atypical lymphocytes in the upper dermis. Electron microscopic findings showed mycosis cells with convoluted nuclei and prominent nucleolei He had been received PUVA therapy combined with topical and systemic corticosteroid for 4 months. Skin lesions were improved markedly after treatment with total 262 joules/crn2 and then maintained with 14 joules/cm2 in every week.
Adult ; Buttocks ; Dermis ; Epidermis ; Humans ; Lower Extremity ; Lymphocytes ; Male ; Mycosis Fungoides* ; PUVA Therapy ; Skin ; Thorax

We report a case of disseminated cutaneous metastatic carcinoma from stomach carcinoma in a 66-year-old male who complained chiefly of widespread cutaneous nodules. He had been admitted to the Department of Internal Medicine for stomach carcinoma. A radiological examination revealed a diffuse stomach wall thickening from the fundus to the antrum, and enlargement of paraaortic and pericaval lymph nodes during an abodominal CT scan. The clinical findings manifested above may suggest cutaneous metastasis from stomach carcinoma. A histological examination of the skin and stomach biopsies showed atypical cells with pleomorphic, hyperchromatic nuclei and bubble-like cytoplasm, which are consistent with poorly differentiated adenocarcinoma. Immunohistochemical stainings showed that these cells were positive for epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA) and low molecular weight cytokeratin.
Adenocarcinoma ; Aged ; Biopsy ; Carcinoembryonic Antigen ; Cytoplasm ; Humans ; Internal Medicine ; Keratins ; Lymph Nodes ; Male ; Molecular Weight ; Mucin-1 ; Neoplasm Metastasis ; Skin ; Stomach* ; Tomography, X-Ray Computed

Twenty-nail dystrophy is an idiopathic nail dystrophy in which all twenty nails are uniformly and simultaneously affected with excess longitudinal ridging and loss of lustre. The pathogenesis is controversial, and the treatment is unsuccessful. It is thought to have a self-limiting and reversible nature when it develops in childhood, but in adults, it is unusual and exists persistently. We re-port here two cases of adult patients with dystrophy of all twenty nails, whose ages were 58 and 55. The disease had been present for one year and may be associated with alopecia areata in the 58 year old and an idiopathic condition in the 55 year old. Negative results were obtained on mycological studies. Biopsies taken from the nail bed revealed marked hyperkeratosis consistent with nail dystrophy.
Adult ; Alopecia ; Alopecia Areata ; Biopsy ; Humans

Due to unknown safety concerns, sugammadex should not be administered to patients withend-stage renal disease (ESRD). However, because the supply of benzylisoquinolinium-typeneuromuscular blocking agents (NMBAs) has been discontinued, rocuronium is the onlynon-depolarizing NMBA that can be used in clinical settings in some countries, includingSouth Korea. The administration of sugammadex cannot be avoided to achieve rapid andcomplete neuromuscular recovery in patients with ESRD or renal transplantation after rocuronium administration. Although there has been a limited number of clinical studies involving the use of sugammadex in patients with ESRD, studies have shown that sugammadexcan effectively and safely reverse rocuronium-induced neuromuscular blockade (NMB) inpatients with ESRD, however recovery of neuromuscular function in patients with ESRD isslower than in patients with normal renal function. Nonetheless, safety-concerns are yet tobe addressed. Considering the small number of clinical studies, high heterogeneity amongstudies, and insufficient safety information, more extensive data on the efficacy and safetyof sugammadex in patients with ESRD are needed. In particular, it is important to securedata on safety, including residual NMB after surgery, recurarization and cardiorespiratorycomplications, anaphylactic reactions, and long-term morbidity and mortality. Furthermore,anesthesiologists should remember that performing proper quantitative neuromuscularmonitoring and neuromuscular management based on the monitoring signs are the mostessential requirements when using sugammadex in patients with ESRD.

Takayasu's arteritis(TA) is a nonspecific areritis of unknown etiology affecting segmentally the aorta and its main branches, which result in stenosis, occlusion or aneurysm of involved arteries. The clinical manifestations present with a variety of symptoms such as headache, dyspnea on exertion, pain and weakness of extremities, pulse deficit, and hypertension according to involves arteries. Usually it can be managed by medical or surgical treatment, and recently by percutaneous transluminal balloon angioplasty. The type III classified by Lupi-Herrena and associates is the most frequent variety of TA. However the case of type III involving both subclavin arteries and both renal arteries has rarely been reported. We experienced a case of TA involving both subcalvian arteries, and both renal arteries presented with paroxysmal hypertension and right flank pain, in which the stenosis of both subclavian arteries were managed by percutaneous transluminal balloon angioplasty and the stenosis and occlusion of both renal arteries were successfully managed by aorto-renal bypass surgery with autogenous right iliac artery and synthetic vessel(Gortex). The patient was discharged uneventfully.
Aneurysm ; Angioplasty, Balloon ; Aorta ; Arteries* ; Constriction, Pathologic* ; Dyspnea ; Extremities ; Flank Pain ; Headache ; Humans ; Hypertension ; Iliac Artery ; Renal Artery* ; Subclavian Artery ; Takayasu Arteritis*

The structure of coxsackievirus and adenovirus receptor's CAR is similar to adhesion molecules. In the adult heart, the majority of CAR localizes at the intercalated disc. Germ line CAR deletion induces embryonic lethality at E11.5 with evidence of a cardiac abnormality. The CAR role as a viral receptor is well known; however, its precise function in the heart for enterovirus infection is not clear. To understand the role of CAR in the cardiac myocyte, we generated cardiac-specific CAR knockout mice using a CAR floxed allele and alpha-MHC-Mer CRE Mer mice. Western blot analysis and immunofluorescent stain of ventricles at 6 weeks after 2 weeks tamoxifen administration, CAR expression was significantly decreased in CAR(f/f) MCM mice but not in CAR(f/f) mice heart. Enterovirus was intraperitoneally infected into CAR(f/f) MCM and CAR(f/f) mice (n=10 each). CAR disruption was dramatically reduced virus infection and replication in the heart but not different in liver, spleen, and pancreas. Cardiac myocyte damage was significantly reduced in the CAR(f/f) MCM mutant mice by evans blue dye stain. In addition, the CAR(f/f) MCM mutant mice heart inflammation and fibrosis were decreased in H&E and trichrome stain compare to CAR(f/f) control mice. CAR expression was required for normal ventricular function, but it is the cause of enterovirus infection. In the adult mice heart, CAR deletion was significantly reduced viral infection, proliferation, and myocarditis. These results suggested that CAR deletion could be useful therapeutic strategy to prevent viral myocarditis.
Adenoviridae ; Adult ; Alleles ; Animals ; Azo Compounds ; Blotting, Western ; Enterovirus ; Enterovirus Infections ; Eosine Yellowish-(YS) ; Evans Blue ; Fibrosis ; Germ Cells ; Heart ; Humans ; Inflammation ; Liver ; Methyl Green ; Mice ; Mice, Knockout ; Myocarditis ; Myocytes, Cardiac ; Pancreas ; Receptors, Virus ; Spleen ; Tamoxifen ; Ventricular Function ; Viruses