The unilateral megalencephaly is a rare brain malformation characterized by cerebral asymmetry and cortical dysplasia caused by faulty migration of the subependymal neuroblasts. We experienced a case of unilateral megalencephaly in a two day-old male with the chief complaint of asymmetric head appearance. Large left hemisphere with agyria, pachygyria, dilatation of lateral ventricle, and the thick cortex of the ipsilateral hemisphere were showed in brain MRL, Clinical findings in this case were intractable seizure, hemiparesis, and psychomotor retardation. A review of literatures was also presented briefly.
Brain ; Dilatation ; Head ; Humans ; Lateral Ventricles ; Lissencephaly ; Male ; Malformations of Cortical Development ; Paresis ; Seizures

Calcifying aponeurotic fibroma (CAF) is an uncommon benign tumor and a locally aggressive fibroblastic lesion. It commonly affects the palmar side of the hand and fingers, and the soles of the feet. The typical clinical manifestations are known as a poorly circumscribed, slow-growing, and asymptomatic firm mass. Most CAFs usually reveal low to intermediate or isointensity on T1-weighted images, and strong heterogeneous enhancement. However, various signal intensities on T2-weighted images have been reported depending on the degree of hypocellularity or the amount of calcification or collagen within the tumor. This report provides the radiographic and MRI finding of CAF arising in uncommon site, the knee region, of a 19-year-old male who presented with a painful and palpable mass.
Collagen ; Fibroblasts ; Fibroma* ; Fingers ; Foot ; Hand ; Humans ; Knee* ; Magnetic Resonance Imaging* ; Male ; Young Adult

Bone marrow involvement in Hodgkin`s lymphoma is not rare at initial diagnosis and is associated with a poor prognosis. Atypical findings such as granuloma, eosinophilia or osteosclerosis may lead to diagnostic confusion, in which case immunohistochemistry may be helpful. We report a case of 25-year old male patient, who presented with back pain, subsequently had a mediastinal mass and was finally diagnosed as having stage IV Hodgkin`s lymphoma. Bone marrow involvement with severe osteosclerosis was found on bone marrow biopsy specimens. He received systemic chemotherapy and was discharged with improved clinical symptoms.
Back Pain ; Biopsy ; Bone Marrow* ; Diagnosis ; Drug Therapy ; Eosinophilia ; Granuloma ; Humans ; Immunohistochemistry ; Lymphoma* ; Male ; Osteosclerosis* ; Prognosis

A case of large aneurysm of azygos anterior cerebral artery(Azygos ACA) is reported. This 52-year-old male patient became unconscious suddenly on working. The CT scan demonstrated small amount of hemorrhage in the interhemispheric fissure and basal cistern and huge intraventricular hematoma with marked dilatation of all ventricles. Emergency external ventricular drainage was done and his consciousness recovered to the level of possible spontaneous eye opening. 4-vessels angiography done a month later revealed a large revealed a large fusiform aneurysm at the bifurcation of distal end of azygos ACA. Authors preferred interhemispheric approach and clipped the aneurysmal neck uneventfully. Despite the successful clipping of the aneurysm confirmed by postoperative angiography, preoperative mutism, spastic weakness of lower extremities and urinary incontinence didn't recovered. This case suggests that preoperative neurological status is no less critical to the postoperative outcome than surgical technique. This is the first case of large aneurysm at this site so far as we know.
Aneurysm* ; Angiography ; Anterior Cerebral Artery* ; Consciousness ; Dilatation ; Drainage ; Emergencies ; Hematoma ; Hemorrhage ; Humans ; Lower Extremity ; Male ; Middle Aged ; Muscle Spasticity ; Mutism ; Neck ; Tomography, X-Ray Computed ; Urinary Incontinence

Bartter syndrome is a renal tubular defect in electrolyte transport characterized by hypokalemia, metabolic alkalosis, hyperreninemia, hyperaldosteronism, normal blood pressure, and other clinical symptoms. As a clinical and genetical heterogeneous disorder, this syndrome can be classified into two clinical variants, antenatal Bartter syndrome and classic Bartter syndrome according to the onset age. Nephrocalcinosis is common in antenatal Bartter syndrome, but is rare in classic Bartter syndrome. It can also be classified into five genetic subtypes by the underlying mutant gene, all of which are expressed in the tubular epithelial cells of the thick ascending limb of the loop of Henle. Patients with Bartter syndrome type 1, 2 and 4 present at a younger age than classic Bartter syndrome type 3. We have experienced a case of Bartter syndrome with nephrocalcinosis in a 42-year-old woman diagnosed by biochemical and radiologic studies. We had successful response with potassium chloride and spironolactone.
Adult* ; Age of Onset ; Alkalosis ; Bartter Syndrome* ; Blood Pressure ; Epithelial Cells ; Extremities ; Female ; Humans ; Hyperaldosteronism ; Hypokalemia ; Loop of Henle ; Nephrocalcinosis* ; Potassium Chloride ; Spironolactone

Since Wands et al. reported for the first time in 1975 the reactivation of the hepatitis B virus in hematologic disease patients who had been receiving chemotherapy, the efficacy of chemotherapy and immunosuppressants has improved. As a result, the frequency of the reactivation of hepatitis B is increasing. Reported herein is a case of a non-Hodgkin lymphoma patient in her 70s who was suspected to have had HBsAg negative/anti-HBs negative occult HBV infection. The patient experienced fulminant hepatitis caused by the reactivation of hepatitis B, and died three months after the R-CHOP regimen was completed. In the HBsAg negative plus HBV DNA-negative case, there were few instances of viral activation of HBV. In this case, antiviral therapy was needed when the patient was confirmed to have become HBV DNA positive through regular monitoring, but its necessity is often overlooked, unlike the preemptive antiviral treatment in the HBsAg positive cases.
DNA ; Drug Therapy* ; Hematologic Diseases ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Virus Activation ; Rituximab

BACKGROUND: Computed tomography (CT) is commonly used to evaluate the degree of sinus involvement in cases of inverted papilloma (IP). However, CT cannot differentiate tumor from adjacent inflammatory mucosa or retained secretions. By contrast, magnetic resonance imaging (MRI) has been reported to be useful in distinguishing IP from paranasal sinusitis. This study investigated whether preoperative assessment with MRI and CT accurately predict the extent of IP. MATERIALS AND METHODS: CT and MRI were retrospectively reviewed in 9 cases of IP. Patients were categorized into stages based on CT and MRI findings, according to the staging system proposed by Krouse. The involvement of IP in each sinus was also assessed. RESULTS: Differentiation of IP from inflammatory disease may be more successful in routine cases where the inflammatory mucosa has low signal intensity on T1-weighted images and very high signal intensity on T2-weighted images. CT imaging could not differentiate tumor from adjacent inflammatory mucosa or retained secretions. CONCLUSION: Preoperative MRI of IP can predict the location and extent of the tumor involvement in the paranasal sinuses and sometimes predicts malignant changes.
Humans ; Magnetic Resonance Imaging* ; Mucous Membrane ; Papilloma, Inverted* ; Paranasal Sinuses ; Retrospective Studies ; Sinusitis

OBJECTIVE: The primary purpose of this study was a replication of the effectiveness and tolerability of risperidone in the treatment of patients with acute mania in very larger cohort in naturalistic treatment setting to extend the data on the effect and tolerability of risperidone in the treatment of patients with acute mania to Asian population. METHODS: A total of 909 patients with DSM-IV criteria of bipolar disorder current manic and hypomanic episode, entered this large, open, multicentre study. The Young Mania Rating Scale (YMRS), Clinical Global Impression (CGI) and Simpson-Angus Rating Scale (SARS) were measured at baseline and weeks 1, 3 and 6, for the assessment of effectiveness and extrapyramidal symptom (EPS). RESULTS: This study showed statistically significant reduction of scores on the YMRS and CGI-s (mean change=-23.5+/-11.8, p<0.0001;mean change=-2.7+/-1.5, p<0.0001, respectively) from the baseline to the endpoint (week 6). Number of patients with 50% reduction or more in the YMRS and CGI-s scores was 693 (77.8%) and 630 (70.7%) at endpoint, respectively. There were no statistically significant increments of scores on SARS. Risperidone was generally well tolerated. CONCLUSION: The present larger open study demonstrates that risperidone add-on therapy is effective and tolerable in treatment of bipolar disorder, replicating results in various controlled and uncontrolled studies from Western countries.
Asian Continental Ancestry Group ; Bipolar Disorder* ; Cohort Studies ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Risperidone*

BACKGROUND: Saliva is considered an important vector for the Helicobacter pylori infection. The presence of the babA2 gene, encoding for BabA (blood-group antigen binding adhesin), in the H. pylori genome is crucial for H. pylori-related pathogenesis. METHODS: The study was performed in the group of 215 patients. The detection of H. pylori and babA2 in saliva and gastric tissue was done by PCR (polymerase chain reaction). Moreover, gastric tissues were stained with hematoxylin-eosin as well as with modified Giemsa methods for the analysis of Helicobacter pylori density. RESULTS: The positive rate of H. pylori by nested PCR was 78.6% in gastric tissue and 72.7% in saliva. In addition, the positive rate of H. pylori was 55.5% by the histological analysis of Helicobacter pylori density in gastric tissue. The positive rate of babA2 by PCR was 33.9% in gastric tissue, and 8.2% in saliva. CONCLUSION: We revealed that the H. pylori PCR results obtained in gastric tissue correlated well with those obtained in saliva. As saliva is more available specimen, it is more suitable for clinical application of H. pylori detection by PCR. However, clinical use of - BabA PCR seems to be limited because of its low-sensitivity.
Genome ; Helicobacter pylori* ; Helicobacter* ; Humans ; Polymerase Chain Reaction* ; Saliva*

OBJECTIVES: The aim of this study was to investigate the gender differences of direct aggression and relational aggression in Korean elementary and middle school students. METHODS: Parents of 946 elementary school students(age 9.54±1.72 years, 485 boys, 461 girls) completed the Child Behavior Checklist(CBCL). Six-hundred-and-three middle school students(age 13.98±0.93 years, 301 boys, 302 girls) completed the Youth Self-Report(YSR). Independent t-test, chi-square test, and Fisher's exact test were used. RESULTS: Boys had significantly higher direct aggression scores than girls in elementary school students(p<0.001). There was no significance gender difference of relational aggression in elementary school students(p=0.235). In middle school students, boys had significantly higher direct aggression than girls(p=0.017), and girls had significantly higher relational aggression compared to the boys(p<0.001). CONCLUSION: Our results suggest the presence of gender differences in manifestation of aggression subtypes in Korean elementary and middle school students. These gender differences should be taken into account in prevention and intervention approaches of aggression in children and adolescents.
Adolescent* ; Aggression* ; Child Behavior ; Child* ; Female ; Humans ; Parents