The changes of electroencephalogram(EEG) in patients with dementia of Alzheimer's type are most commonly studied by analyzing power or magnitude in traditionally defined frequency bands. However because of the absence of an identified metric which quantifies the complex amount of information, there are many limitations in using such a linear method. According to the chaos theory, irregular signals of EEG can be also resulted from low dimensional deterministic chaos. Chaotic nonlinear dynamics in the EEG can be studied by calculating the largest Lyapunov exponent(L1). The authors have analyzed EEG epochs from three patients with dementia of Alzheimer's type and three matched control subjects. The largest L1 is calculated from EEG epochs consisting of 16.384 data points per channel in 15 channels. The results showed that patients with dementia of Alzheimer's type had significantly lower L1 than non-demented controls on 8 channels. Topographic analysis showed that the L1 were significantly lower in patients with Alzheimer's disease on all the frontal, temporal, central, and occipital head regions. These results show that brains of patients with dementia of Alzheimer's type have a decreased chaotic quality of electrophysiological behavior. We conclude that the nonlinear analysis such as calculating the L1 can be a promising tool for detecting relative changes in the complexity of brain dynamics.
Alzheimer Disease ; Brain ; Dementia* ; Electroencephalography* ; Head ; Humans ; Nonlinear Dynamics*

To investigate the imbalance of the cytokine production profile of T cells from atopic asthmatics, we measured concentrations of IL-4, IL-5 and IFN-y by ELISA method in the culture supernatants of peripheral blood mononuclear cells(PBMCs) and Derrnato-phagoides pteronyssinus(Der p) J-stimulated PBMCs from Der p-sensitized atopic asthmatics, Der p-sensitized healthy atopits, non-atopic asthmatics and healthy non-atopics. The suppressive effect of IFN-y on cytokine production of Der p J-stimulated PBMCs was also examined. The PBMCs from atopics showed higher IL-4 and IL-5 production in response to PHA +TPA and higher IFN-gamma production in response to Der p Jq compared with non-atopits. The Der p J-stimulated PBMCs from atopics showed a tendency of increased IL-5 production in response to Der p J and higher IL-4 and IL-5 production in response to PHA+TPA compared with non-atopics. IL-5 production of Der p J-stimulated PBMCs from atopics was suppressed by IFN It is suggested that an imbalance in IL-4, IL-5 and IFN-y production is a feature of the atopic state. The TH2 characteristics of allergen-stimulated PBMCs could be regulated by IFN-y.
Enzyme-Linked Immunosorbent Assay ; Interleukin-4 ; Interleukin-5 ; T-Lymphocytes

Topiramate is an antiepileptic drug effective for multiple types of seizure and is also used to prevent migraine attack. Several side effects have been reported, such as metabolic acidosis, nephrolithiasis, anorexia, weight reduction, drowsiness, glaucoma, hyperthermia, and cognitive dysfunction, whereas skin manifestationis were rarely reported. We report a case of a 12-year-old girl on medication of topiramate for 8 months due to focal epilepsy. She had fever, sore throat, burning sense in the vaginal area, and then flaccid bullae and erythematous patches proceeded to the whole bodyskin and mucosa including the conjunctiva, oral cavity, and genital areas. She was diagnosed with toxic epidermal necrolysis (TEN) and improved after the discontinuation of topiramate and with administration of high-dose intravenous steroid and immunoglobulin. We, herein, report a girl who developed severe side effects on the skin, TEN, due to topiramate.

Multiple primary or secondary malignancies after anticancer therapy were recently reported to be increasing in frequency. The authors describe a case of metachronous metastatic pulmonary basaloid carcinoma to the central nervous system that was discovered after chemotherapy and radiation therapy for cervical uterine carcinoma. Two different types of cancer developed within some interval. There's the possibility that a secondary pulmonary neoplasm developed after the chemotherapy and radiotherapy conducted as cervical cancer treatment.
Central Nervous System ; Drug Therapy* ; Lung Neoplasms ; Neoplasm Metastasis* ; Neoplasms, Second Primary ; Radiotherapy ; Uterine Cervical Neoplasms

Objectives: Although non-ampullary duodenal neuroendocrine tumors (NADNETs) are rare neoplasms, their incidence has been increasing. In this study, we aimed to analyze the long-term outcomes of patients with NADNETs who underwent endoscopic resection (ER) or surgery. Methods: This retrospective study included 55 adults (aged 26–78 years) diagnosed with NADNETs between 2009 and 2022 at Seoul National University Hospital. We categorized the patients into 3 groups: 21 underwent ER, 28 underwent surgical resection, and 6 had no detectable residual tumors after the initial biopsy during the follow-up period. Continuous data were examined using the Mann–Whitney U or Kruskal–Wallis tests, and categorical variables were analyzed using the χ2 or Fisher’s exact tests. Results: A total of 21 patients, with a mean tumor size of 9.2±5.3 mm, underwent successful ER. After ER, three patients experienced perforation (14% [3/21]); two underwent primary repair surgery, and one recovered with conservative treatment. The mean tumor size of 28 patients who underwent surgical resection was 13.9±6.7 mm. There were no cases of postoperative bleeding or perforation; however, four patients experienced ileus and required prolonged hospital stays. The median follow-up periods for patients who underwent ER, surgical resection, and removal after the initial biopsy were 42, 48, and 42.5 months, respectively. During the follow-up period, no recurrence was observed in any group. Conclusions Recurrence-free survival in patients undergoing ER for NADNETs, with an endoscopically measured size of approximately 10 mm, was comparable to that of patients undergoing surgical resection. However, ER carried a relatively high risk of perforation due to the challenging anatomical access and thin duodenal wall.

Objectives: Although non-ampullary duodenal neuroendocrine tumors (NADNETs) are rare neoplasms, their incidence has been increasing. In this study, we aimed to analyze the long-term outcomes of patients with NADNETs who underwent endoscopic resection (ER) or surgery. Methods: This retrospective study included 55 adults (aged 26–78 years) diagnosed with NADNETs between 2009 and 2022 at Seoul National University Hospital. We categorized the patients into 3 groups: 21 underwent ER, 28 underwent surgical resection, and 6 had no detectable residual tumors after the initial biopsy during the follow-up period. Continuous data were examined using the Mann–Whitney U or Kruskal–Wallis tests, and categorical variables were analyzed using the χ2 or Fisher’s exact tests. Results: A total of 21 patients, with a mean tumor size of 9.2±5.3 mm, underwent successful ER. After ER, three patients experienced perforation (14% [3/21]); two underwent primary repair surgery, and one recovered with conservative treatment. The mean tumor size of 28 patients who underwent surgical resection was 13.9±6.7 mm. There were no cases of postoperative bleeding or perforation; however, four patients experienced ileus and required prolonged hospital stays. The median follow-up periods for patients who underwent ER, surgical resection, and removal after the initial biopsy were 42, 48, and 42.5 months, respectively. During the follow-up period, no recurrence was observed in any group. Conclusions Recurrence-free survival in patients undergoing ER for NADNETs, with an endoscopically measured size of approximately 10 mm, was comparable to that of patients undergoing surgical resection. However, ER carried a relatively high risk of perforation due to the challenging anatomical access and thin duodenal wall.

Objectives: Although non-ampullary duodenal neuroendocrine tumors (NADNETs) are rare neoplasms, their incidence has been increasing. In this study, we aimed to analyze the long-term outcomes of patients with NADNETs who underwent endoscopic resection (ER) or surgery. Methods: This retrospective study included 55 adults (aged 26–78 years) diagnosed with NADNETs between 2009 and 2022 at Seoul National University Hospital. We categorized the patients into 3 groups: 21 underwent ER, 28 underwent surgical resection, and 6 had no detectable residual tumors after the initial biopsy during the follow-up period. Continuous data were examined using the Mann–Whitney U or Kruskal–Wallis tests, and categorical variables were analyzed using the χ2 or Fisher’s exact tests. Results: A total of 21 patients, with a mean tumor size of 9.2±5.3 mm, underwent successful ER. After ER, three patients experienced perforation (14% [3/21]); two underwent primary repair surgery, and one recovered with conservative treatment. The mean tumor size of 28 patients who underwent surgical resection was 13.9±6.7 mm. There were no cases of postoperative bleeding or perforation; however, four patients experienced ileus and required prolonged hospital stays. The median follow-up periods for patients who underwent ER, surgical resection, and removal after the initial biopsy were 42, 48, and 42.5 months, respectively. During the follow-up period, no recurrence was observed in any group. Conclusions Recurrence-free survival in patients undergoing ER for NADNETs, with an endoscopically measured size of approximately 10 mm, was comparable to that of patients undergoing surgical resection. However, ER carried a relatively high risk of perforation due to the challenging anatomical access and thin duodenal wall.

Objectives: Although non-ampullary duodenal neuroendocrine tumors (NADNETs) are rare neoplasms, their incidence has been increasing. In this study, we aimed to analyze the long-term outcomes of patients with NADNETs who underwent endoscopic resection (ER) or surgery. Methods: This retrospective study included 55 adults (aged 26–78 years) diagnosed with NADNETs between 2009 and 2022 at Seoul National University Hospital. We categorized the patients into 3 groups: 21 underwent ER, 28 underwent surgical resection, and 6 had no detectable residual tumors after the initial biopsy during the follow-up period. Continuous data were examined using the Mann–Whitney U or Kruskal–Wallis tests, and categorical variables were analyzed using the χ2 or Fisher’s exact tests. Results: A total of 21 patients, with a mean tumor size of 9.2±5.3 mm, underwent successful ER. After ER, three patients experienced perforation (14% [3/21]); two underwent primary repair surgery, and one recovered with conservative treatment. The mean tumor size of 28 patients who underwent surgical resection was 13.9±6.7 mm. There were no cases of postoperative bleeding or perforation; however, four patients experienced ileus and required prolonged hospital stays. The median follow-up periods for patients who underwent ER, surgical resection, and removal after the initial biopsy were 42, 48, and 42.5 months, respectively. During the follow-up period, no recurrence was observed in any group. Conclusions Recurrence-free survival in patients undergoing ER for NADNETs, with an endoscopically measured size of approximately 10 mm, was comparable to that of patients undergoing surgical resection. However, ER carried a relatively high risk of perforation due to the challenging anatomical access and thin duodenal wall.

Objectives: Although non-ampullary duodenal neuroendocrine tumors (NADNETs) are rare neoplasms, their incidence has been increasing. In this study, we aimed to analyze the long-term outcomes of patients with NADNETs who underwent endoscopic resection (ER) or surgery. Methods: This retrospective study included 55 adults (aged 26–78 years) diagnosed with NADNETs between 2009 and 2022 at Seoul National University Hospital. We categorized the patients into 3 groups: 21 underwent ER, 28 underwent surgical resection, and 6 had no detectable residual tumors after the initial biopsy during the follow-up period. Continuous data were examined using the Mann–Whitney U or Kruskal–Wallis tests, and categorical variables were analyzed using the χ2 or Fisher’s exact tests. Results: A total of 21 patients, with a mean tumor size of 9.2±5.3 mm, underwent successful ER. After ER, three patients experienced perforation (14% [3/21]); two underwent primary repair surgery, and one recovered with conservative treatment. The mean tumor size of 28 patients who underwent surgical resection was 13.9±6.7 mm. There were no cases of postoperative bleeding or perforation; however, four patients experienced ileus and required prolonged hospital stays. The median follow-up periods for patients who underwent ER, surgical resection, and removal after the initial biopsy were 42, 48, and 42.5 months, respectively. During the follow-up period, no recurrence was observed in any group. Conclusions Recurrence-free survival in patients undergoing ER for NADNETs, with an endoscopically measured size of approximately 10 mm, was comparable to that of patients undergoing surgical resection. However, ER carried a relatively high risk of perforation due to the challenging anatomical access and thin duodenal wall.

Kikuchi's disease (KD), or histiocytic necrotizing lymphadenitis, is a rare, self-limited lymphadenopathy, typically in young women, that usually remits spontaneously and does not recur. KD is clinically characterized by cervical lymphadenopathy and a high fever. Extranodal involvement (skin, arthritis, meningitis) rarely occurs. When KD is involved in a skin lesion, it presents with various shapes, but rarely manifests with symmetrically distributed, erythematous, firm nodules only on the face. In this report, we describe a patient with KD and unique skin manifestations.
Arthritis ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lymphatic Diseases ; Skin ; Skin Manifestations