Cryptosporidium parvum oocysts were isolated from a child suffering from acute gastroenteritis and successfully passaged in a calf and mice (designated hereafter SNU-H1) in the Republic of Korea; its molecular genotype has been analyzed. The GAG microsatellite region was amplified by a polymerase chain reaction (PCR), with a 238 base pair product, which is commonly displayed in C. parvum. The isolate was shown to be a mixture of the genotypes 1 (anthroponotic) and 2 (zoonotic). To study its infectivity in animals, 2 calves and 3 strains of mice were infected with the SNU-H1; in these animals, the propagation of both genotypes was successful. In immunosuppressed (ImSP) BALB/c and C57BL/6 mice the number of oocysts decreased after day 10 post-infection (PI) ; but in ImSP ICR mice, they remained constant until day 27 PI. The results show that both the C. parvum genotypes 1 and 2 can be propagated in calves and ImSP mice.
Animals ; Cattle ; Child ; Cryptosporidiosis/microbiology ; Cryptosporidium parvum/*genetics/immunology ; Diarrhea/parasitology ; Feces/parasitology ; Genotype ; Human ; Korea ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Mice, Inbred ICR ; Oocysts ; Polymerase Chain Reaction ; Support, Non-U.S. Gov't ; Zoonoses/parasitology

BACKGROUND AND PURPOSE: The claims data of the Korean National Health Insurance (NHI) system can be useful in stroke research. The aim of this study was to validate the accuracy of hospital discharge data used for NHI claims in identifying acute stroke and use of thrombolytic therapy. METHODS: The hospital discharge data of 1,811 patients with stroke-related diagnosis codes were obtained from Jeju National University Hospital (JNUH) and Seoul Medical Center (SMC). Three algorithms were tested to identify discharges with acute stroke [ischemic stroke (IS), intracranial hemorrhage (ICH), or subarachnoid hemorrhage (SAH)]: 1) all diagnosis codes up to nine positions, 2) one primary diagnosis and one secondary diagnosis, and 3) only one primary diagnosis code. Reviews of medical records were considered the gold standards. RESULTS: Overall, the degree of agreement (kappa) was higher for algorithms 1 and 2 than for algorithm 3, and the sensitivity and specificity of the first two algorithms for IS and SAH were both >90%, with almost perfect agreement (kappa=0.83-0.84) in the JNUH data set. Regarding ICH, only algorithm 1 yielded an almost perfect agreement (kappa=0.82). In the SMC data set, almost perfect agreement was found for both ICH and SAH in all three algorithms. In contrast, the three algorithms yielded a range of agreement levels, though all substantial, for IS. Almost perfect agreement was obtained for use of thrombolytic therapy in both data sets (kappa=0.91-0.99). CONCLUSIONS: Discharge with hemorrhagic stroke and use of thrombolytic therapy were identified with high reliability in administrative discharge data. A substantial level of agreement was also obtained for IS, despite variation between the algorithms and data sets.
Data Collection ; Dataset ; Diagnosis ; Hospital Records ; Humans ; Intracranial Hemorrhages ; Medical Records ; National Health Programs* ; Sensitivity and Specificity ; Seoul ; Stroke* ; Subarachnoid Hemorrhage ; Thrombolytic Therapy*

Inflammatory and infectious conditions can involve the cerebral vasculature and cause stroke. Vasculitis involving central nervous system (CNS) is a heterogeneous entity of disorders characterized by inflammation and necrosis of blood vessel walls. It can be caused by noninfectious and infectious diseases. Noninfectious cause includes primary angiitis of CNS, giant cell arteritis, Takayasu's disease and Behcet's disease. Hepatitis C, human immunodeficiency and varicella-zoster viruses as well as bacterial and fungal organisms have been reported to be associated with infectious vasculitis. Inflammatory biomarkers and infectious index are in a portion regarded as risk factors of stroke. However, there is still controversy and further prospective evaluation should be performed. In the current article, the author concisely reviewed contemporary studies about inflammatory and infectious conditions associated with stroke.
Biomarkers ; Blood Vessels ; Central Nervous System ; Communicable Diseases ; Giant Cell Arteritis ; Glycosaminoglycans ; Hepatitis C ; Herpesvirus 3, Human ; Humans ; Inflammation ; Necrosis ; Risk Factors ; Stroke ; Vasculitis

Taking medication early on for aborting migraines has proved to be more effective, but trials using triptans during the aura phase have not shown significant effectiveness. Isometheptene compounds are popularly used as an anti-migraine OTC drug. We report a 27-year-old male patient with migraine with aura whose headache attacks were consistently inhibited by an isometheptene compound administered at the early aura phase, while he received no benefits from adequate treatment during the headache phase.
Adult ; Epilepsy* ; Headache ; Humans ; Male ; Migraine Disorders* ; Migraine with Aura ; Tryptamines

No abstract available.
Telephone*

No abstract available.
Nursing Homes* ; Nursing* ; Nutritional Status*

BACKGROUND: Inflammatory mechanisms play an important role in acute brain ischemia, and they contribute to the functional outcome. The neutrophil-to-lymphocyte ratio (NLR) has recently been described as a predictor of clinical outcomes in patients with acute coronary syndrome. This study assessed the clinical significance of NLR as a new predictor of the outcome in patients with acute ischemic stroke. METHODS: The study included 371 patients diagnosed as acute ischemic stroke within 48 hours after the onset. All subjects were divided into three groups according to tertiles of the NLR in the initial blood test. Functional outcomes were divided into two groups at 3 months and 1 year after stroke onset: favorable (mRS 0~2) or unfavorable (mRS 3~6). RESULTS: The proportion of patients with mRS 0~2 (favorable outcome) decreased as the NLR increased from the first tertile to the third tertile at discharge (74%, 62.9 and 49.2, p<0.001) and at 3 months (74%, 66.9 and 42.7, p<0.001) and 1 year (67.5%, 64.5 and 41.1, p<0.001) after stroke. NLR was higher in patients with an unfavorable outcome than in those with a favorable outcome (3.88 vs. 2.27 at 3 months, p<0.01; 3.67 vs. 2.31 at 1 year, p<0.001). Multivariate analysis revealed that the significant predictors of an unfavorable outcome at 3 months were NLR in the highest tertile (OR 2.28, 95% CI 1.13~4.60), age (OR 1.04, 95% CI 1.01~1.07), and NIHSS score (OR 1.27, 95% CI 1.18~1.36) at admission. CONCLUSIONS: NLR at admission can be used as a predictor of functional outcome at 3 months after ischemic stroke.
Acute Coronary Syndrome ; Brain Ischemia ; Hematologic Tests ; Humans ; Lymphocytes ; Multivariate Analysis ; Neutrophils ; Prognosis ; Stroke

BACKGROUND: Neurocardiogenic syncope (NCS) is the most common type of neurally mediated syncopes. Though presyncopal symptoms may represent hypoperfusion in posterior circulation, studies for evaluating the cerebrovascular response of posterior circulation in patients with NCS were scanty. We evaluated the cerebrovascular response of the posterior circulation using transcranial Doppler monitoring in patients with NCS. METHODS: We measured the blood flow velocity (BFV) of the middle cerebral artery (MCA) and contralateral posterior cerebral artery (PCA) simultaneously in 11 patients with a diagnosis of NCS both at rest and during the head-up tilt test (HUT) for 5 minutes. The mean arterial pressure (MAP), pulse rate (PR), and end-tidal pCO2 (EtCO2) were also monitored. The obtained data were compared with those of 17 normal control subjects. RESULTS: The syncope patients showed a significantly larger decline in BFV of PCA (P<0.05) and a larger increase in pulsatility indexes of MCA and PCA during HUT compared to those of control subjects. In control subjects BFV of PCA decreased less than those of MCA. On the contrary, in patients with NCS, those of PCA decreased more. These different regional cerebrovascular responses to HUT were accompanied with neither presyncopal symptoms nor decrease in MBP. CONCLUSIONS: The regional cerebrovascular response to HUT in NCS patients was different in the PCA flow. Impairment of autonomic neural control of posterior circulation may play an important role in the pathophysiology of NCS.
Arterial Pressure ; Blood Flow Velocity ; Heart Rate ; Humans ; Middle Cerebral Artery ; Passive Cutaneous Anaphylaxis ; Posterior Cerebral Artery ; Syncope ; Syncope, Vasovagal

Pure rhabdomyosarcoma of the spermatic cord is rare. We present a case of rhabdomyosarcoma of the spermatic cord presenting as a large scrotal mass and mimicking testicular tumor. The literatures were reviewed.
Rhabdomyosarcoma* ; Spermatic Cord*

Pure rhabdomyosarcoma of the spermatic cord is rare. We present a case of rhabdomyosarcoma of the spermatic cord presenting as a large scrotal mass and mimicking testicular tumor. The literatures were reviewed.
Rhabdomyosarcoma* ; Spermatic Cord*