Acute disseminated encephalomyelitis (ADEM) is an acute inflammatory demyelinating disease of central nervous system, and is related to allergic or immune-mediated reaction to systemic viral infection or vaccination, which is usually self limited monophasic illness. As the clinical manifestations or laboratory findings is nonspecific, it is diagnosed by brain magnetic resonance imaging (MRI) showing multiple foci of increased T2 signal within white matter. We report the clinical and radiologic imaging findings in a 36-year-old man in whom acute disseminated encephalomyelitis developed after serologically proven herpes infection combined with liver abscess. His clinical course, despite without corticosteroid or plasmapheresis because of liver abscess, was shown spontaneous remission.
Adult ; Brain ; Central Nervous System ; Demyelinating Diseases ; Encephalomyelitis, Acute Disseminated* ; Humans ; Liver Abscess* ; Liver* ; Magnetic Resonance Imaging ; Plasmapheresis ; Remission, Spontaneous ; Vaccination

The effects of styrene on the induction of cytochrome P-450s (P450), (P4501A1/2, P4502B1/2 and P4502El) and activities of other related enzymes were investigated in the male Sprague Dawley rats which were treated with styrene 500 (S1), 1,000 (S2) 1,500 (S3) mg/kg in olive oil intraperitoneally once a day for two days and sacrificed for the preparation of liver microsomes after 24 hrs. 1. The contents of total protein and P450 in the microsomes derived from the styrene treated groups were slightly higher than those from the control group except those from the 53 group (1,500 mg styrene/kg body weight) . The decreases in microsomal protein contents was prominent in the S3 (p<0.05), but the P450 contents was increased significantly in the S2 (p<0.05). 2. The activities of NADPH-P450 and NADH b5 reductase in hepatic microsomes derived from the treated groups were significantly increased in the treated groups(p<0.05). 3. The activities of PROD were also prominently increased with the treatment of styrene except in 53 group, but the activity of EROD was decreased by styrene treatment. The activities of pNPH in the styrene treated groups were higher than that of the control group (p<0.05). 5. Western blotting with monoclonal antibodies against P4502B1/2 isozymes showed the presence of P4502B1/2 in hepatic microsomes from the rats treated with styrene, and the increase in the densities of immunoblots were corelated with the dosages of styrene. The blot densities against P4501A1/2 and P4502El were slightly increased in the styrene treated groups compared with the control group. These results suggested that styrene could primarily induce P4502B1/2 as major and P4501A1/2 and P4502El in minor forms for the metabolism of styrene in rats.
Animals ; Antibodies, Monoclonal ; Blotting, Western ; Cytochrome P-450 CYP1A1 ; Cytochrome P-450 CYP2B1 ; Cytochrome P-450 Enzyme System* ; Cytochromes* ; Humans ; Isoenzymes ; Male ; Metabolism ; Microsomes ; Microsomes, Liver ; NAD ; Olea ; Oxidoreductases ; Rats* ; Rats, Sprague-Dawley ; Styrene*

The effects of styrene on the induction of cytochrome P-450s (P450), (P4501A1/2, P4502B1/2 and P4502El) and activities of other related enzymes were investigated in the male Sprague Dawley rats which were treated with styrene 500 (S1), 1,000 (S2) 1,500 (S3) mg/kg in olive oil intraperitoneally once a day for two days and sacrificed for the preparation of liver microsomes after 24 hrs. 1. The contents of total protein and P450 in the microsomes derived from the styrene treated groups were slightly higher than those from the control group except those from the 53 group (1,500 mg styrene/kg body weight) . The decreases in microsomal protein contents was prominent in the S3 (p<0.05), but the P450 contents was increased significantly in the S2 (p<0.05). 2. The activities of NADPH-P450 and NADH b5 reductase in hepatic microsomes derived from the treated groups were significantly increased in the treated groups(p<0.05). 3. The activities of PROD were also prominently increased with the treatment of styrene except in 53 group, but the activity of EROD was decreased by styrene treatment. The activities of pNPH in the styrene treated groups were higher than that of the control group (p<0.05). 5. Western blotting with monoclonal antibodies against P4502B1/2 isozymes showed the presence of P4502B1/2 in hepatic microsomes from the rats treated with styrene, and the increase in the densities of immunoblots were corelated with the dosages of styrene. The blot densities against P4501A1/2 and P4502El were slightly increased in the styrene treated groups compared with the control group. These results suggested that styrene could primarily induce P4502B1/2 as major and P4501A1/2 and P4502El in minor forms for the metabolism of styrene in rats.
Animals ; Antibodies, Monoclonal ; Blotting, Western ; Cytochrome P-450 CYP1A1 ; Cytochrome P-450 CYP2B1 ; Cytochrome P-450 Enzyme System* ; Cytochromes* ; Humans ; Isoenzymes ; Male ; Metabolism ; Microsomes ; Microsomes, Liver ; NAD ; Olea ; Oxidoreductases ; Rats* ; Rats, Sprague-Dawley ; Styrene*

OBJECTIVE: The purpose of this study was to compare the results of different agents for bronchial artery embolization of hemoptysis. MATERIALS AND METHODS: From March 1992 to December 2006, a bronchial artery embolization was performed on 430 patients with hemoptysis. The patients were divided into three groups. Group 1 included 74 patients treated with a gelfoam particle (1x1x1 mm), while group 2 comprised of 205 patients treated with polyvinyl alcohol (PVA) at 355-500 micrometer, and group 3 included 151 patients treated with PVA at 500-710 micrometer. We categorized the results as technical and clinical successes, and also included the mid-term results. Retrospectively, the technical success was compared immediately after the procedure. The clinical success and mid-term results (percentage of patients who were free of hemoptysis) were compared at 1 and 12 months after the procedure, respectively. RESULTS: Neither the technical successes (group 1; 85%, 2; 85%, 3; 90%) nor the clinical successes (group 1; 72%, 2; 74%, 3; 71%) showed a significant difference among the 3 groups (p > 0.05). However, the mid-term results (group 1; 45%, 2; 63%, 3; 62%) and mid-term results excluding the recurrence from collateral vessels in each of the groups (group 1; 1 patient, 2; 4 patients, 3; 2 patients) showed that group 1 was lower than the other two groups (p < 0.05). No significant difference was discovered for the mid-term results between groups 2 and 3. Moreover, the same results not including incidences of recurrence from collateral vessels also showed no statistical significance between the two groups (p > 0.05). CONCLUSION: Polyvinyl alcohol appears to be the more optimal modality compared to gelfoam particle for bronchial artery embolization in order to improve the mid-term results. The material size of PVA needs to be selected to match with the vascular diameter.
Adolescent ; Adult ; Aged ; Angiography ; *Bronchial Arteries ; Embolization, Therapeutic/*methods ; Female ; Gelatin Sponge, Absorbable/*therapeutic use ; Hemoptysis/etiology/radiography/*therapy ; Hemostatics/*therapeutic use ; Humans ; Male ; Middle Aged ; Polyvinyl Alcohol/*therapeutic use ; Treatment Outcome

PURPOSE: Femoroacetabular impingement (FAI) is considered an important cause of early degenerative arthritis development. Although three-dimensional (3D) imaging such as computed tomography (CT) and magnetic resonance imaging are considered precise imaging modalities for 3D morphology of FAI, they are associated with several limitations when used in out-patient clinics. The paucity of FAI morphologic data in Koreans makes it difficult to select the most effective radiographical method when screening for general orthopedic problems. We postulate that there might be an individual variation in the distribution of cam deformity in the asymptomatic Korean population. MATERIALS AND METHODS: From January 2011 to December 2015, CT images of the hips of 100 subjects without any history of hip joint ailments were evaluated. A computer program which generates 3D models from CT scans was used to provide sectional images which cross the central axis of the femoral head and neck. Alpha angles were measured in each sectional images. Alpha angles above 55° were regarded as cam deformity. RESULTS: The mean alpha angle was 43.5°, range 34.7–56.1°(3 o'clock); 51.24°, range 39.5–58.8°(2 o'clock); 52.45°, range 43.3–65.5°(1 o'clock); 44.09°, range 36.8–49.8°(12 o'clock); 40.71, range 33.5–45.8°(11 o'clock); and 39.21°, range 34.1–44.6°(10 o'clock). Alpha angle in 1 and 2 o'clock was significantly larger than other locations (P < 0.01). The prevalence of cam deformity was 18.0% and 19.0% in 1 and 2 o'clock, respectively. CONCLUSION: Cam deformity of FAI was observed in 31% of asymptomatic hips. The most common region of cam deformity was antero-superior area of femoral head-neck junction (1 and 2 o'clock).
Adult ; Congenital Abnormalities ; Femoracetabular Impingement ; Femur ; Head ; Hip Joint ; Hip ; Humans ; Magnetic Resonance Imaging ; Mass Screening ; Methods ; Neck ; Orthopedics ; Osteoarthritis ; Outpatients ; Prevalence ; Tomography, X-Ray Computed

Purpose: Subpial hemorrhage (SPH) is a subtype of intracranial hemorrhage characterized by damage to the adjacent brain parenchyma. The aim of this study was to describe the sonographic features of SPH in neonates. Methods: The cranial ultrasound (US) findings of neonates with SPH confirmed by brain magnetic resonance imaging (MRI) were analyzed retrospectively. Initial and follow-up US and MRI scans were reviewed by two pediatric radiologists who were blinded to both clinical history and outcomes. The US features were compared with the MRI findings. Results: Sixteen patients were included (median gestational age, 38 weeks; range, 26 to 40 weeks; 69% term). SPH was detected most often in the temporal lobe (63%), and multiple SPHs were found in seven of 16 neonates, based on MRI. Acute SPH with an underlying venous infarct (UVI) was detected on US in 15 of 16 patients: small or large fan-shaped hyperechoic lesions (n=7 and 4, respectively) and gyriform hyperechoic lesions (n=4). The sonographic yin-yang sign was observed in three of the four large fan-shaped SPH cases. The accompanying findings on US were intraventricular hemorrhage (four out of six MRI-confirmed cases), and concurrent periventricular venous infarcts (five out of nine MRI-confirmed cases). In five patients, subpial cysts were observed on follow-up US or MRI (n=4 and n=4, respectively). Conclusion Acute SPH with UVI can appear as a peripheral fan-shaped or gyriform hyperechoic lesion on cranial US. SPH can be detected and suspected based on the US features of SPH with the accompanying findings.

We report a 52-yr-old Korean woman with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) whose diagnosis was confirmed by skin biopsy and the presence of a novel mutation in the NOTCH3 gene. The patient's clinical features were rather unusual in that 1) clinical presentations were only two episodes of stroke and mild dementia unaccompanied by mood disturbances or migraine, and 2) there was no family history. Brain MRI showed T2 hyperintensities in both temporal pole areas in line with the recent suggestion by O'Sullivan et al. that the abnormality could be a radiologic marker of CADASIL. FDG-PET also showed a hypometabolism in the temporal pole areas with an abnormal finding on MRI in addition to the hypometabolism in cortical and subcortical regions. We could learn from this case that CADASIL may be included in the differential diagnoses in patients with vascular dementia associated with a small vessel disease, even in the absence of a family history, especially when there are no known stroke risk factors and when the MRI shows T2 hyperintensity in the temporal pole regions.
Amino Acid Substitution ; Biopsy ; Brain/pathology ; Codon/genetics ; Dementia, Multi-Infarct/diagnosis ; Dementia, Multi-Infarct/genetics* ; Dementia, Multi-Infarct/pathology ; Dementia, Multi-Infarct/radionuclide imaging ; Female ; Human ; Korea ; Magnetic Resonance Imaging ; Middle Aged ; Mutation, Missense* ; Neuropsychological Tests ; Point Mutation* ; Proto-Oncogene Proteins/genetics* ; Skin/pathology ; Tomography, Emission-Computed

OBJECTIVE: To verify the influence of sour taste on swallowing and the presence of reflex cough when sour material was swallowed in patients with dysphagia secondary to brain injury. METHOD: Fifty dysphagic brain injury patients who underwent videofluoroscopic swallowing study (VFSS) were recruited. The patients who had shown severe aspiration at 2 ml of liquid were excluded. The dysphagic patients were given 5 ml each of a sour tasting liquid (SOUR) and a thin liquid barium (LIQUID) in random order. An expert analyzed the result of VFSS by reviewing recorded videotapes. Analysis components consisted of the Penetration-Aspiration-Scale (PAS) score, oral transit time (OTT), pharyngeal transit time (PTT), pharyngeal delay time (PDT) and the reflex cough presence. RESULTS: The PAS score for SOUR was significantly lower than the one for LIQUID (p=0.03). The mean OTT for SOUR was significantly shortened compared to that for LIQUID (p=0.03). The mean PTT and PDT were also shortened in SOUR, although the differences were not statistically significant (p=0.26 and p=0.32, respectively). There was no significant difference between SOUR and LIQUID regarding the presence of reflex cough (p=1.00). CONCLUSION: The sour taste could enhance sensorimotor feedback in the oropharynx, thus lowering the chances of penetration-aspiration caused by shortening of the oropharyngeal passage times. There was no significant difference in the presence of reflex cough produced between LIQUID and SOUR.
Barium ; Brain ; Brain Injuries ; Cough ; Deglutition ; Deglutition Disorders ; Feedback, Sensory ; Humans ; Oropharynx ; Reflex ; Triazenes ; Videotape Recording

von Hippel-Lindau (VHL) disease is an autosomal dominant inherited tumor syndrome associated with mutations of the VHL tumor suppressor gene located on chromosome 3p25. The loss of functional VHL protein contributes to tumorigenesis. This condition is characterized by development of benign and malignant tumors in the central nervous system (CNS) and the internal organs, including kidney, adrenal gland, and pancreas. We herein describe the case of a 74-year-old man carrying the VHL gene mutation who was affected by simultaneous colorectal adenocarcinoma, renal clear cell carcinoma, and hemangioblastomas of CNS.
Adenocarcinoma* ; Adrenal Glands ; Aged ; Carcinogenesis ; Carcinoma, Renal Cell* ; Central Nervous System ; Colorectal Neoplasms ; Genes, Tumor Suppressor ; Hemangioblastoma* ; Humans ; Kidney ; Pancreas ; von Hippel-Lindau Disease*

BACKGROUND: Although combined chemotherapy has increased survival rates among children with cancer, such treatments can induce sensorineural hearing loss. Therefore, we aimed to identify risk factors for hearing impairments in patients with childhood cancer.METHODS: Audiograms were obtained from 115 patients with childhood cancer and survivors (age < 20 years). Pure tone audiometry (PTA) was performed at octave intervals within the range of 250-8000 Hz. We evaluated clinical risk factors associated with hearing impairments. Hearing loss was evaluated based on the maximal decibel (dB) loss in any frequency for each ear (RA(max) or LA(max)) and weighted mean dB loss for specific frequencies (RA(avg) or LA(avg)).RESULTS: Forty percent of patients (N=46) exhibited hearing loss >20 dB based on the weighted mean value in either ear. Severe hearing impairments were observed in 56% of patients with brain tumors. Although cisplatin or vinca alkaloids were significant risk factors for hearing impairment, the use of both cisplatin and vinca alkaloids exhibited the highest odds ratio for hearing impairment (P < 0.001, < 0.001 for R/LA(max); P=0.099, 0.039 for R/LA(avg)). Multivariate analysis revealed that the use of both cisplatin and vinca alkaloids was an independent risk factor for hearing impairment based on RA(max), LA(max), and LA(avg) (P < 0.001, < 0.001, 0.039, respectively).CONCLUSION: Our findings indicate that cisplatin and vinca alkaloids exert an additive effect on the risk of hearing impairment in survivors of childhood cancer. Further prospective studies are thus required to determine the most effective chemotherapeutic regimen for reducing ototoxicity.
Audiometry ; Brain Neoplasms ; Child ; Cisplatin ; Drug Therapy ; Ear ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing ; Humans ; Multivariate Analysis ; Odds Ratio ; Prospective Studies ; Risk Factors ; Survival Rate ; Survivors ; Vinca Alkaloids ; Vinca