A 49-year-old man presented with right basal ganglia hemorrhage due to a ruptured distal lenticulostriate artery aneurysm associated with ipsilateral occlusion of M1 segment of middle cerebral artery with moyamoya-type vessels. Conservative treatment was initially selected. However, the patient suddenly became drowsy with left hemiparesis due to recurrent bleeding 14 days after admission, and excision of the aneurysm was urgently performed via right frontotemporal craniotomy. The follow-up angiography showed successful resolution of the aneurysm. This report describes a rare case of a distal lenticulostriate artery aneurysm associated with ipsilateral middle cerebral artery occlusion with moyamoya-type vessels, which resulted in intracerebral hemorrhage on the right basal ganglia and intraventricular hemorrhage.
Aneurysm* ; Angiography ; Arteries* ; Basal Ganglia ; Basal Ganglia Hemorrhage ; Cerebral Hemorrhage ; Craniotomy ; Follow-Up Studies ; Hemorrhage ; Humans ; Infarction, Middle Cerebral Artery* ; Intracranial Aneurysm ; Middle Aged ; Middle Cerebral Artery* ; Paresis

PURPOSE: Cough is a frequent symptom in bronchial asthma. Acoustic digital analysis of cough has been reported using digital signal processing techniques. Differences between asthmatic and control cough sounds are presented. The main purpose of this study was to examine whether overall spectral energy and the visual observation of the fine details of the cough spectrographs, explain the differences in cough between normal subjects and asthmatic patients. METHODS: We presented data from 7 asthmatic patients and 8 non-asthmatic subjects using a new method of acoustic analysis. Cough sound was digitalized at a sampling rate of 5 kHz. Individual coughs were divided into two or three phases, presents the data of RMS (Root Mean Square), duration, RMS in the frequency band. Factor analysis and iogistic regression analysis were performed to identify groups of variables. RESULTS: Duration of cough was longer in asthmatics cough. The number of additional cough sounds showed no difference. RMS of cough in total cough and 2nd phase cough was stronger for asthmatics cough. Energy of frequency band is significantly different in 1,000-1,500 Hz, 1,500-2,000 Hz, 5,000-5,500 Hz, 5,500-6,000 Hz, 6,000-6,500 Hz, 9,000-9,500 Hz at total phase, 0-500 Hz, 1,000-1,500 Hz, 2,000-2,500 Hz, 5,000-5,500 Hz, 6,000-6,500 Hz, 9,000-9,500 Hz at 1st phase. Factor analysis and logistic regression analysis for the two groups provoded a classification table of 96.3% of sensitivity and 86.0% of specificity. CONCLUSION: We provided a new approach to the analysis of cough sounds. Significant differences were found between asthmatic and non-asthmatic cough sounds. It has potential as a tool with which to study the pathophysiology of cough and diagnosis the respiratory disease.
Acoustics ; Asthma ; Classification ; Cough* ; Diagnosis ; Humans ; Logistic Models ; Sensitivity and Specificity ; Signal Processing, Computer-Assisted

No abstract available.
Asthma*

Acute esotropia following supranuclear cerebral lesions is rare. Although little is known about its mechanism, it may be seen secondary to thalamic and brainstem lesions. We describe 3 patients who showed unilateral esotropia from thalamic hemorrhage. One patient developed an ipsilesional esotropia with bilateral upgaze paralysis. The other patient showed contralesional esotropia with bilateral upgaze paralysis. Another patient had only contralesional esotropia. We discuss the possible mechanism of esotropia in patients with thalamic hemorrhage and review the literature.
Brain Stem ; Esotropia* ; Hemorrhage* ; Humans ; Paralysis

PURPOSE: It is well-known that the bronchial challenge test is very important to evaluate the bronchial hyperresponsiveness in asthma. This study was done to find the items of clinical symptoms and signs as a predictors for bronchial hyperresponsiveness in compare with methacholine challenge test. METHODS: The methacholine challenge test and allergy questionnaire(total 90 items) were done for 76 children with suspected asthma aged 4 to 11 years old who visited children's allergy clinic from the February to the June in 1999. Methacholine was used in increasing doses from 0.125 mg/mL to 16 mg/mL to a greater-than-20%(PC20) drop in FEV1 was obtained, or to the maximum concentration of 16 mg/mL was reached. The subjects were requested to inhale each preparation for 2 minutes. The bronchial hyperreactivity was considered severe if a PC20 was reached at a concentration of 0.125 mg/mL, moderate if the PC20 was reached at between 0.25 and 0.5 mg/mL(group C), mild if the PC20 was obtained with concentrations between 2 and 8 mg/mL(group B), and negative if the PC20 was obtained with concentrations 16 mg/mL or not obtained with any of the concentrations used(group A). We compared bronchial hyperreactivity with items of the questionnaire. RESULTS: 1) Fifteen children are normal(group A), thirty-nine are mild(group B), nineteen are moderate(group C), and three are severe(group C) among 76 children. 2) Symptom score and bronchial hyperreactivity showed statistical significant correlation. 3) Items which had statistical significance(P<0.05) between the methacholine challenge test and the questionnaire are dyspneic asthma attack, more than twice of asthma attck, asthma history diagnosed by doctor, wheezing regardless of common cold, and wheezing episode for last three months. 4) Family history, residential environment, duration of cough and other allergic disease history didn't have any relation. CONCLUSION Some items of asthma questionaire had a close relationship with the severity of bronchial hyperresponsiveness by methacholine challenge test for the children with suspected asthma. We hope that those items of asthma qyestionaire be helpful to predict the airway hyperresponsiveness for childhood asthma.
Asthma* ; Bronchial Hyperreactivity ; Bronchial Provocation Tests ; Child ; Common Cold ; Cough ; Hope ; Humans ; Hypersensitivity ; Methacholine Chloride* ; Surveys and Questionnaires ; Respiratory Sounds

Atopic dermatitis, a chronic inflammatory skin disease can significantly reduce patients’ quality of life. It is commonly observed in infants or young children but can also occur in adults. Patients with atopic dermatitis are at risk of developing food allergies, allergic rhinitis, and asthma.Current Concepts: Treatment of atopic dermatitis should commence with moisturization of epidermal skin and avoidance of environmental factors that may trigger exacerbation of atopic dermatitis. Topical corticosteroid application remains the gold standard for medical management of atopic dermatitis; however, topical corticosteroids are often avoided owing to concerns regarding the adverse effects of these drugs. Recently, several systemic immunosuppressants and biological agents have been introduced for the treatment of atopic dermatitis. These medications are associated with fewer adverse effects than those observed with previous treatments and have therefore shown positive results for successful management of atopic dermatitis.Discussion and Conclusion: It is expected that new drugs tailored to the disease level of each patient will revolutionize the treatment of atopic dermatitis more effectively in future.

Cell-free nucleic acids (cf-NAs) originate in trophoblasts and are detected in the maternal plasma. Using innovative bioinformatic technologies such as next-generation sequencing, cf-NAs in the maternal plasma have been rapidly applied in prenatal genetic screening for fetal aneuploidy. Amniotic fluid is a complex and dynamic fluid that provides growth factors and protection to the fetus. In 2001, the presence of cf-NA in amniotic fluid was reported. Amniotic fluid is in direct contact with the fetus and is derived from fetal urine and maternal and fetal plasma. Therefore, these genetic materials have been suggested to reflect fetal health and provide real-time genetic information regarding fetal development. Recently, several studies evaluated the global gene expression changes of amniot ic fluid cell-free RNA according to gestational age. In addition, by analyzing the transcriptome in the amniotic fluid of fetal aneuploidy, potential key pathways and novel biomarkers for fetal chromosomal aneuploidy were identified. Here, we review the current knowledge of cell-free RNA in amniotic fluid and suggest future research directions.
Amniotic Fluid* ; Aneuploidy ; Biomarkers ; Computational Biology ; Female ; Fetal Development ; Fetus ; Gene Expression ; Gene Expression Profiling ; Genetic Testing ; Gestational Age ; Intercellular Signaling Peptides and Proteins ; Nucleic Acids ; Plasma ; Prenatal Diagnosis ; RNA* ; Transcriptome ; Trophoblasts

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women, which is characterized by the oligo/ anovulation, hyperandrogenism (HA) and polycystic ovarian morphology which are diagnostic criteria. PCOS has diverse clinical aspects in addition to those diagnostic criteria including increased risk for cardiovascular diseases, metabolic syndrome, dyslipidemia, type 2 diabetes and impaired fertility. Because of the heterogeneity of the disease, the pathogenesis of the disease has not been elucidated yet. Therefore, there is no cure for the endocrinopathy. HA and insulin resistance (IR) has been considered two major pillars of the pathogenesis of PCOS. Recent advances in animal studies revealed the critical role of neuroendocrine abnormalities in developing PCOS. Several pathways related to neuroendocrine origin have been investigated such as hypothalamus pituitary ovarian axis, hypothalamus pituitary adrenal axis and hypothalamus pituitary adipose axis. This review summarizes the current knowledge about the role of HA and IR in developing PCOS. In addition, we review the results of recent genome wide association studies for PCOS. This new perspective improves our understanding of the role of neuroendocrine origins in PCOS and suggest a novel potential therapeutic target for the treatment of PCOS.

Ischemic stroke is a heterogeneous disease caused by different pathogenic mechanisms, of which small artery and large artery stroke are the most common. Although the identification of the genes involved is unclear, genetic factors are increasingly recognized as influencing risk for atherosclerosis or arteriolosclerosis directly and indirectly. Genetic makeup may influence the development of major vascular risk factors or alter susceptibility of the cerebral vasculature to these risk factors. Some researchers have reported that atherosclerosis is high in people with functional variants of genes related to matrix deposition (matrix metalloproteinase 3), inflammation (interleukin-6), and lipid metabolism (hepatic lipase, apolipoprotein E, cholesteryl ester transfer protein, and paraoxonase) and clotting (factor V Leiden, fibrinogen). More recently, newly identified risk factors for atherosclerosis, such as plasma homocysteine (5,10-methylenetetrahydrofolate reductase). In this review, we assess the robustness of these associations and examine whether there is any evidence of risk modifications by factors, such as smoking.
Apolipoproteins ; Arteries ; Arteriolosclerosis ; Atherosclerosis ; Brain Ischemia ; Cholesterol Ester Transfer Proteins ; Genetics ; Homocysteine ; Inflammation ; Lipase ; Lipid Metabolism ; Molecular Biology* ; Plasma ; Risk Factors ; Smoke ; Smoking ; Stroke*

Between August 1994 and June 1995, seventeen patients diagnosed as having partial or complete ruptures of the anterior cruciate ligament on MRI were managed by non-operative methods. Among them four patients were excluded due to operation during follow-up and the results were evaluated at a one year follow-up. We selected the patients prospectively for non-operative care using the selection criteria of age, degree of instability, activity level and patient compliance. The average age of them was 37.7 years. Initially knee stress test and MRI were checked, and Cybex study and Lysholm knee scoring were done at post-trauma one year follow-up. They were managed conservatively by ROM and muscle strengthening exercises and a brace fitting schedule for three months. Among them, six cases had partial tears and seven had a complete tear initially. At the one year follow-up, five of six cases who had shown partial ruptures, and two of seven cases with complete tears, recovered continuity of the ruptured ACL on MRI. Their Lysholm knee score was 84.4, and the Cybex test showed no difference in muscle power between the injured and uninjuried side. Those patients who had loss of continuity on follow-up MRI showed Lysholm score of 57.4 and decreased muscle power on Cybex study. Although there are still controversies about the adequate management of ACL injuries, our study suggests that conservative management is a viable alternative to surgery as long as the patients are selected prudently. For more concrete results, however, careful analysis based on a longer follow up period is necessary.
Anterior Cruciate Ligament* ; Appointments and Schedules ; Braces ; Exercise ; Exercise Test ; Follow-Up Studies ; Humans ; Knee ; Magnetic Resonance Imaging ; Patient Compliance ; Patient Selection ; Prospective Studies ; Rupture*