Klippel-Trenaunay syndrome (KTS) is a rare congenital malformation syndrome involving blood and lymph vessels, which is characterized by triad of cutaneous hemangioma, venous varicosities, and overgrowth of the affected limbs. Because vascular malformation in KTS can be located anywhere except the face and brain, the clinical presentation could be extremely variable. But there are only rare case reports that KTS is associated with spinal cord lesion. We report a case of recurrent myelopathy in a patient with KTS.
Brain ; Extremities ; Hemangioma ; Humans ; Klippel-Trenaunay-Weber Syndrome* ; Spinal Cord ; Spinal Cord Diseases* ; Vascular Malformations

No abstract available.
Edema* ; Hydrops Fetalis*

BACKGROUND: Exofocal neuronal death in the substantia nigra (SN) is a well-known form of anterograde transsynaptic cell death. Exofocal neuronal death could theoretically also occur in the globus pallidus (GP) after striatal injury. CASE REPORT: Case 1. A 70-year-old woman visited the emergency room because of decreased mentality. On admission, blood-gas analysis indicated that her oxygen tension was 69.1 mm Hg. The caudate nucleus, putamen, and temporooccipital cortex on both sides of the brain exhibited high-intensity diffusion-weighted magnetic resonance imaging (MRI) signals. At 10 days after admission, new high-intensity signals had developed in the SN and GP on both sides. Case 2. A 48-year-old man visited the emergency room because of right-sided weakness. Lesions were noted in the left caudate nucleus and putamen. At 4 days after admission, newly developed high-intensity MRI signals were observed in the left SN and GP. CONCLUSIONS: Exofocal neuronal death can occur in the GP as well as in the SN; these findings need to be clearly distinguished from those of recurrent ischemic injuries, such as recurrent stroke.
Brain ; Caudate Nucleus ; Cell Death ; Emergencies ; Female ; Globus Pallidus ; Humans ; Magnetic Resonance Imaging ; Neurons ; Oxygen ; Putamen ; Stroke ; Substantia Nigra

Eagle's syndrome is a condition due to elongation of styloid process or calcification of the stylohyoid ligament. The styloid process can cause compression of the cervical carotid arteries leading to flow reduction in these arteries. We report a 49 year-old man who experienced transient right-sided weakness and monocular blindness within 10 seconds of turning his head to the left. Three-dimensional computed tomography revealed compression of left carotid artery by elongated styloid process during symptom provocation.
Arteries ; Blindness ; Carotid Arteries ; Head ; Ischemic Attack, Transient ; Ligaments ; Ossification, Heterotopic ; Temporal Bone

BACKGROUND: Co-morbid vascular disease, such as coronary artery disease or peripheral artery disease (PAD) is frequently combined in patients with ischemic stroke (IS) or transient ischemic attack (TIA). However, PAD has been underestimated and underevaluated in these patients. The aims of this study were to know the prevalence of PAD and to assess the risk factors for PAD in patients with IS or TIA. METHODS: Between February in 2006 and March in 2011, ankle-brachial index (ABI) was measured in 724 patients with acute IS or TIA. We compared the demographics and baseline characteristics, including risk factors and stroke subtypes between patients combined with and without PAD. RESULTS: PAD was found in 13.3% (96/724) and more frequent in patients with large artery disease. Patients with PAD were older (mean age 74.5+/-10.4 vs. 65.5+/-12.5, p<0.001),and had higher body mass index (BMI) (23.15+/-3.46 vs. 24.03+/-3.25; p=0.019), higher serum level of hemoglobin (12.99+/-2.12 vs. 13.68+/-1.87; p=0.001) and severe initial neurological deficit measured by National Institute of Health Stroke Scale (NIHSS) (median 4, IQR:2,7 vs. 2, IQR:1,5; p=0.001) on admission than those without PAD; patients with PAD were more likely to have hypertension (79.2% vs. 61.6%; p=0.001), diabetes (44.8% vs. 29.5%; p=0.004), and previous stroke or TIA (35.4% vs. 23.9%; p=0.022). In multivariable logistic regression analysis, age (OR, 1.069; 95% CI, 1.042-1.096; p<0.001) and diabetes (OR, 1.904; 95% CI, 1.134-3.196; p=0.015) were independently associated with PAD in IS or TIA. CONCLUSIONS: Age and diabetes were independent risk factors for PAD in IS or TIA.
Ankle Brachial Index ; Arteries ; Body Mass Index ; Coronary Artery Disease ; Demography ; Hemoglobins ; Humans ; Hypertension ; Ischemic Attack, Transient ; Logistic Models ; Peripheral Arterial Disease ; Prevalence ; Risk Factors ; Stroke ; Vascular Diseases

BACKGROUND: Liquid-based cytology is currently known as an effective method, and cervical cytology has been shown to be especially effective from of malignancy detection. In our study, the cytological detection rates of the Thinprep (Liquid-based cytology) and conventional cytology (bronchial washing & brushing) for endobronchial lesions were compared. METHODS: Between July 2005 and September 2005, the data from 30 patients with respiration symptom, who had shown abnormal lesion on bronchoscopy, were collected. RESULTS: The bronchoscopic biopsy group was consisted of 30 cytodiagnosis specimens, 24 of which were confirmed to be malignant. The others were tuberculosis (4), bronchiectasis and bronchopulmonary fistula (1 each). Of the 24 malignant case, cancer or atypical cells were detected in 19, 17 and 12 of the Thinprep, brushing cytology and washing cytology cases, respectively. None one of the methods detected cancer cells in the non-malignant specimens. Washing cytology has shown sensitivity, specificity, and positive and negative predictive values of 50, 100, 100 and 33.3% respectively. Brushing cytology has shown sensitivity, specificity, and positive and negative predictive values of 70.8, 100, 100 and 46.2%, respectively. Thinprep has shown sensitivity, specificity, and positive and negative predictive values of 79.2, 100, 100 and 54%, respectively. CONCLUSIONS: Thinprep (liquid-based cytology) showed better sensitivity and negative predictive values for the evaluation of lung cancer than conventional cytology. However a large-scale study will be needed in the future.
Biopsy ; Bronchiectasis ; Bronchoscopy* ; Cytodiagnosis ; Fistula ; Humans ; Lung Neoplasms ; Respiration ; Tuberculosis