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Segmental zoster paresis (SZP) is a clinically rare complication of herpes zoster. But it has not been reported that acute cerebral motor cortical infarction coincidentally occurred in SZP. A 86-year-old woman was admitted due to pain, tingling sensation, and weakness of left arm. She had an acute onset of pain and tingling sensation in left arm at first day, shoulder weakness at second day, and multifocal vesicles at fourth day. Deep tendon reflexes of left arm were decreased than right. Electromyography showed an axonal polyneuropathy at superior trunk level of left brachial plexus. Median and ulnar sensory evoked potential tests were normal. Brain MRI showed a high signal in right primary motor cortex on diffusion weighted image. We report a case of acute cerebral motor cortical infarction coincidentally occurred in SZP.
Polychlorinated biphenyls (PCBs) are accumulated in our body through food chain and cause a variety of adverse health eff ects including neurotoxicities such as cognitive deficits and motor dysfunction. In particular, neonates are considered as a high risk group for the neurotoxicity of PCBs exposure. Th e present study attempted to analyze the structure-activity relationship among PCB congeners and the mechanism of PCBs-induced neurotoxicity. We measured total protein kinase C (PKC) activities, PKC isoforms, reactive oxygen species (ROS), and induction of neurogranin (RC-3) and growth associated protein-43 (GAP-43) mRNA in cerebellar granule cells of neonatal rats with phorbol 12, 13-dibutyrate ([3H]PDBu) binding assay, western blot, ROS assay, and reverse transcription PCR (RT-PCR) analysis respectively following the different structural PCBs exposure. Only non-coplanar PCBs showed a significant increase of total PKC-α and βII activity as measured with [3H]PDBu binding assay. ROS were more increased with non-coplanar PCBs than coplanar PCBs. The mRNA levels of RC-3 and GAP-43 were more induced with noncoplanar PCBs than coplanar PCBs, indicating that these factors may be useful biomarkers for diff erentiating non-coplanar PCBs from coplanar PCBs. Non-coplanar PCBs may be more potent neurotoxic congeners than coplanar PCBs. This study provides evidences that non-coplanar PCBs, which have been neglected in the risk assessment processes, should be added in the future to improve the quality and accuracy of risk assessment on the neuroendocrinal adverse eff ects of PCBs exposures.
목적 : 위암은 국내에서 가장 흔히 발생되는 암이며 암으로 인한 사인에서 두 번째 흔한 원인이다. 근래 조기 위암의 빈도는 증가추세이며 조기 위암의 예후는 우수하다. 본 연구에서는 근치적으로 절제된 조기 위암 환자의 예후 인자를 분석하여 조기 위암 환자에서 최선의 치료 방법을 찾는데 도움을 주고자 연구를 진행하였다. 방법 : 1996년 1월부터 2001년 12월까지 동산의료원에서 598명의 조기 위암 환자에 대해 근치적 절제술을 시행하였다. 조기 위암 환자의 예후에 영향을 줄 수 있는 나이, 성별, 종양의 크기, 조직학적 분화도, 수술방법 등의 인자들을 후향적으로 분석하였다. 결과 : 연구기간동안 발생한 위암 환자 중 조기 위암은 28.4%를 차지하였다. 조기 위암의 5년 생존율과 무재발 생존율은 각각 94.3%와 95.8%였으며 중앙 생존기간은 82.7개월이었다. Cox 회귀분석에서 연령과 림프절 전이 여부가 예후를 예측할 수 있는 예후 인자였다. 결론 : 본 연구 결과 근치적으로 절제된 조기 위암 환자의 5년 전체생존율과 무재발 생존율은 각각 94.3%와 95.8%이며 연령 및 림프절 병기가 전체 생존율에 독립적인 예후 인자로 나타났다. Background : Gastric cancer is the most frequent cancer and second leading cause of death from cancer in Korea. The prognosis of early gastric cancer (EGC) is generally excellent and the proportion of EGC cases is steadily increasing nowadays. We need to find out the best treatment modality of EGC. So, the authors analyse the prognostic factors in curatively resected early gastric cancer. Methods : Retrospective analysis was performed for 598 EGC cases which underwent curative resection in Dongsan Medical Center from 1996 to 2001. In this study, several factors such as age, sex, depth of invasion, lymph node involvement, tumor size, histologic grade and operation method were evaluated to determine the prognostic significance. Results : The incidence of EGC among all gastric cancer was 28.4%. Five year total survival rate and relapse free survival rate of early gastric cancer were 94.3% and 95.8% respectively. Median survival time was 82.7 months. In Cox regression analysis, age and lymph node status shows statistical significance in predicting prognosis. Conclusion : In curatively resected EGC patients, 5-year total survival rate and relapse free survival rate were 94.3% and 95.8%. Age and lymph node involvement were independent prognostic factor for the total survival rate.
Bickerstaff's brainstem encephalitis (BBE), characterized by acute ophthalmoplegia and ataxia, often causes impaired consciousness and hyperreflexia. A 17-year-old man was admitted with an acute meningitic condition including high and neck stiffness. His condition rapidly deteriorated over 2 weeks, and he showed ophthalmoplegia, ataxia, seizure, tetraplegia, comatose mentality, and optic neuropathy. Electroencephalography showed diffuse slow waves. Visual evoked potentials showed no responses in the right eye. This is the first case of BBE with Guillain-Barré syndrome presenting with optic neuropathy and seizure.
Use of recombinant tissue plasminogen activator (rt-PA) for the treatment of acute cerebral infarction secondary to aortic dissection is challenging because of a narrow time window and potential life-threatening complications. An 80-year-old woman with right middle cerebral artery infarction was treated with rt-PA. Although she had no history, symptoms, or sign of aortic dissection, carotid CT angiography revealed aortic arch dissection. Mediastinal widening, which did not show on initial chest X-ray, developed on follow-up chest X-ray. This observation indicates that physicians should monitor patient symptoms for signs of aortic dissection during thrombolysis and perform chest X-ray or carotid angiography immediately after thrombolysis even if the patient has no symptoms or signs of aortic dissection on onset of acute cerebral infarction.
The carotid stump is a known source of cerebral embolisms. Direct ultrasound sonographic visualization of a thrombus in the common carotid stump after development of a cerebral infarction is rare. We report a case of a 69-year-old man who presented with acute ipsilateral ischemic stroke with occlusion of the left common carotid artery, forming a stump proximal to the carotid bifurcation. Carotid duplex sonography revealed a mobile thrombus in the stump. An ipsilateral microembolic signal was observed by transcranial Doppler imaging.