Subject(s)
Central Nervous System Diseases/etiology , Graft vs Host Disease/etiology , Multiple Sclerosis/etiology , Stem Cell Transplantation/adverse effects , Adult , Allografts , Central Nervous System Diseases/diagnosis , Central Nervous System Diseases/diagnostic imaging , Diagnosis, Differential , Graft vs Host Disease/diagnosis , Graft vs Host Disease/diagnostic imaging , Humans , Magnetic Resonance Imaging , Male , Multiple Sclerosis/diagnosis , Multiple Sclerosis/diagnostic imaging , Neuroimaging , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapyABSTRACT
A 25-year-old man presented with blurred vision and chronic headache. His brain MRI revealed bilateral frontal pachymeningeal enhancement with leptomeningeal enhancement. The patient had experienced recurrent oral ulcer and had anterior uveitis and papulopustules skin lesion. We diagnosed him with hypertrophic pachymeningitis (HP) associated with neuro-Behçet's disease (NBD). There have been few reports describing HP in patients with NBD. We report a case of NBD presenting as HP.
ABSTRACT
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) can be caused by a variety of drugs. Dopaminergic drugs might enhance the secretion of the antidiuretic hormone arginine vasopressin by reducing γ-amino butyric acid release through the dopaminergic receptor in supraoptic nucleus. A 75-year-old woman with Parkinson's disease developed asthenia, delirium, aggravated parkinsonian symptoms, and hypotonic hyponatremia along with the diagnostic criteria for SIADH during dose escalation of pramipexole. After pramipexole withdrawal, these symptoms disappeared, and sodium levels returned to normal values. The serum sodium levels of patients receiving pramipexole should be monitored, especially during dose escalation.
ABSTRACT
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) can be caused by a variety of drugs. Dopaminergic drugs might enhance the secretion of the antidiuretic hormone arginine vasopressin by reducing γ-amino butyric acid release through the dopaminergic receptor in supraoptic nucleus. A 75-year-old woman with Parkinson's disease developed asthenia, delirium, aggravated parkinsonian symptoms, and hypotonic hyponatremia along with the diagnostic criteria for SIADH during dose escalation of pramipexole. After pramipexole withdrawal, these symptoms disappeared, and sodium levels returned to normal values. The serum sodium levels of patients receiving pramipexole should be monitored, especially during dose escalation.
ABSTRACT
BACKGROUND AND PURPOSE: Elevated plasma total homocysteine (tHcy) levels are reported to be associated with an increased risk of Alzheimer's disease (AD). However, the mechanism by which homocysteine contributes to the pathogenesis of AD is as yet unknown. The aim of this study was to elucidate the relationship between white matter changes (WMC) and medial temporal lobe atrophy (MTA) on brain magnetic resonance imaging (MRI), and plasma levels of tHcy in AD patients. METHODS: Seventy-two patients with a clinical diagnosis of probable AD were recruited to the study. Plasma tHcy levels, vascular risk factors, and WMC and MTA on brain MRI were evaluated in all patients. The AD patients were classified into two groups: those with no or minimal WMC (69.2+/-8.8 years, mean+/-SD, n=36) and those with moderate-to-severe WMC (74.6+/-4.6 years, n=36) on brain MRI. RESULTS: In a univariate logistic regression analysis, the risk of moderate-to-severe WMC in AD was significantly associated with increasing age, female gender, lower education level, hypertension, high plasma tHcy levels, and lower Mini-Mental State Examination (MMSE) score. Multivariate logistic regression analysis revealed only high plasma tHcy as the independent and significant risk factor for moderate-to-severe WMC [odds ratio (OR; adjusted for age, gender, education level, MMSE score, and hypertension comparing the top tertile - tHcy levels >/=12.9 micromol/L - with the bottom tertile - tHcy levels
ABSTRACT
The Syndrom Kurztest SKT is a brief neuropsychological test battery that consists of nine subtests and defines two independent factors of memory and attention deficit. The aim of this study was to validate the Korean version of the SKT. The reliability of each subtest among three parallel Forms (A, B and C) of the Korean version was high (r = 0.46-0.95). The SKT had good concurrent validity with the Mini-Mental State Examination (r = -0.83, p < 0.001). Factor analysis confirmed the presence of two primary factors, memory and attention. The overall similarities of the factor structures for the Korean data and those for the data from Germany and the USA provide evidence of the transcultural stability of the SKT.
Subject(s)
Attention , Memory , Neuropsychological Tests , Aged , Aged, 80 and over , Female , Humans , Male , Middle AgedABSTRACT
Between 1997 and 2002, 65 patients with suspected mitochondrial diseases were screened for the mitochondrial point mutations A3243G, T3271C, A8344G, and T8356C. Among these patients, 15 were found to have one of these mutations: 12 with A3243G and 3 with A8344G. The phenotypes of A3243G and A8344G mutations were MELAS and MERRF, respectively. Many asymptomatic family members had the same mutations. In this report, detailed clinical and laboratory findings are presented.
Subject(s)
DNA, Mitochondrial/genetics , MELAS Syndrome/genetics , MERRF Syndrome/genetics , Point Mutation , Adolescent , Adult , Biopsy , Child , Child, Preschool , DNA, Mitochondrial/analysis , Female , Humans , Korea , MELAS Syndrome/diagnosis , MELAS Syndrome/pathology , MERRF Syndrome/diagnosis , MERRF Syndrome/pathology , Male , Middle Aged , Muscle, Skeletal/cytology , Muscle, Skeletal/metabolism , Muscle, Skeletal/pathologyABSTRACT
The Bayer-activities of daily living (B-ADL) is a brief and internationally applicable ADL instrument which has been validated in three European countries. The B-ADL has been developed to provide a tool for the assessment of functional deficits in performance of every day tasks as they are observed in mild to moderate stages of dementia. The B-ADL has been constructed for use in clinical trials as well as in clinical practice. From an international perspective the major application is the evaluation of treatment effects in clinical studies and the current study was to validate the Korean version of the B-ADL. The B-ADL was administered to a total of 129 subjects with varying degrees of cognitive decline. A substantial cross-sectional correlation between B-ADL and MMSE scores was found. The internal consistency of B-ADL was above 0.98. A factor analysis revealed that a one factor solution accounted for most of the total variance. The B-ADL global score significantly increased as the severity of dementia, assessed by global deterioration scale increased from stage 1 to 5. Test-retest reliabilities of B-ADL global score and each item were very high. All of these results were very similar to those from three European countries except for the proportion of 'non-applicability' in some ADL items. These findings provide evidence that the Korean version of B-ADL can be useful not only for clinical purposes but also for international multicentre studies.
Subject(s)
Activities of Daily Living/psychology , Alzheimer Disease/psychology , Dementia, Vascular/psychology , Psychiatric Status Rating Scales/standards , Aged , Aged, 80 and over , Alzheimer Disease/rehabilitation , Cross-Cultural Comparison , Dementia, Vascular/rehabilitation , Female , Humans , Korea , Male , Middle Aged , Psychometrics , Reproducibility of ResultsABSTRACT
Ovarian hyperstimulation syndrome is a serious complication of ovulation induction and has a diverse clinical spectrum from edema to thromboembolism. Antiphospholipid antibody syndrome, one of the well known hypercoagulable states, can be also manifested as an arterial or venous thrombosis and recurrent spontaneous abortion. Sometimes a patient with antiphospholipid antibodies might not notice a miscarriage and seek for assisted reproduction treatment, which harbors a chance of developing ovarian hyperstimulation syndrome. If this happens, the ovarian hyperstimulation syndrome can exacerbate the thrombotic complication of underlying antiphospholipid antibody syndrome, resulting in a catastrophic vascular event. The authors experienced a case of middle cerebral artery infarct, which developed during ovarian hyperstimulation syndrome in a 33-yr-old woman with a previous history of fetal loss. An elevated titer of anticardiolipin antibodies was noticed and persisted thereafter. The authors suggest screening tests for the presence of antiphospholipid antibodies before controlled ovarian hyperstimulation.