• Title/Summary/Keyword: acute lesion

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Atypical Manifestation of Acute Hemorrhagic Leukoencephalitis (Hurst's Disease) (비전형적인 중상으로 발현한 급성 출혈성 백질뇌염)

  • Min, Ju-Hong;Lee, Su-Ho;Cho, Joong-Yang;Park, Sung-Hye;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.7 no.1
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    • pp.37-42
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    • 2005
  • Acute disseminated encephalomyelitis (ADEM) and acute hemorrhagic leukoencephalitis (Hurst's disease) are rare autoimmune demyelinating disorders, which show a monophasic illness with preceding infection. We report a 42-year-old woman presented with multiphasic and progressive neurologic deterioration without definite evidences of infection. She developed hypesthetic ataxia, followed by ipsilateral weakness after a weak, and finally encephalopathy after a month. In contrast to the first MRI showing a small longitudinal lesion, the next images revealed massive bilateral frontal lesions with hemorrhagic necrosis and biopsy unveiled inflammatory demyelination.

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Acute-on-Chronic Subdural Hematoma : Not Uncommon Events

  • Lee, Kyeong-Seok;Shim, Jae-Jun;Yoon, Seok-Mann;Doh, Jae-Won;Yun, Il-Gyu;Bae, Hack-Gun
    • Journal of Korean Neurosurgical Society
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    • v.50 no.6
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    • pp.512-516
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    • 2011
  • Objective : Patients with asymptomatic chronic subdural hematoma (SDH) are prone to fall or slip. Acute trauma on these patients may develop acute subdural bleeding over the chronic SDH. We recently experienced 9 patients with acute-on-chronic SDH. We report the clinical and radiological features of this lesion. Methods : We retrospectively examined the computed tomographic (CT) scans of 107 consecutive patients who diagnosed as chronic SDH from January 2008 to December 2010. All cases of CSDH were diagnosed on CT with or without MRI scan. Results : Acute-on-chronic SDH is not rare, being 8% of chronic SDH. The most common cause of trauma was a slip in drunken state. Alcoholism with multiple episodes of trauma was one of the prominent histories. Acute-on-chronic SDH appeared as a hyperdense layer of clot with irregular blurred margin or lumps in liquefied hematoma. Single or two burr holes was usually effective to remove the hematoma. Conclusion : Repeated trauma may cause acute bleeding over the chronic SDH. It will be helpful to understand the role of repeated trauma as a mechanism of hematoma enlargement.

The functional imaging to Diagnose Acute Cerebral infarction Comparing between CT Perfusion and MR Diffusion Imaging (급성 뇌경색 진단을 위한 CT관류영상과 MR확산영상의 비교)

  • Kim, Seon-Hee;Eun, Sung-Jong;Rim, Chae-Pyeong
    • Journal of the Korean Society of Radiology
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    • v.6 no.1
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    • pp.19-26
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    • 2012
  • It is very important for early diagnosis and therapy with ischamic cerebral infarction patients. This study was to know the ischemic penumbra lesion which compared CT-perfusion and diffusion weighted MRI(DWMRI) with acute cerebral infarction patients. 12 acute cerebral infarction patients had performed perfusion CT and performed DWMRI. Perfusion images including cerebral blood volume(CBV), cerebral blood flow(CBF), time to peak(TTP) and mean transit time(MTT) maps obtained the values with defect lesion and contralateral normal cerebral hemisphere and DWMRI was measured by signal intensity and compared of lesion size between each perfusion map. All perfusion CT maps showed the perfusion defect lesions in all patients. There were remarkable TTP and MTT delay in perfusion defect lesions. The lesions on CBF map was the most closely correlated with the lesions on DWMRI. The size of perfusion defect lesions on TTP and MTT map was larger than that of lesions on DWMRI, suggesting that MTT map can evaluate the ischemic penumbra. Perfusion CT maps make it possible to evaluate not only ischemic core and ischemic penumbra, but also hemodynamic status in the perfusion defect area. These results demonstrate that perfusion CT can be useful to the diagnosis and treatment in the patients with acute cerebral ischemic infarction.

Neuronal Activity of the Vestibular Nuclei Following Acute Hypotension in Rats

  • Park, Byung-Rim;Kim, Min-Sun;Baik, Kum-Hyun;Lee, Moon-Young;Choi, Myung-Ae;Lee, Jae-Hyo
    • The Korean Journal of Physiology and Pharmacology
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    • v.6 no.4
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    • pp.199-205
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    • 2002
  • The role of peripheral vestibular receptors in acute hypotension was investigated in anesthetized rats. Acute hypotension was induced by either intravenous infusion of sodium nitroprusside (SNP) or by experimental hemorrhage, and electrical activity and expression of cFos-like immunoreactive (cFL) protein were measured in the medial vestibular nuclei (MVN). Blood pressure decreased proportionately to the does of intravenous SNP and to the volume of the hemorrhage. Blood pressure decreased 10, 30, 50% for the 5, 10, $15{\mu}g/kg$ SNP injection, respectively, and also decreased 30 and 50% after 1- and 2-ml blood loss, respectively, due to hemorrhage. In animals with intact labyrinths, acute hypotension induced by either intravenous infusion of SNP or hemorrhage produced different electrical activities with three different patterns in type I and II neurons of MVN. The responses of type I neurons showed excitatory in 2/3 of recorded neurons and inhibitory or no change in 1/3 of neurons, while the responses of type II neurons showed inhibitory in 2/3 of recorded neurons and excitatory or no change in 1/3 of neurons. In unilateral labyrinthectomized animals, 2/3 of type I neurons ipsilateral to the lesion showed an inhibitory response, and 2/3 of contralateral type I neurons showed an excitatory response after the induction of acute hypotension. The response patterns of type II neurons were opposite from those of the type I neurons. After 30% decrease in blood pressure, cFL protein expressed in the bilateral vestibular nuclei of control animals with intact labyrinths. Expression of cFL protein increased significantly proportionately to the reduction of blood pressure. The unilateral labyrinthectomized animals with acute hypotension produced expression of cFL neurons in contralateral vestibular nuclei to the lesion side, but not in ipsilateral vestibular nuclei. However, cFL protein was not expressed in bilateral vestibular nuclei after acute hypotension in bilateral labyrinthectomized animals. These results suggest that the peripheral vestibular receptors might play a significant role in controlling blood pressure following acute hypotension via activation of type I neurons and inhibition of type II neurons in the vestibular nuclei.

A Clinical Study on the Patients Admitted at the Acute Stage of Stroke (급성기 뇌졸중 환자에 대한 임상적 고찰)

  • Jang, In-Soo;Yu, Kyung-Suk;Lee, Jin-Goo;Yun, Hee-Sik;Lee, Young-Goo;Kang, Hyon-Chel;Son, Dong-Hyug
    • The Journal of Internal Korean Medicine
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    • v.21 no.2
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    • pp.203-212
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    • 2000
  • Objective : We studied only patients at the acute stage but existing studies on stroke didn't almost classify the stage. We examined 243 patients admitted to the Woo Suk university oriental medical hospital from January 1998 to December 1999 for 2 years. Methods : We analyzed patients into sex, Sasang constitution, the incidence and lesion according to the stroke types, post and family history, onset time, period to admission and physical treatment from onset, and symptom, blood pressure, cholesterol level and herb medicine at entry. Results : Our study was similar to existing studies in the distribution of sex, age and the lesion of stroke, post and family history, and symptoms at entry. But it differed in the constitution, incidence of cerebral infarction and intracranial hemorrhage, attack time, period to admission and physical treatment from onset day, and the symptoms, blood pressure, cholesterol level and herb medication. In comparison between infarction and hemorrhage patients, there was some difference in the distribution of onset time, but wasn't in the cholesterol level. Conclusions : Our study on the acute stage of stroke was similar to existing studies in the general characteristics. But it showed some differences in the herb medicine at entry. In particular, there were much differences in the blood pressure at entry and the incidence of infarction and hemorrhage. We hoped that stroke patients would be synthetically studied in western and oriental medicine.

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Mild encephalopathy with a reversible splenial lesion in a girl with acute pyelonephritis

  • Yeom, Jung Sook;Koo, Chung Mo;Park, Ji Sook;Seo, Ji-Hyun;Park, Eun Sil;Lim, Jae-Young;Woo, Hyang-Ok;Youn, Hee-Shang
    • Clinical and Experimental Pediatrics
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    • v.61 no.2
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    • pp.64-67
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    • 2018
  • We report the case of a 12-year-old girl who had mild encephalopathy with a reversible splenial lesion (MERS) associated with acutepyelonephritis caused by Escherichia coli. The patient was admitted with a high fever, and she was diagnosed with acute pyelonephritis based on pyuria and the results of urine culture, which detected cefotaxime-sensitive E. coli. Although intravenous cefotaxime and tobramycin were administered, her fever persisted and her C-reactive protein level increased to 307 mg/L. On day 3 of admission, she demonstrated abnormal neuropsychiatric symptoms, such as delirium, ataxia, and word salad. Magnetic resonance imaging (MRI) of the brain performed on day 4 showed marked hyperintensities in the bilateral corpus callosum and deep white matter on diffusion-weighted images, with corresponding diffusion restriction on apparent diffusion coefficient mapping. No abnormalities or pathogens were detected in the cerebrospinal fluid; however, lipopolysaccharides (LPS, endotoxin) were detected in plasma (41.6 pg/mL), associated with acute neurological deterioration. Her clinical condition gradually improved, and no neurological abnormalities were observed on day 6. Follow-up brain MRI performed 2 weeks later showed near-disappearance of the previously noted hyperintense lesions. In this patient, we first proved endotoxemia in a setting of MERS. The release of LPS following antibiotic administration might be related to the development of MERS in this patient. The possibility of MERS should be considered in patients who present with acute pyelonephritis and demonstrate delirious behavior.

Effects of Coptidis Rhizoma Herbal Acupuncture Extract on the Acute Gastric Mucosal Lesion Progression Induced by Compound 48/80 in Rats

  • Mou, Jong-Cheng;Lee, Sena;Kim, Myung-Gyou;Seo, Il-Bok;Leem, Kang-Hyun
    • The Korea Journal of Herbology
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    • v.28 no.1
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    • pp.1-7
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    • 2013
  • Objectives : Coptidis Rhizoma has been used for stomach disease. However, its property is so cold that it might be avoided to prescribe for the elderly and the infirm having indigestion or diarrhea. Accordingly, the present study was designed to investigate the protective effects of Coptidis Rhizoma herbal acupuncture extract against acute gastric mucosal lesions induced by compound 48/80 in rats. Methods : The Coptidis Rhizoma herbal acupuncture (CRHA) was injected in Choksamni and Chungwan 1 h before compound 48/80 treatment. The animals were sacrificed under anesthesia 3 h after compound 48/80 treatment. The stomachs were removed and the amount of gastric adherent mucus, gastric mucosal hexosamine, SOD, XO, TBARS and histological examination were performed. Results : The decline of gastric adherent mucus, gastric mucosal hexosamine and the histological defects of gastric mucus were significantly protected by CRHA treatment. Gastric adherent mucus in control group was reduced to $38.2{\pm}5.0%$. CRHA groups significantly protected the loss of mucus to $77.5{\pm}4.9%$. Mucosal hexosamine content showed similar patterns. Mucosal hexosamine content in control group was reduced to $45.2{\pm}6.2%$. CRHA groups significantly protected the loss of mucus to $83.0{\pm}7.0%$. The changes of gastric mucosal SOD and TBARS were recovered by CRHA treatment as well. Conclusions : CRHA showed the protective effects on the acute gastric mucosal lesions induced by compound 48/80 in rats. These results suggest that CRHA may have protective effects on the gastritis.

The Effect of Alnus japonica Cortex Extract on Gastric Lesion and Ulcer of Rats (오리나무 수피엑스의 위염 및 위궤양에 대한 효과)

  • 정춘식;우병희;이은방;정기화
    • Biomolecules & Therapeutics
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    • v.4 no.1
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    • pp.84-88
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    • 1996
  • Alnus japonica cortex has been used as antidiarrhea, antihemorrhage and the remedy of indigestion. This study was performed to investigate the effectiveness of the methanol extracts of the Alnus japonica cortex on the gastric lesion and ulcer. The methanol extract was fractionated with hexane, chloroform and butanol, followed by bioassay on antigastritic and antiulcer activity. The methanol extract showed low acute toxicity with minimum lethal dose of more than 5000 mg/kg, p.o. in mice. The chloroform and the butanol fraction reduced gastric lesion in HCI. ethanol induced gastritic model. On gastric secretion in pylorus ligated rat, the hexane and chloroform fraction decreased the volume and acidity. The butanol fraction had significant inhibitory effects on aspirin and Shay's ulcer. The butanol fraction showed a tendency to inhibit the decrease of mucin secretion due to ingestion of absolute ethanol.

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Transient splenial lesion of the corpus callosum in a case of benign convulsion associated with rotaviral gastroenteritis

  • Jang, Yoon-Young;Lee, Kye-Hyang
    • Clinical and Experimental Pediatrics
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    • v.53 no.9
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    • pp.859-862
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    • 2010
  • Transient magnetic resonance (MR) signal changes in the splenium of the corpus callosum (SCC) arise from many different conditions, including encephalopathy or encephalitis caused by infection, seizures, metabolic derangements, and asphyxia. Few case reports exist on reversible SCC lesions associated with rotavirus infection. A benign convulsion with mild gastroenteritis (CwG) is frequently associated with rotaviral infections. This entity is characterized by normal laboratory findings, electroencephalogram, neuroimaging, and good prognosis. We report a case of a 2.5-year-old Korean girl with rotavirus-associated CwG demonstrating a reversible SCC lesion on diffusion-weighted MR images. She developed 2 episodes of brief generalized tonic-clonic seizure with mild acute gastroenteritis without any other neurologic abnormality. Stool test for rotavirus antigen was positive. Brain MRI done on the day of admission showed a linear high signal intensity and decreased apparent diffusion coefficient values on the SCC. The lesion completely disappeared on follow-up MRI 6 days later. The patient fully recovered without any sequelae.

SURGICAL CORRECTION OF MAXILLOFACIAL DEFORMITY WITH FIBROUS-OSSEOUS LESION OF MANDIBLE USING THE INTRAORAL VERTICAL RAMUS OSTEOTOMY (하악의 섬유-골성 병소를 가진 안면 기형에서 구내 상행지 수직 골절단술을 사용한 수술적 교정)

  • Kim, Hyung-Jin;Hong, Jong-Rak
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.6
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    • pp.496-500
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    • 2005
  • A 22-year-old male patient had developed a submasseteric abscess secondary to a mandibular osteomyelitis at the age of 7 years old. The initial presentation at that time seems to be acute suppurative parotitis. The computed tomographic scans taken before surgery demonstrated diffuse deformity, sclerotic change and osteolytic lesion in the mandible. There was no marrow space on both sides of mandibular ramus and thin-walled cortical bone was seen. So, from the results of the computed tomography, the surgery was performed intraoral vertical ramus osteotomy (IVRO) instead of performing the more commonly used bilateral sagittal split ramus osteotomy (BSSRO). In this report, we present a case of surgical correction of mandibular prognathism with fibrous-osseous lesion of mandible with using IVRO.