ABSTRACT
Kimura's disease is a chronic inflammatory disease producing subcutaneous tumor-like nodules chiefly in the head and neck region. It is characterized histologically by lymphoid follicles, intense aggregations of eosinophils, vascular proliferation and fibrosis combined with peripheral blood eosinophilia. We report a 56-year-old man who presented with dysarthria and right hemiparesis. On physical examination, a non-ender mass 5 x 6 cm was identified in the right submandibular area. He was diagnosed with Kimura's disease by biopsy. One month after admission, he complained of paresthesia in the left lower extremity. CT angiography revealed thromobosis in the left femoral vein and bilateral pulmonary embolism. To our knowledge, the concomitant occurrence of acute cerebral infarction, deep vein thrombosis and pulmonary embolism in patients with Kimura's disease has never been reported. Eosinophil-derived cytotoxic proteins are presumed to be fundamental to the pathogenesis of these disorders in Kimura's disease.
Subject(s)
Humans , Middle Aged , Angiography , Biopsy , Cerebral Infarction , Dysarthria , Eosinophilia , Eosinophils , Femoral Vein , Fibrosis , Head , Lower Extremity , Neck , Paresis , Paresthesia , Physical Examination , Proteins , Pulmonary Embolism , Venous ThrombosisABSTRACT
BACKGROUND: Chronic subclinical ischemia has been considered as one of major causes of leukoaraiosis, although its trigger is unknown. The vascular endothelium plays a major role in maintaining cerebral perfusion through autoregulation. In this study we evaluated the endothelial bioavailability of nitric oxide (NO) in patients with leukoaraiosis. METHODS: We enrolled consecutive patients with lacunar syndrome or transient ischemic attack; the control group comprised age- and sex-matched patients with hypertension but with no neurological abnormality. All participants underwent flow-mediated dilatation of the brachial artery (FMD) to evaluate endothelial function. Leukoaraiosis was defined as ill-defined patches with high signal intensities on FLAIR and low signal intensities on T1-weighted images. Patients were defined as having ischemic leukoaraiosis if they presented with leukoaraiosis and lacunar infarction. Leukoaraiosis only was defined when patient had leukoaraiosis without lacunar infarction leukoaraiosis without lacunar infarction. RESULTS: In total, 75 patients (37 with leukoaraiosis and 38 controls) were enrolled in this study. The demographic and clinical characteristics were similar in the two groups. FMD was lower in patients with leukoaraiosis than in controls (p0.05). CONCLUSIONS: The bioavailability of NO in the vascular endothelium is decreased in patients with leukoaraiosis only and in those who also have ischemic leukoaraiosis compared to controls. These results are suggestive of a causative role of endothelial dysfunction in the pathomechanism of leukoaraiosis.
Subject(s)
Humans , Biological Availability , Brachial Artery , Dilatation , Endothelium , Endothelium, Vascular , Homeostasis , Hypertension , Ischemia , Leukoaraiosis , Nitric Oxide , Perfusion , Stroke, Lacunar , VasodilationABSTRACT
Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system characterized by optic neuritis and longitudinal extensive transverse myelitis. The clinical course can be either polyphasic (relapsing-remitting) or monophasic. The relapsing-remitting course is observed in more than 80% of NMO cases, and relapse generally occurs within 1 year in 60% of patients, and within 3 years in 90%. We report a rare case of long spontaneous remission in untreated NMO.
Subject(s)
Humans , Central Nervous System , Demyelinating Diseases , Myelitis, Transverse , Neuromyelitis Optica , Optic Neuritis , Recurrence , Remission, SpontaneousABSTRACT
No abstract available.
Subject(s)
Aneurysm, False , Brachial Plexus Neuropathies , Vertebral Artery , Vertebral Artery DissectionABSTRACT
Neuroleptic malignant syndrome (NMS) is a fatal complication most often caused by an adverse reaction to neuroleptic or antipsychotic drugs, and is mostly brought out in the initial stage of medication. Late onset NMS after long term intake of neuroleptics is uncommon, and the neurochemical mechanism is undiscovered. We report a patient of late onset NMS after a long term intake of haloperidol who was successfully treated with dantrolene and bromocriptine.
Subject(s)
Humans , Antipsychotic Agents , Bromocriptine , Dantrolene , Haloperidol , Neuroleptic Malignant SyndromeABSTRACT
The incidence of uterine myoma with cystic degeneration is 4% and symptomatic uterine myoma requires surgical management. We experienced a case of intraligamentary leiomyoma with huge cystic degeneration with its total weight 2526gm in 48 years old woman and brief review of the case and its literatures are presented.
Subject(s)
Female , Humans , Middle Aged , Incidence , LeiomyomaABSTRACT
A 45 year old man was admitted for further examination of an abnormal shadow of the right posterior mediastinum. The patient suffered from dysesthesia in the right thoracic wall of dermatome T7. CT scan and MRI revealed that two separate tumors had developed in the right paravertebral area linked to the vertebral canal via an intervertebral foramina. One-stage removal of the tumors were performed safely through the right posterolateral thoracotomy following the resection of the rib head and vertebral pedicle. The tumors were confirmed as histologically neurilemomas. The postoperative course was uneventful.