AIMS: Low serum 25-hydroxyvitamin D (25(OH)D) levels have been linked to metabolic syndrome. However, community-based data for healthy Korean individuals are lacking. We aimed to assess the vitamin D status and the association of 25(OH)D deficiency with metabolic syndrome in the South Korean population (latitude 33-38°N). METHODS: In this population-based ...

It has been suggested previously that rebound hypercoagulability may be responsible for morbidity and mortality following clopidogrel cessation in adults with acute coronary syndrome. We report a case of acute occlusion of a modified Blalock-Taussig shunt in an infant after clopidogrel discontinuation.

The pull-through technique is an interventional radiological procedure used when an occluded lesion cannot be traversed from one direction. To pass the lesion, a long guidewire is traversed from the opposite side and pulled through the ipsilateral sheath using a snare wire. The present report describes a case of severe ...

PURPOSE OF REVIEW: To describe the most recent advances and clinical applications of adjunctive techniques in mechanical ventilation, focusing on their overall impact on mortality and their potential indications in critically ill patients. RECENT FINDINGS: The modern variants of extracorporeal membrane oxygenation are not only rescue alternatives but also therapeutic ...

INTRODUCTION AND OBJECTIVES: The role of high-density lipoproteins in the context of acute chest pain has not been well characterized. The objective of this study was to determine the relative contribution of lipid profile to the risk of acute coronary syndrome in patients admitted to a cardiology ward for chest ...

The data available to guide clinical management of acute lung injury and acute respiratory distress syndrome are much more limited for infants and children than for adult patients. This paper reviews the available medical data and the pertinent physiology on the management of pediatric patients with acute lung injury. With ...

OBJECTIVE:: Acute lung injury and acute respiratory distress syndrome have been reported in a significant proportion of patients with critical neurologic illness. Our aim was to identify risk factors for acute lung injury/acute respiratory distress syndrome in this population. DESIGN:: Prospective, observational study. SETTING:: A 22-bed, adult neurosciences critical care ...

Guillain-Barré syndrome (GBS) is the eponym used to describe acute inflammatory polyradiculoneuropathies, which manifest with weakness and diminished reflexes. Although the classic form of GBS is considered to be an ascending demyelinating polyneuropathy, several variants have been described in the literature, including the Miller-Fisher syndrome, acute panautonomic neuropathy, acute motor ...

OBJECTIVE:: Fibrocytes are mesenchymal progenitors involved in normal and pathologic repair. The aims of this study were: 1) to quantify fibrocytes in bronchoalveolar lavage fluid from patients with or without acute lung injury and acute respiratory distress syndrome; and 2) to evaluate the prognostic value of bronchoalveolar lavage fibrocyte percentage ...

A research committee supported by the Japanese government conducted a nationwide survey on the epidemiology of acute encephalopathy in Japan using a questionnaire. A total of 983 cases reportedly had acute encephalopathy during the past 3years, 2007-2010. Among the pathogens of the preceding infection, influenza virus was the most common, ...

Acute aortic syndromes (AAS) comprise a group of potentially lethal conditions that require prompt recognition, diagnosis as well as acute medical stabilization and surgical intervention. The purpose of this article is to review the relevant variants of AAS presentation, as well as diagnostic and management issues, including adequate long-term medical ...

Context:Type 1 hyperlipoproteinemia (T1HLP) in childhood is most often due to genetic deficiency of lipoprotein lipase (LPL) or other related proteins.Objective:The aim was to report a case of marked hypertriglyceridemia and recurrent acute pancreatitis due to the presence of LPL autoantibody in a young girl who was subsequently diagnosed with ...

In recent years, acute-on-chronic liver failure has been recognized as a specific clinical form of liver failure associated with cirrhosis. The syndrome refers to an acute deterioration of liver function and subsequently of other end organs over a period of weeks following a precipitating event in a patient with previously ...

Budd-Chiari syndrome (BCS) consists of a group of disorders with obstruction of hepatic venous outflow leading to increased hepatic sinusoidal pressure and portal hypertension. Clinically, two forms of disease (acute and chronic) are recognized. Mostly the patients present with ascites, hepatomegaly, and portal hypertension. In acute disease the liver is ...

Pancreatic panniculitis represents a rare cutaneous disorder most commonly associated with acute or chronic pancreatitis or pancreatic carcinoma. We describe a case of a 17-year-old woman who presented with a 2-day history of erythematous patches involving her bilateral knees and tender, scattered red-brown nodules involving her bilateral anterior shins. She ...

Acute aortic syndromes are a life-threatening set of conditions that require rapid triage and intervention to obtain satisfactory outcomes. The Methodist Hospital is the first institution to establish an Acute Aortic Treatment Center (AATC) based on a clinical care pathway that expedites the care of acute aortic syndromes. This pathway ...

The importance of nutrition support in critically ill patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) cannot be overstated. ALI and ARDS are characterized by a proinflammatory response associated with hypercatabolism that could lead to significant nutrition deficits. Nutrition support is necessary to prevent cumulative caloric ...

A 7-hour-old alpaca was presented for lethargy and depression. The cria responded favorably to initial treatment but developed acute-onset dyspnea 48 hours later. Acute respiratory distress syndrome was diagnosed by thoracic imaging and blood gas analysis. The cria was successfully treated with corticosteroids and discharged from the hospital.

Acute respiratory distress syndrome (ARDS) is a syndrome of acute respiratory failure that is associated with several clinical disorders including direct pulmonary injury and indirect pulmonary injury. Vascular surgical patients are at risk for ARDS. A 23-year old man was admitted to our respiratory intensive care unit with short of ...

Acute Eosinophilic Pneumonia (AEP) is a severe syndrome which can be potentially induced by many reasons, including drugs. It is characterized by pulmonary infiltrates, peripheral blood eosinophilia and respiratory failure. AEP has rarely been associated with antidepressant treatment. We report a case of an 80-year-old woman who presented with fever, ...

Acute respiratory distress syndrome and acute lung injury were defined at the North American-European Consensus Conference in 1994 (Bernard et al, 1994). They both have acute onsets of refractory hypoxaemia and are spectrums of the same syndrome, with the more severe acute respiratory distress syndrome having a ratio of partial ...

We recently treated a patient with adult-onset Still's disease who developed macrophage activation syndrome (MAS) secondary to disseminated histoplasmosis while being treated with adalimumab. The gastroenterology service was consulted early, before diagnosis, as the patient presented with elevated liver enzymes and disseminated intravascular coagulation. MAS is an exaggerated immune response ...

Clin Microbiol Infect 2011; 17: 135-139 ABSTRACT: Disseminated Mycobacterium avium complex (MAC) infection is a rare but severe disease mostly seen in patients with AIDS. It has been previously described in patients suffering from other kinds of immunodeficiency (e.g. primary immunodeficiency diseases in children or hairy cell leukaemia). We report ...

Total fat replacement of the pancreas is rare. Focal fatty replacement is the most common degenerative lesion of pancreas. Focal fatty deposits have no major clinical significance; however, extreme fat replacement is of pathologic significance, as it is associated with marked reduction in exocrine function of pancreas, resulting in malabsorption ...

Hamman-Rich syndrome, also known as acute interstitial pneumonia, is a rare and fulminant form of idiopathic interstitial lung disease. It should be considered as a cause of idiopathic acute respiratory distress syndrome. Confirmatory diagnosis requires demonstration of diffuse alveolar damage on lung histopathology. The main treatment is supportive care. It ...

Cardiorenal syndrome (CRS) clinical types, prevalence, aetiology, and acute cardiovascular morbidity impact on the outcome of acute kidney function perturbation were determined. Forty-seven of 101 (46.53%) patients with perturbed kidney function had CRS. Types 3 and 5 CRS were found in 10 and 37 patients, respectively. Type 3 CRS was ...

We present a case of severe H1N1 influenza with hypoxemic acute respiratory failure necessitating mechanical ventilation benefited from noninvasive positive pressure ventilation (NIPPV). The NIPPV may be of great use in treating patients with H1N1-related acute respiratory distress syndrome in a resource poor setting or when invasive ventilator is unavailable.

A 47-year-old woman with a recent clinical diagnosis of acute cholecystitis developed acute adrenal failure. Initial computed tomograms of the abdomen showed bilateral adrenal swelling which evolved into bilateral adrenal hemorrhage on repeat examination a few days later. Laboratory investigations revealed a previously undiagnosed primary antiphospholipid syndrome and homozygosity for ...

A brief overview on the physiology and regulation of digestive enzyme secretion by the exocrine pancreas is presented. Knowledge about the physiology of the exocrine pancreas should help for a better understanding of the pathophysiology of both acute and chronic pancreatitis. In the pathophysiology of acute pancreatitis, fusion of zymogen ...

We report a case of disseminated Kikuchi disease (KD) associated with Hemophagocytic syndrome (HS) in a 9-month-old boy with recurrent fever and tender cervical and inguinal lymphadenopathy. Disseminated necrotizing lymphadenopathies can be observed on whole-body MR imaging.

Acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) is an acute life-threatening form of hypoxemic respiratory failure with a high mortality rate, and there is still a great need for more effective therapies for such a severe and lethal disease. Dysfunction of endothelial and epithelial barriers is one of the ...

The significant impact of stroke on health care results in an unmet need for efficient stroke care in resources limited environments. Practical, inexpensive and easy to obtain predictive EEG parameters have been suggested in anterior circulation syndromes. We investigated whether EEG parameters are of additional predictive value with regard to ...

Although progressive hemiparesis occurs frequently in acute ischemic stroke, the topography and mechanisms associated with progressive motor deficit (PMD) remain unclear. The aim of this study was to identify the differences in PMD according to lesion location and the presumed underlying pathogenesis in patients with lacunar motor syndrome. Consecutive patients ...

The most common coagulopathy associated with snake envenoming worldwide is venom-induced consumption coagulopathy (VICC), which results from activation of the coagulation pathway by snake toxins including thrombin-like enzymes, prothrombin activators, and factor X activators. VICC has often been likened to disseminated intravascular coagulation (DIC) because of the elevated D-dimer, prolonged ...

To explore the main characteristics of syndromes in traditional Chinese medicine (TCM) in post-stroke depression (PSD) and to provide basis for treatments with TCM herbs. According to diagnostic criteria of PSD, stroke patients and depression patients from Department of Neurology, First Affiliated Hospital, Anhui University of Traditional Chinese Medicine were ...

Recombinant tissue plasminogen activator (rtPA)-associated hyperperfusion syndrome in brainstem after acute stroke has not yet been reported. The current report demonstrates that rtPA-associated hyperperfusion syndrome can be a cause of clinical deterioration following improvement (DFI) after rtPA in acute stroke. We observed a transient DFI in a 59-year-old man with ...

Disseminated intravascular coagulation (DIC) and thrombotic thrombocytopenic purpura (TTP) are different disease states, while ADAMTS13 deficiency could occur in sepsis-induced DIC. We report 2 patients who had septic DIC with features of idiopathic TTP characterized by low ADAMTS13 activity and positive ADAMTS13 inhibitor. They had a specific fulminant course and ...

Acute promyelocytic leukemia (APL) is frequently associated, often from the earliest phases, with a life-threatening coagulation/bleeding syndrome; disseminated intravascular coagulation (DIC) is described in majority of patients. We report a case of 49-year-old male, without cardiovascular risk factors, who suddenly developed ischemic stroke and splenic infarction as presenting symptoms of ...

Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease characterised by subcortical high-signal white matter lesions on T2 weighted MRI. It most commonly occurs in children following an acute viral illness. We present a case study in which ADEM was the presenting condition in an adult female with small cell lung ...

This paper will review the involvement of disseminated intravascular coagulation-induced microvascular thrombosis in the pathogenesis of multiple organ dysfunction syndrome and the interaction between disseminated intravascular coagulation and systemic inflammatory response syndrome in critically ill patients. The published literature on clinical and experimental studies are the data sources of the ...

Hypereosinophilic syndrome (HES) is a rare disorder that can cause ischemic stroke. We present a patient with middle cerebral artery (MCA) occlusion resulting from HES. Transarterial thrombolysis resulted in MCA recanalization and adjuvant therapy may have contributed to stabilization of the underlying HES in our patient.

BACKGROUND: Lacunar syndrome not due to lacunar infarct is poorly characterised. This single centre, retrospective study was conducted to describe the clinical characteristics of patients with lacunar syndrome not due to lacunar infarct and to identify clinical predictors of this variant of lacunar stroke. METHODS: A total of 146 patients ...

We describe two cases of disseminated sporotrichosis as a manifestation of immune reconstitution inflammatory syndrome. After the initiation of highly active anti-retroviral therapy, one patient presented disseminated lesions, whereas the other patient's preexisting lesions worsened and became more extensive. Simultaneously, their CD4 T cell counts increased and HIV viral loads ...

A 32-year-old woman was admitted with intermittent rectal bleeding with disseminated intravascular coagulation (DIC)-like coagulopathy. CT and MRI revealed a retroperitoneal tumor, and we diagnosed giant retroperitoneal hemangioma complicated with Kasabach-Merritt syndrome, following blood pool scintigraphy. Corticosteroid and interferon-alpha were not effective, and gabexate mesilate was also ineffective for coagulopathy. ...

This article highlights the latest findings regarding the cognitive-behavioral syndromes of neglect and anosognosia for hemiplegia that occur following right hemisphere stroke. We review papers published in the past 2 years pertaining to neurophysiology, assessment, and intervention for these two syndromes.

Platypnea-orthodeoxia is a syndrome characterized by dyspnea and hypoxemia in orthostatism relieved by supine position. This phenomenon is frequently associated with interatrial communication, mainly patent foramen ovale. The association of platypnea-orthodeoxia syndrome with recurrent stroke and patent foramen ovale is extremely uncommon. A 73-year-old woman experienced recurrent attacks of dyspnea ...

The presence of a phantom limb (PL) resulting from a cerebral lesion has been reported to be a rare event. No prior study, however, has systematically investigated the prevalence of this syndrome in a group of post-stroke individuals. Fifty post-stroke individuals were examined with structured interview/questionnaire to establish the presence ...

The systemic inflammatory response syndrome (SIRS) is a clinicopathological manifestation of overexuberant acute-phase inflammation caused by infectious or noninfectious etiologies. The systemic release of pro-inflammatory cytokines, chemokines, and lipid and vasoactive mediators induces endothelial damage and microvascular thrombosis, potentially culminating in disseminated intravascular coagulation (DIC), acute respiratory distress syndrome (ARDS), ...

Aim of this review is to discuss recent findings concerning the management of stroke-like episodes (SLEs) in patients with mitochondrial disorders (MIDs). Various databases were searched for appropriate literature. SLEs are a dominant feature of MIDs and occur most frequently in MELAS-syndrome, less frequently in MERRF-syndrome, Kearns-Sayre-syndrome, or Leigh-syndrome. SLEs ...

BACKGROUND: Cognitive syndromes (CS) after stroke may be important to measure and monitor for management and emerging therapies. AIM: To describe the spectrum and frequency of CSs in the first month after stroke and to relate these to stroke etiology and topography. METHODS: A validated cognitive examination was administered during ...