Anterior Spinal Artery Syndrome in 13-year Old boy:A Case Report

We herein report a rare case of a child patient with anterior spinal artery syndrome. The patient presentedwith mobility impairment in the lower limbs after suffering from a common cold. Temperature perceptionand pain perception were lost in both sides below the level of the fourth thoracic spine. In a thoracicspine MRI, abnormal signals were detected in the ventral side of the spinal cord below the Th3 level, thusleading to our diagnosis of anterior spinal artery syndrome. Gamma globulin therapy and steroid pulse therapywere applied concomitantly but no obvious effects were obtained. Continuing treatment with rehabilitationstarted for one month. Four months later, he was able to maintain a standing position and walk using awalking stick. The loss of temperature perception and pain perception in both sides below the Th4 remained.In the present case, movements in daily life became possible through the effects of rehabilitation. However,an impairment in the patient\u27s temperature and pain perception remained, and thus close attention is requiredfor various disorders and in daily life

Image Analysis with the Brain Easy Analysis Tool (BEAT) Method in Cases of Encephalomalacia Following Shaken Baby Syndrome

Brain easy analysis tool( BEAT) is newly released software to calculate composite images both MRI andSPECT on computer graphics. At first, we herein report two cases with shaken baby syndrome associatedwith multicystic encephalomalasia diagnosed based on MRI. Next, we created fusion MRI-SPECT imagesusing BEAT. The result of composited images was not only well recognized in anatomical visually but alsoeasy to explain data to patients. This report is the second case report with this software called BEAT

Lennox-Gastaut Syndrome Associated with Unilateral Hemispheric Porencephaly

We report an 18 year-old male with a hemispheric large porencephaly who demonstrated symptomaticWest syndrome and then developed into Lennox-Gastaut syndrome. An electroencephalogram showed anasymmetrical high voltage slow spike and wave discharges only on the right side as a side of porencephalichemisphere. Interestingly, on the opposite side of the porencephalic hemisphere, an electroencephalogramshowed a low amplitude background activity in general. In this unique features both right side hemisphericporencephaly and asymmetric high voltage slow spike and waves due to Lennox-Gastaut syndrome, theporencephalic hemisphere due to cortical parenchymal loss may be more affected than the other hemisphereby epileptiform discharge in this patient

Positive Therapeutic Response to Bevacizumab Plus Paclitaxel in a Patient with Advanced, Life-Threatening Breast Cancer and Carcinomatous Lymphangitis:a Subsequent Treatment Change to Hormone Therapy

We present a case of advanced, life-threatening breast cancer with carcinomatous lymphangitis treatedwith bevacizumab plus paclitaxel. A positive therapeutic response was achieved and the treatment was subsequentlychanged to hormone therapy.The patient was a 53-year-old postmenopausal woman with a non-contributory medical history. She presentedto a nearby hospital with chief complaints of continued exertional dyspnea and coughing since March2012. Physical findings included a palpable mass in the left breast, and the patient was referred and presentedto our hospital in May. Examinations at our hospital revealed left-sided breast cancer (estrogen receptorpositive, progesterone receptor positive, and no amplification of the human epidermal growth factorreceptor 2 by FISH). The patient had bone metastasis and carcinomatous lymphangitis (cT2N3cM1-stageIV). The condition was life threatening, and administration of bevacizumab plus weekly paclitaxel was initiatedwith the expectation of a high response rate. Coughing and dyspnea resolved two weeks later. CTscans were taken in August after the completion of 3 cycles and showed improvement in carcinomatouslymphangitis. No major side effects were observed due to bevacizumab plus weekly paclitaxel. When theCT scans were taken in December after the completion of 6 cycles, the primary lesion and lymph node metastaseswere reduced in size. In the lung field, there was no thickening of the interlobular septa or subpleuralinterstitium, and the findings of carcinomatous lymphangitis were improved. Thus, bevacizumab plus paclitaxelwere discontinued and the treatment was changed to oral letrozole (2.5 mg/day). The patient hasbeen followed up with no recurrence as of March 2013

A Case of Inflammatory Pseudotumor of the Breast after Augmentation Mammoplasty

Inflammatory pseudotumor is a benign reactive lesion which forms due to diverse tissue responses of inflammatory cells and mesenchymal cells. It can occur in various organs of the body but rarely in the breast. We report a case of inflammatory pseudotumor of the breast after augmentation mammoplasty. The patient was a 78-year-old woman who noticed a mass in her right breast in July 2012. She had a history of augmentation mammoplasty at age 24 years. She was referred to our hospital for thorough examination. A 3-cm immovable induration was palpated in the upper lesion of the right breast. Ultrasound examination revealed a hypoechoic mass at the same site. The mass was 2.9×1.7 cm with irregular, ill-defined borders. Mammography revealed some areas of elevated density with coarse, lucent-centered calcifications in bilateral breasts but no clear findings of malignancy. Core needle biopsy of this site revealed marked fibrous hyperplasia and proliferation of fibroblast-like spindle cells. Infiltration of neutrophils and plasma cells was observed in the stroma. There were spindle cells with no atypia and scarce mitotic figures. Thus, the patient was diagnosed with inflammatory pseudotumor. The patient received only follow-up observation without surgical resection as per the patient\u27s wishes. There has not been any change as of May 2013

Clustered Tonic Spasms Developed after Disappearance of Hypsarrythmia in West Syndrome

We report an infant case of West syndrome with clustered tonic spasms seen after the disappearance of hypsarrythmia. This time lag until the development of tonic spasms implies that their development is not directly related to hypsarrythmia. In other words, this clinical evidence suggests that the hypsarrythmia and tonic spasms did not directly originate from the same mechanism in West syndrome. In this report, we describe the patient\u27s demonstrable neuro-radiological imaging with CT, MRI, ^Tc-ECD SPECT, and EEG changes over her clinical course before and after low-dose ACTH therapy for West syndrome. In addition, the mechanisms of hypsarrythmia and infantile spasms are discussed with a literature review

MRA Diagnosis of Down Syndrome Associated with Moyamoya Syndrome Presenting Multiple Cerebral Infarctions in a 1-year-old Girl

It is known that various complications are observed in patients with Down syndrome. We report a 1-year-old girl with Down syndrome who developed moyamoya syndrome presenting multiple cerebral infarction. Her chief complaints were recurrent convulsion and weakness on the left side of the body. Brain CT and MRI demonstrated multiple abnormal signals, and the lesion was diagnosed as multiple cerebral infarction. Since obstruction of the right anterior and middle cerebral arteries was observed by MRA, the patient was diagnosed with moyamoya syndrome. Moyamoya syndrome accompanied by Down syndrome advances in the early stage, and since it often occurs with cerebral infarction, the timing of its early diagnosis by MRA and caution of cerebral infarction are important. However, no guidelines for the control of moyamoya syndrome have been established in Down syndrome. Therefore, MRA should be performed in patients in whom moyamoya disease is suspected, because no useful method for the prevention of this complication disease has established

Three Cases of Shaken Baby Syndrome without a History of Shaking

Three cases of Shaken Baby Syndrome (SBS) without a history of abusive shaking have been reported.The reason why SBS without intentional shaking as follows;case 1was throwing, case 2 was dropping, case3 was unknown. For all 3 reported cases, attending physicians suspected the SBS from the presence of subduralhematoma and fundus hemorrhage. All 3 cases occurred at home, and the parents had no knowledgeof SBS. After a detailed interview, the diagnosis of SBS without a history of intentional shaking was made.Although the mechanism in detail was unclear in 3 cases, these SBS may happen by the difference betweenacceleration and the deceleration during the throwing and dropping movement;similar to intentional shakingthat causes of common SBS.For subdural hematoma and fundus hemorrhage of unknown cause, it is important to conduct an interviewwith the possibility of unintentional SBS in mind, without the occurrence of abusive shaking. In addition,attention should be paid to both pediatrician and parents about the risk of SBS in the care of infant inthe everyday life

ヨード ゾウエイ ザイ ニヨル アナフィラキシー ショック ノ 3レイ : ブンケンテキ コウサツ

造影CT検査は悪性腫瘍の質的診断や病期診断,解離性動脈瘤の診断に欠かせない.しかし,ヨード造影剤で重篤な副作用が生じる危険性がある.気管支喘息など危険因子はいわれているものの,実際,副作用発現は予測不能である.今回,我々は,ここ8ヶ月の間にヨード造影剤による重篤なアナフィラキシーショックを生じた3例を経験したので文献的考察を加えて報告する.Recently, iodinated contrast media are necessary for CT examinations and they occupy an important position in the radiological diagnosis. Nonionic contrast media significantly reduce the prevalence of all degree of adverse reaction to contrast media rather than ionic contrast media. So, generally, iodinated contrast media are safe and widely used, but adverse reaction after intravenous iodinated contrast media are not uncommon. Severe and potentially life-threatening reaction occur by using the iodinated contrast media practically. Patients at risk must be identified before the contrast media study, and all possible measures must be taken to deal effectively with spontaneous anaphylactic reactions. We report three cases of anaphylactic reactions by iodinated contrast media on CT

Computer-aided Diagnosis of Breast Elastography

Ultrasonography has been an important imaging technique for detecting breast tumors. As opposed tothe conventional B-mode image, the real-time tissue elastography by ultrasound is a new technique for imagingthe elasticity and applied to detect the stiffness of tissues. The red region of color elastography indicatesthe soft tissue and the blue one indicates the hard tissue. The harder tissue usually is classified as malignancy.In this paper, the authors proposed a computer-aided diagnosis( CAD) system on elastography tomeasure whether this system is effective and accurate to classify the tumor into benign and malignant. Accordingto the features of elasticity, the color elastography was transferred to hue, saturation, and value(HSV) color space and extracted meaningful features from hue images. Then the neural network was utilizedin multiple features to distinguish tumors. In this experiment, there are 180 pathology-proven cases including113 benign and 67 malignant cases used to examine the classification. The results of the proposedsystem showed an accuracy of 83.89 %, a sensitivity of 82.09 % and a specificity of 84.96 %. Compared withthe physician\u27s diagnosis, an accuracy of 78.33 %, a sensitivity of 53.73 % and a specificity of 92.92 %, theproposed CAD system had better performance. Moreover, the agreement of the proposed CAD system andthe physician\u27s diagnosis was calculated by kappa statistics, the kappa 0.64 indicated there is a fair agreementof observers