Higher prevalence of idiopathic normal pressure hydrocephalus-like MRI features in progressive supranuclear palsy: An imaging reminder of atypical parkinsonism.

Objectives: The classic triad of idiopathic normal pressure hydrocephalus (NPH) encompass gait disturbance, cognitive impairment, and urinary incontinence. These symptoms overlap with parkinsonism but with distinct treatment. Lacking applicable differentiation also hampers the prediction to therapeutic response.

Autonomic impairment in treatment-naive patients with chronic hepatitis B and C infections.

Background: Peripheral neuropathy is not an uncommon manifestation in patients with chronic hepatitis. The role of cryoglobulin (CG) in neuropathy in patients with chronic hepatitis remains controversial. There is limited information about the autonomic neuropathy in chronic hepatitis.

Recessively-Inherited Adult-Onset Alexander Disease Caused by a Homozygous Mutation in the GFAP Gene.

Background: Alexander disease (AxD) is an autosomal-dominant leukodystrophy caused by heterozygous mutations in the glial fibrillary acidic protein (GFAP) gene.

Objectives: The objective of this report is to characterize the clinical phenotype and identify the genetic mutation associated with adult-onset AxD.

Methods: A man presented with progressive unsteadiness since age 16.

Type III Secretion System Translocon Component EseB Forms Filaments on and Mediates Autoaggregation of and Biofilm Formation by Edwardsiella tarda.

The type III secretion system (T3SS) of Edwardsiella tarda plays an important role in infection by translocating effector proteins into host cells. EseB, a component required for effector translocation, is reported to mediate autoaggregation of E. tarda.

The relationship of leukoaraiosis and the clinical severity of vascular Parkinsonism.

Vascular Parkinsonism (VP) is referred to as secondary Parkinsonian syndrome. It occurs with lacunar state or sub-cortical white matter micro-angiopathy and is highly associated with vascular risk factors and leukoaraiosis, also known as cerebral white matter lesions (WML). This study aimed to assess the prevalence of different vascular risk factors and WML in patients with VP, and their impact on clinical features.

A novel APP mutation (D678H) in a Taiwanese patient exhibiting dementia and cerebral microvasculopathy.

We report a novel missense mutation, D678H, in the APP gene in a Taiwanese patient who had progressive cognitive decline beginning in middle age. Brain MRI showed leukoencephalopathy, cortical microhemorrhages and focal superficial cortical hemosiderosis, which are consistent with cerebral amyloid angiopathy. A phenotype of combined dementia and cerebral microvasculopathy suggested concurrent increases in brain parenchymal and cerebrovascular beta-amyloid peptide (Aβ) deposition in this patient.

Association between MIF gene polymorphisms and carotid artery atherosclerosis.

Atherosclerosis is a chronic inflammatory disorder. Macrophage migration inhibitory factor (MIF) is a potent cytokine that plays an important role in the regulation of immune responses. Polymorphisms including five- to eight-repeat CATT variants ((CATT)(5-8)) and G-173C in the promoter region of the MIF gene are associated with altered levels of MIF gene transcription.

[Relationships between spatial distribution of two dominant small-sized fishes and submerged macrophyte cover in Niushan Lake of China].

By using a set of pelagic gillnets with eight mesh sizes, an investigation was made on the spatial distribution of small fishes in submerged macrophyte habitats in a shallow macrophytic lake (Niushan Lake) in the middle reach of Yangtze River in summer, 2005. The fish composition, abundance, and size structure were examined along a biomass gradient of the most dominant submerged macrophyte Potamogeton maackianus. A total of 1124 individuals from 13 fish species were caught during the study period.

An unusual presentation of hypokalemic paralysis with evolving pure motor hemiparesis.

Pure motor hemiparesis is a vascular syndrome that is occasionally mimicked by central or spinal pathologies. However, metabolic neuromuscular disorders have not been reported to mimic this condition. We present a 52-year-old male patient with hypokalemic paralysis who presented with the early symptoms of acute-onset pure motor hemiparesis.

Cavernous malformations of the central nervous system combined with cutaneous vascular lesions due to KRIT1 mutation: a case report.

Cavernous malformations (CMs) of the central nervous system can occur in a sporadic condition or as a familial form with an autosomal-dominant inherited pattern. Apart from a family history, some clinical features may help to identify familial CMs. We demonstrate clinical, neuroradiological, pathological, and genetic data of a patient with cerebral and spinal CMs.

Association of plasma homocysteine concentration with cerebral white matter hyperintensity on magnetic resonance images in stroke patients.

Background: Homocysteine (Hcy) has been recognized as a risk factor for atherosclerosis. White matter hyperintensity (WMH) on MRI has been regarded as a hallmark for cerebral small vascular disease. The study is to investigate the relationship between plasma Hcy level and WMH on a hospital-based cohort of Taiwanese stroke patients.

Uncoupling of protein C and antithrombin III activity in cerebral ischemia patients associated with cutis marmorata.

Purpose: Cutis marmorata is a cutaneous livedoid disorder which can be differentiated from livedo reticularis in both clinical and pathological presentations. Unlike Sneddon syndrome, a detailed immunocoagulation profile has not yet been delineated for cutis marmorata in patients with cerebral ischemia.

Methods: To analyze the immunocoagulation profile in cutis marmorata patients associated with cerebral ischemia (CMCI) in a series of 135 cerebral ischemia patients.

Kennedy disease mimics amyotrophic lateral sclerosis: a case report.

Kennedy disease (KD) is an X-linked inherited motor neuron disease that is often accompanied by androgen insensitivity. Its estimated incidence in the US is approximately 1 case in 40,000 men. KD has also been reported in individuals of different racial backgrounds, especially in Japanese but the prevalence rate in Taiwan has not been fully investigated.

Crossed cheiro-oral syndrome.

Objectives: Cheiro-oral syndrome is characterized by sensory impairment confined to perioral area and ipsilateral fingers/hand. It results from an involvement of the ascending sensory tracts above the pons. However, a crossed pattern of perioral and acral paresthesia was rarely reported before.

Association between cerebral microbleeds and prior primary intracerebral hemorrhage in ischemic stroke patients.

Objective: To investigate association between cerebral microbleeds (CMB) and prior intracerebral hemorrhage (ICH) on MRI and topographic correlation of the two types of lesions.

Patients And Methods: Two hundred and sixty consecutive patients (67.0+/-11.

Cheirobuccal sensory syndrome.

Two patients presented with sensory impairments confined to their right intraoral cheek and right first three fingers. An objective decrease of pinprick pain was detected at these sites. Neuroimaging illustrated recent infarcts in the contralateral ventral thalamus of both patients.

Decreased muscular radionuclide uptake in Tc-99m MIBI scintigraphy during paralytic phase of thyrotoxic periodic paralysis.

The underlying pathophysiology of thyrotoxic periodic paralysis (TPP) is still obscure. From histologic surveys, vacuole formation and abundant mitochondrial abnormalities ranged from swelling, matrical pallor, pleomorphism, and reduced cristae were often disclosed in the muscle fibers during paralytic periods. In a 47-year-old man experiencing 2 episodes of transient paralysis, hyperthyroidism with TPP was diagnosed.

Cerebellar hemorrhage provoked by combined use of nattokinase and aspirin in a patient with cerebral microbleeds.

Nattokinase is used as a health-promoting medicine for preventing thrombosis due to its fibrinolytic activity. Cerebral microbleed is remnant of blood extravasations from the damaged vessels related to cerebral microangiopathies. We report a patient, having used aspirin for secondary stroke prevention, who had an acute cerebellar hemorrhage after taking nattokinase 400 mg daily for 7 consecutive days.

Intracranial hypertension associated with danazol withdrawal: a case report.

Pseudotumor cerebri (PTC) is a seldom seen entity characterized by signs and symptoms associated with the intracranial hypertension (IH) without obvious causes. Some medical disorders and exogenous agents have been implicated in the development of PTC. Danazol is a popular gonadotropin inhibitor used for the treatment of endometriosis, breast disease and hereditary angioedema.

Hyperhomocysteinemia relates to the subtype of antiphospholipid antibodies in non-SLE patients.

Abnormal increases of antiphospholipid antibody and plasma homocysteine levels are recently emerging as nonlipidic risk factors for cerebral atherogenesis and thrombosis. Both antiphospholipid antibody and homocysteine share many similar bioeffects in hemostasis, but their interaction is still inconsistent. In this study, we examined the relation between the plasma homocysteine level and lupus anticoagulant, anticardiolipin antibody, and anti-beta2-glycoprotein I antibody in patients with noncardiac cerebral ischemia.

The relation between plasma homocysteine level and cardiovascular risk factors in cerebral ischemia.

Purpose: Hyperhomocysteinemia (HHcy) is associated with a higher risk of cerebral ischemia and other vascular thrombosis. Homocysteine is greatly influenced by a broad spectrum of physiological and pathological conditions but the confounding factor for HHcy is unknown in our population, especially in normocreatininemic individuals. It is our aim in this study to elucidate the relation between homocysteine and cardiovascular risk factors, and also describe the distribution of plasma homocysteine level in cerebral ischemia patients with normal serum creatinine level.

Delayed catastrophic antiphospholipid syndrome after massive cerebral infarction.

Introduction: Catastrophic antiphospholipid syndrome (CAPS) is a life-threatening disorder urgent for aggressive treatment, and its characterized systemic thromboses and coagulopathy prompt for a rapid diagnosis.

Case Report: A woman fell into unconsciousness two weeks after a stable course of massive cerebral ischemia was identified due to CAPS with Sjogren syndrome. Her thrombocyte count and coagulation times were was normal at initial.

Postoperative parkinsonism and lupus anticoagulant: a model of autoantibody-mediated neurotoxicity in stress.

Primary Objective: Nigrostriatal hypodopaminergism is the fundamental basis in parkinsonism. It may arise secondarily from a variety of disorders but is rarely mentioned shortly after surgery.

Methods And Procedures: To report the clinical course of five patients who had had symptomatic parkinsonism developed shortly after surgery (lumbar laminectomy, prostatectomy and cholestectomy).