Internal medicine
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Coronary malperfusion complicating Type A aortic dissection is relatively rare. The diagnosis of Type A aortic dissection as the cause of coronary ischemia is a challenge. ⋯ We report a 45-year-old man presenting with acute inferior wall ST segment elevation myocardial infarction who was finally diagnosed to have Type A aortic dissection complicated by hemopericardium and cardiac tamponade. Coronary spasm is the most likely cause of transient myocardial ischemia in this patient and should be considered as another possible cause of coronary malperfusion in patients with Type A aortic dissection.
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Case Reports
Cervical epidural abscess presenting with Brown-Sequard syndrome in a patient with type 2 diabetes.
An 80-year-old woman with type 2 diabetes was admitted due to right-handed muscle weakness. The patient presented with Brown-Sequard syndrome, with complete paralysis of the right lower limb along with a loss of pain and temperature sensations in the left lower limb. ⋯ These interventions ameliorated the neurological deficits. The present case suggests the importance of epidural abscess as a rare pathogenetic cause of Brown-Sequard syndrome in type 2 diabetes.
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It is believed that viral infections and the hyperimmune reaction due to these infections are involved in the etiology of Kikuchi-Fujimoto Disease (KFD), a rare cause of fever of unknown origin. Axillary lymphadenopathy and neurologic involvement are rare in KFD. ⋯ Subsequently, incidental sinus aspergilloma was diagnosed radiologically in the patient and acute disseminated encephalitis developed during follow-up. This report aims to draw attention to the co-existence of KFD and Acute Disseminated Encephalomyelitis, two diseases of which the origins are not clear.
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In the advanced stage of Parkinson's disease (PD), motor fluctuation is a frequent and a disabling problem. Despite its importance, motor fluctuation has received little scientific analysis probably due to limitation in objective assessment. Here, we focused on gait disorders to estimate motor fluctuation in daily activities. ⋯ Characterization of motor fluctuation using this device could help in the selection of appropriate anti-PD medications.
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Clinical Trial
Improved assessment of aortic calcification in Japanese patients undergoing maintenance hemodialysis.
Vascular calcification is a feature of arteriosclerosis and in hemodialysis (HD) patients it may be severe, even at a relatively young age, and is closely related to the overall prognosis. We used the aortic calcification area index (ACAI), derived from the aortic calcification index (ACI), to evaluate and analyze the risk factors for abdominal aortic calcification in HD patients. ⋯ Risk factors for abdominal aortic calcification in HD patients include age, systolic blood pressure, and serum calcium, according to ACAI evaluation. The ACAI was accurate and useful for evaluating abdominal calcification.