Asymptomatic hepatobiliary cystadenoma of the hepatic caudate lobe: a case report

Human hepatobiliary cystadenoma is a rare benign cystic tumor of the liver, and is extremely rare in the caudate lobe. We herein present a case of a 70-year-old male with a hepatobiliary cystadenoma originating from the caudate lobe.

Clinical Types and Outcome of Minor Ischemic Stroke in Northern China: A Retrospective Cohort Study

Background: As a common and high incidence of disease, the minor ischemic stroke (MIS) has become an important public health problem. The aim of this study was to address whether patients with MIS have different types and outcome in the elderly in northern China. Methods: A retrospective cohort of consecutive patients was selected for study;all registered neurologic outpatients of the tertiary teaching hospital in northern Jiangsu, China between February, 2011 and February, 2012. A total of 433 outpatients, clinically only having had an initial visit and a MRI study of the brain, were enrolled. Results: Of 433 outpatients, 247 (57.0%) patients with MIS were diagnosed. The clinical types of MIS included stable MIS in 58.3%, acute progressive MIS in 5.3%, and chronic progressive MIS in 36.4% of patients. After adjusted Odd ratio (OR), only aged (OR, 1.0;95% confidence interval [CI], 1.007 - 1.087, p = 0.021), episode duration (OR, 1.8;95% CI, 1.011 - 1.024, p = 0.001), initial number of MIS (OR, 1.1;95% CI, 1.047 - 1.207, p = 0.001), and infarcts volume (OR, 1.8;95% CI, 1.253 - 2.681, p = 0.002) were independently associated with stable MIS and progressive MIS. Total survival was favorable among groups (p = 0.094), but the followed mRS score was significantly higher among those progressive MIS than those stable MIS (2.3 ± 1.0 vs 0.1 ± 0.3, p Conclusion: MIS had a very high prevalence and different clinical types. Stable MIS is a benign stroke, whereas those progressive MIS may have long-term instability or acute and chronic progressive trend. This information is important in prospectively determining outcome of MIS and in patient treatment.

Hemichorea in nonketotic hyperglycemia: Putamenal and cerebellum lesion on MR imaging

Hemichorea with corresponding putamenal T1 hyper-intensity and T2 hypointensity on MR imaging has occasionally been reported in diabetes mellitus with nonketotic hyperglycemia. However, the signal intensity in pu-tamenal and cerebellum lesion on MR imaging, which is believed to be pathogenetically related to hemichorea, is rarely documented in diabetes mellitus with nonketotic hyperglycemia. We describe a 57-year-old man with nonketotic hyperglycemic hemichorea on his right arm and legs, whose signal intensity in putamenal and cerebellum lesion was demonstrated by MR imaging.

Rare Huge Congenital Intracranial Silent Teratoma in Older People: A Case Report

The huge?congenital?intracranial teratoma is very rare. We report a case of a 77 years old male with giant congenital brain teratoma without clinical symptoms. His computed tomography (CT) scan showed a massive tumor (6 × 5 × 6 cm) of irregular high density (inside with some point flaky low density) in left temporal lobe region, the lower corner of the left ventricle downward shift, and enhanced CT scan no enhancement. Magnetic resonance imaging (MRI) on brain showed an irregular huge tumor in the left temporal lobe area, with multiple nodular or lobulated mixd high and low or equal signal changes, in which the liquid signal based. The midline was shift to the right, and the posterior horn of the left ventricle was compressed and downward shift, expansion, and hydrocephalus. After follow-up 12 months, the patient presents a normal daily life and work and no neurological signs as usual. Our observations show that the huge tumor in brain with multiple nodular or lobulated variety of mixed signal changes on MRI without symptoms is a congenital intracranial silent teratoma.

A minor perimesencephalic subarachnoid hemorrhage on CT changes

Despite the increasing number of reports of patients with perimesencephalic subarachnoid hemorrhage (PMSAH), a minor or atypical PMSAH on CT changes has not been reported. We present the first described case of a minor subarachnoid hemorrhage located in the right perimesencephalic cistern on CT 4 h after headache onset. Twenty-six hours after headache on-set, another CT of the head showed that blood dis-persion. On the third day in hospital, examination of cerebrospinal fluid revealed xanthochromia. Minor PMSAH is rare type of SAH, and can been missed if there is a delay in CT imaging of the head. Any pa-tient with a suspected minor PMSAH or equivocal results on CT should undergo routine lumbar punc-ture.

Acute headache in general neurology of China: Cause changes and predictors of short-term outcome

Background: Although patients with acute headache frequently present in emergency department, the causes and predictors of short-term outcome in patients with acute headache in general neurology have not been adequately investigated. Methods: We prospectively reviewed the medical records of 130 hospitalized acute headache pa-tients in general neurology of China. Their initial CT scan was assessed, as was their lumbar puncture (LP) examination if performed. Results: The main cause of acute headache was acute secondary headache (80.8%), which was mainly attributable to acute cerebrovascular events (72.4%) followed by intracranial infection (19.0%). Among the 10.8% of patients who died during hospitalization most (85.7%) had subarachnoid hemorrhage (SAH). Significant predictors of survival were severe headache versus thunderclap headache, meningismus, de-layed loss of consciousness, and hypertension (all p < 0.05). Multiple logistic regression analyses showed significant differences in severe headache or thunderclap headache (OR, 0.255;95%CI, 0.066 - 0.990;p = 0.048) and delayed loss of consciousness (OR, 0.060;95%CI, 0.016 - 0.224, p = 0.000) between patients who died and those who survived. Conclusions: The main underlying cause of hospitalized acute headache was acute cerebrovascular events. Severe headache and delayed loss of consciousness are predictors for poor outcome of acute headache.

MHC class Ⅱ in renal tubules plays an essential role in renal fibrosis

Immunomodulation has been considered a potential therapeutic approach for chronic kidney disease(CKD).Although it has been previously reported that CD4+T cells contribute to the development of renal fibrosis after UUO,the role of MHC class Ⅱ(MHCII)in UUO-induced renal fibrosis remains largely uncharacterized.The present study reports that the expressions of MHCII molecules in renal cortical tubules are upregulated in a mouse unilateral ureter obstruction(UUO)model.Global or renal tubule-specific ablation of MHCII significantly alleviates renal fibrosis following UUO.Additionally,renal expression of profibrotic genes showcased consistent reduction in both MHCII gene deficient mouse lines.These results demonstrate that renal tubular MHCII plays an important role in pathogenesis of renal fibrosis.