Abnormal motor behaviors caused by ipsilateral hemispheric lesions have not been frequently reported. However, a 76-year-old woman developed left hemiparesis and abnormal movements of the right limb. Upon observation, she would unintentionally rotate her hand continuously on the table in a stereotypical way. A brain CT showed an infarction in the basal ganglia and corona radiata. We report this patient with unilateral hyperkinesia and contralateral hemiparesis due to ipsilateral basal ganglia lesions.
Aged ; Basal Ganglia* ; Brain ; Dyskinesias ; Extremities ; Female ; Hand ; Humans ; Hyperkinesis* ; Infarction* ; Paresis*

Purpose: This study was performed to determine whether the T1 relaxation time of gadoxetic acid-enhanced liver MR imaging is useful for detecting and staging liver fibrosis in patients with chronic liver disease. Materials and Methods: One hundred and three patients with suspected focal liver lesion underwent MR imaging and Fibroscan. Fibroscan was chosen as the reference standard for classifying liver fibrosis. T1 relaxation times were acquired before (preT1), 20 minutes after (postT1) contrast administration, and reduction rate of T1 relaxation time (rrT1) on transverse 3D VIBE (volumetric interpolated breath-hold examination) sequence using 3T MR imaging. The optimal cut-off values for the fibrosis staging were determined with ROC analysis. Results: PreT1 and postT1 increased and rrT1 decreased constantly with increasing severity of liver fibrosis according to the METAVIR score (F0–F4). There were statistically significant differences between F2 and F3 in preT1 (F2, 836.0 ± 74.7 ms; F3, 888.6 ± 77.5 ms, p < 0.05) and between F3 and F4 in postT1 (F3, 309.0 ± 80.2 ms; F4, 406.6 ± 147.7 ms, p < 0.05) and rrT1 (F3, 65.4 ± 7.7%; F4, 57.3 ± 11.4%, p < 0.05). ROC analysis revealed that combination test (preT1 + postT1) was the best test for predicting liver fibrosis. Conclusion PreT1 and postT1 increased constantly with increasing severity of liver fibrosis. T1 mapping in gadoxetic acid-enhanced liver MR imaging could be a helpful complementary sequence to determine the liver fibrosis stage.

Purpose: This study was performed to determine whether the T1 relaxation time of gadoxetic acid-enhanced liver MR imaging is useful for detecting and staging liver fibrosis in patients with chronic liver disease. Materials and Methods: One hundred and three patients with suspected focal liver lesion underwent MR imaging and Fibroscan. Fibroscan was chosen as the reference standard for classifying liver fibrosis. T1 relaxation times were acquired before (preT1), 20 minutes after (postT1) contrast administration, and reduction rate of T1 relaxation time (rrT1) on transverse 3D VIBE (volumetric interpolated breath-hold examination) sequence using 3T MR imaging. The optimal cut-off values for the fibrosis staging were determined with ROC analysis. Results: PreT1 and postT1 increased and rrT1 decreased constantly with increasing severity of liver fibrosis according to the METAVIR score (F0–F4). There were statistically significant differences between F2 and F3 in preT1 (F2, 836.0 ± 74.7 ms; F3, 888.6 ± 77.5 ms, p < 0.05) and between F3 and F4 in postT1 (F3, 309.0 ± 80.2 ms; F4, 406.6 ± 147.7 ms, p < 0.05) and rrT1 (F3, 65.4 ± 7.7%; F4, 57.3 ± 11.4%, p < 0.05). ROC analysis revealed that combination test (preT1 + postT1) was the best test for predicting liver fibrosis. Conclusion PreT1 and postT1 increased constantly with increasing severity of liver fibrosis. T1 mapping in gadoxetic acid-enhanced liver MR imaging could be a helpful complementary sequence to determine the liver fibrosis stage.

A 63-year-old man was admitted with newly developed left hemiparesis. He had experienced left hemiparesis that had resulted from an earlier right thalamic hemorrhage. Diffusion-weighted images showed only high signal intensity lesion in the left internal capsule. Ipsilateral motor evoked potentials were obtained at the affected hand muscles when the unaffected motor cortex was stimulated. This suggests that cortical reorganization in the unaffected hemisphere after the first stroke may be involved in the occurrence of such symptom.
Evoked Potentials, Motor ; Hand ; Hemorrhage ; Humans ; Internal Capsule* ; Middle Aged ; Motor Cortex ; Muscles ; Paresis* ; Stroke*

BACKGROUND: Frontotemporal dementia (FTD) has a characteristic pattern of lobar atrophy in frontal and/or temporal lobes. Asymmetry in the lateral ventricle size on brain magnetic resonance image (MRI) in FTD patients may have clinical significance. This study compares the ventricular asymmetry seen on MRI with that of the neuropsychological difference and asymmetric hypoperfusion using statistical parametric mapping (SPM) analysis of brain SPECT in patients with FTD. METHODS: Thirteen FTD patients who underwent Brain MRI, TC-99m ECD SPECT and neuropsychological testing and who had the ventricular asymmetry on brain MRI were retrospectively selected. The patients were divided into two groups (5 right dominant group, 8 left dominant group) according to the ventricular asymmetry on brain MRI. We compared the regional blood flow pattern on TC-99m ECD SPECT images using SPM analysis and the results of neuropsychological tests between the two groups. RESULTS: In the right dominant group, a significant perfusion deficit was identified at the bilateral frontal regions. In the left dominant group, significant hypoperfusion was found at the left frontotemporal regions (uncorrected p<0.001). There was no significant difference of neuropsychological testing in between the two groups. However, the score on the Neuropsychiatric Inventory (NPI) in the right dominant group was higher than that of the left dominant group (p=0.043). CONCLUSIONS: Hemispheric asymmetry on brain MRI was common in patients with FTD and was related with a characteristic pattern of hypoperfusion on brain SPECT images and neuropsychiatric symptoms.
Atrophy ; Brain ; Cysteine ; Frontotemporal Dementia ; Humans ; Lateral Ventricles ; Magnetic Resonance Spectroscopy ; Neuropsychological Tests ; Organotechnetium Compounds ; Perfusion ; Regional Blood Flow ; Retrospective Studies ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon

Eyelid tumors, including metastatic lid tumors, present clinically as recurrent chalazia, multicentric nodules, ul cerated lesions, diffuse swelling, or chronic blepharocon juntivitis. Lid tumors consist of benign lesions(69%) and malignant lesions(31%). Basal cell carcinoma and squa mous cell carcinoma account for 92% of the malignant lesions. Metastatic lid disease was found to be of rare occurence, accounting for 0.1% of all lid lesions and 0.3% of malignant lid lesions. We report a case of metastatic lid carcinoma of sto mach cancer. A 60-year-old man developed a painless, slow-growing nodular lesion of his right lower eyelid. Excisional biopsy revealed metastatic undifferentiated ade nocarcinoma. We believe this is the first case in Korean literature.
Biopsy ; Carcinoma, Basal Cell ; Chalazion ; Eyelids ; Humans ; Middle Aged ; Stomach Neoplasms* ; Stomach*

BACKGROUND: To investigate the optimal values of transcranial doppler (TCD) index in the evaluation of leptomeningeal collateral circulation (CC) in patients with middle cerebral artery (MCA) stenosis. METHODS: Forty-one patients, with angiographically confirmed single stenosis or occlusion of the M1 segment of the MCA, were studied with TCD and brain MRI. Patients were divided into two groups according to the existence of CC though ipsilateral anterior cerebral artery on transfemoral cerebral angiography (TFCA). Mean flow velocities (mFV) of anterior and middle cerebral arteries (ACA, MCA) were analyzed. We then investigated the optimal values of TCD flow index: 1) ipsilateral mFV ACA/MCA (AMVR), 2) ACA velocity ratio (ACAVR), 3) mFVACA. We then correlated TCD flow index with TFCA results. RESULTS: TFCA revealed single moderate to severe M1 stenosis (n=35) and occlusion (n=6). Presence of CC was found in 11 (27%), absence of CC in 30 (73%). The mean of AMVR, ACAVR and mFVACA differed between the two groups: 1.76 +/- 0.69, 1.43 +/- 36, 86.27 +/- 31.73 cm/s in the presence of CC; 0.48 +/- 0.24, 1.21 +/- 0.39, 65.93 +/- 23.24 in the absence of CC. The optimal cutoff values for detection of CC were found at AMVR>or=0.9, ACAVR>or=1.30 and mFVACA>or=80 cm/s. The combination of individual TCD indexes had improved the specificity and positive predicted value in the detection of CC. CONCLUSIONS: TCD enables detecting the existence of CC in patients with MCA stenoocclusion. These optimal values may provide a noninvasive method for evaluate the pathomechanism of stroke and prospect the prognosis of these patients.
Anterior Cerebral Artery* ; Brain ; Cerebral Angiography ; Collateral Circulation* ; Constriction, Pathologic ; Humans ; Infarction, Middle Cerebral Artery* ; Magnetic Resonance Imaging ; Middle Cerebral Artery* ; Prognosis ; Sensitivity and Specificity ; Stroke

Most cystic lesions of the liver are found incidentally in imaging studies because they are not symptomatic, and generally do not require treatment. Rarely, however, symptomatic hepatic cysts may develop complications and require treatment. Here, we describe a case of a 77-year-old woman who developed biliary obstruction with abdominal pain due to compression of the bile duct by a simple hepatic cyst. We confirmed the diagnosis based on symptoms and imaging studies. The patient's symptoms improved after simple cyst ablation by sclerotherapy.
Abdominal Pain ; Aged ; Bile Ducts ; Cholestasis ; Diagnosis ; Female ; Humans ; Liver* ; Sclerotherapy

Objective: The aim of this study was to investigate whether a new generic rosuvastatin is non-inferior to a proprietary one in terms of lipid-lowering efficacy. We also evaluated its non-lipid effects including adverse events. Methods: One-hundred and fifty-eight patients with cardiovascular risks requiring pharmacological lipid-lowering therapy were screened. After a 4-week run-in period, 126 individuals who met the lipid criteria for drug therapy were randomly assigned to receive the new generic or proprietary rosuvastatin 10 mg daily for 8 weeks. The primary outcome variables were low-density lipoprotein-cholesterol (LDL-C) reduction and LDL-C target achievement. Hematological and biochemical parameters and adverse events were assessed. Results: After 8 weeks of drug treatment, the mean percentage change in LDL-C was not different between the groups (−45.5%±19.9% and −45.1%±19.0% for generic and proprietary rosuvastatin, respectively; p=0.38). The LDL-C target achievement rate was similar between the groups (75.0% and 77.1% for generic and proprietary rosuvastatin, respectively; p=0.79). The percentage change in the other lipid profiles was not significantly different. Although generic- and proprietary rosuvastatins modestly affected creatine kinase and blood pressure, respectively, the changes were all within normal ranges. Incidence of adverse events did not differ between the receivers of the 2 formulations. Conclusion The new generic rosuvastatin was non-inferior to the proprietary rosuvastatin in terms of lipid-lowering efficacy. The rosuvastatin formulations did not exhibit clinically significant non-lipid effects with good safety profiles. Our study provides comprehensive data regarding 2 rosuvastatin formulations in East Asian subjects.

BACKGROUND: Myocardial perfusion scintigraphy with intravenous adenosine has proved efficacy for the diagonosis and risk stratification of coronary artery disease. To determine the safety of adenosine infusion in conjunction with radionuclide imaging, we evaluated prospectively 1,093 patients who underwent myocardial perfusion study. METHODS: Informations on safety and adverse events during and immediately after adenosine infusion were collected and statistical analysis was performed. RESULTS: The adverse events were reported in 730 patients (66.8%), but no death or myocardial infarction. There asverse events were well tolerated and no prolonged effect was noted. Chest pain occured in 223 patients(20.4%) and facial flushing and dyspnea were reported by 246 patients(22.5%) and 253 patients(23.1%), respectively. ECG changes, such as mild arrhythmia, ST depression and AV block were checked in 230 patients(21.0%). The infusion was prematurely terminated in 32 patients(2.9%), due to serve chest pain, serve brochospasm, or third degree AV block. Higher frequency of chest pain was reported in women compare to men(p<0.05), and ST segment depression was more frequent in patients with abnormal myocardial perfusion scitigraphic findings(p<0.05). CONCLUSION: These results demonstrate that intravenous infusion of adenosine is relatively safe, and myocardial perfusion scintigraphy with intravenous ademosine is feasible technique in the evaluation of the coronary artery disease patients unable to exercise.
Adenosine* ; Arrhythmias, Cardiac ; Atrioventricular Block ; Chest Pain ; Coronary Artery Disease ; Depression ; Dyspnea ; Electrocardiography ; Female ; Flushing ; Humans ; Infusions, Intravenous ; Myocardial Infarction ; Myocardial Perfusion Imaging* ; Perfusion ; Perfusion Imaging ; Prospective Studies ; Radionuclide Imaging