Purpose: Metabolic abnormalities in hepatic encephalopathy (HE) cause brain edema or demyelinating disease, resulting in symmetric regional cerebral edema (SRCE) on MRI. This study aimed to investigate the usefulness of the clustering analysis of SRCE in predicting the development of brain failure. Materials and Methods: MR findings and clinical data of 98 consecutive patients with HE were retrospectively analyzed. The correlation between the 12 regions of SRCE was calculated using the phi (φ) coefficient, and the pattern was classified using hierarchical clustering using the φ 2distance measure and Ward’s method. The classified patterns of SRCE were correlated with clinical parameters such as the model for end-stage liver disease (MELD) score and HE grade. Results: Significant associations were found between 22 pairs of regions of interest, including the red nucleus and corpus callosum (φ = 0.81, p < 0.001), crus cerebri and red nucleus (φ = 0.72, p < 0.001), and red nucleus and dentate nucleus (φ = 0.66, p < 0.001). After hierarchical clustering, 24 cases were classified into Group I, 35 into Group II, and 39 into Group III. Group III had a higher MELD score (p = 0.04) and HE grade (p = 0.002) than Group I. Conclusion Our study demonstrates that the SRCE patterns can be useful in predicting hepatic preservation and the occurrence of cerebral failure in HE.

Purpose: Metabolic abnormalities in hepatic encephalopathy (HE) cause brain edema or demyelinating disease, resulting in symmetric regional cerebral edema (SRCE) on MRI. This study aimed to investigate the usefulness of the clustering analysis of SRCE in predicting the development of brain failure. Materials and Methods: MR findings and clinical data of 98 consecutive patients with HE were retrospectively analyzed. The correlation between the 12 regions of SRCE was calculated using the phi (φ) coefficient, and the pattern was classified using hierarchical clustering using the φ 2distance measure and Ward’s method. The classified patterns of SRCE were correlated with clinical parameters such as the model for end-stage liver disease (MELD) score and HE grade. Results: Significant associations were found between 22 pairs of regions of interest, including the red nucleus and corpus callosum (φ = 0.81, p < 0.001), crus cerebri and red nucleus (φ = 0.72, p < 0.001), and red nucleus and dentate nucleus (φ = 0.66, p < 0.001). After hierarchical clustering, 24 cases were classified into Group I, 35 into Group II, and 39 into Group III. Group III had a higher MELD score (p = 0.04) and HE grade (p = 0.002) than Group I. Conclusion Our study demonstrates that the SRCE patterns can be useful in predicting hepatic preservation and the occurrence of cerebral failure in HE.

Purpose: Metabolic abnormalities in hepatic encephalopathy (HE) cause brain edema or demyelinating disease, resulting in symmetric regional cerebral edema (SRCE) on MRI. This study aimed to investigate the usefulness of the clustering analysis of SRCE in predicting the development of brain failure. Materials and Methods: MR findings and clinical data of 98 consecutive patients with HE were retrospectively analyzed. The correlation between the 12 regions of SRCE was calculated using the phi (φ) coefficient, and the pattern was classified using hierarchical clustering using the φ 2distance measure and Ward’s method. The classified patterns of SRCE were correlated with clinical parameters such as the model for end-stage liver disease (MELD) score and HE grade. Results: Significant associations were found between 22 pairs of regions of interest, including the red nucleus and corpus callosum (φ = 0.81, p < 0.001), crus cerebri and red nucleus (φ = 0.72, p < 0.001), and red nucleus and dentate nucleus (φ = 0.66, p < 0.001). After hierarchical clustering, 24 cases were classified into Group I, 35 into Group II, and 39 into Group III. Group III had a higher MELD score (p = 0.04) and HE grade (p = 0.002) than Group I. Conclusion Our study demonstrates that the SRCE patterns can be useful in predicting hepatic preservation and the occurrence of cerebral failure in HE.

Congenital dislocation of the knee is very rare skeletal deformity and was firstly described by Chatelaine in 1822. Since then there have been a few number of case reports and some series discussing the etiology and treatment. The tibia is displaced anteriorly in relation to the femur. It is generally subdassified as simple hyperextention, subluxation, and dislocation depending on the degree of the joint displacement and the severity of disease. Early gentle manipulation and serial splintage or plaster cast are recommended for treatment and were successful in the majority except the case of quadriceps contrarture or late correction. The authors experienced one case of congenital dislocation of the right knee and brief review of the related literatures was made.
Casts, Surgical ; Congenital Abnormalities ; Dislocations* ; Femur ; Joints ; Knee* ; Tibia

BACKGROUND: There were several reports that thyroid autoimrnune disease commonly found in myasthenia gravis patients. We performed this study to determine the prevalence of thyroid autoimmune disease as well as analyze correlation between acetylcholine receptor antibody and various thyroid autoantibadies among the myasthenia gravis patients in Korea. METHOD: The patient group, 48 patients, diagnosed as myasthenia gravis from January 1985 to December 1995 at the department of Neurology, Internal medicine at Dongsan Medical Center was compaired to the control group, 40 patients, with no age and sex difference from the patient group. The samples were collected from both group for the measure of the values of acetylcholine receptor antibody, thyroid autoantibody and thyroid hormones. RESULT: 1) The values of acetylcholine receptor antibody in myasthenia gravis group and control group were 5.78+-0.7nM and 0.05+-0.06nM respectively. Of 48 patients with myasthenia gravis, 38 patients have been measured acetylcholine receptor antibody value > 0.5nM, Their mean average value was 7.24+-0.66nM. 2) The severe myasthenia gravis group with value of acetylcholine receptor antibody 0.5nM and severe myasthenia gravis group with value of acetylcholine receptor antibody 0.5nM showed thyroglobulin antibody value of 159.6+-79.91IU/mL versus 56.86+-32.99IU/mL. also thyroid microsomal antibody value showed 159.0+-79.9IU/mL and 23.633+-0.19IU/mL respectively. 3) Of 48 myasthenia gravis patients, 12 patients (24%) had high value of antithyroglobulin antibody or anti-microsomal antibody and 5 patients (10%) had both antibodies at the same times. In contrast, only 3 patients (8%) were observed with high value of either one of antibodies. Patient with both antibodies was not observed in normal control group. CONCLUSION: According to the datas we have obtained, appearence of the thyroid autoantibody is significantly greater in severe myasthenia gravis group than normal control group. Therefore it is suggested that the prevalence of thyroid autoimmune disease is higher in severe myasthenia gravis group than mild myasthenia gravis group or normal control group.
Acetylcholine* ; Antibodies ; Autoimmune Diseases ; Humans ; Internal Medicine ; Korea ; Myasthenia Gravis* ; Neurology ; Prevalence* ; Sex Characteristics ; Thyroglobulin ; Thyroid Diseases* ; Thyroid Gland* ; Thyroid Hormones

Purpose: This study evaluated volumetric analysis using automatic whole-brain segmentation as a potential tool to enhance diagnostic accuracy alongside traditional magnetic resonance imaging (MRI) markers in the diagnosis of idiopathic normal pressure hydrocephalus (INPH). Materials and Methods: Twenty-six patients diagnosed with INPH exhibited progressive symptoms, including gait dysfunction and cognitive impairment, confirmed by MRI evidence of enlarged ventricles and normal cerebrospinal fluid pressure. Automatic segmentation was performed on sagittal T1-weighted volumetric images using LesionQuant. Age- and sex-matched groups with Alzheimer’s disease (AD) and normal control (NC) groups were included. Multinomial logistic regression was applied to predict diagnoses (NC, INPH, or AD) based on volumetric parameters. Results: Compared to the AD and NC groups, enlarged inferior lateral ventricles were observed in the INPH group. The inferior lateral ventricle volume showed a positive linear correlation with the Evans’ index (R2 = 0.639) and a negative linear correlation with the callosal angle (R2 = 0.482). High classification accuracy was achieved, with 87.5% of NC cases, 88.5% of INPH cases, and 76% of AD cases correctly identified. Conclusion Automated volumetric markers appear valuable for diagnosing INPH and distinguishing it from other neurodegenerative diseases.

Purpose: This study evaluated volumetric analysis using automatic whole-brain segmentation as a potential tool to enhance diagnostic accuracy alongside traditional magnetic resonance imaging (MRI) markers in the diagnosis of idiopathic normal pressure hydrocephalus (INPH). Materials and Methods: Twenty-six patients diagnosed with INPH exhibited progressive symptoms, including gait dysfunction and cognitive impairment, confirmed by MRI evidence of enlarged ventricles and normal cerebrospinal fluid pressure. Automatic segmentation was performed on sagittal T1-weighted volumetric images using LesionQuant. Age- and sex-matched groups with Alzheimer’s disease (AD) and normal control (NC) groups were included. Multinomial logistic regression was applied to predict diagnoses (NC, INPH, or AD) based on volumetric parameters. Results: Compared to the AD and NC groups, enlarged inferior lateral ventricles were observed in the INPH group. The inferior lateral ventricle volume showed a positive linear correlation with the Evans’ index (R2 = 0.639) and a negative linear correlation with the callosal angle (R2 = 0.482). High classification accuracy was achieved, with 87.5% of NC cases, 88.5% of INPH cases, and 76% of AD cases correctly identified. Conclusion Automated volumetric markers appear valuable for diagnosing INPH and distinguishing it from other neurodegenerative diseases.

Purpose: This study evaluated volumetric analysis using automatic whole-brain segmentation as a potential tool to enhance diagnostic accuracy alongside traditional magnetic resonance imaging (MRI) markers in the diagnosis of idiopathic normal pressure hydrocephalus (INPH). Materials and Methods: Twenty-six patients diagnosed with INPH exhibited progressive symptoms, including gait dysfunction and cognitive impairment, confirmed by MRI evidence of enlarged ventricles and normal cerebrospinal fluid pressure. Automatic segmentation was performed on sagittal T1-weighted volumetric images using LesionQuant. Age- and sex-matched groups with Alzheimer’s disease (AD) and normal control (NC) groups were included. Multinomial logistic regression was applied to predict diagnoses (NC, INPH, or AD) based on volumetric parameters. Results: Compared to the AD and NC groups, enlarged inferior lateral ventricles were observed in the INPH group. The inferior lateral ventricle volume showed a positive linear correlation with the Evans’ index (R2 = 0.639) and a negative linear correlation with the callosal angle (R2 = 0.482). High classification accuracy was achieved, with 87.5% of NC cases, 88.5% of INPH cases, and 76% of AD cases correctly identified. Conclusion Automated volumetric markers appear valuable for diagnosing INPH and distinguishing it from other neurodegenerative diseases.

No abstract available.
Picibanil* ; Pleural Effusion, Malignant*

OBJECTIVE: To evaluate the effect of stellate ganglion block (SGB) on the lymphoscintigraphic findings in patients with secondary lymphedema after breast cancer treatment. METHOD: Fourteen patients were included in this retrospective study. Consecutive SGBs were performed three times, once every two weeks. The parameters for the lymphoscintigraphic findings included the extent of dermal backflow (small extent/large extent group), the presence of a washout pattern (washout/non-washout group) and visualization of lymph nodes on the 3-hour image (visualized/non-visualized group). The upper arm and forearm circumferences were used as the outcome parameters. We investigated the relationship between the lymphoscintigraphic findings and the arm circumferences. RESULTS: Regardless of the extent of dermal backflow, significant decreases of the upper arm and forearm circumferences were observed between the initial and final follow-up data. The small extent group showed a significant decrease of the forearm circumference at the first follow-up. The large extent group showed a pattern of significant decrease of the forearm circumference since the second follow-up. The washout group showed a decrease in both the upper arm and forearm circumferences, while the non-washout group showed a decrease only in the forearm circumference at the last follow-up. No difference was observed between the visualized and the non-visualized group. CONCLUSION: The extent of dermal backflow and the presence of a washout pattern on lymphoscintigraphy showed correlation with the change of arm circumference. Lymphoscitigraphy prior to performance of SGB for lymphedema patients might be helpful to predict the outcome of SGB.
Arm ; Breast Neoplasms ; Follow-Up Studies ; Forearm ; Humans ; Lymph Nodes ; Lymphedema ; Lymphoscintigraphy ; Retrospective Studies ; Stellate Ganglion