Even a single brain infarct can cause dementia when it occurs in functionally critical areas of the brain. A 71- year-old female developed sudden cognitive impairment without any other focal neurologic deficits. A brain MRI revealed a bilateral anterior fornix infarction. Neuropsychological evaluation revealed verbal and visual memory deficits, visuospatial dysfunction, and frontal executive dysfunction. The cognitive impairment did not improve for 3 months and the patient showed impairments in daily activities. We report a patient who demonstrated strategic infarct dementia after a bilateral anterior fornix infarction.
Brain ; Dementia* ; Dementia, Vascular ; Female ; Fornix, Brain ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Memory Disorders ; Neurologic Manifestations

Central pontine myelinolysis (CPM) is well-recognized osmotic demyelination syndrome that is related to various conditions such as rapid correction of hyponatremia and chronic alcoholism. Acute ataxia as a sole clinical sign in CPM is rare. We report a case of a 59-year-old man with dysarthria, intention tremor, and a significant gait ataxia starting after alcohol withdrawal, with radiological evidence of CPM. CPM should be included in the differential diagnosis of alcoholic patients who develop a sudden ataxia. Chronic alcohol abuse is one of the most commonly encountered predisposing factors. Alcohol withdrawal represents an additional vulnerability factor, being responsible for electrolyte imbalances which are not always demonstrable but are certainly involved in the development of CPM.
Alcoholics* ; Alcoholism ; Ataxia ; Causality ; Demyelinating Diseases ; Diagnosis, Differential ; Dysarthria ; Gait Ataxia ; Humans ; Hyponatremia ; Middle Aged ; Myelinolysis, Central Pontine* ; Tremor

Hemichorea have been reported in patients with nonketotic hyperglycemia. Usually, hemichorea and hyperglycemia are concomitant. A 73-year-old woman was admitted for investigation of an acute hemichorea. T1-weighted brain magnetic resonance imaging showed hyperintensity in the right putamen. Although she was a diabetic patient, she had no hyperglycemia. Interestingly, 4 weeks earlier, the patient was admitted due to nonketotic hyperglycemia. However, there were no hemichorea at that time. Although pathophysiologically controversial, a delayed hemichorea without nonketotic hyperglycemia should be considered as one of many different causes when evaluating acute hemichorea in diabetic patients.
Aged ; Brain ; Chorea ; Female ; Humans ; Hyperglycemia* ; Magnetic Resonance Imaging ; Putamen

No abstract available.
Herpes Zoster Ophthalmicus* ; Herpes Zoster*

PURPOSE: To examine the correlation between the Navigation and radiographic measurements for the postoperative mechanical axis and component position in total knee arthroplasty. MATERIALS AND METHODS: From December 2005 to May 2006, Navigation assisted MIS TKA was performed on 46 knees of 34 patients. After fixing the components, the mechanical axis (MA) of the lower extremity, femoral component position to the mechanical axis in the coronal plane (theta), tibial component position in the coronal (beta) and sagittal (sigma) planes was measured using the Navigation. Two observers measured the same angles using the postoperative follow-up radiographs. The measurements were compared and the correlation between the Navigation and radiographic measurement was analyzed. RESULTS: The average Navigation measurements were valgus 0.02+/-1.09 degrees for MA, varus 0.05+/-0.96 degrees for theta, valgus 0.02+/-0.86 degrees for beta and 4.03+/-1.25 degrees for sigma. The mean radiographic measurements of observer 1 were valgus 0.71+/-3.73 degrees for MA, valgus 1.14+/-1.72 degrees for theta, valgus 0.90+/-1.47 degrees for beta and 4.51+/-2.03 degrees for sigma. Those of observer 2 were valgus 0.12+/-3.39 degrees, valgus 0.16+/-1.96 degrees, valgus 0.30+/-1.65 degrees and 3.85+/-1.60 degrees, respectively. CONCLUSION: The average of measurement for the component position showed a statistically significant difference in the MA (p=0.001), theta (p=0.000) and beta (p=0.000) among three groups. There were a relatively high correlation between observer 1 and 2 for the radiographic measurements (r=0.67-0.96). However there was a very low correlation between the Navigation and radiographic measurements (r=0.10-0.39). Therefore, the possibility of a difference between the Navigation and radiographic measurement need to be considered when evaluating the component position.
Arthroplasty* ; Axis, Cervical Vertebra ; Follow-Up Studies ; Humans ; Knee* ; Lower Extremity

BACKGROUND: The role of glycated hemoglobin (HbA1c) in the prediction of ischemic stroke in non-diabetic subjects is not clear. We performed a study to analyze the role of HbA1c in the risk prediction of ischemic stroke in non-diabetic Korean males adult. METHODS: A total of 307 non-diabetic male patients with ischemic stroke were enrolled, and 253 age-matched control subjects without a history of diabetes, hypertension, or cardiovascular disease were selected from a Health Check-up database. Anthropometric measurement data, fasting glucose level, lipid profile, and HbA1c level were available for all subjects. Associations of the variables and the presence or absence of ischemic stroke were analyzed. RESULTS: The ischemic stroke patient group had significantly higher HbA1c levels (5.8+/-0.5% vs. 5.5+/-0.5%, P<0.01) and mean systolic and diastolic blood pressure compared with the control group. Among the variables, smoking, low high density lipoprotein cholesterol, systolic blood pressure, and HbA1c were the significant determinants for ischemic stroke. The highest quartile of HbA1c showed a 9.6-fold increased odds ratio for ischemic stroke compared with the lowest quartile of HbA1c (odds ratio, 9.596; 95% confidence interval, 3.859 to 23.863, P<0.01). The proportion of ischemic stroke patients showed a significant trend for increment as the deciles of HbA1c increased (P for trend <0.01). CONCLUSION: Higher HbA1c indicated a significantly increased risk for ischemic stroke after adjusting for other confounding variables in non-diabetic Korean adult males. HbA1c might have significance in predicting the risk for ischemic stroke even in the non-diabetic range.
Adult ; Asian Continental Ancestry Group ; Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Confounding Factors (Epidemiology) ; Fasting ; Glucose ; Hemoglobins ; Humans ; Hypertension ; Lipoproteins ; Male ; Odds Ratio ; Smoke ; Smoking ; Stroke

No abstract available.
Adult ; Hemoglobins ; Humans ; Male ; Stroke

Brain-MR studies are sensitive to intracranial ischemia and vascular flow. However, brain MR study for brain death is clinically limited because keeping the ventilation is difficult during study. In our hospital, three 'brain death patients' brain-MR studies were performed under the anesthetic Mapleson's circuit-F system. Three patients' clinical states were not changed after the studies. We confirmed that brain herniation, absent intracranial flow void, no intracranial contrast enhancement, poor gray/white matter differentiation, and prominent nasal enhancement findings. The value of brain-MR study for brain death may be possible.
Brain ; Brain Death ; Ischemia ; Ventilation

Ginkgo nuts have been eaten as oriental medicine and food since ancient times in Korea. However, the potential toxicity of the ginkgo nuts is not well-known. It has been reported that 4-O-methoxypyridoxine in ginkgo nuts causes generalized seizures but no status epilepticus. This report describes a 58-year-old male presented with status epilepticus after overconsumption of ginkgo nuts. After treatment with anticonvulsants and pyridoxine, symptoms were resolved. The toxicity of ginkgo nuts should be considered as a cause of status epilepticus.
Anticonvulsants ; Ginkgo biloba ; Humans ; Korea ; Male ; Medicine, East Asian Traditional ; Middle Aged ; Nuts ; Pyridoxine ; Seizures ; Status Epilepticus

BACKGROUND: The pain-screening questionnaire is a self-reported description of the intensity and nature of pain. This study aimed to develop the Korean Neuropathic Pain Questionnaire (KNPQ) and to assess its reliability and validity regarding the diagnosis of neuropathic pain. METHODS: Four screening tools and two rating scales were translated and modified to develop the preliminary KNPQ. Following a development phase and a pilot study, we generated the final 25-item version of the KNPQ. Each item was rated on a numerical scale of 0-10. The validation procedure was performed in 62 patients with neuropathic pain (21 with central pain and 41 with peripheral pain) and in 34 patients with nonneuropathic pain. The internal consistency between items was assessed to determine the reliability of the KNPQ, and its concurrent validity was determined by evaluating the relationship between the Visual Analogue Scale (VAS) and KNPQ scores. RESULTS: The KNPQ was not influenced by age, sex, or pain duration. The 25-item questionnaire demonstrated high internal consistency. The total score of the KNPQ was correlated with the global pain intensity on a VAS. These items were able to differentiate neuropathic pain from nonneuropathic pain with a sensitivity of 84% and a specificity of 44% (when using a cut-off point of 46). CONCLUSIONS: The newly developed KNPQ may be used for the initial screening of neuropathic pain patients. However, it cannot be used to differentiate central neuropathic pain from peripheral neuropathic pain.
Humans ; Mass Screening ; Neuralgia ; Pain Measurement ; Pilot Projects ; Surveys and Questionnaires ; Reproducibility of Results ; Sensitivity and Specificity ; Weights and Measures