OBJECTIVES: The objectives of this study were to clarify which biological manganese exposure indices reflect the pallidal signal intensities in magnetic resonance imaging (MRI) in liver cirrhotics. METHODS: We examined whole blood, plasma, RBC and urinary manganese concentrations, as well as, brain MRI in 22 cirrhotic patients and 10 healthy controls. From MRI scans we calculated the signal intensity of the globus pallidus using the pallidal index (PI), the ratio of the globus pallidus to subcortical frontal white-matter signal intensity in axial T1-weighted MRI planes multiplied by 100. In addition, we studied the relationships between PI and other measurements. RESULTS: The high signal intensity in the globus pallidus on T1-weighted MRI was observed in 18 (81.8%) patients. There was a significant correlation between whole blood and RBC manganese concentration, and PI on MRI. According to multiple linear regression, whole blood and RBC manganese concentration reflected PI on MRI better the other indices did. CONCLUSIONS: Whole blood and RBC manganese concentrations could be useful as biological manganese exposure indices that reflect PI on MRI.
Brain ; Globus Pallidus ; Humans ; Linear Models ; Liver* ; Magnetic Resonance Imaging* ; Manganese* ; Plasma

The author analysed CT findings and long-term outcomes of 67 patients with acute carbon monoxide poisoning. Low density lesions were demonstrated in 44 patients (65.7%). Hemorrhage and calcification also showed with low density lesions in 3 and 2 patients, respectively. The most common findings, seen in 22 patients, was bilaterally symmetrical round low density lesion in the globus pallidus and adjacent area of internal capsule with variable sizes. In 18 patients there were diffuse symmetrical low density lesion in the cerebral white matter, especially around the centrum semiovale, with slight or marked extension. Of 44 patients with CT abnormalities seven patients recovered without disability, fifteen recovered with some disability, eighteen remained in the vegetative state, and four died. The outcome of acute carbon monoxide poisoning depended on the severity of the cerebral white matter change in CT of brain. The size of the bilateral globus pallidus lesion was not heopful to determine the longterm outcome of acute carbon monoxide poisoning.
Brain* ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Globus Pallidus ; Hemorrhage ; Humans ; Internal Capsule ; Persistent Vegetative State

Among the series of 272 cases of surgically treated anterior circulation aneurysms, we experienced 6 cases of central infarctions involving caudate nucleus, globus pallidus, putamen and genu of internal capsule respectively or in combination. These surgery related complications were caused by the injury to the perforators going to the anterior perforated substance during manipulation of the large aneurysm or the aneurysms ruptured prematurely. The clinical courses of these patients, however, were not so severe. The morbidities were minimal or none after the average follow-up periods of 17 months. Thorough knowledge of the anatomy of the perforators may help to minimize the severe morbidity in the management of large or difficult aneurysms.
Aneurysm* ; Caudate Nucleus ; Follow-Up Studies ; Globus Pallidus ; Humans ; Infarction* ; Internal Capsule ; Olfactory Pathways ; Putamen

OBJECTIVES: This study was carried out to evaluate manganese exposure marker and the clinical significance of high signal intensity observed on brain magnetic resonance imaging(MRI) in mild steel/arc welders. METHODS: Brain MRI, blood and urinary manganese concentration measurements, physical and neurologic examinations, questionnaire and biochemistry were performed on 53 mild steel/arc welders(exposed group) and 112 non-manganese handling productive workers(control group). We calculated the pallidal index, the ratio of signal intensity of globus pallidus to subcortical frontal white-matter on sagittal 71-weighted MRI. And we studied the relationships between the pallidal index and other measurements. RESULTS: In 35(66.3%) exposed workers, high signal intensity were observed on the globus pallidus. Blood and urinary manganese levels were higher in exported group than control group. Pallidal index were significantly correlated with working duration, blood manganese level, urinary manganese level and positive rates of clinical symptoms and signs. CONCLUSIONS: The results of this study suggests that high signal intensity finding on brain MRI may be considered as useful tool for the evaluation of workers who have manganese exposure.
Biochemistry ; Brain* ; Globus Pallidus ; Magnetic Resonance Imaging* ; Manganese ; Neurologic Examination ; Questionnaires

OBJECTIVE: To investigate the effect of deep brain stimulation (DBS) on reducing dystonia and disability in adults with cerebral palsy (CP) and to compare the therapeutic outcomes between primary dystonia patients and CP patients over two years after bilateral pallidal DBS. METHODS: Five patients with primary dystonia and seven CP patients with dystonia were recruited. All subjects received DBS surgery in both globus pallidus. Burke-Fahn-Marsden dystonia rating scale consisting of dystonia movement score and disability score and subjective satisfaction scale were assessed after 1 month and every 6 months over two years following DBS treatment. RESULTS: On the dystonia movement scale, both groups of primary dystonia patients and CP patients showed a significant decrease over time following DBS. On the disability scale, patients with primary dystonia showed a significant decrease over time, whereas the disability score of CP patients did not change over the two years. Comparing the dystonia movement and disability scores of CP patients at each assessment, patients with primary dystonia showed a significant reduction after 6 months. Comparing the satisfaction scores of CP patients after DBS, patients with primary dystonia showed significantly higher subjective satisfaction. CONCLUSION: Whereas dystonia can be significantly reduced in patients with primary dystonia, CP patients showed a modest improvement on the dystonia movement scale, but not on the disability scale. Therefore, DBS may be considered with caution as a treatment modality of CP patients with dystonia.
Adult* ; Cerebral Palsy* ; Deep Brain Stimulation* ; Dystonia ; Dystonic Disorders ; Globus Pallidus ; Humans

OBJECTIVE: To investigate the effect of deep brain stimulation (DBS) on reducing dystonia and disability in adults with cerebral palsy (CP) and to compare the therapeutic outcomes between primary dystonia patients and CP patients over two years after bilateral pallidal DBS. METHODS: Five patients with primary dystonia and seven CP patients with dystonia were recruited. All subjects received DBS surgery in both globus pallidus. Burke-Fahn-Marsden dystonia rating scale consisting of dystonia movement score and disability score and subjective satisfaction scale were assessed after 1 month and every 6 months over two years following DBS treatment. RESULTS: On the dystonia movement scale, both groups of primary dystonia patients and CP patients showed a significant decrease over time following DBS. On the disability scale, patients with primary dystonia showed a significant decrease over time, whereas the disability score of CP patients did not change over the two years. Comparing the dystonia movement and disability scores of CP patients at each assessment, patients with primary dystonia showed a significant reduction after 6 months. Comparing the satisfaction scores of CP patients after DBS, patients with primary dystonia showed significantly higher subjective satisfaction. CONCLUSION: Whereas dystonia can be significantly reduced in patients with primary dystonia, CP patients showed a modest improvement on the dystonia movement scale, but not on the disability scale. Therefore, DBS may be considered with caution as a treatment modality of CP patients with dystonia.
Adult* ; Cerebral Palsy* ; Deep Brain Stimulation* ; Dystonia ; Dystonic Disorders ; Globus Pallidus ; Humans

Chorea-acanthocytosis (ChAc) is a rare hereditary disorder characterized by involuntary choreiform movements and erythrocytic acanthocytosis. Pharmacotherapy for control of involuntary movements has generally been of limited benefit. Deep brain stimulation (DBS) has recently been used for treatment of some refractory cases of ChAc. We report here on the effect of bilateral high-frequency DBS of globus pallidus interna in a patient with ChAc.
Abetalipoproteinemia ; Chorea ; Deep Brain Stimulation* ; Drug Therapy ; Dyskinesias ; Globus Pallidus* ; Humans ; Neuroacanthocytosis*

Parasites are recorded from the red squirrel, Sciurus vulgaris, from Cheongju, the Republic of Korea. A total of 5 road-killed squirrels were thoroughly examined for internal and external parasites from November 2011 to May 2014. Total 4 parasite species, including 1 tapeworm and 3 ectoparasite species were recovered. They were morphologically identified as Catenotaenia dendritica (Cestoda: Catenotaeniidae), Hirstionyssus sciurinus, Leptotrombidium pallidum, and Ceratophyllus (Monopsyllus) indages. Among them, C. dendritica and H. sciurinus are recorded for the first time in the Korean parasite fauna. In addition, the possibility that the red squirrel could act as a reservoir host for a zoonotic disease like tsutsugamushi disease with L. pallidum as its vector has been raised.
Cestoda ; Chungcheongbuk-do* ; Globus Pallidus ; Korea* ; Parasites ; Republic of Korea ; Sciuridae* ; Scrub Typhus ; Trombiculidae ; Zoonoses

A purpose of present study is to provide basic information evaluating the utility of Magnetic Resonance imaging as a biological marker estimating manganese effects to central nervous system among welders, which is conducted by comparing urinary and blood manganese concentrations and signal intensities of brain MR images between exposed group and non-exposed group, evaluating the objectivity of subjective grading estimated by correlations between Pallidal signal intensity index (P. I) and subjective grades among exposed group, and comparing the difference of signal intensities according to presence of neurologic symptoms, signs and exposure variables among the exposed group. The exposed group is composed of 11 welders complaining severe symptoms or showing neurological signs, and the non-exposed group is composed of 5 patients who admitted a hospital. Urinary manganese concentrations and signal intensities in T1-weighted MR images among exposed group were higher than those of the non-exposed group significantly, which exhibits that increased signal intensities in T1-weighted MR image represent the effect of manganese exposure. P. Is among the exposed group revealed relatively high correlations with subjective grades ( gamma =0.63, p=0.037) , which suggests the objectivity of subjective grade. Signal intensity in globus pallidus was a suitable single variable representing the effect of manganese accumulation in C.N.S system appropriately, which was verified as follows ; Increased signal intensities among the exposed group had the highest frequency and intensity in the globus pallidus, and the P.I. had a relatively high correlation coefficient ( gamma 0.62, p=0.044) with total score of subjective grades. Signal intensity with subjective grading in globus pallidus represented very high correlation gamma =0.97, p=0.00) with total score of subjective grades, and had a similar correlation coefficient with many variables. It is hard to argue that signal intensities are markers representing pathologic change in C.N.S system or can be used as a diagnostic tool for manganese intoxication, because signal intensities had no difference between the exposed group and the non-exposed group according to presence of neurological signs.
Biological Markers ; Brain ; Central Nervous System ; Globus Pallidus ; Humans ; Magnetic Resonance Imaging* ; Male* ; Manganese ; Neurologic Manifestations

A few neurosurgical alleviate to alleviate some dyskinesias of cerebral palsy(CP) have been tried. For the spastic and tremor type, the selective posterior rhizotomy and thalamotomy are regarded as treatments of choice but other dyskinesias remains a tough challenge. The authors have performed 48 cases of MRI-guided stereotactic thalamotomy(MGST) in 37 CP patients with mixed dyskinesias from Jun. '92 to Jan. '95 using CRW stereotactic frame and MRI, without any ventriculogram. Depending upon the types of main dyskinesias, the target including ventrolateral nucleus of thalamus or medial nucleus of globus pallidus was(were) selected. Clinical results were verified in terms of preoperative symptoms improvement and patient's satisfaction. In athetoid(42 MGSTs in 32CPs) : excellent 6, good 26, fair 10, and in dystonia(30 MGSTs in 23 CPs): excellent 2, good 18, fair 10, and in spasticity(20 in 17 CPs): excellent 3, good 12, fair 5, and in choreoor choreoathetoid(7 in 6 CPs) : good 5, fair 2. Recurrence of symptoms after operation was noted in 6 cases(12.5%). Postoperative morbidity including motor weakness, speech disturbance, swallowing difficulty, and sensory abnormality were transiently noted in 9 cases(18.8%). It is the authors observation that MGST seems to be one of the beneficial procedures for relieving symptoms of CP with mixed dyskinesias.
Cerebral Palsy* ; Deglutition ; Dyskinesias* ; Globus Pallidus ; Humans ; Magnetic Resonance Imaging ; Muscle Spasticity ; Recurrence ; Rhizotomy ; Thalamus ; Tremor