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

BACKGROUND: The infection rate of syphilis in married couples has been reported by a few investigators during the 1940s. However, studies on recent trends of that particular aspect of syphilis in married couples have not yet been done. OBJECTIVE: We therefore studied the infectivity of T. pallidum and recent trends of conjugal syphilis by observing the spouses of patients with untreated syphilis. METHODS: Couples married for more than 1 year who visited Yonsei Medical Center from 1983 to 1990 for syphilis were entered into this study. We observed the infection rate among spouses of 224 index patients (defined as, between husband and wife, the one who was the first to be diagnosed to have syphilis) who were not treated for syphilis. Syphilis was diagnosed on the basis of physical examination, history of extramarital sexual contacts, and the results of VDRL, TPHA, FTA-ABS, and 19S(IgM)-FTA tests. RESULTS: Fifty-six wives(48%) of 117 male index patients and 50 husbands (47%) of 107 female index patients had been infected at the time of examination. Among the 224 couples, 106(47%) were both infected and in 118(53%), only either husbands(27%) or wives(26%) were infected. Two spouses(50%) of the 4 first incident patients with primary syphilis, 9(53%) of 17 with secondary syphilis and 23(72%) of 32 with early latent syphilis were infected at the time of examination. CONCLUSION: From our results showing the low infection rates among married couples, even in early syphilis when the infectivity is high, it can be deduced that T. pallidum has only a low infectivity.
Family Characteristics ; Female ; Globus Pallidus ; Humans ; Male ; Physical Examination ; Research Personnel ; Spouses ; Syphilis* ; Syphilis, Latent

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

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

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

ABSTRACT OBJECTIVES: We report event-related functional magnetic resonance imaging(fMRI) methodology to investigate human brain activity during motor imagery. METHODS: A 1.5 Tesla clinical MR scanner was used in the acquisition of a series of T2* weighted MR images covering the whole brain. Blood oxygenation level-dependent(BOLD) signal changes associated with the imagery event were subsequently detected while healthy right-handed subjects imagined clenching of a right hand cued by auditory stimulus. RESULTS: Group analysis across nine right-handed subjects revealed activations in the medial and superior frontal gyri, cuneus, insula, middle/superior temporal gyri, and anterior cingulate gyri. Bilateral primary motor, premotor and supplementary motor areas exhibited event-related MR signal changes. Although unilateral hand clenching was imagined, bilateral activation of eloquent motor areas was observed. The proposed method also allowed for the visualization of subcortical areas, such as putamen, globus pallidus and thalamus, responsive to the event of motor imagery. CONCLUSION: The major cortical and subcortical areas in the motor pathways were identified and visualized during motor imagery event. Our results suggest that motor imagery and actual movement share common neural substrates.
Brain ; Brain Mapping ; Efferent Pathways ; Globus Pallidus ; Hand ; Humans ; Magnetic Resonance Imaging* ; Oxygen ; Putamen ; Thalamus

OBJECTIVE: The purpose of this study was to analyze in detail the relationship between outcome and time course of effect in medically refractory primary cervical dystonia (CD) with phasic type that was treated by bilateral globus pallidus internus (Gpi) deep brain stimulation (DBS). METHODS: Six patients underwent bilateral implantation of DBS into the Gpi under the guide of microelectrode recording and were followed for 18.7 +/- 11.1 months. The mean duration of the CD was 5.8 +/- 3.4 years. The mean age at time of surgery was 54.2 +/- 10.2 years. Patients were evaluated with the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and relief scale using patient self-reporting. RESULTS: The TWSTRS total scores improved by 64.5%, 65.5%, 75.8%, and 76.0% at 3, 6, 12 months, and at the last available follow-up after surgery, respectively. Statistically significant improvements in the TWSTRS scores were observed 3 months after surgery (p = 0.028) with gradual improvement up to 12 months after surgery, thereafter, the improvement was sustained. However, there was no statistically significant difference between the scores at 3 and 12 months. Subjective improvement reported averaged 81.7 +/- 6.8% at last follow-up. Mild dysarthria, the most frequent adverse event, occurred in 3 patients. Conclusions: Our results show that the bilateral Gpi-DBS can offer a significant therapeutic effect from 3 months postoperatively in patients with primary CD with phasic type, without significant side effects.
Deep Brain Stimulation ; Dysarthria ; Follow-Up Studies ; Globus Pallidus ; Humans ; Microelectrodes ; Torticollis

Hemiballism is a ballistic, involuntary movement disorder, usually of a sudden onset, an often occurs due to encephalomalasic lesion, mostly an infarction, of deep structure of contralateral cerebral hemisphere, rarely by a small hemorrhage. The lesion site is thought to be mainly subthalamic nucleus contralateral to the abnormal movement. But there have been several reports on hemiballism without involvement of subthalmic nucleus throughout the world. We report a case of acute vascular hemiballism occurred due to a small hemorrhage with involvement of left putamen and globus pallidus, which was demonstrated by computed tomography and magnetic resonance imaging study of brain.
Brain ; Cerebrum ; Dyskinesias* ; Globus Pallidus ; Hemorrhage ; Infarction ; Magnetic Resonance Imaging ; Putamen ; Subthalamic Nucleus