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

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

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

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

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: 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

The experience of pediatric deep brain stimulation (DBS) of the globus pallidus internus (GPi) in the treatment of early-onset DYT1 generalized dystonia is still limited. Here, we report the surgical experience of bilateral GPi-DBS under general anesthesia by using microelectrode recording in a 7-year-old girl with early-onset DYT1 generalized dystonia. Excellent improvement of her dystonia without neurological complications was achieved. This case report demonstrates that GPi-DBS is an effective and safe method for the treatment of medically refractory early-onset DYT1 generalized dystonia in children.
Anesthesia, General ; Child ; Deep Brain Stimulation ; Dystonia ; Globus Pallidus ; Humans ; Microelectrodes

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

OBJECTIVE: The purpose of this study is to investigate the effect of ipsilateral subthalamic nucleus(STN) lesioning on the spontaneous behavioral changes and the alteration of neuronal activities of deep cerebral nuclei in the rat parkinsonian model with 6-hydroxydopamine(6-OHDA). METHODS: To identify the spontaneous behavioral changes, apomorphine-induced rotational test and forepaw adjusting step were performed. We subsequently investigated the alteration of neuronal activities in the substantia nigra pars reticulata(SNpr) and globus pallidus(GP), in order to compare them with the behavioral changes in rat parkinsonian models. RESULTS: The STN lesioning in the rat parkinsonian model clearly improved behavioral changes. Compared to the normal control rats, rat PD models exhibited a significant increase in mean firing rates and the percentage of bursting neurons in the STN and SNpr. In the STN-lesioned rat PD models, mean firing rates and the percentage of bursting neurons in the SNpr were reduced and those in the GP increased. CONCLUSION: STN lesioning induced behavior improvement in rat parkinsonian models seems to be consistent with the surgical outcomes of the STN stimulation therapy in advanced Parkinsonn's disease(PD). The alteration of the neuronal activities in the SNpr and GP suggests that these sites are responsible for the improvement of parkinsonian motor symptoms observed following STN lesioning in rat parkinsonian models. The significance of bursting activity in the SNpr and GP remains obscure. Further study is necessary to elucidate the pathophysiological mechanism of PD.
Animals ; Fires ; Globus Pallidus ; Kainic Acid* ; Neurons* ; Oxidopamine* ; Parkinson Disease ; Rats* ; Substantia Nigra ; Subthalamic Nucleus