Postpartum cerebral angiopathy is a benign, reversible clinicoradiologic syndrome. The clinical significance of this syndrome is the difficulty in differentiating it from other severe disorders such as subarachnoid hemorrhage and cere-bral vasculitis. A 25-year-old woman who developed a severe headache, transient total blindness ,and generalized tonic clonic seizures 14 days postpartum was admitted to our hospital. A MRI of the brain revealed a bilateral anterior cere-bral artery (ACA) infarction. A cerebral angiography showed the narrowing of the M1 and M2 segments of the left middle cerebral artery (MCA), the right MCA M1 segment, and the A1 and proximal A2 segments of the right ACA. Also, it showed the narrowing of the proximal basilar artery portion from which the anterior inferior cerebellar artey arose, P1, P2, and P3 segments of the left posterior cerebral artery (PCA), and the right PCA P1 segment. With the treatment of nimodipine, the abnormalities on these studies were markedly improved two weeks later.
Adult ; Arteries ; Basilar Artery ; Blindness ; Brain ; Cerebral Angiography ; Cerebrovascular Disorders ; Female ; Headache ; Humans ; Infarction ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Nimodipine ; Passive Cutaneous Anaphylaxis ; Posterior Cerebral Artery ; Postpartum Period* ; Pregnancy Complications ; Seizures ; Subarachnoid Hemorrhage ; Vasculitis

OBJECTIVES: The purpose of this study is to investigate the professional knowledge and perceptions of the early screening of Autism Spectrum Disorder (ASD) in practitioners who have contact with patients with ASD. METHODS: A survey was carried out among 674 practitioners in total, where practitioners are defined as those who work at primary medical centers, public institutions, educational institutions and treatment institutions. The survey was carried out both online and offline, and it mainly focused on 1) knowledge about ASD symptoms, 2) knowledge about the early screening of ASD, 3) measures taken after ASD detection, 4) thoughts on the development of early screening tools for ASD, and 5) the current status of ASD treatment. The data collected were analyzed through descriptive statistics, analysis of frequency and cross tabulation analysis using SPSS WIN 22.0. RESULTS: The results of this study suggest that the practitioners were not aware of the exact symptoms of ASD and their professional knowledge and the environment for early screening were insufficient. Furthermore, very few and inappropriate measures were taken after the detection of ASD. In addition, there was a high demand for early ASD screening tools to be used on site and, regarding treatment, the significance of the implementation of evidence based treatments as well as the continuity of relevant research came to the fore. CONCLUSION: It seems that there is a lack of knowledge and perception of the early screening of ASD and that education and training among practitioners is urgently required. This issue is discussed in more detail in the paper.
Autism Spectrum Disorder* ; Autistic Disorder* ; Education ; Humans ; Mass Screening*

BACKGROUND: Based on trends demonstrated in the United States, a very insignificant number of people have shown a predisposition to left-sided skin cancer. However, to date, no systematic review or meta-analysis has demonstrated the predominance of left-sided skin cancers over right-sided skin malignancies. OBJECTIVE: We systematically reviewed and meta-analyzed all data pertaining to locations of skin cancers. METHODS: All data were pooled using the Mantel-Haenszel method (random-effects weighting); an inverse variance model featuring fixed-effects weighting was applied to explore the robustness of modeling. Heterogeneity was evaluated using the I2 test. Dichotomous outcomes with respect to the prevalence of left- and right-sided skin cancers are presented as relative risks (RRs) with 95% confidence intervals (CIs). RESULTS: Nine studies were included in our evaluation. Our study sample included: 182,840 patients with malignant melanoma (MM), 1,419 patients with basal cell carcinoma (BCC), and 331 patients with squamous cell carcinoma (SCC). Meta-analyses of pooled observational data revealed greater prevalence of left-sided MM compared to right-sided MM (RR 0.91, 95% CI 0.89~0.92, p<0.01), while left-sided SCC was more prevalent than right-sided SCC (RR 0.83, 95% CI 0.71~0.97, p=0.02). However, right-sided BCC was more prevalent than left-sided BCC (RR 1.07, 95% CI 0.95~1.19, p=0.26). CONCLUSION: Observational studies vary greatly in terms of design, methodological quality, and types of patients studied. Of note, only a few studies analyzing BCC and SCC were included in our present meta-analysis. Additionally, a selection and reporting bias could have affected our results. Our meta-analysis suggests that both MM and SCC demonstrate a left-side bias, but BCC does not.
Bias (Epidemiology) ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Humans ; Melanoma ; Methods ; Population Characteristics ; Prevalence* ; Skin Neoplasms* ; Skin* ; United States

BACKGROUND: Based on trends demonstrated in the United States, a very insignificant number of people have shown a predisposition to left-sided skin cancer. However, to date, no systematic review or meta-analysis has demonstrated the predominance of left-sided skin cancers over right-sided skin malignancies. OBJECTIVE: We systematically reviewed and meta-analyzed all data pertaining to locations of skin cancers. METHODS: All data were pooled using the Mantel-Haenszel method (random-effects weighting); an inverse variance model featuring fixed-effects weighting was applied to explore the robustness of modeling. Heterogeneity was evaluated using the I2 test. Dichotomous outcomes with respect to the prevalence of left- and right-sided skin cancers are presented as relative risks (RRs) with 95% confidence intervals (CIs). RESULTS: Nine studies were included in our evaluation. Our study sample included: 182,840 patients with malignant melanoma (MM), 1,419 patients with basal cell carcinoma (BCC), and 331 patients with squamous cell carcinoma (SCC). Meta-analyses of pooled observational data revealed greater prevalence of left-sided MM compared to right-sided MM (RR 0.91, 95% CI 0.89~0.92, p<0.01), while left-sided SCC was more prevalent than right-sided SCC (RR 0.83, 95% CI 0.71~0.97, p=0.02). However, right-sided BCC was more prevalent than left-sided BCC (RR 1.07, 95% CI 0.95~1.19, p=0.26). CONCLUSION: Observational studies vary greatly in terms of design, methodological quality, and types of patients studied. Of note, only a few studies analyzing BCC and SCC were included in our present meta-analysis. Additionally, a selection and reporting bias could have affected our results. Our meta-analysis suggests that both MM and SCC demonstrate a left-side bias, but BCC does not.
Bias (Epidemiology) ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Humans ; Melanoma ; Methods ; Population Characteristics ; Prevalence* ; Skin Neoplasms* ; Skin* ; United States

PURPOSE: We wanted to measure the vascular pedicle width (VPW) in normal Korean adults and correlate the VPW with the body physique and we also wanted to establish the index for normal VPWs, which could be utilized in reading chest PAs. MATERIALS AND METHODS: The VPW was measured on the posteroanterior (PA) chest radiographs of 262 normal Korean adults (134 men and 128 women, age range: 22-88 years, mean age: 45.2 years), who visited the hospital for a general health examination. The relationship between the VPW and the height and the Body Mass Index (BMI) was evaluated. Correlations between height and the thoracic spine length (TSL) and between the BMI and the lateral chest wall thickness (CWT) were analyzed as well. RESULTS: The mean VPW was 47.4 (+/-6.4) mm. The VPW was positively correlated with the height (p<0.01) and the BMI (p<0.01) of the subject. The patient's height was well correlated with the TSL, and the BMI was correlated with the CWT (r=0.75, r=0.76). The table for the normal VPWs according to patient's TSL and CWT was established. CONCLUSION: By measuring the TSL and the CWT on chest PA, which reflect the height and BMI, respectively, and by utilizing the provided table for the normal VPW, we can determine the normality of a patient's VPW.
Adult* ; Blood Vessels ; Body Mass Index ; Female ; Humans ; Male ; Radiography, Thoracic ; Spine ; Thoracic Wall ; Thorax*

BACKGROUND: Hereditary neuropathy with liability to pressure palsy (HNPP) and Charcot-Marie-Tooth1A (CMT1A) are autosomal dominant inherited demyelinating neuropathy associated with the deletion or duplication of 17p11.2-p12 segments including the gene for peripheral myelin protein 22 (PMP22). The aim of this study is to compare the electrophysiological features of these two disorders genetically related. METHODS: We studied the nerve conduction studies of genetically confirmed 43 HNPP in 23 families and 31 CMT1A patients in 13 families. RESULTS: Nerve conduction studies presented prolonged terminal latency, slow nerve conduction velocity and low amplitude of compound muscle or nerve action potentials in both diseases, but more severe in CMT1A. The incidence of conduction block with or without dispersion was higher in CMT1A than HNPP, with 23.6% and 5.7% respectively. CMT1A revealed a rather even distribution of abnormalities in segmental nerve conduction studies than HNPP. HNPP showed frequent involvements at the segment of entrapment-prone site such as peroneal and ulnar nerves. The characteristical differences of these diseases could be defined by the quantitative correlation study. The correlation coefficients of nerve conduction velocities between tested nerves in the same or different limbs and between tested segments of the same nerve was much higher in CMT1A than HNPP. CONCLUSIONS: We conclude that CMT1A presents with more severe diffuse and uniform slowing, whereas HNPP presents with focal electrophysiological abnormalities.
Action Potentials ; Extremities ; Humans ; Incidence ; Myelin Sheath ; Neural Conduction* ; Paralysis* ; Statistics as Topic ; Ulnar Nerve

Myopathies associated with anti-signal-recognition particle (SRP) antibodies usually present with severe muscle weakness and exhibit necrotizing myopathy with little inflammation pathologically. Here we report a case of a 61-year-old man who presented with subacute progressive proximal muscle weakness, dysarthria, and dysphagia. Although polymyositis was expected clinically, muscle biopsy revealed myopathic changes with degenerating fibers without definite inflammation. Further laboratory study revealed that the patient was positive for anti-SRP antibodies.
Antibodies ; Autoantibodies ; Biopsy ; Deglutition Disorders ; Dysarthria ; Humans ; Inflammation ; Middle Aged ; Muscle Weakness ; Muscles ; Muscular Diseases ; Myositis ; Polymyositis ; Signal Recognition Particle

BACKGROUND AND PURPOSE: Two conversion scales between the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) have been validated for Korean patients with Parkinson's disease. The aim of the present study was to validate these conversion scales for all patients with cognitive impairments regardless of dementia subtype. METHODS: Medical records of 323 subjects who completed both MMSE and MoCA on the same day were retrospectively reviewed. Mean, median, and root mean squared error (RMSE) of the difference between true and equivalent MMSE scores were calculated. Intraclass correlation coefficients (ICCs) between true and equivalent MMSE scores were also calculated. The validity of MoCA-MMSE conversion scales was evaluated according to educational level (low educated: ≤6 years; high educated: ≥7 years) and subtypes of cognitive impairment. RESULTS: The difference between true and equivalent MMSE scores had a median value of 0, a mean value of 0.19 according to the van Steenoven scale, a mean value of 0.57 according to the Lawton scale, RMSE value of 2.2 according to the van Steenoven scale, and RMSE value of 0.42 according to the Lawton scale. Additionally, ICCs between true and equivalent MMSE scores were 0.92 and 0.90 on van Steenovan and Lawton conversion scales, respectively. These results were maintained in subgroup analyses. CONCLUSIONS: Findings of the present study suggest that both van Steenovan and Lawton MoCA-MMSE conversion scales are applicable to transforming MoCA scores into MMSE scores in patients with cognitive impairments regardless of dementia subtype or educational level.
Cognition Disorders* ; Dementia ; Humans ; Medical Records ; Methylenebis(chloroaniline) ; Parkinson Disease ; Retrospective Studies ; Weights and Measures*

No abstract available.
Cluster Headache ; Frontal Sinus ; Frontal Sinusitis ; Headache ; Magnetic Resonance Imaging ; Sinusitis

Spontaneous intracranial hypotension (SIH) is characterized by orthostatic headache, diffuse dural thickening, and enhancement in magnetic resonance imaging. Cerebral venous thrombosis (CVT) has been reported to be a rare complication of SIH. There is no consensus in anticoagulation treatment of CVT secondarily caused by SIH. We report a female patient with SIH complicated by CVT and spontaneously regressed CVT not by anticoagulation but by epidural blood patch.
Blood Patch, Epidural ; Consensus ; Female ; Headache ; Humans ; Intracranial Hypotension ; Magnetic Resonance Imaging ; Venous Thrombosis