Bilateral calcifications of the basal ganglia, the thalami, the dentate nuclei of the cerebellum, and the white matter of the cerebral hemisphere characterize Fahr's disease. The common clinical manifestations of the disease are movement disorders accompanied by cognitive impairment and mood disorder. Herein we report a case of Fahr's disease with atypical clinical manifestations. The patient was a 48 year-old man who presented with behavioral changes. His neurological examination showed no focal neurological deficits except for frontal dysfunctions. Abnormal involuntary movement was absent. Neuroimaging work-ups were compatible with Fahr's disease.
Basal Ganglia ; Cerebellum ; Cerebrum ; Dyskinesias ; Frontal Lobe* ; Humans ; Middle Aged ; Mood Disorders ; Movement Disorders ; Neuroimaging ; Neurologic Examination

OBJECTIVE: The purpose of this study is to determine the proper hand position during driving by measuring of the wheel rotation strength according to the wheel angle and hand position to the wheel. METHOD: BTE Work Simulator was used to measure the clockwise and counter clockwise static wheel rotation force of twenty healthy men in three different hand position (2~10 spot, 3~9 spot, and 4~8 spot) and two different wheel angle (45 degrees and 60 degrees), average and peak force were measured during maximal isometric contraction. RESULTS: The average and peak force was significantly different by the wheel angle, and hand position (p<0.01), but the direction of rotation didn't an effect on the rotation force. The hand position was the most significant factor, especially wheel rotation force at 2~10 spot hand position was significantly lower than that of 3~9 spot and 4~8 spot (p<0.05). The rotation force by the wheel angle was influenced by hand position, and lower in 60 degrees wheel angle in the 2~10 spot (p<0.05). CONCLUSION: The rotation force of wheel was influenced by the hand position. Therefore proper hand position is recommended during driving to reduce muscle fatigue.
Hand* ; Humans ; Isometric Contraction ; Male ; Muscle Fatigue

Portal biliopathy refers to the changes in the bile duct caused by portal vein thrombosis or obstruction. It is assumed to be caused by cavernous transformation due to the development of the venous system surrounding the bile duct, but the exact pathology is still unknown. Biliary morphologic abnormalities of portal biliopathy are discovered incidentally on radiographic images, but it is sometimes difficult to differentiate them from cholangiocarcinoma. Given the poor prognosis of cholangiocarcinoma, a surgical approach can be considered when the diagnosis is uncertain. Herein, we report a case of portal biliopathy with bile ductal wall thickening, which was diagnosed after surgical resection was performed due to the presumed diagnosis of cholangiocarcinoma.

Immunoglobulin G4 (IgG4)-related disease is a novel disease entity that can involve diverse organs, causing specific diseases, including autoimmune pancreatitis, sclerosing cholangitis, cholecystitis, inflammatory aortic aneurysm, and inflammatory pseudotumor. IgG4-related disease is characterized by elevated serum IgG4 concentrations, abundant IgG4 lymphoplasmacytic infiltration, and dramatic steroid responses. It is clinically important to differentiate this rare disease from primary sclerosing cholangitis and cholangiocarcinoma, because the treatment and prognosis of these two diseases are completely different. However, the preoperative diagnosis is challenging, and the disease is frequently misdiagnosed. If the serum level of IgG4 is within the normal range, the diagnosis of IgG4-related disease is more difficult. This article reports on a 59-year-old man with IgG4-related disease mimicking unresectable gallbladder cancer with normal serum IgG4 concentrations.
Aortic Aneurysm ; Cholangiocarcinoma ; Cholangitis, Sclerosing ; Cholecystitis ; Gallbladder ; Gallbladder Neoplasms ; Granuloma, Plasma Cell ; Humans ; Immunoglobulin G ; Immunoglobulins ; Middle Aged ; Pancreatitis ; Prognosis ; Rare Diseases ; Reference Values

BACKGROUND AND PURPOSE: To analyze 18F-THK5351 positron emission tomography (PET) scans of patients with clinically diagnosed nonfluent/agrammatic variant primary progressive aphasia (navPPA). METHODS: Thirty-one participants, including those with Alzheimer's disease (AD, n=13), navPPA (n=3), and those with normal control (NC, n=15) who completed 3 Tesla magnetic resonance imaging, 18F-THK5351 PET scans, and detailed neuropsychological tests, were included. Voxel-based and region of interest (ROI)-based analyses were performed to evaluate retention of 18F-THK5351 in navPPA patients. RESULTS: In ROI-based analysis, patients with navPPA had higher levels of THK retention in the Broca's area, bilateral inferior frontal lobes, bilateral precentral gyri, and bilateral basal ganglia. Patients with navPPA showed higher levels of THK retention in bilateral frontal lobes (mainly left side) compared than NC in voxel-wise analysis. CONCLUSIONS: In our study, THK retention in navPPA patients was mainly distributed at the frontal region which was well correlated with functional-radiological distribution of navPPA. Our results suggest that tau PET imaging could be a supportive tool for diagnosis of navPPA in combination with a clinical history.
Alzheimer Disease ; Aphasia, Primary Progressive* ; Basal Ganglia ; Broca Area ; Diagnosis ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Neurofibrillary Tangles ; Neuropsychological Tests ; Positron-Emission Tomography ; Primary Progressive Nonfluent Aphasia ; tau Proteins

OBJECTIVES: Busan is reported to have the highest mortality rate among 16 provinces in Korea, as well as considerable health inequality across its districts. This study sought to examine overall and cause-specific mortality and deprivation at the town level in Busan, thereby identifying towns and causes of deaths to be targeted for improving overall health and alleviating health inequality. METHODS: Standardized mortality ratios (SMRs) for all-cause and four specific leading causes of death were calculated at the town level in Busan for the years 2005 through 2008. To construct a deprivation index, principal components and factor analysis were adopted, using 10% sample data from the 2005 census. Geographic information system (GIS) mapping techniques were applied to compare spatial distributions between the deprivation index and SMRs. We fitted the Gaussian conditional autoregressive model (CAR) to estimate the relative risks of mortality by deprivation level, controlling for both the heterogeneity effect and spatial autocorrelation. RESULTS: The SMRs of towns in Busan averaged 100.3, ranging from 70.7 to 139.8. In old inner cities and towns reclaimed for replaced households, the deprivation index and SMRs were relatively high. CAR modeling showed that gaps in SMRs for heart disease, cerebrovascular disease, and physical injury were particularly high. CONCLUSIONS: Our findings indicate that more deprived towns are likely to have higher mortality, in particular from cardiovascular disease and physical injury. To improve overall health status and address health inequality, such deprived towns should be targeted.
Cause of Death ; Confidence Intervals ; Geographic Information Systems ; Health Services Accessibility ; *Health Status Disparities ; Humans ; Korea/epidemiology ; Life Expectancy ; Mortality/*trends ; Normal Distribution ; Poverty/*statistics & numerical data ; Regression Analysis ; Risk ; Socioeconomic Factors

Congenital microgastria results in growth retardation early in a patient's life due to poor oral intake, malnutrition and failure to gain weight. An one-month-old female was admitted with a history of poor oral intake, vomiting and recurrent pneumonia after birth. She had an extremely small, tubular stomach in the midline of the abdomen, a megaesophagus and severe gastroesophageal reflux (Reflux Index: 41.1%, DeMeester score: 152.2). A Hunt- Lawrence Pouch (Roux-en-Y double barrel jejunal food pouch formation) procedure was performed for augmenting the small stomach after failure of conservative management such as small, frequent feedings and prokinetics. The postoperative UGI and esophageal pH study showed marked improvement of the GER (13.7%, 68.9 respectively). Although her preoperative symptoms have subsided, her weight is still below normal (third percentile). Creating a Hunt-Lawrence pouch is the treatment of choice for congenital microgastria that is refractory to conservative management.
Abdomen ; Esophageal Achalasia ; Esophagitis ; Female ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration ; Malnutrition ; Parturition ; Pneumonia ; Stomach ; Vomiting

The funding acknowledgment in this article was omitted as published.

BACKGROUND/AIMS: Pancreatic acini of streptozotocin (STZ)-induced diabetic rats release amylase less than normal acini on cholecystokinin (CCK) stimulation. Pancreatic enzyme secretion has been closely related to the intracellular calcium concentration ([Ca2+]i) of the acinar cell. In the present study, sequential changes of the intracellular calcium signal which probably underlie the altered enzyme secretion in response to CCK-8 were investigated using pancreatic acini from diabetic rats. METHODS: Diabetic rats were prepared by single intravenous injection of STZ (70 mg/kg). Stimulating experiments with CCK-8 were performed 7 days later. Pancreatic acini were isolated by collagenase digestion. Amylase release and [Ca2+]i were measured by colorimethod and calcium imaging, respectively. The geometry of intracellular calcium signal was analyzed. RESULTS: Normal acini exhibited concentration-dependent [Ca2+]i increase and regular oscillatory calcium signal on CCK-8 stimulation. Amylase release was also concentration-dependent. However, diabetic acini showed significantly less [Ca2+]i increase, prolonged time to peak [Ca2+]i, decreased calcium spikes number, and decreased amylase release compared with normal acini. The decreased [Ca2+]i in diabetic acini was restored significantly by insulin treatment. CONCLUSIONS: Relatively decreased amylase release in diabetic pancreatic acini in response to CCK, appears to be associated with altered calcium signal due to insulin deficiency.
Amylases/*secretion ; Animals ; Calcium Signaling/*drug effects ; Diabetes Mellitus, Experimental/*physiopathology ; Pancreas/cytology/metabolism/*secretion ; Rats ; Rats, Sprague-Dawley ; Sincalide/*pharmacology

In this work we have measured the dose distribution and the percent depth dose of 20 MeV electron beam using the X-OMAT films in order to verify the effects of transverse magnetic field on high energy elecrtron beam in a phantom. The result shows about 30% increase of the percent depth dose at 4.5 cm depth under the transverse magnetic field of 1.5 Tesla at 7.5 cm depth. We have verified that these were in an agreement with other theoretical results.
Magnetic Fields*