Therapeutic hypothermia in cardiac arrest patients is associated with favorable outcomes mediated via neuroprotective mechanisms. We report a rare case of a 32-year-old male who demonstrated complete recovery of signal changes on perfusion-weighted imaging after therapeutic hypothermia due to cardiac arrest. Brain MRI with perfusion-weighted imaging, performed three days after ending the hypothermia therapy, showed a marked decrease in relative cerebral blood flow (rCBF) and delay in mean transit time (MTT) in the bilateral basal ganglia, thalami, brain stem, cerebellum, occipitoparietal cortex, and frontotemporal cortex. However, no cerebral ischemia was not noted on diffusion-weighted imaging (DWI) or fluid-attenuated inversion recovery (FLAIR) sequences. A follow-up brain MRI after one week showed complete resolution of the perfusion deficit and the patient was discharged without any neurologic sequelae. The mechanism and interpretation of the perfusion changes in cardiac arrest patients treated with therapeutic hypothermia are discussed.
Adult ; Basal Ganglia ; Brain ; Brain Ischemia ; Brain Stem ; Cerebellum ; Cerebrovascular Circulation ; Follow-Up Studies ; Heart Arrest ; Humans ; Hypothermia ; Hypothermia, Induced ; Magnetic Resonance Imaging ; Male ; Perfusion

PURPOSE: Imaging plays a significant role in diagnosing leptomeningeal metastases. However, the most appropriate sequence for the detection of leptomeningeal metastases has yet to be determined. This study compares the efficacies of contrast-enhanced T2 fluid attenuated inversion recovery (FLAIR) and contrast-enhanced 3D T1 black-blood fast spin echo (FSE) imaging for the detection of leptomeningeal metastases. MATERIALS AND METHODS: Tube phantoms containing varying concentrations of gadobutrol solution were scanned using T2 FLAIR and 3D T1 black-blood FSE. Additionally, 30 patients with leptomeningeal metastases were retrospectively evaluated to compare conspicuous lesions and the extent of leptomeningeal metastases detected by T2 FLAIR and 3D T1 black-blood FSE. RESULTS: The signal intensities of low-concentration gadobutrol solutions (< 0.5 mmol/L) on T2 FLAIR images were higher than in 3D T1 black-blood FSE. The T2 FLAIR sequences exhibited significantly greater visual conspicuity scores than the 3D T1 black-blood sequence in leptomeningeal metastases of the pial membrane of cistern (P = 0.014). T2 FLAIR images exhibited a greater or equal extent (96.7%) of leptomeningeal metastases than 3D T1 black-blood FSE images. CONCLUSION: Because of its high sensitivity even at low gadolinium concentrations, contrast-enhanced T2 FLAIR images delineated leptomeningeal metastases in a wider territory than 3D T1 black-blood FSE.
Gadolinium ; Humans ; Membranes ; Neoplasm Metastasis ; Retrospective Studies

PURPOSE: To investigate the influence of clinical and demographical variables on depression, instrumental activities of daily living (IADL), and cognitive function in patients with Parkinson's disease. METHOD: Using a structured questionnaire data were collected from 100 participants registered in the neurology department of C university hospital. Duration and stage of disease, fall history, vision impairment, duration and quality of sleep, orthostatic hypotension, ambulation impairment, and use of walking aid were included in clinical variables. Depression, IADL, and cognitive function were assessed using Kee's GDSSF-K, Cho's scale, and K-MMSE. Collected data were analyzed using the SAS program. RESULTS: The depression score for the participants was 7.78, higher than cut-off score(5). Participants who were male, living with spouse, above high school education, high economic status, with no vision impairment, and no ambulation impairment revealed high cognitive scores. Average IADL score were significantly higher for participants who were male, who had high economic status, low stage of disease, and no ambulation impairment. Depression IADL & cognitive function scores were significantly different according to ambulation impairment. Scores for ADL and cognitive function were positively correlated. CONCLUSION: It is recommended that make programs for patients with Parkinson's disease, clinical and demographic variables should be considered according to their individual needs.
Activities of Daily Living* ; Cognition ; Depression* ; Education ; Humans ; Hypotension, Orthostatic ; Male ; Neurology ; Parkinson Disease* ; Surveys and Questionnaires ; Spouses ; Walking

Advances in radiomics and deep learning (DL) hold great potential to be at the forefront of precision medicine for the treatment of patients with brain metastases.Radiomics and DL can aid clinical decision-making by enabling accurate diagnosis, facilitating the identification of molecular markers, providing accurate prognoses, and monitoring treatment response. In this review, we summarize the clinical background, unmet needs, and current state of research of radiomics and DL for the treatment of brain metastases. The promises, pitfalls, and future roadmap of radiomics and DL in brain metastases are addressed as well.

Intracranial chordoma is a rare tumor, originating from embryonic remnants of the primitive notochord. It typically appears as an enhancing extradural midline tumor with bone involvement. We introduce a rare case of a 27-year-old male who had a nonenhancing intradural chordoma showing paramedian location, involving the left cavernous sinus, Meckel's cave, and prepontine cistern. The pathologic diagnosis was confirmed as an intradural chordoma. The imaging findings of this unusual case of a nonenhancing intradural paramedian chordoma will be presented with the differential diagnosis focused on the epidermoid cyst.

No abstract available.
Protein-Losing Enteropathies

OBJECTIVE: To study the neonatal outcomes of pregnancies complicated with preterm premature rupture of the membranes (PPROM) and to assess the prognostic factors for poor neonatal outcomes. METHODS: We performed a retrospective study of pregnancies registered and managed in Korea from Jan 1st, 2000 to Dec 31st, 2005. The 217 women with preterm premature rupture of membranes in singleton pregnancies from 16 to 36 gestational weeks were enrolled in this study. We investigated respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), and neonatal infection for poor neonatal outcomes. Prognostic variables included for analysis were age, BMI, parity, history of PPROM, history of preterm labor, preterm labor, amniotic fluid index, tocolysis, antibiotics, antenatal steroid, hemoglobin, WBC, CRP, gestational age at PPROM, interval from PPROM to delivery, gestational age at delivery, placental findings, and etc. We compared the characteristics of those who developed neonatal morbidity (n=144) with those who did not (n=65) using the Student t test for continuous variables, and the Pearson's chi-square or the Fisher exact test for categorical variables. RESULTS: Total of 217 cases of PPROM were registered and treated expectantly during the study period. The majority of cases were delivered within 48 hours of PPROM. There were 64 cases diagnosed with RDS, 21 with IVH, 3 with NEC, 117 with neonatal infection and 8 neonatal mortalities. The gestational age at PPROM (p<0.000), interval from PPROM to delivery (p<0.036), gestational age at delivery (p<0.000), decreased amniotic fluid index (p<0.048), and high level of WBC, CRP (p<0.010, p<0.049) were significantly correlated with poor neonatal outcomes. Birth weight (p<0.000) and APGAR (p<0.000) score at 5 minute were significantly lower in cases resulting in neonatal morbidity. CONCLUSION: Neonatal outcomes of pregnancies with preterm premature rupture of membranes are related to gestational age at PPROM, interval from PPROM to delivery, and gestational age at delivery. The decreased amniotic fluid index, and high level of WBC, CRP presented before delivery are significantly correlated with poor neonatal outcomes. Birth weight and APGAR scores at 5 minute are significantly lower in cases resulting in neonatal morbidity.
Amniotic Fluid ; Anti-Bacterial Agents ; Birth Weight ; Enterocolitis, Necrotizing ; Female ; Gestational Age ; Hemorrhage ; Humans ; Infant ; Infant Mortality ; Korea ; Membranes* ; Obstetric Labor, Premature ; Parity ; Pregnancy* ; Retrospective Studies ; Rupture* ; Tocolysis

Cannabis or marijuana is the most commonly used recreational drug after alcohol in the world, and usage is generally recognized as having few serious adverse effects. However, usage is restricted in South Korea. The report of ischemic stroke associated with cannabis is rare in literature. We present a case of a 47-year-old female patient with no underlying disease presenting with acute ischemic stroke after smoking cannabis in South Korea. The result for synthetic cannabinoid metabolites (delta-9 tetrahydrocannabinol) screening was positive. Absence of other vascular risk factors and drug screening results suggest a causal role of cannabis in this ischemic stroke case. The patient eventually progressed to brain death. The underlying mechanism, clinical manifestation, and imaging findings of cannabis-related stroke will be reviewed.
Brain Death ; Cannabis ; Drug Evaluation, Preclinical ; Female ; Humans ; Korea ; Mass Screening ; Middle Aged ; Risk Factors ; Smoke ; Smoking ; Stroke

PURPOSE: To investigate the levels of uncertainty and anxiety at admission and discharge to the isolation unit for patients undergoing hematopoietic stem cell transplantation (HSCT). METHOD: The data were collected from 60 patients who were admitted to the department of HSCT. Uncertainty and anxiety were assessed using the Mishel Uncertainty in Illness Scale (MUIS) and Anxiety Inventory (STAI). Collected data were analyzed using the SAS program. RESULTS: The mean score for anxiety at admission was 2.20, and at discharge 2.10. The mean score for uncertainty at admission was 2.19, and at discharge 2.07. The anxiety at admission the group with physical discomfort was higher than that of group without physical discomfort. A positive relationship was found between anxiety and uncertainty at admission and at discharge. The major variables were expectation for cure and physical discomfort, explaining 25.87% of the anxiety at admission. The major variable was expectation for cure, explaining 20.94% of the uncertainty at admission. CONCLUSION: From the above results, it can be concluded that support and consideration are required to reduce anxiety of the inpatient in single room.
Anxiety* ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Inpatients ; Stem Cell Transplantation ; Uncertainty*

Purpose: Smart insoles are wearable devices that are inserted into shoes. Smart insoles with built-in pressure and acceleration sensors can measure the plantar pressure, stride length, and walking speed. This study evaluated the validity and reliability of the plantar pressure measurements of smart insoles during walking on flat ground. Materials and Methods: Twenty one subjects were included in this study. After wearing smart insoles, I-SOL® (Gilon, Seongnam, Korea), the subjects walked a 10 m corridor six times at a rate of 100 steps/min, and the middle three steps, free from direction changes, were chosen for data analysis. The same protocol was repeated after wearing Pedar-X (Novel Corporation, Munich, Germany), an insoletype plantar pressure measurement equipment with proven validity. The average maximum pressure (Ppeak , kPa) and the time at which Ppeak appeared (Ptime , %stride) were calculated for each device. The validity of smart insoles was evaluated by using the interclass correlation coefficient (ICC) of Ppeak and Ptime between the two instruments, and Cronbach’s alpha was obtained from the Ppeak values to evaluate the reliability. Results: The ICC of Ppeak was 0.651 (good) in the hallux, 0.744 (good) in the medial forefoot, 0.839 (excellent) in the lateral forefoot, and 0.854 (excellent) in the hindfoot. The ICC of Ptime showed 0.868 (excellent) in the hallux, 0.892 (excellent) in the medial forefoot, 0.721 (good) in the lateral forefoot, and 0.832 (excellent) in the hindfoot. All ICC values showed good or excellent results. The Cronbach’s alpha of Ppeak measured in the smart insoles was 0.990 in the hallux, 0.961 in the medial forefoot, 0.973 in the lateral forefoot, and 0.995 in the hindfoot; all indicated excellent reliability in all areas. Conclusion The plantar pressure measurements of smart insoles during walking on a flat ground showed validity compared to Pedar-X, and high reliability after repeated measurements.