No abstract available.
Magnetic Resonance Imaging ; Spine

With increasing sensitivity, availability, and use of magnetic resonance imaging (MRI) in the past three decades, there is also an increase in incidental abnormal findings. The most common findings of these incidental abnormalities are white matter lesions that are interpreted as demyelinating based on radiological criteria. MRI findings suggestive of multiple sclerosis (MS) in patients without typical MS symptoms and with normal neurologic findings are now defined as a radiologically isolated syndrome (RIS) which reported relatively low incidence, especially hard to find case report in Korea. The natural history and pathophysiologic processes of RIS remain largely unknown. The nature, prevalence, and long-term prognosis of RIS, as well as the role of disease-modifying therapy should be established in the future.
Demyelinating Diseases ; Humans ; Incidence ; Korea ; Magnetic Resonance Imaging ; Multiple Sclerosis ; Natural History ; Neurologic Manifestations ; Prevalence ; Prognosis ; White Matter

No abstract available.
Asian Continental Ancestry Group ; Encephalitis, Japanese ; Humans ; Temporal Lobe

BACKGROUND AND OBJECTIVES: It is controversial that decreased left ventricular function could predict poststroke outcomes. The purpose of this study is to elucidate whether left ventricular ejection fraction (LVEF) can predict cardiovascular events and mortality in acute ischemic stroke (AIS) without atrial fibrillation (AF) and coronary heart disease (CHD). METHODS: Transthoracic echocardiography was conducted consecutively in patients with AIS or transient ischemic attack at Soonchunhyang University Hospital between January 2008 and July 2016. The clinical data and echocardiographic LVEF of 1,465 patients were reviewed after excluding AF and CHD. Poststroke disability, major adverse cardiac events (MACE; nonfatal stroke, nonfatal myocardial infarction, and cardiovascular death) and all-cause mortality during 1 year after index stroke were prospectively captured. Cox proportional hazards regressions analysis were applied adjusting traditional risk factors and potential determinants. RESULTS: The mean follow-up time was 259.9±148.8 days with a total of 29 non-fatal strokes, 3 myocardial infarctions, 33 cardiovascular deaths, and 53 all-cause mortality. The cumulative incidence of MACE and all-cause mortality were significantly higher in the lowest LVEF ( < 55) group compared with the others (p=0.022 and 0.009). In prediction models, LVEF (per 10%) had hazards ratios of 0.54 (95% confidence interval [CI], 0.36–0.80, p=0.002) for MACE and 0.61 (95% CI, 0.39–0.97, p=0.037) for all-cause mortality. CONCLUSIONS: LVEF could be an independent predictor of cardiovascular events and mortality after AIS in the absence of AF and CHD.
Atrial Fibrillation ; Coronary Disease ; Echocardiography ; Follow-Up Studies ; Humans ; Incidence ; Ischemic Attack, Transient ; Mortality ; Myocardial Infarction ; Prospective Studies ; Risk Factors ; Stroke ; Stroke Volume ; Ventricular Function, Left

BACKGROUND AND OBJECTIVES: It is controversial that decreased left ventricular function could predict poststroke outcomes. The purpose of this study is to elucidate whether left ventricular ejection fraction (LVEF) can predict cardiovascular events and mortality in acute ischemic stroke (AIS) without atrial fibrillation (AF) and coronary heart disease (CHD). METHODS: Transthoracic echocardiography was conducted consecutively in patients with AIS or transient ischemic attack at Soonchunhyang University Hospital between January 2008 and July 2016. The clinical data and echocardiographic LVEF of 1,465 patients were reviewed after excluding AF and CHD. Poststroke disability, major adverse cardiac events (MACE; nonfatal stroke, nonfatal myocardial infarction, and cardiovascular death) and all-cause mortality during 1 year after index stroke were prospectively captured. Cox proportional hazards regressions analysis were applied adjusting traditional risk factors and potential determinants. RESULTS: The mean follow-up time was 259.9±148.8 days with a total of 29 non-fatal strokes, 3 myocardial infarctions, 33 cardiovascular deaths, and 53 all-cause mortality. The cumulative incidence of MACE and all-cause mortality were significantly higher in the lowest LVEF ( < 55) group compared with the others (p=0.022 and 0.009). In prediction models, LVEF (per 10%) had hazards ratios of 0.54 (95% confidence interval [CI], 0.36–0.80, p=0.002) for MACE and 0.61 (95% CI, 0.39–0.97, p=0.037) for all-cause mortality. CONCLUSIONS LVEF could be an independent predictor of cardiovascular events and mortality after AIS in the absence of AF and CHD.

A 61-year-old woman with chronic kidney disease presented with general weakness and a confused mentality. Two days before admission she had been diagnosed as Bell's palsy at an outpatient clinic, and started to take oral prednisolone and acyclovir. A blood test at admission revealed hyponatremia (128 mmol/L). After withdrawing acyclovir, her plasma sodium levels began to increase, returning to normal 2 weeks later. This case could provide further evidence for a causal relationship between acyclovir and hyponatremia.
Acyclovir* ; Ambulatory Care Facilities ; Bell Palsy* ; Female ; Hematologic Tests ; Humans ; Hyponatremia* ; Middle Aged ; Plasma ; Prednisolone ; Renal Insufficiency, Chronic ; Sodium

BACKGROUND AND PURPOSE: The relationship between the side of motor symptoms and cognitive impairment has rarely been reported in Parkinson’s disease (PD). We aimed to estimate the influence of motor laterality on cognition in PD patients. METHODS: We enrolled 67 patients with PD, and they were divided into two groups according to side of symptom onset or predominant motor symptom presentation (right and left). Right-sided PD (RPD, 40) and left-sided PD (LPD, 27) patients underwent a neuropsychological battery exploring memory, attention/working memory, frontal/executive, visuospatial, and language functions. Student's t-test and Chi-square test have been carried out to compare the clinical and neuropsychological data between two groups. RESULTS: There were no significant differences in any neuropsychological test between the RPD and LPD groups, except for digit forward span test. RPD patients scored lower on the digit forward span test than LPD patients (5.43±9.49 vs. 6.15±1.38, p=0.045). CONCLUSIONS: RPD patients seem to experience more difficulties in attention and working memory than did LPD patients. The laterality of motor symptoms is not a major determinant for cognitive impairment in PD patients but, we should consider differences of cognitive deficits depending on the side of motor symptoms to treat patients with PD.
Cognition ; Cognition Disorders* ; Humans ; Memory ; Memory, Short-Term ; Neuropsychological Tests ; Parkinson Disease*

BACKGROUND AND PURPOSE: There is conflicting evidence for whether or not the incidence of stroke is influenced by the daily temperature. The association between daily temperature and incidence of stroke is largely unknown in Korea. This study attempted to evaluate whether the maximum or minimum daily temperature is associated with increased numbers of strokes and stroke subtypes among Seoul residents. METHODS: We obtained the maximum and minimum daily temperatures in Seoul from the Korean Meteorological Administration between January 2005 and December 2014. Consecutive patients with acute stroke were registered who visited the emergency room or outpatient clinic in Soonchunhyang University Hospital, Seoul. The residential addresses of cases were restricted to within a 2-kilometer radius of this hospital. The stroke events were prospectively recorded with onset time, and were classified by subtypes. The categories of daily temperature were divided by 10℃ from the mean temperature. The mean daily number of strokes was calculated during the study period. One-way analysis of variance and Duncan's post-hoc test were applied to compare the number of strokes among the temperature groups. RESULTS: In total, 2,313 acute strokes were identified during the period: 1,643 ischemic strokes and 670 hemorrhagic strokes. The number of cases was significantly higher when the maximum daily temperature was >32℃ or ≤3℃ (p=0.048) or the minimum daily temperature was ≤-11.0℃ (p=0.020). The lowest maximum daily temperature was associated with increased instances of intracerebral hemorrhage (p=0.029) and small-vessel occlusion (p=0.013), while the highest maximum daily temperature was associated with an increased instance of large-artery atherosclerosis (p=0.045). CONCLUSIONS: The daily temperature had measurable and different associations with the number of strokes and strokes subtypes in Seoul, Korea.
Ambulatory Care Facilities ; Atherosclerosis ; Cerebral Hemorrhage ; Emergency Service, Hospital ; Humans ; Incidence ; Korea ; Prospective Studies ; Radius ; Seoul* ; Stroke*

PURPOSE: The reverse digital island flap is useful for the repair of various fingertip injuries. We present a modified surgical technique with skin strip elevation for the prevention of postoperative congestion. METHODS: From January 2005 to October 2015, we performed 31 reconstructive procedures for finger injury using a reverse digital artery island flap with and without skin strip retention. Patients' clinical characteristics, surgical outcomes, and complications were investigated. RESULTS: All flaps survived and there were no donor site problems. The mean follow-up time was 5 months (range, 3-8 months). In skin strip retention group, mild venous congestion was observed in 1 case, although it resolved spontaneously. Another case retained flexion contracture, and 2 patients had stiffness at the distal interphalangeal joint. Whereas, in no retention group, venous congestion was observed in 3 cases, 1 patient had partial flap necrosis and 2 patient suffer in flexion contracture at metacarpophalangeal joint. CONCLUSION: The reverse digital island flap procedure produces consistent results and is reliable for the treatment of fingertip injury. Our modified surgical technique of elevating the flap accompanied by skin strip retention helps prevent postoperative congestion.
Arteries ; Contracture ; Estrogens, Conjugated (USP)* ; Finger Injuries ; Follow-Up Studies ; Humans ; Hyperemia ; Joints ; Metacarpophalangeal Joint ; Necrosis ; Skin* ; Tissue Donors