No abstract available.
Hydralazine*

The Pill Questionnaire (PillQ) has been proposed as a simple way to evaluate cognitive deficits and their impact on the daily lives of those with Parkinson’s disease (PD) by asking patients or caregivers about whether patients can independently manage their pills. We used the PillQ to investigate the association of ability to manage medication with cognition and activities of daily living (ADLs) in patients with PD. Patients were divided into two groups based on PillQ scores. The no-impact group was able to take their antiparkinsonian medication independently, and the impact group exhibited problems describing their treatment or taking their drugs independently. A total of 208 participants (93 men) were included. 111 patients (53.4%) were included in the no-impact group, and 97 (46.6%) were included in the impact group. The impact group showed significantly lower cognitive functioning, difficulties with the performance of ADLs, and severe motor dysfunction. PillQ scores were significantly correlated with Mini-Mental State Examination and the Montreal Cognitive Assessment, and Clinical Dementia Rating scores. Management of medication by PD patients is associated with cognitive function, and the PillQ is an easy and useful test for detecting cognitive impairment and its impact on daily life.

Trichofolliculoma is an adnexal tumor of hair follicle oriyin, considered to be of intermediate differentiation between a hair follicle nevus, a simple hyperolasia of the hair follicle, and trichoepithelioma, Which usually lacks mature hair follicles. Grossly the tumor usually appears on the head or neck as a 0.5 to 1.0cm solitary white to pearly papule, Many lesions show a cental pore, and occasionally woolly or cottony hairs may protrude from this pore. Histologically, trichofolliculomas are characterized by a central dilated follicle filled with keratin or hair. Radiating from this primary hair follicle are numerous secndary hair follicles of varying degrees of maturation. An organized fibro-vascular stroma surrounds these epithelial structure, giving it a well-defined nodular appearance. We presented here two case of trichofolliculoma with typical clnical and histopathological findings, one in a 65 year-old female and the other a 56 year-old males.
Aged ; Female ; Hair ; Hair Follicle ; Head ; Humans ; Male ; Middle Aged ; Neck ; Nevus

Trichofolliculoma is an adnexal tumor of hair follicle oriyin, considered to be of intermediate differentiation between a hair follicle nevus, a simple hyperolasia of the hair follicle, and trichoepithelioma, Which usually lacks mature hair follicles. Grossly the tumor usually appears on the head or neck as a 0.5 to 1.0cm solitary white to pearly papule, Many lesions show a cental pore, and occasionally woolly or cottony hairs may protrude from this pore. Histologically, trichofolliculomas are characterized by a central dilated follicle filled with keratin or hair. Radiating from this primary hair follicle are numerous secndary hair follicles of varying degrees of maturation. An organized fibro-vascular stroma surrounds these epithelial structure, giving it a well-defined nodular appearance. We presented here two case of trichofolliculoma with typical clnical and histopathological findings, one in a 65 year-old female and the other a 56 year-old males.
Aged ; Female ; Hair ; Hair Follicle ; Head ; Humans ; Male ; Middle Aged ; Neck ; Nevus

Although most of the known pathogenic mutations in the progranulin gene (PGRN) are null mutations leading to a reduction in the serum PGRN protein levels, missense mutations also have been identifi ed in patients with frontotemporal lobar degeneration and in patients with Alzheimer disease. Among these, p.R564C mutation was identifi ed in a late-onset AD patient with a reduced serum PGRN level. However, recently, we found the p.R564C mutation in a healthy control subject raising doubts whether this is a pathogenic mutation. In this report, we measured the serum PGRN levels in 20 subjects without the p.R564C mutation and in one subject with the p.R564C mutation, to determine whether the p.R564C mutation is associated with reduced serum PGRN levels. We found that the serum PGRN level in the subject with the p.R564C mutation was not reduced compared to the subjects without the p.R564C mutation. Our result reiterates that p.R564C may not be a pathogenic mutation.

We report a rare case of multiple intracerebral hemorrhage, subarachnoid hemorrhage, and intraventricular hemorrhage that developed after successful cardiopulmonary resuscitation (CPR). A 66-year-old man underwent CPR for about 10 minutes in his community hospital. At that time, his only sequela was ST depression in leads V3, and V4 with an ECG. There was no definite parenchymal lesion in the brain computed tomography (CT) scan taken in the community hospital, and the patient was transferred to Wonju christian hospital for post-resuscitation management. Upon arrival, echocardiographic findings showed akinesia of the anterior wall and anteroseptal wall together with decreased ejection fraction (34%). A cardiac enzyme assay showed a CK-MB concentration of 19.4 ng/ml and a troponin-I level of 1.66 ng/ml. He was mentally comatose and both pupils were isocoric and reflexive to light. We concluded that the cause of cardiac arrest was acute myocardial infarction (AMI), and the patient was treated with drugs including aspirin, clopidogrel, enoxaparin-sodium (1 mg/kg subcutaneous), and isosorbide dinitrate. At 10 hours after admission, a follow-up ECG showed ST elevation in lead I, aVL and all leads from V1 to V6. Right anisocoria was seen in neurologic examination at that time. A subsequent brain CT revealed multiple intracerebral hemorrhage, subarachnoid hemorrhage into all cisternal spaces, and intraventricular hemorrhage. Clotting evaluations yielded a prothrombin time (PT) of 14.6 sec., partial thromboplastin time (PTT) of 45.3 sec. and an INR of 1.32, and a hemoglobin count of 16.2 g/dL.
Aged ; Anisocoria ; Aspirin ; Brain ; Cardiopulmonary Resuscitation ; Cerebral Hemorrhage ; Coma ; Depression ; Electrocardiography ; Enoxaparin ; Enzyme Assays ; Follow-Up Studies ; Heart Arrest ; Hemoglobins ; Hemorrhage ; Hospitals, Community ; Humans ; International Normalized Ratio ; Intracranial Hemorrhages ; Isosorbide Dinitrate ; Light ; Myocardial Infarction ; Neurologic Examination ; Partial Thromboplastin Time ; Prothrombin Time ; Pupil ; Reflex ; Resuscitation ; Subarachnoid Hemorrhage ; Ticlopidine ; Troponin I

Both genetic and environmental factors play important roles in the pathogenesis of Parkinson Disease (PD). The contribution of many environmental factors including dietary factor remains unproven. The purpose the study was to investigate the dietary habits, nutrient intake and dietary quality of Korean PD patients according to the duration of disease. PD patients were recruited from K and S university hospitals from May 2005 to January 2006. This study was carried out after approval by the Institute Review Board (IRB). British Brain Bank criteria was used to diagnose PD. The subjects were classified into 2 groups based on the duration of PD: < 25 months and > or = 25 months groups. General characteristics, anthropometric measurements, food habits and dietary intakes were investigated. The results of this study were as follows: 1) The mean age of < 25 months group (66.9 +/-8.0 yr) was significantly higher than that of > or = 25 months group (62.2 +/- 8.8 yr) (p < 0.05). No significant differences were found for academic background, occupation, living status and social activity, however, numbers of diseases, exercise and family history of PD were significantly different. 2) Anthropometric measurements were not different between the two groups. 3) The frequency of taking snacks was significantly higher in <25 months group and the amounts of alcohol consumption were significantly higher in > or = 25 months group. 4) Daily intakes of most nutrients were very low compared with DRI. 5) The MAR score was significantly lower in < 25 months group (p < 0.05;) however, the scores of DVS, DDS and DQI were not significantly different. As a conclusion an overall nutrient intake and dietary quality of the Parkinson's Disease patients need to be improved regardless of duration of the disease and a well-balanced diet should be emphasized.
Alcohol Drinking ; Brain ; Diet ; Food Habits ; Hospitals, University ; Humans ; Nutritional Status ; Occupations ; Parkinson Disease ; Snacks

Both genetic and environmental factors play important roles in the pathogenesis of Parkinson Disease (PD). The contribution of many environmental factors including dietary factor remains unproven. The purpose the study was to investigate the dietary habits, nutrient intake and dietary quality of Korean PD patients according to the duration of disease. PD patients were recruited from K and S university hospitals from May 2005 to January 2006. This study was carried out after approval by the Institute Review Board (IRB). British Brain Bank criteria was used to diagnose PD. The subjects were classified into 2 groups based on the duration of PD: < 25 months and > or = 25 months groups. General characteristics, anthropometric measurements, food habits and dietary intakes were investigated. The results of this study were as follows: 1) The mean age of < 25 months group (66.9 +/-8.0 yr) was significantly higher than that of > or = 25 months group (62.2 +/- 8.8 yr) (p < 0.05). No significant differences were found for academic background, occupation, living status and social activity, however, numbers of diseases, exercise and family history of PD were significantly different. 2) Anthropometric measurements were not different between the two groups. 3) The frequency of taking snacks was significantly higher in <25 months group and the amounts of alcohol consumption were significantly higher in > or = 25 months group. 4) Daily intakes of most nutrients were very low compared with DRI. 5) The MAR score was significantly lower in < 25 months group (p < 0.05;) however, the scores of DVS, DDS and DQI were not significantly different. As a conclusion an overall nutrient intake and dietary quality of the Parkinson's Disease patients need to be improved regardless of duration of the disease and a well-balanced diet should be emphasized.
Alcohol Drinking ; Brain ; Diet ; Food Habits ; Hospitals, University ; Humans ; Nutritional Status ; Occupations ; Parkinson Disease ; Snacks

Background and Objectives: This study aimed to examine factors of poor outcome by analyzing the outcomes of bilateral subthalamic deep brain stimulation in Parkinson’s disease after 3 years. Methods: We assumed that patients who could not manage independent life in their best stimulationon/medication-on condition after a defi ned period might not have been a good surgical candidate. A poor outcome is defi ned as a failure to maintain functional independence at three years during a stimulation-on/medication-on state. Results: A total of 84 patients underwent bilateral subthalamic deep brain stimulation and all were followed up for 3 years. We excluded one patient who had intracranial hemorrhage. Twenty-one patients of the 83 patients could not keep up independent life even during their best condition for the following reasons: freezing in 15 patients, dementia in 5, depression in 3, musculoskeletal problems in 7, and cancer in one patient. Conclusions: Many patients could not keep up independent life during their best condition as early as three years after deep brain stimulation. Musculoskeletal problems were one major cause of disabilities, as were freezing and dementia. We emphasize that musculoskeletal problems need more attention in the preoperative screening of deep brain stimulation candidates and during the follow up.

The clinical features of corticobasal degeneration (CBD) are quite asymmetric. The severity of clinical symptoms and dopamine transporter (DAT) bindings were less correlated compared to other parkinsonisms, suggesting that presynaptic nigrostriatal dopaminergic dysfunction may not explain extrapyramidal manifestations in CBD. Therefore we wanted to reexamine asymmetry and severity between DAT imaging and clinical findings. We studied patients meeting the diagnostic criteria for CBD based on clinical features. We collected their clinical information and imaging retrospectively. Seven patients were enrolled and all had asymmetric rigidity, bradykinesia and unilateral limb dystonia. These symptoms did not improve with levodopa. All patients showed symptoms bilaterally in the last visit, but asymmetry of clinical symptoms was remarkable at the time of DAT imaging. The DAT bindings were decreased in six subjects. However, one patient showed normal DAT binding. Four patients had a more evident DAT reduction on the side contralateral to the more clinically affected side, however, two patients had a more prominent reduction on the ipsilateral side. The symptoms that we regard as parkinsonian features in CBD are not only explained by presynaptic dopaminergic dysfunction. Our findings suggest that postsynaptic dopaminergic or nondopaminergic systems may play a major role in parkinsonian symptoms in corticobasal syndrome.
Parkinsonian Disorders