Relationship Between Deep Vein Thrombosis and Lower Limb Swelling in Patients with Brain Lesions

The objective was to identify the correlation between the sign of lower limb swelling and unilateral deep vein thrombosis (DVT) in patients with brain lesions. A total of 194 patients, between May 12th, 2011 and December 30th, 2015, who had initially elevated plasma D-dimer level (> 0.55 mg/L) and underwent enhanced DVT computed tomography (CT) were recruited in this study. The circumference of bilateral lower limbs in CT image, below 10 cm and above 15 cm from the prominence of tibial tuberosity, were measured by a single intra-observer using NIH ImageJ software. The difference of 2 cm or more between both sides was considered as significant swelling. We also evaluated patients' range of mobility and cognitive function and its relation to lower limb swelling in DVT in patients with brain lesions. Thirty-five patients were diagnosed with DVT. The presence of lower limb swelling was not statistically significant between patients with DVT and those without DVT in the proximal limb (p = 0.330) and distal limb (p = 0.405). In DVT patients (n = 35), there was no statistically significant correlation between lower limb swelling and other covariates of the patient group. There was no statistically significant correlation between lower limb circumference and DVT.

Lipoma Compressing the Sciatic Nerve in a Patient With Suspicious Central Post-stroke Pain

Lipomas are mostly located in the subcutaneous tissues and rarely cause symptoms. Occasionally, peripheral nerve compression by lipomas is reported. We describe a case of a 59-year-old man with a left-middle cerebral artery infarction who was newly diagnosed as right basal ganglia and thalamic intracranial hemorrhage. He had neuropathic pain in the left arm and leg that was suspected to be central post-stroke pain. The administration of pain medication brought only temporary symptom relief. Nerve conduction and electromyography studies revealed left L5 radiculopathy and he showed a positive ‘sign of the buttock’ in the left hip. Left-hip magnetic resonance imaging revealed an intermuscular lipoma compressing the sciatic nerve. After surgery, the range of motion in the left hip joint was significantly increased, and the patient's pain was relieved.

Determination of Injection Site in Flexor Digitorum Longus for Effective and Safe Botulinum Toxin Injection

OBJECTIVE: To determine the optimal injection site in the flexor digitorum longus (FDL) muscle for effective botulinum toxin injection. METHODS: Fourteen specimens from eight adult Korean cadavers were used in this study. The most proximal medial point of the tibia plateau was defined as the proximal reference point; the most distal tip of the medial malleolus was defined as the distal reference point. The distance of a line connecting the proximal and distal reference points was defined as the reference length. The X-coordinate was the distance from the proximal reference point to the intramuscular motor endpoint (IME), or motor entry point (MEP) on the reference line, and the Y-coordinate was the distance from the nearest point from MEP on the medial border of the tibia to the MEP. IME and MEP distances from the proximal reference point were evaluated using the raw value and the X-coordinate to reference length ratio was determined as a percentage. RESULTS: The majority of IMEs were located within 30%-60% of the reference length from the proximal reference point. The majority of the MEPs were located within 40%-60% of the reference length from the proximal reference point. CONCLUSION: We recommend the anatomical site for a botulinum toxin injection in the FDL to be within a region 30%-60% of the reference length from the proximal reference point.

Automatic Attentional Bias in Individuals with Somatization Tendencies : An Event-Related Potential Study / 신경정신의학

OBJECTIVES: The purpose of this study was to examine the automatic attentional bias to disease/body-related stimuli in individuals exhibiting somatization tendencies using Event-Related Potential (ERP). METHODS: The participants were classified according to somatization and control groups based on the somatization symptom scales of the Symptom Checklist-90-Revised and Somatosensory Amplification Scale scores. ERP were recorded in the somatization and control groups while participants were performing the task to respond with neutral (standard stimuli) or disease/body-related words (target stimuli). We compared N100, P200, and P300 ERP components between the two groups. RESULTS: In the somatization group, the reaction times to disease/body-related words were faster than for neutral words. In ERP analysis, N100 to standard stimuli was not observed in the somatization group. The somatization group showed higher P200 and P300 amplitudes to target stimuli than standard stimuli. On the contrary, in the control group, no difference in P200 and P300 amplitudes was observed between target and standard stimuli. CONCLUSION: It is suggested that individuals exhibiting somatization tendencies have automatic attentional bias to disease/body-related stimuli and interpret disease/body-related stimuli as self-relevant stimuli.

Three Cases of Perforating Disorder / 대한피부과학회지

The perforating disorders comprise a group of unrelated pathologic abnormalities sharing the common characteristic of transepidermal elimination. This phenomenon is characterized by the elimination or extrusion of altered dermal substances and, in some cases, by such material behaving as foreign material. Traditionally, four diseases have been included in this group: Kyrle's disease, perforating folliculitis, reactive perforating collagenosis, elastosis perforans serpiginosum. We describe three cases of perforating disorder which showed different clinical and histopathological figures.