Association Between Gait and Dysautonomia in Patients With De Novo Parkinson’s Disease: Forward Gait Versus Backward Gait

Objective@#Studies on gait and autonomic dysfunction have been insufficient so far, particularly de novo Parkinson’s disease (PD). The aim of this study was to identify the association between gait dynamics and autonomic dysfunction in patients with de novo PD. @*Methods@#A total 38 patients with de novo PD were retrospectively included in this study. Details of patients’ dysautonomia were assessed using the Scales for Outcomes in Parkinson’s Disease-Autonomic Dysfunction (SCOPA-AUT). For assessment of gait, a computerized gait analysis was performed using the GAITRite system for forward gait and backward gait. High SCOPA-AUT score (PD-HSAS) group and low SCOPA-AUT score (PD-LSAS) group were identified according to their SCOPA-AUT scores. @*Results@#Nineteen (50%) patients with high SCOPA-AUT scores above median value (12.5) were assigned into the PD-HSAS group and others were assigned to the PD-LSAS group. Compared with the PD-LSAS group, the PD-HSAS group exhibited slower gait, shorter stride, decreased cadence, increased double support phase, decreased swing phase, and increased variability in swing time. Total SCOPA-AUT score showed significantly positive correlations with gait variability and instability but a negative correlation with gait hypokinesia. In subdomain analysis, urinary dysautonomia was highly associated with impairment of gait dynamics. All significant results were found to be more remarkable in backward gait than in forward gait. @*Conclusion@#Our findings suggest that alteration in gait dynamics, especially backward gait, is highly associated with autonomic dysfunction in patients with de novo PD.

Clinical Characteristics of Involuntary Movement in Hospitalized Patients

OBJECTIVE: Neurological symptoms in hospitalized patients are not rare, and neurological consultation for movement disorders is especially important in evaluating or managing those with various movement disorders. Therefore, we investigated a clinical pattern of in-hospital consultations for various movement disorders in a tertiary care university hospital. METHODS: Over two years, a total of 202 patients (70.7 ± 11.8 years of age) presenting with movement disorders referred to movement disorder specialists were investigated. RESULTS: The main symptoms referred by nonneurologists were tremor (56.9%), parkinsonism (16.8%), and gait disturbance (8.9%). The most frequent diagnostic category was toxic/metabolic-caused movement disorder (T/MCMD) (35%) with regard to medications, followed by Parkinson’s disease (PD) (16%). Regarding the mode of onset, T/MCMD was the leading cause for acute (68%) and subacute onset (46%), while PD was the leading disorder (31%) for chronic onset. CONCLUSION: The current study showed a characteristic pattern of inpatients presenting with movement disorders. Furthermore, our findings highlighted the clinical significance of drug use or metabolic problems for treating this patient population.

Probable Creutzfeldt-Jakob Disease Presenting as Progressive Supranuclear Palsy

Progressive supranuclear palsy (PSP) is a clinical syndrome comprising vertical supranuclear palsy, parkinsonism, postural instability, and mild dementia. Other disorders can present with similar clinical pictures. In this report we describe a case of Creutzfeldt-Jakob disease (CJD) presenting with the PSP and discuss which features may help to prevent misdiagnosis. To the best of our knowledge, this is the first report of CJD presenting with PSP syndrome in Korea.

Methanol Intoxication With Delayed Extensive Bilateral Subcortical Hemorrhage

The most characteristic radiological finding following methanol intoxication is bilateral necrosis of the putamina with varying degrees of hemorrhage. We report here on a 61-year-old Russian male with methanol intoxication who had delayed cerebral hemorrhage with a fatal course. The magnetic resonance image taken on admission revealed diffusion restriction lesions in the bilateral putamina, thalamus, and frontal and occipital subcortical white matter, without hemorrhage. Brain computed tomography performed on the 18th day revealed extensive bilateral hemorrhage in the multiple subcortical white matter, which led ultimately to death.

The Influence of Propofol Concentration on the Generation of Reactive Oxygen Species after Reoxygenation in Rat Embryonic Heart H9c2 Cell / 대한마취과학회지

BACKGROUND: Reoxygenation of an ischemic heart causes a decrease in the cardiac function, which is known as reperfusion injury that is associated with an increase in the concentration of reactive oxygen species (ROS). This study examined the effect of the propofol concentration on the generation of ROS during reoxygenation in rat embryonic heart H9c2 cells. METHODS: Cultured H9c2 cells were examined in the following sequences: Prehypoxic, Hypoxic and Reoxygenation period. Each period required 60 minutes. The cells were exposed to propofol at the beginning of the prehypoxic period. Thirty minutes later, DCFH-DA (dichlorofluorescin diacetate) 10 micrometer was added to detect the ROS. The propofol concentrations used were 0, 5, 25, 50, 250 micrometer in the first experiment and 0, 1, 2, 3, 4, 5 micrometer in the second experiment. The ROS level was estimated using a fluorometer at 5-minute intervals from 5 to 60 minutes after reoxygenation. RESULTS: When the propofol concentrations was > 5 micrometer, the ROS levels were significantly lower than those of the untreated group (P0) (P 5 micrometer inhibited ROS production over the whole period, and even 1micrometer showed some inhibition of ROS.

Delayed Radiation Myelopathy: Serial Changes of MRI Findings

It is very difficult to differentiate radiation myelopathy from metastatic intramedullary spinal cord tumor. We described a case of chronic progressive radiation myelopathy, in which serial magnetic resonance imaging was of great value for the differential diagnosis.

Two Cases with Subacute Combined Degeneration Showing High Signal Lesion of the Spinal Cord on MR Imaging

No abstract available.