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Objective@#Cortical iron deposition has recently been shown to occur in Alzheimer’s disease (AD). In this study, we aimed to evaluate how cortical gray matter iron, measured using quantitative susceptibility mapping (QSM), differs in the clinical cognitive impairment spectrum. @*Materials and Methods@#This retrospective study evaluated 73 participants (mean age ± standard deviation, 66.7 ± 7.6 years;52 females and 21 males) with normal cognition (NC), 158 patients with mild cognitive impairment (MCI), and 48 patients with AD dementia. The participants underwent brain magnetic resonance imaging using a three-dimensional multi-dynamic multi-echo sequence on a 3-T scanner. We employed a deep neural network (QSMnet+) and used automatic segmentation software based on FreeSurfer v6.0 to extract anatomical labels and volumes of interest in the cortex. We used analysis of covariance to investigate the differences in susceptibility among the clinical diagnostic groups in each brain region.Multivariable linear regression analysis was performed to study the association between susceptibility values and cognitive scores including the Mini-Mental State Examination (MMSE). @*Results@#Among the three groups, the frontal (P < 0.001), temporal (P = 0.004), parietal (P = 0.001), occipital (P < 0.001), and cingulate cortices (P < 0.001) showed a higher mean susceptibility in patients with MCI and AD than in NC subjects. In the combined MCI and AD group, the mean susceptibility in the cingulate cortex (β = -216.21, P = 0.019) and insular cortex (β = -276.65, P = 0.001) were significant independent predictors of MMSE scores after correcting for age, sex, education, regional volume, and APOE4 carrier status. @*Conclusion@#Iron deposition in the cortex, as measured by QSMnet+, was higher in patients with AD and MCI than in NC participants. Iron deposition in the cingulate and insular cortices may be an early imaging marker of cognitive impairment related neurodegeneration.
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Background@#Texture analysis may capture subtle changes in the gray matter more sensitively than volumetric analysis. We aimed to investigate the patterns of neurodegeneration in semantic variant primary progressive aphasia (svPPA) and Alzheimer’s disease (AD) by comparing the temporal gray matter texture and volume between cognitively normal controls and older adults with svPPA and AD. @*Methods@#We enrolled all participants from three university hospitals in Korea. We obtained T1-weighted magnetic resonance images and compared the gray matter texture and volume of regions of interest (ROIs) between the groups using analysis of variance with Bonferroni posthoc comparisons. We also developed models for classifying svPPA, AD and control groups using logistic regression analyses, and validated the models using receiver operator characteristics analysis. @*Results@#Compared to the AD group, the svPPA group showed lower volumes in five ROIs (bilateral temporal poles, and the left inferior, middle, and superior temporal cortices) and higher texture in these five ROIs and two additional ROIs (right inferior temporal and left entorhinal cortices). The performances of both texture- and volume-based models were good and comparable in classifying svPPA from normal cognition (mean area under the curve [AUC] = 0.914 for texture; mean AUC = 0.894 for volume). However, only the texture-based model achieved a good level of performance in classifying svPPA and AD (mean AUC = 0.775 for texture; mean AUC = 0.658 for volume). @*Conclusion@#Texture may be a useful neuroimaging marker for early detection of svPPA in older adults and its differentiation from AD.
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Purpose@#: This descriptive survey investigated the effects of clinical nurses’ critical reflection competency, professional pride, and person-centered care practices on patient safety management activities. @*Methods@#: The participants were 183 clinical nurses working at a tertiary hospital in South Korea. The questionnaires consisted of the Critical Reflection Competency Scale for Clinical Nurses Professional Pride the Person-Centered Nursing Assessment Tool and Patient Safety Management Activities. The collected data were analyzed using descriptive statistics, t-tests, ANOVA, Tukey’s HSD, Pearson’s correlation coefficient, and multiple regression using SPSS 29.0. @*Results@#: The mean score for patient safety management activities was 4.65±0.34 out of 5. There were significant differences in patient safety management activities according to age (F=3.90, p=.010), education level (t=-2.56, p=.013), total work experience (F=3.87, p=.010), and the number of healthcare accreditation system experiences (F=5.22, p=.006). Patient safety management activities were positively correlated with critical reflection competency (r=.337, p＜.001), professional pride (r=.271, p＜.001), and person-centered care practices (r=.399, p＜.001). The results indicated that person-centered care practices affected patient safety management activities (β=.358, p＜.001) with the explanatory power of 22.5%. @*Conclusion@#: To improve clinical nurses’ patient safety management activities, it is necessary to develop participatory educational programs that can integrate skills and attitudes based on conceptual knowledge of person-centered care. Intervention studies are needed to test the effect of person-centered care on patient safety when applied in clinical practice.
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Purpose@#Diabetes mellitus (DM) is implicated in the pathogenesis of iron dysregulation and Alzheimer’s disease. We aimed to evaluate whether the presence of DM and status of cognitive impairment affect cortical iron accumulation in older adults, as quantified by the susceptibility measurements using the deep neural network QSMnet+. @*Materials and Methods@#In this retrospective analysis of a prospective cohort, 50 patients with normal cognition with or without subjective memory impairment (controls), 49 with early mild cognitive impairment (MCI), and 43 with late MCI were evaluated. We employed QSMnet+ to compute a quantitative susceptibility map and FreeSurfer 6.0 to obtain anatomical labels. The effects of MCI and DM on cortical susceptibility and volume were evaluated using a two-way analysis of covariance. @*Results@#Whole-cortex susceptibility differed according to MCI (p < 0.001) but not according to DM (p = 0.554), with higher values in the early and late MCI groups than in the control group. MCI and the DM status showed a significant interaction in the whole cortex (p = 0.023). Among the patients with early MCI, those with DM exhibited higher cortical susceptibility than those without DM, whereas those with late MCI showed no such difference. Cortical susceptibility did not correlate with the cortical volume in patients with DM and inversely correlated with the cortical volume in patients without DM. Only disease status (p = 0.008) and DM (p = 0.023) were independent predictors of whole-cortex susceptibility, after correcting for covariates. @*Conclusion@#Our findings demonstrated that cognitive impairment and DM are linked to alterations in cortical susceptibility in older adults. This observation suggests that cortical iron accumulation results from the combined effects of DM and neurodegenerative processes related to the cognitive status.
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This study aimed to examine the distribution of gastrointestinal parasitic infections in domestic pigs in the Republic of Korea. From May 2020 to October 2021, 364 pig fecal samples were collected from 75 farms in 7 Provinces and microscopically examined. A total of 170 (46.7%) pigs were infected with at least one of the following parasites: Balantioides coli, strongyles, Ascaris suum, Trichuris suis, and coccidia. By parasite species, B. coli, strongyles, A. suum, T. suis, and coccidia oocysts or eggs were detected in 144 (39.6%), 24 (6.6%), 14 (3.8%), 4 (1.1%), and 1 (0.3%) samples, respectively. One hundred fifty-four, 15, and 1 cases showed single, double, and triple infections, respectively. Of the swine fecal samples from 75 farms, 69 specimens (92.0%) were infected with 1 or more parasites. All surveyed farms across the country exhibited a positive rate of over 30%, among which the highest positive rate was 65.0% in Chungcheongnam-do, and Jeollabuk-do was followed by 61.9%. Winter showed a statistically lower prevalence than other seasons. This study showed that gastrointestinal parasites are prevalent in pigs in Korea, although the diversity of parasites is low.
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Background@#and Purpose Both hypertension and hypotension increase cerebral white matter hyperintensities. However, the effects of hypotension in individuals with treated hypertension are unknown. We analyzed the association of low blood pressure with the location and amount of white matter hyperintensities between elderly individuals with controlled hypertension and those without hypertension. @*Methods@#We enrolled 505 community-dwelling, cognitively normal elderly individuals from the participants of the Korean Longitudinal Study on Cognitive Aging and Dementia. We measured blood pressure three times in a sitting position using a mercury sphygmomanometer and defined low systolic and diastolic blood pressure as ≤110 and ≤60 mm Hg, respectively. We segmented and quantified the periventricular and deep white matter hyperintensities from 3.0 Tesla fluid-attenuated inversion recovery magnetic resonance images. @*Results@#Low systolic blood pressure was independently associated with larger volume of periventricular white matter hyperintensity (P=0.049). The interaction between low systolic blood pressure and hypertension was observed on the volume of periventricular white matter hyperintensity (P=0.005). Low systolic blood pressure was associated with the volume of periventricular white matter hyperintensity in individuals with controlled hypertension (F1,248=6.750, P=0.010), but not in those without hypertension (P=0.380). Low diastolic blood pressure was not associated with the volumes of white matter hyperintensities regardless of presence of controlled hypertension. @*Conclusions@#Low systolic blood pressure seems to be associated with larger volume of periventricular white matter hyperintensity in the individuals with a historyof hypertension but not in those without hypertension.
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OBJECTIVES@#Mild cognitive impairment (MCI) patients show decreased semantic memory-processing ability including that for naming objects. We examined event-related potentials (ERPs) associated with the semantic processing of MCI patients and compared their ERPs to those of cognitively normal elderly subjects.@*METHODS@#A total of 25 MCI patients and 23 age-matched cognitively normal elderly controls (CN) participated in an object-word matching task that consisted of responding to whether a word stimulus matched the picture stimulus preceding it. There were three types of object-name pairs: 1) matched pair, 2) related but mismatched pair, and 3) unrelated mismatched pair. We compared the mean amplitude of ERPs to examine the mismatch effects between matched and mismatched pairs (N400M) and the category effect between inner category and outer category mismatched words (N400C) in CN and MCI patients.@*RESULTS@#Compared to the CN subjects, the MCI patients showed a distinct N400M response to mismatch conditions, but the observed range was limited in the centroparietal area. While CN individuals showed a significantly larger N400C amplitude for unrelated mismatch pairs than those for related mismatch pairs, MCI patients exhibited no significant difference between those pair types.@*CONCLUSION@#The MCI showed a lack of the category effects in ERP responses, which may reflect latent behavioral impairments.
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PURPOSE: In the present case report, visual pathway damage confirmed by retinal ganglion cell layer (GCL) damage on optical coherence tomography (OCT) in occipital lobe epilepsy was described. CASE SUMMARY: A 25-year-old female with idiopathic generalized epilepsy developed visual blurring followed by a generalized seizure. On brain magnetic resonance imaging (MRI), very subtle changes of the cortex in the left parietooccipital lobe were observed. Two days after the attack, even after the disappearance of epileptiform wave on electroencephalogram (EEG), visual acuity in both eyes was 0.5 and a perimetry revealed nearly complete visual defect in both eyes. OCT showed severe thinning of GCL and mild thinning of retinal nerve fiber layer (RNFL). No additional seizure attack occurred thereafter. One month after the attack, her visual acuity was recovered to 1.0 in both eyes and her left visual hemifield defect was recovered. However, even 6 months after the attack, her right visual hemifield defect and GCL damage persisted in both eyes. CONCLUSIONS: We reported a case in which the visual pathway damage caused by occipital lobe epilepsy was identified using OCT, despite very subtle changes in brain imaging. This case indicated GCL thinning is an objective and prognostic index for the irreversible visual field defect in occipital lobe epilepsy.
Subject(s)
Adult , Female , Humans , Brain , Electroencephalography , Epilepsies, Partial , Epilepsy, Generalized , Magnetic Resonance Imaging , Nerve Fibers , Neuroimaging , Occipital Lobe , Retinal Ganglion Cells , Retinaldehyde , Seizures , Tomography, Optical Coherence , Visual Acuity , Visual Field Tests , Visual Fields , Visual PathwaysABSTRACT
BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease that is a significant source of morbidity and mortality when it manifests in the central nervous system. The early detection and treatment of neuropsychiatric SLE (NPSLE) is very important, but a confirmative diagnostic tool has yet to be developed. CASE REPORT: We report here a case of neuropsychiatric manifestations in a patient that were associated with SLE, and evidence of reversal of bilateral amygdala and parahippocampal lesions in the brain revealed by 18fluorodeoxy glucose-positron emission tomography. CONCLUSIONS: We are suggestive of 18fluorodeoxy glucose-positron emission tomography appear to be more sensitive in detecting subtle brain changes in NPSLE.