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1.
Neurointervention ; : 78-85, 2016.
Article in English | WPRIM | ID: wpr-730322

ABSTRACT

PURPOSE: To assess patient radiation doses during cerebral angiography and embolization of intracranial aneurysms across multi-centers and propose a diagnostic reference level (DRL). MATERIALS AND METHODS: We studied a sample of 490 diagnostic and 371 therapeutic procedures for intracranial aneurysms, which were performed at 23 hospitals in Korea in 2015. Parameters including dose-area product (DAP), cumulative air kerma (CAK), fluoroscopic time and total angiographic image frames were obtained and analyzed. RESULTS: Total mean DAP, CAK, fluoroscopy time, and total angiographic image frames were 106.2 ± 66.4 Gy-cm2, 697.1 ± 473.7 mGy, 9.7 ± 6.5 minutes, 241.5 ± 116.6 frames for diagnostic procedures, 218.8 ± 164.3 Gy-cm², 3365.7 ± 2205.8 mGy, 51.5 ± 31.1 minutes, 443.5 ± 270.7 frames for therapeutic procedures, respectively. For diagnostic procedure, the third quartiles for DRLs were 144.2 Gy-cm² for DAP, 921.1 mGy for CAK, 12.2 minutes for fluoroscopy times and 286.5 for number of image frames, respectively. For therapeutic procedures, the third quartiles for DRLs were 271.0 Gy-cm² for DAP, 4471.3 mGy for CAK, 64.7 minutes for fluoroscopy times and 567.3 for number of image frames, respectively. On average, rotational angiography was used 1.5 ± 0.7 times/session (range, 0-4; n=490) for diagnostic procedures and 1.6 ± 1.2 times/session (range, 0-4; n=368) for therapeutic procedures, respectively. CONCLUSION: Radiation dose as measured by DAP, fluoroscopy time and image frames were lower in our patients compared to another study regarding cerebral angiography, and DAP was lower with fewer angiographic image frames for therapeutic procedures. Proposed DRLs can be used for quality assurance and patient safety in diagnostic and therapeutic procedures.


Subject(s)
Angiography , Cerebral Angiography , Fluoroscopy , Humans , Intracranial Aneurysm , Korea , Patient Safety , Radiation Exposure
2.
Article in English | WPRIM | ID: wpr-228620

ABSTRACT

OBJECTIVE: To assess patient radiation doses during cerebral angiography and embolization of intracranial aneurysms in a large sample size from a single center. MATERIALS AND METHODS: We studied a sample of 439 diagnostic and 149 therapeutic procedures for intracranial aneurysms in 480 patients (331 females, 149 males; median age, 57 years; range, 21-88 years), which were performed in 2012 with a biplane unit. Parameters including fluoroscopic time, dose-area product (DAP), and total angiographic image frames were obtained and analyzed. RESULTS: Mean fluoroscopic time, total mean DAP, and total image frames were 12.6 minutes, 136.6 +/- 44.8 Gy-cm2, and 251 +/- 49 frames for diagnostic procedures, 52.9 minutes, 226.0 +/- 129.2 Gy-cm2, and 241 frames for therapeutic procedures, and 52.2 minutes, 334.5 +/- 184.6 Gy-cm2, and 408 frames for when both procedures were performed during the same session. The third quartiles for diagnostic reference levels (DRLs) were 14.0, 61.1, and 66.1 minutes for fluoroscopy time, 154.2, 272.8, and 393.8 Gy-cm2 for DAP, and 272, 276, and 535 for numbers of image frames in diagnostic, therapeutic, and both procedures in the same session, respectively. The proportions of fluoroscopy in DAP for the procedures were 11.4%, 50.5%, and 36.1%, respectively, for the three groups. The mean DAP for each 3-dimensional rotational angiographic acquisition was 19.2 +/- 3.2 Gy-cm2. On average, rotational angiography was used 1.4 +/- 0.6 times/session (range, 1-4; n = 580). CONCLUSION: Radiation dose in our study as measured by DAP, fluoroscopy time and image frames did not differ significantly from other reported DRL studies for cerebral angiography, and DAP was lower with fewer angiographic image frames for embolization. A national registry of radiation-dose data is a necessary next step to refine the dose reference level.


Subject(s)
Adult , Aged , Aged, 80 and over , Cerebral Angiography , Databases, Factual , Embolization, Therapeutic , Female , Fluoroscopy , Humans , Intracranial Aneurysm/diagnosis , Male , Middle Aged , Patients , Radiation Dosage , Retrospective Studies
3.
Article in English | WPRIM | ID: wpr-74086

ABSTRACT

OBJECTIVE: A small branch-incorporated aneurysm is an aneurysm with a small branch incorporated into the sac or the neck. It is one of the most difficult aneurysms to treat with coil embolization. The aim of this study was to evaluate the safety and effectiveness of the coil-protected embolization technique for small-branch incorporated aneurysm. MATERIALS AND METHODS: Fourteen aneurysms (2 ruptured and 12 unruptured) in 12 patients (mean age, 56 years, range, 40-73 years; 6 men and 6 women) were treated with the coil-protected embolization technique during the period between February 2007 and October 2011. Clinical and angiographic outcomes were retrospectively evaluated. RESULTS: All aneurysms were successfully treated without any complications during the procedure. Immediate post-treatment angiographies demonstrated complete or near complete occlusion in 12 and incomplete occlusion in 2 patients. Two patients had a delayed small embolic infarction in the relevant posterior circulation territory and middle cerebral artery territory 10 days and 14 days later, respectively, but both recovered completely or almost completely (modified Rankin scale score [mRS score], 0 and 1, respectively). During the clinical follow-up period (mean, 21 months; range: 2-58 months), all patients reported an mRS score of 0 (n = 10) or 1 (n = 2). Vascular imaging follow-up (catheter angiography: n = 3 and MR angiography: n = 8) was available in 11 aneurysms at 6-12 months. All 11 aneurysms showed complete occlusion except for 1 minor neck recurrence that did not require further treatment. CONCLUSION: In this series of cases, the coil-protected embolization technique seems to be feasible and effective in the treatment of small-branch incorporated aneurysms.


Subject(s)
Adult , Aged , Aneurysm, Ruptured/diagnosis , Embolization, Therapeutic/instrumentation , Female , Humans , Intracranial Aneurysm/diagnosis , Magnetic Resonance Angiography , Male , Middle Aged , Retrospective Studies , Treatment Outcome
4.
Neurointervention ; : 15-22, 2013.
Article in English | WPRIM | ID: wpr-730224

ABSTRACT

PURPOSE: The aim of this study was to evaluate the feasibility and safety of the transfacial venous embolization of cavernous or paracavernous dural arteriovenous fistula (DAVF) in which approach via inferior petrosal sinus (IPS) was not feasible. MATERIALS AND METHODS: We identified the cases of transfacial venous embolization of cavernous sinus (CS) or adjacent dural sinuses from the neurointerventional database of three hospitals. The causes and clinical and angiographic outcomes of transfacial venous embolization were retrospectively evaluated. RESULTS: Twelve patients with CS (n = 11) or lesser wing of sphenoid sinus (LWSS, n = 1) DAVF were attempted to treat by transvenous embolization via ipsilateral (n = 10) or contralateral (n = 2) facial vein. Trans-IPS access to the target lesion was impossible due to chronic occlusion (n = 11) or acute angulation adjacent the target lesion (n = 1). In all twelve cases, it was possible to navigate through facial vein, angular vein, superior ophthalmic vein, and then CS. It was also possible to further navigation to contralateral CS through intercavernous sinus in two cases, and laterally into LWSS in one case. Post-treatment control angiography revealed complete occlusion of the DAVF in eleven cases and partial occlusion in one patient, resulting in complete resolution of presenting symptom in eight and gradually clinical improvement in four patients. There was no treatment-related complication during or after the procedure. CONCLUSION: In the cavernous or paracavernous DAVF in which trans-IPS approach is not feasible, the facial vein seems to be safe and effective alternative route for transvenous embolization.


Subject(s)
Angiography , Arteriovenous Fistula , Cavernous Sinus , Caves , Central Nervous System Vascular Malformations , Humans , Retrospective Studies , Sphenoid Sinus , Veins
5.
Article in English | WPRIM | ID: wpr-100459

ABSTRACT

The authors present a case of isolated dural arteriovenous fistula (DAVF) in the transverse sinus, which developed six years after microvascular decompression caused by hemifacial spasm via suboccipital craniectomy. The lesion was successfully treated by transarterial embolization using Onyx. We reviewed the related radiologic and therapeutic features of DAVF involving an isolated sinus and described the feasibility of the use of Onyx.


Subject(s)
Central Nervous System Vascular Malformations , Hemifacial Spasm , Microvascular Decompression Surgery
6.
Article in English | WPRIM | ID: wpr-11975

ABSTRACT

We report a patient with a ruptured vertebral artery (VA) dissecting aneurysm that was treated by internal trapping of the aneurysm and parent artery using detachable coils with subsequent antegrade recanalization of occluded vertebral artery during the follow-up period. A 38-year-old man was admitted with a ruptured right VA dissecting aneurysm just distal to origin of right posterior inferior cerebellar artery. The dissected segment of the VA was occluded by coil embolization. The 14 months follow-up angiography showed that dissected aneurysm was completely occluded, but the parent artery was recanalized in an antegrade fashion. Based on this unique case, the authors suggest that careful angiographic follow-up of dissecting aneurysm is required, even in patients successfully treated with endovascular occlusion of the affected artery and aneurysm.


Subject(s)
Adult , Aneurysm , Aneurysm, Dissecting , Angiography , Arteries , Follow-Up Studies , Humans , Parents , Vertebral Artery
7.
Article in Korean | WPRIM | ID: wpr-34101

ABSTRACT

Pituitary stalk interruption and ectopic neurohypophysis seen on magnetic resonance Imaging (MRI) are often associated with either isolated growth hormone (GH) deficiency or combined anterior pituitary hormone deficiency, but their pathogenesis is not clear and the clinical data regarding these anatomical defect is limited. We experienced a 23-year-old male with the absence of secondary sexual characteristics and this was accompanied with pituitary stalk dysgenesis and ectopic neurohypophysis. He received growth hormone for a year when he was 12 years old due to his short stature. Sella MRI showed no visible pituitary stalk with minimal high signal change, suggesting ectopic neurohypophysis. The combined pituitary stimulation test revealed blunted responses of growth hormone, follicle stimulating hormone and luteinizing hormone. For the hypogonadotropic hypogonadism, the patient was given testosterone intramuscularly and he gradually developed secondary sexual characteristics. We concluded that the hypogonadism and growth hormone deficiency in this patient was caused by hypopituitarism due to pituitary stalk dysgenesis and ecopic nuerohypophysis.


Subject(s)
Follicle Stimulating Hormone , Growth Hormone , Humans , Hypogonadism , Hypopituitarism , Luteinizing Hormone , Magnetic Resonance Imaging , Male , Pituitary Gland , Pituitary Gland, Posterior , Testosterone , Young Adult
8.
Neurointervention ; : 110-114, 2010.
Article in English | WPRIM | ID: wpr-730140

ABSTRACT

We report the case of a 42- year-old woman with spontaneous, right vertebral arteriovenous fistula associated with neurofibromatosis type 1. The patient presented with neck pain, retroauricular bruit, quadriparesis, and cervical spinal cord compression caused by an enlarged epidural vein. Endovascular treatment using coils and a balloon resulted in successful occlusion of the fistula. At six months post-embolization, the patient had improved significantly and was ambulant with support.


Subject(s)
Arteriovenous Fistula , Female , Fistula , Humans , Neck Pain , Neurofibromatoses , Neurofibromatosis 1 , Quadriplegia , Spinal Cord Compression , Veins
9.
Article in English | WPRIM | ID: wpr-201061

ABSTRACT

The patient was a 44-yr-old man with end-stage renal disease who had developed chorea as a result of hypoglycemic injury to the basal ganglia and thalamus and who was subsequently diagnosed with depression and restless legs syndrome (RLS). For proper management, the presence of a complex medical condition including two contrasting diseases, chorea and RLS, had to be considered. Tramadol improved the pain and dysesthetic restlessness in his feet and legs, and this was gradually followed by improvements in his depressed mood, insomnia, lethargy, and feelings of hopelessness. This case suggests that the dopaminergic system participates intricately with the opioid, serotoninergic, and noradrenergic systems in the pathophysiology of RLS and pain and indirectly of depression and insomnia.


Subject(s)
Adult , Analgesics, Opioid/therapeutic use , Anti-Dyskinesia Agents/therapeutic use , Chorea/complications , Citalopram/therapeutic use , Drug Therapy, Combination , Haloperidol/therapeutic use , Humans , Kidney Failure, Chronic/complications , Magnetic Resonance Imaging , Male , Restless Legs Syndrome/complications , Serotonin Uptake Inhibitors/therapeutic use , Tramadol/therapeutic use
10.
Article in English | WPRIM | ID: wpr-43021

ABSTRACT

We report an extremely rare case of a diffuse hepatic hemangiomatosis without extrahepatic involvement in an adult. The imaging findings of this tumor were similar to those of a hepatic hemangioma and included contrast enhancement with a centripetal filling pattern of the entire hepatic tumor on the delayed phase of a dynamic CT and inhomogeneous diffuse uptake of the entire tumor on blood-pool images obtained five hours later on a 99mTc-labeled red blood cell scan. Despite its rarity, diffuse hepatic hemangiomatosis can be suggested in adult patients with diffusely involved hepatic tumors showing the radiological findings of a hepatic hemangioma.


Subject(s)
Adult , Female , Gated Blood-Pool Imaging , Hemangioma/diagnosis , Humans , Liver Neoplasms/diagnosis , Tomography, X-Ray Computed
11.
Article in Korean | WPRIM | ID: wpr-654148

ABSTRACT

Angiofibromas commonly arise in the nasopharynx in adolescent male patients. The individual's history and clinical findings can make primarily the preliminary diagnosis of nasopharyngeal angiofibroma. Primary extranasopharyngeal angiofibromas are very rare, and clinical characteristics do not confirm to that of nasopharyngeal angiofibroma. Therefore, they can present diagnostic challenges. We present a case of extranasopharyngeal angiofibroma arsing from the ethmoid sinus of a 72-year-old man who had been followed up for recurrent epistaxis and nasal stuffiness.The tumor was successfully removed by endoscopic resection and histopathologic examination confirmed the diagnosis. In a 3 year follow up, the patient is free from relapse.


Subject(s)
Adolescent , Aged , Angiofibroma , Diagnosis , Epistaxis , Ethmoid Sinus , Follow-Up Studies , Humans , Male , Nasopharynx , Recurrence
12.
Yonsei Medical Journal ; : 321-324, 2007.
Article in English | WPRIM | ID: wpr-180512

ABSTRACT

Marchiafava-Bignami disease (MBD) is a fatal disorder characterized by demyelination of the corpus callosum. MRI, suggestive of corpus callosum demyelination with associated white matter involvement in both cerebral hemispheres, indicates a diagnosis of MBD. In this case, MR diffusion-weighted findings taken at an acute stage of MBD revealed lesions not only in the corpus callosum but also in the cerebral cortex. Lower apparent diffusion coefficient values of the corpus callosum and cortical lesions were associated with poor clinical outcome.


Subject(s)
Middle Aged , Male , Humans , Demyelinating Diseases/pathology , Corpus Callosum/pathology , Brain/pathology , Alcoholism/complications
13.
Article in Korean | WPRIM | ID: wpr-221801

ABSTRACT

PURPOSE: To evaluate the significance of diffusion weighted imaging (DWI) for the diagnosis of pyogenic ventriculitis. MATERIALS AND METHODS: In this retrospective study, 9 patients with pyogenic ventricultis underwent a set of imaging sequences that included DWI, T1-and T2-weighted imaging, FLAIR and enhanced T1 weighted imaging. DWI consisted of an axial single shot spin echo EPI pulse sequence with b values of 0 and 1000 sec/mm2. We evaluated the presence and signal intensity of ventricular debris, hydrocephalus, periventricular signal abnormality, and ependymal enhancement. The apparent diffusion coffiecient values of ventricular debris and cortical gray matter were calculated from the ADC map. RESULTS: In all patients, ventricular debris was hyperintense on the DWIs. A periventricular hyperintense signal was present in all cases on FLAIR and T2WI. Ependymal enhancement was detected in eight (89%) of 9 cases. A hydrocephalus was observed in 6 (67%) of 9 cases. The mean ADC value of ventricular debris was 0.735 +/- 0.117 (10(-3) mm2/sec). These ADC values were significantly lower than those for cortical gray matter (1.052 +/- 0.149 (10(-3) mm2/sec)). CONCLUSION: Ventricular debris was most conspicuous finding of ventriculitis on DWI. Areas of intraventricular hyperintensity on DWI corresponded to the decreased ADC values.


Subject(s)
Cerebral Ventricles , Diagnosis , Diffusion Magnetic Resonance Imaging , Diffusion , Encephalitis , Humans , Hydrocephalus , Retrospective Studies
14.
Article in English | WPRIM | ID: wpr-182507

ABSTRACT

OBJECTIVE: The purpose of the study was to review the current status of intra-arterial (IA) thrombolysis in Korea by conducting a retrospective analysis of the data from multiple domestic centers. MATERIALS AND METHODS: The radiologists at each participating institution were asked to fill out case report forms on all patients who had undergone IA recanalization due to acute anterior circulation ischemia. These forms included clinical, imaging and procedure-related information. A central reader analyzed the CT/MR and angiographic results. The rates of successful recanalization, hemorrhagic transformation and functional outcome were obtained. The univariate analyses were performed together with the multivariate analysis. RESULTS: We analyzed the data from 163 patients, and they had been treated at seven institutes. The initial imaging modalities were CT for 46 patients (28%), MR for 63 (39%), and both for 54 (33%). Various mechanical treatment methods were applied together in 50% of the patients. Radiologically significant hemorrhage was noted in 20/155 patients (13%). We found various factors that influenced the recanalization rate and the occurrence of significant hemorrhagic transformations. The favorable outcome rate, reported as modified Rankin Scale < or = 2, was 40%, and the mortality rate was 11%. The factors that predicted a poor functional outcome were old age (p = 0.01), initially severe neurological symptoms (p < 0.0001), MR findings of a wide distribution of lesions (p = 0.001), involvement of the basal ganglia (p = 0.01), performance of procedures after working hours (p = 0.01), failure of recanalization (p = 0.003), contrast extravasation after the procedure (p = 0.007) and significant hemorrhagic transformation (p = 0.002). The subsequent multivariate analysis failed to show any statistically significant variable. CONCLUSION: There was a trend toward increased dependency on MR imaging during the initial evaluation and increased usage of combined pharmacologic/mechanical thrombolysis. The imaging and clinical outcome results of this study were comparable to those of the previous major thrombolytic trials.


Subject(s)
Acute Disease , Cerebral Angiography , Cerebral Infarction/diagnosis , Female , Fibrinolytic Agents/administration & dosage , Humans , Injections, Intra-Arterial , Logistic Models , Magnetic Resonance Imaging , Male , Middle Aged , Retrospective Studies , Thrombolytic Therapy/methods , Tomography, X-Ray Computed , Treatment Outcome
15.
Article in English | WPRIM | ID: wpr-174910

ABSTRACT

OBJECTIVE: We wanted to evaluate the role of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) for detecting breast tumors, as compared with the T1- and T2-weighted images. MATERIALS AND METHODS: Forty-one female patients underwent breast MRI, and this included the T1-, T2-, DWI and dynamic contrast-enhanced images. Sixty-five enhancing lesions were detected on the dynamic contrast-enhanced images and we used this as a reference image for detecting tumor. Fifty-six breast lesions were detected on DWI and the histological diagnoses were as follows: 43 invasive ductal carcinomas, one mucinous carcinoma, one mixed infiltrative and mucinous carcinoma, seven ductal carcinomas in situ (DCIS), and four benign tumors. First, we compared the detectability of breast lesions on DWI with that of the T1- and T2-weighted images. We then compared the ADCs of the malignant and benign breast lesions to the ADCs of the normal fibroglandular tissue. RESULTS: Fifty-six lesions were detected via DWI (detectability of 86.2%). The detectabilities of breast lesions on the T1- and T2-weighted imaging were 61.5% (40/65) and 75.4% (49/65), respectively. The mean ADCs of the invasive ductal carcinoma (0.89 +/- 0.18x10(-3)mm2/second) and DCIS (1.17 +/- 0.18x10(-3)mm2/ second) are significantly lower than those of the benign lesions (1.41 +/- 0.56x10(-3)mm2/second) and the normal fibroglandular tissue (1.51 +/- 0.29x10(-3)mm2/ second). CONCLUSION: DWI has a high sensitivity for detecting breast tumors, and especially for detecting malignant breast tumors. DWI was an effective imaging technique for detecting breast lesions, as compared to using the T1- and T2-weighted images.


Subject(s)
Adenocarcinoma, Mucinous/diagnosis , Adult , Aged , Breast/pathology , Breast Neoplasms/diagnosis , Carcinoma, Ductal, Breast/diagnosis , Carcinoma, Intraductal, Noninfiltrating/diagnosis , Contrast Media/administration & dosage , Diffusion Magnetic Resonance Imaging/methods , Female , Gadolinium DTPA , Humans , Image Enhancement/methods , Imaging, Three-Dimensional/methods , Middle Aged , Observer Variation , Sensitivity and Specificity
16.
Neurointervention ; : 50-55, 2007.
Article in English | WPRIM | ID: wpr-730273

ABSTRACT

In the case of giant vertebrobasilar junction aneurysm with an outflow directly draining into the basilar artery, trapping of ipsilateral vertebral artery is technically challenging. Endosaccular coil embolization may be an option, but it may aggravate symptoms due to mass effect or aneurysmal regrowth after coil compaction. Occlusion of the ipsilateral vertebral artery proximal to the aneurysm may be another option. However, complete thrombosis should be eventually achieved to prevent symptom progression from the retrograde flow or mass effect by the partial thrombosis within the aneurysm. The authors describe a case of giant vertebrobasilar aneurysm initially treated with proximal occlusion. As the aneurysm getting partial thrombosis, the bulbar compression symptom was slowly aggravated. We performed endosaccular coiling of small remaining sac 2 months later, which resulted in complete resolution of compression symptom.


Subject(s)
Aneurysm , Arteries , Basilar Artery , Embolization, Therapeutic , Humans , Parents , Thrombosis , Vertebral Artery
17.
Article in Korean | WPRIM | ID: wpr-70950

ABSTRACT

PURPOSE: We wanted to analyze the citation trend and to find a way to improve the impact factor (IF) of the Journal of the Korean Radiological Society (JKRS). MATERIALS AND METHODS: The number of articles and references, the total citations and self-citations, the IF and the IF excluding self-citations (ZIF) were described by an analysis of Korean Medical Citation Index (KoMCI) during 2000-2005. The total and self citations of the JKRS were compared to that of the Top 5 journals. RESULTS: There was a 57% decrease of papers for 6 years. The Korean references/paper ranged from 0.98-0.85. The number of total citations received steadily decreased from 394 in 2000 to 180 in 2005. The IF (ZIF) of the JKRS has been gradually lowered from 0.142 (0.049) in 2000 to 0.063 (0.059) in 2005. Although the total citations that cited all papers published/the annual number of papers was 55% of that of the top 5 journals, the total citations citing papers published within the recent two years was only 24% of that of the top 5 journals. CONCLUSION: The citation status of the JKRS hassteadily decreased for the recent 6 years, and the IF of the JKRS was very low among all the Korean medical journals. To improve the IF, active advertising for the journal members of the importance of the IF is needed to encourage citing JKRS papers that have been published within the recent two years.


Subject(s)
Statistics as Topic
18.
Article in Korean | WPRIM | ID: wpr-26147

ABSTRACT

Background: Verbal learning test is useful and significant test to evaluating memory function. There were many memory tests but few for elderly and dementia patients. Although there have been a variety of Korean memory tests developed, these tests were difficult to administer to dementia patients and elderly individuals with low educational levels. Therefore, we developed the Korean Memory Test (KMT). Methods: The KMT task consists of three trials of free recall of 10 simplified line drawing figures of familiar materials. Three immediate recall trials and one 20 minutes delayed recall and one recognition trial were administered. Sixty-five of probable Alzheimer's patients received the Korean version of Mini-Mental State Examination (K-MMSE), Korean version of expanded Clinical Dementia Rating Scale (CDR) and KMT. Also sixty-seven of normal controls were enrolled. We tested reliability and validity of the KMT and also evaluated scores of the KMT with progression of dementia. Results: The parameters of the KMT correlated with CDR -0.74~-0.77 (p<0.01), K-MMSE 0.66~0.68 (p<0.01). The internal consis- tency was 0.78 (Cronbach's alpha). Most of the KMT's parameters decreased with CDR significantly (p<0.01). Conclusions: The KMT is a good test for evaluating memory function of elderly with low educational level. Also it is a sensitive and specific test to detection of dementia in early stage and has excellent reliability and validity.


Subject(s)
Aged , Alzheimer Disease , Dementia , Humans , Memory , Memory, Short-Term , Neuropsychology , Reproducibility of Results , Verbal Learning
19.
Article in Korean | WPRIM | ID: wpr-23928

ABSTRACT

BACKGROUND: The rate of cognitive change and prognostic factor in Alzheimer's disease are important for clinical management, but little is known in Korea. We report a one year follow-up study of comprehensive evaluation including cognitive functions, behavioral and psychological symptoms of dementia (BPSD) and activity of daily living (ADL). METHODS: 43 patients with Alzheimer's disease were enrolled. All subjects received the Korean version of Mini-Mental State Examination (K-MMSE), the Severe Dementia Scale (SDS), the extended version of Korean Clinical Dementia Rating Scale (CDR) and Sum of Box (CDR-SB), the Barthel index of Activity of Daily Living (B-ADL), the Korean Instrumental Activity of Daily Living (K-IADL) and the Korean version of the Neuropsychiatric Inventory (K-NPI). We retested each scale after 1 year and evaluated the changes. RESULTS: The mean change rates of K-MMSE, SDS, CDR, CDR-SB and B-ADL scores were 2.0 +/- 3.2 (-7~8) mean +/- SD (range), 3.5 +/- 4.9 (-7~14), -0.4 +/- 0.7 (-2~1), -0.8 +/- 4.4 (-10~9) and 1.5 +/- 3.7 (-7~9). The change of K-MMSE and B-ADLscore according to CDR were significantly different. The annual rates of changes of scores on K-MMSE, B-ADL and CDR were largest in CDR 1 group (K-MMSE: 4.0 +/- 2.7, B-ADL: 3.4 +/- 2.8, CDR: -1 +/- 0.7). The change rate of SDS was largest in CDR 4 (7.2 +/- 4.3). There were not any significant factors that affected the change of K-MMSE, SDS, B-ADL or CDR. CONCLUSIONS: These results suggest that K-MMSE is sensitive to the early stage and SDS is sensitive to the later stage. The deterioration rate of cognitive function in Alzheimer's disease is large at middle stage.


Subject(s)
Alzheimer Disease , Cognition , Dementia , Follow-Up Studies , Humans , Korea , Longitudinal Studies , Prognosis
20.
Article in Korean | WPRIM | ID: wpr-203795

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the usefulness of single photon emission computed tomography (SPECT) of bone using Tc-99m MDP in the diagnosis of osteoporotic vertebral fractures. MATERIALS AND METHODS: Thirty two patients with osteoporotic vertebral fracture were included in this study (mean age: 67 +/- 8, male: 5, female: 27). Seventy nine vertebral fractures were detected (38 thoracic/thoracolumbar lesions and 41 lumbar lesions), which were classified by type of deformity (wedge, biconcave or compression). The patterns and locations of increased uptakes were examined and analyzed. RESULTS: Forty seven wedge fractures, 20 biconcave fractures and 12 compression fractures were found. Diffuse and asymmetric uptakes were common in fractured bodies. More than one uptake were examined in 69 posterior elements of fractured vertebrae (87.3%) including 40 of 47 wedge fractures (85.1%), 17 of 20 biconcave fractures (85.0%) and 12 of 12 compression fractures (100%). Wedge fractures were predominant fracture in thoracic/thoracolumbar spine whereas incidence of biconcave or compression type was similar to that of wedge fracture in lumbar spine (p=0.04). Spinous process uptake was more frequently seen in lumbar lesions than thoracic/thoracolumbar lesions (p=0.009). Facet joint uptake in biconcave fracture was more common in lumbar spine (92.3%) than thoracic/thoracolumbar spine (57.1%). Spinous process uptake in biconcave fracture was also more frequently detected in lumbar spine (p=0.043). CONCLUSION: Bone SPECT was useful in the evaluation of osteoporotic vertebral fracture, especially posterior elements of vertebrae.


Subject(s)
Congenital Abnormalities , Diagnosis , Female , Fractures, Compression , Humans , Incidence , Male , Osteoporosis , Spine , Technetium Tc 99m Medronate , Tomography, Emission-Computed, Single-Photon , Zygapophyseal Joint
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