Uremic Encephalopathy with Atypical Magnetic Resonance Features on Diffusion-Weighted Images

Uremic encephalopathy is a well-known disease with typical MR findings including bilateral vasogenic or cytotoxic edema at the cerebral cortex or basal ganglia. Involvement of the basal ganglia has been very rarely reported, typically occurring in uremic-diabetic patients. We recently treated a patient who had non-diabetic uremic encephalopathy with an atypical lesion distribution involving the supratentorial white matter, without cortical or basal ganglia involvement. To the best of our knowledge, this is only the second reported case of non-diabetic uremic encephalopathy with atypical MR findings.

The Effect of Asymmetric Dynamic and Static Weight-bearing Force on Bone Mineral Density in Hemiplegic Stroke Patients : Preliminary Study

OBJECTIVE: To measure the foot force and contact area distribution between the paretic and nonparetic sides during static and dynamic weight-bearing states, and to determine their relationship with BMD (bone mineral density). METHOD: Sixteen stroke patients (mean age=63.5+/-7.46 years) were included and BMDs of bilateral femurs were evaluated. Foot force and total foot contact areas were measured using the F-scan insole system. All values were expressed in ratio of paretic versus nonparetic sides. RESULTS: The paretic side showed significantly smaller values in BMD, foot force and total contact area than the nonparetic sides (p0.05), or total contact area ratio during both dynamic and static weight-bearing state (r=0.23, r=0.12, p>0.05). Multiple regression analysis showed that dynamic weight-bearing force ratio and time elapsed since stroke were independently related to BMD ratio (t=3.25, p<0.001 and t=-4.89, p<0.001). CONCLUSION: The present study showed that foot force differences in the dynamic weight-bearing state significantly correlated to post-stroke BMD while foot contact area in both the static and dynamic weight-bearing state did not correlate to post-stroke BMD.

Nerve Conduction Study of Medial Calcaneal Nerve in Healthy Koreans

OBJECTIVE: To determine the normal values of medial calcaneal nerve (MCN) conduction study for the diagnostic reference value. METHOD: The subjects were healthy 54 adults (30 males, 24 females). Antidromic sensory nerve conduction study of medial calcaneal nerve was performed in 108 feet of the subjects. The active surface electrode (G1) was placed to the point of one third of the distance from the apex of the heel to a point midway between the navicular tuberosity and prominence of the medial malleolus. The reference surface electrode (G2) was placed to the apex of the heel. The stimulation was done at the site of 10 cm proximal to the proposed G1 site. RESULTS: Reference values (mean+/-2 SD) were determined for MCN onset latency (1.62+/-0.16 msec), peak latency (2.41+/-0.19 msec), baseline-to-peak amplitude (12.46+/-4.87 microV), onset conduction velocity (62.28 +/-6.30 m/sec), and peak conduction velocity (41.70+/-3.19 m/sec). The maximum intrasubject side-to-side differences of above values were 0.17 msec, 0.17 msec, 2.90 micro V, 6.63 m/sec, and 2.87 m/sec respectively. The MCN response was elicitable in 92.6% of the subjects. CONCLUSION: The results of this study would be used for the electrophysiologic evaluation of the MCN.

Effects of Arteriovenous Fistula on Nerve Conductions in Patients with Chronic Renal Failure

OBJECTIVE: We tried to evaluate the effects of arteriovenous fistula (AVF) on the nerve conductions of the arms in hemodialyzed patients with chronic renal failure (CRF). METHOD: Subjects were 22 patients with AVF in patients with CRF and 10 controls without AVF in patients with CRF. We studied nerve conductions, and compared the findings in the arms with fistula and without fistula, and the arms in controls. RESULTS: In ulnar motor nerve conduction study, the amplitude in fistula side was lower than non-fistula side, but the conduction velocity in non-fistula side was lower than fistula side. In radial motor nerve conduction study, the distallatency in non-fistula side was more delayed than that in fistula side. There were no statistical significancies between fistula side and non-fistula side in the other nerve conduction study parameters in arms. And there was no statistically different incidences of carpal tunnel syndrome in both sides. Comparing with controls, conduction velocities of ulnar and radial motor nerves and peak latencies of ulnar and radial sensory nerves were more delayed in both sides. CONCLUSION: There were no significant local effects of arteriovenous fistula on nerve conductions in patients with chronic renal failure.