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Objective@#Botulinum toxin was used to treat patients with difficulty in relaxation of the upper esophageal sphincter (UES), but the treatment did not always yield good results. We, therefore, attempted to investigate if there was any other factor affecting the outcome and hypothesized that this could be caused due to pharyngeal constriction. @*Methods@#We conducted a retrospective study on a botulinum toxin injection treatment given to eleven patients with nasal backflow and pharyngeal stasis in the course of a videofluoroscopic swallowing study from August 2006 to December 2012. After the injection, the cases showing an esophageal passage of diluted barium regardless of aspiration were defined as “good”, and the cases showing no passage were defined as “bad”. Pharyngeal strength was measured using the pharyngeal constriction ratio (PCR), which was compared between the two groups using the Mann-Whitney U test for proving the hypothesis. @*Results@#Five of the eleven patients showed esophageal passage after the injection treatment and were assigned to the “good” group. The remaining 6 were assigned to the “bad” group. When comparing the average PCR of each group, the ‘good’ group’s ratio was at 0.09±0.03 and the ‘bad’ group was at 0.29±0.16, showing a statistically significant difference (P＜0.05). @*Conclusion@#The strength of pharyngeal constriction could be considered to be an important factor influencing the outcome after botulinum toxin treatment for the difficulty in relaxation of the UES.
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Objective@#To determine the incidence of anconeus epitrochlearis (AE) muscle and evaluate the correlation between AE muscle and ulnar motor nerve conduction velocity (NCV). Method: Forty healthy volunteers (80 arms) were evaluated. Ulnar motor nerve conduction study was performed. NCVs at the forearm and across the elbow were calculated. Ultrasonography (US) was used to obtain a transverse scan view of the cubital tunnel and confirm the presence of the AE muscle. Cross-sectional areas (CSAs) of following structures were obtained: ulnar nerve (UNCSA), cubital tunnel (CTCSA), and AE (AECSA). AECSA was divided by CTCSA to obtain the AE/CT ratio. Pearson correlation coefficient (PCC) was calculated to evaluate the relationship between NCV across elbow and each variable obtained by US. @*Results@#Sixty-three (78.75%) of eighty arms showed the presence of AE muscle. NCV had no significant correlations with sonographic variables. However, when 17 arms with a relatively low NCV value (≤ 60 m/s) were analyzed, NCV showed significant correlations with AECSA (PCC: r = −0.674, p=0.003) and AE/CT ratio (PCC: r = −0.516, p=0.034). @*Conclusion@#When all 63 cases with AE muscle were analyzed, ulnar NCV showed no significant correlations with sonographic variables. However, when those with NCV value of 60 m/s or less were analyzed, NCV showed significant negative correlations with AECSA and AE/CT ratio.
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A 2-year-old spayed female Border Collie presented with visual deficits and behavioral changes. Neurological examination revealed bilateral menace response deficit with a normal pupil light reflex. Cerebral cortical thinning, cerebral sulci and cerebellar fissure widening, ventriculomegaly, and cerebral atrophy were observed on magnetic resonance imaging (MRI). Histopathology revealed fluorescent lipopigment accumulation in the cerebrum, and the dog was diagnosed with neuronal ceroid lipofuscinosis. This is the first case report describing the changes in clinical signs, MRI findings, and histopathologic changes in neuronal ceroid lipofuscinosis in Korea.