Subject(s)
Brain Diseases, Metabolic, Inborn/metabolism , Brain/metabolism , Dementia, Vascular/metabolism , Glutarates/urine , Amino Acid Metabolism, Inborn Errors/genetics , Amino Acid Metabolism, Inborn Errors/metabolism , Amino Acid Metabolism, Inborn Errors/physiopathology , Brain/pathology , Brain/physiopathology , Brain Diseases, Metabolic, Inborn/genetics , Brain Diseases, Metabolic, Inborn/physiopathology , Cognition Disorders/genetics , Cognition Disorders/metabolism , Cognition Disorders/physiopathology , DNA Mutational Analysis , Dementia, Vascular/genetics , Dementia, Vascular/physiopathology , Enoyl-CoA Hydratase/genetics , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Mutation/genetics , Nerve Fibers, Myelinated/pathology , RNA-Binding Proteins/genetics , Reflex, Abnormal/physiologyABSTRACT
In a patient with symptomatic ocular myoclonus, the authors observed the regional cerebral metabolic rate of glucose use (rCMRGlu) before and after successful treatment with clonazepam. Even after the symptoms resolved, the rCMRGlu in the hypertrophic olive increased persistently, whereas that in the inferior cerebellar vermis contralateral to the hypertrophic olive decreased. The inferior cerebellar vermis, belonging to the vestibulocerebellar system, may be associated with the generation of symptomatic ocular myoclonus.
Subject(s)
Cerebellum/metabolism , Glucose/metabolism , Myoclonus/pathology , Aged, 80 and over , Brain Stem/pathology , Cerebellum/diagnostic imaging , Cerebral Hemorrhage/complications , Electronystagmography/methods , Female , Humans , Magnetic Resonance Imaging/methods , Myoclonus/diagnostic imaging , Myoclonus/metabolism , Ocular Motility Disorders/diagnostic imaging , Ocular Motility Disorders/pathology , Ocular Motility Disorders/physiopathology , Ocular Motility Disorders/radiotherapy , Positron-Emission Tomography/methods , RadiographySubject(s)
Antiviral Agents/therapeutic use , Hepatitis C, Chronic/complications , Interferon-beta/therapeutic use , Myositis, Inclusion Body/drug therapy , Aged , Carrier State/blood , Carrier State/virology , Disease Progression , Hepacivirus/isolation & purification , Hepatitis C, Chronic/pathology , Humans , Kidney Failure, Chronic/complications , Male , Muscle Weakness/etiology , Muscle, Skeletal/pathology , Muscle, Skeletal/virology , Myositis, Inclusion Body/etiology , Myositis, Inclusion Body/pathology , Myositis, Inclusion Body/virology , RNA, Viral/analysis , RNA, Viral/blood , Viral Load , Viremia/complicationsABSTRACT
We report the findings of diffusion-weighted MRI (DWI) taken serially in a patient with Japanese encephalitis (JE). The patient was a 43-year-old woman presenting with headache, high fever and consciousness disturbance. The diagnosis of JE was made based on more than fourfold elevation of serum complement fixation antibody titer for JE virus in the convalescent phase of illness. The DWI on the second day of illness (Day-2) disclosed high-signal intensity lesions in the left thalamus, substantia nigra and frontal lobe cortex. The signal intensity of these lesions on the DWI increased on Day-3 but gradually decreased thereafter and normalized on Day-28. The improvement of the DWI findings was paralleled with that of the consciousness level and the cell number and neuron specific enolase concentration in the CSF, suggesting that DWI is useful for evaluation of the disease activity in JE. The lesions in the brain suffering from Japanese encephalitis are usually bilateral and diffuse. To our knowledge, this is the first report of JE presenting with unilateral lesions on MRI, of which phathomechanism remains to be elucidated.
Subject(s)
Brain/pathology , Encephalitis, Japanese/diagnosis , Magnetic Resonance Imaging , Adult , Diffusion , Female , HumansABSTRACT
AIM: To evaluate a new approach to the differentiation of the right and left ribs, the vertical displacement sign, and to compare its efficacy with the big rib sign. MATERIALS AND METHODS: One hundred and nine lateral chest radiographs that clearly showed both the gastric air bubble sign and the cardiac silhouette sign were retrospectively reviewed by two radiologists. Each study was evaluated by consensus. Each radiograph was assessed for suitability of reading with each technique. Suitable radiographs were then reviewed using both the big rib sign and vertical displacement sign independently. RESULTS: Applicability of the vertical displacement sign [107 of 109 (98%)] was greater than that of the big rib sign [95 of 109 (87%)] (P = 0.0017). The accuracy of the vertical displacement sign [105 of 107 (98%)] was higher than that of the big rib sign [74 of 95 (78%)] (P < 0.001). CONCLUSION: The vertical displacement sign seems to be a reliable technique for the differentiation of right and left ribs on the lateral chest radiograph and can be used as a complementary technique when the big rib sign is not applicable.
Subject(s)
Radiography, Thoracic/methods , Ribs/diagnostic imaging , Adult , Aged , Aged, 80 and over , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
The ribs are essential structures of the osseous thorax and provide information that aids in the interpretation of radiologic images. Techniques for making precise identification of the ribs are useful in detection of rib lesions and localization of lung lesions. The big rib sign and the vertical displacement sign can be used to differentiate the right and left ribs on lateral chest radiographs. The clavicle, the xiphoid process, and the sternal angle may be used as anatomic landmarks for rib counting on computed tomographic scans. For rib counting on lateral chest radiographs, the sternal angle or the 12th rib may be used. Anatomic rib variants include developmental deformities, cervical rib, and short rib and may mimic true rib diseases. Detection of thoracic deformities such as funnel chest (pectus excavatum) and barrel-shaped thorax requires an awareness of the strong correlation between the transverse appearance of the thorax and costal shape. Shadows around the rib cage (eg, rib companion shadows, sharp lines along the lower margin of the ribs, rib overlying shadows) may mimic pleural and extrapleural disease on frontal chest radiographs. It is imperative that the radiologist be familiar with normal rib anatomy, normal rib variants, and the radiologic appearance of the ribs to prevent misdiagnosis.
