Young cheol weon’s scientific contributions in white matter and magnetic resonance imaging anoxi

[show abstract] [hide abstract] ABSTRACT: background

Internal carotid artery (ICA) occlusion mainly manifests as ischemia of the anterior circulation. There are very few reports of ICA occlusion manifesting as only ischemia of the posterior circulation related to a fetal type posterior communicating artery or other arteries.

Case presentation

The authors experienced a case of ICA occlusion with persistent primitive trigeminal artery (PPTA) manifesting only as ischemia of the posterior circulation. In this case, the initial NIHSS score was high (35/42 points). Additionally, cross flow of the anterior communicating artery, ICA occlusion and basilar artery (BA) occlusion were represented on the initial head MRA.Anoxi


therefore, our first impression was a presumptive diagnosis of BA occlusion. Prior head MRI/MRA performed for screening purposes, had incidentally demonstrated a right PPTA. Based on this understanding, we were able to determine the exact angioarchitectural mechanism of the ICA occlusion. Because of the presence of the PPTA, successful recanalization was accomplished expeditiously.

Conclusion

Although the presence of PPTA is rare and ICA occlusion patients with PPTA is even more unusual, if ICA occlusion and BA occlusion appear simultaneously on MRA, the presence of PPTA should be considered.

[show abstract] [hide abstract] ABSTRACT: background:

Manganese (mn) can have neurotoxic effects upon overexposure.Anoxi we previously reported poorer cognitive and motor development in children exposed to mn through drinking water, suggesting possible neurotoxic effects from mn in water. Hyperintensity in the globus pallidus (GP) on T1-weighted magnetic resonance imaging (MRI) indicates excessive brain mn accumulation. Previous studies have reported GP hyperintensity related to mn exposure in occupationally exposed individuals. However, no study has used MRI in children exposed to mn in drinking water and who show no sign of overt intoxication.

Objective:

To examine MRI signal intensity in the GP in children exposed to contrasted levels of mn in drinking water.

Methods:

We enrolled 13 children exposed to low mn concentration in water and 10 children (ages 9-15 years) with high concentration (median of 1 and 145μg/L, respectively).Anoxi we calculated three MRI T1 indexes: (i) standard pallidal index (PI) using frontal white matter as reference; (ii) PI using pericranial muscles as reference; and (iii) T1 relaxation time. Each MRI index was compared between exposure groups, and with respect to the estimated mn intake from water consumption.

Results:

The standard PI did not differ between mn-exposure groups. However, children in the group with high water-mn concentration had significantly lower pericranial muscles PI than those with lower exposure and, accordingly, higher T1 relaxation time. Mn intake from water consumption was not correlated with the standard PI, but was significantly related to the pericranial muscles PI and T1 relaxation time.Anoxi motor performance was significantly lower in the high-exposure group.

Conclusion:

We observed lower signal intensity in the GP of children with higher exposure to mn from drinking water. This result stands in contrast to previous MRI reports showing GP hyperintensity with greater mn exposure. Differences in exposure pathways are discussed as a potential explanation for this discrepancy.

[show abstract] [hide abstract] ABSTRACT: purpose

Mechanical thrombectomy using a solitaire stent has been associated with a high recanalization rate and favorable clinical outcome in intra-arterial thrombolysis. To achieve a higher recanalization rate for mechanical solitaire thrombectomy, we used an intra-arterial low-dose booster tirofiban injection into the occluded segment after stent deployment.Anoxi we report the safety and recanalization rates for mechanical solitaire thrombectomy with a low-dose booster tirofiban injection.

Materials and methods

Between february and march 2013, 13 consecutive patients underwent mechanical solitaire thrombectomy with low-dose booster tirofiban injection. The occlusion sites included the proximal middle cerebral artery (5 patients), the internal carotid artery (5 patients), the top of the basilar artery (2 patients) and the distal middle cerebral artery (M2 segment, 1 patient). Six patients underwent bridge treatment, including intravenous tissue plasminogen activator. Tirofiban of 250 µg was used in all patients except one (500 µg). All occluded vessels were recanalized after 3 attempts at stent retrieval (1 time, n=9; 2 times, n=2; 3 times, n=2).Anoxi

Results

Successful recanalization was achieved in all patients (TICI 3, n=8; TICI 2b, n=5). Procedural complications developed in 3 patients (subarachnoid hemorrhage, n=2; hemorrhagic transformation, n=1). Mortality occurred in one patient with a basilar artery occlusion due to reperfusion brain swelling after mechanical solitaire thrombectomy with low-dose booster tirofiban injection. Favorable clinical outcome (mrs≤2) was observed in 8 patients (61.5%).

Conclusion

Our modified mechanical solitaire thrombectomy method using a low-dose booster tirofiban injection might enhance the recanalization rate with no additive hemorrhagic complications.

[show abstract] [hide abstract] ABSTRACT: brain imaging technology has allowed researchers to conduct rigorous studies of the dynamic course of alcoholism through periods of drinking, sobriety, and relapse and to gain insights into the effects of chronic alcoholism on the human brain.Anoxi magnetic resonance imaging (MRI) studies have distinguished alcohol-related brain effects that are permanent from those that are reversible with abstinence. In support of postmortem neuropathological studies showing degeneration of white matter, MRI studies have shown a specific vulnerability of white matter to chronic alcohol exposure. Such studies have demonstrated white-matter volume deficits as well as damage to selective gray-matter structures. Diffusion tensor imaging (DTI), by permitting microstructural characterization of white matter, has extended MRI findings in alcoholics. MR spectroscopy (MRS) allows quantification of several metabolites that shed light on brain biochemical alterations caused by alcoholism.Anoxi this article focuses on MRI, DTI, and MRS findings in neurological disorders that commonly co-occur with alcoholism, including wernicke’s encephalopathy, korsakoff’s syndrome, and hepatic encephalopathy. Also reviewed are neuroimaging findings in animal models of alcoholism and related neurological disorders. This report also suggests that the dynamic course of alcoholism presents a unique opportunity to examine brain structural and functional repair and recovery.

[show abstract] [hide abstract] ABSTRACT: lymphoepithelioma-like carcinoma (LELC) of the breast is an exceedingly rare variant of mammary cancer. To our knowledge, only twenty – one cases have been reported in the literature. Diagnosis of this type of mammary carcinoma may be challenging, owing to its rarity and the histopathological similarity to common inflammatory and malignant lesions of the breast mainly granulomatous mastitis, medullary carcinoma, pleomorphic lobular carcinoma, lymphoma and other hematological malignancies.Anoxi our case is the 22nd case of lymphoepithelioma-like carcinoma reported in the breast, presenting with a palpable tender mass in a post-menopausal female. Her clinical picture had been mistaken for inflammatory disease. We present our case, with its detailed clinical history, radiological findings, histopathological and immune-histochemical findings along with a review of the literature. Highlighting this type of tumors may help in appropriate diagnosis. Moreover, studying the behavior of these rare neoplasms is essential to expedite treatment for this tumor type.

[show abstract] [hide abstract] ABSTRACT: spinal epidural hematoma is a rare neurosurgical emergency in respect of motor and

Sensory loss.Anoxi identifiable reasons for spontaneous hemorrhage are vascular

Malformations and hemophilias. We presented a case of spontaneous epidural

Hematoma in an 18-year-old female patient who had motor and sensory deficits that

Had been present for 1 day. On MRI, there was spinal epidural hematoma posterior to

T2-T3 spinal cord. The hematoma was evacuated with T2 hemilanectomy and T3

Laminectomy. Patient recovered immediately after the surgery. Literature review

Depicted 112 pediatric cases (including the presented one) of spinal epidural

Hematoma. The female:male ratio is 1.1:2. Average age at presentation is 7.09 years.

Clinical presentations include loss of strength, sensory disturbance, bowel and bladder

anoxi

Disturbances, neck pain, back pain, leg pain, abdominal pain, meningismus, respiratory

Difficulty, irritability, gait instability, torticollis. Most common spinal level was

Cervicothoracic spine. Time interval from symptoms onset to clinical diagnosis varied

From immediate to 18 months. Spinal epidural hematoma happened spontaneously in

71.8% of the cases, hemophilia was the leading disorder (58%) in the cases with a

Definable disorder. Partial or complete recovery is possible after surgical interventions

And factor supplementations.

[show abstract] [hide abstract] ABSTRACT: the current study was designed to evaluate the sensitivity, feasibility, and effectiveness of the pallidal index (PI) serving as a biomarker of brain manganese (mn) accumulation, which would be used as an early diagnosis criteria for mn neurotoxicity.Anoxi

The weighted mean difference (WMD) of the PI between control and mn-exposed groups was estimated by using a random-effects or fixed-effects meta-analysis with 95% confidence interval (CI) performed by STATA software version 12.1. Moreover, the R package metacor was used to estimate correlation coefficients between PI and blood mn (mnb).

A total of eight studies with 281 occupationally mn-exposed workers met the inclusion criteria. Results were pooled and performed with the meta-analysis. Our data indicated that the PI of the exposed group was significantly higher than that of the control (WMD: 7.76; 95% CI: 4.86, 10.65; I2 = 85.7%, p0.0001). A random effects model was used to perform meta-analysis.Anoxi these findings were remarkably robust in the sensitivity analysis, and publication bias was shown in the included studies. Seven out of the eight studies reported the pearson correlation (r) values. Significantly positive correlation between PI and mnb was observed (r = 0.42; 95% CI, 0.31, 0.52).

PI can be considered as a sensitive, feasible, effective and semi-quantitative index in evaluating brain mn accumulation. MnB can also augment the evaluation of brain mn accumulation levels in the near future. However, the results should be interpreted with caution.