Nonprogressive Unilateral Intracranial Arteriopathy in Children with Arterial Ischemic Stroke

The nonprogressive unilateral intracranial arteriopathy known as transient (focal) cerebral arteriopathy is not a well-recognized arteriopathy among practitioners of Korea and Japan, although it cannot be easily differentiated from early moyamoya disease. This review summarizes the nomenclature, pathophysiology, diagnostic evaluation, clinico-radiological features, and management of nonprogressive (reversible or stable) unilateral arteriopathy based on the relevant literature and our own experiences. Nonprogressive unilateral arteriopathy should be strongly suspected in children presenting with basal ganglia infarction and arterial beading. The early identification of patients likely to have nonprogressive or progressive arteriopathy would ensure proper management and guide further research for secondary stroke prevention.     

Correlation between balance and gait according to pelvic displacement in stroke patients

[Purpose] The purpose of this study was to investigate the correlations of balance and gait according to pelvic displacement in stroke patients. [Subjects] The subjects of this study were 58 stroke patients who had been admitted to a hospital. [Methods] A Global Postural System was used to measure pelvic displacement. To measure the balance ability, a Tetrax balance system was used to measure the weight distribution index and stability index. Gait ability was measured during the 10-Meter Walking Test and Figure-of-8 Walk Test. [Results] The results of this study showed that was significant positive correlation between the anterior superior iliac spine height difference in pelvic displacement and the weight distribution index and significant positive correlation between the posterior superior iliac spine height difference and the stability index in the normal position with the eyes closed. Statistically significant positive correlation also was found between the anterior superior iliac spine height difference and the straight and curved gait ability. [Conclusion] The increased pelvic displacement in stroke patients results in a decrease in balance ability and gait speed. This suggests that control of pelvic displacement is necessary before functional training for patients with stroke.Key words: Balance, Pelvic displacement, Stroke     

Correlation between apoptotic endothelial microparticles and serum interleukin-6 and C-reactive protein in healthy men

Inflammation has been associated with increased cardiovascular risk, and endothelial cell (EC) apoptosis has been implicated in atherogenesis. The correlation between circulating concentrations of interleukin-6 (IL-6), C-reactive protein (CRP), and endothelial microparticles (EMPs) expressing an apoptotic (EMP31) or activation (EMP62E) phenotype in 20 middle-aged healthy men was investigated. IL-6 was significantly correlated with EMP31 (r = 0.6, p = 0.004), which persisted after adjusting for body mass index and CRP. CRP was significantly correlated with body mass index (r = 0.49, p = 0.02) but not with EMP31 or EMP62E. EC apoptosis is associated with IL-6 levels in men and might be partially responsible for the increased cardiovascular risk associated with subclinical inflammation.     

Comparisons of shoulder stabilization muscle activities according to postural changes during flexi-bar exercise

[Purpose] The purpose of this study was to compare shoulder stabilization muscle activities according to postural changes during flexi-bar exercise. [Subjects] The subjects included 18 students (10 males, 8 females) at B University. [Methods] The subjects performed the following flexi-bar exercises: 1) medio-lateral oscillation with the 90° shoulder abduction, with the hand in the neutral position; 2) dorso-ventral oscillation with 90° shoulder flexion, with the hand in the neutral position; 3) superior-inferior oscillation with 90° shoulder flexion, with the 80° hand pronation. [Results] The activity of the serratus anterior showed significant differences between each position; however, activities of the upper trapezius and middle trapezius were not significantly different. [Conclusion] The results of this study indicate that posture control is important for selective strengthening of the serratus anterior muscle during flexi-bar exercises.Key words: Flexi-bar exercise, Shoulder stabilization, Muscle activity     

Isolated Cerebellar Variant of Adrenoleukodystrophy with a de novo Adenosine Triphosphate-Binding Cassette D1 (ABCD1) Gene Mutation

X-linked adrenoleukodystrophy (X-ALD) shows a wide range of phenotypic expression, but clinical presentation as an isolated lesion of the cerebellar white matter and dentate nuclei has not been reported. We report an unusual presentation of X-ALD only with an isolated lesion of the cerebellar white matter and dentate nuclei. The proband, a 37-year-old man presented with bladder incontinence, slurred speech, dysmetria in all limbs, difficulties in balancing, and gait ataxia. Brain magnetic resonance imaging showed an isolated signal change of white matter around the dentate nucleus in cerebellum. With high level of very long chain fatty acid, gene study showed a de novo mutation in exon 1 at nucleotide position c.277_296dup20 (p.Ala100Cysfs^*10) of the adenosine triphosphate-binding cassette D1 gene. It is advised to consider X-ALD as a differential diagnosis in patients with isolated cerebellar degeneration symptoms.     

Cervical Arthroplasty for Moderate to Severe Disc Degeneration: Clinical and Radiological Assessments after a Minimum Follow-Up of 18 Months: Pfirrmann Grade and Cervical Arthroplasty

Purpose

Clinical outcomes and radiologic results after cervical arthroplasty have been reported in many articles, yet relatively few studies after cervical arthroplasty have been conducted in severe degenerative cervical disc disease.

Materials and Methods

Sixty patients who underwent cervical arthroplasty (Mobi-C®) between April 2006 and November 2011 with a minimum follow-up of 18 months were enrolled in this study. Patients were divided into two groups according to Pfirrmann classification on preoperative cervical MR images: group A (Pfirrmann disc grade III, n=38) and group B (Pfirrmann disc grades IV or V, n=22). Visual analogue scale (VAS) scores of neck and arm pain, modified Oswestry Disability Index (mODI) score, and radiological results including cervical range of motion (ROM) were assessed before and after surgery.

Results

VAS and mean mODI scores decreased after surgery from 5.1 and 57.6 to 2.7 and 31.5 in group A and from 6.1 and 59.9 to 3.7 and 38.4 in group B, respectively. In both groups, VAS and mODI scores significantly improved postoperatively (p<0.001), although no significant intergroup differences were found. Also, cervical dynamic ROM was preserved or gradually improved up to 18 months after cervical arthroplasty in both groups. Global, segmental and adjacent ROM was similar for both groups during follow-up. No cases of device subsidence or extrusion were recorded.

Conclusion

Clinical and radiological results following cervical arthroplasty in patients with severe degenerative cervical disc disease were no different from those in patients with mild degenerative cervical disc disease after 18 months of follow-up.