• The Journal of Internal Korean Medicine
• /
• v.38 no.5
• /
• pp.789-796
• /
• 2017

Objectives: We examined the effects of Sinbi-tang on a patient with pontine hemorrhage and respiratory disturbance. Methods: A patient diagnosed with pontine hemorrhage and respiratory disturbance was treated with herbal medicine and acupuncture. We checked the peripheral oxygen saturation ($SpO^2$) by oximetry three times a day, and obtained an average value. We evaluated the improvement of symptoms by changes in the average applied $O^2$ and average $SpO^2$. Results: After taking Sinbi-tang and treatment with acupuncture therapy, the patient showed improvement in respiratory disturbance. Applied $O^2$ was gradually decreased from 4 L/min to 0 L/min and $SpO^2$ was stabilized. Conclusions: Korean medicine may provide effective treatment for respiratory disturbance in patients with pontine hemorrhage, but further study is needed.

• Journal of Oral Medicine and Pain
• /
• v.38 no.2
• /
• pp.215-219
• /
• 2013

The descending control system is composed of a group of structures in the midbrain, medulla oblongata and pons that form a network of descending inhibitory projections. In the clinical setting, it has been shown that the application of a electrical counterirritant to these structures and diminishes the pain in patients. Thus, depression and anxiety have been shown to predict the development of chronic neuropathic pain state. These factors could influence pain might also involve descending controls. Interestingly, reduced descending controls are seen in patients with irritable bowel syndrome and theses patients had greater anxiety, depression compared to controls. And, the influence of anxiety on the chronicity of pain and on the descending control pathways should be tested in animal models, using modern techniques. Given this Knowledge, it is no wonder that pain is a highly personal experience that is susceptible to a variety of biologic, pharmacologic, and environmental influences.

• Journal of the Korean Society of Radiology
• /
• v.81 no.4
• /
• pp.912-919
• /
• 2020

Purpose This study aimed to compare the brain perfusion status of patients with chronic kidney disease to a normal control group to identify any significant differences. Materials and Methods The perfusion state of the brain was measured by MRI using the arterial spin labeling technique in 36 patients undergoing hemodialysis due to chronic kidney disease and 36 normal controls. Images were then analyzed in a voxel-wise manner to detect brain areas showing significant perfusion differences between the two groups. Results Patients with chronic kidney disease showed increased perfusion in the form of large clusters across the right fronto-parieto-temporal lobe and the left parieto-occipital lobe. In addition, perfusion increased in the bilateral thalami, midbrain, pons, and cerebellum (p < 0.01, familywise error corrected). Conclusion Brain perfusion appears to increase in patients with chronic kidney disease compared to normal controls. Uremic toxicity is thought to be the cause of this increase as it can cause damage to the microscopic blood vessels and their surrounding structures.

• The Korean Journal of Nuclear Medicine
• /
• v.32 no.5
• /
• pp.397-402
• /
• 1998

Purpose: The purpose of this study was to evaluate the phenomenon of diaschisis in the cerebellum and cerebral cortex in patients with pure basal ganglia hemorrhage using cerebral blood flow SPECT. Materials and Methods: Twelve patients with pure basal ganglia hemorrhage were studied with Tc-99m ECD brain SPECT. Asymmetric index (AI) was calculated in the cerebellum and cerebral cortical regions as |$C_R-C_L$/$(C_R-C_L){\times}200$, where $C_R$and $C_L$ are the mean reconstructed counts for the right and left ROIs, respectively. Hypoperfusion was considered to be present when AI was greater than mean +2 SD of 20 control subjects. Results: Mean AI of the cerebellum and cerebral cortical regions in patients with pure basal ganglia hemorrhage was significantly higher than normal controls (p<0.05): Cerebellum ($18.68{\pm}8.94$ vs $4.35{\pm}0.94$, $mean{\pm}SD$), thalamus ($31.91{\pm}10.61$ vs $2.57{\pm}1.45$), basal ganglia ($35.94{\pm}16.15$ vs $4.34{\pm}2.08$), parietal ($18.94{\pm}10.69$ vs $3.24{\pm}0.87$), frontal ($13.60{\pm}10.5$ vs $4.02{\pm}2.04$) and temporal cortex ($15.92{\pm}11.95$ vs $5.13{\pm}1.69$). Ten of the 12 patients had significant hypoperfusion in the contralateral cerebellum. Hypoperfusion was also shown in the ipsilateral thalamus (n=12), ipsilateral parietal (n=12), frontal (n=6) and temporal cortex (n=10). Conclusion: Crossed cerebellar diaschisis (CCD) and cortical diaschisis may frequently occur in patients with pure basal ganglia hemorrhage, suggesting that CCD can develop without the interruption of corticopontocerebellar pathway.

• The Korean Journal of Pharmacology
• /
• v.30 no.1
• /
• pp.29-37
• /
• 1994

Inhibition of the nociceptive Tail Flick Reflex (TFR) was observed with electrical stimulation of the locus coeruleus/subcoeruleus (LC/SC) in the male Sprague - Dawley rats under light anesthesia, and the involved neurotransmitter (s) were characterized. Electrical stimulation of LC/SC induced the analgesia with the stimulation threshold (intensity of the current, given for 100 usec and in 100 Hz frequency, which caused the TF latency longer than 6.5 sec) around 55 uA. Intrathecal administrations of ${\alpha}_2$ antagonist, yohimbine (30 ug) or opioid antagonist, naloxone (20 ug) increased the stimulation threshold by 147% and 123% respectively (from 55 uA to 135 uA,9 and from 54 uA to 123 uA;P0.01, n=5, each). The basal TF latency without stimulation (3.1 sec) was reduced by the antagonists (to 2.5 sec by yohimbine, p<0.05, n=5; to 2.6 sec by naloxone, p<0.1, n=5), vehicle only did not show any effect. Noradrenaline(NA) in the spinal cord superfusates measured with HPLC was increased by the LC/SC stimulation, from 4.18 ng/ml before to 7.74 ng/ml after stimulation (P<0.05, n=10). The result suggest that analgesia induced by LC/SC stimulation is mediated, at least in part, by the noradrenergic system in which ${\alpha}_2$ receptor is involved, as well as the opioid system.

• Clinical and Experimental Pediatrics
• /
• v.52 no.1
• /
• pp.99-104
• /
• 2009

Purpose : Magnetic resonance diffusion tensor imaging-based three-dimensional fiber tractography (DTI-FT) is a new method which demonstrates the orientation and integrity of white matter fibers in vivo. However, clinical application on children with cerebral palsy is still under investigation. We present various abnormal patterns of DTI-FT findings and accordance rate with clinical findings in children with hemiplegic cerebral palsy, to recognize the use fulness of DTI-FT. Methods : The thirteen children with hemiplegic cerebral palsy evaluated at Yeungnam University hospital from March, 2003 to August, 2007 were enrolled in this study and underwent magnetic resonance DTI-FT of the corticospinal tracts. Two regions of interest (ROI) were applied and the termination criteria were fractional anisotropy ${\geq}0.3$, angle ${\leq}70^{\circ}$. Results : The patterns and distribution of abnormal DTI-based corticospinal tractographic findings were interruption(10 cases, 76.9%), reduction of fiber volume (8 cases, 61.5%), agenesis of corticospinal tract (3 cases, 23.1%), transcallosal fiber (2 cases, 15.4%) and, aberrant corticospinal tracts (4 cases, 30.8%). Abnormal DTI-based corticospinal tractographic findings were in accordance with the clinical findings of cerebral palsy in 84.6% of the enrolled patients. Conclusion : Our results suggest that DTI-FT would be a use ful modality in the assessment of the corticospinal tract abnormalities in children with hemiplegic cerebral palsy.

• Investigative Magnetic Resonance Imaging
• /
• v.10 no.1
• /
• pp.1-7
• /
• 2006

Purpose : Recent development of diffusion tensor imaging enables the evaluation of the microstructural characteristics of the brain white matter. However, optimal imaging parameters for diffusion tensor imaging, particularly concerning the number of diffusion gradient direction, have not been studied thoroughly yet. The purpose of this study was to evaluate the influence of the number of diffusion gradient direction on the fiber tracking of the white matter. Materials and methods : 13 healthy volunteers (ten men and three women, mean age 30 years, age range 23-37 years) were included in this study. Diffusion tensor imaging was performed with different numbers of diffusion gradient direction as 6, 15, and 32, keeping the other imaging parameters constant. The imaging field ranged from 1 cm below the pons to 2-3 cm above the lateral ventricle, parallel to the anterior commissure-posterior commissure line. FA (fractional anisotropy) maps were created via image postprocessing, and then FA and its standard deviation were calculated in the genu and the splenium of the corpus callosum on each of FA maps. Fiber tracking of the corticospinal tract in the brain was performed and the number of the reconstructed fibers of the tract was measured. FA, standard deviation of FA and the number of the reconstructed fibers were compared statistically between the different diffusion gradient directions. Results : FA is not statistically significantly different between the different diffusion gradient directions. By increasing the number of diffusion gradient direction, standard deviation of FA decreased significantly, and the number of the reconstructed fibers increased significantly. Conclusion : The higher number of diffusion gradient direction provided better quality of fiber tracking.

• Journal of The Korean Society of Inherited Metabolic disease
• /
• v.5 no.1
• /
• pp.33-43
• /
• 2005

Purpose: X-linked adrenoleukodystrophy(ALD) is a rare disorder that shows a great deal of phenotypic variability. We subdivided chidhood X-linked ALD patients into several phenotypes by the age at onset, the sites of most severe clinical involvement and the rate of progression of neurologic symptoms. Methods: Thirteen patients who had been diagnosed as X-linked ALD and followed up for at least one year were enrolled from 1996 to 2003. Results: 1. Ten had childhood cerebral ALD, who showed first neurologic symptoms at 7.02 years and progressed rapidly: interval between first symptoms and vegetative state was 1.35 years, and interval from initial symptoms to death was 3.35 years. Treatment with Lorenzo's oil did not prevent neurologic progression. Two patients who underwent umbilical cord blood transplantation died. 2. Two had adolescent cerebral ALD. They had first symptoms at 11.5 years, and showed tendency to progress less rapidly than childhood cerebral form patients. 3. One "Addison only" patient who had adrenal insufficiency without nervous system involvement remained asymptomatic during Lorenzo's oil treatment. 4. All cerebral form patients except one showed the lesions in both parieto-ocipital white matter in brain magnetic resonance imaging. Conclusion: The cerebral ALD was the most common form in childhood and was asoociated with a serious prognosis.

• Journal of Acupuncture Research
• /
• v.22 no.3
• /
• pp.123-135
• /
• 2005

Objective : The aim of this study was to rivew systemically literature and clinical trials in the treatment of urinary incontinence or lower urinary tract syndrome(LUTS). Methods : Computerized literature searches were carried out on two electronic database, and computerized searching on some korea oriental medicine journals in library of Kyung-Hee Medical center. Results : 1. Three reports of review study, six reports of experimental study and fourteen reports of clinical trials were collected and reviewed. Three reports of review study were all printed in the korea oriental medicine journal. From 2000, researches and studies have been increased in quantity and improved in quality. 2. Urinary disturbance include variable symptoms of lower urinary tract symptoms, urinary incontinence, in theaspect of Oriental medicine these symptoms are anurin, dysuria, urinary incontinence, nochumal enuresis, uracratia and so on. 3. Roughly physiological procedure of Acupuncture in Treatment of Urianry Disturbance may be that effect of acupuncture stimulation for parasympathetic nerve, sleep-arousal system in cerebrum, pontine/spinal urination center and pudendal/pelvic nerve affect bladder in expansion of bladder capacity, inhibition of urinary contraction and affection in periurethral muscle by continuous excitement of spinal annular circuit and synapse of neuron. 4. Clinical result for acupuncture treatment in urinary disturbance is summarized that acupuncture treatment in urianation disturbance of Neurogenic Bladder, Incontinence, Cycitis, Nocturnal Enuresis, Prostatitis/Pelvic Pain Syndrom and so on is significant clinical trials and technique. Conclusion : Hereafter, in the old age society these variable urinary disturbance patients are increased and desire of treatment may be also increased. So study of various and formal treatment and tecnnique is needed.

• Sleep Medicine and Psychophysiology
• /
• v.8 no.2
• /
• pp.121-128
• /
• 2001

Objectives: In narcoleptic patients diagnosed with ICSD (international classification of sleep disorders, 1990) criteria, nocturnal polysomnography, and MSLT (multiple sleep latency test), we tried to find characteristic features of quantitative electroencephalography (QEEG) in a wakeful state. Methods: We compared eight drug-free narcoleptic patients with sex- and age-matched normal controls, using computerized electroencephalographic mapping technique and spectral analysis. Absolute power, relative power, interhemispheric asymmetry, interhemispheric and intrahemispheric coherence, and mean frequency in each frequency band (delta, theta, alpha and beta) were measured and analyzed. Results: Compared with normal controls, narcoleptic patients showed decrease in monopolar interhemispheric coherence of alpha frequency bands in occipital ($O_1/O_2$), parietal ($P_3/P_4$), and temporal ($T_5/T_6$) areas and beta frequency band in the occipital ($O_1/O_2$) area. Monopolar intrahemispheric coherences of alpha frequency bands in left hemispheric areas ($T_3/T_5$, $C_3/P_3$ & $F_3/O_1$) decreased. Decrease of monopolar interhemispheric asymmetry of delta frequency band in the occipital ($O_1/O_2$) area was also noted. The monopolar absolute powers of beta frequency bands decreased in occipital ($O_2,\;O_z$) areas. Conclusion: Decreases in coherences of narcoleptic patients compared with normal controls may indicate fewer posterior neocortical interhemispheric neuronal connections, and fewer left intrahemispheric neuronal connections than normal controls in a wakeful state. Therefore, we suggest that abnormal neurophysiological sites of narcolepsy may involve complex areas such as neocortex and subcortex as well as the brainstem.