• Title/Summary/Keyword: 신경학적 검사

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The Effect of Combination Intervention of Occupation - Based Intervention and Computerized Cognitive Rehabilitation on Depression in Stroke Patients for Wellness (작업기반 중재와 전산화인지재활치료의 결합 중재가 뇌졸중 환자의 웰니스를 위한 우울감에 미치는 영향)

  • Kim, Sun-Ho
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.1
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    • pp.229-236
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    • 2021
  • The purpose of this study is to investigate how the combined intervention of occupation-based intervention and computerized cognitive rehabilitation treatment affects the psychosocial function, cognitive function, and depression of stroke patients. 23 stroke patients were divided into experimental group(n=11) and a control group(n=12), and the experimental group and the control group received CoTras for 4 weeks and 30 minutes each, and additionally the experimental group received task-based intervention for 30 minutes before the start of CoTras. It was conducted 20 times for a total of 4 weeks. Self-efficacy scale, stress scale, depression scale, neurobehavioral cognitive status examination were used. As a result of the study, the experimental group showed significant improvement in improvement of self-efficacy, stress, and depression than the control group, and the experimental group showed a small effect difference in magnitude of effect from the control group in cognitive function. Based on this study, it is possible to utilize the simultaneous task-based intervention with CoTras to improve psychosocial function, depression and cognitive function in stroke patients.

A Case Report of Pontine Infarction as an Initial Manifestation of Systemic Lupus Erythematosus: Diagnostic Clues from MRI and Digital Subtraction Angiography (전신성 홍반성 루푸스의 초기 증상으로 나타난 교뇌경색의 증례 보고: 자기공명영상 및 디지털감산 혈관조영술에서의 진단 단서)

  • Mi Sun Chung;Jun Soo Byun;Younghee Yim
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1281-1286
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    • 2021
  • Brainstem infarction due to vertebrobasilar insufficiency is a rare initial presentation of systemic lupus erythematosus (SLE) patients and small-vessel dissection as the direct cause of infarction has not been reported. We report the case of a 20-year-old female with acute infarction on the right side of the pons due to a small artery (pontine perforator) dissection, identified on digital subtraction angiography and high-resolution vessel wall MRI (vwMRI). She was diagnosed with SLE based on the presence of neurologic disorders and relevant laboratory findings. The pontine perforator-dissecting aneurysm had occluded and the right distal vertebral artery had resolved on subsequent vwMRI. She had a modified Rankin Scale (mRS) score of 1 at discharge with mild symptom improvement, and exhibited no further aggravation of symptoms at 3 or 12 months, maintaining an mRS score of 1.

Comparison of hypertonic saline treatment in meningitis with cerebral edema (뇌수막염에서 발생한 뇌부종 치료에서 고장성 식염수 비교)

  • Kim, Hyung Su;Kim, Hee Ra
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1275-1281
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    • 2006
  • Purpose : Cerebral edema in meningitis is a potentially complication. Hypertonic saline of various concentrations are frequently used to treat cerebral edemas in meningitis. We analyzed the safety and efficacy of osmotic therapy in cerebral edema by comparison of various hypertonic saline concentrations and mannitol. Methods : The medical records of 42 patients, who were followed up in the Department of Pediatrics, Busan Medical Center, from Jan. 2002 to Oct. 2005, were analyzed retrospectively. We measured intracranial pressure, mean flow velocity, and various laboratory parameters. Results : In cerebral edema developed in meningitis, intracranial pressure and symptoms were improved in treatment of hypertonic saline and mannitol. Serial bolus infusion of 3 percent hypertonic saline resulted in the best outcome. There was not a statistically considerable difference on the mean values of the intracranial pressure gap. On transcranial doppler, mean flow velocity was increased and pulsatilty index was decreased. Laboratory findings (osmolarity, Na, Cl, pH, lactic acid, Ca) were diffenent during the treatment period as opposed to K, Hb, bicarbonate, base excess. There was not a specific form of hypertonic saline used in meningitis treatment with cerebral edema. Conclusion : The therapy for cerebral edema in meningitis remains largely empirical. Serial bolus infusion of 3 percent hypertonic saline is better than other hypertonic salines. Various concentrations and different infusion methods of hypertonic saline statistically does not influence the result of treatment. More research aimed at improving cerebral edema treatment is needed to identify new, effective forms of treatment.

A Study on the Nutritional Assessment and the Effects of Enteral Nutritional Supports of Tube Feeding In-patients (경관급식 중인 입원환자의 영양상태 평가와 영양 보충제 투여의 영향에 관한 연구)

  • 윤숙영;김성미
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.25 no.5
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    • pp.855-864
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    • 1996
  • The purpose of this study is to evaluate nutritional status of tube feeding patients, and to investigate the effects of giving enteral nutritional support to them. 83 in-patients have been examined for their nutritional status. The mean caloric density was 0.77kca1/m1. 36.1% to 75.9% of them were malnourished in terms of biochemical assessment. The energy intake showed the significant and positive correlation in all biochemical parameters. And the protein intake showed the significant and positive correlation in total protein, serum albumin, serum iron, hemoglobin, hematocrit and TLC. But age was correlated negatively to serum albumin and transferrin. The amount of energy and protein intake has been significantly increased as the tube feeding duration became longer. Also the effect of enteral nutritional support for 6 weeks has been investigated. Case group(n=8) was administered 250kca1 of polymeric formula in addition to their usual diet, while control group(n=8) kept the amount of their original intake. When comparing the biochemical changes of the case group and those of control group at week 0 and week 6 respectively, it showed significant differences in total protein, serum transferrin and TLC. This study suggests that the malnourished status of tube feeding patients can be improved and even prevented if nutritional support is properly administered.

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Tc-99m ECD Brain SPECT in Patients with Traumatic Brain Injury: Evaluating Distribution of Hypoperfusion and Assesment of Cognitive and Behavioral Impairment in Relation to Thalamic Hypoperfusion (뇌외상 환자의 Tc-99m ECD 뇌 SPECT에서 뇌 혈류감소의 분포 및 시상의 혈류감소에 대한 인지 및 행동장애 평가)

  • Park, Soon-Ah;Lim, Seok-Tae;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.6
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    • pp.445-455
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    • 2000
  • Purpose: We evaluated the distribution of hypoperfusion in patients with traumatic brain injury (TBI) and the relationship of thalamic hypoperfusion to severity of cognitive and behavioral sequelae. Materials and Methods: Tc-99m ECD SPECT and MRI were performed in 103 patients (M/F=81/22, mean age $34.7{\pm}15.4$ yrs) from 0.5 to 55 months (mean 10.3 months) after TBI. The patients were divided into three groups showing no abnormalities (G1), focal (G2) and diffuse injury (G3) on MRI. Psychometric tests assessed 11 cognitive or behavioral items. In all patients, we evaluated the distribution of hypoperfused areas in SPECT, and in 57/103 patients, neuropsychological (NP) abnormalities in patients with thalamic hypoperfusion were compared with those of patients without thalamic hypoperfusion. Results: The perfusion deficits were most frequently located in the frontal lobe (G1, 42.3%: G2 34.5%: G3 33.3%), temporal lobe ($24{\sim}26%$) thalami ($21{\sim}22.4%$), parietal and occipital lobe (${\leq}10%$). Numbers of NP abnormalities in the cases of cortical hypoperfusion with or without concomitant thalamic hypoperfusion were following: the former $4.7{\pm}1.5$ and the latter $3.2{\pm}1.4\;in\;G1,\;5.0{\pm}1.1\;and\;4.8{\pm}1.2\;in\;G2,\;6.8{\pm}1.8\;and\;6.3{\pm}1.1\;in\;G3$, respectively. This difference according to thalamic hypoperfusion was significant in G1 (p=0.002), but was not significant in G2 or G3. Conclusion: SPECT in patients with TBI had demonstrated hypoperfusion mostly involving the frontal, temporal and thalami. In normal group on MRI, frontal hypoperfusion was more prominent than that of any other group, Furthermore in this group, SPECT could predict severity of NP outcome by concomitant thalamic hypoperfusion with cerebral cortical abnormalities.

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SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY FINDINGS IN ATTENTION DEFICIT- HYPERACTIVITY DISORDER (주의력결핍 ${\cdot}$ 과잉운동장애의 단일광자방출 전산화단층촬영 소견에 관한 연구)

  • Cho, Soo-Churl;Lee, Myung-Chul;Moon, Dae-Hyuk
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.27-39
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    • 1990
  • The neural mechanisms involved in attention deficit hyperactivity disorder are largely unknown. In order to investigate the neuroanatomical lesions of attention deficit hyperactivity disorders and their relationships with psychopathology, Single Photon Emission Computed Tomography(SPECT) using HMPAO was performed in 46 ADHDS and Yale Children's Inventory(YCI), Conners Parent Questionaire and DSM-III-R Questionaire for Disruptive Behavior Disorder were used to assess the psychopathology of ADHDS The results are summarized as follows; 1) 30.4% (14/46) of this series revealed decreased perfusion In SPECT. 2) Regions of hypoperfusion were seen in cerebral cortex(17.4%, 8/46), thalamus(13.0%, 6/46), deep gray matter(8.7%, 4/46), basal ganglia(6.5%, 3/46) and cerebellum(2.2%, 1/ 46). 3) The mean scores of the total YCI revealed significant difference between the two groups(SPECT abnormal versus normal group), and among the subscales, hyperactivity, language and fine-motor subscales showed significant differences between the two groups. Although the relationship between the abnormal findings and specific symptom clusters of ADHDS remains unclear, we can suggest that these abnormal findings could be associated with ADHD, and based on these findings, the ADHDS can be subclassified into two groups. This study can be said to reinforce the current conception of heterogeneity of ADHD.

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Analysis of Differences in Fractional Anisotropy of Diffusion Tensor Images of Basal Ganglia in the Brain Gray Matter according to Smoking (뇌 회백질 기저핵 부위의 흡연유무에 따른 확산텐서 비등방도 측정값 차이분석)

  • Kwak, Jong Hyeok;Jeong, Jae Beom;Son, Bong Kyeong;Sung, Soon Ki;Kim, Seong Jin;Kang, Dong Won;Park, Chan Hyeok;Im, Hyeon Wha;Lee, Yu Hui;Lee, Bong Sang;Kim, Dong hyeon
    • Journal of the Korean Society of Radiology
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    • v.12 no.2
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    • pp.261-269
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    • 2018
  • The fractional anisotropy value of the basal ganglia fibers in the brain gray matter region was analyzed by Tract-Based Spatial Statics(TBSS) method after acquiring the diffusion tensor image to identify the presence or absence of brain white matter damage to smoking in male. As a result of measurement analysis, the fractional anisotropy measurement value was lower in smokers than non-smokers in all areas, and the FA value was statistically significant. smoking significantly affects all the anatomic micro structural changes in the brain gray matter and damages the nerve fiber tract. As a result, it can affects functional abnormalities related to the minute changes of the brain due to smoking.

The Ornithine Transcarbamylase (OTC) Deficiency Identified by a Novel Mutation (새로운 유전자 돌연변이로 확진된 Ornithine Transcarbamylase (OTC) 결핍증 1례)

  • Song, Ari;Lee, Kiwuk;Yang, Aram;Kim, Jinsup;Park, Hyung-Doo;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.3
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    • pp.148-154
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    • 2016
  • A urea cycle disorder is a condition caused by a defect of the enzymes in the urea cycle, and deficiency of ornithine transcarbamylase (OTC), which converts carbamoyl phosphate and ornithine into citrulline, is the most common type of the disorder. OTC deficiency induces the accumulation of precursors of urea, ammonia, and glutamine, leading to neurological symptoms including hypotonia, respiratory failure, seizure, lethargy, and coma and sometimes to death. Because OTC deficiency is inherited in an X-linked manner, typical symptoms such as vomiting, poor feeding, and lethargy appear mainly in male neonates. We recently had a case that presented with neonatal onset lethargy, vomiting, and apnea in a 4-day-old boy. He was diagnosed with OTC deficiency by biochemical phenotype, including hyperammonemia and an increased orotic acid level in the urine. Genetic analysis of the OTC gene showed a novel mutation c.780_781insCAGGCAGTGT (p.Ile261Glnfs*35). He was treated for hyperammonemia using continuous venovenous hemofiltration (CVVH) at 118 hours after birth. After 4 days of CVVH, his consciousness and blood ammonia concentration were normalized, and he was discharged at the age of 53 days. At around 12 months of age, bilateral femur fractures and osteomyelitis occurred in this patient. Two months after the fracture, he died of septic shock, insulin-resistant hyperglycemia, and multi-organ failure.

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A Case of Propionic Acidemia Presenting with Dilated Cardiomyopathy (확장성 심근병증으로 발현된 프로피온산혈증 1례)

  • Son, Jisoo;Choi, Yoon-Ha;Seo, Go Hun;Kang, Minji;Lee, Beom Hee
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.21 no.1
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    • pp.22-27
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    • 2021
  • Propionic acidemia (PA) is an inherited autosomal recessive disorder, due to the deficiency of propionyl-CoA carboxylase (PCC). PCC is the enzyme which catalyzes the conversion of propionyl-CoA to D-methylmalonyl-CoA, and it is critical for the metabolism of amino acids, odd-chain fatty acids, and side chains of cholesterol. The clinical manifestations present mostly at the neonatal period with life-threatening metabolic acidosis and hyperammonemia. Here, we described a case of a 16-year-old Korean boy with late-onset PA who presented with embolic cerebral infarction due to dilated cardiomyopathy (DCMP) with left ventricular noncompaction. And he has family history of sudden cardiac death, so we performed metabolic screening and genetic tests. Elevated levels of 3-hydroxypropionic acid, methylcitric acid and propionylglycerine were detected in urine. Plasma acylcarnitine profile showed elevated propionylcarnitine (C3). Diagnosis of PA was confirmed by genetic analysis, which revealed compound heterozygous mutations, c.[1151T>G] (p.[Phe384Cys]) and c.[1228C>T] (p.[Arg410Trp]) in PCCB gene. His heart function is in improving state and the results of biochemical analysis are stable with heart failure medication and metabolic managements. We present a case of patient without episodes of metabolic decompensation who manifests DCMP as the first symptom of PA.

A comparison of the absolute error of estimated speaking fundamental frequency (AEF0) among etiological groups of voice disorders (음성장애의 병인 집단 간 추정 발화 기본주파수 절대 오차 비교)

  • Seung Jin Lee;Jae-Yol Lim;Jaeock Kim
    • Phonetics and Speech Sciences
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    • v.15 no.4
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    • pp.53-60
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    • 2023
  • This study compared the absolute error of estimated fundamental frequency (AEF0) using voice - (VRP) and speech range profile (SRP) tasks across various etiological groups with voice disorders. Additionally, we explored the association between AEF0 and related voice parameters within each specific etiological group. The participants included 120 individuals, comprising 30 each from the functional (FUNC), organic (ORGAN), and eurological (NEUR) voice disorder groups, and a normal control group (NC). Each participant performed voice and SRP tasks, and the fundamental frequency of connected speech was measured using electroglottography (EGG). When comparing the AEF0 measures across the etiological groups, there were no differences in Grade and Severity among the patients. However, variations were observed in AEF0VRP and AEF0SUM. Specifically, AEF0VRP was higher in the ORGAN group than in the FUNC and NC groups, whereas AEF0SUM was higher in the ORGAN group than in the NC group. Furthermore, within FUNC and NEUR, AEF0 showed a positive correlation with Grade, while in ORGAN, it exhibited a positive correlation with the mean closed quotient (CQ). Attention should be paid to the application of AEF0 measures and related voice variables based on the etiological group. This study provides foundational information for the clinical application of AEF0 measures.