• Title/Summary/Keyword: 신경학적 검사

Search Result 472, Processing Time 0.029 seconds

Analysis of Medical Decisions related to Epidural Hematoma after Spinal Surgery -Focusing on the Lumbar MRI- (척추 수술 후 발생한 경막외 혈종 관련 의료 판결 분석 -요추 MRI 시행 여부를 중심으로-)

  • Lee Dongjin
    • The Korean Society of Law and Medicine
    • /
    • v.25 no.1
    • /
    • pp.61-86
    • /
    • 2024
  • The purpose of this study was to investigate the importance of continuous and detailed follow-up of patients after spinal surgery by reviewing the literature on epidural hematoma and the lower court ruling on lumbar MRI during the judgment on the negligence of postoperative follow-up. In the case of neglecting MRI examination or cooperation after surgery, delaying MRI examination after pain and symptom appeal after surgery, and returning home immediately after neurological symptom development after surgery, negligence in progress observation was recognized. In the case of the case where the negligence was not recognized even after the occurrence of the aftereffects by taking measures against the symptoms, and the case where the scope of the doctor's discretion for the execution of the test was recognized, It is hoped that this study will help prevent medical accidents and disputes related to follow-up after spinal surgery by increasing awareness of the importance of prompt MRI examination, diagnosis, surgical treatment, and power, especially in the case of new neurological symptoms.

The Neuropsychological Characteristics of the Elementary School Aged Child by 'Computerized Neurocognitive Function Test' ('전산화 신경인지기능검사'를 통한 학령기 정상아동의 신경심리학적 특성)

  • Lee, Jong-Bum;Kim, Jin-Sung;Seo, Wan-Seok;Shin, Hyoun-Jin;Bai, Dai-Seg;Lee, Jun-Heob
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.11 no.2
    • /
    • pp.118-136
    • /
    • 2003
  • Objective: This study is to examine the neuropsychological and developmental characteristics of the Computerized Neurocognitive Function Test among normal children in elementary school. Methods: K-ABC, K-PIC, and Computerized Neurocognitive Function Test were performed to the 120 body of normal children(10 of each male and female) from June, 2002 to January, 2003. Those children had over the average of intelligence and passed the rule out criteria. One-way ANOVA and Bonferroni were used for statistical analysis. Results: In sampling of normal children in elementary school, the control of intelligence level and strict rule out criteria were applied. As a result, although 21.1% were excluded from of total participants, the children that passed the rule out criteria had over the average of intelligence and not differ in the intelligence level among the graders. Comparing Computerized Neurocognitive Function Test results among the graders, almost of variables had significant difference among the graders and especially between the 1st to 2nd and the 5th to 6th graders. In the attention tests, as rising the graders, the performance of tests were improved. In the short-term memory tests, the difference between forward and backward tests were same as the previous research result. The verbal auditory learning test composed of recall task and visual figure memory test composed of recognition task were same as the previous research result using the individual power or achievement test and also as rising the graders, the performance of those tests were improved. The higher cognitive function tests had the same results with other tests. Conclusion: The Computerized Neurocognitive Function Test devised for adult can be used of assessing child neuropsychological characteristics. For this objective, more strict sampling criteria, control of the intelligence and psychopathology were needed.

  • PDF

The Results of the ATP Based Chemotherapy Response Assay in Gastric Cancer Tissues (ATP-CRA 방법을 이용한 위암조직의 항암제 감수성 검사결과)

  • Lee, Je-Hyung
    • Journal of Gastric Cancer
    • /
    • v.7 no.3
    • /
    • pp.160-166
    • /
    • 2007
  • Purpose: Recently, chemosensitivity tests have become widely used for the selection of effective drugs in gastric cancer patients. In this study, a chemosensitivity test was performed to select agents to increase the effectiveness of adjuvant chemotherapy. Materials and Methods: Chemosensitivity testing was performed in 81 gastric cancer patients that received a gastrectomy at the Yeungnam University Hospital. An ATP (adenosine triphosphate) based chemotherapy response assay was used. Clinicopatholgical factors such as sex, age, expression of tumor markers (CEA and CA19-9 levels), location of the tumor, morphology of advanced cancer, histological type, cell differentiation, depth of invasion, Lauren classification, Ming classification, lymphatic invasion, vascular invasion, neural invasion, lymph node metastasis and TNM stage were used to correlate the chemosensitivity and clinicopathological factors. Results: The most effective antitumor agents in gastric cancer patients were (in order of effectiveness) 5-FU, Epirubicin, lrinotecan and Oxaliplatin in our series. The chemosensitivity test showed a significant difference in susceptibility according to clinicopathological factors. Conclusion: Further studies on multidrug therapy are needed to evaluate synergistic effects of drugs. Therefore, for effective chemotherapy, it is more efficacious to select a chemosensitive drug than continue to use the same drug regimen.

  • PDF

Assessment of Cerebral Collateral Circulation Using $^{99m}Tc$-Hexamethyleneamine Oxime (HMPAO) SPECT During Internal Carotid Artery Balloon Test Occlusion (내경동맥 풍선 시험 결찰술(BTO)시 $^{99m}Tc$-HMPAO 뇌 SPECT를 이용한 대뇌 측부 순환의 평가)

  • Ryu, Young-Hoon;Yun, Mi-Jin;Chung, Tae-Sub;Lee, Jong-Doo;Park, Chang-Yun
    • The Korean Journal of Nuclear Medicine
    • /
    • v.29 no.1
    • /
    • pp.22-30
    • /
    • 1995
  • To predict preoperatively the safety of permanent occlusion of an internal carotid artery with $^{99m}Tc$-HMPAO brain single photon emission computed tomography(SPECT) from an objective point of view, Twenty-four patients underwent balloon test occlusion (BTO) of the internal carotid arteries because of neck and skull base tumors. The authors assessed the uptake of both middle cerebral artery territories before and during BTO with $^{99m}Tc$-HMPAO brain SPECT using semiquantitative analysis method and compared the results with other factors(neurologic examination, arterial stump pressure and electroenceph-alogram). Nineteen patients had not experienced neurological deteriorating or any problem during BTO. Their comparative uptakes of the middle cerebral artery territories were 95 to 101% of the pre-BTO state. The remaining five patients showed severe neurologic symptoms such as transient hemiplegia and unconsciousness. Their comparative uptake of the middle cerebral artery territories were 77 to 85% of the pre-BTO state, and were well matched with other factors. $^{99m}Tc$-HMPAO brain SPECT before and during BTO seems to be a simple and objective method for prediction of permanent neurologic deficits when the comparative uptake of middle cerebral artery territories during BTO is lower than 85% of that before BTO.

  • PDF

Correlations of Cerebellar Function with Psychotic Symptoms and Cognitive Function in Schizophrenic Patients (남자 정신분열병 환자의 소뇌기능과 정신증상 및 인지기능간의 연관성)

  • Kim, Seo Young;Jun, Yong Ho;Kwon, Young Joon;Jeong, Hee Yeon;Hwang, Bo Young;Shim, Se Hoon
    • Korean Journal of Biological Psychiatry
    • /
    • v.14 no.3
    • /
    • pp.184-193
    • /
    • 2007
  • Objectives:There is increasing evidence that the cerebellum plays an important role in cognition and psychiatric symptoms as well as motor coordination. The concept of cognitive dysmetria has been making cerebellar function in schizophrenia the focus of current studies. In other words, disruption in the corticocerebellum-thalamic -cortical circuit could lead to disordered cognition and clinical symptoms of schizophrenia. The purposes of this study were to determine cerebellar dysfunction in male schizophrenic patients semiquantitatively with ICARS and to investigate the clinical and cognitive correlates of ICARS in patients. Methods:We compared the scores of cerebellar neurologic sign using ICARS in 47 male patients with a DSM-IV-TR diagnosis of schizophrenia with 30 gender and age-matched healthy control subjects. The semiquantitative 100-point ICARS consists of 19 items divided into 4 unequally weighted subscores:posture and gait disturbances, kinetic functions, speech disorders and oculomotor disorders. All subjects were also assessed with cognitive function test. Cognitive functions were evaluated by Korean-Mini Mental Status Examination (K-MMSE), Verbal fluency test, and Clock drawing test. The patients were administered Korea version of Positive and Negative Symptom Scale(K-PANSS) to assess the symptom severity. Results:Schizophrenic patients had significantly higher scores on the ICARS than control subjects with posture and gait disturbances, kinetic functions, and oculomotor disorders. They also showed more significant impairments in cognitive function tests than control subjects. There was a significant correlation between ICARS and negative symptoms of patients. In cognitive function test, Clock drawing test was significantly associated with negative symptoms. In addition, Clock drawing test was negatively correlated with the total score of ICARS. Conclusion:In this study, we confirmed that schizophrenic patients have significant impairments in cognitive and cerebellar function, and that those were related with negative symptoms of schizophrenic patients. These results support a role of the cerebellum in schizophrenia. It is meaningful that we used a structured, and reliable procedure for rating neurological soft signs, ICARS. We hope that future prospective studies using a similar design help that rate of neurological sign should have been visible with the progression of illness.

  • PDF

A Case of Intrapulmonary Neurilemmoma (폐실질안의 신경초종 체험 1례)

  • Park, Jong-Ho;Baek, Hui-Jong
    • Journal of Chest Surgery
    • /
    • v.30 no.5
    • /
    • pp.540-543
    • /
    • 1997
  • In this paper, we present an extremely rare case of a primary intrapulmonary neurogenic tumor, in which localization of S-100 protein was investigated using immunohistochemical staining. The patient, who was a 47 year old man, experienced no symptoms, however, a routine chest X-ray revealed a round tumor like shadow in the hilar area of left lung. To confirm and cure the mass, surgery was performed. Histopathological examination of the excised tumor revealed it to be a primary intrapulmonary neurilemmoma. Immunohistochemical staining demonstrated the presen e of S-100 protein in the tumor cells.

  • PDF

Prognostic Value of Repeated Cerebrospinal Latex Agglutination Testing in Bacterial Meningitis (세균성 뇌수막염에서 뇌척수액 Latex 응집 추적검사의 유용성)

  • Lee, Soo Jeong;Ahn, So Hyun;Cho, Su Jin;Kim, Hae Soon;Lee, Seung Joo
    • Clinical and Experimental Pediatrics
    • /
    • v.46 no.4
    • /
    • pp.345-350
    • /
    • 2003
  • Purpose : Bacterial meningitis is a serious infection of childhood associated with a significant morbidity and mortality. Repeated cerebrospinal fluid(CSF) examination is a useful prognostic indicator and a delayed sterilization is associated with a higher incidence of neurologic abnormalities. In this study we tried to determine the prognostic value of repeated CSF latex agglutination testing. Methods : We retrospectively evaluated 19 patients admitted to Ewha Womans University Mokdong Hospital for bacterial meningitis from January 1997 to June 2002. Bacterial meningitis was confirmed by a positive CSF culture and a positive CSF latex agglutination test. Repeated CSF examinations were done at three, seven, 14, 21 and 28 days after antibiotics therapy. Neuroradiologic studies were performed. Results : The mean age was $10.6{\pm}12.3months$(range; two to 33 months). The male to female ratio was 2.8 : 1. The causative organisms were Haemophilus influenzae type b 57.9%, Group B Streptococcus 21.1%, Streptococcus pneumoniae 15.7% and Escherichia coli 5.3%. Three days after the initiation of antibiotics therapy, repeated CSF latex agglutination tests persisted as positive in nine (47.4%) out of 19 cases, but all CSF cultures became negative. In those cases with negative latex agglutination tests three days after antibiotics therapy, neuroradiologic findings were completely normal. But, in cases with positive latex agglutination tests three days after antibiotics therapy, neuroradiologic abnormalities such as cerebral infarction, encephalomalasia occurred in 44.4%. Conclusion : Repeated CSF latex agglutination testing was valuable as a prognostic factor in bacterial meningitis. Neuroradiologic abnormalities may occur in cases with delayed clearance of CSF latex agglutination tests more often than in cases with negative latex agglutination tests three days after antibiotics therapy.