• Title/Summary/Keyword: 신경학적 검사

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COMPARISON OF DEMOGRAPHIC, CLINICAL, PSYCHOLOGICAL CHARACTERISTICS BETWEEN CHILDHOOD AND ADOLESCENT-ONSET SCHIZOPHRENIA (소아기 발병 및 청소년기 발병 정신분열병 환아의 인구학적, 임상적, 심리학적인 특성)

  • Chungh Dong-Seon;Lim Myung-Ho;Kim Soo-Kyoung;Jung Gwang-Mo;Hwang Jun-Won;Kim Boong-Nyun;Shin Min Sup;Cho Soo-Churl;Hong Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.219-230
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    • 2005
  • Objectives : This study was designed to compare the demographic data, clinical characteristics, developmental delay, and psychological tests between childhood-onset and adolescent-onset schizophrenic in-patients. Methods Medical records of the 17 childhood-onset (very early onset) Schizophrenia and 16 adolescent-onset (early onset) Schizophrenia in-patients were reviewed. Sex, age, psychiatric past history, prodromal symptoms and period, subtype, co-morbid disease, developmental delay, prescribed drug and dosage, treatment response, intelligence quotient (IQ), and Rorschach test were evaluated. Results : The mean admission age of childhood-onset (very early onset) group and adolescent-onset (early onset) group were 12.69$({\pm}2.34)$ and 15.13$({\pm}1.04)$ years. The mean onset age of childhood-onset(very early onset) group and adolescent-onset (early onset) group were 10.79$({\pm}1.95)$ and 14.46$({\pm}0.82)$ years. The mean prodromal period of childhood-onset (very early onset) group and adolescent-onset (early onset) group were 15.94$({\pm}12.33)$ and 8.06$({\pm}6.10)$ month. The time to remission period of childhood-onset (very early onset) group and adolescent-onset (early onset) group were 50.58$({\pm}24.67)$ and 30.06$({\pm}18.04)$ days. Longer time to remission period in childhood-osnet (very early onset) group was associated with earlier age of onset. The mean of total IQ, performance IQ, verbal IQ were at an average level. Discussion : Childhood-onset (very early onset) group and adolescent-onset (early onset) group Schizophrenia had different clinical and psychological features including prodromal period, and IQ subtests.

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The Effect of working Noise Exposure and Military Background on the Hearing Threshold (특수병과의 과거 군 소음 노출이 소음 노출 작업자의 청력에 미치는 영향)

  • Chung, Ho-Keun;Kim, Kyoo-Sang
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.2
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    • pp.137-146
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    • 2003
  • Objectives : Impaired hearing is a prevalent occupational hazard, not only in industry, but also in the armed forces. In military life, noise has unusual characteristics, and constitutes a serious hazard to hearing. The aim of this study was to analyze the hearing threshold data in order to compare the hearing loss among shipyard workers, representing different workers, and a military service background. Methods : A cross-sectional audiological survey, combined with a questionnaire study, was conducted on a stratified random sample of 440 shipyard workers, with long-term exposure to noise. The employees were divided into four groups, according to their working and military service backgrounds, in relation to their exposure to noise. Results : As expected, the working and military noise exposure group (Group I) had significantly poorer hearing than the other groups. The high frequencies (2-8 kHz) showed the greatest difference in terms of poorer fearing in both ears. The prevalence of noise-induced hearing loss (NIHL) was highest in Group I. A logistic regression analysis was applied to determine the dependence of the NIHL in relation to age, smoking, drinking, working duration, ear protection, past history of ear diseases, and working and military sonics backgrounds, on the noise exposure The important factors found to be related to the NIHL, in relation to noise exposure were: age, work duration, and working and military service backgrounds. The adjusted odds ratio estimates for NIML in the right ear were 4.5 times greater (95% CI 1.7-11.6) for the military noise exposed group, and 7.9 times greater (95% CI 2.0-31.3) for the working noise exposed group than in the controls. The hearing thresholds at the pure-tone average and 4 kHz were significantly increased with age and work duration with both the working and military service backgrounds. Conclusions : From these results, specific preventive programs were planned, which should be assessed by epidemiological surveillance of the military noise exposed population.

The study of Intercostal Nerve Block and Patient-Controlled Analgesia for Post-Thoracotomy Pain (개흉술 후 동통억제에 대한 신경차단법 및 환자자가 치료법의 비교연구)

  • 김우종;이길노
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.920-926
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    • 1997
  • Remarkable effect of pain relief and prevention of the postoperative Complications after thoracotomy has been achieved by continuous intravenous analgesia. This study was carried out with thirty patients who underwent posterolateral thoraco tony. The patients were divided into three groups: Group I(n= 10), the patients with intermittent intramuscular analgesia(piroxicam 20 mg), Group II(n=10), the patients with continuous epidural analgesia(0.5% bupivacaine 30m1 + normal saline 30 ml + morphine 10 mg), and Group III(n= 10) the patients with controlled intravenous infusion of analgesics(fentanyl 2500 mfg +normal saline 10 ml). The results w re as follows; 1) There were no significant changes of vital signs, between groups. 2) Tidal volume and FVC were significantly improved in the group II and III compared with the group I during the first postoperative day. 3) A significant reduction of immediate post-thoracotomy pain was achieved in the group II and III compared with the group I. 4) The limitation of motion in the operative side was less in the group II and III compared with the group I. 5) A signi(icant reduction of the postoperative analgegics consumption was noticed in group II and III. 6) Significant complications were not occured during follow-up period in all groups.

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Association of Diagnostic Criteria and Autoantibodies with Juvenile Dermatomyositis in Newly Diagnosed Children (소아기 피부근염의 진단 기준과 자가항체의 진단적 의의)

  • Shin, Kyung Sue;Kim, Joong Gon
    • Clinical and Experimental Pediatrics
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    • v.46 no.9
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    • pp.898-902
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    • 2003
  • Purpose : To determine the clinical association of diagnostic criteria and the prevalence of autoantibodies in newly diagnosed children with juvenile dermatomyositis(JDM). Methods : Thirty-two children with JDM were identified at Seoul National University Children's Hospital from March 1985 to March 1999 by retrospective review. The diagnosis of JDM was based on the criteria proposed by Bohan and Peter. We investigated for the presence of several autoantibodies: antinuclear(ANA), double-stranded DNA, anti-Sm, anti-ribonucleoprotein(RNP), anti-SSA/ SSB, anti-Jo1, anti-Scl-70 antibodies and rheumatoid factor(RF). Results : Sex ratio and age at diagnosis were similar to data published in other studies. All the newly diagnosed children with JDM had a typical rash(100%) and proximal muscle weakness(100%); 17(53%) had muscle pain or tenderness; 10(31%) calcinosis; eight(25%) dysphagia; eight(25%) arthritis, and seven(22%) fever. Muscle enzymes were elevated in 90% of the patients. Of the 27 patients who had an electromyogram, 20(70%) had diagnostic results. Sixteen(70%) of biopsied patients had appropriated results for JDM. Patients were negative for all autoantibodies except ANA and RF. ANA and RF were detected in 47% and 7% of the patients respectively. Conclusion : Although the sensitivity of the criteria proposed by Bohan and Peter is superior, each of these criteria has possible confounding factors. Additional criteria may be needed for early diagnosis of JDM. Based on our findings of autoantibodies in JDM, we do not recommend routine testing for autoantibodies in children with typical JDM.

Cerebral-perfusion Reserve after Carotid-artery Stenting: Relationship with Power Spectrum of Electroencephalography (경동맥스텐트삽입술 후의 뇌관류예비능: 뇌파파워스펙트럼과의 연관성)

  • Jeong, Da-hye;Jung, Seokwon;Kwak, Byeonggeun;Kim, Young-Soo;Kim, Soo-kyoung;Kwon, Oh-Young
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.2
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    • pp.144-152
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    • 2016
  • Carotid-artery stenosis may reduce cerebral perfusion, and affect cerebral neuronal activities. We examined the question of whether the recovery of cerebral-perfusion reserve after carotid-artery stenting (CAS) can affect the EEG power-spectrum. Nineteen candidates for CAS were initially recruited. Subtraction imaging of single photon emissary computerized tomography (SPECT) and an electroencephalogram (EEG) were taken twice, before and 1 month after CAS. At each time point, the EEGs were recorded before and after injection of acetazolamide (pre-ACZ EEG and post-ACZ EEG). Finally, 7 patients were enrolled after exclusion of incomplete studies. We obtained the spectral ratio (SR) of each hemisphere. SR was defined as the divided value of the power-spectrum sum of fast activities by that of slow activities. The power-spectrum values between hemispheres were compared using the inter-hemispheric index of spectral ratio (IHISR), and we examined the correlation between the power-spectrum and the cerebral-perfusion reserve. Cerebral-perfusion reserve improved after CAS on the stent side in 6 of 7 patients. In 3 patients with unilateral carotid-artery stenosis, CAS increased SR on the pre-ACZ EEGs, and IHISR on the post-ACZ EEGs. The increases of SR and IHISR were concordant with the increment of cerebral-perfusion reserve. In contrast, the results in the other patients with bilateral stenosis showed complex patterns. The SR of pre-ACZ EEGs and IHISR of post-ACZ EEGs may be useful electrophysiological markers for the blood-flow reserve after CAS in patients with unilateral carotid-artery stenosis, but not in those with bilateral stenosis.

Studies on the Repeated Toxicity Test of Food Red No.2 for 4 Weeks Oral Administration in SD Rat (SD랫드에서 식용색소 적색2호의 4주간 경구투여에 따른 반복독성시험에 관한 연구)

  • Yoo, Jin-Gon;Jung, Ji-Youn
    • Journal of Food Hygiene and Safety
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    • v.27 no.1
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    • pp.42-49
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    • 2012
  • This study was carried out to investigate the toxicity of food Red No.2 in the Sprague-Dawley (SD) female rat for 4 weeks. SD rats were orally administered for 28 days, with dosage of 500, 1,000, 2,000 mg/kg/day. Animals treated with food Red No.2 did not cause any death and show any clinical signs. They did not show any significant changes of body weight, feed uptake and water consumption. There were not significantly different from the control group in urinalysis, hematological, serum biochemical value and histopathological examination. In conclusion, 4 weeks of the repetitive oral medication of food Red No.2 has resulted no alteration of toxicity according to the test materials in the group of female rats with injection of 2,000 mg/kg. Therefore, food Red No.2 was not indicated to have any toxic effect in the SD rats, when it was orally administered below the dosage 2,000 mg/kg/day for 4 weeks.

The relationship between the time from arrival at a hospital to delivery and the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age (재태주령 34주 이전에 출생한 미숙아에서 병원도착시점에서 분만까지 소요된 시간과 뇌성마비 발생과의 관련성)

  • Hwang, Jae Woong;Heo, A Lum;Koo, Soo Hyun;Lee, Hae Jung;Lee, Jun Wha;Lee, Joo Seok;Cho, Kyung Lae
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1228-1233
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    • 2009
  • Purpose : This study aimed to evaluate whether a shorter time from the arrival at a hospital to delivery is related to the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age. Methods : We studied 142 newborns of less than 34 weeks of gestational age. The time from the arrival at the hospital to delivery was measured. The correlation between the time required for delivery and the occurrence of cerebral palsy was elucidated by diagnosing cerebral palsy in neonates using the Korean Infant Development Screening Test and neurological examination. Results : Preliminary result suggested that a shorter time from hospital arrival to delivery was related to a lower development score for gross motor activity and to a higher frequency of cerebral palsy occurrence. Moreover, it was responsible for a tendency of obtaining lower Apgar scores at 1 and 5 minutes. The shorter delivery time was associated with a higher probability of respiratory distress syndrome (RDS) occurrence when the length of delivery time was less than 6 hours and there was a higher probability of a shorter gestation period. However, the multifactor analysis revealed that there was little impact of delivery time on the occurrence of cerebral palsy. Conclusions : The length of hospital arrival time to delivery did not significantly influence the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age.

Neuroprotective effects of geneticin (G418) via apoptosis in perinatal hypoxic-ischemic brain injury (주산기 저산소성 허혈성 뇌손상에서 항고사를 통한 geneticin (G418)의 신경보호 효과)

  • Ju, Mi;Lee, Hyun Ju;Lee, Sun Ju;Seo, Eo Su;Park, Hye Jin;Lee, Kye Yang;Lee, Gyeong Hoon;Choi, Eun Jin;Kim, Jin Kyung;Lee, Jong Won;Chung, Hai Lee;Kim, Woo Taek
    • Clinical and Experimental Pediatrics
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    • v.51 no.2
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    • pp.170-180
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    • 2008
  • Purpose : Some antibiotics were known to exert neuroprotective effects in the animal model of hypoxic-ischemic (H-I) brain injury, but the mechanism is still unclear. A recent study reported that geneticin (G418), an aminoglycoside antibiotic, increased survival of human breast cancer cells by suppressing apoptosis. We investigated the neuroprotective effects of systemically administrated geneticin via anti-apoptosis following the H-I brain injury Methods : Seven-day-old Sprague-Dawley rat pups were subjected to unilateral (left) common carotid artery occlusion followed by 2.5 hours of hypoxic exposure and the cortical cell culture of rat brain was done under a hypoxic incubator. Apoptosis was measured in the injured hemispheres 7 days after H-I insult and in the injured cells from hypoxic chamber using morphologic analysis by Terminal dUTP Nick-end Labeling(TUNEL) assay and immunohistochemistry for caspase-3, and cytologic analysis by western blot and real time PCR for bax, bcl-2, and caspase-3. Results : The gross appearance and hematoxylin and eosin stain revealed increased brain volume in the geneticin-treated animal model of perinatal H-I brain injury. The TUNEL assay revealed decreased apoptotic cells after administration of geneticin in the cell culture model of anoxia. Immunohistochemistry showed decreased caspase-3 expression in geneticin-treated cortical cell culture. Western blot and real-time PCR showed decreased caspase-3 expression and decreased ratio of Bax/Bcl-2 expression in geneticin-treated animal model. Conclusion : Geneticin appears to exert a neuroprotective effect against perinatal H-I brain injury at least via anti-apoptosis. However, more experiments are needed in order to demonstrate the usefulness of geneticin as a preventive and rescue treatment for H-I brain injuries of neonatal brain.

Clinical Characteristics and Prognosis of Neonatal Seizures (신생아 경련의 임상적 양상 및 예후에 관한 고찰)

  • Kim, Chang Wu;Jang, Chang Hwan;Kim, Heng Mi;Choe, Byung Ho;Kwon, Soon Hak
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1253-1259
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    • 2003
  • Backgroud : Seizures in the neonate are relatively common and their clinical features are different from those in children and adults. The study aimed to provide the clinical profiles of neonatal seizure in our hospital. Methods : A total of 41 newborns with seizures were enrolled in this study over a period of three years. They were evaluated with special reference to risk factors, neurologic examinations, laboratory data, neuroimaging studies, EEG findings, seizure types, response to treatment, and prognosis, etc. Results : The average age at onset of seizures was $6.1{\pm}4.6days$ and the majority of patients(42%) had multifocal clonic seizure and 24% had subtle seizure. Factors that are known to increase risk of neonatal seizures include abnormal delivery history, birth asphyxia, and electrolyte imbalance, etc. However, they remain obscure in about 20% of cases. More than 50 percent showed abnormal lesions on neuroimaging studies such as brain hemorrhage, periventricular leukomalacia, brain infarction, cortical dysplasia, hydrocephalus, etc. and 17 out of 32 patients showed abnormal electroencephalographic patterns. Phenobarbital was tried as a first line antiepileptic drug and phenytoin was added if it failed to control seizures. The treatments were terminated in the majority of patients during the hospital stay. The overall prognosis was relatively good except for those with abnormal EEG background or congenital central nervous system malformations. Conclusion : Neonatal seizures may permanently disrupt brain development. Better understanding of their clinical profiles and appropriate management may lead to a reduction in neurological disability in later childhood.

Radiosurgery with Linac Based Photon Knife in Cerebral Arteriovenous Malformation (선형가속기를 이용한 Photon Knife 방사선수술에 의한 뇌동정맥기형의 치료)

  • Kim, Jin-Hee;Choi, Tae-Jin
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.1-9
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    • 2003
  • Purpose : The purpose of this study was to analyze the effect of a Linear accelerator based Photon Knife Radiosurgery System developed by the staff of Keimyung University Dongsan Medical Center for the treatment of cerebral arterlovenous malformation Material and Methods : Between December 1993 and October 2000, 30 patients with cerebral arteriovenous malformation (AVM) were treated with the Linac based Photon knife Radlosurgery System In the Department of Therapeutlc Radiology at Keimyung University Dongsan Medical Center. The median age was 34, ranging from 7 to 63 years, with a 2 : 1 male to female ratio. The locations of the AVM nidi were the frontal lobe (motor cortex), parletal lobe, and the thalamus, In that order. The diameters of the AVM nidi ranged 1.2 to 5.5 cm with a mean on 2.9 cm, and target volumes of between 0.5 and 20.5 cc, with a mean of 5.8 cc. The majority of patients received radiation doses of between 1,500 and 2,500 cGy, w14h a mean of 2,000 cGy, at 80% the isodose line. Twenty-five patients were treated with one isocenter, 4 with two, and 1 with four. The follow-up radiological evaluations were peformed with cranial computed tomogram (CT) or MRI between 6 month and one year interval, and if the AVM nidus had completely disappeared in the CT or MRI, we confirmed thls was a complete obliteration, with a cerebral or magnetic resonance angiogram (MRA). The median iollow-up period was 39 months with a range of 10 to 103 months. Results : Twenty patients were radloiogicaiiy followed up ior over 20 months, with complete obliteration observed in 14 (70%). According to the maximal diameter, all four of the small AVM (<2 cm) completely obliterated, 8 of the 10 patients with a medium AVW (2~3 cm) showed a complete obliteration, and two showed partial obliteration. Among the patients with a large AVM (>3 cm), only one showed complete obliteration, and S showed partial obliteration, but 3 oT these underwent further radiosurgery 3 years later. One who followed up for 20 months fellowing further radiosurgery eventually showed complete obliteration. Ten patients with seizure symptoms had no recurrent seizure due to radiosurgery and medication. One of the eleven patients who suffered intracranlal bleeding developed further bleeding at 9 and 51 months fellowing the radiosurgery although complete obliteration was eventually observed and the patient was managed in hospital then recovered. No patient suffered severe complications fellowing the radiosurgery. Conclusion : The radiosurgery with Linac-based Photon knife radiosurgery system, developed by the staff at our hospital, is a safe and effective treatment for AVM patients having diameters or volumes of less than 3 cm or 10 cm$^{3}$, respectively, located In Inoperable areas or who refused neurosurgery. We suggest that staged AVM radiosurgery may initially be considered, if the AVM target volume is above 10 cm$^{3}$