• Title/Summary/Keyword: 중추

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Acute Hyponatremia in Pneumonia and CNS Infections of Children (소아의 폐렴과 중추신경계 감염에서 급성 저나트륨혈증의 발생 양상)

  • Shin, Sung Hyun;Um, Tea Min;Lee, Yun Jin;Son, Seung Kook;Kim, Seong Heon;Kim, Su Yung
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.89-94
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    • 2012
  • Purpose: The option of selecting isotonic rather than hypotonic fluids for maintenance fluid in children has been advocated by some authors. Pneumonia and CNS infections are frequent clinical settings for acute hyponatremia because of nonosmotic anti-diuretic hormone stimuli in children. We conducted the present study to identify the incidence of hyponatremia in pneumonia and CNS infection of children and to determine the importance of maintenance intravenous fluid therapy regimen and other related factors. Methods: The study included 1,992 patients admitted to the Department of Pediatrics at Pusan National University Children's Hospital between November 2008 and August 2011, who were diagnosed with pneumonia or CNS infections and checked for serum sodium concentration. Their clinical data including laboratory findings were reviewed retrospectively. Results: During the study period, 218 patients were identified to have acute hyponatremia among 1,992 patients. The overall incidence of hyponatremia was 10.9%. The incidence of hyponatremia in encephalitis (37.3%) was highest and the incidence in bacterial meningitis (27.4%), viral meningitis (20.0%), bacterial pneumonia (11.1%), mycoplasma pneumonia (9.2%), and viral pneumonia (6.8%) were in descending order. The mean age was higher in hyponatremic patients than in isonatremic patients. The incidence of hyponatremia was higher in who had 0.18% NaCl in 5% dextrose (D5 0.18% NS) than 0.45% NaCl in 5% dextrose infusion (D5 1/2NS) (9.0% vs. 2.2%). SIADH was identified in 20.5% among hospital acquired hyponatremic patients after adequate evaluation for SIADH. Conclusion: We recommend D5 1/2NS rather than D5 0.18% NS as the maintenance fluid given to children with pneumonia or infectious CNS diseases.

Effect of Knee Joint Stimulation on the Activity of Phrenic Nerve and Inspiratory Nuron in the Cat (슬관절 자극이 횡격신경 및 흡식중추신경에 미치는 영향)

  • Cho, Dong-Ill;Han, Hee-Chul;Nahm, Sook-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.683-693
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    • 1993
  • Background: During movement the major inputs to nervous system come from firstly the muscle and joint to maintain posture and motion and secondly the chemoreceptors and baroreceptors to adjust the cardiovascular and respiratory function. Their complex relationships are generally studied for many years but the direct relation between the joint and respiratory system is not studied thoroughly until now. So this experiment was performed to determine whether the natural movement of knee joint can cause the enhancement of respiratory function by observation of the changes of respiratory rate, phrenic nerve activity and inspiratory neuron activity during the stimulation of knee joint in cat anesthetized with $\alpha$-chloralose. Method: Twenty six male adult cats were used and the extracelluar recording using bipolar platinum electrode and carbon filament electrode was done to record the changes in the activities of phrenic nerve and inspiratory neuron movement of knee joint, injection of chemicals into the joint cavity and electrical stimulation of articular nerve were done. Results: The 60 Hz. could not but 120 Hz. flexion-extension movement of knee joint increased respiratory rate(R.R.), tidal neural activity(TNA) and minute neural activity(MNA). Intra-articular injection of lactate could not increase R.R. but significantly increase TNA and MNA which represented the enhanced respiratory function. Injection of potassium chloride showed similar effects with the case of lactate but the duration of effect was shorter. The electrical stimulation of medial articular nerve with IV strength which could activate only group I and II afferents showed increased TNA and MNA during stimulation but 20 V stimulation which could activate all the afferents increased all the respiratory parameters. The changes of inspiratory neuron activity by knee joint stimulation was similar to that of phrenic nerve. Conclusion: The respiratory center could be directly stimulated by the activation of group I and II articular afferents and it seemed that the magnitude of the respiratory center enhancement is proportional to the amount of sensory information from the knee joint. These facts might suggest that the respiratory function could be enhanced even by the normal movement of knee joint.

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A Case of Pulmonary Langerhans Cell Histiocytosis associated with Central Diabetes Insipidus in Adult -A case report - (성인에서 발견된 중추성 요붕증이 합병된 폐 랑게르한스 세포 조직구증 -1예 보고-)

  • Yoo Byung Su;Lee Jae Woong;Jo Tae Jun;Hong Ki Woo;Kim Kun Il;Lee Weon Yong;Kim Dong Gyu;Jun Sun Young
    • Journal of Chest Surgery
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    • v.38 no.12 s.257
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    • pp.866-869
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    • 2005
  • Langerhans Cell Histiocytosis (LCH) is a pathologic proliferation and infiltration of various organs by Langerhans' cells of unknown cause. Incidence rate of one million parties 3$\∼$4 is seen in young child but the incidence is not sure in adult. Organ systems involved by LCH may include skin, ear, bone marrow, liver, spleen, lung, pituitary gland - hypothalamus and Gl tracts. In case pituitary-hypothalamus axis are involved, diabetes insipidus happened. Primary Pulmonary Langerhans Cell Histiocytosis(PLCH) with uninvolvement of other organs is rare and accompanied diabetes insipidus is more rare. There are many cases of LCH with diabetes insipidus involve such as central nervous system except lung. PLCH accompany central diabetes insipidus is only 1 case. We report a case of PLCH that accompany central diabetes insipidus with literature investigation in Department of Thoracic and Cardiovascular Surgery, Hallym University.

Effect of Task-oriented Training on Cognitive Function Recovery and CNS Plasticity in Scopolamine-induced Dementia Rats (치매모델 쥐의 과제지향 훈련이 인지기능 회복과 중추신경계 가소성에 미치는 영향)

  • Kim, Souk-Boum;Kim, Dong-Hyun
    • The Journal of Korean society of community based occupational therapy
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    • v.9 no.2
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    • pp.23-31
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    • 2019
  • Objective : The purpose of this study is to repeatedly conduct task-oriented training in scopolamine-induced dementia rats and as a result observe changes in the content of acetylcholine, a marker of cognitive function and central nervous system plasticity, to identify the improvement effect of dementia. Methods : It consisted of two groups. One group I was that did not perform task-oriented training in scopolamine-induced dementia rats and the other group II was that performed task-oriented training. Task-oriented training involved stretching, grasping and moving arms and walking obstacles on the legs. We performed a quantified passive avoidance test in the measurement of memory for cognitive function and compared the change in the content of acetylcholine for the plasticity of the central nervous system. Results : The results of the study are as follows: First, there was a significant improvement in cognitive function since the 4th days after task-oriented training of scopolamine-induced dementia rats(.00). Second, task-oriented training applied to scopolamine-induced dementia rats showed a significant increase in acetylcholine content. Conclusion : In this study, task-oriented training, which is often performed on senile dementia patients during occupational therapy intervention, was scientifically demonstrated in scopolamine-induced dementia rats by enhancement of cognitive function through memory improvement and increase in the content of acetylcholine confirming central nervous system plasticity.

Radiation Therapy In Management Of Primary Non-Hodgkin's Lymphoma Of Central Nervous System (원발성 중추신경계 림프종에 대한 방사선치료)

  • Hong, Seong-Eon
    • Radiation Oncology Journal
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    • v.12 no.1
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    • pp.33-42
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    • 1994
  • From 1982 to 1991, sixteen Patients with primary non-Hodgkin's lymphoma of the central nervous system(CNS) were seen at Kyung Hee University Hospital. The most common subtypes were large, noncleaved cell lymphoma and immunoblastic lymphoma of B cells. Lesions most commonly involved were the parietal lobes and/or deep nuclei. Positive cerebrospinal fluid cytology was rare at initial presentation. Sixteen patients were treated with surgical biopsy or resection followed by whole brain radiotherapy at a median dose of 40 Gy(range=30-50 Gy) with variable boost doses. Of 16 patients who underwent surgery and postoperative radiotherapy, fourteen patients died between 2 and 49 months following treatment, and two are alive with no evidence of disease at 8 and 22 months. The 1-and 2-year survival rates were 55.6$ \% $ and 34.7$ \% $, respectively with 12 months of median survival. Patterns of failure were analyzed in eleven patients of total 16 patients. Failure at the original site of involvement was uncommon after radiotherapy treatment. In contrast, failure in the brain at sites other than those originally invovled was common in spite of the use of whole brain irradiation. Failure occurred in the brain 11/16(68.7$ \% $), in spinal axis 4/16(25.0$ \% $). The age, sex, location of involvement within CNS, numbers of lesion, or radiation dose did not influence on survival. The authors conclude that Primary CNS lymphoma is a locally aggressive disease that is poorly controlled with conventional radiation therapy. The limitation of current therapy for this disease are discussed, and certain promising modality should be made in regarding the management of future patients with this disease.

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The Effect of Intermittent Craniospinal Irradiation and Intrathecal Chemotherapy for Overt Meningeal Leukemia (급성 임파구성 백혈병의 뇌척수액내 재발시 간헐적인 전중추신경계 방사선조사 및 척수강내 화학요법의 효과)

  • Kim In Ah;Choi Ihl Bhong;Chung Su Mi;Shinn Kyung Sub
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.403-409
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    • 1993
  • Between 1988 and 1992, seven patients with overt meningeal leukemia who had received adequate central nervous system (CNS) prophylaxis were treated with intermittent craniospinal irradiation and intrathecal methotrexate (IIIC). Follow-up time ranged from 8 months to 41 months with median of 20 months. Three of 7 patients developed subsequent CNS relapse. CNS remission durations were 8, 9, 13, 20, 28, 34, 36 months from diagnosis of CNS leukemia for which IIIC was given. Disease free survival after CNS relapse ranged from 2 to 36 months with median of 11 months. Overall survival after CNS relapse ranged from 8 to 41 months with median of 28 months. Five patients died of sepsis and bleeding secondary to bone marrow relapse. Two patients are alive at present. But they developed recurrent CNS disease 10 to 11 months after completion of IIIC. To improve the outcome, modification of IIIC by reduction of rest period and prolonged administration of intrathecal chemotherapy after completion of IIIC are required.

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Comparisons of the Plastic Changes in the Central Nervous System in the Processing of Neuropathic Pain (신경병증성 통증의 처리 과정에 있어 중추신경계의 가소성 변화 비교)

  • Kwon, Minjee
    • Science of Emotion and Sensibility
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    • v.24 no.2
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    • pp.39-48
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    • 2021
  • According to International Associating for the Study of Pain (IASP) definition, neuropathic pain is a disorder characterized by dysfunction of the nervous system that, under normal conditions, mediates virulent information to the central nervous system (CNS). This pain can be divided into a disease with provable lesions in the peripheral or central nervous system and states with an incorporeal lesion of any nerves. Both conditions undergo long-term and chronic processes of change, which can eventually develop into chronic pain syndrome, that is, nervous system is inappropriately adapted and difficult to heal. However, the treatment of neuropathic pain itself is incurable from diagnosis to treatment process, and there is still a lack of notable solutions. Recently, several studies have observed the responses of CNS to harmful stimuli using image analysis technologies, such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and optical imaging. These techniques have confirmed that the change in synaptic-plasticity was generated in brain regions which perceive and handle pain information. Furthermore, these techniques helped in understanding the interaction of learning mechanisms and chronic pain, including neuropathic pain. The study aims to describe recent findings that revealed the mechanisms of pathological pain and the structural and functional changes in the brain. Reflecting on the definition of chronic pain and inspecting the latest reports will help develop approaches to alleviate pain.

Dynamic p-y Backbone Curves for a Pile in Saturated Sand (포화 사질토 지반에서의 동적 p-y 중추곡선)

  • Yang, Eui-Kyu;Yoo, Min-Taek;Kim, Hyun-Uk;Kim, Myoung-Mo
    • Journal of the Korean Geotechnical Society
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    • v.25 no.11
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    • pp.27-38
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    • 2009
  • In this study, a series of 1 g shaking table model pile tests were carried out in saturated dense and loose sand to evaluate dynamic p-y curves for various conditions of flexural stiffness of a pile shaft, acceleration frequency and acceleration amplitude for input loads. Dynamic p-y backbone curve which can be applied to pseudo static analysis for saturated dense sand was proposed as a hyperbolic function by connecting the peak points of the experimental p-y curves, which corresponded to maximum soil resistances. In order to represent the backbone curve numerically, empirical equations were developed for the initial stiffness ($k_{ini}$) and the ultimate capacity ($p_u$) of soils as a function of a friction angle and a confining stress. The applicability of a p-y backbone curve was evaluated based on the centrifuge test results of other researchers cited in literature, and this suggested backbone curve was also compared with the currently available p-y curves. And also, the scaling factor ($S_F$) to account for the degradation of soil resistance according to the excess pore pressure was developed from the results of saturated loose sand.

A Ukulele Playing Intervention for Improving the Hand Function of Patients With Central Nervous System Damage: A TIMP Case Study (중추신경계 손상 성인 대상 손 기능 향상을 위한 우쿨렐레 활용 치료적 악기연주(TIMP) 사례)

  • Joo, Ye-Eun;Park, Jin-Kyoung
    • Journal of Music and Human Behavior
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    • v.19 no.2
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    • pp.81-103
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    • 2022
  • The effects of therapeutic instrumental music performance (TIMP) using a ukulele were examined in adults with central nervous system damage and impaired hand functions. The participants were three adults with neurological damage who participated in 30-min sessions twice a week over 6 weeks. Changes in hand function was measured by the Box and Block Test (BBT), the 9-Hole Peg Test (9-HPT), and the Jebsen-Taylor Hand Function Test (JTHFT). Following the intervention, all three participants showed increases in the BBT and 9-HPT scores, indicating positive changes in fine motor coordination and dexterity. In terms of the JTHFT, all three participants showed increases in the "writing" and "card flipping" subtask scores, indicating that the intervention was effective in improving more coordinated finger movements. All participants reported the satisfaction with the intervention. They also pointed out that they were motivated to play the ukulele and that following the intervention used their affected hand more frequently in daily activities. These findings suggest that TIMP with a ukulele for patients with central nervous system damage can have positive effects on their functional hand movements and motivate these patients to practice their rehabilitation exercises.

국방조달 업무절차와 제도 개선

  • Gwon, Yeong-Hyo
    • Defense and Technology
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    • no.1 s.227
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    • pp.36-47
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    • 1998
  • 조달본부는 국방예산을 집행하는 중추기관임을 깊이 인식하고 국방조달업무의 투명성을 확립하기 위해 노력할 것이다. 또한 2000년대 국방조달 환경변화에 대처할 수 있도록 미래 지향적인 제도와 조직발전 및 국방조달의 정보화, 과학화를 추진하여 군과 국민으로부터 신뢰받는 국방조달을 구현할 수 있도록 노력을 경주할 것이다.

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