• 한방재활의학과학회지
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• 제25권3호
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• pp.119-125
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• 2015

A chronic subdural hematoma (CSDH) is an old collection of blood and blood breakdown products between the surface of the brain and its outermost covering. We present two cases with tibia fracture caused by traffic accident progressed to chronic subdural hematoma. A 72-year-old male patient had shown signs of headache, urinary incontinence and mental storm when he has been in the hospital after 3weeks without CSDH diagnosis. And a 78-year-old male patient with mild head injury suffered from right side headache after traffic accident. We took korean medical treatments associate with tibial fracture. And we knew subdural hematoma through Brain CT. It is good report which shows CSDH can can occur from traffic accident. It requires correct diagnosis and closed observation for traffic accident patients.

• International Journal of Stem Cells
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• 제11권2호
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• pp.177-186
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• 2018

Background and Objectives: Glial scarring and inflammation after spinal cord injury (SCI) interfere with neural regeneration and functional recovery due to the inhibitory microenvironment of the injured spinal cord. Stem cell transplantation can improve functional recovery in experimental models of SCI, but many obstacles to clinical application remain due to concerns regarding the effectiveness and safety of stem cell transplantation for SCI patients. In this study, we investigated the effects of transplantation of human mesenchymal stem cells (hMSCs) that were genetically modified to express Olig2 in a rat model of SCI. Methods: Bone marrow-derived hMSCs were genetically modified to express Olig2 and transplanted one week after the induction of contusive SCI in a rat model. Spinal cords were harvested 7 weeks after transplantation. Results: Transplantation of Olig2-expressing hMSCs significantly improved functional recovery in a rat model of contusive SCI model compared to the control hMSC-transplanted group. Transplantation of Olig2-expressing hMSCs also attenuated glial scar formation in spinal cord lesions. Immunohistochemical analysis showed that transplanted Olig2-expressing hMSCs were partially differentiated into Olig1-positive oligodendrocyte-like cells in spinal cords. Furthermore, NF-M-positive axons were more abundant in the Olig2-expressing hMSC-transplanted group than in the control hMSC-transplanted group. Conclusions: We suggest that Olig2-expressing hMSCs are a safe and optimal cell source for treating SCI.

• Clinical and Experimental Pediatrics
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• 제60권9호
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• pp.302-306
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• 2017

Purpose: This study aimed to investigate whether serum neuron-specific enolase (NSE) was expressed in acute encephalitis syndrome (AES) that causes neuronal damage in children. Methods: This prospective observational study was conducted in the pediatric neurology ward of Soetomo Hospital. Cases of AES with ages ranging from 1 month to 12 years were included. Cases that were categorized as simple and complex febrile seizures constituted the non-AES group. Blood was collected for the measurement of NSE within 24 hours of hemodynamic stabilization. The median NSE values of both groups were compared by using the Mann-Whitney U test. All statistical analyses were performed with SPSS version 12 for Windows. Results: In the study period, 30 patients were enrolled. Glasgow Coma Scale mostly decreased in the AES group by about 40% in the level ${\leq}8$. All patients in the AES group suffered from status epilepticus and 46.67% of them had body temperature >$40^{\circ}C$. Most of the cases in the AES group had longer duration of stay in the hospital. The median serum NSE level in the AES group was 157.86 ng/mL, and this value was significantly higher than that of the non-AES group (10.96 ng/mL; P<0.05). Conclusion: AES cases showed higher levels of serum NSE. These results indicate that serum NSE is a good indicator of neuronal brain injury.

• 대한전기학회:학술대회논문집
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• 대한전기학회 1987년도 전기.전자공학 학술대회 논문집(II)
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• pp.1329-1332
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• 1987

This paper describes a design of the expert system for diagnosis of abnormal gait patients. This system makes the rule-based representation that can easily extend the knowledge-base and naturally represent the uncertainty, and the inference engine that uses forward chaining which covers the reasoning from the first condition to the goal. The results of inferring various maladies using this system are as follows: 1) In cases of progressive muscular dystrophy, cerebral vascular accident, peripheral neuropathic lesion and peroneal nerve injury, the result of inference is the same as that of medical specialists' with 100% accuracy. 2) In cases of Neuritis, Paralysis agitan and Brain tumor, the accuracy of inference is less than 50% compared to that of medical specialists. With above results, we decide that the rule-based representations of some maladies ard accurate relatively, but that the correction and the extention of some rules and some methods of problem solving are required in order to construct the complete expert system for diagnosis of abnormal gait patients.

• 동의생리병리학회지
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• 제19권5호
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• pp.1450-1455
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• 2005

Tremor is an most common abnormal movements disease which is to-and-fro shaking. It is caused by problems -with the nerves supplying certain muscles. It can affect the whole body or just certain areas. Parkinson's disease, Brain disease like injury of Frontal lobe, Cerebellum and Brainstem, drug and alcohol caused this symptom. It could be occured by physiological and Essential cause. In this paper, authors report three cases who showed tremor after Cerebral infarction. And we suggest that 'Ssanghwa-Tang' should be helpful for tremor patients.

• 동의생리병리학회지
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• 제22권4호
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• pp.993-999
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• 2008

Ischemic brain injury such as cerebral infarction is characterized by acute local inflammatory response mediated by cytokines. The mechanism of cytokines involved in cerebral infarction progression are uncompletely revealed yet. We investigated to find out the relationship between single nucleotide polymorphism (SNP) of interleukin 4 receptor(IL4R) and Oriental Medicine therapy efficacy in patients with cerebral infarction for 2 weeks. Oriental Korean Medicine therapies (herbal medicine and acupuncture) were applied daily and motor functions of patients were assessed using the modified cerebral vascular accident (MCVA) scores. Genotyping for IL4R polymorphism was done by pyrosequencing analysis. In IL4R genotypes and the frequency of alleles, there was no significant difference between cerebral infarction patients (n=124) and controls group (n=175). And there was also no significant difference among good and bad responders in cerebral infarction patients. In this study the IL4R genotype might not be the risk factor or a good predictive genetic marker for good and bad responders in cerebral infarction patients in Korean. Further studies including different cytokine genes will be necessary for the exact genetic markers.

• Perspectives in Nursing Science
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• 제2권1호
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• pp.76-91
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• 2005

Stroke patients often develop post stroke sequelae when they survive. Post stroke fatigue and emotional disturbances including depression are common along with motor dysfunction. However, medical personnel have paid relatively little attention to emotional changes and the presence of fatigue following strokes. Post-stroke fatigue was common, occurring in 57% of the patients in our series. The post-stroke fatigue appears to be related to the pre-stroke fatigue, physical disability and post stroke depression (PSD) although the relation to the lesion location remains elusive. The prevalence of post-stroke emotional disturbance has been reported to range from 12% to 64%. The wide variation in the frequency of post stroke depression may be related to methodological heterogeneity in items such as the criteria for depression, the timing of assessment, and the study population. Emotional incontinence, which is characterized by inappropriate or excessive laughing or crying is also common. The incidence of and factor related to this post-stroke emotional incontinence (PSEI) also remains unclear. We reported that out-patients with single, unilateral stroke, 18% had PSD and 34% had PSEI. Although both PSD and PSEI were related to motor dysfunction and location (anterior vs. posterior cortex) of the lesion, the latter was a stronger determinant for PSD. PSEI was more closely associated with subcortical strokes than was PSD. Another manifestation of post stroke patients is the occurrence of post stroke anger proneness (PSAP). They may become easily irritated, impulsive, less generous, and prone to be angry or aggressive at others. We also have reported the PSAP which seems to be closely associated with the presence of PSEI. The lesion distribution appears to be also similar. Both PSEI and PSAP respond well to serotonin reuptake inhibitors suggesting that these symptomsmay be possibly related to the alteration of serotonin after brain injury. Likewise, PSAP also produces a great deal of frustration and embarrassment among patients and caregivers. In summary, emotional disturbances such as depression, emotional incontinence, anger-proneness and fatigue are fairly common but under-recognized sequelae of stroke. These emotional disturbances decrease the quality of life of the patients and caregivers, and may adversely affect the overall prognosis. Therefore, these problems must be appropriately recognized and alleviated. Finding strategies to relieve the symptoms is imperative by understanding the causative factors in individual patient.

• Journal of Korean Neurosurgical Society
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• 제60권2호
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• pp.239-249
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• 2017

Objective : The purpose of this study is to evaluate the associations between 30-day mortality and various radiological and clinical factors in patients with traumatic acute subdural hematoma (SDH). During the 11-year study period, young patients who underwent surgery for SDH were followed for 30 days. Patients who died due to other medical comorbidities or other organ problems were not included in the study population. Methods : From January 1, 2004 to December 31, 2014, 318 consecutive surgically-treated traumatic acute SDH patients were registered for the study. The Kaplan-Meier method was used to analyze 30-day survival rates. We also estimated the hazard ratios of various variables in order to identify the independent predictors of 30-day mortality. Results : We observed a negative correlation between 30-day mortality and Glasgow coma scale score (per 1-point score increase) (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.52-0.70; p<0.001). In addition, use of antithrombotics (HR, 2.34; 95% CI, 1.27-4.33; p=0.008), history of diabetes mellitus (HR, 2.28; 95% CI, 1.20-4.32; p=0.015), and accompanying traumatic subarachnoid hemorrhage (hazard ratio, 2.13; 95% CI, 1.27-3.58; p=0.005) were positively associated with 30-day mortality. Conclusion : We found significant associations between short-term mortality after surgery for traumatic acute SDH and lower Glasgow Coma Scale scores, use of antithrombotics, history of diabetes mellitus, and accompanying traumatic subarachnoid hemorrhage at admission. We expect these findings to be helpful for selecting patients for surgical treatment of traumatic acute SDH, and for making accurate prognoses.

• 한국산학기술학회논문지
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• 제18권10호
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• pp.178-184
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• 2017

본 연구는 2007년 1월부터 2015년 12월까지 본원에서 쯔쯔가무시병으로 진단을 받고 치료 중인 상태에서 뇌경색이 발생하거나, 뇌경색이 생겨 입원 치료를 받던 중 쯔쯔가무시병이 발견된 16명의 환자를 대상으로 하였다. 급성기 뇌경색의 진단은 뇌자기공명영상 및 뇌자기공명혈관영상으로 하였으며 쯔쯔가무시병의 진단은 PCR (Polymerase chain reaction)로 하였다. 일반적인 뇌경색과 쯔쯔가무시병을 동반한 뇌경색의 차이점을 구별하기 위해 내원시 혈압과 체온을 측정하여 보았다. 일반적으로 급성기 뇌경색에서는 혈압이 올라가는데 흥미롭게도 본 연구에서는 수축기 혈압이 130mmHg 미만인 환자가 12명으로 급성기 뇌경색에서 흔히 보이는 혈압 양상과는 다른 모습을 보였다. 쯔쯔가무시병을 동반한 뇌경색의 특징을 알아보기 위해 발병 위치 및 단일 혹은 다발성 뇌경색 여부를 확인하여 보았는데, 앞순환 동맥 영역의 뇌경색 발생 환자가 13명이었으며 뒤순환 동맥 영역의 뇌경색 발생 환자는 3명이었다. 응고장애를 진단하기 위해 트롬보플라스틴시간(Prothrombin Time, PT), 활성화부분트롬보플라스틴시간(activated partial thromboplastin time, aPTT), D-dimer, 섬유소원(fibrinogen), 섬유소분해산물(fibrin degradation product, FDP)를 기록하였다. 뇌경색시 일반적으로 수치가 증가하는 것으로 알려진 D-dimer의 경우 13명의 환자에서 큰 폭의 증가 소견을 보였다. 섬유소분해산물(FDP)는 15명의 환자에서 큰 폭의 증가 소견을 보였다. 쯔쯔가무시병의 병태생리학적 기전은 혈관염으로 알려져 있는데 이로 인한 대뇌혈관의 내피세포 손상 및 증식이 있을 수 있고 그 과정에서 응고장애가 동반되어 뇌경색이 발생할 수 있다. 또는 내피세포 손상 및 증식이 없더라도 혈관염으로 인한 혈관연축이 발생하여 혈관수축이 오며 뇌경색이 발생 할 수도 있다.

• Journal of Trauma and Injury
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• 제22권1호
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• pp.71-76
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• 2009

Purpose: The goal of this study was to compare the outcome of the after trauma team (AfterTT) group to the before trauma team (BeforeTT) group. Methods: All trauma patients who visited to emergency room (ER) between July 1, 2006 and February 29,2008 based on trauma registry, with systolic blood pressure (SBP) < 90 mmHg or GCS < 9 were included in this study. We compared the amount of packed RBC transfusion, the ER stay time, the ER visit to CT evaluation time, the ER visit to operation time, the length of ICU stay, the length of hospital admission and the survival discharge rate between the AfterTT group and the BeforeTT group. Patients with brain injuries had little chance of survival. Burn patients, who visited the ER 24 hours after injury and patients who were dead on arrival (DOA) were excluded from this study. Results: Total of 93 patients were included in this study: 42 in the AfterTT group and 51 in the BeforeTT group. The AfterTT group and the Before TT group showed no differences in Revised Trauma Score (RTS) and mean age. The amount of packed RBC transfusion was lower in the AfterTT group, but no statistically significant difference was noted (AfterTT 11${\pm}$11units, BeforeTT 16${\pm}$15units, p=0.136). The ER visit to operation time was shorter in the AfterTT group, but there were no statistically significant difference between the groups (AfterTT 251${\pm}$223 minutes, BeforeTT 486${\pm}$460 minutes, p=0.082). The length of ICU stay was shorter in the AfterTT group, but the difference was not statistically significant (AfterTT 11${\pm}$12 days, Before TT 15${\pm}$30 days, p=0.438). The length of Hospital admission was shorter in the AfterTT group (AfterTT 43${\pm}$37 days, BeforeTT 68${\pm}$70 days, p=0.032), but this difference was not statistically significant. Conclusion: Simple Trauma team activation criteria decreased the amount of packed RBC transfusion and the hospital admission duration. Hemodynamic instability (SBP < 90 mmHg) and decreased mental state (GCS<9) are good indices for activating the trauma team.