• 대한두개안면성형외과학회지
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• 제13권1호
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• pp.54-56
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• 2012

Purpose: Dandy-Walker syndrome is a rare congenital brain malformation that occurs one in every 25,000-35,000 live births, mostly in females. It is characterized by cystic enlargement of the fourth ventricle, agenesis or hypogenesis of the cerebellar vermis and enlargement of the posterior fossa. In this report, the authors aimed to address a rare case of a 14-months-old female Dandy-Walker syndrome patient that is presented with submucous cleft palate. Methods: A 14-months-old female patient admitted to our outpatient clinic, via the department of pediatrics, with the complaints of nasal regurgitation, choking and breathing difficulties. She was diagnosed as Dandy-Walker syndrome by magnetic resonance imaging evaluation, at another hospital and underwent a shunt operation for the hydrocephalus continuing treatments. On physical examination, she had structural abnormality of bifid uvula, and palpable notch in the posterior surface of the hard palate. Her submucous cleft palate was corrected, which used a double opposing Z-plasty under general anesthesia. Results: In a follow-up period of 2 months, no complications, such as wound dehiscence, necrosis and infection occurred, which shows satisfactory results. She consulted with pediatric neurologists and physical therapists for further evaluation and management of the abnormalities in the central nervous system. Conclusion: Dandy-Walker syndrome patient with a cleft palate is a very rare case to find, which only a few cases are reported around the world. Authors would like to share this case of Dandy-Walker syndrome patient, with submucous cleft palate, who underwent a double opposing Z-plasty that shows satisfactory results.

• 사상체질의학회지
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• 제11권2호
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• pp.377-383
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• 1999

임상에서 가장 빈번하게 당면하는 빈혈의 하나로 여러종류의 만성적 원질환에 동반되는 빈혈이 있다. 이에 본 증례에서 소뇌 출혈이후의 합병증인 폐렴으로 인해 만성 염증성 빈혈이 발생한 환자에서 한방치료에 의해 전신상태 호전과 함께 빈혈이 교정된 증례가 있어 이에 보고하고자 한다. 75세의 여환으로 뇌출혈 후유증으로 인한 두통과 현훈, 보행장애, 연하장애, 전신무력감으로 본원 내원하였으며. 내원당시 혈액학 검사상 normocytic normochromic anemia 소견을 보이고 있었다. 이를 소음인 울광증으로 변증하고 승양익기의 치법에 준하여 팔물군자탕을 투여한 결과 전신증상의 호전과 빈혈의 치료를 확인하였다.

• Archives of Pharmacal Research
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• 제18권3호
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• pp.153-158
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• 1995

The levels of extracellualr glutamate, intracellular $Ca^{2+}\;([Ca2+]_i)$ and cGMP were determined for 1 h with the excitatory amino acids, N-methyl-D-aspartate (NMDA) or kainate in cultured cerebellar granule cells. Both NMDA and kainate produced a time-dependent release of glutamate, and kainate was more potent than NMDA in glutamate elevation. The elevation of extracellular glutamate was not purely governed by intracellular $Ca^{2+}$ concentration. However, in opposite to the time-dependent elevation of glutamate, the elevation of cGMP by NMDA and kainate were at maximum level in short-time (1 min) incubation then remarkably decreased with longer incubation times. Post-applications (30 min after agonist) of EAA antagonist did not block EAAs-induced glutamate elevation. However, NMDA antagonist, phencyclidine (PCP), blocked NMDA-induced cGMP elevation at pre- or post-application, but kainate antagonist, 6,7-dinitroquinoxaline-2,3-dione (DNQX), paradoxically augmented kainate-induced cGMP elevation for 1 h incubation. These results show that NMDA or kainate induces time-dependent elevations of extracellular glutamate, while the elevations of cGMP by these EAAs are remarkably decreased with longer incubation times. However, NMDA- arid kainate-indcued glutamate release was blocked by pre-application of each receptor antagonist but not by post-application while EAA-induced $[Ca^{2+}]_i$ was blocked by post-application of antagonist. These observations suggest that EAA-induced elevation of $[Ca^{2+}]_i$ is not parallel with elevation of glutamate release or cGMP.

• 한국정보통신학회논문지
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• 제21권2호
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• pp.395-400
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• 2017

본 논문에서는 산소 센서를 이용하여 CMAC 신경회로망 학습제어에 의한 차량의 연료분사 제어방법에 대해 논한다. 기본 차량 내연기관과 연료 분사 제어시스템의 동역학적인 비선형성으로 인하여 불연속적인 연로를 분사한다. 정밀 연료 분사량 제어에 어려움을 발생시키기 때문에 엔진성능은 저하된다. 본 연구에서는 CMAC 신경회로망을 이용한 연료 분사시스템을 제안한다. CMAC 신경회로망은 매우 넓은 범위의 함수로부터 비선형 관계를 학습 할 수 있고, 학습이 빠르며, 수렴 특성을 가지고 있다. 그리고 산소 센서의 출력특성을 파악하여 연료분사 속도를 계산해서 설정된 공연비 값을 유지시켜준다. 게다가 기존 가솔린 엔진의 구조변경이 없이 어떤 상황에서도 공연비를 정밀하게 제어할 수 있으며, 배기가스 배출량을 절감시킬 수 있다. 시뮬레이션을 통해 일반적인 차량의 제어 방법과 비교 분석하였고, 제안된 방법이 차량의 연비 향상과 친환경 성능 등에 더 효과적임을 확인하였다.

• 대한정형외과 초음파학회지
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• 제7권1호
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• pp.49-66
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• 2014

지금까지 경추부 중재술은 방사선 투시하에 하는 것이 표준화된 방법이었다. 그러나 방사선을 피폭해야 하는 문제가 있으며, 실시간으로 조영제를 이용하여 투시하거나 컴퓨터단층촬영 유도하 시술로써 안전하게 시행하려는 노력에도 불구하고, 특히 경추간공 차단술에서, 예기치 않은 주사제의 동맥내 주입이 발생하여 심각한 합병증인 척수 손상, 소뇌 및 뇌간 경색 등의 증례들이 방사선 투시하 시술에서 보고되는 것이 사실이다. 최근에는 그 대안으로서 경추부 초음파 유도하 중재술이 시행되고 있는데, 초음파는 주요 신경 및 혈관 구조물들의 위치를 관찰하면서 목표 부위 주위로 주사제가 퍼져나가는 양상을 파악할 수 있다는 장점이 있기 때문이다. 또한 초음파는 방사선이 없고 간편하며 주사하는 동안 실시간으로 계속 영상을 제공함으로써 시술의 정확도를 높일 수 있는 술기이다. 결국 초음파 유도하 시술은 주요 신경과 혈관의 위치를 확인하면서 그에 대한 손상 혹은 주사를 피할 수 있기 때문에 이러한 구조물들의 손상 위험이 높은 경추부에서 안전하게 시행할 수 있다는 중요한 장점이 있는 술기이다. 그리하여 저자는 실시간 초음파 유도하라는 술기가 경추부 중재술에서 얼마나 유용한가에 대해 분석하여 기술하였다.

• 대한한방내과학회지
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• 제22권3호
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• pp.477-482
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• 2001

Tremor refers to rhythmic shaking of a body part. Tremor is a symptom of many disorders, including Parkinson's disease, essential tremor, orthostatic tremor, cerebellar disease, peripheral neuropathy and alcohol withdrawal. Tremors may be classified as postural, rest or action tremors. Symptomatic treatment is tailored to the tremor type. Because Dansambohyul-tang has been used to treat patients differentiated with an insufficiency of the heart and the spleen(心脾兩虛) in oriental medicine, we treated a 78 year-old female patient who suffered from tremor in mouth, chin and hand and insomnia, with improvement of general condition, who was differentiated with an insufficiency of the heart and the spleen(心脾兩虛) with Dansambohyul-tang, herb complex. After 78 days of treatment with Dansambohyul-tang and some other herb complex, we observed improvement of tremor, insomnia and general condition So Dansambohyul-tang shows therapeutic effects on tremor.

• 대한임상검사과학회지
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• 제43권1호
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• pp.19-25
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• 2011

The purpose of this study was to analyse brainstem auditory evoked potentials (BAEP) wave change data during microvascular decompression (MVD). The nerve function of Cranial Nerve VIII is at risk during MVD. Intraoperative monitoring of BAEP can be a useful tool to decrease the danger of hearing loss. Between January and December 2009, 242 patients had MVD for hemifacial spasm (HFS) and trigeminal neuralgia (TN). Among intraoperative BAEP changes, amplitude of V-V' was the most frequently observed during cerebellar retraction and decompression step of the MVD procedure. 138 patients (57%) had no BAEP change while 104 patients (42.98%) had BAEP change. 69 patients (28.5%) had Type A-I, 16 patients (6.6%) had Type A-II, 5 patients (2.1%) had Type B, and 13 patients (5.37%) had Type C. MVD is a surgical procedure to relieve the symptoms (e.g. pain, muscle twitching) caused by compression of a nerve by an artery or vein. During BAEP intraoperative monitoring, the surgical step is important in interpreting the changes of wave V. Several potential mechanisms of injury may affect the cochlear nerve, and complete loss of BAEP is often associated with postoperative hearing loss. Intraoperative BAEP monitoring may provide an early warning of hearing disturbance after MVD.

• Journal of Korean Neurosurgical Society
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• 제37권5호
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• pp.357-363
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• 2005

Objective: The microvascular decompression(MVD) for trigeminal neuralgia(TN) is known as an effective surgical technique. But the failed MVD cases have been reported in long term follow-up studies. This study is to evaluate the efficacy of MVD through our operative techniques, offending vessels in operative field, failed cases with the review of the literatures. Methods: We analyzed total 63 cases of TN which underwent MVD from 1955 to 2003 according to characters of pain, operative findings, operative results related to causative vessel compression and operative method, progonotic factor. Statistical analysis was performed using paired t-test with SPSS Ver 11.0. Results: In TN, the most common offending vessel was superior cerebellar artery(45.0%). In compression group of nerve root by offending vessel, the cure rate was 91.7%. However, the cure rate of the contact group was 64.7% and the cure rate of the negative group was 37.5%. There was no statistical significance between the degree of compression by vessel and the operative result(p=0.076). In 51 cases with MVD only, the cure rate was 84.3% and in 3 cases with PSR only, 42.8% and in 2 cases with PSR(partial sensory rhizotomy) with MVD, 50.0%. TN recurred in 7 cases within the follow-up period and reoperations(PSR) were added in 2 cases of them. Conclusion: This study shows that MVD provided a high rate of success with a minor risk of complications, which has been regarded as the most safe and effective procedure for trigeminal neuralgia. Additional MVD in recurred TN by severe adhesion of teflon showed poor outcome. But, revisional operation(PSR) in recurred TN showed relatively good outcome. PSR should be considered for treatment of recurrent TN after MVD.

• 대한한방내과학회지
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• 제40권5호
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• pp.768-775
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• 2019

Objective: The aim of this study was to report a case in which Korean medicine treatment with Gami-daebo-tang and acupuncture improved the clinical symptoms in a patient with Wallenberg syndrome. Methods: The patient was treated for 53 days with a Korean medicine treatment consisting of Gami-daebo-tang and acupuncture. We measured dysesthesia based on the number of affected dermatomes. Gait ataxia was estimated with the Korean version of the Berg Balance Scale (K-BBS) and the number of times that the patient had stumbled per day. Dizziness was measured with a numerical rating score (NRS). Results: After treatment, the number of affected dermatomes was decreased. The K-BBS score was improved from 52 to 56, and the frequency of stumbling decreased from 20 to 0 times per day. The NRS score of dizziness decreased from 8 to 0. Conclusion: This case showed that Korean medicine treatment might be helpful for improving the symptoms of patients with Wallenberg syndrome.

• 대한중풍순환신경학회지
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• 제22권1호
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• pp.31-44
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• 2021

The purpose of this case report is to describe the effectiveness of Korean medicine in the treatment of gait disturbance in advanced stage multiple system atrophy-cerebellar type (MSA-C). This inpatient was treated with herbal medicine, acupuncture, pharmaco-acupuncture, moxibustion, cupping, and chuna therapy. The gait disturbance was assessed by Unified Multiple System Atrophy Rating Scale(UMSARS), Tinnetti test, and 16m walking spatial features. After treatment, UMSARS Part I score was enhanced, decreasing from 29 to 24, Part II score from 34 to 18. Tinetti test score increased from 7 to 20. Gait stride length increased and width decreased. This study suggests that Korean medical treatment could be an effective treatment for delaying the progress of gait disturbance in advanced-stage MSA-C patients.