• Journal of The Korean Dental Society of Anesthesiology
• /
• v.14 no.1
• /
• pp.11-15
• /
• 2014

Background: It is imperative that adequate sedation level should be maintained for safe and effective dental sedation. Cerebral state index (CSI) is a empirically derived parameter calculated from the processed electroencephalography (EEG). We investigated whether CSI can be used as a sedation depth indicator. Methods: We continuously recorded CSI and bispectral index (BIS) values from 10 healthy children aged 3.6 yr undergoing dental sedation. We also evaluated sedation level using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S). The correlation between CSI and BIS, or CSI and sedation score were sought a regression analysis. Results: There were good linearity between CSI values and sedation score. (r = 0.916, P < 0.001) The paired CSI and BIS values showed a significant correlation between the two values. (r = 0.895, P < 0.001) The difference between CSI and BIS values was not statistically significant at deep and conscious sedative levels. Conclusions: The CSI monitor can be easy to monitor sedation depth during dental sedation for children.

• Korean Journal of Anesthesiology
• /
• v.71 no.6
• /
• pp.447-452
• /
• 2018

Background: Cerebral state index (CSI) is an anesthesia depth monitor alternative to bispectral index (BIS). Published comparative studies have used propofol or sevoflurane. However, studies using desflurane have not been reported yet. Different volatile anesthetics have different electroencephalography signatures. The performance of CSI may be different in desflurane anesthesia. Therefore, the objective of this study was to compare CSI and BIS during desflurane anesthesia. Methods: Thirty-three patients were recruited. Desflurane and remifentanil were used to maintain general anesthesia. BIS and CSI were recorded simultaneously every minute. End-tidal concentration of desflurane was maintained at 4% from the beginning of surgery for 5 minutes. Pairwise data of CSI and BIS were obtained five times at one-minute intervals. This process was repeated in the order of 6%, 8%, and 10%. Results: BIS and CSI were negatively correlated with the end-tidal concentration of desflurane with a similar degree of correlation (correlation coefficient BIS: -0.847, CSI: -0.844). The relationship between CSI and BIS had a good linearity with a slope close to 1 ($R^2=0.905$, slope = 1.01). For the relationship between CSI and BIS at each end-tidal concentration of desflurane, CSI and BIS showed good linearity in 4% and 10% ($R^2=0.559$, 0.540). However, the linearity and slope were decreased in 6% and 8% ($R^2=0.163$, 0.014). Conclusions: CSI showed an equivalent degree of overall performance compared to BIS in desflurane anesthesia. Accounting for previous literature, CSI can be used as a good substitute for BIS regardless of the kind of anesthetics used.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.5 no.1
• /
• pp.5-11
• /
• 2009

The objective of this study was to assess oral health status such as prevalence of dental caries, gingivitis and other combined disorder, orofacial dysfunction in patients with cerebral palsy(CP), as well as the state of tooth brushing, possibility of dental treatment. Sixty-six subjects with CP aged 9 to 37 years were included in the study. Clinical caries status(DMFT index) and other data were evaluated and statistically analyzed using SPSS program (SPSS 17.0). The results were as follows: The DMFT index and prevalence of gingivitis of study subjects were 2.82(male), 3.33(female) and 89%, respectively. DMFT index classified into four groups according to age as follows: DMFT index were 1.14(ages 6-11), 1.40(ages 12-14), 2.16(ages 15-24), 4.15(ages 25-37). In addition to the physical disorder, speech difficulty(86%), epilepsy(35%) and visual impairment(14%) were associated and the epilepsy medication was the most common medication. And orofacial dysfunction such as the eating difficulties(79%), drooling(36%), swallowing disorder(30%), breathing difficulty(15%), bruxism(30%) and snoring(33%) was shown. Most people with cerebral palsy can't brush alone and didn't use oral care adjunctive supplies. Moreover, Fifty-nine percent of them were noncooperative to dental treatment.

• The Journal of the Society of Stroke on Korean Medicine
• /
• v.13 no.1
• /
• pp.118-125
• /
• 2012

Object : The purpose of this study is to evaluate the effect of Hwangryunhaedok-tang herbal-acupuncture therapy for Agitation(Byun-jo) caused by cerebral infarction. Methods : One patient was admitted who was suffering from insomnia, chest discomfort, anxiety, palpitation of Agitation(Byun-jo), after cerebral infarction. In the point of Differentiation of Syndromes(辨證), we diagnosed this patient as Excessive heat-fire syndrome of stroke(中風火熱證) and treated with Hwangryunhaedok-tang herbal-acupuncture therapy at CV17, BL15, GB20. Results : After Hwangryunhaedok-tang herbal-acupuncture therapy, symtoms of Agitation(Byun-jo) were improved remarkably, and the score of State-Trait Anxiety Inventory(STAI), Pittsburgh Sleep Quality Index(PSQI) were decreased. Conclusions : Hwangryunhaedok-tang herbal-acupuncture therapy has meaningful effect on the symptoms of Agitation(Byun-jo) caused by cerebral infarction and more researches should be followed.

• The Journal of Internal Korean Medicine
• /
• v.19 no.1
• /
• pp.157-167
• /
• 1998

Background and Purpose : Cerebrovascular reactivity(CVR) can be estimated by measuring the change of cerebral blood flow that occurs during vasostimulation. To estimate the cerebrovascular reactivity, we investigated the change of flow velocity of the middle cerebral artery(MCA) during hyperventilation and hypoventilation with the transcranial doppler. So we studied whether the CVR measured by this method could show a significant difference between the normal and the cerebral infarction subjects and whether the CVR may decrease with age in normal subjects. Methods : Using transcranial doppler, we measured the mean velocity(Vm), the pulsatility index(P.I.) at the resting state, the end of breath-holding and the end of hyperventilation in 36 normal and 10 cerebral infarction subjects, so we calculated the percentile change of mean velocity(%${\Delta}$Vm) and P.I.(%${\Delta}$P.I.) after the vasostimulation. We estimated the change of Vm, P.I., %${\Delta}$Vm and %${\Delta}$P.I. by the age group and compared those parameters between the age-matched normal control and cerebral infarction subjects. Results : The Vm in MCA significantly decreased with age(p<0.05), but there was no significant difference in Vm and P.I. between normal and cerebral infarction subjects. The %${\Delta}$Vm and %${\Delta}$P.I. in response to hyperventilation significantly decreased with age in MCA and there was significant difference in $%{\Delta}Vm$ of MCA after breath-holding between the normal and cerebral infarction subjects. Conclusion : The breath-holding and hyperventilation tests could be non-invasive and useful methods in estimation of the cerebrovascular reactivity and could be applied in the basal and follow-up evaluation of the cerebrovascular reserve of the ischemic stroke patients.

• Journal of dental hygiene science
• /
• v.4 no.1
• /
• pp.39-44
• /
• 2004

The primary purpose of this report is to investigate the index of dental caries experiences and the state of oral hygiene for the children with mental retardation, cerebral palsy, and autism. In order to get those things we investigated 99 students that ages from 8 to 13 in three special schools (which are the school for the children with mental retardation, physical difficulties, emotional disturbance). Then collected the statistics and examined if there were some regardful differences among each type. (1) The investigation shows that there is no regardful differences among them in statistice. However, the averages of their dental caries experience have a little gap. The average of the children with mental retardation group is the highest and the autistic children group is the lowest, as we can see the facts of 4.70 for group of children with mental retardation, 4.58 for group of children with cerebral palsy, 3.67 for group of autistic children, children with mental retardation group is severe, autistic children group is few. (2) The conclusion from research of oral hygiene among each type, statistically regardful differences were revealed (p<0.05). It shows children with cerebral palsy is on worst state, children with mental retardation is on next state, autistic children is on best state by compare for averages among each type, 32.30 for group of children with mental retardation 35.00 for group of children with cerebral palsy, 27.79 for autistic children.

• Journal of Korean Neurosurgical Society
• /
• v.66 no.6
• /
• pp.681-689
• /
• 2023

Objective : Subarachnoid hemorrhage (SAH) is a condition characterized by bleeding in the subarachnoid space, often resulting from the rupture of a cerebral aneurysm. Delayed cerebral ischemia caused by vasospasm is a significant cause of mortality and morbidity in SAH patients, and inflammatory markers such as systemic inflammatory response index (SIRI), systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), and derived NLR (dNLR) have shown potential in predicting clinical vasospasm and outcomes in SAH patients. This article aims to investigate the relationship between inflammatory markers and cerebral vasospasm after aneurysmatic SAH (aSAH) and evaluate the predictive value of various indices, including SIRI, SII, NLR, and dNLR, in predicting clinical vasospasm. Methods : A retrospective analysis was performed on a cohort of 96 patients who met the inclusion criteria out of a total of 139 patients admitted Trakya University Hospital with a confirmed diagnosis of aSAH between January 2013 and December 2021. Diagnostic procedures, neurological examinations, and laboratory tests were performed to assess the patients' condition. The Student's t-test compared age variables, while the chi-square test compared categorical variables between the non-vasospasm (NVS) and vasospasm (VS) groups. Receiver operating characteristic (ROC) curve analyses were used to evaluate the diagnostic accuracy of laboratory parameters, calculating the area under the ROC curve, cut-off values, sensitivity, and specificity. A significance level of p<0.05 was considered statistically significant. Results : The study included 96 patients divided into two groups : NVS and VS. Various laboratory parameters, such as NLR, SII, and dNLR, were measured daily for 15 days, and statistically significant differences were found in NLR on 7 days, with specific cut-off values identified for each day. SII showed a significant difference on day 9, while dNLR had significant differences on days 2, 4, and 9. Graphs depicting the values of these markers for each day are provided. Conclusion : Neuroinflammatory biomarkers, when used alongside radiology and scoring scales, can aid in predicting prognosis, determining severity and treatment decisions for aSAH, and further studies with larger patient groups are needed to gain more insights.

• The Journal of Internal Korean Medicine
• /
• v.45 no.2
• /
• pp.246-258
• /
• 2024

This case report describes a patient diagnosed with central post-stroke pain (CPSP) and hemiparesis due to anterior cerebral artery and middle cerebral artery infarction. The patient was treated with Korean medicines, including moxibustion, acupuncture, electroacupuncture, herbal medicine, Western medicine, and rehabilitation therapy for 67 days. CPSP improved based on scores on the Numeric Rating Scale (NRS) (from 8 to 0), paresthesia NRS (7 to 0), Manual Muscle Test (4/1 to 4+/4-),4+/4-), Korean version of the modified Barthel Index (24 to 73), National Institute of Health's Stroke Scale (7 to 0), Global Deterioration Scale (1 to 1), and Korean version of the Mini-Mental State Examination (27 to 29). No seizures, shocks, recurrent ischemic stroke, and liver dysfunction were recorded during the treatment. A moxibustion-induced burn healed within 7 days. This case suggests that moxibustion, combined with other treatments, has the potential to improve CPSP, without severe side effects.

• The Journal of Internal Korean Medicine
• /
• v.44 no.5
• /
• pp.1050-1061
• /
• 2023

This study reported the case of a patient with quadriparesis due to cerebral aneurysm rupture, subarachnoid hemorrhage, and intraventricular hemorrhage (IVH) treated with Korean medicine. The patient was treated with acupuncture, herbal medicine (mainly Tonggyuhwalhyeol-tang-gagam), Western medicine, moxibustion, cupping, and rehabilitative therapy for 75 days, and improved after administration. After treatment, the Manual Muscle Test grade improved from 4/4-/3+/3 to 4+/4+/4+/4+, the Korean version of the modified Barthel Index score improved from 9 to 100, the National Institute of Health's Stroke Scale score improved from 2 to 0, the Global Deterioration Scale score improved from 3 to 2, and the Korean version of the Mini-Mental State Examination score improved from 22 to 30. During administration, the patient did not show seizures, shock, or loss of consciousness, and the vital signs were stable in the normal range. We followed up the brain computed tomography findings for 2 times and found that there was no definite evidence of intracranial hemorrhage or IVH or re-rupture or rebleeding after Korean medicine treatment. This study suggests that Korean medicine treatment with blood-invigorating and stasis-removing herbs could be a safe and effective intervention option for improving quadriparesis due to cerebral aneurysm rupture and subarachnoid hemorrhage.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.38 no.4
• /
• pp.451-461
• /
• 2009

The purpose of this study is to provide fundamental information for snack development contributing to physical growth of children with cerebral palsy. The study was conducted on the children with cerebral palsy of age 1 to 7 by investigating their food behavior, physical growth development, nutritional status, and snack intake. As a result of assessing physical growth by WLI (Weight-Length Index), the proportions of the children with cerebral palsy were the following: underweight 45.5%, normal 45.5%, overweight 6.0%, and obesity 3.0%. The mothers of the children with cerebral palsy mainly bought milk and dairy products for their children's snacks (43.5%) as well as fruits (33.3%). They wanted development of new snacks that helped growth development (50.5%), and preferred more development of the following snacks: Korean rice cakes (47.5%), biscuits (24.2%), bread (22.3%). The result of dietary intake showed that the percentage of RI in zinc and folic acid did not reach the RI in every age categories. The proportion of subjects with less than 75% of RI was 76.8% for the zinc and folic acid, and 52.4% for the calcium and iron. These results indicate that children with cerebral palsy had slower physical development and lesser nutrition intake than normal children. Hence, this study provided the basis to develop the snack for the malnutrition state children with cerebral palsy which helped their physical development. The shape of new snack considered was a rice cake which included zinc and folic acid that were insufficient in RI in children with cerebral palsy.