• International Neurourology Journal
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• v.22 no.4
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• pp.268-274
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• 2018

Purpose: To describe a technique for urodynamic diagnosis of detrusor sphincter dyssynergia (DSD) using urethral pressure measurements and examine potential associations between urethral pressure and bladder physiology among patients with DSD. Methods: Multiple sclerosis (MS) and spinal cord injured (SCI) patients with known DSD diagnosed on videourodynamics (via electromyography or voiding cystourethrography) were retrospectively identified. Data from SCI and MS patients with detrusor overactivity (DO) without DSD were abstracted as control group. Urodynamics tracings were reviewed and urethral pressure DSD was defined based on comparison of DSD and control groups. Results: Seventy-two patients with DSD were identified. Sixty-two (86%) had >20 cm $H_2O$ urethral pressure amplitude during detrusor contraction. By comparison, 5 of 23 (22%) of control group had amplitude of >20 cm $H_2O$ during episode of DO. Mean duration of urethral pressure DSD episode was 66 seconds (range, 10-500 seconds) and mean urethral pressure amplitude was 73 cm $H_2O$ (range, 1-256 cm $H_2O$). Longer (>30 seconds) DSD episodes were significantly associated with male sex (81% vs. 50%, P=0.013) and higher bladder capacity (389 mL vs. 219 mL, P=0.0004). Urethral pressure amplitude measurements during DSD were not associated with significant urodynamic variables or neurologic pathology. Conclusions: Urethral pressure amplitude of >20 cm $H_2O$ during detrusor contraction occurred in 86% of patients with known DSD. Longer DSD episodes were associated with larger bladder capacity. Further studies exploring the relationship between urethral pressure measurements and bladder physiology could phenotype DSD as a measurable variable rather than a categorical observation.

• The Journal of Internal Korean Medicine
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• v.23 no.2
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• pp.286-291
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• 2002

Urinary tract infection(UTI) is one of the common complications in stroke patients. As it has negative effect on the recovery of stroke, it should be cured out immediately. But antibiotics might cause some adverse reactions such as diarrhea, eruption, anorexia, nausea and vomiting. so there have been several reports about treating urinary tract infection with Traditional Korean Medication. We treated a 54-year-old male patient with cerebral hemorrhage, who had had neurogenic bladder after stroke and had been urinated by intermittent catheterization. About 10 days later, he could void by himself without catheter, but showing the symptoms of UTI; Voiding pain, hematuria and yellowish pus. The pus culture grew Staphylococcus spp., which was resistant to most of antibiotics except vancomycin and teicoplanin. Based on accompanying symptoms of intermittent dizziness, headache, insomnia, nocturnal sweating, weak pulse, red tongue and urinary problem, we differentiated him as the deficiency of Yin of the Kidney[腎陰虛] and treated with Gagamyookmijihwang-tang (Jia-Jian-Liu-Wei-De- Huang-Tang), which improved his urinary symptoms and other general conditions without any side effect. In next follow-up culture, there was no pathogen. We conclude that Traditional Korean Medicine based on differentiation is useful in the treatment of urinary tract infection.

• Journal of Veterinary Clinics
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• v.18 no.1
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• pp.67-69
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• 2001

A 3 years-old male Tosa dog was referred to Seoul National University Veterinary Medical Teaching Hospital with a history of difficulty in mastication. Clinical signs of dropped jaw, drooling, mild depression and dehydration were observed. According to history taking, physical examination, neurologic examination, complete blood count (CBC), serum chemical profile and radiography, the dog was diagnosed as idiopathic trigeminal nerve paralysis. Electroacupuncture treatment was applied to the dog on local and distal point at an interval of 7 days. Local points were GB-1 (Tong Zi Liao) of gall bladder meridian and ST-7 (Xia Guan) of stomach meridian. Distal points were PC-4 (Xi Men), PC-6 (Nei Guan) of pericardium meridian. Electrical stimulus was performed for 20 minutes at the frequency of 3 Hz, 3 Volts on ST-7. Ten days after the initial electroacupuncture treatment, clinical signs related to trigeminal nerve paralysis were almost disappeared.

• Journal of Korean Neurosurgical Society
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• v.44 no.2
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• pp.84-87
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• 2008

Spontaneous spinal epidural hematoma (SSEH) is rare in children. especially in infants, in whom only 12 cases have been reported. Because of the nonspecificity of presenting symptoms in children, the diagnosis may be delayed. We report herein a case of SSEH in a 20-month-old girl who initially presented with neck pain, and developed lower extremity motor weakness and symptoms of neurogenic bladder 2 weeks prior to admission. The magnetic resonance imaging showed an epidural mass lesion extending from C7 to T4, and the spinal cord was severely compressed by the mass. After emergency decompressive surgery the neurologic function was improved immediately. Two months after surgery, the neurological status was normal with achievement of spontaneous voiding. We suggest that surgical intervention can provide excellent prognosis in case of SSEH in infants, even if surgery delayed.

• The Korean Journal of Pain
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• v.5 no.1
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• pp.108-112
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• 1992

Pain from pelvic cancer is very difficult to manage because it's vague ness and bilateral nature. Furthermore, nerve blocks in this area are dangerous because sensory afferent nerves from pelvic viscera are adjacent to nerves that regulate bowel and bladder control, and motor nerve of lower extremities'. Bilateral lumbar sympathectomy has been used for malignant pelvic pain with little risk of neurologic complication. However it is not a specific block for pelvic visceral pain, because the lumbar sympathetic chain does not innervate pelvic viscera in a direct manner. Therefore the potentials of lumbar sympathectomy for pelvic visceral pain are attributed to caudad diffusion of neurolytic agents to the smperior hypogastric plexus. I have experienced 3 cases of superior hypogastric plexus neurolysis per se without any significant complications.

• Journal of Veterinary Clinics
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• v.21 no.2
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• pp.177-180
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• 2004

Lower motor neuron signs of hind limbs, anus and bladder were identified by history taking and physical examination in the 6.8 year-old mongrel dog and 2.6 year-old Cocker spaniel. The Cocker spaniel, also showed gradual cranial migration of neurologic deficit including respiratory paralysis. On plain radiography and myelography, intervertebral disc extrusion between L2 and L3, the infiltration of contrast medium into the spinal cord and cord swelling were found in the mongrel dog, and infiltration of contrast medium like hollowness of cord parenchyma was observed in the Cocker spaniel. On the basis of clinical signs and radiographic findings, they were diagnosed tentatively as acute myelomalacia. The Cocker spaniel died of respiratory paralysis on the following day. Decompressive surgery was performed on the mongrel dog and the extensive necrosis and hemorrhage were found at surgery. It was euthanized with the owner's consent because of the perceived poor prognosis. Histopathologic examination after autopsy confirmed acute diffuse hemorrhagic myelomalacia with the swelling and the inflammation of axon, showing hemorrhagic changes in the white matter and the grey matter.

• The Journal of Korean Medicine
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• v.21 no.4
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• pp.236-241
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• 2000

Background and Purpose : Cerebrovascular accident is a serious neurologic event. It can have temporary or permanent effects on survivors, including memory, cognition and volitional control of voiding. The purpose of this study is to evaluate the clinical effect of moxibustion in patients with voiding dysfunction after a cerebrovascular accident. Methods : Twenty patients with post-stroke voiding dysfunction were studied. All patients had computerized tomography(CT) and magnetic resonance imaging(MRI) to localize the lesion in the central nervous system. They were randomly divided into two groups : the control and moxibustion group. Ten of twenty patients underwent moxibustion treatment by randomization. The moxibustion group receieved moxibustion at three points : Chung-guk (Conception Vessel CV3), Kuanwon (CV4) Kihae (CV6). Residual urine volume evaluation was undertaken in all patients. Results : 1. IIn the balanced bladder time, the moxibustion group had the shorter time than non moxibustion group. But there was no significiant difference between the moxibustion group and non-moxibustion group. 2. In the residual urine volume, the moxibustion group and non-moxibustion group showed a tendency to decrease. But there was no significiant difference between the moxibustion group and non-moxibustion group. Conclusions : Though further study is needed, our findings suggested that the time of achieving balanced voiding was shorter with moxibustion than in the control group.

• Development and Reproduction
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• v.19 no.4
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• pp.167-180
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• 2015

Arsenic is a toxic metalloid that exists ubiquitously in the environment, and affects global health problems due to its carcinogenicity. In most populations, the main source of arsenic exposure is the drinking water. In drinking water, chronic exposure to arsenic is associated with increased risks of various cancers including those of skin, lung, bladder, and liver, as well as numerous other non-cancer diseases including gastrointestinal and cardiovascular diseases, diabetes, and neurologic and cognitive problems. Recent emerging evidences suggest that arsenic exposure affects the reproductive and developmental toxicity. Prenatal exposure to inorganic arsenic causes adverse pregnancy outcomes and children's health problems. Some epidemiological studies have reported that arsenic exposure induces premature delivery, spontaneous abortion, and stillbirth. In animal studies, inorganic arsenic also causes fetal malformation, growth retardation, and fetal death. These toxic effects depend on dose, route and gestation periods of arsenic exposure. In males, inorganic arsenic causes reproductive dysfunctions including reductions of the testis weights, accessory sex organs weights, and epididymal sperm counts. In addition, inorganic arsenic exposure also induces alterations of spermatogenesis, reductions of testosterone and gonadotrophins, and disruptions of steroidogenesis. However, the reproductive and developmental problems following arsenic exposure are poorly understood, and the molecular mechanism of arsenic-induced reproductive toxicity remains unclear. Thus, we further investigated several possible mechanisms underlying arsenic-induced reproductive toxicity.

• The Journal of Korean Physical Therapy
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• v.17 no.3
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• pp.377-390
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• 2005

The purpose of this study is to investigate the effect of neuromuscular re-education program and general intervention program. It is focused on difference between changes of experimental before and after on 20 stroke patient's motor control ability. The obtained results are as follows; In change in motor control ability, neuromuscular re-education program group about the motor control ability was a significant difference(p<.01). And traditional intervention program group, the motor control ability was a significant difference in all of items (p<.01; p<.05) but, were not a significant difference in bladder management, social interaction, problem solving and memory. And also comparison of change in motor control ability between the experimental group and control group, the between-subjects factors were a significant difference. Most of the functional items on the functional items on the functional measurement and neuromuscular function measurement are concerned with the physical autonomy of the hemiplegic patients. More in depth knowledge may be acquired about the distribution of physical and motor control patterns with respect to the degree of neurologic deficit for the enhencement of residual motor control function in hemiplegia. In conclusion, the neuromuscular re-education program was more effect then traditional intervention program in motor control ability.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.23 no.1
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• pp.25-30
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• 2023

Leigh syndrome is a rare progressive neurodegenerative mitochondrial disorder with clinical and genetic heterogeneity. Recently, balletic IARS2 variants have been identified in a number of patients presenting broad clinical phenotypes from Leigh and West syndrome to a rare syndrome CAGSSS characterized by cataracts, growth hormone deficiency, sensory neuropathy, sensorineural hearing loss, and skeletal dysplasia syndrome (OMIM#616007). We describe a child with Korean Leigh syndrome with urologic manifestations resulting from a compound heterozygote mutation in IARS2. A 5-year-old girl visited the emergency room with a complaint of abdominal pain accompanied by abdominal distension. Abdominal-pelvic CT showed a markedly distended urinary bladder without definite obstructive lesions. She was diagnosed with neurogenic bladder dysfunction based on a urodynamic study. She had global delayed development due to neurologic regression after 6 months of age and a history of bilateral cataract surgery at the age of 2 years. Her brain magnetic resonance imaging showed symmetrically increased signal intensities in the bilateral putamen and caudate nuclei with diffuse cerebral atrophy. No gene variants were identified through whole-mitochondrial genome analysis. Whole exome sequencing was performed for diagnosis, and compound heterozygous pathogenic variants were identified in IARS2: c.2446C>T (p. Arg816Ter) and c.2450G>A (p. Arg817His). To the best of our knowledge, this is the first case report of bladder dysfunction manifestation in a patient with IARS2-related Leigh syndrome. Thus, it broadens the clinical and genetic spectrum of IARS2-associated diseases.