• Title/Summary/Keyword: Neurological function

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Pituitary Apoplexy Presenting as Isolated Third Cranial Nerve Palsy with Ptosis : Two Case Reports

  • Cho, Won-Jin;Joo, Sung-Pil;Kim, Tae-Sun;Seo, Bo-Ra
    • Journal of Korean Neurosurgical Society
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    • v.45 no.2
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    • pp.118-121
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    • 2009
  • Pituitary apoplexy is a clinical syndrome caused by an acute ischemic or hemorrhagic vascular accident involving a pituitary adenoma or an adjacent pituitary gland. Pituitary apoplexy may be associated with a variety of neurological and endocrinological signs and symptoms. However, isolated third cranial nerve palsy with ptosis as the presenting sign of pituitary apoplexy is very rare. We describe two cases of pituitary apoplexy presenting as sudden-onset unilateral ptosis and diplopia. In one case, brain magnetic resonance imaging (MRI) revealed a mass in the pituitary fossa with signs of hemorrhage, upward displacement of the optic chiasm, erosion of the sellar floor and invasion of the right cavernous sinus. In the other case, MRI showed a large area of insufficient enhancement in the anterior pituitary consistent with pituitary infarction or Sheehan's syndrome. We performed neurosurgical decompression via a transsphenoidal approach. Both patients showed an uneventful recovery. Both cases of isolated third cranial nerve palsy with ptosis completely resolved during the early postoperative period. We suggest that pituitary apoplexy should be included in the differential diagnosis of patients presenting with isolated third cranial nerve palsy with ptosis and that prompt neurosurgical decompression should be considered for the preservation of third cranial nerve function.

Automated Segmentation of the Lateral Ventricle Based on Graph Cuts Algorithm and Morphological Operations

  • Park, Seongbeom;Yoon, Uicheul
    • Journal of Biomedical Engineering Research
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    • v.38 no.2
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    • pp.82-88
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    • 2017
  • Enlargement of the lateral ventricles have been identified as a surrogate marker of neurological disorders. Quantitative measure of the lateral ventricle from MRI would enable earlier and more accurate clinical diagnosis in monitoring disease progression. Even though it requires an automated or semi-automated segmentation method for objective quantification, it is difficult to define lateral ventricles due to insufficient contrast and brightness of structural imaging. In this study, we proposed a fully automated lateral ventricle segmentation method based on a graph cuts algorithm combined with atlas-based segmentation and connected component labeling. Initially, initial seeds for graph cuts were defined by atlas-based segmentation (ATS). They were adjusted by partial volume images in order to provide accurate a priori information on graph cuts. A graph cuts algorithm is to finds a global minimum of energy with minimum cut/maximum flow algorithm function on graph. In addition, connected component labeling used to remove false ventricle regions. The proposed method was validated with the well-known tools using the dice similarity index, recall and precision values. The proposed method was significantly higher dice similarity index ($0.860{\pm}0.036$, p < 0.001) and recall ($0.833{\pm}0.037$, p < 0.001) compared with other tools. Therefore, the proposed method yielded a robust and reliable segmentation result.

Physical Therapy for Acquired Immune Deficiency Syndrome (후천성면역결핍증의 물리치료)

  • Lee, Jeong-Weon;Yun, So-Young
    • Physical Therapy Korea
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    • v.2 no.1
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    • pp.71-79
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    • 1995
  • The purpose of this paper is to review the literature of AIDS/HIV (acquired immune deficiency syndrome/human immunodeficiency virus) and to introduce physical therapy of the AIDS client. It was first reported that five young homosexual men, in 1981 in Los Angeles, died of pneumonia caused by pneumocystis carinii - called "pest of twentieth century". AIDS was implied a fatal breakdown of the functioning of the normal human immune system. The major routes of transmission has occurred via l)sexual contact between men, 2)heterosexual intercourse, 3)contaminated blood and blood products, and 4)intrauterine or pre-natal infection from mothers. AIDS clients who may require physical therapy for a wide range of problems due to respiratory, neurological, musculoskeletal and painful syndromes as well as general decline in fitness and function. AIDS is growing rapidly in our contury as well as all over the world. Therefore, physical therapist has to correct his understandings of AIDS in order to protect himself and to give proper physical therapy to the AIDS clients.

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Two adolescent patients with coexistent Graves' disease and Moyamoya disease in Korea

  • Cheon, Chong Kun;Kim, Su Yung;Yoo, Jae-Ho
    • Clinical and Experimental Pediatrics
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    • v.57 no.6
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    • pp.287-291
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    • 2014
  • Moyamoya disease is a cerebrovascular condition that results in the narrowing of the vessels of the circle of Willis and collateral vessel formation at the base of the brain. Although relationships between Graves' disease and cerebrovascular accidents in Moyamoya disease are obscure, the coexistence of the two diseases is noteworthy. Moyamoya disease has been rarely reported in adolescent patients with thyrotoxicosis. Recently, we encountered two adolescent Korean patients with Moyamoya disease associated with Graves' disease who presented with episodic right-sided hemiparesis and syncope. These two girls who had Graves' disease had no history of other diseases or head trauma. A thyroid function test revealed a euthyroid state and a high thyroid-stimulating hormone (TSH) receptor antibody titer at that time. The patients were diagnosed with Moyamoya disease based on brain magnetic resonance angiography and cerebral four-vessel angiography. The patients underwent cranial revascularization by encephalo-duroarterio-synangiosis as soon as a diagnosis was made, which resulted in successful symptom resolution. They fared well and had no additional neurological symptoms as of their last follow-up visits. Here, we report these two cases of confirmed Moyamoya disease complicated by Graves' disease with a review of the literature, and discuss the possible association between the two diseases. To our knowledge, this is the first report in South Korea on Moyamoya disease associated with Graves' disease in adolescents with a euthyroid.

Prevalence and Clinical Manifestations of Malaria in Aligarh, India

  • Asma, Umm-E;Taufiq, Farha;Khan, Wajihullah
    • Parasites, Hosts and Diseases
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    • v.52 no.6
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    • pp.621-629
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    • 2014
  • Malaria is one of the most widespread infectious diseases of tropical countries with an estimated 207 million cases globally. In India, there are endemic pockets of this disease, including Aligarh. Hundreds of Plasmodium falciparum and P. vivax cases with severe pathological conditions are recorded every year in this district. The aim of this study is to find out changes in liver enzymes and kidney markers. Specific diagnosis for P. falciparum and P. vivax was made by microscopic examination of Giemsa stained slides. Clinical symptoms were observed in both of these infections. Liver enzymes, such as AST, ALT, and ALP, and kidney function markers, such as creatinine and urea, were estimated by standard biochemical techniques. In Aligarh district, P. vivax, P. falciparum, and mixed infections were 64%, 34%, and 2%, respectively. In case of P. falciparum infection, the incidences of anemia, splenomegaly, renal failure, jaundice, and neurological sequelae were higher compared to those in P. vivax infection. Recrudescence and relapse rates were 18% and 20% in P. falciparum and P. vivax infections, respectively. Liver dysfunctions and renal failures were more common in P. falciparum patients, particularly in elderly patients. Artesunate derivatives must, therefore, be introduced for the treatment of P. falciparum as they resist to chloroquine as well as sulfadoxine-pyrimethamine combinations.

Spinal Cord Injury Treatment using a Noble Biocompatible Bridge

  • Hossain, S.M. Zakir;Babar, S.M. Enayetul;Azam, S.M. Golam;Sarma, Sailendra Nath;Haki, G.D.
    • Molecular & Cellular Toxicology
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    • v.3 no.3
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    • pp.151-158
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    • 2007
  • The failure of injured axons to regenerate in the mature central nervous system (CNS) has devastating consequences for victims of spinal cord injury (SCI). Traditional strategies to treat spinal cord injured people by using drug therapy and assisting devices that can not help them to recover fully various vital functions of the spinal cord. Many researches have been focused on accomplishing re-growth and reconnection of the severed axons in the injured region. Using cell transplantation to promote neural survival or growth has had modest success in allowing injured neurons to re-grow through the area of the lesion. Strategies for successful regeneration will require tissue engineering approach. In order to persuade sufficient axons to regenerate across the lesion to bring back substantial neurological function, it is necessary to construct an efficient biocompatible bridge (cell-free or implanted with different cell lines as hybrid implant) through the injured area over which axons can grow. Therefore, in this paper, spinal cord and its injury, different strategies to help regeneration of an injured spinal cord are reviewed. In addition, different aspects of designing a biocompatible bridge and its applications and challenges surrounding these issues are also addressed. This knowledge is very important for the development and optimalization of therapies to repair the injured spinal cord.

Movement Dysfunction in Spastic Hemiparesis: A Problem of Spasticity or Muscular Weakness? (강직성 편마비 환자에서의 운동장애는 강직 때문인가? 근육약화 때문인가?)

  • Kim, Jong-Man;Ahn, Duck-Hyun
    • Physical Therapy Korea
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    • v.9 no.3
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    • pp.125-135
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    • 2002
  • In most of the medical literature that discusses the common problem of movement in patients with cerebral lesions. This critical problem is ascribed to a mechanism involving uninhibited neural activity. The goals of neurological physical therapy are focus on reduce of muscle hypertonicity, facilitates muscle activities, and improve of performance in living environment. A variety of studies suggest that spasticity is a distinct problem and separate from the muscle weakness. It has become increasingly recognized that the major functional deficits following brain damage are largely due to negative features such as muscle weakness and loss of performance rather than spasticity. Adequate recruitment of prime mover, not release was able to carry out the movement tasks well. The strengthening exercise of spastic limbs on changes in muscle properties and performance skill, the repeated motor practice has been identified as crucial for motor recovery. This article support the concept that strengthening is an appropriate intervention to improve the quality of physical function in patients with central nervous system lesions. Further studies and therapeutic approaches should be efforts at improving motor neuron recruitment in agonist rather than reducing activity in antagonists while retraining muscle strengthening.

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Ambulatory Anesthesia Management of the Patient with Adrenoleukodystrophy for Dental Treatment -A Case Report- (부신백질이영양증 환자의 치과치료를 위한 외래전신마취 -증례 보고-)

  • Seo, Kwang-Suk;Bak, So-Yeon;Shin, Teo-Jeon;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.10 no.1
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    • pp.45-49
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    • 2010
  • Adrenoleukodystrophy (ALD) is a rare X-linked genetic disorder associated with various central nervous system problems and adrenal insufficiency. It is common in childhood and symptoms include loss of previously acquired neurological abilities, seizures, ataxia, Addison's disease as well as degeneration of visual and auditory function. These children frequently require anesthesia during imagining procedure such as MRI or during some surgical procedures like gastrostomy. There is special need for careful management because of numerous anesthetic challenges like difficulty in cooperation, seizure disorders, life-threatening airway obstruction, copious oral secretion and possibility of aspiration. In addition, adrenal involvement and hypofunction must be considered for safe anesthesia management. We report a successful anesthetic management in a patient with ALD for dental procedures.

Effects of the Photic Stimulation on Electroencephalogram in Pediatric Epilepsy Patients

  • Yoon, Joong Soo;Choi, Hyun Ju
    • Biomedical Science Letters
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    • v.18 no.4
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    • pp.428-434
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    • 2012
  • Epilepsy is a chronic neurological disease showing a symptom of repeated seizures without any other physical disorders. Among the diagnostic examination for epilepsy, the electroencephalogram (EEG) has been known as an important test. This study aimed to investigate the EEG with photic stimulation in the pediatric epilepsy patients. They underwent digital sleep and waking EEGs or waking EEGs with photic stimulation. Epilepsy type, seizure history, and season of occurring seizure were analyzed. Epilepsy patients showed more response during the period of photic-on and eye close at the frequency of 10~20 Hz during the EEG activation procedure. Photoparoxysmal response (PPR) was shown in 206 patients out of total 1,551 epilepsy patients. PPR was appeared more frequently during summer and winter seasons, and especially in the patients who had a history of seizure. During the PPR, EEG pattern showed spike (77.18%), theta (9.71%), and spike + theta (13.11%). On the other hand, beta and theta waves were not significantly changed by photic stimulation. However, alpha wave was decreased and delta wave was increased by photic stimulation (P<0.05). These changes may be due to temporarily altered electrophysiological function of the epileptic patient's brain by the photic stimulation. There was no difference in the EEG pattern between the left and right side in the brain. In conclusion, condition of photic-on with closed eyes and frequency of 10~20 Hz during the procedure of EEG activation could be appropriate for obtaining a definite photoparoxysmal response in the electroencephalogram of the pediatric epilepsy patients.

Interplay between autophagy and programmed cell death in mammalian neural stem cells

  • Chung, Kyung Min;Yu, Seong-Woon
    • BMB Reports
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    • v.46 no.8
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    • pp.383-390
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    • 2013
  • Mammalian neural stem cells (NSCs) are of particular interest because of their role in brain development and function. Recent findings suggest the intimate involvement of programmed cell death (PCD) in the turnover of NSCs. However, the underlying mechanisms of PCD are largely unknown. Although apoptosis is the best-defined form of PCD, accumulating evidence has revealed a wide spectrum of PCD encompassing apoptosis, autophagic cell death (ACD) and necrosis. This mini-review aims to illustrate a unique regulation of PCD in NSCs. The results of our recent studies on autophagic death of adult hippocampal neural stem (HCN) cells are also discussed. HCN cell death following insulin withdrawal clearly provides a reliable model that can be used to analyze the molecular mechanisms of ACD in the larger context of PCD. More research efforts are needed to increase our understanding of the molecular basis of NSC turnover under degenerating conditions, such as aging, stress and neurological diseases. Efforts aimed at protecting and harnessing endogenous NSCs will offer novel opportunities for the development of new therapeutic strategies for neuropathologies.