• Journal of Korean Neurosurgical Society
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• 제30권7호
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• pp.842-848
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• 2001

Objectives : The mortality rate of subarachnoid hemorrhage(SAH) has been reduced recently due to refinement of microsurgical technique and improved perioperative management. Also, many survivors of SAH show excellent neurological recoveries. However, we found that a high proportion of the survivors do not fully regain their premorbid status in cognitive and memory function. Object of this study is to evaluate which factors might influence on cognitive and memory impairment in ruptured aneurysmal SAH patients. Methods : In this prospective study, a series of 66 patients with aneurysmal subarachnoid hemorrhage(SAH) from 1996 to 1998, most of whom had a "good" or "fair" neurological outcome, were assessed with various tests of cognition and memory function. All patients underwent clipping operation by pterional approach. Right side approach was performed in 16 case and left 21 cases. K-WAIS(Korean-Wechsler Adult Intelligence Scale) was used as method of cognition and memory function test. The time interval between SAH and assessment varied between 4 months and 8 months, averaging 6.2 months. Statistical analyses were carried out for each test score to see whether aneurysm site(A-com : non A-com), route of approach, age and sex, vasospasm, Hunt-Hess grade and Fisher CT group at admission, Glasgow Outcome Scale(GOS) at discharge affect cognitive and memory function. Results : Aneurysm site was not shown to be associated with performance on any test, and the initial grade (Hunt-Hess grade, Fisher CT group) of SAH and vasospasm had only minimal predictive values. The grade at discharge( GOS) was proved to be the best predictor of impairment of cognition and memory function within 1 year after operation. Conclusion : The authors conclude that the diffuse effects of SAH are more important than focal neuropathology in relation to cognitive impairment in this group of patients.

• Annals of Clinical Neurophysiology
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• 제13권1호
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• pp.1-12
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• 2011

Transcranial magnetic stimulation (TMS) is a non-invasive tool used to study aspects of human brain physiology, including motor function and the pathophysiology of various brain disorders. A brief electric current passed through a magnetic coil produces a high-intensity magnetic field, which can excite or inhibit the cerebral cortex. Although various brain regions can be evaluated by TMS, most studies have focused on the motor cortex where motor evoked potentials (MEPs) are produced. Single-pulse and paired-pulse TMS can be used to measure the excitability of the motor cortex via various parameters, while repetitive TMS induces cortical plasticity via long-term potentiation or long-term depression-like mechanisms. Therefore, TMS is useful in the evaluation of physiological mechanisms of various neurological diseases, including movement disorders and epilepsy. In addition, it has diagnostic utility in spinal cord diseases, amyotrophic lateral sclerosis and demyelinating diseases. The therapeutic effects of repetitive TMS on stroke, Parkinson disease and focal hand dystonia are limited since the duration and clinical benefits seem to be temporary. New TMS techniques, which may improve clinical utility, are being developed to enhance clinical utilities in various neurological diseases.

• 대한한의학회지
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• 제21권4호
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• pp.227-235
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• 2000

Background and Purpose : Medical and Neurological complications in patients with acute stroke may affect their prognosis including death rate, function and admission period. Some of these complications may be preventable. But few data exist regarding complications occurring in the first weeks. So we sought to observe the type, timing, and frequency of complications in hospitalized patients after stroke. Methods : We retrospectively examined the case notes of patients admitted in Won Kwang Oriental Medical Hospital after stroke. Two observers inspected the case notes using predifined diagnostic criteria and recorded the type, timing, and frequency of complications that occurred during the inpatient period. Results : Complications were recorded in 43 patients(82.7%). The most common medical complications were constipation(25.0%) and shoulder pain(21.2%). The most frequent serious medical problems were pulmonary infection(9.6%) and UTI(7.7%). The most common neurological complications were insomnia(34.6%) and dysphagia(23.7%). The most frequent serious medical problem was mental deterioration(7.7%). Conclusion : Complications after acute stroke are common. There were more medical complications than neurological complications. So we should compile much knowledge about medical complications and treat them actively. The differences between our study and previous studies are attributable to the different methods including patient selection and diagnostic criteria.

• 대한임상검사과학회지
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• 제46권1호
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• pp.38-45
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• 2014

Intraoperative Neurophysiological Monitoring (INM) inspection has a very important role. While preserving the patient's neurological function be sure to safe surgery, neurological examination should thank. Cerebello pontine angle tumor surgery, especially in the nervous system is more important to the meaning of INM. In cochlear nerve, facial nerve, trigeminal nerve, which are intricate brain surgery, doctors are only human eye and brain to the brain that it is virtually impossible to distinguish the nervous system. They receives a lot of help from INM. In this paper, we examined six kinds broadly. First, the methods of spontaneous EMG and Free-running EMG, which can instantly detect a damage inflicted on a nerve during surgery. Second, methods of triggered EMG and direct nerve electrical stimulation, which directly stimulate a nerve using electricity to distinguish between nerves and brain tumors. Third, the method of knowing a more accurate neurologic status by informing neurological surgeons about Free-running EMG wave forms that are segmetalized into four. Fourth, three ways of knowing when a patient will be awaken from intraoperative anesthesia, which happens due to a weak anesthetic. Fifth, a method of understanding the structures of a brain tumor and a facial nerve as five dividend segments. Sixth, comparisons between cases normal facial nerve recovery and occurrence of a facial nerve paralysis during the postoperative course.

• 대한한의학회지
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• 제30권6호
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• pp.53-68
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• 2009

Objectives: This study demonstrates the neurological effects of Bojungikki-tang and Bojungikki-tang-gamibang on the focal cerebral ischemia of rats with ischemic damage caused by middle cerebral artery occlusion (MCAO). Methods: Rats were treated with Bojungikki-tang and Bojungikki-tang-gamibang extracts for about five days after MCAO, and the size and volume of cerebral infarction and the ratio of cerebral edema were observed. From the immunohistochemical view, significant changes of outbreak of Bax, Bcl-2, c-Fos, HSP72, and iNOS were observed in the brain tissues. Results: Bojungikki-tang repressed only brain edema and iNOS revelation led by focal cerebral ischemia, when considering significance. In contrast, Bojungikki-tang-gamibang demonstrated significant suppression of cerebral infarction, brain edema, Bax, c-Fos, HSP72, and iNOS induced by focal cerebral ischemia. Conclusions: Bojungikki-tang is considered functional treatment for cerebral ischemic damage; it can be effective to relieve secondary brain edema and immune response. Bojungikki-tang-gamibang can have a direct function to alleviate brain infarct and to control the natural death of nerve cells which cerebral ischemic damage brings about.

• 한방재활의학과학회지
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• 제20권1호
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• pp.13-26
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• 2010

Objectives : This study was designed to evaluate neuroprotective effects of Neutral Pharmacopuncture for Blood Stasis(NPBS) into SP10 and Tangguisusangami-tang (dangguixusanjiawei-tang)(TGT) in the experimental Traumatic Brain Injury(TBI)rats. Methods : Male rats were divided into 4 groups. Group I was no treatment after TBI. Group II was treatment with NPBS into SP10 after TBI. Group III was treatment with TGT after TBI. Group IV was NPBS into SP10 and TGT after TBI. The author carried out neurological motor behavioral, histological assessment test. Results : 1. In neurological motor behavior tests, motor and cognitive function recovery was significantly increased in the Group II, III, IV. Also Group IV was increased as compared with Group II, III. 2. In BAX expression, according to priority Group IV, III, II, I were decresed in 7 and 14 days later. Especially Group IV was significantly decreased in 14 days later. 3. In BCL-2 expression, Group IV was increased slightly in 7 days later. Most incresed expression was experimented in the Group IV in 14 days later. 4. In TUNEL expression, IV was decreased as compared with each Group I, II, III in 7 days later. Group IV, III were decreased as compared with each Group I, II, III in 14 days later. Conclusions : According to the results, NPBS and TGT can inhibit apoptosis of cells after TBI in rats by contol of BAX and BCL-2, TUNEL expression. And also can help neurological motor behavioral function.

• 정보교육학회논문지
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• 제18권4호
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• pp.559-566
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• 2014

본 연구는 인지적 발달단계에 대한 신경학적 역동 발달주기를 규명하기 위하여 추상적 발달단계인 추상적 맵핑, 추상적 체계, 단일원리의 각 학습단계별 뇌파의 변화와 역동적 학습발달 간의 관계를 규명하였다. 컴퓨터 수학학습에서 일어나는 자발적 학습은 수학과제를 수행할 때 적은 학습지원 으로 나타나는 학습효과에 중점을 두었으며 이해적 학습은 적절한 학습지원을 통해 나타내는 학습효과를 중심으로 인지적 변화와 뇌파와의 관계성을 통해 뇌와 뇌신경의 발달관점에서 파악한 것이다. 연구 결과, 추상적 맵핑과 추상적 시스템 단계에서 지원을 통한 이해적 학습이 두정엽과 전두엽에서 의미 있는 뇌 활동성을 가져왔으며 추상적 개념학습의 마지막 단계인 단일원리에서는 피험자의 발달단계가 적정나이보다 작아 오히려 지원을 통한 이해적 학습이 더 적은 뇌 활동성을 가져왔다.

• 대한한방내과학회지
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• 제42권5호
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• pp.727-737
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• 2021

Objectives: This study investigated the effect of Korean medicine on an elderly patient with posterior circulation cerebral infarction, chronic kidney disease (CKD), and early neurological deterioration (END). Methods: The patient, who already had CKD, was treated with Korean medicine, comprising herbal medicine, acupuncture, moxa, and cupping combined with Western medicine (antiplatelet, diabetes) and physical therapy. A manual muscle test (MMT) and a modified Barthel index (MBI) were used to observe the treatment effects, and blood tests were performed to check estimated glomerular filtration rate (eGFR), creatinine and blood urea nitrogen (BUN), which represent renal function. Results: After the treatment, MMT, MBI, and renal function scores had increased. Conclusions: This study suggests that Korean medicine can effectively treat posterior circulation cerebral infarction with END in CKD, but further studies should be conducted.

• Asian Spine Journal
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• 제12권6호
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• pp.981-986
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• 2018

Study Design: Retrospective case series. Purpose: Cauda equina syndrome (CES) is associated with etiologies such as lumbar disc herniation (LDH) and lumbar canal stenosis (LCS). CES has a prevalence of 2% among patients with LDH and exhibits variable outcomes, even with early surgery. Few studies have explored the factors influencing the prognosis in terms of bladder function. Therefore, we aimed to assess the factors contributing to bladder recovery and propose a simplified bladder recovery classification. Overview of Literature: Few reports have described the prognostic clinical factors for bladder recovery following CES. Moreover, limited data are available regarding a meaningful bladder recovery status classification useful in clinical settings. Methods: A single-center retrospective study was conducted (April 2012 to April 2015). Patients with CES secondary to LDH or LCS were included. The retrieved data were evaluated for variables such as demographics, symptom duration, neurological symptoms, bladder symptoms, and surgery duration. The variable bladder function outcome during discharge and at follow-up was recorded. All subjects were followed up for at least 2 years. A simplified bladder recovery classification was proposed. Statistical analyses were performed to study the correlation between patient variables and bladder function outcome. Results: Overall, 39 patients were included in the study. Majority of the subjects were males (79.8%) with an average age of 44.4 years. CES secondary to LDH was most commonly seen (89.7%). Perianal sensation (PAS) showed a significant correlation with neurological recovery. In the absence of PAS, bladder function did not recover. Voluntary anal contraction (VAC) was affected in all study subjects. Conclusions: Intactness of PAS was the only significant prognostic variable. Decreased or absent VAC was the most sensitive diagnostic marker of CES. We also proposed a simplified bladder recovery classification for recovery prognosis.

• 대한신경과학회지
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• 제36권4호
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• pp.302-309
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• 2018

Background: Although orthostatic hypotension (OH) and cognitive impairment (CI) are common non- motor symptoms of Parkinson's disease (PD), the relationship between OH and CI remains to be clarified. This study was aimed to investigate the relationship between OH and CI in PD. Methods: We recruited 192 patients who were diagnosed as PD based on the UK Brain Bank diagnostic criteria. The Hoehn & Yahr stages were ranged I to III and patients underwent extensive clinical evaluation, including brain magnetic resonance imaging (MRI) for cerebral white matter hyperintensity (WMH), tilt table test, the Korean version of Montreal Cognitive Assessments and the Korean version of Mini-Mental Status Examination in one month from the first clinic visit. The participants were divided into two groups according to the presence of OH (OH+ vs. OH-) and cognitive function (cognitive normal, CN vs. CI), respectively. Results: Significant relationship between OH and cognitive function (p=0.04) was found in our patients. The patients with OH+ had higher risk of CI by 2.6 times than that of OH- patients. Maximum heart rate change during tilt table test was correlated with cognitive function and white matter changes, whereas blood pressure change during tilt table test showed no correlation with those parameters. Conclusions: There was significant relationship between OH and CI in PD. Therefore, PD patients with either symptom may need periodic evaluation and proper management for OH and cognitive functions.