• Archives of Craniofacial Surgery
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• v.23 no.2
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• pp.59-63
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• 2022

Background: Deformational plagiocephaly is usually managed conservatively, as it tends to improve over time and with the use of conservative measures. However, before the year 2017 we operated on patients with severe plagiocephaly and neurological symptoms at the Helsinki Cleft Palate and Craniofacial Center. Methods: Of the 20 infants with severe deformational plagiocephaly and neurological symptoms referred to us between 2014 and 2016, 10 underwent cranioplasty open reshaping of the posterior cranial vault. The parents of the last 10 patients were given information on the natural history of the condition and the patients were followed up with an outpatient protocol. The aim of this study was to gain information on the brain electrophysiology and recovery of patients after total cranial vault reconstruction by measuring the electroencephalogram (EEG) somatosensory evoked potentials (SEP; median nerve). Results: Of the 10 participants in the operation arm, six had abnormal SEP at least on the affected cerebral hemisphere and all SEPs were recorded as normal when controlled postoperatively. In the follow-up arm, eight out of 10 participants had abnormal SEP at the age of approximately 24 months, and all had normalized SEPs at control visits. Conclusion: Our data suggest that cranioplasty open reshaping of the posterior cranial vault did not affect abnormal SEP-EEG recordings. We have abandoned the operations in deformational plagiocephaly patients due to findings suggesting that expanding cranioplasty is not beneficial for brain function in this patient group.

• Physical Therapy Korea
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• v.29 no.2
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• pp.147-155
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• 2022

Background: Although various conventional approaches have been employed to reduce spasticity in neurological rehabilitation, only a few studies have shown scientific evidence for its effectiveness. Thus, we introduced a different concept (Ueda method) of rehabilitation therapy that can complement the limitations of conventional therapy. Objects: This study aimed to investigate the immediate effects of the application of the Ueda method on patients with spasticity after stroke via an electrophysiological study. Methods: We conducted a randomized double-blind pilot study in two rehabilitation hospitals involving 30 stroke patients who were randomly allocated to the Ueda (n = 15) and convention (n = 15) groups. Electromyographic data of six examined muscles in both upper extremities of all patients were recorded. The A-ApA index and activation ratios of upper extremity muscles were evaluated and compared between the groups to confirm post-intervention changes in upper-extremity flexor spasticity and flexion synergies. Repeated-measures analysis of variance was conducted to confirm the therapeutic effect (2 × 2) as a function of group (Ueda vs. convention) and time (pre-/post-intervention) on all outcome measures (p < 0.05). Results: In the Ueda group, the mean A-ApA index values differed significantly before and after the intervention (p = 0.041), indicating a weak evidence level; however, the effect size was medium (d = -0.503). The interaction effects of the A-ApA index between the Ueda and convention groups and between pre-intervention and post-intervention stages were significant (p = 0.012). The effect size was large (n_p² = 0.220). In the Ueda group, the activation ratios of the anterior deltoid fiber significantly decreased after the intervention in all reaching tasks. Conclusion: The Ueda method reduces upper-extremity flexor spasticity and changes its synergy in stroke patients and should be considered a rehabilitation therapy for spastic stroke patients.

• Journal of Korean Neurosurgical Society
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• v.66 no.6
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• pp.735-742
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• 2023

Nephrotic syndrome (NS) is associated with cerebral venous sinus thrombosis (CVST), which is a rare cerebrovascular disorder in children. Systemic anticoagulation with heparin is the standard therapy for CVST, and mechanical thrombectomy (MT) has been described as a salvage treatment for adult anticoagulant refractory CVST, However, it has never been reported in children. We describe a case of MT for refractory CVST in a child with NS. A 13-year-old boy with newly diagnosed NS presented to an emergency department with acute headache. A head computed tomography showed acute thrombus in the superior sagittal sinus, straight sinus and transverse sinus. The child was started on heparin therapy, but clinically deteriorated and became unresponsive. In view of the rapid deterioration of the condition after anticoagulation treatment, the patient received intravascular treatment. Several endovascular technologies, such as stent retriever and large bore suction catheter have been adopted. After endovascular treatment, the patient's neurological condition was improved within 24 hours, and magnetic resonance venography of the head demonstrated that the CVST was reduced. The child recovered with normal neurological function at discharge. This case highlights the importance of considering MT for refractory CVST, and we suggest that MT may be considered for refractory CVST with NS in children.

• Therapeutic Science for Rehabilitation
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• v.2 no.2
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• pp.47-59
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• 2013

Objective : This study is conducted to find the influence on upper extremity function, cognitive function and activities of daily living when stroke patients receive task-oriented training in group or individually. Methods : Twenty-six inpatients are assigned to two groups(task training group and individual training group) randomly, who receive rehabilitation therapy after stroke diagnosis for 5 months(june to november, 2012) in a hospital. Both groups receive a task-oriented training for 30 minutes a day for 3 weeks. FMA were used to measure upper extremity function, K-MMSE were used to measure cognition, and MBI for ADL. Results : Before training. two groups were not different significantly in upper extremity function and cognitive function. But in activities of daily living, bathing self(p<.001), feeding, personal hygiene and total score(p<.05) are higher in group training group. After training, upper extremity function is higher in individual training group(p<.001). In both training group, upper extremity function, feeding, personal hygiene, bathing self, dressing, toilet, chair/bed transfers, ambulation and stair climbing, total score are improved significantly(p<.05). In comparing of variation before and after training, upper extremity function(p<.001), feeding and total score of activities of daily living are more improved significantly in individual training group(p<.05). Conclusion : The outcome shows that task-oriented training can improve upper extremity function and activities of daily living in both training group. Especially, the more upper extremity function is improved, the more activities of daily living is improved. In the future, it will be necessary longitudinal study for a long time for more patients.

• Therapeutic Science for Rehabilitation
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• v.7 no.3
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• pp.9-21
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• 2018

Objective : This systematic review aimed to evaluate the global literature on the effect of early intervention for preschool children with autism spectrum disorder (ASD). Methods : A literature search of the PubMed database identified 10 studies published up to December 2017, using the following search terms: autism, autism spectrum disorder, ASD, high-function autism, high-function ASD, Asperger syndrome, pervasive developmental disorder, PDDNOS, intervention, and early intervention. Results : Early intervention for children with ASD used Applied Behavior Analysis in 8 of the 10 selected studies. The other two studies used a Sensory Integration approach and Technology-based intervention. Most studies reported positive effects on communication skills, social interaction skills, intelligence, adaptive behavior, and improved attention through early intervention. Conclusions : These results suggested a basis for early intervention for children with ASD. Further research is needed to determine the effectiveness of early intervention.

• Journal of Korean Neurosurgical Society
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• v.56 no.5
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• pp.375-382
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• 2014

Objective : To assess the effect of bone marrow mononuclear cells (BMMNCs) transplantation in the expression of nuclear factor-${\kappa}B$ (NF-${\kappa}B$) in spinal cord injury (SCI) in rats. Methods : BMMNCs were isolated from tibia and femur by a density gradient centrifugation. After establishment of acute transection SCI, rats were divided into experiment (BMMNCs), experiment control (0.1 M PBS infused) and sham surgery groups (laminectomy without any SCI). Locomotor function was assessed weekly for 5 weeks post-injury using BBB locomotor score and urinary bladder function daily for 4 weeks post-injury. Activity of NF-${\kappa}B$ in spinal cord was assessed by immunohistochemistry and reverse transcriptase polymerase chain reaction. Results : At each time point post-injury, sham surgery group had significantly higher Basso, Beattie, Bresnahan locomotor and urinary bladder function scores than experiment and experiment control group (p<0.05). At subsequent time interval there were gradual improvement in both experiment and experiment control group, but experiment group had higher score in comparison to experiment control group (p<0.05). Comparisons were also made for expression of activated NF-${\kappa}B$ positive cells and level of NF-${\kappa}B$ messenger RNA in spinal cord at various time points between the groups. Activated NF-${\kappa}B$ immunoreactivity and level of NF-${\kappa}B$ mRNA expression were significantly higher in control group in comparison to experiment and sham surgery group (p<0.05). Conclusion : BMMNCs transplantation attenuates the expression of NF-${\kappa}B$ in injured spinal cord tissue and thus helps in recovery of neurological function in rat models with SCI.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.6
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• pp.894-901
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• 2012

The effect of Sopung-tang(SPT) and trans-cranial direct current stimulation(tDCS) was investigated in photothrombotic brain infarction(PTI) rats. Sprague-Dawley 80 rats, were divided into four groups. group I was experiental control group(n=20), group II was PTI induced and oral administration of SPT(n=20), group III was PTI induced and tDCS administration(n=20) and group IV was PTI induced and SPT and tDCS administration for 28 days on stroke rats(n=20). Analysis the neurological function test, 25 point behavior functional score test, and immunohistochemistric finding of GDNF expression, and electron microscopy assessment In motor behavior test, the outcome of group IV was significantly difference than the other group, and In immunohistochemistric finding, group II, III, IV were increase GDNF expression on 28 days, In electron microscopy finding, the all groups were degenerated of cell organelles, and synaptic plasticity were improvement of group II, III, IV(especially group IV) These results suggest that, 28days application of SPT and tDCS was the motor function and histopathologic, micro-morphological improvement of motor function recovery and positive influence on synaptic plasticity.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.25 no.1
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• pp.13-15
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• 2014

Presbyphonia is defined as voice change caused by aging. Since presbyphonia is one of the natural aging processes, the treatment should be considered for the patients complaining communication difficulties. The treatment should not only target on presbylaryngis, but also on underlying systemic conditions such as lung function, neurological diseases and medications. Therefore, the treatment for the patients with presbyphonia should be multidisciplinary including underlying disease control, voice therapy and surgical treatment. Although various experiments on treatment of presbylaryngis are currently being tried, repeated injection laryngoplasty is still playing an important role because presbyphonia is destined to get worse over time.

• Journal of Korean Neurosurgical Society
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• v.59 no.2
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• pp.161-164
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• 2016

Few preoperative extrapontine myelinolysis (EPM) cases with pituitary adenoma have been reported. No such case had long follow-up to see the outcome of EPM. We reported a 38-year-old man complaining of nausea, malaise and transient loss of consciousness who was found to have severe hyponatremia. Neurologic deficits including altered mental status, behavioral disturbances, dysarthria and dysphagia developed despite slow correction of hyponatremia. Endocrine and imaging studies revealed hypopituitarism, nonfunctional pituitary macroadenoma and extrapontine myelinolysis. Transsphenoidal surgery was performed after three weeks of supportive therapy, when neurological symptoms improved significantly. The patient recovered function completely 3 months after surgery. Our case indicates that outcome of EPM can be good even with prolonged periods of severe neurologic impairment.

• 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.