• 제목/요약/키워드: Neurological recovery

검색결과 165건 처리시간 0.023초

코로나 전후 보험유형에 따른 서울 지역 병원밖 급성심정지 환자의 결과 비교 (Comparing the outcomes of out-of-hospital cardiac arrest between national health insurance and medical aid in Seoul before and during COVID-19 pandemic)

  • 이경열
    • 한국응급구조학회지
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    • 제27권3호
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    • pp.7-16
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    • 2023
  • Purpose: The objective of this study was to compare the outcome of out-of-hospital cardiac arrest (OHCA) between National Health Insurance(NHI) and Medical Aid(MA), before (2019) and during 2020 COVID-19 in Seoul. Methods: This is a retrospective cohort study that used nationwide OHCA registry collected in 2019 and 2020. The participants were patients with medical etiology who lived in Seoul and were transferred by 119 ambulance in Seoul. It was classified into NHI and MA according to health insurance status. Main outcomes included survival rate and good neurological recovery. Results: A total of 2,888 patients (2,543 NHI and 345 MA) in 2019 and 2,949 patients (2,638 NHI and 311 MA) in 2020 were included. In 2020, the bystander cardiopulmonary resuscitation (CPR), was significantly lower in MA (25.7%) than in NHI (38.1%). Survival rate in the MA decreased from 11.6% in 2019 to 10.6% in 2020, while increased from 10.1% to 13.3% in NHI. The odds ratio of good neurological recovery were 0.47 (95%CI, 0.25-0.86) for the MA group compared with NHI during 2020 COVID-19. Conclusion: There were disparities in bystander CPR and good neurological recovery by health insurance status during COVID-19 pandemic. Public health interventions should strive to reduce disparity of MA group in OHCA.

Ginseng extract and ginsenosides improve neurological function and promote antioxidant effects in rats with spinal cord injury: A meta-analysis and systematic review

  • Sng, Kim Sia;Li, Gan;Zhou, Long-yun;Song, Yong-jia;Chen, Xu-qing;Wang, Yong-jun;Yao, Min;Cui, Xue-jun
    • Journal of Ginseng Research
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    • 제46권1호
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    • pp.11-22
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    • 2022
  • Spinal cord injury (SCI) is defined as damage to the spinal cord that temporarily or permanently changes its function. There is no definite treatment established for neurological complete injury patients. This study investigated the effect of ginseng extract and ginsenosides on neurological recovery and antioxidant efficacies in rat models following SCI and explore the appropriate dosage. Searches were done on PubMed, Embase, and Chinese databases, and animal studies matches the inclusion criteria were selected. Pair-wise meta-analysis and subgroup analysis were performed. Ten studies were included, and the overall methodological qualities were low quality. The result showed ginseng extract and ginsenosides significantly improve neurological function, through the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale (pooled MD = 4.40; 95% CI = 3.92 to 4.88; p < 0.00001), significantly decrease malondialdehyde (MDA) (n = 290; pooled MD = -2.19; 95% CI = -3.16 to 1.22; p < 0.0001) and increase superoxide dismutase (SOD) levels (n = 290; pooled MD = 2.14; 95% CI = 1.45 to 2.83; p < 0.00001). Both low (<25 mg/kg) and high dosage (25 mg/kg) showed significant improvement in the motor function recovery in SCI rats. Collectively, this review suggests ginseng extract and ginsenosides has a protective effect on SCI, with good safety and a clear mechanism of action and may be suitable for future clinical trials and applications.

척수 손상 백서에서 MK801 투여가 체성감각 유발전위 및 척수 조직에 미치는 효과 (The Effect of MK801 on SSEP and Patholoy in Chronic Spinal Cord Injured Rat)

  • 노성우;김영수;윤도흠;임승철;공경엽;박성혜;이경희
    • Journal of Korean Neurosurgical Society
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    • 제29권9호
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    • pp.1153-1160
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    • 2000
  • Objectives : This study was undertaken to investigate the effect of noncompetitive NMDA receptor blocker, MK801 on motor recovery, SSEP and pathology in spinal cord injured rat. Methods : The effects of MK801 on neuronal function protection, SSEP, and pathology were measured on spinal cord injury rats which were divided into 6 groups according to dose, time of drug delivery and magnitude of injury. Spinal cord injury was made with the magnitude of 25gm-cm and 50gm-cm on 42 rats. BBB locomotor function test was performed to evaluate the motor power recovery in hindlimb for 2 weeks after injury. After motor function test was completed, SSEP was measured. Amplitude and latency of the P1, N1 peak was measured and compared between groups. Finally rats were sacrificed, and pathologic findings including measurement of area of necrotic cord were studied and compared between groups. Results : Motor recovery at 2 weeks was better in MK801 group comparing to saline control group. SSEP at 2 weeks showed no difference in N1, P1 latencies, but significantly greater amplitude in MK801 group, compared to saline control group. On light microscope, there was no specific histologic differences between experimental groups. The cystic necrotic area in coronal plane was measured and compared in each group. The necrotic area was significantly smaller in MK801 1mg/kg group(delivered after injury) than vehicle group. The necrotic area in MK801 5mg/kg group and MK801 1mg/kg group(delivered before injury) was smaller than vehicle group even though it was not statistically significant. Conclusion : From the above result, it is speculated that NMDA blocker, MK801 can improve impaired neuronal function in spinal cord injury.

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Optimal Ratio of Wnt3a Expression in Human Mesenchymal Stem Cells Promotes Axonal Regeneration in Spinal Cord Injured Rat Model

  • Yoon, Hyung Ho;Lee, Hyang Ju;Min, Joongkee;Kim, Jeong Hoon;Park, Jin Hoon;Kim, Ji Hyun;Kim, Seong Who;Lee, Heuiran;Jeon, Sang Ryong
    • Journal of Korean Neurosurgical Society
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    • 제64권5호
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    • pp.705-715
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    • 2021
  • Objective : Through our previous clinical trials, the demonstrated therapeutic effects of MSC in chronic spinal cord injury (SCI) were found to be not sufficient. Therefore, the need to develop stem cell agent with enhanced efficacy is increased. We transplanted enhanced Wnt3-asecreting human mesenchymal stem cells (hMSC) into injured spines at 6 weeks after SCI to improve axonal regeneration in a rat model of chronic SCI. We hypothesized that enhanced Wnt3a protein expression could augment neuro-regeneration after SCI. Methods : Thirty-six Sprague-Dawley rats were injured using an Infinite Horizon (IH) impactor at the T9-10 vertebrae and separated into five groups : 1) phosphate-buffered saline injection (injury only group, n=7); 2) hMSC transplantation (MSC, n=7); 3) hMSC transfected with pLenti vector (without Wnt3a gene) transplantation (pLenti-MSC, n=7); 4) hMSC transfected with Wnt3a gene transplantation (Wnt3a-MSC, n=7); and 5) hMSC transfected with enhanced Wnt3a gene (1.7 fold Wnt3a mRNA expression) transplantation (1.7 Wnt3a-MSC, n=8). Six weeks after SCI, each 5×105 cells/15 µL at 2 points were injected using stereotactic and microsyringe pump. To evaluate functional recovery from SCI, rats underwent Basso-Beattie-Bresnahan (BBB) locomotor test on the first, second, and third days post-injury and then weekly for 14 weeks. Axonal regeneration was assessed using growth-associated protein 43 (GAP43), microtubule-associated protein 2 (MAP2), and neurofilament (NF) immunostaining. Results : Fourteen weeks after injury (8 weeks after transplantation), BBB score of the 1.7 Wnt3a-MSC group (15.0±0.28) was significantly higher than that of the injury only (10.0±0.48), MSC (12.57±0.48), pLenti-MSC (12.42±0.48), and Wnt3a-MSC (13.71±0.61) groups (p<0.05). Immunostaining revealed increased expression of axonal regeneration markers GAP43, MAP2, and NF in the Wnt3a-MSC and 1.7 Wnt3a-MSC groups. Conclusion : Our results showed that enhanced gene expression of Wnt3a in hMSC can potentiate axonal regeneration and improve functional recovery in a rat model of chronic SCI.

소풍탕이 허혈성 뇌손상 흰쥐의 인지 및 운동기능회복에 미치는 효과 (Neuroprotective Effects of Sopung-tang(Shufeng-tang) on Cognition and Motor Function Recovery after Ischemic Brain Injury in Rats)

  • 추민규;최진봉;신미숙;김선종
    • 한방재활의학과학회지
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    • 제18권2호
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    • pp.45-60
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    • 2008
  • Objectives : Sopung-tang(Shufeng-tang) is a famous herbal prescription that treated ischemic brain injury. This study was designed to evaluate the effects of Sopung-tang(Shufeng-tang) on congnition and motor function recovery after ischemic brain injury in rats. Methods : Male rats were divided into 4 groups. Those rats caused ischemic brain injury by occlusion of MCA as Longa method. Control group I was per os normal saline for 7 days after ischemic brain injury. Control group II was per os normal saline for 14 days after ischemic brain injury. Experimental group I(Ex I) was taken with Sopung-tang(Shufeng-tang) for 7 days after ischemic brain injury. Experimental group II(Ex II) was taken with Sopung-tang(Shufeng-tang) for 14 days after ischemic brain injury. The author carried out neurological, cognitive motor behavior tests and histological assessment. Neurological motor behavior tests consist of limb placement test, beam-walking test and horizontal wire test. Morris water maze test was used for cognitive motor behavior test. In the histological assessment test, TTC(2,3,5-triphenylteterazolium chloride) staining, Hematoxylin & Eosin staining and immunohistochemical staining were experimented. Results : 1. In neurological motor behavior tests, motor function recovery was significantly increased in the experimental groups as compared with control groups(p<0.05). Especially Ex II was significantly increased as compared with Ex I(p<0.05). 2. In Morris water maze test, congnitive motor function recovery was significantly increased in the experimental groups as compared with control group(p<0.05). Especially Ex II was significantly increased as compared with Ex I(p<0.05). 3. In the immunohistochemical staining for the expression of BDNF in hippocampus, more immune reaction was investigated in the experimental groups as compared with control groups. Especially most immune reaction was experimented in the EX II. Conclusions : According to the above results, Sopung-tang(Shufeng-tang) can treat on the congnition and motor function recovery after ischemic brain injury in rats. And it is effective method in expression of BDNF in hippocampus.

Surgical treatment of spinal cord compression in client owned dogs with different grades of neurological dysfunction

  • Kuricova, Maria;Ledecky, Valent;Liptak, Tomas
    • 대한수의학회지
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    • 제56권2호
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    • pp.113-116
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    • 2016
  • Our retrospective study reports the clinical findings and population characteristics of 81 surgically treated dogs for spinal cord compression. We compared the outcome of dogs with different grades of neurological dysfunction due to spinal cord compression and focused on the long-term outcome of surgical treatment, for which there are only a few recent records. We recorded a 13.6% recurrence, regardless of the degree of dysfunction. However, the degree of dysfunction negatively affected the recovery length.

Comparison of Early Surgical Outcome between Unilateral Open-Door Laminoplasty and Midline Splitting Laminoplasty

  • Baek, Hyun-Chul;Kang, Suk-Hyung;Jeon, Sang-Ryong;Roh, Sung-Woo;Rhim, Seung-Chul
    • Journal of Korean Neurosurgical Society
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    • 제41권6호
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    • pp.382-386
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    • 2007
  • Objective : Various techniques of cervical laminoplasty have been developed to decompress the spinal canal in patients with multilevel cervical spondylotic myelopathy. This study compared the early surgical outcomes between unilateral open-door laminoplasty and midline splitting cervical laminoplasty. Materials and Methods : From March 2004 to August 2005, we performed cervical laminoplasty in 34 patients with cervical myelopathy. Of these patients, 24 were treated by unilateral open-door laminoplasty [open-door group] and 10 by midline splitting cervical laminoplasty [splitting group]. The mean duration of follow up was 9.2 months in the open-door group and 15.8 months in the splitting group. We retrospectively analyzed neurological outcomes using the Japanese Orthopedic Association [JOA] score, and compared the radiological changes between the two groups. Results : Postoperative JOA score and recovery rate were $13.29{\pm}4.01$ and $56.28{\pm}44.91%$ in the open-door group and $15.75{\pm}0.88$ and $72.69{\pm}19.99%$ in the splitting group. There was no statistical difference between the two groups [p>0.05]. Regarding the radiological assessment, the increase of postoperative axial canal area was $63.23{\pm}23.24%$ in the open-door group and $42.30{\pm}14.96%$ in the splitting group [p<0,05]. Conclusion : There was no statistical difference in the neurological outcome when the early surgical outcomes of the open-door group and the splitting group were compared. However, the open-door group showed wider cervical spinal canal areas than the splitting group.

소아의 척추 외상 (Spinal Cord Injury without Radiographic Abnormalities in Children)

  • 양홍기;두정희
    • 한국전문물리치료학회지
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    • 제3권1호
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    • pp.57-64
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    • 1996
  • Spinal cord injury in child often occurs without evidence of fracture or dislocation. The mechanisms of neural damage in this syndrome of spinal cord injury without radiographic abnormality(SCIWORA) include flexion, hyperextension, longitudinal distraction, and ischemia. Inherent elasticity of the vertebral column in infants and young children, among other age-related anatomical peculiarities, render the pediatric spine exceedingly vulnerable to deforming forces. The neurological lesions encountered in this syndrome include a high incidence of complete and severe partial cord lesions. Children younger than 8years old sustain more serious neurological damage and suffer a larger number of upper cervical cord lesions than children aged over 8 years. Of the children with SCIWORA. 52% have delayed onset of paralysis up to 4 days after injury, and most of these children recall transient paresthesia, numbness, or subjective paralysis. The long-term prognosis in cases of SCIWORA is grim. Most children with complete and severe lesions do not recover; only those with initially mild neural injuries make satisfactory neurological recovery.

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Anterior Cervical Interbody Fusion with the Carbon Composite Osta-Pek Frame Cage in Degenerative Cervical Diseases

  • Han, Kwang-Wook;Kim, Joon-Soo;Kim, Kyu-Hong;Cho, Yong-Woon;Lee, In-Chang;Bae, Sang-Do
    • Journal of Korean Neurosurgical Society
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    • 제37권6호
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    • pp.422-426
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    • 2005
  • Objective: Different types of interbody fusion cages are available for use in the surgical treatment of degenerative cervical diseases. The purpose of this study is to assess the technical feasibility, clinical efficacy and radiological results of intervertebral fusion with a carbon composite Osta-Pek frame cage (Co-Ligne AG, Switzerland) following anterior cervical discectomy. Methods: 41 patients (25males and 16females) with minimum 6months follow-up were included in the study. Disc height, cervical lordotic angle, segmental angle, and fusion rate were assessed by lateral radiographs. In this retrospective analysis, clinical outcome was assessed as evaluated according to Odom's criteria. Results: Fifty-four cages were implanted in 30 single-level, 9 two-level, and 2 three-level procedures. The mean disc height, cervical lordosis angle, segmental angle were $4.2{\pm}1.8mm,\;23.5{\pm}7.2^{\circ},\;2.3{\pm}3.3^{\circ}$ pre-operatively and $5.3{\pm}2.1mm,\;24.2{\pm}8.3^{\circ},\;3.8{\pm}3.5^{\circ}$ at 6months after the surgery. Six months after surgery, there was radiographic evidence of fusion in 92.7% (38/41) of the patients. According to Odom's criteria, 37 of 41 (90.2%) patients experienced good to excellent functional recovery. Conclusion: These clinical and radiological results suggest that the carbon composite Osta-Pek frame cages are safe and effective alternative to autologous bone graft after anterior cervical discectomy for treatment of degenerative cervical disease.