• Title/Summary/Keyword: Right Brain

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The Influence of Gender on Clinical Outcomes in Elderly Patients Underwent Coronary Artery Bypass Grafting Surgery

  • Moon, Seong-Min
    • Biomedical Science Letters
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    • v.17 no.4
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    • pp.329-336
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    • 2011
  • The female has previously been shown to be an independent risk factor for mortality and morbidity after coronary artery bypass grafting surgery (CABG). The aim of this retrospective study is to evaluate gender differences of the perioperative outcomes in elderly patients underwent CABG. Data for seventy elderly patients (>70 years) that underwent CABG (between January 2005 and July 2011) were divided into two groups: male patients (n=33, male group) and female patients group (n=37, female group). Heights, body weights, body surface area and coronary artery obstruction rate (right coronary artery territory) in the female group were lower than those of the male group ($P$ <0.05). History of hypertension, hyperlipidemia, congestive heart failure and percutaneous coronary artery intervention in the female group was higher than that of the male group ($P$ <0.05). Total cholesterol and brain natriuretic peptide levels in the female group were higher than those of the male group ($P$ <0.05). Platelet count in the female group was higher than the male group at preoperative (Pre-OP) period ($P$ <0.05). Erythrocyte count, hematocrit and hemoglobin levels in the female group were lower than those of the male group at Pre-OP period ($P$ <0.05). But, erythrocyte count, hematocrit and hemoglobin levels in the female group were higher than those of the Male group at postoperative (Post-OP) period ($P$ <0.05). Left ventricular ejection fraction in the female group was higher than the male group at Post-OP period ($P$ <0.05). Hospital stay length in the female group was higher than the male group ($P$ <0.05). Post-OP bleeding volume and incidence of ventricular premature contraction in the female group were lower than those of the male group ($P$ <0.05). These results suggest that despite female gender have a greater risk factors and require a longer hospitalization than male, there was no significant difference incidence of mortality and complication.

One case Treated Cerebral Infarction with Aphasia by Jihwangumja (지황음자(地黃飮子)를 투여(投與)한 중풍(中風) 실어증(失語症) 환자 치험1례)

  • Shin Woo-Jin;Hong Hyun-Woo;Kim Ji-Yun;Jeong Jae-Ook;Seo Sang-Ho;Kim Jong-Hwan;Jang Ja-Won;Park Dong-Il
    • The Journal of Internal Korean Medicine
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    • v.24 no.4_2
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    • pp.1014-1022
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    • 2003
  • Aphasia is speech disorder caused by injuries on the speech nerve center. It usually occur due to a disease in the right cerebral cortex and is divided into the various aphasia such as Global aphasia, Broca's aphasia, Wernicke's aphasia, conduction aphasia, Anomic aphasia, etc. Jihwangumja is used the cerebral infarction with Aphasia due to deficiency syndrome of kidneys. The purpose of this study is to examine the efficacy of oriental treatment for cerebral infarction with aphasia by Jihwangumsa. In the hospital, the patient showed the symptoms of mental disorder, Rt. hemiparesis G3/G4, aphasia, chest discomfort, obstipation, frequent urination, etc. The case showed that acute infarction on Lt. fronto-temporo-parietal lobe in Brain-CT. We identified the patient's clinical conditions and treated accordingly. As a result of treatment, symptoms were markedly improved and he was discharged. Further elaboration of oriental diagnostic classification could possibly lead to the fundamental treatment.

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The effects of labeling gap and susceptibility artifacts in pCASL perfusion MRI (pCASL 관류 영상에서 표지 간격과 자화감수성 인공물이 영상에 미치는 영향)

  • Kim, Seong-Hu
    • Journal of the Korean Society of Radiology
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    • v.9 no.4
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    • pp.213-217
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    • 2015
  • To report problems found in a patient who has implemented stent implantation and then conducted a perfusion MRI using ASL(Arterial Spin Labeling), in order to suggest a solution to them. The perfusion MRI was conducted, using pCASL among ASL methods. Data from pCASL(Pseudo Continuous Arterial Spin Labeling) was acquired together with the structural image simply by changing position(labeling gap 15 mm, 170 mm) of the labeling pulse to avoid stent. Data was processed through the ASLtbx. When perfusion MRI was acquired using pCASL, it showed that the position of the conventional labeling pulse (labeling gap 24 mm) was overlapped with that of stent, which made signal intensity in right brain tissue appear as if it were void. When the labeling pulse was positioned (labeling gap 15 mm) to avoid stent, high signal intensity images were acquired. In labeling pulse (labeling gap 170 mm), the signal intensity was more reduced due to relaxation before labeled blood arrived at the imaging slice. pCASL can be stably repeated measurements because it does not use a contrast agent. And it should be selected with the appropriate image acquisition parameters for the high quality image.

Experimental Study on Cavo-Pulmonary Anastomosis (상공정맥-우폐동맥 문합에 관한 실험적 연구)

  • 양기민
    • Journal of Chest Surgery
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    • v.10 no.2
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    • pp.281-294
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    • 1977
  • Superior vena cava to pulmonary arterial shunting operation was made between the superior vena cava and the right pulmonary artery in the fashion of end-to-end anastomosis in 20 mongrel dogs. The experimental animals were divided into three group and blood flow in the superior vena cava was occluded for 20, 30 and 60 minutes respectively, and observations were made for the changes in caval pressure and cerebrospinal fluid pressure. And pathologic examinations were also performed. On occluding the caval blood flow, the superior vena caval pressure was sharply and immediately elevated from $103.5{\pm}19.8mmH_2O$ at thoracotomy to $556.4{\pm}86.lmmH_2O$ within 2 minutes to make its plateau thereafter, and the cerebrospinal fluid pressure followed closely the changes of the superior vena caval pressure in its level and pattern being elevated from $102.0{\pm}19.9mmH_2O$ to $490.5{\pm}79.9mmH_2O$. The drops of both the caval and cerebrospinal fluid pressures were definite and marked on opening the shunt flow through the anastomosis, but these postoperative pressures retained still higher ones above their levels measured at thoracotomy. The pathological examinations of the brain and the spinal cord were also performed in six animals. Characteristic changes uniformly seen in all area and in all animals were the findings of capillary congestion and perivascular edema. On the other hand, ischemic nerve cell changes were rather evident, revealing their degrees and extents being related to the prolongation of the time of caval occlusion which has followed by the sustained high pressures in both the superior vena and the cerebrospinal fluid. The experiment suggests the safety of this surgical procedure with minimal, if any, permanent damage as long as the occlusion of the caval blood flow is not prolonged beyond the expected.

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A Clinical Study on Stroke patients(CVA) in Seosan province (서산 지역에서의 중풍에 대한 임상적 고찰)

  • Lee, Geun-Dong;Seo, Jong-Eun;Han, Sung-Soo
    • The Journal of Internal Korean Medicine
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    • v.21 no.5
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    • pp.715-721
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    • 2000
  • Objective : The purpose of this study is about stroke patients in Seosan. Method : The subjects of this study were 45 patients who were admitted to Hanseo University Oriental Hospital because of stroke. Each patients was diagnosed with Brain CT, sasang constitutional analysis. Results : 1. The rates in CVA was 58% on cerebral infarction, and 42% on cerebral hemorrhage. 2. The sites of cerebral infarction were Basal ganglia, MCA, Internal. External capsule. Thalamus, ect. Sites of cerebral hemorrhage were Thalamus, Basal ganglia, Cerebellum. 3. The ratio of left and right hemiplegia in cerebral infarction was 1:1.6, and in cerebral hemorrhage it was 1:2. 4. The most chief complaints in cerebral infarction, were hemiplegia, dysarthria, facial palsy, headache. In cerebral hemorrhage, their were hemiplegia, dysarthria, headache, dizziness, and facial palsy. 5. Classification of human corporal constitution in cerebral hemorrhage, the most was Taeumin, Soyangin, Soeumin. And in cerebral infarction, the most was Soyangin, Taeumin, Soyumin. 6. The ratio between male and female was 1.25:2 in cerebral hemorrhage, 2.5:5 in cerebral infarction. 7. The most prevalent age groups in cerebral hemorrhage was fifties to sixties. and in cerebral infarction was fifties to sixties. 8. The most common preceding disease in cerebral hemorrhage was HTN, DM. 9. The recurrence rate of cerebral hemorrhage was 16%, and cerebral infarction was 8%. 10. The ratio of recovery in cerebral hemorrhage was 84%, in cerebral infarction 58%. Conclusion : From this study, in cerebral hemorrhage most patients were Taeumin, in their fifties to sixties. And in cerebral infarction most patients were Soyangin, in their sixties to eighties. In both stroke patients, there were more female than male patients.

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Selective Toxicity to Central Serotonergic Nervous System in Prenatally and Postnatally Lead-Exposed Rats

  • 서동욱;정은영;정재훈;신찬영;오우택;고광호
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.335-335
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    • 1994
  • Possibility whether lead ingestion can cause selective toxicity to central serotonergic nervous system in rats was tested. Three groups of wistar rats; 1)Control, 2) Low dose and 3) High dose groups, were prepared. In prenatally lead-exposed rats, until parturition from dams, rat pups were intoxicated via placenta of mother rats having received drinking water containing either 0%(control ), 0.05%(low dose) or 0.2%(high dose) of lead acetate respectively, In postnatally lead-exposed rats, right after parturition from dams rat pups received drinking water containing either 0% (control), 0.05%(low dose) or 0.2%(high dose) of lead acetate. At 2, 4, 6 and 8 weeks of age, tryptophan hydroxylase (TPH) activity and Na$\^$+//K$\^$+/-ATPase activity were measured in 4 areas of rat brain; Telencephalon, Diencephalon, Midbrain and Pons/Medulla. TPH activities were assayed by modified method of Beevers et al. (1983) using L-(5-$^3$H)-tryptophan as substrate. TPH activity was determined as a criterion of lead poisoning to central serotonergic nervous system and Na$\^$+//K$\^$+/-ATPase activity as a criterion of non specific lead poisoning to any kinds of tissues. Selective toxicity of lead poisoning to central serotonergic nervous system was evaluated by the changes of TPH activities without concomitant changes of Na$\^$+//K$\^$+/-ATPase activities. In prenatally lead-exposed rats. this selectivity was found in Telencephalon (2 weeks of age), Diencephalon/Midbrain (2 weeks of age), Midbrain (4 and 6 weeks of age), Pons/Medulla (2, 4 and 6 weeks of age) In rats exposed to low dose of lead and Pons/Medulla (2 weeks of age) to high dose of lead. In postnatal Iy lead-exposed rats, this selectivity was found in Telencephalon (8 weeks of age), Diencephalon(8 weeks of age), Pons/Medulla (6 and 8 weeks of age) in rats exposed to low dose of lead and Pons/Medulla (8 weeks of age) to high dose of lead. These results suggest that lead poisoning may exhibit selective toxicity to central serotonergic nervous system.

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A Case of Penetrating Head Injury by a Western-Style Arrow - A Case Report - (양궁화살에 의한 두부 관통상 1례 - 증례보고 -)

  • Cho, Tae-Hyun;Song, Jun-Hyeok;Kim, Myung-Hyun;Park, Hyang-Kwon;Kim, Sung-Hak;Shin, Kyu-Man;Park, Dong-Been
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1538-1541
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    • 2000
  • Apenetrating head injury by an arrow is extremely rare being only two cases reported in the literature. We report a case of 12-year-old boy who presented with an arrow lodged at the posterior fossa through nasal nostril. He was slightly drowsy, but neurologically intact except a sixth nerve palsy in the left eye. Brain CT showed no intracerebral hemorrhage. The arrow was entered through the right nostril and the tip was stucked in the left cere-bello-pontine angle through the sphenoid sinus. We removed the arrow without craniotomy since the tip was verified smooth and no cerebral arteries were in contact with the arrow. The patient recovered well without any significant complications. The sixth nerve palsy resolved completely after six months. The verification of the shape of the offending material, a retrograde removal of the arrow in the direction of its line of trajectory, and an identification of adjacent cerebral arteries seem to be important in the management of this type of injury.

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Localization of Broca's Area Using Functional MR Imaging: Quantitative Evaluation of Paradigms

  • Kim, Chi-Heon;Kim, Jae-Hun;Chung, Chun-Kee;Kim, June-Sic;Lee, Jong-Min;Lee, Sang-Kun
    • Journal of Korean Neurosurgical Society
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    • v.45 no.4
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    • pp.219-223
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    • 2009
  • Objective : Functional magnetic resonance imaging (fMRI) is frequently used to localize language areas in a non-invasive manner. Various paradigms for presurgical localization of language areas have been developed, but a systematic quantitative evaluation of the efficiency of those paradigms has not been performed. In the present study, the authors analyzed different language paradigms to see which paradigm is most efficient in localizing frontal language areas. Methods : Five men and five women with no neurological deficits participated (mean age, 24 years) in this study. All volunteers were right-handed. Each subject performed 4 tasks, including fixation (Fix), sentence reading (SRI. pseudoword reading (PR), and word generation (WG). Fixation and pseudoword reading were used as contrasts. The functional area was defined as the area(s) with a t-value of more than 3.92 in fMRI with different tasks. To apply an anatomical constraint, we used a brain atlas mapping system, which is available in AFNI, to define the anatomical frontal language area. The numbers of voxels in overlapped area between anatomical and functional area were individually counted in the frontal expressive language area. Results : Of the various combinations, the word generation task was most effective in delineating the frontal expressive language area when fixation was used as a contrast (p<0.05). The sensitivity of this test for localizing Broca's area was 81 % and specificity was 70%. Conclusion : Word generation versus fixation could effectively and reliably delineate the frontal language area. A customized effective paradigm should be analyzed in order to evaluate various language functions.

LEFT INFERIOR FRONTAL GYRUS RELATED TO REPETITION PRIMING: LORETA IMAGING WITH 128-CHANNEL EEG AND INDIVIDUAL MRI

  • Kim, Young-Youn;Kim, Eun-Nam;Roh, Ah-Young;Goong, Yoon-Nam;Kim, Myung-Sun;Kwon, Jun-Soo
    • Proceedings of the Korean Society for Cognitive Science Conference
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    • 2005.05a
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    • pp.151-153
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    • 2005
  • We investigated the brain substrate of repetition priming on the implicit memory taskusing low-resolution electromagnetic tomography (LORETA) with high-density 128 channel EEG and individual MRI as a realistic head model. Thirteen right-handed, healthy subjects performed a word/nonword discrimination task, in which the words and nonwords were presented visually,and some of the words appeared twice with a lag of one or five items. All of the subjects exhibited repetition priming with respect to the behavioral data, in which a faster reaction time was observed to the repeated word (old word) than to the first presentation of the word (new word). The old words elicited more positive-going potentials than the new words, beginning at 200 ms and lasting until 500 ms post-stimulus. We conducted source reconstruction using LORETA at a latency of 400 ms with the peak mean global field potentials and used statistical parametric mapping for the statistical analysis. We found that the source elicited by the old words exhibited a statistically significant current density reduction in the left inferior frontal gyrus. This is the first study to investigate the generators of repetition priming using voxel-by-voxel statistical mapping of the current density with individual MRI and high-density EEG.

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A case of Niemann-Pick disease type A (A형 Niemann-Pick 병 1례)

  • Yu, Ho Yen;Oh, Ji Eun;Park, Jae Sun;Kim, Mi Hyang;Kim, Sin Dong;Jung, Kyung Soon
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1358-1362
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    • 2006
  • Niemann-Pick disease is a group of autosomal recessive disorders associated with hepatosplenomegaly, variable neurologic deficits, and the storage of sphingomyelin and other lipids. Seven cases have been reported in Korea. We report an additional case presenting with hypotonia, early neurodevelopmental delay, hepatosplenomegaly and death by persistent pneumonia and asphyxia at the age of 23 months. MRI of brain and fundoscopic findings of our case at 4 months of age were normal. However, abnormal intensity of the thalamus and atrophy of the right temporal lobe on the MRI and macular cherry red spots were noticed at the age of 17 months. A bone marrow biopsy showed large foamy cells, while hexosaminidase A and B levels were normal. Although biochemical or molecular workup was not done, these findings led to the diagnosis of infantile onset Niemann-Pick disease, probably type A. A brief review of the related literatures was made.