• Title/Summary/Keyword: Stroke and Brain disease

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Improvement of medical law regulations for telemedicine services (원격의료서비스를 위한 의료법 관련 규제 개선방향)

  • Choi, Jung-Ah;Jung, Yong Gyu
    • The Journal of the Convergence on Culture Technology
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    • v.1 no.2
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    • pp.85-89
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    • 2015
  • It has been reported that cerebral disease is the most leading to death as a single disease even though next to cancer in the most important cause of death in the country. Even if patients maintain a life without death, it will have to suffer from side effects such as hemiplegia and language disorders. In this paper, the symptoms and treatment of cerebral infarction cases are described through the medical dramas (The Third Hospital, The Brain) and movie (Amur). Even if there is the same stroke each drama or movie, depending on the previous history or current physical condition of the patient knew which treatment the law is different.

A Study on Cerebral Infarction using Medical Drama (의학드라마를 통한 뇌경색 탐구)

  • Kim, Chang Ki;Choi, Jung-Ah;Jung, Yong Gyu
    • The Journal of the Convergence on Culture Technology
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    • v.1 no.1
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    • pp.65-68
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    • 2015
  • It has been reported that cerebral disease is the most fatal as a single disease, standing next to cancer as the most important cause of death in Korea. Even though patients maintain their lives, they will have to suffer from side effects such as hemiplegia and language disorders. In this paper, the symptoms and treatment of cerebral infarction cases are described through the medical dramas (The Third Hospital, The Brain) and movie (Amur). Even if there is the same stroke in each drama or movie, each receives different treatment depending on the previous history or current physical condition of the patient.

Two Cases of MELAS Syndrome Manifesting Variable Clinical Cour (다양한 임상경과를 보인 멜라스(MELAS, mitochondrial encephalopathy, lactic acidosis, and stroke-like episode) 증후군 2례)

  • Choi, Seo Yeol;Lee, Seung-Ho;Myung, Na-Hye;Lee, Young-Seok;Yu, Jeesuk
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.2
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    • pp.102-108
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    • 2016
  • Mitochondrial encephalopathy, lactic acidosis, and stroke-like episode (MELAS) syndrome is one of mitochondrial encephalopathy. As the early clinical manifestations can be variable, it is important to suspect the disease, especially in patients with multiple organ dysfunctions. A boy was diagnosed with epilepsy when he was 9 years old. Two years later, severe headache and blurred vision developed suddenly. On examination, left homonymous hemianopsia was detected with corresponding cerebral parenchymal lesions in right temporo-occipito-parietal areas. MELAS syndrome was confirmed by genetic test, which showed m.3243 A>G mitochondrial DNA mutation. Multivitamins including coenzyme Q10 were added to anticonvulsant. He experienced 4 more events of stroke-like episodes over 5 years, but he is able to perform normal daily activities. A 13-year-old boy was brought to the hospital due to suddenly developed respiratory arrest and asystole associated with pneumonia. Past medical history revealed that he had multiple medical problems such as epilepsy, failure-to-thrive, optic atrophy, and deafness. He has been on valproic acid as an anticonvulsant which was prescribed from local clinic. He recovered after the resuscitation, but his cognition and motor function were severely damaged. He became bed-ridden. He was diagnosed with MELAS syndrome by brain MRI, muscle biopsy, and clinical features. Genetic test did not reveal any mitochondrial gene mutation. Four years later, he expired due to suddenly developed severe metabolic acidosis combined with hyperglycemic hyperosmolar nonketotic coma. The clinical features of MELAS syndrome are variable. Early diagnosis before the presentation to the grave clinical course may be important for the better clinical outcome.

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Review on Laser or LED Therapy for the Photobiomodulation of Diseases of the Cerebral Nervous System (뇌신경질환에 사용된 레이저 및 광선치료에 대한 임상 연구 고찰)

  • Lee, Kyung-Goo;Shin, Jong-Hun;Lee, Kyung-Jin;Sun, Seung-Ho;Han, Chang-Ho;Jang, In-Soo
    • The Journal of Internal Korean Medicine
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    • v.35 no.4
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    • pp.546-555
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    • 2014
  • Objectives: Recently, many studies have reported beneficial effects from the application of laser and light-emitting diode (LED) therapy for cerebral nervous disease. Transcranial laser therapy and LED therapy may be an effective method to treat diseases of the cerebral nervous system. This study aims to discuss the possibility of laser and LED therapy for cerebral nervous disease by reviewing literature about its effectiveness. Methods: We searched papers using PubMed, Science Direct, CINAHL, KTKP, Oasis and NDSL, using the keywords "Laser therapy, low-level", "Transcranial laser", "Transcranial light emitting diode" and "stroke", "traumatic brain injury", "dementia", "anxiety", "cognitive", "emotional effects", "psychiatric disorder", "multiple sclerosis", "Parkinson's disease". The search range included randomized controlled trials (RCTs) and clinical case series. Reviews and animal experiments were not included. Studies not matched with inclusion criteria were excluded. Results: A total 1,119 studies were found. 1,100 were excluded from scanning titles and abstracts and finally 9 articles were selected. Among the 9 articles, 5 were RCTs, one was a controlled study, and the other 3 were case reports. They reported that transcranial laser therapy and LED treatment had beneficial effects from photobiomodulation to the cerebral nervous system. Clinical evaluation factors showed favorable trends. Conclusions: Transcranial laser therapy and LED therapy seem to be effective to the cerebral nervous system and they may be a favorable choice for cerebral nervous disease.

The Effect of Complex Exercise Program of Diabetic Rats with Ischemic Brain Injury Model (허혈성 뇌손상 모델 당뇨쥐의 복합운동프로그램의 효과)

  • Kim, Dong-Hyun;Bang, Hyun-Soo
    • The Journal of Korean society of community based occupational therapy
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    • v.6 no.1
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    • pp.41-48
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    • 2016
  • Objective : We tried to know the improvement and neurological effect of diabetes when the complex exercise training was applied on diabetes that delayed the recovery of the ischemic brain injury. Methods : We performed this study in a animal lab which located in Gyengsangbukdo. We used 10 diabetes rats with ischemic brain injury, which is induced by STZ. We applied the complex exercise training on the rats for 4 weeks. We executed the maze test to confirm the recovery of the brain function and checked the blood sugar to know the improvement. Results : As a result of applying the complex exercise on diabetes rats with ischemic brain injury, there was a significant reduce of error and escape time in 3 weeks and 1 weeks, respectively. There was no difference of the blood sugar in control but there was a significant improvement in experiment group after applying the exercise training in 4 weeks. Conclusion : The senile disease like stroke and diabetes was increased currently. It is important for rehabilitation to improve the quality of life during the remainder of their life. In the study, we've known the improvement of diabetes and the recovery of the brain function when the complex exercise training was applied the rats with both diabetes and the ischemic brain injury.

A study on stroke patient's characteristics and damage (뇌혈관 손상환자의 특성 및 장애에 대한 연구)

  • Choi, Young-Deog
    • Journal of Korean Physical Therapy Science
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    • v.5 no.4
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    • pp.785-794
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    • 1998
  • We have made a survey of 40 patients in the university hospitals and oriental medical centers in Seoul from Sep. 1, 1997 to Mar. 1, 1998. We sampled 25 of them and the result shows that there were 12 MCA damaged patients(48%), 5 SAH(20%), 5 ACA(20%), 2 PCA (8%), 1 PCOA(4%). The number of MCA patients were the most. 1. As the cause of each disease, 4 of the 12 MCA damaged patients(33.35%) have infarction and cerebral hemorrhage, 2 of 5 SAH patients(40%) have cerebral hemorrhage and head injury, 3 ACA damaged patients have cerebral hemorrhage. 11 of 25 brain bloodvessel damaged patients(44%) were hemorrhage patients. 2. Rt. hemiparesis was the main symptom of 6 of 12 MCA damaged patients(50%) and 3 of 5 SAH patients(60%), and the main symptom of 3 of 5 ACA patients(60%) was Lt. hemiparesis. The main symptom of 13 of 25 brain bloodvessel damaged patients(52%) was Lt. hemiparesis 11 of them(44%) Rt. hemiparesis, and 1 of them(8.3%) Quadriplegia. 3. Language was the most well preserved function. 12 MCA damaged patients could understand language. 4. Retraction of shoulder girdle, among VIE flexor synergy, was the most frequent element because 9 of 12 MCA damaged patients had it. Among VIE flexor synergy, 5 SAH patient's most frequent synergy was Elbow flexion because all of them had it. All of 5 ACA damaged patients have shoulder girdle elevation, shoulder joint, hyperextension, abduction, and external rotation among VIE flexor synergy. 5. 7 of 12 MCA damaged patients(58.3%) were stereognosis handicapped patients, 3 of 5 SAH patients(60%) have handicap of position sense, light touch, and temperature, 3 of 5 ACA patients(60%) have position handicap. 13 of brain bloodvessel damaged patients(52%) have light touch handicap. 6. 8 of MCA damaged patients(66.7%) have facial palsy, 4 of SAH damaged patients(80%) have memory and action decline, and 3 of ACA damaged patients(60%) have action decline and facial palsy. The problem of Hemiplegia is very extensive from muscle weakness, atrophy, or deformation to psychical problems. Therefore physical therapists should have sufficient interest in psychological handicap as well as physical handicap as they deal with adult hemiplegia.

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Studies on Gene Expression of Yukmijihwang-tang using High-throughput Gene Expression Analysis Techniques (대규모 유전자 분석 기법을 이용한 육미지황원의 유전자 발현 연구)

  • Kang, Bong-Joo;Kim, Yun-Taik;Cho, Dong-Wuk
    • Korean Journal of Oriental Medicine
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    • v.8 no.2 s.9
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    • pp.95-107
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    • 2002
  • Yukmijihwang-tang(YM) is a noted herbal prescription in Chinese and Korean traditional medicines, and it has been known to reinforce the vital essence and has been widely used for a variety of disease such as stroke, osteoporosis, anti-tumor, and hypothyrodism. Regarding its traditional use, YM has been known to reinforce the Yin (vital essence) of liver and kidney. Also it has been known to reinforce nutrition and biological function in brain. Recently, studies suggested that YM increase antioxidant activities and exert the protective effect against oxidant-induced liver cell injury. We investigated the high-throughput gene expression analysis on the Yukmijihwang-tang administrated in SD rats. Microarray data were validated on a limited number of genes by semiquantitative RT-PCR and Western blot analyses. The recent availability of microarrays provides an attractive strategy for elaborating an unbiased molecular profile of large number of genes in drug discovery This experimental approach offers the potential to identify molecules or cellular pathways not previously associated with herbal medicine. Total RNA from normal control brain and Yukmijihwang-tang administrated brain were hybridized to microarrays containing 10,000 rat genes. The 52 genes were found to be up-regulated(twice or more) excluding EST gene. The nine genes were found to be down-regulated(twice or more) excluding EST gene. Gene array technology was used to identify for the first time many genes expression pathway analysis that arecell cycle pathway, apoptosis pathway, electron transport chain pathway, cytoplasmic ribosomal protein pathway, fatty acid degradation pathway, and TGF-beta signaling pathway. These differentially expressed genes pathway analysis have not previously been iavestigated in the context of herbal medicine efficacy and represent novel factors for further study of the mechanism of herbal medicine efficacy.

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Ischemic Infarcion Model by Middle Cerebral Artery Occlusion using Allogenic Blood Clot in Beagle Dogs (비글견에서 동종혈전 색전술을 이용한 중간대뇌동맥의 허혈성 뇌경색 모델)

  • Kim, Younghwan;Choi, Sooyoung;Lee, Kija;Han, Woosok;Choi, Hojung;Lee, Youngwon
    • Journal of Veterinary Clinics
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    • v.33 no.1
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    • pp.10-15
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    • 2016
  • The purpose of this study was to establish reproducible ischemic infarction model using allogenic blood clot in beagle dogs and identify induced ischemic lesion after middle cerebral artery occlusion using magnetic resonance imaging (MRI) and histopathologic findings. Twenty eight male beagle dogs with no evidence of neurologic disease were experimented. Allogenic embolus was made using a healthy beagle dog. After internal carotid artery (ICA) was exposure, 16G catheter was introduced through the ICA. The dog was administered 0.3 ml blood clot for 15 seconds followed by 3 ml of saline for 15 seconds. MRI scans were performed with 1.5T to evaluate ischemic lesion at 7 days after middle cerebral artery occlusion procedure. Evaluation parameters of MRI include location, distribution, infarction type, margin, shape, mass effect and intensity of T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), fluid attenuated inversion recovery (FLAIR) sequence, diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC). On MRI, all dogs (28/28) showed focal or multifocal lesion including telencephalon and thalamus lesions, especially caudate nucleus (24/28). These lesions had well-defined margin from adjacent brain parenchyma, none or mild mass effect and various shape. Most of dogs appeared hyperintensity on T1WI, T2WI, FLAIR, and DWI/ADC, corresponding to chronic infarction. These lesions were histopathologically confirmed atrophic changes and unstained lesion. In conclusion, MRI is the useful method to provide information about ischemic infarction in dogs and the best reproducible ischemic infarction model was developed by using allogenic blood clot.

Surgical Treatment for Acute, Severe Brain Infarction

  • Park, Je-On;Park, Dong-Hyuk;Kim, Sang-Dae;Lim, Dong-Jun;Park, Jung-Yul
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.326-330
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    • 2007
  • Objective : Stroke is the most prevalent disease involving the central nervous system. Since medical modalities are sometimes ineffective for the acute edema following massive infarction, surgical decompression may be an effective option when medical treatments fail. The present study was undertaken to assess the outcome and prognostic factors of decompressive surgery in life threatening acute, severe, brain infarction. Methods : We retrospectively analyzed twenty-six patients (17 males and 9 females; average age, 49.7yrs) who underwent decompressive surgery for severe cerebral or cerebellar infarction from January 2003 to December 2006. Surgical indication was based on the clinical signs such as neurological deterioration, pupillary reflex, and radiological findings. Clinical outcome was assessed by Glasgow Outcome Scale (GOS). Results : Of the 26 patients, 5 (19.2%) showed good recovery, 5 (19.2%) showed moderate disability, 2 (7.7%) severe disability, 6 (23.1%) persistent experienced vegetative state, and 8 (30.8%) death. In this study, the surgical decompression improved outcome for cerebellar infarction, but decompressive surgery did not show a good result for MCA infarction (30.8% overall mortality vs 100% mortality). The dominant-hemisphere infarcts showed worse prognosis, compared with nondominant-hemisphere infarcts (54.5% vs 70%). Poor prognostic factors were diabetes mellitus, dominant-hemisphere infarcts and low preoperative Glasgow Coma Scale (GCS) score. Conclusion : The patients who exhibit clinical deterioration despite aggressive medical management following severe cerebral infarction should be considered for decompressive surgery. For better outcome, prompt surgical treatment is mandatory. We recommend that patients with severe cerebral infarction should be referred to neurosurgical department primarily in emergency setting or as early as possible for such prompt surgical treatment.

The Effect of Korean Medicine Treatment on Cerebral Infarction with Hemiplegia: A Case Report (아급성기 뇌경색 환자의 좌측 편마비에 대한 한의 치료 1례)

  • Oh, Ju-hyun;Sung, Jae-yeon;Seo, Hye-jin;Lee, Yu-ra;Song, Jin-young;Kong, Geon-sik;Kang, Man-ho;Lee, Hyung-chul;Eom, Guk-hyeon;Song, Woo-sub
    • The Journal of Internal Korean Medicine
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    • v.40 no.5
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    • pp.990-998
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    • 2019
  • Introduction: Stroke refers to a sudden brain disease that results in disorders in the anatomy of the brain. The cause is a sudden circulatory disorder of the cerebrovascular system that creates a consciousness disorder and hemiplegia. Despite aggressive treatment after the onset, stroke is a social problem because the patient has difficulty in recovering from sequelae that can include limb movement disorders, language disorders, and emotional disorders. In this study, we describe the effect of traditional Korean medicine treatment on the sequelae in a subacute cerebral infarction patient admitted to a Korean medical hospital. Case presentation: A 67-year-old male patient was diagnosed with cerebral infarction circa 2005, and his condition had not improved. Around March 15, 2018, he experienced the sudden onset of a cerebral infarction in his daily life. This was confirmed by a brain MRI, and he was hospitalized at other hospitals, but he showed no improvement. We conducted a manual muscle test (MMT) to evaluate the patient's exercise and strength. His gait level was measured to evaluate his degree of walking. He was treated with Bojungikgi-tang and acupuncture twice a day. After 34 days of inpatient treatment, the patient's exercise strength improved from Grade 2+~Grade 3 to Grade 3+ determined by the MMT, and his walking ability improved from Gait Level 3 to Gait Level 4. Conclusion: The findings of this study indicate that acupuncture and herbal medicine treatment can help treat patients with hemiplegia due to cerebral infarction.