• Journal of Yeungnam Medical Science
• /
• v.15 no.2
• /
• pp.371-380
• /
• 1998

Systemic lupus erythematosus(SLE) is an autoimmune disease which may affect many different organs and disclose various clinical manifestations. Recently central nervous system(CNS) involvement has been recognized as an increasingly significant contributor to morbidity and mortality of SLE. The clinical manifestations of CNS-lupus are highly variable and range from mild cognitive dysfunction, movement disorder, headache, psychosis to life-threatening stroke and coma. Among the neuropsychiatric disorders encountered in patients with SLE, cerebrovascular disease has been a relatively rare complication. The diagnosis and management of CNS-lupus is difficult because of the lack of useful diagnostic methods. If cerebrovascular involvement is suspected, aggressive treatment such as high dose steroid, immunosuppressive therapy, plasma exchange may be required to reduce high mortality rate. We experienced 2 cases cerebrovascular dis eases occurring in SLE patients which presented with various neuropsychiatric manifestations. They were diagnosed as CNS-lupus by neuropsychiatric symptoms, brain MRI, and BEG, and showed good response to high dose steroid pulse therapy.

• The Journal of Korean Medicine
• /
• v.19 no.2
• /
• pp.59-74
• /
• 1998

Clinical observation was done on 272 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1997. 1. The cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage. and transient ischemic attack. The most case of them was the cerebral infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension. and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 7. The common symptoms were motor disability and verbal disturbance. 8 The average time to start physical therapy was 1l.3rd day after stroke in cerebral infarction and it was 15.2th day after stroke in cerebral hemorrhage. 9. The common complications were urinary tract infection, pneumonia, myocardial infarction. 10. Hypercholesterolemia and hypertriglyceridemia are usually found more frequently in cerebral infarction than in hemorrhage. 11. In acute or subacute stage, the methods of smoothening the flow of ki(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. and in recovering stage, the methods of replenishing ki(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

• Journal of Pharmaceutical Investigation
• /
• v.20 no.4
• /
• pp.223-228
• /
• 1990

The contribution of endogenous transport systems to the blood-brain barrier (BBB) transport of basic and acidic drugs was studied by using a carotid injection technique in rats and an isolated bovine cerebrovascular disease state were compared between the normotensive rats (WKY) and stroke-prone spontaneously hypertensive rats (SHRSP) which have been well established as an animal model with pathogenic similarities to humans. Basic drugs such as eperisone, thiamine and scopolamine inhibited, in a concentration dependent manner the in vivo uptake of $[{^3}H]choline$ through BBB, whereas amino acids and acidic drugs such as salicylic acid and valproic acid did not inhibit the uptake. The uptake of $[^3H]choline$ by B-CAP increased with time and showed a remarkable temperature dependency. The uptake of $[^3H]choline$ by B-CAP showed the very similar inhibitory effects as observed in the in vivo brain uptake, and was competitively inhibited by a basic drug, eperisone. The in vivo BBB uptakes of $[^3H]acetic$ acid and $[^{14}C]salicylic$ acid were dependent on pH of the injectate and the concentration of drugs. Several acidic drugs such such as salicylic acid, benzoic acid and valproic acid inhibited the in vivo uptake of $[^3H]acetic$ acid, whereas amino acid, choline and a basic drug such as eperisone did not inhibit the uptake. The uptake of acetic acid by B-CAP was competitively inhibited by salicylic acid. The permeability surface area product (PS) through BBB for $[^3H]choline$ in SHRSP was significantly lower than that in WKY. The concentration of choline in the brain dialysate in SHRSP was about half of that in WKY, while no significant difference was observed in the plasma concentration of choline between SHRSP and WKY. No significant difference was observed in the transport of monocarboxylic acids, glucose and neutral amino acid through BBB between SHRSP and WKY. From these results, it was concluded that BBB transport system of choline contributes to the transport of basic drugs through BBB, that acidic drugs can be transported via a moncarboxylic acid BBB transport system and that the specific dysfuntion of the BBB choline transport in SHRSP was ascribed to the reduction of the maximum velocity of choline concentration in the brain interstitial fluids.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.24 no.5
• /
• pp.883-891
• /
• 2010

The purpose of this study was to investigate the relation between each pattern identification such as Dampness-Phlegm, Fire-Heat, Deficiency of Qi, Deficiency of Yin and Blood Stagnation and blood lipid level in acute stroke patients. This study was done over patients hospitalized in 13 Oriental Medical Hospitals in the period of November 2006 to Jun 2009. Patients had been interviewed by residents and medical specialists who studied standard operation procedures in Fundamental Study for Syndrome of Oriental Medicine for Stroke. Study subjects consisted of group A that was distributed to specified pattern identification by medical specialist and discriminating program, group B that was distributed to specified pattern identification by medical specialist or discriminating program, and the control group that wasn't distributed to specified pattern identification by medical specialist and discriminating program. For the purpose of obtaining suitable result, we analyzed blood lipid level of each group by univariate analysis. In this study, there was not statistically significant relation between most of each pattern identification and blood lipid level except relation between Fire-Heat pattern group B and decreasing HDL cholesterol. Based on these results, it is suggested that Dampness-Phlegm would not be the independent predictors of hyperlipidemia unlike other studies that were presented in. More prospective studies between Fire-Heat and decreasing HDL cholesterol are to be done with more clinical data.

• Journal of Institute of Control, Robotics and Systems
• /
• v.20 no.6
• /
• pp.647-650
• /
• 2014

Assessment and rehabilitation of patients with unilateral visual neglect has been one of the fields that require assistive technology. Paper-and-pencil tests, including the LBT (Line Bisection Test), have been one of the most commonly used visual neglect assessment methods used in a clinical setting. The key motivation of this study was to establish a computer-based real-time assessment system for the hemi-neglect patients without altering the conventional paper-and-pencil based user tools. A digital penbased assessment and rehabilitation system, the ePen System, could eliminate the manual assessment time while maintaining measurement accuracy. As a result, the proposed system may assist rehabilitation specialists to assess and diagnose patients with unilateral visual neglect. This system can be applied to a range assessment and rehabilitation modalities based on a pen and paper. It can also be applied to various patients such as those with Parkinson's disease, stroke sufferers, or those who have experienced different forms of brain lesions.

• The Journal of Korean Physical Therapy
• /
• v.23 no.2
• /
• pp.61-68
• /
• 2011

Purpose: The purpose of this study was to provide basic data for the effectiveness and the necessity of home visiting physical therapy through examining performance ability and functional changes in daily life activities by investigating the life of disabled persons living at home. Methods: After selecting 100 people with physical disabilities greater than level 3 and brain damage related disabilities living in Youngam-Gun, we conducted mobility tests according to a Modified Bathel Index (MBI), the Berg Balance Scale (BBS), and floor and bed movements? for Activities of Daily Living evaluation. We did this before the experiment and after doing home visiting physical therapy for 90 minutes at a time, once a week for 6 months Results: 1) Persons who live in a bed are higher than those who live in a floor. There was a significant difference between persons who live in a floor and those who live in a bed in the change in MBI and BBS scores after home visiting physical therapy. 2) Those with a musculoskeletal disorder had a significantly different change in MBI and BBS according to the type of disease and kind of disability. Those with neuropathy had a significantly different change in MBI. Those with physical disabilities showed a significant difference in MBI and BBS. Conclusion: A home visiting physical therapist can cause an improved performance ability and lead to the ability of disabled persons living at home to carry out activities of daily livingin a large part and the study for brain lesion disabilities except physical disabilities and stroke which occupy large proportion of disabled persons should be done.

• Journal of the Korean Society of Radiology
• /
• v.10 no.4
• /
• pp.279-284
• /
• 2016

Single-shot echo planar imaging(SS-EPI) is well established as high sensitivity for ischemic stroke. However, it is prone to susceptibility artifact in brain stem that diminish the image quality. single-shot turbo spin echo(SS-TSE) is a new DWI technique that can reduce susceptibility artifact. Thus, this research was conducted so as to reduce geometric distortion in brain stem by using single-shot turbo spin echo technique. Thirty patients without brain disease underwent diffusion MR on a 3T scanner with SS-EPI and SS-TSE. Obtained images with both sequences were analyzed for geometric distortion and error percentage as well. Image quality in terms of geometric distortion of SS-TSE were found to be significantly better than those for SS-EPI. And error percentage was considerably reduced for 2.4% of b0 image(from 11.1% to 8.7%), 1.2% of b1000 image(from 11.4% to 10.1%), respectively. In summary, diffusion MR using SS-TSE significantly reduce geometric distortion compared to SS-EPI in brain stem and may provide improved diagnostic performance.

• Clinical and Experimental Pediatrics
• /
• v.56 no.11
• /
• pp.500-504
• /
• 2013

Here we present the case of an 11-year-old female patient diagnosed with Caroli syndrome, who had refractory esophageal varices. The patient had a history of recurrent bleeding from esophageal varices, which was treated with endoscopic variceal ligation thrice over a period of 2 years. However, the bleeding was not controlled. When the patient finally visited the Emergency Department, the hemoglobin level was 4.4 g/dL. Transhepatic intrajugular portosystemic shunt was unsuccessful. Subsequently, the patient underwent percutaneous transhepatic variceal obliteration. Twenty hours after this procedure, the patient complained of aphasia, dizziness, headache, and general weakness. Six hours later, the patient became drowsy and unresponsive to painful stimuli. Lipiodol particles used to embolize the coronary and posterior gastric veins might have passed into the systemic arterial circulation, and they were found to be lodged in the brain, kidney, lung, and stomach. There was no abnormality of the portal vein on portal venography, and blood flow to the azygos vein through the paravertebral and hemiazygos systems was found to drain to the systemic circulation on coronary venography. Contrast echocardiography showed no pulmonary arteriovenous fistula. Symptoms improved with conservative management, and the esophageal varices were found to have improved on esophagogastroduodenoscopy.

• Annals of Clinical Neurophysiology
• /
• v.9 no.1
• /
• pp.1-4
• /
• 2007

Vertigo is an illusion of rotation, which results from an imbalance within the vestibular system. This review focuses on two common presentations of spontaneous vertigo: acute prolonged spontaneous vertigo and recurrent spontaneous vertigo. Common causes of acute prolonged spontaneous vertigo include vestibular neuritis, labyrinthitis, and brainstem or cerebellar stroke. The history and detailed neurological/neurotological examinations usually provide the key information for distinguishing between peripheral and central causes of vertigo. Brain MRI is indicated in any patient with acute vertigo accompanied by abnormal neurological signs, profound imbalance, severe headache, and central patterns of nystagmus. Recurrent spontaneous vertigo occurs when there is a sudden, temporary, and largely reversible impairment of resting neural activity of one labyrinth or its central connections, with subsequent recovery to normal or near-normal function. Meniere's disease, migrainous vertigo, and vertebrobasilar insufficiency (VBI) are common causes. The duration of the vertigo attack is a key piece of information in recurrent spontaneous vertigo. Vertigo of vascular origin, such as VBI, typically lasts for several minutes, whereas recurrent vertigo due to peripheral inner-ear abnormalities lasts for hours. Screening neurotological evaluations, and blood tests for autoimmune and otosyphilis are useful in assessment of recurrent spontaneous vertigo that are likely to be peripheral in origin.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.16 no.6
• /
• pp.1291-1296
• /
• 2002

Blood circulation of brain is divided into two major categories; anterior one from carotid artery and posterior one from vertebrobasilar artery. In stroke patients, it is important to diagnose which is involved, because there is many difference in the aspects of clinical menifestations and prognosis, especially in the acute stage. In some cases of vertebrobasilar infarction, such as Wallenberg's syndrome, charicteristic cranial nerve signs, eye movement disorders and cerebellar signs are appeared. And in Dejerine's syndrome, only pure motor or sensory defecits can be appeared without any brainstem signs. So It shoud be differenciated by Brain MRI from those of the cerebral hemisphere lesions. And in the cases that nausea, vomitting and dysphagia are the first menifestations, it is frequently misdiagnosed as internal medical disease, causing appropriate treatment delayed. In this case report, we are to describe the clinical menifestations and progresses of two cases of brainstem infarctions, review previously published case reports about them and compare them to our cases. The first is Dejerine's syndrome i.e. medial medullary infarction, the second is Wallenberg's syndrome i.e. lateral medullary infarction. Simultaneously we are to investigate the oriental medical approach in the bran stem infarctions.