• Title/Summary/Keyword: Traumatic brain Injury

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Memory Dysfunctions after Mild and Moderate Traumatic Brain Injury : Comparison between Patients with and without Frontal Lobe Injury

  • Kim, Jin-Sung;Kim, Oh-Lyong;Seo, Wan-Seok;Koo, Bon-Hoon;Joo, Yeol;Bai, Dai-Seg
    • Journal of Korean Neurosurgical Society
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    • v.46 no.5
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    • pp.459-467
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    • 2009
  • Objective : The purpose of this study was to assess memory dysfunction in patients with mild and moderate traumatic brain injury (TBI) with and without frontal lobe injury (FLI). Methods : The subjects were 110 TBI patients, who had recovered from the acute clinical phase, and comprised 20 (18.2%) mild TBI (MTBI) patients with FLI, 16 (14.5%) MTBI patients without FLI, 51 (46.4%) moderate TBI (MOTBI) patients with FLI and 23 (20.9%) MTBI patients without FLI. All patients were administrated the Korean version of the Memory Assessment Scale (K-MAS). Results : Almost all the Summary Scale scores on the K-MAS failed to show any differences between TBI patients with and without FLI, but differences did emerge by types at severities. TBI patients with FLI showed higher Global Memory ability than TBI patients without FLI if their TBI was only mild, but when their TBI was more severe, this finding was reversed, and TBI patients with FLI showed lower Verbal and Global Memory abilities than TBI patients without FLI. Conclusion : Different kinds of assessment tools are needed for the measurement of memory abilities in TBI patients with FLI, and that the selection of the appropriate tool depends on the severity of the TBI.

Minocycline Directly Blocks Activation of Caspases After Oxidative Stress in PC12 Cells

  • Choi, Yu-Keum;Kim, Gab-Seok;Han, Byung-Hee
    • Proceedings of the PSK Conference
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    • 2003.10b
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    • pp.79.2-79.2
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    • 2003
  • Minocycline is known to protect neurons from microglia-mediated cell death in many experimental models of brain diseases including ischemic stroke, Huntington's disease (HD), amyotrophic lateral sclerosis (ALS), traumatic brain injury, multiple sclerosis, and Parkinson's disease. Activation of caspase-2, 3, 8, and 9 was evident within 2-8 hr following oxidative insult with 0.5 mM hydrogen peroxide in PC12 cells. Minocycline significantly attenuated activation of these caspases up to 18 hr, resulting a significant increase in cell viability as assessed by MTT assay. (omitted)

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Spinal Subdural Hemorrhage as a Cause of Post-Traumatic Delirium

  • Se, Young-Bem;Chun, Hyoung-Joon;Yi, Hyeong-Joong
    • Journal of Korean Neurosurgical Society
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    • v.43 no.5
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    • pp.242-245
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    • 2008
  • A 64-year-old man with TBI was admitted to our institute. In following days, he showed unusual behavior of agitation, restlessness, emotional instability and inattention. Post-traumatic delirium was tentatively diagnosed, and donepezil was given for his cognitive dysfunction. Although there was partial relief of agitation, he sustained back pain despite medication. Lumbar magnetic resonance image revealed SDH along the whole lumbar spine, and surgical drainage was followed. Postoperatively, his agitation disappeared and further medication was discontinued. We report a unique case of post-traumatic delirium in a patient with concomitant TBI and spinal subdural hemorrhage (SDH) that resolved with operative drainage of spinal hemorrhage.

Targeted Nanomedicine that Interacts with Host Biology

  • Ju, Jin-Myeong
    • Proceedings of the Korean Institute of Surface Engineering Conference
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    • 2017.05a
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    • pp.81-81
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    • 2017
  • Nanotechnology is of great importance to molecular biology and medicine because life processes are maintained by the action of a series of molecular nanomachines in the cell machinery. Recent advances in nanoscale materials that possess emergent physical properties and molecular organization hold great promise to impact human health in the diagnostic and therapeutic arenas. In order to be effective, nanomaterials need to navigate the host biology and traffic to relevant biological structures, such as diseased or pathogenic cells. Moreover, nanoparticles intended for human administration must be designed to interact with, and ideally leverage, a living host environment. Inspired by nature, we use peptides to transfer biological trafficking properties to synthetic nanoparticles to achieve targeted delivery of payloads. In this talk, development of nanoscale materials will be presented with a particular focus on applications to three outstanding health problems: bacterial infection, cancer detection, and traumatic brain injury. A biodegradable nanoparticle carrying a peptide toxin trafficked to the bacterial surface has antimicrobial activity in a pneumonia model. Trafficking of a tumor-homing nanoprobes sensitively detects cancer via a high-contrast time-gated imaging system. A neuron-targeted nanoparticle carrying siRNA traffics to neuronal populations and silences genes in a model of traumatic brain injury. Unique combinations of material properties that can be achieved with nanomaterials provide new opportunities in translational nanomedicine. This framework for constructing nanomaterials that leverage bio-inspired molecules to traffic diagnostic and therapeutic payloads can contribute on better understanding of living systems to solve problems in human health.

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Medial Reorganization of Primary Motor Cortex in Patient with Traumatic Brain Injury: a fMRI Case Study (외상성 뇌손상 환자에서 대뇌피질의 재조직화: 사례보고)

  • Choi, Jin-Ho;Kwon, Yong-Hyun
    • The Journal of Korean Physical Therapy
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    • v.17 no.3
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    • pp.421-428
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    • 2005
  • The tenn 'Brain plasticity' has been identified that our central nervous system is continuously being adapted and modulated according to environmental needs and demands, and has been used to encompass the multifarious mechanisms related to learning, development, and recovery from damage to the nervous system. The purpose of this study was to demonstrate cortical reorganization in a 26-year-old right-handed hemiparetic patient with traumatic primary motor cortex (M1) injury, using functional MRI (fMRI). The unaffected (left) primary sensori-motor cortex centered on the precentral knob was activated during unaffected (right) hand movements. However, the medial area of the injured M1 was activated during affected (left) hand movements. It seems that the motor function of the affected hand in this patient was reorganized into the medial area of the injured precentral knob. These investigations provide a great useful information and clinical evidences with the specialized clinician in stroke physical therapy about patient's prognosis and therapeutic guidelines.

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Clinical Characteristics in Patients for Mental Disability Assessment Following Traumatic Brain Injury -Comparison between Patients with and without Abnormal Brain Imaging- (두부외상 후 장애평가 환자들의 임상적 특징 -뇌영상검사 이상유무에 따른 비교-)

  • Ha, Kang-Su;Kim, Sang-Hoon;Kim, Hack-Ryul;Park, Sang-Hag;Pyo, Kyung-Sik;Cho, Yong-Rae
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.1
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    • pp.28-36
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    • 2001
  • Objectives : This study was undertaken to identify the clinical and psychological characteristics in patients of mental disability assessment following traumatic brain injury who had the finding with or without abnormal brain imaging study. Methods : A consecutive series of 59 patients were assessed in hospital from January 1994 to December 1998. Patients were divided into 2 groups based on normal or abnormal brain imaging and the two groups were compared in demographic characteristics, psychiatric symptoms, type of head injury, clinical psychological findings. There were 27 patients with abnormal findings and 32 with normal findings in brain imaging study. Results : Abnormal finding group in brain imaging study had significantly higher incidence of psychosis, decreased memory, decreased appetite, increased nihilistic idea, and intracranial hemorrhage. Also, abnormal finding group showed significantly lower level of performance on the block design subtest of K-WAIS and had significantly lower scores on F, hypochodriasis, depression, hysteria, psychopathic deviate, psychasthenia and schizophrenia subscale of the MMPI. Conclusion : The findings suggest that the patients undergone brain surgery due to intracranial hemorrage at that time of brain injury may have higher frequency of abnormal findings in brain imaging study, complain more cognitive and affective symptoms, and have lower the abstract concept formation and perceptual organization abilities.

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Blood-Brain Barrier Disruption in Mild Traumatic Brain Injury Patients with Post-Concussion Syndrome: Evaluation with Region-Based Quantification of Dynamic Contrast-Enhanced MR Imaging Parameters Using Automatic Whole-Brain Segmentation

  • Heera Yoen;Roh-Eul Yoo;Seung Hong Choi;Eunkyung Kim;Byung-Mo Oh;Dongjin Yang;Inpyeong Hwang;Koung Mi Kang;Tae Jin Yun;Ji-hoon Kim;Chul-Ho Sohn
    • Korean Journal of Radiology
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    • v.22 no.1
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    • pp.118-130
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    • 2021
  • Objective: This study aimed to investigate the blood-brain barrier (BBB) disruption in mild traumatic brain injury (mTBI) patients with post-concussion syndrome (PCS) using dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging and automatic whole brain segmentation. Materials and Methods: Forty-two consecutive mTBI patients with PCS who had undergone post-traumatic MR imaging, including DCE MR imaging, between October 2016 and April 2018, and 29 controls with DCE MR imaging were included in this retrospective study. After performing three-dimensional T1-based brain segmentation with FreeSurfer software (Laboratory for Computational Neuroimaging), the mean Ktrans and vp from DCE MR imaging (derived using the Patlak model and extended Tofts and Kermode model) were analyzed in the bilateral cerebral/cerebellar cortex, bilateral cerebral/cerebellar white matter (WM), and brainstem. Ktrans values of the mTBI patients and controls were calculated using both models to identify the model that better reflected the increased permeability owing to mTBI (tendency toward higher Ktrans values in mTBI patients than in controls). The Mann-Whitney U test and Spearman rank correlation test were performed to compare the mean Ktrans and vp between the two groups and correlate Ktrans and vp with neuropsychological tests for mTBI patients. Results: Increased permeability owing to mTBI was observed in the Patlak model but not in the extended Tofts and Kermode model. In the Patlak model, the mean Ktrans in the bilateral cerebral cortex was significantly higher in mTBI patients than in controls (p = 0.042). The mean vp values in the bilateral cerebellar WM and brainstem were significantly lower in mTBI patients than in controls (p = 0.009 and p = 0.011, respectively). The mean Ktrans of the bilateral cerebral cortex was significantly higher in patients with atypical performance in the auditory continuous performance test (commission errors) than in average or good performers (p = 0.041). Conclusion: BBB disruption, as reflected by the increased Ktrans and decreased vp values from the Patlak model, was observed throughout the bilateral cerebral cortex, bilateral cerebellar WM, and brainstem in mTBI patients with PCS.

Promising candidate cerebrospinal fluid biomarkers of seizure disorder, infection, inflammation, tumor, and traumatic brain injury in pediatric patients

  • Kim, Seh Hyun;Chae, Soo Ahn
    • Clinical and Experimental Pediatrics
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    • v.65 no.2
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    • pp.56-64
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    • 2022
  • Cerebrospinal fluid (CSF) is a dynamic metabolically active body fluid that has many important roles and is commonly analyzed in pediatric patients, mainly to diagnose central nervous system infection and inflammation disorders. CSF components have been extensively evaluated as biomarkers of neurological disorders in adult patients. Circulating microRNAs in CSF are a promising class of biomarkers for various neurological diseases. Due to the complexity of pediatric neurological disorders and difficulty in acquiring CSF samples from pediatric patients, there are challenges in developing CSF biomarkers of pediatric neurological disorders. This review aimed to provide an overview of novel CSF biomarkers of seizure disorders, infection, inflammation, tumor, traumatic brain injuries, intraventricular hemorrhage, and congenital hydrocephalus exclusively observed in pediatric patients.

Intracranial Pressure and Experimental Model of Diffuse Brain Injury in Rats

  • Blaha, Martin;Schwab, Juraj;Vajnerova, Olga;Bednar, Michal;Vajner, Ludek;Michal, Tichy
    • Journal of Korean Neurosurgical Society
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    • v.47 no.1
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    • pp.7-10
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    • 2010
  • Objective: In this study, we present a simple closed head injury model as a two-stage experiment. The height of the weight drop enables gradation of head trauma severity. Methods: The head injury device consists of three parts and there are three adjustable parameters-weight (100-600 g). height of fall (5-100 cm) and elasticity of the springs. Thirty male Wistar rats underwent monitoring of intracranial pressure with and without induction of the head injury. Results: The weight drop from 45 to 100 cm led to immediate seizure activity and early death of the experimental animals. Severe head injury was induced from 40 cm weight drop. There was 50% mortality and all surviving rats had behavioral deterioration. Intracranial pressure was 9.3${\pm}$3.76 mmHg. Moderate head injury was induced from 35 cm, mortality decreased to 20-40%, only half of the animals showed behavioral pathology and intracranial pressure was 7.6${\pm}$3.54 mmHg. Weight drop from 30 cm caused mild head injury without mortality and neurological deterioration. Intracranial pressure was slightly higher compared to sham group- 5.5${\pm}$0.74 mmHg and 2.9${\pm}$0.81 mmHg respectively. Conclusion: This model is an eligible tool to create graded brain injury with stepwise intracranial pressure elevation.

The Role of Tc-99m HMPAO Brain Perfusion SPECT in the Psychiatric Disability Evaluation of Patients with Chronic Traumatic Brain Injury (만성 외상성 뇌 손상 환자의 정신의학적 후유 장애 평가에서 Tc-99m HMPAO 뇌혈류 SPECT의 역할)

  • So, Young;Lee, Kang-Wook;Lee, Sun-Woo;Ghi, Ick-Sung;Song, Chang-June
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.4
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    • pp.232-243
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    • 2002
  • Purpose: We studied whether brain perfusion SPECT is useful in the psychiatric disability evaluation of patients with chronic traumatic brain injury (TBI). Materials and Methods: Sixty-nine patients (M:F=58:11, age $39{\pm}14$ years) who underwent Tc-99m HMPAO brain SPECT, brain MRI and neuropsychological (NP) tests during hospitalization in psychiatric wards for the psychiatric disability evaluation were included; the severity of injury was mild in 31, moderate in 17 and severe in 21. SPECT, MRI, NP tests were peformed $6{\sim}61$ months (mean 23 months) post-injury. Diagnostic accuracy of SPECT and MRI to show hypoperfusion or abnormal signal intensity in patients with cognitive impairment represented by NP test results were compared. Results: Forty-two patients were considered to have cognitive impairment on NP tests and 27 not. Brain SPECT showed 71% sensitivity and 85% specificity, while brain MRI showed 62% sensitivity and 93% specificity (p>0.05, McNemar test). SPECT found more cortical lesions and MRI was superior in detecting white matter lesions. Sensitivity and specificity of 31 mild TBI patients were 45%, 90% for SPECT and 27%, 100% for MRI (p>0.05, McNemar test). Among 41 patients with normal brain MRI, SPECT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Conclusion: Brain SPECT has a supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI.