• Journal of Oriental Neuropsychiatry
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• v.11 no.1
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• pp.115-130
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• 2000

Object: Show the treatment about Jungkijeung (Zhongqizheng) by distinguishing Apoplexy(Zhongfeng), yujungfung(Leizhongfeng), gualjung(Juezheng), and observation of cause, process, quality. Method: Researched definition, cause, process, treatment and herb med through chinese & korean medical publication refered to Jungkijeung(Zhongqizheng) Result: 1. Jungkijeung(Zhongqizheng) is simmilar to Apoplexy(Zhongfeng) that spiritual shock occurred to syncope, dysarthria, trismus, quadriplegia. But the symptom of Jungkijeung(Zhongqizheng) is coldness, no-sputum, sink-pluse; that of Apoplexy(Zhongfeng) is warmness, much secretion, float-pulse. 2. Jungkijeung(Zhongqizheng) is mainly caused by the serious anger and the reverse movement of spints by the seven emotional factor. The process of Jungkijeung(Zhongqizheng) are "Fire and Fever(huore)" "Weatness and sputum(shitan)", and most importantly "Weakness of vital-qi(qixi)" 3. The treatment of Jungkijeung(Zhongqizheng) is adjustment and circulation of jiao. In early stage, don't use of Apoplexial- Med. 4. As following herb-med are used for Jungkijeung (Zhongqizheng). Sohaphang-won(Suhexiangyan) is 18 times; Palmisungi-san(Baweishunqisan) is 13 times; Kang-tang(Jiangtang) is 8 times: Mokhyangsungi san(Muxiangshunqisan) is 6 times. 5. Atractylodes macrocephala KOIDZ(Baishu) is used for 40 times most frequently, Saussurea lappa CLARKE (Muxiang), Cyperus rotundus L (Xiangfuzi), Citrus unshiu MARCOR(Chenpi), Glycyrrhiza uralensis FISCH (Gancao), poria cocos WOLF (Furing), Panax ginseng NESS (Renshen) etc are orderly used. 6. Acupoints same as GV20(Baihui), LI4(Hegu), Liv2(Xingjian), 12 Junghyul(Jingxue) is used for acupunture. And CV8(Shenque), CV4(Guanyan) is used for moxibustion. Conclusion: As Jungkijeung(Zhangqizheng) is differed from Apoplexy(Zhongfeng), yujungfung(Leizhongfeng), gualjung(Juezheng), we must also cure Jungkijeung (Zhongqizheng) to the other disease. It is need to distinguishment Jungkijeung(Zhongqizheng) from neurotic, psychotic disease, though similar to conversation neurosis.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.2
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• pp.149-163
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• 2000

The purposes of this study were to investigate the pathway which stroke patients take in seeking medical care and to identify factors which influence that pathway. This study was conducted by a survey. The subjects were 130 adults, who were diagnosed with a stroke between January and April of 2000. Data was collected by means of a interview, questionnaires, and an Activity Index. The result of this study are summarized as follows: 1. The mean age of subject was 61.58 years. Forty-nine percent were men and fifty percent were women. The majority of the subjects were married. For educational level, thirty-three percent finished elementary school, and twenty-three percent, high school. Most of the subjects reported 'middle' economic status. Ninety-two percent lived with their spouse and children. The diagnosis for seventy-two percent was ischemic stroke and for twenty-two percent, hemorrhagic stroke. 2 The most frequent early sign of stroke was hemiplegia(43.3%), loss of consciousness (36.7%), dysarthria(33.3%). The type of hospital first used was a herb hospital(40.8%), or a western hospital(59.2%). The factors in their choice were ; distance from the hospital to the place that the stroke occurred(47.5%), desire for a herb hospital(15.8%), and an invitation(12.9%). The ischemic stroke patients preferred herb hospitals, but hemorrhagic stroke patients preferred a western hospitals. 3. The pattern of stroke patients seeking medical care was that forty-three percent of stroke patients pass through step 1, forty-six percent, through step 2, and 8.5% through step 3. The more steps, the higher the use of herb hospitals. 4. The factors influencing the pathway of stroke patients seeking medical care were diagnosis, and level of consciousness. Ischemic stroke patients used herb hospitals, more frequently hemorrhagic stroke patients, who used western hospitals. The alert patient preferred a herb hospital, but stupor patients preferred a western hospital. 5. The Activity Index was not related to the pathway which stroke patients used in seeking medical care.

• Journal of Yeungnam Medical Science
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• v.30 no.1
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• pp.25-30
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• 2013

Hyponatremia, the most common electrolyte disorder, has been rarely reported as causing rhabdomyolysis. Osmotic demyelination syndrome (ODS), a demyelinating disease of the central pons and/or other areas of the brain, is infrequently reported as associated with rapid correction of hyponatremia. This paper reports a case of ODS after correction of severe hyponatremia complicated by rhabdomyolysis. A 47-year-old female with a history of chronic alcoholism presented herself at the hospital with altered consciousness after three days of nausea and vomiting. She was on a thiazide diuretic for essential hypertension. Her blood tests upon her hospital admission showed hyponatremia ($Na^+$ 98 mEq/L), hypokalemia ($K^+$ 3.0 mEq/L), and elevation of her serum creatine phosphokinase (3,370 IU/L) with an increase in her serum myoglobin level 11,267 ng/mL). She was treated with intravenous fluid therapy that included isotonic and hypertonic salines along with potassium chloride. She became more alert, and her neurological condition gradually improved after the first five days of her therapy. On the ninth day after her admission, she developed progressive quadiaresis associated with dysarthria, dysphagia, and dystonia despite the resolution of her hyponatremia. Magnetic resonance imaging of her brain on 16th day revealed symmetrical areas of signal hyperintensity in her central pons, basal ganglia, and precentral gyrus in T2-weighted images, which are consistent with ODS. Her neurological symptoms steadily improved after six weeks with only supportive treatment and rehabilitation.

• Journal of Korean Neurosurgical Society
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• v.37 no.2
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• pp.112-115
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• 2005

Objective: Thalamic lesioning and deep brain stimulation(DBS) have proved to be beneficial to the treatment of essential tremor(ET). The authors compared the effects and complications of two modalities. Methods: A total of 34 patients with ET were treated with ventral intermediate(Vim) nucleus thalamotomy or Vim DBS from May 1999 to May 2003. The procedure of lesioning or stimulation were performed as usual manner with or without microelectrode recording. Postoperatively, utilizing the various combinations of frequency, voltage and pulse width optimized the stimulation. The degree of improvements of tremor and the occurrence of the complications were evaluated postoperatively and at follow-up. Results: There were 38 procedures, including 27 with Vim thalamotomy and 11 with DBS, in 34 patients. Of the thalamotomy group, left Vim lesioning is 25 and right one is 2. Follow-up duration ranged from 12 to 57 months. In the thalamotomy group, the rate of overall good outcome was 88.9% but 12 patients (44.4%) showed permanent adverse effects. In the cases of stimulation, the rate of overall good outcome was 90.9% and two patients had acceptable dysarthria. Conclusion: Both Vim thalamotomy and Vim DBS were effective for the treatment of ET, although perioperative adverse effects tended to be higher in patients who had thalamotomy. In cases of DBS, adjustments of stimulation parameters enabled an acceptable position to be achieved with tremor control and unwanted effects.

• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.346-350
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• 2009

Objective : The purpose of this study was to analyze in detail the relationship between outcome and time course of effect in medically refractory primary cervical dystonia (CD) with phasic type that was treated by bilateral globus pallidus internus (Gpi) deep brain stimulation (DBS). Methods : Six patients underwent bilateral implantation of DBS into the Gpi under the guide of microelectrode recording and were followed for $18.7{\pm}11.1$ months. The mean duration of the CD was $5.8{\pm}3.4$ years. The mean age at time of surgery was $54.2{\pm}10.2$ years. Patients were evaluated with the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and relief scale using patient self-reporting. Results : The TWSTRS total scores improved by 64.5%, 65.5%, 75.8%, and 76.0% at 3, 6, 12 months, and at the last available follow-up after surgery, respectively. Statistically significant improvements in the TWSTRS scores were observed 3 months after surgery (p=0.028) with gradual improvement up to 12 months after surgery, thereafter, the improvement was sustained. However, there was no statistically significant difference between the scores at 3 and 12 months. Subjective improvement reported averaged $81.7{\pm}6.8%$ at last follow-up. Mild dysarthria, the most frequent adverse event, occurred in 3 patients. Conclusions : Our results show that the bilateral Gpi-DBS can offer a significant therapeutic effect from 3 months postoperatively in patients with primary CD with phasic type, without significant side effects.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.607-611
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• 2010

Bickerstaff's brainstem encephalitis (BBE) is a rare disease diagnosed by specific clinical features such as 'progressive, relatively symmetric external ophthalmoplegia and ataxia by 4 weeks' and 'disturbance of consciousness or hyperreflexia' after the exclusion of other diseases involving the brain stem. Anti-ganglioside antibodies (GM, GD and GQ) in the serum or cerebrospinal fluid (CSF) are sometimes informative for the diagnosis of BBE because of the rarity of positive findings in other diagnositic methods: brain magnetic resonance imaging (MRI), routine CSF examination, motor nerve conduction study, and needle electromyography. We report a rare case of childhood BBE with elevated anti-GM1 antibodies in the serum, who had specific clinical symptoms such as a cranial polyneuropathy presenting as ophthalmoplegia, dysarthria, dysphagia, and facial weakness; progressive motor weakness; altered mental status; and ataxia. However, the brain MRI, routine CSF examination, nerve conduction studies, electromyography, somatosensory evoked potentials, and brainstem auditory evoked potentials were normal. BBE was suspected and the patient was successfully treated with intravenous immunoglobulins.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.80-83
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• 2009

Purpose: Isolated hypoglossal nerve palsy is a rare manifestation of various underlying disease. This article presents a rare complication of general anesthesia associated with an surgical procedure on a case of zygomatic fracture. Methods: An 18-year-old female patient was referred to our department by painful swelling on her left zygomatic area after the traffic accident. Left zygomatic complex fracture was identified on the simple x-ray and facial bone CT scan, and the fracture was treated with open reduction and internal fixation under general anesthesia. On the first postoperative day, she complained of difficulty in swallowing solid food, dysarthria and deviated tongue to her right side. There was no abnormal findings on the neurological examination, brain MRI and routine chemistry. She was diagnosed with transient hypoglossal nerve palsy and dexamethasone with multi-vitamins was administrated intravenously for 5 days. Results: The symptoms were completely resolved by the ninth postoperative day and the patient was discharged without any other complications. Conclusion: The hypoglossal(cranial nerve XII)nerve supplies motor innervation to all of the ipsilateral extrinsic and intrinsic tongue muscles. The hypoglossal nerve damage may caused by the compression between the airway and the hyoid bone during the endotracheal intubation, and direct trauma due to excessive pressure or neck extension. We described a rare case of unintended injury to hypoglossal nerve and care must be taken not to cause the hypoglossal nerve damage especially in facial plastic surgery with excessive neck extension under general anesthesia.

• The Journal of Korean Medicine
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• v.16 no.2 s.30
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• pp.100-114
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• 1995

This bibliographic study was designed to research indications of the Moschus which was representatively used for resuscitation in acute stage of stroke throughout successive books of oriental medicine. Especially, in this study, severe cases with disturbance of consciousness and acute stage of stroke were investigated. The results were summarized as the followings: 1. The Moschus was dried material which secreted from aromatic vescicle of Moschus moschiferus L.. which was pungent in flavor, warm in nature, nontoxic and strongly aromatic. The Moschus removed the obstruction in the channels and used to early stage of stroke. 2. The Moschus was aromatic resuscitatable medicine, which recovered disturbance of consciousness due to stroke. 3. The Moschus had excitatory actions of respirtory center and vascular motor center, heart stimulating action, inhibitatory action of the platelet aggregation and anti thrombin action and recovered cerebral ischemic change. According to these actions, the Moschus could be used cerebral infarction. 4. Prescriptions included the Moschus was used to symptoms of unconsciousness, secretion, stuporous mental state, dysarthria, facial palsy and hemiplegia. That was Angungwoohwangh wan(安宮牛黃丸), Woohwangchungshimwon(牛黃淸心元), Sahyangsohaphangwon(麝香蘇合香元), etc. According to the above mentioned results, the Moschus was aromatic resuscitatable medicine which was used for symptoms of conscius disturbance, convulsion, sudden fainting etc., promoted cerebral blood flow and had good effect on acute stage of stroke and severe cases with conscious disturbance. Therefore, it is considered that the Moschus must be studied for effect of cerebral infarction and hemorrhage in clinic with animal's and pharmacological experimental results.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.10 no.1
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• pp.159-184
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• 1997

A Literature study on the language disturbance, the results are as follows; 1. Utterance was closely concerned not only the vocal organs(pharynx, larynx, epiglottis, lips, tongue, vocal cord etc,) but also five viscera{especially heart, lung, kidney etc.) in The Yellow Emperor's Canon of Internal Medicine. It is very like the vocal mechanism in Medical science. 2. In the language disturbance, It is classified with dysarthria and dysphasia in Medical science. But in Oriental medicine, it is expressed the language disturbance as coma-speech lessness, stiff tongue-speechlessness, frightening-speechlessness etc. Especially in Oriental medicine, Non-utterance is called aphasia in literature study. 3. In the concern of the language disturbance and five viscera, $Heart{\cdot}Lung{\cdot}Kidney$ are counted of first importence. In differential diagnosis, It is divided sthenia-syndrome and asthenia-syndrome. Sthenia-syndrome is classified with wind-cold, fire-evil, adverseness of vital energy, stagnation of phlegm, is easy to cure. Asthenia-syndrome is classified with sexual desire, anxiety-meditation, fear, is hard to cure. 4. The pathogenesis of dysphasia originated from two factors; The first internal damages are consumption of body fluid caused by lung-dryness and yin-dificiency of lung & kidney. The second disease caused by exogenous evjls is sluggishness of lung-energy. 5. In many using points of acupuncture of the language disturbance, the order is LI-4(合谷), H-7(神門), K-l(湧泉), L-3(太衝), K-3(太谿), S-6(三陰交), H-5(通里), G-15(아門), C-23(廉泉), S-40(豊降), K-6(照海), L-7(列缺), S-36(足三里) etc.

• Phonetics and Speech Sciences
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• v.3 no.1
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• pp.135-143
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• 2011

This study evaluated the respiratory capacity of spastic cerebral palsy children who were grouped by GMFCS (Gross Motor Function Classification System) levels and identified the acoustic characteristics of three different types of Korean stops (stop consonants) which are needed for the temporal coordination of larynx and supra-larynx, in these children. Thirty-two children with dysarthria due to spastic cerebral palsy were divided into two subgroups: 14 children classified at GMFCS levels I~III were placed in Group 1 and 18 classified at GMFCS levels IV~V were placed in Group 11, and 18 children with normal speech were selected and placed in the control group. /a/ pronged phonation (sustained vowel /a/) and nine Korean VCV syllables were used. Examined acoustic characteristics were maximum phonation time (MPT) and closure duration and aspiration duration. The results were as follows: 1) The MPTs of the cerebral palsy (CP) groups, both Group I and Group II, were significantly shorter than those of the normal group. 2) The closure durations of the two CP groups were longer than those of the normal group for all 9 target syllables. 3) The aspiration durations of the two CP groups were longer than those of the normal group. 4) The closure duration of the normal and CP Group I was significantly different among tense, aspirated, and lax. However, the CP Group II was different from normal. 5) The aspiration duration of the normal and CP Group I was significantly different among aspirated, tense, and lax. However, the CP Group II was different from normal. 6) The place of articulation influenced less than the manner of articulation on closure and aspiration duration.