The purpose of this study was to examine the effects of hip joint mobilization (HJM) on walking ability, balance ability, and the joint range of motion in stroke patients to minimize the problems of the musculoskeletal system in patients with central nervous system diseases. All volunteers were randomly assigned to the HJM group ($n_1=14$) and the general neurodevelopment therapy (NDT) group ($n_2=16$). The HJM procedure involved applying Maitland mobilization techniques (distraction, lateral gliding, inferior gliding, and anterior gliding) by grade 3 to both hip joint. The mobilization process included mobilization and NDT for 15 min/day, 3 days a week for 4 weeks. The outcome measures were evaluated, including the hip joint passive range of motion (ROM) test and femur head anterior glide test (FHAG) using prone figure four test, dynamic and static balance abilities [timed up and go (TUG) test and center of pressure (COP) analysis], and walking ability [10-meter walking test (10MWT) and 6-min walking test (6MWT)]. Both the groups showed significant post-training differences in the hip joint ROM (FHAG and degree of hip extension) and 10MWT. The post-training improvements in the TUG test were significantly greater in patients of the HJM group than in the NDT group; however, there were no post-training improvements in COP in both groups. Patients in the HJM group showed post-training improvement in the 6MWT; however, statistically significant differences were not observed. Patients in the NDT group showed post-training improvements in the 6MWT. These results suggest that HJM improves hip joint ROM, dynamic balance ability, and walking speed in stroke patients. However, further studies are required to evaluate the long-term therapeutic efficacy of HJM in stroke patients.
Kim, Ah-Young;Kim, Seong-Kyun;Youn, Jin-Young;Jeong, Jae-Seung;Lee, Joo-Ho;Chae, Jeong-Ho;Lee, Yu-Sang
Korean Journal of Biological Psychiatry
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v.18
no.1
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pp.25-35
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2011
Objectives : Cerebral laterality is thought to be an important marker for neurodevelopment. Prenatal testosterone could influence both cerebral laterality and 2nd to 4th finger length ratio(2D : 4D). EEG coherence and 2D : 4D were examined to investigate the relationship between prenatal testosterone level and cerebral laterality. Methods : EEG was recorded in 24 healthy subjects in the eyes closed resting state. Differences in 2D : 4D finger ratio were used to discriminate "masculine finger type" and "feminine finger type" groups. The 2D : 4D ratio was lower and greater than one for the "masculine finger type" group and "feminine finger type" group, respectively. We used coherence analysis to estimate the cortical functional connectivity. Results : There were statistically meaningful relationships among cerebral functional connectivity, sex and finger ratio. Man and masculine finger type group showed higher intra-hemispheric coherence than those of woman and feminine finger type group. Woman and feminine finger type group showed higher inter-hemispheric coherence than those of man and masculine finger type group. Conclusions : These results imply that prenatal testosterone might act as important determinants of cerebral laterality. Further examination of the relationship between 2D : 4D and EEG coherence in schizophrenia could give some clues for the neurodevelopmental hypothesis of schizophrenia genesis.
Choi, Jin Wha;Kim, Jisook;Ahn, So Yoon;Chang, Yun Sil;Park, Won Soon;Sung, Se In
Neonatal Medicine
/
v.25
no.4
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pp.153-160
/
2018
Purpose: The aim of this study is to examine the tolerability and effect of early high-dose amino acid administration in extremely low birth weight infants (ELBWIs). Methods: This retrospective cohort study included ELBWI (birth weight <1,000 g, n=142). Biochemical, nutritional, and neurodevelopmental data were compared between infants who received conventional low amino acid (LAA; 1.5 g/kg/day) and those who received high amino acid (HAA; 3 g/kg/day) within the first 48 hours after birth. Neurodevelopmental data included weight, height, and head circumference at discharge, 12 to 14 and 18 to 24 months of corrected age and the Korean Bayley Scale of Infant Development II (K-BSID-II) score at 18 to 24 months of corrected age. Results: The HAA group demonstrated higher peak plasma albumin ($3.0{\pm}0.4$ vs. $3.2{\pm}0.5$, P<0.05) and lower serum creatinine ($1.7{\pm}0.9$ vs. $1.4{\pm}0.8$, P<0.05) during the first 14 days than the LAA group. Full enteral feeding was achieved significantly earlier in infants in the HAA group than in infants in the LAA group ($46.2{\pm}23.0days$ vs. $34.3{\pm}21days$, P<0.01). There was no difference between the two groups in the z score changes in all growth indicators from birth to discharge and at 12 to 14 and 18 to 24 months of corrected age, as well as in the K-BSID-II score at 18 to 24 months of corrected age. Conclusion: Aggressive administration of amino acids during the first 2 days of life in ELBWI was well tolerated and correlated with earlier full enteral feeding, but did not improve growth and neurodevelopment.
Hong, Minha;Lee, Kyung-Sook;Park, Jin-Ah;Kang, Ji-Yeon;Shin, Yong Woo;Cho, Young Il;Moon, Duk-Soo;Cho, Seongwoo;Hwangbo, Ram;Lee, Seung Yup;Bahn, Geon Ho
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.33
no.1
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pp.16-23
/
2022
Objectives: Early detection of developmental issues in infants and necessary intervention are important. To identify the comorbid conditions, a comprehensive evaluation is required. The study's objectives were to 1) generate scale items by identifying and eliciting concepts relevant to young children (12-71 months) with developmental delays, 2) develop a comprehensive screening tool for developmental delay and comorbid conditions, and 3) assess the tool's validity and cut-off. Methods: Multidisciplinary experts devised the "Infant Comprehensive Evaluation for Neurodevelopmental Delay (ICEND)," an assessment method that comes in two versions depending on the age of the child: 12-36 months and 37-71 months, through monthly seminars and focused group interviews. The ICEND is composed of three parts: risk factors, resilience factors, and clinical scales. In parts 1 and 2, there were 41 caretakers responded to the questionnaires. Part 3 involved clinicians evaluating ten subscales using 98 and 114 questionnaires for younger and older versions, respectively. The Child Behavior Checklist, Strengths and Difficulties Questionnaire, Infant-Toddler Social Emotional Assessment, and Korean Developmental Screening Test for Infants and Children were employed to analyze concurrent validity with the ICEND. The analyses were performed on both typical and high-risk infants to identify concurrent validity, reliability, and cut-off scores. Results: A total of 296 people participated in the study, with 57 of them being high-risk (19.2%). The Cronbach's alpha was positive (0.533-0.928). In the majority of domains, the ICEND demonstrated a fair discriminatory ability, with a sensitivity of 0.5-0.7 and specificity 0.7-0.9. Conclusion: The ICEND is reliable and valid, indicating its potential as an auxiliary tool for assessing neurodevelopmental delay and comorbid conditions in children aged 12-36 months and 37-71 months.
Objective: Cerebral palsy (CP) is a neurodevelopment disorder attributed to an insult or injury to the developing brain with abnormalities in muscular tone, movement and motor skill. Improvement in quality of life and ameliorating symptoms can be achieved. Therefore, this case report details a distinctive approach to treating a 5-year-old male child with quadriplegic spastic cerebral palsy utilizing Unani treatment modalities. Methods: The treatment regimen commenced with 'Habb Ayarij for constipation followed by Sharbat Ustukhuddus administered orally. Notably, Sharbat Ustukhuddus was combined with Melia Azedarach L. leaves vapour bath. Subsequently, Roghan Babunna douche was performed followed by Dalk Layyin andcontinued until symptomatic improvement was observed. Majun Falasfa, Khamira Marwareed and Khameera Gauzaban were administered for 30 days. The therapeutic outcome included anthropometrical measurements, developmental milestones, spasm/reflex scale, and muscle power grading. Results and conclusion: Over the course of a 2-year follow-up, several clinical findings emerged. These included notable improvements in anthropometric measurements, developmental milestones such as improved head control and sitting ability, and a reduction in spasticity of the upper limbs, along with decreased muscle spasms. The therapeutic outcome of this individualized and holistic approach is potentially due to the multifaceted properties of medicinal plants (Musakkin wa Muharrik wa Muqawwi-i- A'sab wa Dimāgh, Munawwim, Dafi-i-Tashannuj, Muqawwi-i-Qalb-i-Ruh). Furthermore, the use of Dalk and Naṭūl was instrumental in providing nourishment to musculoskeletal cells and initiating intracellular signaling cascades. While these findings are encouraging, further research in the form of case series andrandomized controlled trials is warranted to validate the efficacy of this unique holistic approach.
Purpose : The aims of this study were to investigate the long-term outcomes in children with infantile spasms (IS) and to identify the prognostic factors influencing their neurodevelopment. Methods : We retrospectively evaluated seventy two children over five years old who were treated for IS at Asan Medical Center, Seoul, Korea, between 1994 and 2007. Forty-three children were contacted by telephone or medical follow-up to assess their current neurodevelopmental status. Multiple logistic regression was used to calculate odds ratios (ORs) and 95% confidence interval (95% CIs) of risk factors for unfavorable outcomes.Results : The mean follow-up duration for these 43 children was $7.2{\pm}1.5$ years (range, 4.5 to 13.0 years). Of these, 13 (30.2%) had cryptogenic and 30 (69.8%) had symptomatic IS. Eleven (25.6%) children were initially treated with adrenocorticotrophic hormone (ACTH) therapy, with a mean treatment lag of $1.3{\pm}1.9$ months (range; 0.1 to 7.0 months). Eighteen (41.8%) children clinically responded to initial treatment, as shown by EEG response. Overall, 22 (51.2%) children had at least moderate neurodevelopmental disorders and 2 (4.8%) died. In univariate analysis, etiology (symptomatic) and poor electroclinical response to initial treatment were related to long-term unfavorable outcomes. In multivariate analysis, response to primary treatment was the sole significant independent risk factor with a high OR. Conclusion : Overall prognosis of children with IS was poor. Electroclinical non-responsiveness to initial treatment was related to unfavorable long-term outcomes, indicating that initial control of seizures may be important in reducing the likelihood of poor neurodevelopment.
Down syndrome (DS) results from overexpressed genes on an extra copy of human chromosome 21. Among various phenotypes seen in DS patients, mental retardation, such as learning and memory deficits, is a major factor that prevents DS individuals from leading fully independent lives. The Dyrk1A gene that plays a critical role in neurodevelopment has been isolated from chromosome 21, and transgenic mice with over-expression of Dyrk1A show severe hippocampal dependent learning and memory defects. In the present study, as an initial step to test the treatment of Dyrk1A dependent mental retardation phenotypes in model animals, we isolated human Dyrk1A specific lentiviral short hairpin RNA (shRNA) that inhibits the exogenous human Dyrk1A expression, but not the endogenous mouse expression in transgenic mice with human Dyrk1A overexpression. This limited and specific repression of exogenous human Dyrk1A will prove to be valuable information, if Dyrk1A dependent learning and memory defects in DS patients could be treated or at least ameliorated in vivo.
Park, Geun-Hwa;Choi, Sang-Youn;Kim, Sung-Mi;Kim, Mi-Ae;Lee, Eun-Ju
Neonatal Medicine
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v.17
no.2
/
pp.207-216
/
2010
Purpose: The aim of this study was to identify the effects of neonatal developmental intervention program (NDT) in promoting motor development and growth and to determine the usefulness of Hammersmith Neonatal Neurological Examination (HNNE) and Neonatal Behavioral Assessment Scale (NBAS) in premature infants. Methods: We performed NDT on selected premature infants (PI, n=42) and compared them with the full term control group (FC, n=20). NDT protocol and development assessment (HNNE, NBAS) were manipulated by the physical therapist in the neonatal intensive care unit. The data of this study were collected prospectively. Results: The PI with GA <34 weeks (VPI) subgroup showed a more use of mechanical ventilator and surfactant, severe bronchopulmonary dysplasia and intraventricular hemorrhage, and patent ductus arteriosus treated surgically than the PI with GA $\geq$34 weeks but less than 37 weeks (LPI) subgroup. The average scores improved significantly in the PI group between the 1st, 2nd, and 3rd assessment by repeated measure (P=0.000). Also, the PI group showed significantly higher total scores and average score at 40 weeks postmenstrual age, P=0.000, respectively than in the FC group. The LPI subgroup showed more weight gain and change in the head circumference between the 1st and 3rd assessment by repeated measure, respectively, P<0.05. The PI group showed no apnea, bradycardia and late sepsis associated with intervention and assessment. Conclusion: The NDT might be a safe and useful intervention to promote motor and growth outcomes in premature infants. Also, the HNNE and NBAS might be safe and useful tools for assessing neurodevelopment in premature infants.
Ha Jung Moon;Seung Hyun Lee;Hyun Seung Shin;Eui-Man Jung
Journal of Life Science
/
v.33
no.4
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pp.371-381
/
2023
Endocrine disrupting chemicals (EDCs), used in a variety of products in modern society, are hormone-like substances that cause various diseases. Humans are exposed to EDCs through their inclusion in pesticides, plastics, cosmetics, detergents, and drugs. Bisphenol A (BPA), one of the representative endocrine disruptors, is an estrogen-like substance that has been widely used commercially in plastic and epoxy resins. BPA is a chemical that can disrupt the endocrine system, leading to reduced reproductive function, obesity, cancer, and neurodevelopmental disorders. Since the adverse health effects of BPA began to be reported the use of BPA has been regulated worldwide. Various alternatives to BPA have been widely used worldwide; representatively, bisphenol S (BPS) and bisphenol F (BPF) are the most commonly used in commercial contexts. BPS and BPF may cause endocrine-disrupting effects like those of BPA due to their similar chemical structures. Recent studies have reported that BPS and BPF disrupt the neurodevelopmental process and cause neurodevelopmental disorders. Therefore, future studies will be required for safety verification of BPA alternatives and the development of new alternatives to BPA for brain health. In this review, we reviewed the effects of BPA and the alternatives, BPS and BPF, on the nervous system.
During pregnancy, maternal immune activation (MIA) from infection increases the risk of neurodevelopmental diseases, including schizophrenia and autism spectrum disorders. MIA induced by polyinosinic-polycytidylic acid (poly (I:C)) and lipopolysaccharide (LPS) in animal experiments has led to offspring with abnormal behaviors and brain development. In addition, it has recently been reported that microglia, which reside in the brain and function as immune cells, play an important role in behavioral abnormalities and brain development in MIA-induced offspring. However, the underlying mechanism remains unclear. In this study, we investigated whether microglia-specific inhibition of GPR56, a member of the G protein-coupled receptor (GPCR) family, causes behavioral abnormalities in brain development. First, MIA induction did not affect the microglia population, but when examining the expression of microglial GRP56 in MIA-induced fetuses, GPR56 expression was inhibited between embryonic days 14.5 (E14.5) and E18.5 regardless of sex. Furthermore, microglial GPR56-suppressed mice showed abnormal behaviors in the MIA-induced offspring, including sociability deficits, repetitive behavioral patterns, and increased anxiety levels. Although abnormal cortical development such as that in the MIA-induced offspring were not observed in the microglial GPR56-suppressed mice, their brain activity was observed through c-fos staining. These results suggest that microglia-specific GPR56 deficiency may cause abnormal behaviors and could be used as a biomarker for the diagnosis and/or as a therapeutic target of behavioral deficits in MIA offspring.
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