• Clinical and Experimental Pediatrics
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• v.53 no.5
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• pp.616-622
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• 2010

Enterovirus 71 (EV71) has been recognized as a frequent cause of epidemics of hand-foot-and-mouth disease (HFMD) associated with severe neurological symptoms. In the spring of 2009, HFMD was epidemic in Korea. Severe cases with complication, including death, have been reported and it has become a public health issue. Most symptomatic EV71 infections commonly result in HFMD or herpangina. These clinical manifestations can be associated with neurologic syndromes frequently. Neurologic syndromes observed in EV71 include meningitis, meningoencephalomyelitis, poliomyelitis-like paralytic disease, Guillain-Barr$\acute{e}$ syndrome, transverse myelitis, cerebellar ataxia, opsoclonus-myoclonus syndrome, benign intracranial hypertension, and brainstem encephalitis. Examinations for EV 71 were performed from the stools, respiratory secretion or CSF of the children by realtime PCR. Gene analysis showed that most of them were caused by EV71 subgenotype C4a which was prevalent in China, 2008. Public health measures including personal and environmental hygiene, must to target daycare centers, kindergartens, and schools where highly susceptible children congregate. To prevent the spread of infection, preschools where transmission persists for more than 2 incubation periods, have been recommended for closure, and trigger criteria for voluntary closure was instituted. During closure, operators are to thoroughly clean the centers before they are allowed to reopen. In addition, parents are advised to ensure that their children adopt a high standard of personal hygiene and to keep the infected child at home until full recovery. Because the outbreaks occur in a cyclical pattern, surveillance system to predict next outbreaks and adequate public health measures to control need to be planned for future. Control of EV71 epidemics through surveillance and public health intervention needs to be maintained in Korea. Future research should focus on understanding of EV71 virulence, identification of the receptor(s) for EV71, development of antiviral agents and development of vaccine.

• Journal of Korean Neurosurgical Society
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• v.53 no.3
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• pp.194-196
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• 2013

Isolated abducens nerve paresis related to ruptured vertebral artery (VA) aneurysm is rare. It usually occurs bilaterally or ipsilaterally to the pathologic lesions. We report the case of a contralateral sixth nerve palsy following ruptured dissecting VA aneurysm. A 38-year-old man was admitted for the evaluation of a 6-day history of headache. Abnormalities were not seen on initial computed tomography (CT). On admission, the patient was alert and no signs reflecting neurologic deficits were noted. Time of flight magnetic resonance angiography revealed a fusiform dilatation of the right VA involving origin of the posterior inferior cerebellar artery. The patient suddenly suffered from severe headache with diplopia the day before the scheduled cerebral angiography. Neurologic examination disclosed nuchal rigidity and isolated left abducens nerve palsy. Emergent CT scan showed high density in the basal and prepontine cistern compatible with ruptured aneurismal hemorrhage. Right vertebral angiography illustrated a right VA dissecting aneurysm with prominent displaced vertebrobasilar artery to inferiorly on left side. Double-stent placement was conducted for the treatment of ruptured dissecting VA aneurysm. No diffusion restriction signals were observed in follow-up magnetic resonance imaging of the brain stem. Eleven weeks later, full recovery of left sixth nerve palsy was documented photographically. In conclusion, isolated contralateral abducens nerve palsy associated with ruptured VA aneurysm may develop due to direct nerve compression by displaced verterobasilar artery triggered by primary thick clot in the prepontine cistern.

• Journal of The Korean Society of Clinical Toxicology
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• v.11 no.1
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• pp.28-30
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• 2013

A 66-year-old male with chronic alcoholism presented with tremor, gait disturbance, memory impairment, insomnia, decreased appetite, and confusion. The patient had been taking lithium daily for treatment of bipolar disorder. Brain CT showed no specific abnormality, and serum lithium and ammonia levels were 3.63 mEq/L (therapeutic range, 0.6~1.2 mEq/L) and $85{\mu}g/dL$ (reference range: $19{\sim}54{\mu}g/dL$), respectively. Therefore, the initial differential diagnosis included chronic lithium intoxication, hepatic encephalopathy, Wernicke encephalopathy, or alcohol withdrawal syndrome. Even with the provision of adequate hydration, the patient's neurologic status did not show improvement, so that lactulose enema, thiamine replacement, and continuous venovenous hemodiafiltration (CVVHDF) were started on the third admission day. By the fifth admission day he had made a rapid neurologic recovery, and was discharged on the 20th admission day. Therefore, CVVHDF might be a treatment for patients with chronic lithium intoxication, because, even if serum lithium concentration is normal, lithium concentration in the brain may be different from that of the serum.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1273-1285
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• 2022

Purpose MR neurography (MRN) is an imaging technique optimized to visualize the peripheral nerves. This review aimed to discover an optimized protocol for MRN of the lumbosacral plexus (LSP) and identify evidence for the clinical benefit of lumbosacral plexopathies. Materials and Methods We performed a systematic search of the two medical databases until September 2021. 'Magnetic resonance imaging', 'lumbosacral plexus', 'neurologic disease', or equivalent terms were used to search the literature. We extracted information on indications, MRN protocols for LSP, and clinical efficacy from 55 studies among those searched. Results MRN of the LSP is useful for displaying the distribution of peripheral nerve disease, guiding perineural injections, and assessing extraspinal causes of sciatica. Three-dimensional short-tau inversion recovery turbo spin-echo combined with vascular suppression is the mainstay of MRN. Conclusion Future work on the MRN of LSP should be directed to technical maturation and clinical validation of efficacy.

• Journal of Acupuncture Research
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• v.26 no.6
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• pp.205-214
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• 2009

Objectives : This study was designed to evaluate objectively the efficacy of bee-venom acupuncture on Central post-stroke patients. Methods : After screening, 25 patients recruited with eligible criteria. Among them 1 dropped out in treatment group, 4 in control group. We applied bee-venom acupuncture 6 points of body($LI_{15}$, $GB_{21}$, $LI_{11}$, $GB_{31}$, $ST_{36}$, $GB_{39}$) 2 times a week for 3 weeks for treatment group, and normal saline for control group in the same way. After 3 weeks treatment and 2 weeks follow up we measured VAS, categorial rating scale as a pain assessment also MBI, Modified Rankin Scale as a stroke recovery. Results : 1. Treatment group showed significant difference in VAS, categorial rating scale after treatment and 2 weeks follow up, compared with baseline. The control group showed significant difference between baseline and after treatment But the 2 weeks follow up, there is no significant difference compared with baseline. Also there's no significant difference in categorial rating scale. 2. MBI showed significant difference in treatment group between baseline and after treatment, but the control group did not have any difference. There's no significant difference in Modified Rankin Scale for treatment group and control group. 3. There's no significant difference between control group and treatment group. This is because of the small sample size in the study, Thus it seems to reflect individual difference strongly. Conclusions : There are positive effect on CPSP patients in pain and stroke recovery treating with bee-venom acupuncture than control group.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.8 no.2
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• pp.109-118
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• 2014

The purpose of this study was to compare the effectiveness of rehabilitation therapy with natural recovery in patients who had dysphagia due to stroke. Swallowing functions were examined on a total of 98 patients with stroke-caused dysphagia based on a videofluoroscopic swallowing study (VFSS) for 8 weeks. The each group was evaluated with DOSS, DSS and FOSS to assess swallowing ability in the first week and re-evaluated in the $8^{th}$ week during the session for investigating the recovery status. The author compared the above initial data and follow-up data using a Mann-Whitney U test, Kruskal-Wallis test and Wilcoxon's Signed Rank test, ANCOVA to confirm statistically controlling for the effects of other continuous variables, performed by IBM SPSS Statistics 20.0 for windows. There was statistically significant recovery in the experimental group except measure of DOSS (p>0.05). In the control group, it showed improvement in all the scales(p<0.05). After terminating each session, the comparison of the two group of patients showed statistical significant differences in DSS and FOSS(p<0.05). These results suggest that possibility of natural neurologic recovery has positive effects on early stage of dysphagia caused by stroke.

• Journal of Korean Neurosurgical Society
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• v.38 no.2
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• pp.102-106
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• 2005

Objective : The purposes of this study are to evaluate the efficacy of en bloc open-door laminoplasty and to investigate the validity of various factors as prognotic indicators in patients with multisegmental spondylotic myelopathy and ossification of posterior longitudinal ligament[OPLL]. Methods : The authors reviewed 43 cases in whom laminoplasty were performed for cervical myelopathy between January 2000 and December 2002. Clinical symptoms and results were evaluated using the Japanese Orthopaedic Association[JOA] scale. The recovery rate was calculated and then assessed for prognostic factors such as preoperative JOA scores, ages, history of previous trauma, duration of symptoms and signal change in cord on T2-weighted magnetic resonance Image. Results : In cervical stenosis, canal widening of antero-posterior diameter and dimension after laminoplasty is 4.16mm, $87.43mm^2$ and in OPLL is 6.20mm, $117.61mm^2$. In all cases there wasn't neurologic deterioration, mild postoperative complications developed in seven cases. Four patient had a limitation of range of neck motion and the other one showed kyphotic change and another two showed C5 radiculopathy. The recovery rate of JOA score in cervical stenosis and OPLL was 62% and 68% respectively. Duration of symptoms, the severity[preoperative JOA score], and signal change in cord on T2-weighted magnetic resonance image had close relationship to the clinical outcomes. Conclusion : Unilateral en bloc laminoplasty is simultaneous expansile and decompressive method. And preoperative JOA score, symptom duration and high signal intensity on T2-weighted magnetic resonance image can be used to predict prognosis.

• Korean Journal of Exercise Nutrition
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• v.13 no.2
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• pp.115-122
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• 2009

Intracerebral hemorrhage (ICH) is a common cause of stroke, and it occurs mainly in the striatum, thalamus, cerebellum, and pons. Physical exercise is known to ameliorate neurologic impairment induced by various brain insults. In the present study, the influence of pre-and post-conditioning of treadmill exercise on spatial learning ability, the lesion volume, and apoptotic neuronal cell death in the striatum following ICH in rats was investigated. ICH in the striatum was induced by injection of collagenase using strereotaxic instrument. The rats in the pre-exercise group were scheduled to run on a treadmill before ICH induction for 2 consecutive weeks. The rats in the post-exercise group were scheduled to run on a treadmill after ICH induction for 2 weeks. The rats in the pre-exercise and post-exercise group were scheduled to run on a preconditioning treadmill exercise 2 weeks before ICH induction until postconditioning treadmill exercise 2 weeks after ICH induction, except the day of surgery. For this study, radial arm maze task, Nissl staining, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay, and immunohistochemistry for caspase-3 were performed. Our date showed that treadmill exercise suppressed the ICH-induced apoptotic neuronal cell death and decreased lesion volume in the stratum. Treadmill exercise also alleviated the ICH-induced impairment of spatial learning ability. Preconditioning treadmill exercise before the ICH insult and postconditioning treadmill exercise after the ICH insult showed similar effectiveness on the recovery of ICH. In this study, however, preconditioning exercise before the ICH insult and postconditioning exercise after the ICH insult showed the most potent effectiveness on the recovery of ICH.

• Pediatric Infection and Vaccine
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• v.30 no.3
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• pp.180-187
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• 2023

In Korea, >90% of children and adolescents aged <19 years have been infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since 2020. Among confirmed cases of pediatric coronavirus disease 2019 (COVID-19), 40-60% of patients developed neurologic symptoms such as seizures, headache, and encephalitis. Herein, we report the case of a 3-year-old female patient with SARS-CoV-2 infection who presented with seizures and altered consciousness and was diagnosed with COVID-19 encephalitis. The patient recovered after treatment with intravenous immunoglobulin, high-dose steroids, anti-seizure drugs, and an anti-viral agent. She was discharged after regaining the ability to speak words and walk alone on hospital day 39. Complete recovery was observed at the 1-year follow-up. The findings in this case suggest that early detection and active intervention is associated with better outcomes in patients with COVID-19 encephalitis.

• Physical Therapy Korea
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• v.16 no.4
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• pp.44-52
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• 2009

It is known that individual factors as cognitive, perception, emotion, and motivation may greatly influence on recovery from neurologic region. This study was to investigate the effects of environmental reinforcement through motivation to perform the tasks voluntarily on motor and cognition function in rats with focal ischemic brain injury. Focal ischemic brain injury was induced in Sprague-Dawley rats (15 rats, $250{\pm}50$ g) through middle cerebral artery occlusion (MCAo). And then, experiment groups were randomly divided into three groups; The control group: MCAo induction ($n_1$=5), the environmental reinforcement (ER) group: the application for ER after MCAo induction ($n_2$=5), the environmental reinforcement through motivation (ERM) group: the application for ERM after MCAo induction ($n_3$=5). The climbing test (CT) and the modified limb placing tests (MLPTs) to measure the motor function and the Morris water maze acquisition test (MWMAT) and the Morris water maze retention test (MWMRT) to measure the cognitive function were performed. For the CT, the ERM group was significantly larger than the ER group. For the MLPTs, the ERM group was significantly decreased compared to other groups. For the MWMAT, the time to find the circular platform in the ERM group significantly decreased compared to other groups. For the MWMRT, the time to dwell on the quadrant circular platform in the ERM group was significantly increased compared to other groups. These results suggested that the ERM could improve the motor and cognitive functions in the rats with focal ischemic brain injury.