• Title/Summary/Keyword: neurological disease

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Understanding of Neurological Examination for Clinical Therapist (임상치료사를 위한 신경학적 검사의 이해)

  • Kim, Byung-Jo
    • Journal of the Korean Society of Physical Medicine
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    • v.2 no.2
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    • pp.229-236
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    • 2007
  • Clinical therapist use neurological examination to acquire the necessary information from the patients who is neurological damaged. It is necessary to have enough neurological knowledge and clinical experience to collect useful data. Neurological disease of symptom is well correspond with anatomical location and function, therefore neurological examination is one of the powerful tool to diagnosis. These tools will be a great help to clinical therapist to evaluate the patients and helps to select most pertinent treatment approach to patients. Neurological examination can classified and evaluate with Mental Status Examination, Cranial Nerves Examination, Motor and Sensory System Examination, Reflexes, Gait and Station Evaluation, Special Maneuver. Generally, various neurological examination tools are used by therapist in clinical field. Understanding of method of Neurological examination tools and understanding of result of examination from patients's response is very important. Therefore, this research will help to understand clinical meaning by neurological examination.

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Cross-sectional and Comparative Study between First Attack and Reattack Groups in Acute Stroke Patients - Multi-Center Trials (급성기 중풍환자의 재발군과 초발군에 대한 단면조사연구 - 다기관 임상연구)

  • Lee, In-Whan;Gwak, Ja-Young;Cho, Seung-Yeon;Shin, Ae-Sook;Kim, Na-Hee;Kim, Hye-Mi;Na, Byung-Jo;Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Internal Korean Medicine
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    • v.30 no.4
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    • pp.696-707
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    • 2009
  • Objective : We designed this study to investigate differences between stroke reattack and stroke first attack group to establish fundamental data and prevent a secondary stroke. Methods : 826 subjects were recruited from the patients admitted to the department of internal medicine at Kyung Hee University Oriental Medical Center, Kyung Hee University East-West Neo Medical Center, Kyungwon University Incheon Oriental Medical Center, Kyungwon University Songpa Oriental Medical Center and Dongguk University Ilsan Oriental Medical Center from 1 April 2007 to 31 August 2009. We compared general characteristics, classification of diagnosis, subtypes of cerebral infarction, risk factors, Sasang constitution, diagnostic classifications between stroke reattck and stroke first attack groups. Results : 1. In general characteristics, age differed significantly between the reattck and first attack groups. 2. Classification of diagnosis differed significantly between reattck and first attack groups. 3. In risk factors, hypertension, diabetes mellitus, alcohol drinking, and stress were significantly different between reattck and first attack groups. 4. Diagnostic classifications were significantly different between reattck and first attack groups. Conclusion : To prevent recurrence of stroke, education on stroke risk factors associated with recurrence is needed. In addition, those who are diagnosed as Dampness-Phlegm need to be well-controlled.

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A Comparison on the General Characteristics of Acute Stroke Patients between Fire-Heat and Deficiency of Yin (화열과 음허로 진단된 급성기 뇌질환 환자의 특성 비교 연구)

  • Kim, Hye-mi;Gwak, Ja-young;Cho, Seung-yeon;Shin, Ae-sook;Lee, In-whan;Kim, Na-hee;Na, Byung-Jo;Park, Seong-Uk;Jung, Woo-sang;Mun, Sang-gwan;Park, Jung-mi;Ko, Chang-nam;Cho, Ki-ho;Kim, Young-suk;Bae, Hyung-sup
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.10 no.1
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    • pp.33-39
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    • 2009
  • Objects : This study propose to compare on general characteristics of acute stroke patients between Fire-Heat group and Deficiency of Yin group. Method : We recruited acute stroke patient within 4 weeks after stroke admitted to Department of Internal Medicine of Kyunghee University Oriental Medicial Center, Dongguk University Ilsan Oriental Medical Center, Kyungwon University Songpa Oriental Medical Centar and Kyungwon University Incheon Oriental Medical Center from April 2007 to August 2009. We investigate age, sex, type of stroke, past history, general characteristics, smoking, drinking alcohol, marriage sasang constitution, etc. Result : It was significant different in sex, smoking, dringking alcohol and marriage between Fire-Heat group and Deficiency Yin group. We need more cases for another result that could associate with diagnosis of stroke. Conclusion : We found that Fire heat group was more associated with lifestyle than deficiency yin group. Further study will be needed to analysis for the diagnosis and the treatments of stroke.

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Atlantoaxial Rotatory Fixation - Report of 3 Cases - (Atlantoaxial Rotatory Fixation - 3 례 보 고 -)

  • Sohn, Moon Jun;Rhim, Seung Chul;Roh, Sung Woo;Park, Hyung Chun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.4
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    • pp.580-585
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    • 2000
  • The atlantoaxial rotatory fixation is a uncommon disease of deformity, occuring much more frequently in children than in adults. Despite of its benign clinical course, delayed recognition or improper management may cause persistent deformity or recurrence. We report three cases of typical atlantoaxial rotatory fixation. Successful reduction was achieved with posterior atlantoaxial fusion in one case and nonoperative treatment in others. We emphasize that it is necessary to perform dynamic CT scan to obtain correct diagnosis and to plan proper treatment for this disease entity.

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Application of Iron Related Magnetic Resonance Imaging in the Neurological Disorders (신경계 질환에서 철 관련 자기공명영상 기법의 활용)

  • Kim, Tae-Hyoung;Lee, Jae-Hyeok
    • Annals of Clinical Neurophysiology
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    • v.16 no.1
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    • pp.1-7
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    • 2014
  • Iron is an important element for brain oxygen transport, myelination, DNA synthesis and neurotransmission. However, excessive iron can generate reactive oxygen species and contribute neurotoxicity. Although brain iron deposition is the natural process with normal aging, excessive iron accumulation is also observed in various neurological disorders such as neurodegeneration with brain iron accumulation, Parkinson's disease, Alzheimer's disease, multiple sclerosis, Friedreich ataxia, and others. Magnetic resonance image (MRI) is a useful method for detecting iron deposits in the brain. It can be a powerful tool for diagnosis and monitoring, while furthering our understanding of the role of iron in the pathophysiology of a disease. In this review, we will introduce the mechanism of iron toxicity and the basics of several iron-related MRI techniques. Also, we will summarize the previous results concerning the clinical application of such MR imagings in various neurological disorders.

The Effect of Adding Kami-guibi-tang to Acetylcholinesterase Inhibitor Treatment on the Cognitive Function of Mild Alzheimer's Disease Patients: Study Protocol of a Randomized, Placebo-Controlled, Double-Blind Pilot Trial

  • Yang, Seung-bo;Kim, Ha-ri;Shin, Hee-yeon;Kim, Jeong-hwa;Lee, Chang-woo;Jahng, Geon-ho;Park, Seong-uk;Ko, Chang-nam;Park, Jung-mi
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.326-338
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    • 2020
  • Background: Alzheimer's disease (AD) is a chronic neurodegenerative disease that causes disorientation, mood swings, problems with language, and difficulty remembering recent events. Acetylcholinesterase inhibitors (AchEIs) and memantine have been used to slow the course of the disease, but they can neither modify its progression nor prevent disease onset. Previous studies have suggested that Kami-guibi-tang (KGT) could be beneficial for supporting cognitive function in AD patients, but few clinical trials have been published. This pilot study aimed to evaluate the effect of KGT in improving cognitive function in AD patients. Methods: The study will be a randomized, placebo-controlled, double-blind, single-center trial conducted using subjects diagnosed with mild AD by neurologists. Study subjects will be randomly assigned to either a treatment or control group. The treatment group will receive KGT granules for 24 weeks, while the control group will receive placebo granules. AchEI administration will be maintained in both groups during the entirety of the study. Subjects will be assessed using the following exams: the Seoul Neuropsychologic Screening Battery (SNSB) for cognitive function; brain magnetic resonance imaging (MRI) for brain metabolite, neurotransmitter, and cerebral blood flow (CBF) measurements; the Korean version of Quality of Life-Alzheimer's Disease (KQol-AD) for quality of life; the Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI) for neurobehavioral symptoms; blood tests for amyloid and tau proteins and general blood parameters; and electrocardiography (ECG) before and after taking the medication. Discussion: Our findings will provide insight into the feasibility of large-scale trials to consolidate evidence for the efficacy of KGT for dementia treatment. Registration ID in CRIS: KCT0002904 (Clinical Research Information Service of the Republic of Korea).

Surgical Outcome of Spinal Cord Hemangioblastomas

  • Park, Chang Hyun;Lee, Chang-Hyun;Hyun, Seung Jae;Jahng, Tae-Ahn;Kim, Hyun-Jib;Kim, Ki-Jeong
    • Journal of Korean Neurosurgical Society
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    • v.52 no.3
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    • pp.221-227
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    • 2012
  • Objective : Spinal cord hemangioblastomas are rare tumors. Despite their benign, slow-growing nature, they can cause severe neurological consequences. The purpose of this study was to evaluate variable factors, including clinical features, tumor findings, the extent of resection, and its recurrence or progression, which determine postoperative functional outcomes. Methods : This study included sixteen patients at our institute who underwent microsurgical resection for sporadic spinal intramedullary hemangioblastomas and spinal intramedullary hemangioblastomas associated with von Hippel-Lindau (VHL) disease, between June 2003 and March 2012. Results : A total of 30 operations were performed. Total resection (TR) of the tumor was achieved in 10 patients, and subtotal resection (STR) was achieved in 6. Postoperatively, the initial presenting symptoms were improved in 18.7% of the patients and were unchanged in 56.3%, but 25% were worse. Stable postoperative neurological functions were found in 83% of patients with preoperative McCormick grade I, and TR was achieved in 75% of these patients. In the STR group, poorer neurological status was observed in one patient, despite multiple operations. There were no poorer outcomes in the four cases of VHL disease. Various factors were analyzed, but only a correlation between the pre- and postoperative neurological status was verified in the TR-group patients. Conclusion : Preoperative focal neurological impairment and meticulous microsurgical manipulation may be predictors of favorable outcomes for solitary hemangioblastomas. In addition, the preservation of function is more important than the extent of resection in VHL disease.

Prognostic Factors and Clinical Outcomes of Acute Intracerebral Hemorrhage in Patients with Chronic Kidney Disease

  • Kim, Jin Kyu;Shin, Jun Jae;Park, Sang Keun;Hwang, Yong Soon;Kim, Tae Hong;Shin, Hyung Shik
    • Journal of Korean Neurosurgical Society
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    • v.54 no.4
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    • pp.296-301
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    • 2013
  • Objective : We conducted a retrospective study examining the outcomes of intracerebral hemorrhage (ICH) in patients with chronic kidney disease (CKD) to identify parameters associated with prognosis. Methods : From January 2001 to June 2008, we treated 32 ICH patients (21 men, 11 women; mean age, 62 years) with CKD. We surveyed patients age, sex, underlying disease, neurological status using Glasgow Coma Scale (GCS), ICH volume, hematoma location, accompanying intraventricular hemorrhage, anti-platelet agents, initial and 3rd day systolic blood pressure (SBP), clinical outcome using the modified Rankin Scale (mRS) and complications. The severity of renal functions was categorized using a modified glomerular filtration rate (mGFR). Multifactorial effects were identified by regression analysis. Results : The mean GCS score on admission was $9.4{\pm}4.4$ and the mean mRS was $4.3{\pm}1.8$. The overall clinical outcomes showed a significant relationship on initial neurological status, hematoma volume, and mGFR. Also, the outcomes of patients with a severe renal dysfunction were significantly different from those with mild/moderate renal dysfunction (p<0.05). Particularly, initial hematoma volume and sBP on the 3rd day after ICH onset were related with mortality (p<0.05). However, the other factors showed no correlation with clinical outcome. Conclusion : Neurological outcome was based on initial neurological status, renal function and the volume of the hematoma. In addition, hematoma volume and uncontrolled blood pressure were significantly related to mortality. Hence, the severity of renal function, initial neurological status, hematoma volume, and uncontrolled blood pressure emerged as significant prognostic factors in ICH patients with CKD.

Prognostic Factors and Therapeutic Outcomes in 22 Patients with Pleomorphic Xanthoastrocytoma

  • Lim, Sungryong;Kim, Jeong Hoon;Kim, Sun A;Park, Eun Suk;Ra, Young Shin;Kim, Chang Jin
    • Journal of Korean Neurosurgical Society
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    • v.53 no.5
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    • pp.281-287
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    • 2013
  • Objective : Pleomorphic xanthoastrocytoma (PXA) is a rare primary low-grade astrocytic tumor classified as WHO II. It is generally benign, but disease progression and malignant transformation have been reported. Prognostic factors for PXA and optimal therapies are not well known. Methods : The study period was January 2000 to March 2012. Data on MR findings, histology, surgical extents and adjuvant therapies were reviewed in twenty-two patients diagnosed with PXA. Results : The frequent symptoms of PXA included seizures, headaches and neurologic deficits. Tumors were most common in the temporal lobe followed by frontal, parietal and occipital lobes. One patient who died from immediate post-operative complications was excluded from the statistical analysis. Of the remaining 21 patients, 3 (14%) died and 7 (33%) showed disease progression. Atypical tumor location (p<0.001), peritumoral edema (p=0.022) and large tumor size (p=0.048) were correlated with disease progression, however, Ki-67 index and necrosis were not statistically significant. Disease progression occurred in three (21%) of 14 patients who underwent GTR, compared with 4 (57%) of 7 patients who did not undergo GTR, however, it was not statistically significant. Ten patients received adjuvant radiotherapy and the tumors were controlled in 5 of these patients. Conclusion : The prognosis for PXA is good; in our patients overall survival was 84%, and event-free survival was 59% at 3 years. Atypical tumor location, peritumoral edema and large tumor size are significantly correlated with disease progression. GTR may provide prolonged disease control, and adjuvant radiotherapy may be beneficial, but further study is needed.

A Retrospective Study of Intervertebral Disk Disease Confirmed by MRI in Dogs: 89 Cases (2012-2015)

  • Kim, Dam;Kang, Jin-su;Kim, Young-ung;Lee, Dong-bin;Heo, Su-young;Kim, Nam-soo
    • Journal of Veterinary Clinics
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    • v.36 no.3
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    • pp.139-144
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    • 2019
  • Intervertebral disk disease is a common neurological disease in dogs. In veterinary neurology clinics, the incidence of intervertebral disk disease and the spinal cord compression rate of the disk are well documented. However, the direction of herniation of the intervertebral disk is relatively less known on Magnetic resonance imaging (MRI). Therefore, this study systematically investigated and analyzed the intervertebral disk disease in dogs. Especially, classification according to the direction of herniation of the disk, the degree of pre - treatment neurological manifestation, and the compression rate was investigated. In addition, the treatment methods of patients who received treatment after visiting the Chonbuk animal medical center (CAMC) were divided into pharmacological treatment and surgical treatment. The location of intervertebral disc in spinal canal was mainly ventral (69.9%), and when the prognosis was evaluated according to the compression rate of the spinal cord, the prognosis of the surgical treatment (72.7%) was more effective than the non - surgical medication (40.6%). Surgical treatment (83.3%) was more successful than nonsurgical medication (60%), especially in cases of severe spinal cord compression (> 50%). In this study, surgical treatment was more effective when the neurological symptoms were severe or the spinal cord compression rate was high.