• Title/Summary/Keyword: neurological disease

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A Rare Atypical Case of Asymptomatic and Spontaneous Intraneural Hematoma of Sural Nerve: A Case Report and Literature Review

  • Shin Hyuk Kang;Il Young Ahn;Han Koo Kim;Woo Ju Kim;Soo Hyun Woo;Seung Hyun Kang;Soon Auck Hong;Tae Hui Bae
    • Archives of Plastic Surgery
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    • v.51 no.2
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    • pp.208-211
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    • 2024
  • Intraneural hematoma is a rare disease that results in an impaired nerve function because of bleeding around the peripheral nerve, with only 20 cases reported. Trauma, neoplasm, and bleeding disorders are known factors for intraneural hematoma. However, here we report atypical features of asymptomatic and spontaneous intraneural hematoma which are difficult to diagnose. A 60-year-old woman visited our clinic with the complaint of a palpable mass on the right calf. She reported no medical history or trauma to the right calf and laboratory findings showed normal coagulopathy. Ultrasonography was performed, which indicated hematoma near saphenous vein and sural nerve or neurogenic tumor. We performed surgical exploration and intraneural hematoma was confirmed on sural nerve. Meticulous paraneuriotomy and evacuation was performed without nerve injury. Histological examination revealed intraneural hematoma with a vascular wall. No neurologic symptoms were observed. In literature review, we acknowledge that understanding anatomy of nerve, using ultrasonography as a diagnostic tool and surgical decompression is key for intraneural hematoma. Our case report may help establish the implications of diagnosis and treatment. Also, we suggested surgical treatment is necessary even in cases that do not present symptoms because neurological symptoms and associated symptoms may occur later.

The Effects of Coenzyme Q10 Supplementation on Oxidative Status and Lipid Profile in Migraine Patients: A Randomized Double-Blinded Controlled Clinical Trial

  • Monireh Dahri;Atefeh Sarafan Sadeghi;Naseh Pahlavani;Elyas Nattagh-Eshtivani;Mazyar Hashemilar;Mohammad Asghari-Jafarabadi;Hanieh Barghchi;Ali Tarighat-Esfanjani
    • Clinical Nutrition Research
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    • v.12 no.4
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    • pp.257-268
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    • 2023
  • Migraine is a common neurological disease correlated with oxidative stress and lipid profile disorders. The present study was designed to determine the effects of Coenzyme Q10 (Co-Q10) supplementation on oxidative status and lipid profile in migraine individuals. This clinical trial was conducted on 84 females aged 18-50 years, diagnosed for episodic migraine according to the International Headache Society. Subjects were randomized to receive either Co-Q10 supplement (400 mg/day) or placebo for 12 weeks. Lipid profile and oxidative stress indices including malondialdehyde (MDA) and total antioxidant capacity (TAC) were measured before and after intervention in both groups. Also, anthropometric indices, dietary intakes, and clinical features were collected. Data analysis was conducted using SPSS version 16. Seventy-seven of the participants, with mean age of 33.70 ± 7.75 years, completed the study. After 12-week intervention, Co-Q10 led to a significant decrease in MDA levels compared to placebo (p = 0.009), with no effect on TAC levels (p = 0.106). A significant increase in serum Co-Q10 concentration and high-density lipoprotein cholesterol (HDL-C) level in Co-Q10 group was observed, but no significant differences were found in other lipid profile variables (low-density lipoprotein cholesterol, triglycerides and total cholesterol). Among anthropometric variables, Co-Q10 only caused a significant reduction in body fat percentage (BFP), but we did not find any significant changes in others. A 12-week Co-Q10 supplementation led to significant improvement in clinical features, BFP, and HDL-C level among migraine individuals.

A Neurobehavioral Performance Assessment in Lacunar Infarction Case-control Study (열공성 뇌경색 환자-대조군에서 신경행동검사의 수행 평가)

  • Kim, Ham-Gyum;Park, Sue-Kyung;Lee, Kun-Sei;Kim, Hyeoug-Su;Kim, Wha-Sun;Chang, Soung-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.3
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    • pp.255-262
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    • 2003
  • Objectives : We carried out tests for neurobehavior by using WHO-NCTB (neurobehavioral core test battery) and Perdue pegboard score test to identify differences between lacunar infarction cases and controls. Methods : Among the subjects who underwent MRI between February 2001 and March 2002 in a university hospital located in Seoul and who were diagnosed only as lacunar infarction without any intracranial disease, 46 patients were selected as cases (male: 21, female: 25). Controls were selected who had no cerebrovascular disease on MRI by matching age (5 years), gender, and education (2 years) in a ratio of 1:1 , Among WHO-NCTB, the following 5 tests and Perdue pegboard score test were used to categorize the study subjects: digit and symbol matching, simple reaction time, Benton visual retention, digit span, and Pursuit aiming test, Results : Among the above 6 tests of neurobehavior, lacunar infarction cases showed lower score than controls except for the simple reaction time test. As the controlling variables of multivariate analysis in the stepwise regression analysis, the followings were selected due to their significant association: age, education, BMI, gender, drinking, exercise, add systolic blood pressure. From multivariate regression analysis, there was significant difference (p<0.05) between lacunar infarction cases and controls in digit and symbol matching, Benton visual retention, digit span, pursuit aiming, and Perdue pegboard score test, but not in the score of simple reaction time test. Conclusions : We suggest that the above 5 tests for neurobehavior, with the exception of the simple reaction time test, might be used as the basis for recommendation of further treatment and other neurological tests by the earlier defection for neurological abnormality in lacunar infarction.

A Study on Occupational Diseases of Fire Officials (소방공무원의 직무질환에 관한 연구)

  • Cho, Kwang-Rae
    • Korean Security Journal
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    • no.61
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    • pp.109-135
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    • 2019
  • The purpose of this study is to investigate the occupational diseases(the number of medical treatment) of fire officials by using time-series analysis. The results of the study are as follows. First, the average rates of the occupational diseases of fire officials were as follows: ① internal diseases were the highest at 9.24% in December, the lowest at 7.76% in February, ② otolaryngologic diseases were the highest at 9.29% in December, the lowest at 6.74% in August, ③ dermatological diseases were the highest at 10.03% in July, the lowest at 7.35% in January and February, ④ surgical diseases were the highest at 10.38% in November, the lowest at 5.62% in February, ⑤ orthopedic diseases were the highest at 9.69% in March, the lowest at 7.52% in November, ⑥ neurosurgical diseases were the highest at 9.33% in April, the lowest at 6.82% in February, ⑦ neurological diseases were the highest at 9.47% in December, the lowest at 7.06% in October, and ⑧ mental health diseases were the highest at 9.93% in December, the lowest at 6.51% in May. Second, the seasonal decomposition of the disease occurrence of fire officials were described by assigning seasonal factor(S), trend factor(T), circulation factor(C) and irregular factor(R): ① internal diseases were 1.075(S) × 189.355(T·C) × 1.174(R) = 238.975(F), ② otolaryngologic diseases were 1.023(S) × 69.605(T·C) × 1.040(R) = 74.000(F), ③ dermatological diseases were 1.002(S) × 73.088(T·C) × 0.874(R) = 64.000(F), ④ surgical diseases were 1.099(S) × 27.229(T·C) × 0.669(R) = 20.000(F), ⑤ orthopedic diseases were 1.115(S) × 73.182(T·C) × 1.213(R) = 99.000(F), ⑥ neurosurgical diseases were 0.993(S) × 27.836(T·C) × 1.303(R) = 36.000(F), ⑦ neurological diseases were 1.029(S) × 62.417(T·C) × 1.152(R) = 74.000(F), and ⑧ mental health diseases were 1.210(S) × 8.781(T·C) × 1.035(R) = 11.000(F).

Long-term Clinical Consequences in Patients with Urea Cycle Disorders in Korea: A Single-center Experience (요소회로대사 질환 환자들의 장기적인 임상 경과에 대한 단일 기관 경험)

  • Lee, Jun;Kim, Min-ji;Yoo, Sukdong;Yoon, Ju Young;Kim, Yoo-Mi;Cheon, Chong Kun
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.21 no.1
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    • pp.15-21
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    • 2021
  • Purpose: Urea cycle disorder (UCD) is an inherited inborn error of metabolism, acting on each step of urea cycle that cause various phenotypes. The purpose of the study was to investigate the long-term clinical consequences in different groups of UCD to characterize it. Methods: Twenty-two patients with UCD genetically confirmed were enrolled at Pusan National University Children's hospital and reviewed clinical features, biochemical and genetic features retrospectively. Results: UCD diagnosed in the present study included ornithine transcarbamylase deficiency (OTCD) (n=10, 45.5%), argininosuccinate synthase 1 deficiency (ASSD) (n=6, 27.3%), carbamoyl-phosphate synthetase 1 deficiency (CPS1D) (n=3, 13.6%), hyperornithinemia-hyperammonemia-homocitrullinuria syndrome (HHHS) (n=2, 9.1%), and arginase-1 deficiency (ARG1D) (n=1, 4.5%). The age at the diagnosis was 32.7±66.2 months old (range 0.1 to 228.0 months). Eight (36.4%) patients with UCD displayed short stature. Neurologic sequelae were observed in eleven (50%) patients with UCD. Molecular analysis identified 37 different mutation types (14 missense, 6 nonsense, 6 deletion, 6 splicing, 3 delins, 1 insertion, and 1 duplication) including 14 novel variants. Progressive growth impairment and poor neurological outcomes were associated with plasma isoleucine and leucine concentrations, respectively. Conclusion: Although combinations of treatments such as nutritional restriction of proteins and use of alternative pathways for discarding excessive nitrogen are extensively employed, the prognosis of UCD remains unsatisfactory. Prospective clinical trials are necessary to evaluate whether supplementation with BCAAs might improve growth or neurological outcomes and decrease metabolic crisis episodes in patients with UCD.

Neuronal injury in AIDS dementia: Potential treatment with NMDA open-channel blockers and nitric oxide-related species

  • Lipton, Stuart A.
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1996.04a
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    • pp.19-29
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    • 1996
  • The neurological manifestations of AIDS include dementia, encountered even in the absence of opportunistic superinfection or malignancy. The AIDS Dementia Complex appears to be associated with several neuropathological abnormalities, including astrogliosis and neuronal injury or loss. How can HIV-1 result in neuronal damage if neurons themselves are only rarely, if ever, infected by the vitus\ulcorner In vitro experiments from several different laboratiories have lent support to the existence of HIV- and immune-related toxins. In one recently defined pathway to neuronal injury, HIV-infected macrophages/microglia as well as macrophages activated by HIV-1 envelope protein gp120 appear to secrete excitants/neurotoxins. These substances may include arachidonic acid, platelet-activating factor, free radicals (NO - and O$_2$), glutamate, quinolinate, cysteine, cytokines (TNF-${\alpha}$, IL1-B, IL-6), and as yet unidentified factors emanating from stimulated macrophages and possibly reactive astrocytes. A final common pathway for newonal suscepubility appears to be operative, similar to that observed in stroke, trauma, epilepsy, and several neurodegenerative diseases, including Huntington's disease, Parkinson's disease, and amyotrophic lateral sclerosis. This mechanism involves excessive activation of N-methyl-D-aspartate (NMDA) receptor-operated channels, with resultant excessive influx of Ca$\^$2+/ leading to neuronal damage, and thus offers hope for future pharmacological intervention. This chapter reviews two clinically-tolerated NMDA antagonists, memantine and nitroglycerin; (ⅰ) Memantine is an open-channel blocker of the NMDA-associated ion channel and a close congener of the anti-viral and anti-parkinsonian drug amantadine. Memantine blocks the effects of escalating levels of excitotoxins to a greater degree than lower (piysiological) levels of these excitatory amino acids, thus sparing to some extent normal neuronal function. (ⅱ) Niuoglycerin acts at a redox modulatory site of the NMDA receptor/complex to downregulate its activity. The neuroprotective action of nitroglycerin at this site is mediated by n chemical species related to nitric oxide, but in a higher oxidation state, resulting in transfer of an NO group to a critical cysteine on the NMDA receptor. Because of the clinical safety of these drugs, they have the potential for trials in humans. As the structural basis for redox modulation is further elucidated, it may become possible to design even better redox reactive reagents of chinical value. To this end, redox modulatory sites of NMDA receptors have begun to be characterized at a molecular level using site-directed mutagenesis of recombinant subunits (NMDAR1, NMDAR2A-D). Two types of redox modulation can be distinguished. The first type gives rise to a persistent change in the functional activity of the receptor, and we have identified two cysteine residues on the NMDARI subunit (#744 and #798) that are responsible for this action. A second site, presumably also a cysteine(s) because <1 mM N-ethylmaleimide can block its effect in native neurons, underlies the other, more transient redox action. It appears to be at this, as yet unidentified, site on the NMDA receptor that the NO group acts, at least in recombinant receptors.

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Characteristics of patients with decreased mental status while staying in an emergency department: Comparative study with alert patients (응급실 체류 중에 의식이 저하된 환자의 특성: 의식명료 환자와의 비교연구)

  • Moon, Sun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.10
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    • pp.222-230
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    • 2018
  • This was a retrospective study that compared the characteristics of patients with decreased mental status (DMS) during their stays in an emergency department (ED) with that of patients with alert mental status (AMS). The participants in this study consisted of 90 patients with DMS who were staying in an ED along with 100 randomly selected patients with AMS. The DMS group contained more instances of cerebrovascular disease, liver disease, diabetes, and hypertension compared to the AMS group (p=0.001, p=0.003, p<0.001, and p=0.002, respectively). With regard to triage, the DMS group had higher severity than the AMS group (p<.001). The final diagnosis for the DMS group was as follows: 64.9% neurological and 63.3% related to the digestive system, which differed from that of the AMS group (p<.001). Fifty-six (62.2%) patients with DMS had their statuses discovered by nurses, while nine patients in the DMS group had received cardiopulmonary resuscitation. These results suggest that ED nurses frequently assess the consciousness of patients who they suspect may have neurologic or digestive diseases and are classified as high severity, even when the patients are alert.

Clinical Application of Mesenchymal Stem Cells in a Dog with Intervertebral Disc Disease (추간판 탈출증이 발생한 개에서 동종의 지방유래 줄기세포의 임상적 적용)

  • Kim, Young-Ki;Lee, Seung-Yong;Park, Se-Jin;Lee, Scott-S.;Kim, Jin-Hyun;Lee, Hee-Chun;Chang, Hong-Hee;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.122-127
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    • 2011
  • A 5-year old, intact male, Cocker spaniel dog was referred with paraplegia and loss of deep pain perception. Physical, neurological examinations, radiography, and computed tomography were evaluated. Based on the clinical examinations, the dog was diagnosed with severe disc herniation ($L_2$ to $L_3$ intervertebral disc space). On the next day of presentation (6 days after loss of deep pain perception), hemilaminectomy was performed. After decompression of spinal cord and removal of herniated disc materials, $1{\times}10^6$ canine allogenic adipose tissue-derived mesenchymal stem cells (MSCs) diluted by $50{\mu}l$ saline were directly applied to the injured site of the spinal cord. Ten weeks of follow-up after surgery, full recovery of deep pain perception and motor function were evaluated in both hind limbs. Based on the result, we suggest that the transplantation of allogenic adipose tissue-derived MSCs to dogs with spinal cord injuries could be a considerable method to expect better clinical outcomes in veterinary practice.

A Study on the Spacial Environment Satisfaction for Evidence Based Design of Rehabilitative Health-Care Facilities -convergent approach for patient-centered rehabilitative healthcare service (근거중심 재활 공간 디자인을 위한 공간 환경 만족도 연구 -환자 중심 재활의료서비스를 위한 융복합적 접근)

  • Lee, Nakyung;Suh, Dasom;Song, Kyungeun
    • Journal of Digital Convergence
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    • v.15 no.10
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    • pp.327-337
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    • 2017
  • The purpose of this study is to investigate patient satisfaction for the spacial environment of the rehabilitative facilities, and by this to examine areas of patients' needs to develop patient-friendly improvement in spacial environment. 308 patients were surveyed at physical therapy centers of 6 hospitals or rehabilitative institutions in Daejeon with patient satisfaction questionnaire. The spatial environment satisfaction was categorized into 7 constructs and the data were statistically analyzed and compared by t-test and ANOVA according to the patient characteristics. As a result, inter-floor transfer was found to be the area with the least satisfaction, especially in the in-patient group. Locating floor level was the second lowest satisfied construct. Comfort was relatively highly satisfied construct overall, but patients with neurological disease had less satisfaction than with musculoskeletal disease. Patients in 20's were less satisfied in wayfinding than 60's. Satisfaction for interior design was lower in subject in 50's than 70's. These findings can be used as evidences to improve spacial environment design for rehabilitative facilities to the better patient satisfaction.

A Systematic Review on the Association between Cognitive Function and Upper Extremity Function in the Elderly (노인의 인지기능과 상지기능의 관련성에 관한 체계적 고찰)

  • Moon, Mi-Sook;Jung, Min-Ye
    • Therapeutic Science for Rehabilitation
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    • v.5 no.2
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    • pp.23-33
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    • 2016
  • Objectives: The aim of this study was to investigate the association between cognitive function and upper extremity function in the elderly. The articles were analyzed based on patient, intervention, comparison, and outcome using the P.I.C.O. principle. Methods: We systematically examined papers from January, 2000 to November, 2015 published papers through the foreign journals which were Medline & Pubmed for three months. mainly used key words were elderly, dementia, Alzheimer's disease, Mild cognitive impairment, age-related, aging, cognitive, upper extremity function, hand function, hand-grip strength, grip force, complex motor function, bimanual, dexterity, UE performance, and coordination. Results: The number of discovered outcomes for association between cognitive function and upper extremity function in the elderly was 7; grip strength & sex are impact on manipulation object, 1. The results show that cognitive function is associated with upper extremity function in the elderly. Conclusion: This study is expected to help selecting intervention, assessment tools according to the individual's degree of cognitive level and upper extremity function. In future domestic research, variety assessment tools need to be used and more qualitative level experiment will be carried out.