• Phonetics and Speech Sciences
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• v.5 no.1
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• pp.27-38
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• 2013

Healthcare providers in Korea are using conservative pharmacological treatment for Alzheimer's disease (AD) to delay the progress of the disease or to mitigate its behavioral and neurological symptoms. However, there is a growing need for interventions using practical non-pharmacologic treatment, as the effects of pharmacological treatments has faced limitations. This research provided a cognitive rehabilitation program to 3 AD patients and used a multiple baseline design across subjects to examine the effects. Performing reality orientation therapy (ROT) for 1 cycle (4 weeks) resulted in a slight increase in accuracy and responsiveness on an orientation task, mainly with patients with mild cases of AD. Also, in the sub-domain of the Korean-Mini Mental Status Examination performed to examine changes in cognitive ability, there were minimal changes in place orientation. In functional communication, however, there were no significant differences before and after the intervention. In conclusion, we found that ROT was an effective intervention for improving accuracy and responsiveness in the orientation of patients with mild cases of AD. In future studies, the effect of non-pharmacological interventions can be evaluated more reliably by examining the interaction effects of sample size, length of the intervention, outcome measurements, and pharmacological intervention.

• Childhood Kidney Diseases
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• v.19 no.2
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• pp.180-183
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• 2015

We report the case of a 14-year-old girl who visited the emergency room because of suprapubic discomfort and sudden acute urinary retention. She did not have any significant medical and surgical history, and her neurological examinations were all normal. Urinary catheterization led to the passage of 500 mL urine. Abdominal ultrasonography showed a hematocolpos that was compressing the urinary bladder. Gynecologic history taking revealed that the patient has not had menarche yet. Therefore, a cruciate incision was performed and her urination became normal. As the surgical outcome after adequate hymenotomy for imperforate hymen is usually good, the diagnosis of imperforate hymen is important. However, this condition is easily missed in the clinic because the first physician visited by the patient rarely takes a detailed gynecologic history or performs appropriate physical examinations. Although rare, imperforate hymen should be considered as a cause of acute urinary retention in the adolescence period. If an adolescent girl presents with abdominal pain and voiding dysfunction, a detailed gynecologic history and appropriate physical examinations of the genital introitus should be performed.

• Journal of Korean Neurosurgical Society
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• v.29 no.7
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• pp.923-928
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• 2000

Objective : The reliability of transcranial doppler sonography(TCD) for predicting delayed ischemic neurologic deficit( DIND) was investigated in patients with aneurysmal subarachnoid hemorrhage(SAH). Methods : The velocity of blood flow through the middle cerebral artery was measured by TCD in 70 patients treated surgically within 72 hours due to ruptured cerebral aneurysm. A correlation between measured maximal mean blood flow velocities and clinical factors including age, hypertension, Hunt-Hess grade, Fisher grade, DIND, and outcome was made. Results : An age-dependent reduction of the measured maximal mean velocities was found(r＝-0.4043, p<0.001). Flow velocities in hypertensive patients were significantly lower than in the normotensive individuals(two-tailed T test, p<0.05). There was no significant difference between the flow velocities and evaluated other clinical factors. When the flow velocities of 14 patients who developed DIND were compared with those of patients without deficits, no significant difference was seen. A significant increase in flow velocities in the days before the onset of DIND was found only in 4 of 14 cases. High flow velocities did not necessarily mean impending neurological deficits : 6 of 70 patients tolerated flow velocities over 160cm/s. Conclusion : We suggest that TCD readings have limited utility for predicting DIND following SAH, especially in older or hypertensive patients. More direct measurements of blood flow are necessary to adequately predict which patients are at high risk of DIND.

• Journal of Korean Neurosurgical Society
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• v.44 no.4
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• pp.205-210
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• 2008

Objective : Aneurysms are very rarely encountered in the distal posterior inferior cerebellar artery (PICA). The authors experienced 5 cases with a distal PICA aneurysm among 368 cases of intracranial aneurysms during the period from January 2003 to January 2008. Here, the authors describe their clinical and surgical experiences and include a review of the relevant literature. Methods : Using radiologic findings and charts, we retrospectively reviewed the surgical results of 5 cases with a distal PICA aneurysm treated from January 2003 to January 2008. Results : The current five cases were composed of four cases of 'Good' and one case of 'Fair'. No postoperative complications occurred other than a ventriculo-peritoneal shunt due to hydrocephalus in Case 2. In all five cases, treatment was successful without neurological deficit. Conclusion : Surgical outcome of PICA aneurysms have been reported to be excellent because the amount of intraparenchymal injury is limited. More clinical experience, microsurgical technique developments, and endovascular surgery advancements are certain to improve treatment outcomes.

• Clinical and Experimental Pediatrics
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• v.58 no.8
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• pp.309-312
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• 2015

Permanent neonatal diabetes mellitus refers to diabetes that occurs before the age of 6 months and persists through life. It is a rare disorder affecting one in 0.2-0.5 million live births. Mutations in the gene KCNJ11, encoding the subunit Kir6.2, and ABCC8, encoding SUR1 of the ATP-sensitive potassium ($K_{ATP}$) channel, are the most common causes of permanent neonatal diabetes mellitus. Sulfonylureas close the $K_{ATP}$ channel and increase insulin secretion. KCNJ11 and ABCC8 mutations have important therapeutic implications because sulfonylurea therapy can be effective in treating patients with mutations in the potassium channel subunits. The mutation type, the presence of neurological features, and the duration of diabetes are known to be the major factors affecting the treatment outcome after switching to sulfonylurea therapy. More than 30 mutations in the KCNJ11 gene have been identified. Here, we present our experience with a patient carrying a novel p.H186D heterozygous mutation in the KCNJ11 gene who was successfully treated with oral sulfonylurea.

• Journal of Korean Neurosurgical Society
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• v.42 no.3
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• pp.228-231
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• 2007

The intracranial hemorrhage in regions remote from the site of initial operations is unusual but may present as fatal surgical complication. We report a rare case of multiple, sequential, remote intracranial hematomas after cranioplasty in a patient who did not have any prior risk factors. A 51-years-old man was transferred to the hospital after a head trauma. The brain computed tomography (CT) revealed acute subdural hemorrhage on the right hemisphere with prominent midline shifting. After performing decompressive craniectomy and hematoma removal, the patient recovered without any complications. However, the patient showed neurological deterioration immediately after cranioplasty, which was done three months after the first surgery. There was extensive hemorrhage in the posterior fossa remote from the site of the initial operation site. The brain CT taken soon after removing this hematoma evacuation displayed large epidural hematoma on the left hemisphere. This case represents posterior fossa hemorrhage after supratentorial procedure and sequential delayed hematoma on the contralateral supratentorial region thus seems very rare surgical complications. Despite several possible pathogenetic mechanisms for such remote hematomas, there are usually no clear cut relationships with each case as in our patient. However, for the successful outcome, prompt evaluation and intensive management seem mandatory.

• Journal of Korean Neurosurgical Society
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• v.40 no.3
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• pp.164-168
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• 2006

Objective : The goal of treatment for spinal cord ependymoma is complete removal without postoperative neurological deficit. The authors analyzed the surgical results and factors influencing the postoperative prognosis. Methods : Fifty-one cases of primary spinal cord ependymoma, surgically treated between 1979 and 2003, were retrospectively analyzed. The mean follow-up period was 44 months. Results : Gross total removal was achieved in 42 patients and incomplete removal in nine. The proportion of complete surgical removals was influenced by tumor location and histology. Disease progression was observed in five cases [9.8%], the mean progression free interval after surgical removal was 48 months and the 5-year progression free rate was 68%. Disease progression was found in none of the 42 cases who underwent complete removal, and in 5 of 9 cases who hadincomplete removal group [P<0.001]. Statistically significant disease-progression factors by multivariate analysis were the surgical extent of removal [P=0.012]. preoperative functional status [P=0.032] the presence of intratumoral cysts [P=0.007] and postoperative radiation therapy [P=0042]. Of those patients who underwent incomplete removal, radiation therapy was found to significantly improve the clinical result [P=0042]. Conclusion : In the surgical treatment of spinal cord ependymoma, preoperative functional status, the presence of intratumoral cysts, the extent of removal, and postoperative radiation therapy were found to be significant prognostic factors of postoperative outcome.

• Journal of Korean Neurosurgical Society
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• v.29 no.9
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• pp.1184-1187
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• 2000

Spontaneous spinal epidural hematoma is rare disease and usually presents with a progressive neurological syndrome for which surgical decompression is usually indicated. The cause of bleeding in epidural hematoma remains unknown in most of the cases. The most frequently identified risk factor is coagulopathy or treatment with anticoagulants. Recently, authors experienced a case of spontaneous spinal epidural hematoma with intraoperative profuse bleeding at the cervicothoracic location. Laboratory examination showed no evidence of coagulopathy or hepatic disease. On neurologic examination, left hemiparesis(Grade : II) and left side sensory change were noted. On MRI scan, there was a mass of high signal intensity in T2WI and isosignal intensity in T1WI compressing the cord to left side. The patients had good surgical outcome after decompressive laminectomy and hematoma removal.

• Journal of TMJ Balancing Medicine
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• v.5 no.sup
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• pp.25-30
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• 2015

Therapeutic effect of Yinyang Balancing Appliance of functional cerebrospinal therapy (FCST) for meridian and neurologic yinyang balance was observed in a lumbar spinal stenosis case. One lumbar spinal stenosis case was managed with the Yinyang Balancing Appliance on temporomandibular joint (TMJ), combined with acupuncture. Clinical outcome measurement was based on subjective measures and clinical observations. The patient showed positive changes even after the initial treatment and this effect maintained over the follow-up period. further clinical and biological research on FCST is expected.

• Journal of TMJ Balancing Medicine
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• v.4 no.1
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• pp.21-26
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• 2014

Therapeutic effect of Yinyang Balancing Appliance of functional cerebrospinal therapy (FCST) for meridian and neurologic yinyang balance was observed in recurrent or habitual type temporomandibular joint (TMJ) dislocation. One Recurrent or habitual type TMJ dislocation case was managed with the Yinyang Balancing Appliance on TMJ, combined with acupuncture. Clinical outcome measurement was based on subjective measures and clinical observations. The patient showed positive changes even after the initial treatment and this effect maintained over the follow-up period. Although it is not clear the effect is sustaining or temporary in its nature, a positive effect was observed and further clinical and biological research on FCST is expected.