• Journal of Korean Neurosurgical Society
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• v.57 no.2
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• pp.100-107
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• 2015

Objective : To report a minimally invasive treatment option using percutaneous pedicle screw fixation with adjuvant treatment for metastatic thoraco-lumbar and lumbar spinal tumors. Methods : This is a retrospective study of charts of patients with spinal metastases. All were older than 18 years of age and were considered to have more than 3 months of life expectancy. The patients had single or two level lesions, and compression fracture or impending fracture. Exclusion criterion was metastasis showing severe epidural compression with definite neurological symptoms. Usually spinal segments from one level above to below pathology were stabilized. Visual analog scale (VAS) score for pain assessment and Frankel scale for neurological deficit were used, while pre- and post-operative performance status was evaluated using the Eastern Cooperative Oncology Group (ECOG). Results : Twelve patients (nine men, three women; median age 54.29 years) underwent surgery. All patients presented with back pain with/without radicular pain. There were no early complications and perioperative mortalities. Following surgery, a significant difference between average pre- and post-operative VAS scores was found (p=0.003). Overall, 91.8% of patients (11/12) experienced improvement in their ECOG score post-operatively. The mean ambulation time was 196.9 days [95% confidence interval (CI), 86.2-307.6 days; median, 97 days]. During follow-up, nine patients died and the mean overall survival time in enrolled twelve patients was 249.9 days (95% CI, 145.3-354.4 days; median, 176 days). Conclusion : Minimally invasive treatment using percutaneous pedicle screw fixation with adjuvant treatment is a good alternative treatment option for potential instability of the thoraco-lumbar and lumbar spinal metastasis.

• Journal of Korean Neurosurgical Society
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• v.43 no.1
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• pp.5-10
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• 2008

Objective : To evaluate the surgical outcomes of ventral interbody grafting and anterior or posterior spinal instrumentation for the treatment of advanced spondylodiscitis with patients who had failed medical management. Methods : A total of 28 patients were evaluated for associated medical illness, detected pathogen, level of involved spine, and perioperative complications. Radiological evaluation including the rate of bony union, segmental Cobb angle, graft- and instrumentation-related complications, and clinical outcomes by mean Frankel scale and VAS score were performed. Results : There are 14 pyogenic spondylodiscitis, 6 postoperative spondylodiscitis, and 8 tuberculous spondylodiscitis. There were 21 males and 7 females. Mean age was 51 years, with a range from 18 to 77. Mean follow-up period was 10.9 months. Associated medical illnesses were 6 diabetes, 3 pulmonary tuberculosis, and 4 chronic liver diseases. Staphylococcus was the most common pathogen isolated (25%), and Mycobacterium tuberculosis was found in 18% of the patients. Operative approaches, either anterior or posterior spinal instrumentation, were done simultaneously or delayed after anterior aggressive debridement, neural decompression, and structural interbody bone grafting. All patients with neurological deficits improved after operation, except only one who died from aggravation as military tuberculosis. Mean Frankel scale was changed from $3.78{\pm}0.78$ preoperatively to $4.78{\pm}0.35$ at final follow up and mean VAS score was improved from $7.43{\pm}0.54$ to $2.07{\pm}1.12$. Solid bone fusion was obtained in all patients except only one patient who died. There was no need for prolongation of duration of antibiotics and no evidence of secondary infection owing to spinal instrumentations. Conclusion : According to these results, debridement and anterior column reconstruction with ventral interbody grafting and instrumentation is effective and safe in patients who had failed medical management and neurological deficits in advanced spondylodiscitis.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.5
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• pp.3293-3302
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• 2015

This study was conducted to identify families' perception and attitude toward application of physical restraint(PR) in general neurological wards. The study is based on subjects from 70 family members who have cared patients applying PR. Data was collected using self-report questionnaires and reviewing of patients' medical records. 68.6% of subjects were female and the mean age was 47.9 years old. Family members were either sons, daughters or spouses. The questionnaires analyzed families' perceptions based on a score of 5, the results showed a mean score of 4.2, and items related to maintaining therapeutic tools scored the highest. The application of PR with two hands was perceived by families as more important than PR applied with one hand. In families' attitude toward PR, there was general agreement that families had the right to decide to apply and remove PR. Continuous education and information regarding PR is required to support families.

• The Journal of Internal Korean Medicine
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• v.39 no.6
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• pp.1313-1320
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• 2018

Objectives: This case study reports on the effects of Korean medicine on a corticobasal syndrome with apraxia. Methods: We used acupuncture, bee-venom, pharmaco-acupuncture and herbal medicine to treat a corticobasal syndrome patient during hospitalization for 32 days. We observed changes in the UPDRS score, hand movement by opening and closing of hands, the making of a tower with 10 blocks and writing. Results: The hand movement count was improved from 2 to 10. The time needed for making a tower with 10 blocks decreased from 68 to 50 sec, and the number of stroke when writing the Korean word '철' decreased. In addition, the UPDRS score was decreased after treatment from 27 to 24. Conclusion: This clinical case study suggests that Korean medicine treatment could be used in the treatment of corticobasal syndrome.

• Journal of Acupuncture Research
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• v.36 no.3
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• pp.140-146
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• 2019

Background: This study investigated the effects of Vipera lebetina turanica snake venom (SV) on cerebral infarction induced by middle cerebral artery occlusion in mice. Methods: Following cerebral infarction, SV was injected intravenously or added to BV2 cell culture. Tissue injury was detected using triphenyltetrazolium chloride (TTC) staining, neurological deficit score, NO, ROS, and GSH/GSSG assays, qPCR, Western blot, and cell viability. Results: Cerebral infarction caused by middle cerebral artery occlusion as observed by TTC staining, showed SV inhibited cell death, reducing the number of brain cells injured due to infarction. SV treatment for cerebral infarction showed a significant decrease in abnormal behavior, as determined by the neurological deficit score. The oxidation and inflammation of the cells that had cerebral infarction caused by middle cerebral artery occlusion (NO assay, ROS, GSH/GSSG assay, and qPCR), showed significant protection by SV. Western blot of brain infarction cells showed the expression of iNOS, COX-2, p-IkB-${\alpha}$, P38, p-JNK, p-ERK to be lower in the SV group. In addition, the expression of IkB increased. BV2 cells were viable when treated with SV at $20{\mu}g/mL$ or less. Western blot of BV2 cells, treated with 0.625, 1.5, $2.5{\mu}g/mL$ of SV, showed a significant decrease in the expression of p-IkB-${\alpha}$, p-JNK, iNOS, and COX-2 on BV2 cells induced by LPS. Conclusion: SV showed anti-inflammatory and anti-oxidant effects against cerebral infarction and inflammation.

• The Journal of the Society of Stroke on Korean Medicine
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• v.19 no.1
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• pp.31-40
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• 2018

■ Objectives The purpose of this case study is to report the effectiveness of Korean medicine in the treatment of chronic hyperhidrosis. ■ Methods The patient was diagnosed as a Soeumin Mang-yang Syndrome, and treated with Korean medical treatment such as Sungyangikgibuja-tang and acupuncture treatment. The severity of symptom was assessed using Numerical Rating Scale (NRS) and follow-up of Hyperhidrosis Quality of Life Index (HidroQOL) ■ Results After treatment, the severity of hyperhidrosis was decreased from NRS 10 to NRS 2, HidroQOL score was also decreased from 32 to 19. ■ Conclusion Korean medical treatment for hyperhidrosis was effective in decreasing the NRS and HidroQOL score. The results suggest that Korean medical combined treatment including Sungyangikgibuja-tang and acupuncture treatment can be a effective option for treating hyperhidrosis.

• Journal of Trauma and Injury
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• v.29 no.4
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• pp.151-154
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• 2016

Purpose: To evaluate the association between time to surgery and injury severity score (ISS). Methods: Medical charts and records were reviewed for polytrauma patients who underwent trauma surgery from November 2014 to March 2016. The patients were divided into two groups based on the ISS. Results: Among the 217 operated patients, 22 patients underwent first and second surgery. The patients with an ISS over 17 (mean 13.0 days) had a longer interval between surgeries than patients with an ISS of 17 or less (mean 7.5 days) (p=0.031). One hundred and twenty-one patients only underwent elective surgery and there is a positive correlation between ISS and time to elective surgery (p<0.028, Pearson's correlation coefficient=0.224). Seventy-four patients underwent emergent surgery only. Among these, the patients with an ISS of 17 or less underwent general surgery (86%) but the patients with an ISS more than 17 underwent neurological surgery (47%). Conclusion: Patients with high ISS need critical care during the preoperative and postoperative period.

• Journal of Korean Neurosurgical Society
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• v.42 no.3
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• pp.191-194
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• 2007

Objective : Homeless patients probably have epidemiologic features that are different from those of general population. However, there have been no published articles about clinical characteristics of neurosurgical homeless patients. The authors tried to assess the clinical characteristics and treatment outcome of homeless neurosurgical patients. Methods : We retrospectively reviewed the medical records and radiological films of 76 homeless patients and 72 non-homeless patients following head trauma who were admitted to our neurosurgical department between June 2001 and June 2005. We compared two groups of the patients with the demographics, the clinical and laboratory characteristics. Also, 3D-day mortality was determined according to Glasgow Coma Scale (GCS) score. Results : Age of homeless patients was younger than that of non-homeless patients. Homeless patients had previous craniotomy evidences in skull x-rays more frequently (10.5% vs. 1.4%). Acute subdural hematoma was the most common type of head injury in the two groups. Moderate and severe head injury, based on GCS score on admission was more frequent in homeless patients (64% vs. 39%). Fifty percent of homeless patients underwent operation for traumatic head injury. However, 3D-day mortality according to GCS score was not significantly higher in homeless patients. Conclusion : Most homeless neurological patients were relatively young men. Also, moderate or severe brain injuries were observed more frequently. However, mortality rate of homeless patients in neurosurgical field is not significantly higher in the present study.

• The Journal of Korean Physical Therapy
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• v.27 no.6
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• pp.381-385
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• 2015

Purpose: This study was to identify the relationship between the game score and muscle strength in order to elucidate whether the obtained score for the dorsiflexor and plantar flexor muscles in the ankle joint using an EMG-based interactive game system can reflect muscle strength as measured conventionally. Methods: Forty adults were enrolled in the present study. They had no congenital deformities, and no neurological or orthopedic disorders in the 6 months prior to the start of the study. The Biodex were used to measure the isokinetic concentric maximal strength of the plantar flexor and dorsiflexor muscles in the ankle joint. EMG electrodes were attached to the tibialis anterior and gastrocnemius. Results: (1) There was a positive relationship between the obtained game score by the plantar flexor (sPF) and muscle strength of the plantar flexor (tPF) and dorsiflexor (tDF). In addition, the tPF affected the sPF, but the tDF did not. Thus, the higher the tPF, the higher the sPF. (2) There was no relationship between the obtained game score of dorsiflexor (sDF) and tPF or tDF. In addition, neither the tDF or tPF affected the sDF. Conclusion: The game score had a relationship with muscle strength, which is related to ankle instability and re-impairment. Thus we suggest that this game system can be used to predict the degree of weakness of muscle strength.

• Journal of Korean Neurosurgical Society
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• v.30 no.1
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• pp.12-19
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• 2001

Objective : Albumin is a very useful drug for the improving of cerebral blood volume and the oncotic effect in cerebral ischemia or cerebral vasospasm. The purpose of this study was to examine the morphological and neurological effect of albumin therapy on reperfusion injury following transient focal cerebral ischemia. Materials and Methods : 18 Male Sprague-Dawley rats weighing 270-320g were used. The ischemia model was produced by 2-hour period of transient middle cerebral artery occlusion with a poly-L-lysin coated intraluminal suture. The agent(20% human serum albumin[HSA]) or control solution(NaCl 0.9%) was administered intravenously at a dosage of 1% of body weight immediate after reperfusion following a 2-hour period occlusion. Neurological function was evaluated by the postural reflex and the forlimb placing test during occlusion(at 60 min) and daily for 3 days thereafter. The brain was perfusion-fixed, and infarct volumes and brain edema were measured. Results : The HSA significantly improved the neurological score in treated group. The rats of albumin treatment group showed significantly reduced total infarct volume(by 34%) and brain edema(by 81%) compared with salinetreated rats. Conclusion : HSA showed a substantial effect on the transient focal cerebral ischemia and reperfusion injury model. These results may indicate its usefulness in treating reperfusion injury patients after thrombolysis treatment for the thrombo-embolic major cerebral artery occlusions.