• Title/Summary/Keyword: permanent impairment

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Ameliorating Effects of Cheongnoemyeongsin-hwan on Learning and Memory Impairment Induced by Cerebral Hypoperfusion in Rats (청뇌명신환(淸腦明神丸)이 뇌혈류저하 흰쥐의 학습 및 기억 장애 개선에 미치는 영향)

  • Chang, Suk Hee;Hwang, Won Deuk
    • Herbal Formula Science
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    • v.25 no.1
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    • pp.69-87
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    • 2017
  • Objectives : Cheongnoemyeongsin-hwan (CNMSH) is a herb medicine to treat cognitive impairment. This study was investigated the effects of CNMSH on learning and memory impairment induced by cerebral hypoperfusion. Cerebral hypoperfusion was produced chronically by permanent bilateral common carotid artery occlusion (BCCAO) in rats. Methods : CNMSH was administered orally once a day (250 mg/kg) for 28 days starting at 4th week after the BCCAO. The acquisition of learning and the retention of memory were tested on 9th week after the BCCAO using the Morris water maze. In addition, effect of CNMSH on neuronal apoptosis and ${\beta}-amyloid$ accumulation in the hippocmapus was evaluated with immunohistochemistry and Western blotting. Results : 1. CNMSH and ChAL significantly shortened the escape latencies on the 2nd day of acquisition training trials. 2. ChAL significantly prolonged the swimming time spent in the target and peri-target zones and CNMSH also significantly prolonged the swimming time spent in the peri-target zone. 3. CNMSH and ChAL significantly increased the number of target heading in the retention test. 4. ChAL significantly shortened the time of the 1st target heading in the retention test, but CNMSH insignificantly shortened the time of that. 5. CNMSH and ChAL significantly increased the memory score in the retention test. 6. CNMSH and ChAL significantly attenuated the reduction of CA1 neurons, but insignificantly attenuated the reduction of CA1 thickness. 7. CNMSH and ChAL significantly attenuated the up-regulation of Bax expression in the CA1 of hippocampus. 8. CNMSH and ChAL significantly attenuated the up-regulation of cascapse-3 expression in the CA1 of hippocampus. 9. CNMSH and ChAL significantly attenuated the ${\beta}-amyloid$ accumulation in the CA1 of hippocampus. 10. CNMSH and ChAL significantly attenuated the up-regulation of APP expression in the CA1 of hippocampus. 11. CNMSH and ChAL significantly attenuated the up-regulation of BACE-1 expression in the CA1 of hippocampus. Conclusions : The results show that CNMSH attenuates neuronal apoptosis and ${\beta}-amyloid$ accumulation in the hippocampus and alleviates the impairment of learning and memory produced by chronic cerebral hypoperfusion. These results suggest that CNMSH may be a beneficial medicinal herb to treat cognitive impairment associated with neurodegenerative diseases.

Postthyroidectomy Hypocalcemia (갑상선수술후의 저칼슘혈증)

  • Choi Daeh-Wa;Kim Kyu-Yul;Ko Byung-Kyun;Nam Chang-Woo;Yu Hwa-Kyung;Cho Hong-Rae
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.1
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    • pp.52-60
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    • 1999
  • Objectives: For investigation of the differentiation between transient and permanent hypocalcemia, we focused on a postoperative calcium requirement and an interval of normalization in serum hypocalcemic level and studied for the causes of postoperative hypocalcemia. Material and Method: Postthyroidectomy hypocalcemia was studied in 193 patients who were admitted from January, 1991 to December, 1998 and underwent lobectomy, subtotal thyroidectomy or total thyroidectomy. We compared postoperative serum calcium, phosphate and ionized calcium levels among three groups which were lobectomy, subtotal thyroidectomy and total thyroidectomy, respectively. Result: All patients revealed postoperative decline in serum calcium and ionized calcium, especially, the lowest serum calcium level was seen in 48 hours after surgery. Serum calcium level was returned to normal in five to six postoperative days in most patients. But 24 patients required calcium supplementation due to symptomatic hypocalcemia. In this series, we discovered that the important period for monitoring of serum calcium level was 24 to 96 hours after surgery. If the calcium replacement therapy was not required in the first 72 hours after surgery, it would not be needed during the remainder of the patient's hospital course. Symptomatic transient hypocalcemia was 22 cases(11.4%) and permanent hypocalcemia was 2 cases(1%). Conclusion : We found that hypoalbuminemia, preoperative hyperthyroidism and impairment of blood supply to parathyroid were the main causes of postthyroidectomy hypocalcemia. We also thought that the interval from initial medication to normalization in serum calcium level, and the increase of requirement in calcium and vitamin D were the important factors for differentiation between transient and permanent hypocalcemia.

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Treatment of juvenile rheumatoid arthritis

  • Kim, Kwang-Nam
    • Clinical and Experimental Pediatrics
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    • v.53 no.11
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    • pp.936-941
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    • 2010
  • The systematic approach to pharmacologic treatment is typically to begin with the safest, simplest, and most conservative measures. It has been realized that the more rapidly inflammation is under control, the less likely it is that there will be permanent sequelae. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the mainstay of initial treatment for inflammation. In addition, the slow-acting antirheumatic drugs (SAARDs) and disease-modifying antirheumatic drugs (DMARDs) have efficacy of anti-inflammatory action in children with chronic arthritis. New therapeutic modalities for inflammation, such as etanercept and infliximab, promise even further improvements in the risk/benefit ratio of treatment. It is not typically possible at the onset of the disease to predict which children will recover and which will go on to have unremitting disease with lingering disability or enter adulthood with serious functional impairment. Therefore, the initial therapeutic approach must be vigorous in all children.

Giant Cell Tumor of the Temporal Bone in an Old Patient

  • Paek, Kyung-Il;Kim, Seon-Hwan;Song, Shi-Hun;Kim, Youn
    • Journal of Korean Neurosurgical Society
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    • v.37 no.6
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    • pp.462-465
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    • 2005
  • We report a case of a 67-year-old woman with giant cell tumor of the temporal bone. A 67-year-old woman presented with localized tenderness, swelling, sensory dysesthesia, dizziness, and headache over the left temporal bone. She was neurologically intact except left hearing impairment, with a nonmobile, tender, palpable mass over the left temporal area. A brain computed tomography(CT) scans showed a relatively well defined heterogenous soft tissue mass with multiple intratumoral cyst and radiolucent, osteolytic lesions involving the left temporal bone. The patient underwent a left frontotemporal craniotomy and zygoma osteotomy with total mass removal. Permanent histopathologic sections revealed a giant cell tumor. She remains well clinically and without tumor recurrence at 2 years after total resection.

Neuroprotective Effect of Duloxetine on Chronic Cerebral Hypoperfusion-Induced Hippocampal Neuronal Damage

  • Park, Jin-A;Lee, Choong-Hyun
    • Biomolecules & Therapeutics
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    • v.26 no.2
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    • pp.115-120
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    • 2018
  • Chronic cerebral hypoperfusion (CCH), which is associated with onset of vascular dementia, causes cognitive impairment and neuropathological alterations in the brain. In the present study, we examined the neuroprotective effect of duloxetine (DXT), a potent and balanced serotonin/norepinephrine reuptake inhibitor, on CCH-induced neuronal damage in the hippocampal CA1 region using a rat model of permanent bilateral common carotid arteries occlusion. We found that treatment with 20 mg/kg DXT could attenuate the neuronal damage, the reduction of phosphorylations of mTOR and p70S6K as well as the elevations of $TNF-{\alpha}$ and $IL-1{\beta}$ levels in the hippocampal CA1 region at 28 days following CCH. These results indicate that DXT displays the neuroprotective effect against CCH-induced hippocampal neuronal death, and that neuroprotective effect of DXT may be closely related with the attenuations of CCH-induced decrease of mTOR/p70S6K signaling pathway as well as CCH-induced neuroinflammatory process.

Sudden Infant Death Syndrome and Inborn Metabolic Disorders (유아돌연사증후군과 유전성대사질환)

  • Yoon, Hye-Ran
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.13 no.2
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    • pp.75-80
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    • 2013
  • Specific genetic conditions may lead to sudden unexpected deaths in infancy, such as inborn errors of fatty acid oxidation and genetic disorders of cardiac ion channels. The disease may present dramatically with severe hypoketotic hypoglycemia, Reye syndrome or sudden death, typically with a peak of frequency around 3-6 month, whilst neonatal sudden death is quite rare. When undetected, approximately 20-25% of infants will die or suffer permanent neurologic impairment as a consequence of the first acute metabolic decompensation. Meanwhile, the advent of newborn screening for metabolic diseases has revealed populations of patients with disorders of fatty acid oxidation (FAO), the most frequent of which is medium chain acyl-CoA dehydrogenase (MCAD) deficiency. Without this screening, affected individuals would likely succumb to sudden infant death syndrome (SIDS). Here we describe an overview of sudden infant death syndrome and inherited metabolic disorder.

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Clinical genetics of defects in thyroid hormone synthesis

  • Kwak, Min Jung
    • Annals of Pediatric Endocrinology and Metabolism
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    • v.23 no.4
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    • pp.169-175
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    • 2018
  • Thyroid dyshormonogenesis is characterized by impairment in one of the several stages of thyroid hormone synthesis and accounts for 10%-15% of congenital hypothyroidism (CH). Seven genes are known to be associated with thyroid dyshormonogenesis: SLC5A5 (NIS), SCL26A4 (PDS), TG, TPO, DUOX2, DUOXA2, and IYD (DHEAL1). Depending on the underlying mechanism, CH can be permanent or transient. Inheritance is usually autosomal recessive, but there are also cases of autosomal dominant inheritance. In this review, we describe the molecular basis, clinical presentation, and genetic diagnosis of CH due to thyroid dyshormonogenesis, with an emphasis on the benefits of targeted exome sequencing as an updated diagnostic approach.

Disability Evaluation of the Pain : The Present and Prospect in Korea

  • Lee, Kyeong-Seok;Shim, Jai-Joon;Yoon, Seok-Mann;Doh, Jae-Won;Yun, Il-Gyu;Bae, Hack-Gun
    • Journal of Korean Neurosurgical Society
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    • v.45 no.5
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    • pp.293-296
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    • 2009
  • Objective : Pain has long been regarded as a subjective symptom. Recently, however, some regard a type of intractable chronic pain as a disease. Furthermore, chronic persistent pain becomes a cause of permanent impairment (PI) In 6th edition, the American Medical Association (AMA) Guides has rated the pain as a PI. In Korea, pain has been already been rated as a PI. Here, we examined the present status and the prospect of disability evaluation for the pain in Korea. Methods : Pain can be rated as a PI by the Workmen's Compensation Insurance Act (WCIA) and Patriots and Veterans Welfare Corporation Act (PVWCA) in Korea. We examined the definition, diagnostic criteria and grades of the pain related disability (PRD) in these two acts. We also examined legal judgments, which were made in 2005 for patients with severe pain. We also compared the acts and the judgments to the criteria of the 6th AMA Guides. Results : The PRD can berated as one of the 4 grades according to the WCIA. The provisions of the law do not limit the pain only for the complex regional pain syndrome (CRPS). The PRD can berated as one of the 3 grades by the PVWCA. If there were objective signs such as osteoporosis, joint contracture and muscle atrophy corresponding to the CRPS, the grade is rated as 6. When the pain always interferes with one's job except easy work,the grade is rated as high as 5. In Korea, judicial precedents dealt the pain a sa permanent disability in 2005. Conclusion : Although there were no objective criteria for evaluation of the PRD, pain has been already rated as a PI by the laws or judicial precedents, in Korea. Thus, we should regulate the Korean criteria of PRD like the AMA 6th edition. We also should develop the objective tools for evaluation of the PRD near in future.

Chronic cerebral hypoperfusion and plasticity of the posterior cerebral artery following permanent bilateral common carotid artery occlusion

  • Cho, Kyung-Ok;Kim, Seul-Ki;Kim, Seong Yun
    • The Korean Journal of Physiology and Pharmacology
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    • v.21 no.6
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    • pp.643-650
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    • 2017
  • Vascular dementia (VaD) is a group of heterogeneous diseases with the common feature of cerebral hypoperfusion. To identify key factors contributing to VaD pathophysiology, we performed a detailed comparison of Wistar and Sprague-Dawley (SD) rats subjected to permanent bilateral common carotid artery occlusion (BCCAo). Eight-week old male Wistar and SD rats underwent BCCAo, followed by a reference memory test using a five-radial arm maze with tactile cues. Continuous monitoring of cerebral blood flow (CBF) was performed with a laser Doppler perfusion imaging (LDPI) system. A separate cohort of animals was sacrificed for evaluation of the brain vasculature and white matter damage after BCCAo. We found reference memory impairment in Wistar rats, but not in SD rats. Moreover, our LDPI system revealed that Wistar rats had significant hypoperfusion in the brain region supplied by the posterior cerebral artery (PCA). Furthermore, Wistar rats showed more profound CBF reduction in the forebrain region than did SD rats. Post-mortem analysis of brain vasculature demonstrated greater PCA plasticity at all time points after BCCAo in Wistar rats. Finally, we confirmed white matter rarefaction that was only observed in Wistar rats. Our studies show a comprehensive and dynamic CBF status after BCCAo in Wistar rats in addition to severe PCA dolichoectasia, which correlated well with white matter lesion and memory decline.

Sensory change and recovery of infraorbital area after zygomaticomaxillary and orbital floor fractures

  • Sang Woo, Han;Jeong Ho, Kim;Sug Won, Kim;Sung Hwa, Kim;Dae Ryong, Kang;Jiye, Kim
    • Archives of Craniofacial Surgery
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    • v.23 no.6
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    • pp.262-268
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    • 2022
  • Background: To compare the sensory change and recovery of infraorbital area associated with zygomaticomaxillary and orbital floor fractures and their recoveries and investigate the factors that affect them. Methods: We retrospectively reviewed 652 patients diagnosed with zygomaticomaxillary (n= 430) or orbital floor (n= 222) fractures in a single center between January 2016 and January 2021. Patient data, including age, sex, medical history, injury mechanism, Knight and North classification (in zygomaticomaxillary fracture cases), injury indication for surgery (in orbital floor cases), combined injury, sensory change, and recovery period, were reviewed. The chi-square test was used for statistical analysis. Results: Orbital floor fractures occurred more frequently in younger patients than zygomaticomaxillary fractures (p< 0.001). High-energy injuries were more likely to be associated with zygomaticomaxillary fractures (p< 0.001), whereas low-energy injuries were more likely to be associated with orbital floor fractures (p< 0.001). The sensory changes associated with orbital floor and zygomaticomaxillary fractures were not significantly different (p= 0.773). Sensory recovery was more rapid and better after orbital floor than after zygomaticomaxillary fractures; however, the difference was not significantly different. Additionally, the low-energy group showed a higher incidence of sensory changes than the high-energy group, but the difference was not statistically significant (p= 0.512). Permanent sensory changes were more frequent in the high-energy group, the difference was statistically significant (p= 0.043). Conclusion: The study found no significant difference in the incidence of sensory changes associated with orbital floor and zygomaticomaxillary fractures. In case of orbital floor fractures and high-energy injuries, the risk of permanent sensory impairment should be considered.