• Journal of Korean Clinical Nursing Research
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• v.22 no.1
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• pp.46-55
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• 2016

Purpose: The purpose of this study was to describe performance and education needs related to neurologic assessment by neurologic ward nurses. Methods: The study was conducted with a cross-sectional descriptive design. Participants, 297 neurologic ward nurses working in ten major hospitals in Seoul and Gyeonggi were surveyed from September 7 to October 1, 2015. Results: The mean score for performance of neurologic assessments was 3.04 points. Performances performed with high quality were orientation exam, mental status documentation, and muscle strength of extremities in that order. Performances performed with low quality were assessment of accessory nerves, hypoglossal nerves, and cerebellum function in that order. There were significant differences according to whether there was ward education programs on neurologic assessment and teaching experiences within a year. These variables significantly affected the quality of neurologic assessment performance. The need for neurologic assessment training was 3.14 points. Conclusion: Amount of performance and demand for education on neurologic assessment, which are required in the clinical setting, were significantly high. To perform neurologic assessments with high quality, development of education program for neurologic assessment and continuous education courses are required at either the department or neurological nursing organization level.

• Journal of Chest Surgery
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• v.39 no.11 s.268
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• pp.875-878
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• 2006

A 39-year-old man presented with a esophageal submucosal tumor on regular check up examination. Preoperative exams showed the typical submucosal tumor as leiomyoma and operative procedure was enucleation for complete resection. Postoperative pathologic diagnosis including histologic and immunohistochemical study was compatible with plexiform schwannoma. Plexiform schwannoma is one of the least common variant of schwannoma that typically shows a plexiform or multinodular pattern. To our knowledge, there is rare case report of plexiform schwannoma originating in the esophagus and we report ore case with related literature.

• Proceedings of the Korean Society of Computer Information Conference
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• 2019.01a
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• pp.397-398
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• 2019

망막혈관 영상에서(retinal image) 혈관의 모양 또는 생성변화를 효과적으로 검진하기 위해서 망막혈관을 자동적으로 분리하는 영상분할 기법의 개발은 매우 중요한 사안이다. 이를 위해서 주로 망막혈관영상의 잡음을 억제하고 또한 혈관의 명암대비도(contrast)를 증가시키는 전처리 과정을 거쳐서 혈관의 국부적인 화소값의 변화, 방향성을 판별하여 혈관을 자동적으로 검출하는 방법들이 제시되어왔으며 최근에는 합성곱 신경망(CNN) 딥러닝 학습모델을 활용한 망막혈관 분리 알고리즘들이 제시되고 있다.

• Neonatal Medicine
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• v.18 no.2
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• pp.399-403
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• 2011

Brain abscesses in neonates are extremely rare and usually occur in patients with certain risk factors. A 1-month-old boy presented at the hospital with fever and irritability. As a result of preterm delivery and low birth weight, he had a history of admission to the neonatal intensive care unit. Neuroimaging revealed a large, space-occupying lesion in both frontal lobes, which was suspected to be an abscess with the midline shifting to the right. With a single aspiration and abscess drainage along with concurrent prolonged parenteral antibiotic therapy, the patient showed an excellent treatment outcome with normal development. The focus will be placed on minimally invasive surgical management as well as positive outcomes.

• Proceedings of the KSLP Conference
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• 2003.11a
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• pp.174-175
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• 2003

후두기능의 전기생리학적 특징에 대한 관심은 1940년대부터 시작되어 1950년대와 1960년대에는 유럽 및 일본에서 Faborg-Anderson, Hirano 등이 후두근전도의 임상적 적용에 대해서 보고한바 있으며, 1970년대부터는 미국에서도 Bleir, Miller등이 후두근전도의 임상적 역할에 대해 보고하고 있다 이와 같이 후두근전도가 임상에 도입된 지 오래되었고 신경후두학 분야에서 후두근육의 전기생리상태를 알 수 있는 아주 중요한 진단도구이나 아직까지 후두근전도는 양적인 평가가 가능한 표준화된 검사는 아니고 내시경이나 방사선학적 검사처럼 경험이 있는 의사에 의해 판독되어지는 검사로 음성장애가 있는 모든 환자에서 집단검진(screening test)으로 이용될 수 있는 검사도구는 아니다. 후두근전도가 임상에서 유용하게 이용되고 있는 질환은 성대운동 장애와 연축성 음성장애이다. 최근 성대운동 장애에 대한 다양한 수술방법이 개발되면서 수술 방법 및 시기 결정, 예후측정에 후두근전도의 이용이 필수적이 되었으며 또한 연축성 음성장애 환자에서 어떤 후두 근육에 botulinum toxin을 주사할 지를 결정하는 데 이용하고 있다. 이번 강의에서는 위 두 가지 질환을 중심으로 후두근전도의 임상적 유용성을 살펴보기로 하겠다.

• Journal of Korean Society of Spine Surgery
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• v.25 no.4
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• pp.169-174
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• 2018

Study Design: Case report. Objectives: We report a case of pure epidural cavernous hemangioma located at the thoracolumbar spine in a 53-year-old woman that mimicked a neurogenic tumor on magnetic resonance imaging (MRI). Summary of Literature Review: A pure spinal epidural cavernous hemangioma without bony involvement is a very rare lesion about which limited information is available in the literature. Materials and Methods: A 53-year-old woman visited our clinic for hypoesthesia with a tingling sensation in the left anterolateral thigh that had begun a month ago. No other neurologic symptoms or signs were present upon a neurologic examination. MRI from an outside hospital showed a $2.0{\times}0.5cm$ elongated mass at the T11-12 left neural foramen. The tumor was completely removed in piecemeal fashion. Results: The histopathologic examination revealed a cavernous hemangioma, which was the final diagnosis. The outcome was favorable in that only operation-related mild back pain remained, without any neurologic deficits, after a postoperative follow-up of 2 years and 3 months. No recurrence was observed on MRI at 2 years postoperatively. Conclusion: Pure epidural spinal cavernous hemangioma is very rare, and it is very difficult to differentiate from other epidural lesions. However, we believe that it should be included in the differential diagnosis of spinal epidural tumors due to its favorable prognosis.

• Journal of the Korean Orthopaedic Association
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• v.55 no.6
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• pp.534-539
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• 2020

The management of severe scoliosis remains a challenge to spine surgeons. The rapid intraoperative correction of severe scoliosis may increase the risk of perioperative complications, such as neurological compromise and implant failure. To minimize these risks, various preoperative traction methods have been employed to achieve partial correction before performing definitive corrective surgery. On the other hand, some studies have shown that one of the complications associated with halo traction could lead to cranial nerve palsy, with the sixth nerve (abducens nerve) being most commonly affected. To reduce the complications, gradual increases in the traction weight and detailed neurological examinations are needed, particularly for patients who have previously undergone brain or cervical surgery. The authors report a case of sixth cranial nerve palsy by preoperative halo-pelvic traction in patients with severe scoliosis who underwent previous decompression surgery for a Chiari I malformation with a review of the relevant literature.

• Journal of Genetic Medicine
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• v.7 no.2
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• pp.145-150
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• 2010

Acrodysostosis is an extremely rare disorder characterized by short fingers and toes with peripheral dysostosis, nasal hypoplasia, and mental retardation. We report a 16-year-old Korean boy with acrodysostosis who had characteristic clinical features and cervical spine stenosis manifested by neurologic symptoms. On presentation, he complained of difficulty in raising his arms, and suffered from intermittent pain and weakness in both upper extremities. He had short stature and dysmorphic facial features, including a broad, depressed nasal bridge, small, upturned nose, bilateral epicanthal folds, and mild hypertelorism. Moderate mental retardation and sensorineural hearing loss in both ears were also present. Radiological findings included broad, short metacarpals and phalanges with cone-shaped epiphyses, bilateral Madelung deformities, hypertrophied first metatarsals, and thickening of the calvarium. Magnetic resonance imaging findings included stenosis of the cervical spine, platybasia with compression into the cervicomedullary junction, and downward displacement of the cerebellar tonsils. Here, we report a case of acrodysostosis with symptoms and signs of cervical spinal stenosis first in Korea. If it is diagnosed in the early stages, possible life-threatening complications, including spinal canal stenosis, can be managed properly and permanent neurologic sequelae might be avoided. Therefore, it is important to consider acrodysostosis in the differential diagnosis of peripheral dysostosis.

• Clinical and Experimental Pediatrics
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• v.49 no.11
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• pp.1158-1166
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• 2006

Purpose : The purpose of this study is to make a diagnostic classification and discuss a diagnostic strategy of floppy infants by investigating clinical, neurological, electrophysiological, and genetic analysis of infants admitted to intensive care units with the complaint of hypotonia. Methods : A retrospective study was performed from Jan. 1993 to Dec. 2005 in neonatal and pediatric intensive care units of Seoul National University Children's Hospital. Clinical features and all tests related to hypotonia were investigated. Results : There were 21 cases of floppy infants admitted to intensive care units. Final diagnosis was classified as centra (7 cases[33.3 percent]), peripheral (11 cases [52.4 percent]), and unspecified (3 cases [14.3 percent]). Among the central group, three patients were diagnosed as hypoxic ischemic encephalopathy, two patients as Prader-Willi syndrome, one patient as chromosomal disorder, and one patient as transient hypotonia. Among the peripheral group, four patients were diagnosed as myotubular myopathy, three patients as SMA type 1, two patients as congenital myotonic dystrophy, one patient as congenital muscular dystrophy, and one as unspecified motor-neuron disease. Motor power was above grade 3 on average, and deep tendon reflex was brisk in the central group. Among investigations, electromyography showed 66 percent sensitivity in the peripheral group, and muscle biopsy was all diagnostic in the peripheral group. Brain image was diagnostic in the central group, and Prader-Willi FISH or karyotyping was helpful in diagnosis in central group. Morbidity and mortality was more severe in the peripheral group Conclusion : Classification of diagnosis by clinical characteristics in this study, and application of investigations step by step, may provide an effective diagnostic strategy.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.19 no.1
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• pp.20-25
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• 2019

Very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency (OMIM#201475) is an autosomal recessively inherited metabolic disorder of mitochondrial long-chain fatty acid oxidation. The clinical features of VLCAD deficiency is classified by three clinical forms according to the severity. Here, we report a case of later-onset episodic myopathic form of VLCAD deficiency whose diagnosis was confirmed by plasma acylcarnitine analysis and" multigene panel multigene panel sequencing. A 34-year old female patient visited genetics clinic for genetic evaluation for history of recurrent myopathy with intermittent rhabdomyolysis. She suffered first episode of rhabdomyolysis with acute renal failure requiring hemodialysis at twelve years old. After then, she suffered several times of recurrent rhabdomyolysis provoked by prolonged exercise or fasting. Physical and neurologic exam was normal. Serum AST/ALT and creatinine kinase (CK) levels were mildly elevated. However, according to her previous medical records, her AST/ALT, CK were highly elevated when she had rhabdomyolysis. In suspicion of fatty acid oxidation disorder, multigene panel sequencing and plasma acylcarnitine analysis were performed in non-fasting, asymptomatic condition for the differential diagnosis. Plasma acylcarnitine analysis revealed elevated levels of C14:1 ($1.453{\mu}mol/L$; reference, 0.044-0.285), and C14:2 ($0.323{\mu}mol/L$; 0.032-0.301) and upper normal level of C14 ($0.841{\mu}mol/L$; 0.065 -0.920). Two heterozygous mutation in ACADVL were detected by multigene panel sequencing and confirmed by Sanger sequencing: c.[1202G>A(;) 1349G>A] (p.[(Ser 401Asn)(;)(Arg450His)]). Diagnosis of VLCAD deficiency was confirmed and frequent meal with low-fat diet was educated for preventing acute metabolic derangement. Fatty acid oxidation disorders have diagnostic challenges due to their intermittent clinical and laboratorial presentations, especially in milder late-onset forms. We suggest that multigene panel sequencing could be a useful diagnostic tool for the genetically and clinically heterogeneous fatty acid oxidation disorders.