• Title/Summary/Keyword: 중추신경계 질환

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Two Cases of Delirium Induced by Transdermal Scopolamine(Kimite$^{(R)}$) (Transdermal Scopolamine(Kimite$^{(R)}$)으로 인해 유발된 섬망 2례)

  • Woo, Haing-Won;Lim, Weon-Jeong;Lee, Yu-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.241-246
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    • 1999
  • Delirium is a syndrome characterized by impairement of consciousness, disorientation, disturbance of sleep-wake cycle, memory impairement, disturbance of perception. It is induced by many causes, which are CNS diseases(head trauma, vascular disease, brain tumor, etc), medical diseases(metabolic disorder, endocrine disturbance, cardiovascular disease) and drugs(anticholinergics, anticonvulsant, antipsychotics, cimetidine etc). Transdermal scopolamine which is usually used to prevent motion sickness has anticholinergic property, and so it can induce delirium. The authors report two cases of delirium induced by transdermal scopolamine. The cases shared common characteristics which were as follows : 1. All of two patients were elderly women. 2. Delirium symptom was abruptly occurred during trip after attaching scopolamine patches. 3. Delirium symptom was rapidly improved within 2-3 days. It is important to educate for both users and managers about directions for transdermal scopolamine patch usage to prevent delirium. And careful history taking is needed to diagnose delirium induced by transdermal scopolamine accurately.

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ORAL MANIFESTATIONS OF NEUROFIBROMATOSIS TYPE 1: CASE REPORT (제1형 신경섬유종증 환아의 구강내 병소의 치험례)

  • Gwon, Sun-Yeon;Kim, Tae-Wan;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.3
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    • pp.556-561
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    • 2008
  • Neurofibromatosis is an autosomal dominant disorder caused by a mutation of a tumor supressor gene on the long arm of chromosome 17. There are two types of neurofibromatosis, and development of neurofibroma is one of clinical diagnostic criteria for neurofibromatosis. The clinical signs of neurofibromatosis include as skin lesions, bone deformities, and tumors involving central nervous system. About 25% of neurofibromatosis involves oral neurofibroma. Radiographically, oral neurofibroma is well-defined unilocular radiolucency, which involves mandibular canal, mandibular foramen and mental foramen. When a lesion is small and approachable, complete resection, including 1cm of marginal connective tissue, is feasible. However, there are studies reporting that the recurrence rate after surgical resection is high and frequent recurrence may even increase the risk of malignant transformation. This case reports a patient with neurofibromatosis type I, accompanying oral neurofibroma, who shows a favorable result after surgical resection of the oral lesion.

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뇌로의 약물송달(2) -혈액-뇌관문(BBB)의 Osmotic Opening법에 의한 뇌로의 약물송달

  • 황만용;박경호;손영택;이민화
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1993.04a
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    • pp.177-177
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    • 1993
  • 뇌모세혈관내피세포로 구성된 혈액-뇌관문(BBB)은 tight junction으로 구성되어 있을뿐만 아니라 fenestra가 없는 등 BBB가 가진 특성으로 인해 물질 수송에 장벽역할을 하기 때문에 주로 중추신경계 질환시의 약물요법에 많은 제한이 따른다. 따라서 뇌로의 효율적인 약물 송달방법에 대해 많은 연구가 진행중에 있는데 본 연구에서는 BBB의 hyperosmotic opening법을 이용하여 뇌로 잘 수송되지 않는 약물의 뇌송달 방법에 대해 연구하고자 하였다. 먼저 수용성으로 인해 BBB 에 잘 통과하지 않는 물질로 신장 및 뇌영상 촬영시 사용되는 방사성 의약품이 Tc-DTPA를 이용하여, hyperosmotic opening법에 의한 뇌투과 증가정도를 검토하였으며, 실험방법이 확립됨에 따라 뇌암의 항암요법을 위해 뇌로의 투과가 적은 항암제(5-Fluorouracil, 5-FU)의 뇌송달에 대해 본 방법을 적용하여 검토하였다. 실험동물로는 S.D.계 웅성 랫트를 사용하였으며, 실험방법은 다음과 같이 하였다. 랫트의 좌측 외경동맥(left external carotid artery)에 혈류의 역방향으로 혈관 분지점에서 1-2mm 전까지 PE-50 catheter를 삽입하고, 1.6 molal L-(+)- arabinose 고장액(1580mOsm)을 0.12ml/sec의 일정한 속도로 30초간 infusion함으로 BBB를 opening 한 다음, 5분 후에 Tc-DTPA를 대퇴 정맥으로 주사하여 0, 10, 30초, 1, 1.5, 2, 3, 4, 5, 7 및 10분 간격으로 대퇴동맥에 설치한 카테타로부터 혈액을 채취하고 마지막 혈액을 취한 후 즉시 단두하여 뇌를 적출하였다. 채취한 뇌를 액체질소에 담근 후 tissue Tek으로 고정하고 autoradiography를 하기 위한 slice와 농도측정을 위해 필요한 부위를 취한 후 감마카운터로 Tc-DTPA의 brain각 부위별 및 혈장농도를 측정하였다. 뇌조직중 혈액부피의 측정은 Tc-albumin를 이용하여 구하였다. 같은 방법으로 5-FU에 대한 실험도 행하였고, 이때 각 혈장 및 조직중의 5-FU함량은 HPLC로 하였다.

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A Case of Hunter Syndrome Diagnosed at Age of 2.5 Year (2.5세에 진단된 헌터증후군 1례)

  • Choi, Miran;Kwun, Younghee;Jin, Dongkyu;Lee, Jieun
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.2
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    • pp.178-181
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    • 2014
  • Hunter syndrome (mucopolysaccharidosis type II, MPS II) is a X-linked lysosomal storage disease caused by a deficiency in the lysosomal enzyme, iduronate-2-sulfatase (IDS), leading to accumulation of glycosaminoglycans within lysosomes of many organs and tissues. Since the enzyme replacement therapy was approved and available in the treatment of MPS I, II, VI, early diagnosis and early therapy can bring the better prognosis of disease and the better quality of life in patients. We described a 2.5 year old child presented with frequent otitis media and developmental delay including speech impairment, who was diagnosed as Hunter syndrome with IDS NM_000202.5:c. 263G>A(p.Arg88His) mutation.

A Study on the quantitative Evaluation of Spasticity Implementing Pendulum Test (진자실험을 통한 경직의 정량적 평가에 관한 연구)

  • Lim H.K.;Cho K.H.;Kim B.O.;Chae J.M.;Lee Y.S.
    • Journal of Biomedical Engineering Research
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    • v.21 no.3 s.61
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    • pp.303-309
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    • 2000
  • An accurate quantitative biomechanical evaluation for the spasticity caused by the disorder of central nervous system was made in this study. A sudden leg dropper was designed to generate objective testing environment at every trial. 3-dimensional motion analysis system(Elite. B.T.S. Italy) was used to measure kinematic data which were angle. and angular velocity of a lower limb. A program was developed to analyze the kinematic data of lower limb motion. and dynamic EMG data at the same time. To evaluate spasticity quantitatively. total 26 parameters including 14 parameters newly driven were analyzed, and statistical analysis were made for bilateral correlations. Results showed possibility to make accurate quantitative and objective evaluation for spasticity with various new parameters using new devices and program.

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A Case Report of Central Nervous System Disorder Induced Intractable Hiccups Treated with Korean Medicine (중추신경계 질환자에게 이환된 난치성 딸꾹질의 한방치험1례)

  • Moon, Jiseong;Min, Seonwoo;Kim, Yeseul;Park, Jiyoon;Hong, Junghwa;Choi, Dong-jun
    • The Journal of Internal Korean Medicine
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    • v.43 no.2
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    • pp.191-200
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    • 2022
  • Intractable hiccups are those which persist for more than one month and can often occur in patients with disorders of the central nervous system, such as stroke, epilepsy, or brain tumor. An 80-year-old male patient undergoing conservative hemodialysis for diabetic nephropathy, recently developed paralysis and dysphagia due to central nervous system complications including stroke and epilepsy. He was admitted to the ◯◯ Oriental Medicine Hospital, and treated with herbal medicine (Gyulpijugyeo-tang, Jeonssiigong-san, and Ijin-tang) and electrical acupuncture for 30 days. No side effects were observed during hospitalization. The frequency and duration of hiccups were measured daily and found to reduce, and the effect persisted during his admission. The patient took no other nervous system drugs. In conclusion, Korean medicine like gyulpijugyeo-tang and acupuncture can be effective for patients with intractable hiccups who cannot use alternative drugs or treatment, because of other complications.

Relationship Between Cognitive Function and Arterial Blood Gases in Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자의 인지기능과 동맥혈가스와의 상관 관계)

  • Kim, Young-Kyoon;Kwon, Soon-Seog;Kim, Kwan-Hyoung;Han, Ki-Don;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.1
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    • pp.7-14
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    • 1992
  • Background: Cognitive deficit by hypoxia and/or hypercapnia is one of neuropsychological impairments frequently observed in patients with chronic obstructive pulmonary disease (COPD). The degree of cognitive deficit is variable among patients with similar level of hypoxia and/or hypercapnia, although a cause of this individual difference is well not known. COPD can be divided into two characteristic clinical entities including predominant emphysema and predominant bronchitis. This study was designed to evaluate the individual difference in cognitive deficit respond to hypoxia and/or hypercapnia in patients with COPD. Method: Sixteen patients with COPD (9 emphysema-dominant and 7 bronchitis-dominant) participated in this study. On admission arterial blood gas analysis and trail-making B (TMB) test for the evaluation of cognitive function were done in all patients. Mean TMB scores and the correlations between TMB scores and arterial blood gases were compared between two clinical groups. Results: 1) Mean TMB scores and arterial blood gases between two clinical groups were not different. 2) There was a tendency to be higher TMB score in hypoxemia, acidemia, and hypercapnia. However these findings were not statistically significant. 3) In emphysema-dominant group, $PaCO_2$ was mostly well correlated with TMB score (r=0.693). 4) In bronchitis-dominant group, arterial pH was mostly well correlated with TMB score (r=-0.526). Conclusion: Our data suggest that the individual difference in cognitive deficit respond to hypoxia and/or hypercapnia in patients with COPD may be dependent on their clinical entities, and arterial blood gases mostly well correlated with cognitive function that may be different according to their clinical entities.

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Alcohol Use Disorder in Consultation-Liaison Psychiatry (자문 조정의학에서의 알코올 사용 장애)

  • Seo, Jeong-Seok
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.1
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    • pp.15-19
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    • 2011
  • Alcohol is so-called "a magic bullet" affecting on the various organs and central and peripheral nervous systems and causes mental illness as well as physiological and psychological dependence. Also, alcohol problem is related with serious social problems including family violence, suicide, loss of job and crimes. Because alcohol use disorder is a common cause of consultation and liaison in general hospital, we could consider alcohol use disorder of one of psychosomatic disorder. Thus, I reviewed the prevalence, rate of consultation, and general consultant and treatment issues in treating patients with substance use disorder in a psychosomatic medicine.

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Cognitive Impairment in the Patients with Mildly Active Systemic Lupus Erythematosus (경증 전신성 홍반성 루프스 환자의 인지기능장애)

  • Kim, Jin-Hee;Lee, Chul;Lee, Chang-Uk;Paik, In-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.1
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    • pp.89-96
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    • 1997
  • This study was designed to determine whether cognitive impairment was evident in patients with SLE. Also, it aimed to examine the association of cognitive impairment with other clinical variables. The subjects consisted of 20 patients with mildly active SLE and 20 healthy controls. Methods : A total of 20 SLE patients and 20 normal controls completed a computerized neuropsychological test battery using Vienna Test System. These included Cognitrone test, Continuous attention test, Corsi block tapping test, Standard progressive matrices. Also, neuro-behavioral cognitive status examination was done. The symptom severity of depression was measured with Beck Depression Inventory, Hamilton Depression Rating Scale, and current medications were documented. Disease activity was rated using the SLE diasease activity index (SLEDAI). Results : SLE patients had poorer performance than normal controls on the tests of Cognitrone, attention, nonverbal IQ and memory, independent of age, education, disease activity, steroid use and depression status. Conclusion : Cognitive dysfunction was not uncommon in ambulatory SLE patients as measured by standardized neuropsychological tests. It seemed to occur independently of various clinical variables. These findings would suggest that cognitive dysfunction in SLE may be explained by reflecting subclinical central nervous system(CNS) involvement, rather than coexisting psychological distress due to chronic illness or side effect of medication.

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Clinical Manifestation of Children with Failure to Thrive (Failure to Thrive를 주소로 내원한 환아들의 임상상)

  • Moon, Jeong-Hee;Kim, Ji-Young;Beck, Nam-Sun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.68-74
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    • 2000
  • Purpose: This study was to investigate the clinical manifestations of FTT in children. Methods: From March 1997 to July 1999, clinical observations were made on patients with FTT who had visited to Samsung Medical Center. Detailed histories and through physical examinations were taken, and when suspected organic FTT, basic laboratory studies were done. Results: Upon the review of medical records, we investigated the clinical manifestations of 74 children, aged 1 month and 13 year 1 month. The causes of FTT were composed of either physiologic (47.8%) or pathologic (52.2%) ones. Among the physiologic FTT, were there familial short stature (FSS, 14.5%), intrauterine growth retardation (IUGR, 14.5%), constitutional growth delay (CGD, 11.6%), idiosyncrasy and prematurity. Among pathologic causes, neurologic disorders (20%) are the most common causes of FTT, and then follow by GI (13.4%), allergic and infectious disorders in decreasing order. The data showed that average caloric intake in patients with FTT was 76,2% of recommended amount. FTT patients with CGD, IUGR, and idiosyncrasy had tendency to take small foods. The FTT children with prematurity, IUGR and pathologic FTT, were short and thin for their ages. However FTT children with CGD and FSS had tendency to be thin with relatively normal heights for their ages, in comparison with those of the children with prematurity, IUGR and pathologic FTT. Conclusion: The diagnosis of FTT was easily obtained with simple and through medical history, physical examination, and minimal laboratory tests. In this study, organic FTT was more prevalent than physiologic one. This results indicate that early intervention is mandatory, because children may develop significant long-term sequelae from nutritional deficiency.

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