• The Journal of Korean Medicine
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• v.23 no.4
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• pp.73-90
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• 2002

Objectives: This study investigated significant factors that influence functional evaluation of stroke so as to be a fundamental data for estimating prognosis of stroke patients. Methods: 204 patients were studied within 7 days of admission, after the diagnosis of stroke through brain CT scan, brain MRI scan and clinical observations. They were hospitalized in the oriental medical hospital of Dongeui University from February to July in 2001. They were examined at the early stage of onset, after 2 weeks, 4 weeks and 6 weeks, and measured for average mark and the degree of improvement by using the Activity Index. Results: Ischemic stroke, past history of stroke, hypertension, diabetes mellitus, risk factor of obesity, non-professional emergency treatment and hospitalizing time after 1 day from onset, high blood pressure, tachycardia pulse and high blood sugar in abnormal vital sign in acute stage, conscious, cognitive or communication disorder, motor aphasia, dysphagia, constipation for more than 3 days, urinary incontinence, visual field defect, insomnia, and chest discomfort in early stage of onset had a negative influence on functional evaluation. Conclusions: Type of stroke, past history, risk factors, emergency treatment and hospitalizing time after onset, abnormal vital sign and intercurrent symptoms in Acute stage were relevant factors in predicting functional evaluation of stroke.

• Clinical and Experimental Pediatrics
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• v.56 no.11
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• pp.500-504
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• 2013

Here we present the case of an 11-year-old female patient diagnosed with Caroli syndrome, who had refractory esophageal varices. The patient had a history of recurrent bleeding from esophageal varices, which was treated with endoscopic variceal ligation thrice over a period of 2 years. However, the bleeding was not controlled. When the patient finally visited the Emergency Department, the hemoglobin level was 4.4 g/dL. Transhepatic intrajugular portosystemic shunt was unsuccessful. Subsequently, the patient underwent percutaneous transhepatic variceal obliteration. Twenty hours after this procedure, the patient complained of aphasia, dizziness, headache, and general weakness. Six hours later, the patient became drowsy and unresponsive to painful stimuli. Lipiodol particles used to embolize the coronary and posterior gastric veins might have passed into the systemic arterial circulation, and they were found to be lodged in the brain, kidney, lung, and stomach. There was no abnormality of the portal vein on portal venography, and blood flow to the azygos vein through the paravertebral and hemiazygos systems was found to drain to the systemic circulation on coronary venography. Contrast echocardiography showed no pulmonary arteriovenous fistula. Symptoms improved with conservative management, and the esophageal varices were found to have improved on esophagogastroduodenoscopy.

• Speech Sciences
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• v.11 no.2
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• pp.27-38
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• 2004

This study attempted to determine the effects of a cooperative and cognitive group therapy compared to individual therapy in 24 aphasic subjects. Two dependent variables were measured overall language performance, functional communication skills. 18 subjects with different types and severity of aphasia participated in the group therapy. 6 aphasic subjects participated in the individual therapy and they functioned as a control group. The subjects were ranged from 27 to 59 years in age. The group therapy using the cooperative learning utilized the following procedures. First, 6 aphasics constituted 1 group where each subject peformed a task and they monitored one another. Second, 2 aphasics consisted 1 group and they cooperated to perform a task. Third, 3 groups with 2 aphasics in a group competed one another in a task where the 2 aphasics had to cooperated. Finally, the investigator gave the feedback to the group and she and the subjects discussed the overall procedures of the therapy. The above mentioned 2 tests were administered pre- and post-treatment. A repeated two-way ANOVA was performed for analysis. The results showed that the group therapy was more effective in improving overall language performance as compared to the individual therapy. And, the group therapy was more effective in increasing functional communication skills as compared to the individual therapy.

• Speech Sciences
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• v.4 no.2
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• pp.91-102
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• 1998

The present study attempted to modify the conventional Melodic Intonation Therapy (MIT) in three aspects: number of syllables of adjacent target utterances (ATU), melody patterns of ATU, and initial listening of melody and intoned speech with the eyes closed. The modified Melodic Intonation Therapy (MMIT) was applied to two severe Korean aphasics. The patients exhibited a severely nonfluent aphasia resulting from a left CVA(Cerebrovascular Accident). The purpose of the modification was to avoid perseveration and improve reflective listening skills. First, the treatment program avoided ATU with the same number of syllables. Second, four different patterns of melody were developed: rising type, falling type, V-type, and inverted V-type. One type of prosodic pattern was preceded and followed by another type of melody. These two variations were to decrease perseverative behaviors. Finally, the patients kept their eyes closed when the clinician played and hummed a target melody at the initial stage of the program in order to improve reflective listening skills. A single-subject alternating treatment design was used. The effects of MMIT were compared to the conventional MIT. Differing the number of syllables and the type of melodic patterns decreased perseverative behaviors and produced more correct names. The initial listening of the target melody with the patients' eyes closed seemed to increase their attentiveness and result in a more fluent production of target utterances. Probable reasons for the effectiveness of MMIT were discussed.

• Journal of Genetic Medicine
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• v.12 no.1
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• pp.19-24
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• 2015

Speech and language are uniquely human-specific traits, which contributed to humans becoming the predominant species on earth. Disruptions in the human speech and language function may result in diverse disorders. These include stuttering, aphasia, articulation disorder, spasmodic dysphonia, verbal dyspraxia, dyslexia and specific language impairment. Among these disorders, stuttering is the most common speech disorder characterized by disruptions in the normal flow of speech. Twin, adoption, and family studies have suggested that genetic factors are involved in susceptibility to stuttering. For several decades, multiple genetic studies including linkage analysis were performed to connect causative gene to stuttering, and several genetic studies have revealed the association of specific gene mutation with stuttering. One notable genetic discovery came from the genetic studies in the consanguineous Pakistani families. These studies suggested that mutations in the lysosomal enzyme-targeting pathway genes (GNPTAB, GNPTG and NAPGA) are associated with non-syndromic persistent stuttering. Although these studies have revealed some clues in understanding the genetic causes of stuttering, only a small fraction of patients are affected by these genes. In this study, we summarize recent advances and future challenges in an effort to understand genetic causes underlying stuttering.

• Annual Conference on Human and Language Technology
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• 2015.10a
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• pp.151-154
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• 2015

실어증은 뇌손상으로 인해 발생하는 후천적 언어장애로서, 언어를 이해하고 표현하는 능력이 손상된 것이다. 이는 환자 개인의 어려움은 물론이고, 가족과 사회에도 문제를 초래할 수 있으므로 실어증 환자의 진단 및 치료는 중요하다. 그 중에서도 빠른 언어 치료는 발병 후 조기에 시작할수록 회복이 빠르다는 점에서 연구 결과들이 일치하고 있기 때문에 더욱 중요하다. 하지만 환자 대비 언어치료전문가의 수가 적어 치료시기를 놓칠 수 있기 때문에 가장 중요한 것은 빠른 실어증 진단과 전문가와의 접근성이다. 우리나라는 인터넷 보급률과 컴퓨터 보급률이 높기 때문에, 웹기반으로 시스템을 개발 한다면 우수한 접근성을 보장받을 수 있다. 본 연구에서는 개발된 '온라인 언어 재활 훈련 및 진단 시스템'을 제안하고 본 시스템을 통해 얻을 수 있는 데이터와, 이 데이터를 어떻게 가공하여 의미 있는 결과를 도출해 낼 수 있는지 소개한다. 본 시스템은 짧은 시간 안에 실어증 여부 확인과 언어 재활 훈련을 수행할 수 있고, 웹기반으로 개발되어 누구나 쉽게 치료와 관련된 콘텐츠, 정보, 그리고 재활 방법을 공유할 수 있다.

• The Journal of Internal Korean Medicine
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• v.22 no.3
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• pp.463-469
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• 2001

Valvular heart disease is one of the main current of cardiac problems and has many problems must be solved by sequelae and complications, etc. Rheumatic Mitral Stenosis is mainly attacked by rheumatic fever and developed by process of treatment of mitral valve or formation of trace. The purpose of this study is to examine the efficacy of oriental treatment for Cerebral Infarction with Rheumatic Mitral Stenosis. At the time of visiting ER, he was shown the symptoms of dull mentality, Rt. hemiplegia, global aphasia, dysphagia, chest discomfort, insomnia, dyspnea, etc, It showed that Atrial fibrillation in EKG monitoring, Atrial fibrillation, Rheumatic Mitral Stenosis, Ejection-Fraction slope 60% in Cardiac echography, Lt. atrial hypertrophy, Rt. atrial hypertrophy, Rt. ventricular hypertrophy with pulmonary congestion in chest X-ray. From the view of oriental diagnostic criteria. We classified the patient's clinical conditions and treated accordingly. As a result of treatment, symptoms were markedly improved and he was discharged. Further elaboration of oriental diagnostic classification could possibly lead to the fundamental treatment.

• Journal of Genetic Medicine
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• v.17 no.2
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• pp.79-82
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• 2020

In epilepsy-aphasia spectrum (EAS) disorders, mutations in the glutamate receptor ionotropic N-methyl-D-aspartate type subunit 2A (GRIN2A) have become important for screening the disease. Research into the phenotypic variability of several types of neurologic impairment involving these mutations is in progress. However, the non-neurological problems related to these mutations are poorly understood. EAS disorders usually have epileptic, cognitive, or behavioral manifestations. In this case report, we present a female patient with epilepsy, delay in expressive language and social development, and intellectual disability with low intelligence quotient and memory quotient, but normal motor development. Through genetic analysis, she was found to have a missense and a nonsense mutation in GRIN2A (c.1770A>C; p.Lys509Asn and c.3187G>T; p.Glu1063∗, respectively) and we consider the nonsense mutation as 'pathogenic variant'. She was also discovered to have congenital hypothyroidism, growth hormone deficiency and Rathke's cleft cyst in the brain, which were previously unknown features of GRIN2A mutation. Our findings should widen understanding of the spectrum of GRIN2A phenotypes, and emphasize the need for more research into the association between GRIN2A mutations and non-neurologic clinical presentations.

• Journal of Trauma and Injury
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• v.37 no.1
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• pp.79-82
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• 2024

The potential for traumatic brain injury resulting from falling coconuts is frequently overlooked. These incidents can cause focal lesions in the form of brain hemorrhage. Corpus callosum hemorrhage due to blunt trauma from a falling object is rare and typically associated with poor prognosis. The purpose of this report is to detail a case of corpus callosum hemorrhage caused by a coconut fall and to discuss the conservative management approach employed. We report the case of a 54-year-old woman who was admitted to the hospital with symptoms of unconsciousness, headache, and expressive aphasia after being struck by a falling coconut. Notably, hemorrhage was detected within the body of the corpus callosum, as revealed by imaging findings. The patient received intensive monitoring and treatment in the intensive care unit, including oxygen therapy, saline infusion, an osmotic diuretic, analgesics, and medication to prevent stress ulcers. The patient demonstrated marked clinical improvement while undergoing conservative treatment. Despite the typically unfavorable prognosis of these rare injuries, our patient exhibited meaningful clinical improvement with conservative treatment. Timely diagnosis and appropriate interventions were crucial in managing the patient's condition. This report emphasizes the importance of considering traumatic brain injury caused by falling coconuts and highlights the need for further research and awareness in this area.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.4
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• pp.429-433
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• 2023

84 years old gentle man with past medical history of hypertension and diabetes presented with sudden onset right sided weakness and aphasia for two hours. Initial neurological assessment revealed National Institute of Health Stroke Scale (NIHSS) 17. Computed tomography (CT) scan demonstrated minimal early ischemic changes along left insular cortex with occlusion of left middle cerebral artery (MCA). Based on clinical and imaging findings, decision was made to perform mechanical thrombectomy procedure. Initially, right common femoral artery approach was utilized. However, due to unfavorable type-III bovine arch, left internal carotid artery could not be engaged via this approach. Subsequently, access was switched to right radial artery. Angiogram revealed small caliber radial artery, with larger caliber ulnar artery. Attempt was made to advance the guide catheter through the radial artery, however significant vasospasm was encountered. Subsequently, ulnar artery was accessed and successful thrombolysis in cerebral infarction (TICI) III left MCA reperfusion was achieved with a single pass of mechanical thrombectomy via this approach. Post procedure neurological examination demonstrated significant clinical improvement. Doppler ultrasound 48 hours after the procedure demonstrated patent flow in radial and ulnar arteries with no evidence of dissection.