• Annals of Clinical Neurophysiology
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• 제16권2호
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• pp.62-69
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• 2014

Background: Neuromodulation therapy has been used to an adjunctive treatment promoting motor recovery in stroke patients. The objective of the study was to determine the effect of repetitive transcranial magnetic stimulation (rTMS) on neurobehavioral recovery and evoked potentials in rats with middle cerebral artery occlusion. Methods: Seventy Sprague-Daley rats were induced permanent middle cerebral artery occlusion (MCAO) stroke model and successful stroke rats (n=56) assigned to the rTMS (n=28) and sham (n=28) group. The 10 Hz, high frequency rTMS gave on ipsilesional forepaw motor cortex during 2 weeks in rTMS group. The somatosensory evoked potential (SSEP) and motor evoked potential (MEP) were used to evaluate the electrophysiological changes. Behavioral function of the stroke rat was evaluated by the Rota rod and Garcia test. Results: Forty rats ($N_{rTMS}=20;\;N_{sham}=20$) completed all experimental course. The rTMS group showed better performance than sham group in Rota rod test and Garcia test at day 11 (p<0.05) but not day 18 (p>0.05). The amplitude of MEP and SSEP in rTMS group was larger than sham group at day 18 (p<0.05). Conclusions: These data confirm that the high frequency rTMS on ipsilesional cerebral motor cortex can help the early recovery of motor performance in permanent middle cerebral artery stroke model and it may simultaneously associate with changes in neurophysiological activity in brain.

• 대한임상검사과학회지
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• 제47권3호
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• pp.153-158
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• 2015

임상병리학과 학생들의 법의학 교육에 대한 인식개선의 방법을 개선하고, 활성화를 위한 방안을 제시할 목적으로 대구지역 대구보건대학교 임상병리학과 학생 100명을 대상으로 설문 조사를 실시하여 법의학 과목에 대한 인식 및 요구도에 대한 항목들을 빈도 분석하였다. 그 결과 대부분의 학생들이 법의학이라는 인식이 많이 높은 수준으로 조사되었다. 100 응답자 중, 법의학대한 인식 질문에 94 (94 %) 그것을 알고 있다고 조사되었으며 법의학에 대한 기대 또한 높게 조사되었다. 현재 임상병리과 학생들에게서는 법의학 교육의 인식 및 교육의 요구도가 매우 높았다. 따라서 대학 교육과정에 임상병리사가 되기 위한 중점과목에만 집중하는 것보다 전문적 영역 확대와 활성화를 위해 법의학 과목을 통해 특히 임상병리사의 취업을 위한 방안으로 소개하는 프로그램의 도입이 필요하다.

• Tuberculosis and Respiratory Diseases
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• 제59권4호
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• pp.427-431
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• 2005

저자들은 점점 진행하는 하지무력증을 주소로 내원한 48세 남자에서 전기생리검사를 시행하여 VGCC 양성인 LEMS를 진단하였고, 동반한 소세포폐암을 진단하여 항암요법을 시행하였고 완치 판정을 받은 후 특별한 치료 없이도 LEMS의 임상증상과 전기생리검사에서 호전을 보인 1예를 경험하였기에 이를 보고하는 바이다.

• 대한의생명과학회지
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• 제15권1호
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• pp.17-23
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• 2009

The prevalence of patent foramen ovale (PFO) in healthy persons was estimated as about $10{\sim}25%$ and was up to 40% in patients with stroke. Transesophageal echocardiography (TEE) was considered to be the most sensitive method to detect PFO and was used as the gold standard. Transcranial doppler sonography (TCD) of the middle cerebral artery (MCA) during a contrast (saline bubble) injection has recently been proposed as an alternative detecting method for PFO. In this study, we would like to know the difference between TCD value and TEE value in subjects with cryptogenic ischemic stroke. We performed TCD and TEE tests to detect PFO on 64 patients (30 women and 34 men, mean age was 59.4 years) with cryptogenic ischemic stroke. PFO prevalence through TCD was 45.3% (29 of 64 patients) and the prevalence through TEE was 34.4% (22 of 64 patients). There was no statistical significance between PFO test and TCD test (P=0.206). But TCD had a sensitivity of 90.9% (20 of 22 patients), specificity of 78.6% (33 of 42 patients), positive predictive value of 69.0% (20 of 29 patients), and negative predictive value of 94.3% (33 of 35 patients). We concluded that TCD was a highly sensitive method for detecting a right-left shunt. Therefore, the non-invasive TCD test is a method more effective than the anti-invasive TEE test in the cost and evaluation of the existence or nonexistence of right to left shunt in addition to the screening method of the cerebrovascular disorder. Considering these points, TCD test could be recommended for patients with cryptogenic ischemic stroke as a useful and convenient method for screening of the existence or nonexistence of a right to left shunt caused by PFO.

• Annals of Clinical Neurophysiology
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• 제16권1호
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• pp.8-14
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• 2014

Background: Early detection of neuropathy may prevent further progression of this complication in the diabetic patients. The purpose of this study was to evaluate the prevalence of early neuropathic complication in patients with newly diagnosed type 1 and type 2 diabetes. Methods: Nerve conduction studies (median, ulnar, posterior tibial, peroneal, and sural nerves) were performed for 49 type 1 (27 males, mean $14.1{\pm}7.5$ years) and 40 type 2 (27 males, $42.0{\pm}14.1$ years) diabetic patients at onset of diabetes. Children with age at onset under 4 years and adults over 55 years were excluded to eliminate the aging effect and the influence of obstructive arteriosclerosis. Neuropathy was defined as abnormal nerve conduction findings in two or more nerves including the sural nerve. Results: Mean HbA1c level was $12.6{\pm}3.3%$ for type 1 and $10.5{\pm}2.9%$ for type 2 diabetes. The prevalence of neuropathy was 12.2% for type 1, and 35.0% for type 2 diabetes, respectively. There were significant trends in the prevalence of neuropathy with increasing age (p<0.05). The effect of the mean level of glycosylated hemoglobin on the prevalence of polyneuropathy at onset of diabetes was borderline (p=0.0532). Neither sex of the patients nor the type of diabetes affected the neurophysiologic abnormalities at the diagnosis. Conclusions: Even in a population with diabetes at the diagnosis, the prevalence of subclinical neuropathy was not low. Neuropathy has been significantly associated with increasing age indicating the possibility of longer duration of undetected diabetes among them, especially in type 2 diabetes.

• Journal of Korean Neurosurgical Society
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• 제62권2호
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• pp.193-200
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• 2019

Objective : Endovascular treatment (EVT) outcomes for acute M2 segment of middle cerebral artery occlusion remains unclear because most results are obtained from patients with large artery occlusion in the anterior circulation. The objective of this study was to assess procedural outcomes for acute M2 occlusion and compare outcomes according to thrombus location (M1 vs. M2). Methods : A systematic review was performed for online literature published from January 2004 to December 2016. Primary outcome was successful recanalization rate and symptomatic intracranial hemorrhage (S-ICH) after the procedure. A fixed effect model was used if heterogeneity was less than 50%. Results : Eight articles were included. EVT showed successful recanalization rate of 69.1% (95% confidence interval [CI], 54.9-80.4%) and S-ICH rate of 6.1% (95% CI, 4.5-8.3%). The rates of good clinical outcome at 3 months and mortality were 59.4% (95% CI, 49.9-68.2%) and 14.9% (95% CI, 11.4-19.3%), respectively. According to thrombus location (M1 vs. M2), successful recanalization (odds ratio [OR], 1.539; 95% CI, 0.293-8.092; p=0.610) and S-ICH (OR, 1.313; 95% CI, 0.603-2.861; p=0.493) did not differ significantly. Good clinical outcome was more evident in M2 occlusion after EVT than that in M1 occlusion (OR, 1.639; 95% CI, 1.135-2.368; p=0.008). However, mortality did not differ significantly according to thrombus location (OR, 0.788; 95% CI, 0.486-1.276; p=0.332). Conclusion : EVT seems to be technically feasible for acute M2 occlusion. Direct comparative studies between EVT and medical treatment are needed further to find specific beneficiary group after EVT in patient with M2 occlusion.

• Journal of Korean Biological Nursing Science
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• 제23권3호
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• pp.227-236
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• 2021

Purpose: The purpose of this study was to investigate the sleep duration, social jetlag (SJL), and subjective sleep disturbance according to the individual chronotype in rotating shift nurses. Methods: A total of 344 rotating 3-shift nurses (mean age 28.67 years) were recruited at one university affiliated hospital. They completed the following questionnaires, which were used to assess their chronotype and sleep: the morningness-eveningness questionnaire (MEQ), self-reported sleep duration of work days (SDW_shift) and free days (SDF_shift) in each shift (day [D], evening [E], night [N]), and sleep disturbance (Insomnia severity index, ISI). SJL_shift was calculated as the difference in midsleep (MS=sleep onset+1/2 sleep duration) between work days (MSW) and free days (MSF). Results: Subjects were divided into 3 chronotype groups according to the MEQ; morning (MG, 4.4%) intermediate (IG, 57.8%), and evening groups (EG, 37.8%). SDW_D was shortest (4.68 hr) and SDF_E was longest (8.93 hr) in the EG. SJL_D was longest in the EG (3.77 hr), and SJL_N was longest in the MG (7.37 hr). The prevalence of sleep disturbance was 33.3% (MG), 29.6% (IG), and 40.0% (EG), respectively, without any statistical significance. Conclusion: In order to improve the sleep of shift workers, it is recommended that the evening chronotypes should reduce the day shifts and the morning chronotypes should reduce the night shifts. We also propose a study to determine whether these shift assignments can improve the sleep in shift nurses.

• Journal of Korean Neurosurgical Society
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• 제65권3호
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• pp.457-468
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• 2022

Objective : The clinical management paradigm of skull base chordomas is still challenging. Surgical resection plays an important role of affecting the prognosis. Endonasal endoscopic approach (EEA) has gradually become the preferred surgical approach in most cases, but traditional transcranial surgery cannot be completely replaced. This study presents a comparison of the results of the two surgical strategies and a summary of the treatment algorithms for skull base chordomas. Methods : We retrospectively analyzed the surgical outcomes and follow-up data of 48 patients with skull base chordomas diagnosed pathologically who received transnasal midline approaches (TMA) and transcranial lateral approaches (TLA) from 2010 to 2020. Results : Among the 48 patients, 36 cases were adopted TMA and 12 cases were performed with TLA. In terms of gross total resection (GTR) rate, 27.8% in TMA and 16.7% in TLA and with EEA alone it was increased to 38.9%, while 29.7% in primary surgery. In TMA, the cerebrospinal fluid (CSF) leak remains the most common complication (13 cases, 36.1%), other main complications included death, cranial nerve palsy, hypopituitarism, all the comparisons were no statistical significance. The Karnofsky Performance Scale scores in TMA were all better than those in TLA at different time, and the overall survival (OS) and recurrence free survival/progression free survival was just the reverse. Conclusion : The EEA for skull base chordomas resection has improved the GTR rate, but transcranial approach is still an alternative approach. It is necessary to select an appropriate surgical approach based on the location and the pattern of tumor growth in order to obtain the best surgical outcomes.

• 정보처리학회논문지:컴퓨터 및 통신 시스템
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• 제12권7호
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• pp.227-234
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• 2023

심호흡을 통해서 심박수 변이를 측정하고, 이를 이용하여 자율신경계를 평가하는 것은 잘 알려진 방법으로 다양한 임상 분야에서 널리 이용되고 있다. 병원에서는 이를 위해서 고가의 장비가 설치되고 전문가에 의해서 운용되고 있다. 논문에서는 스마트폰을 이용하여 언제 어디서나 간편하게 심호흡을 통해서 자율신경계를 테스트할 수 있는 앱을 개발하고, 실험을 통해서 개발된 앱을 검증하였다. 실험은 지원자 8명에 대해서 순천향대학교 천안병원 신경과 임상실에서 진행되었다. 지원자에 대한 자율신경계 테스트를 다음 두 가지 방법으로 진행하였다. 먼저 병원에 설치된 근전도 검사기를 이용하였고, 다음에 동일한 조건에서 개발된 앱을 적용하였다. Pearson 방법을 이용하여 이 두 가지 방법의 실험 결과간에 상관 분석을 수행하였고, 분석 결과는 0.98의 매우 높은 상관관계를 보여준다.

• 동의생리병리학회지
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• 제37권6호
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• pp.165-171
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• 2023

COVID-19 infection heightens the risk of thromboembolism. To see the similarities between the COVID-19 infection and Taeyang blood retention pattern, we conducted a PubMed search using specific terms related to blood circulation issues in the context of COVID-19, summarizing findings from 13 cases and 4 observational studies involving actual patients. Patients with COVID-19 are at risk of blood coagulation due to factors such as viral-induced cytokine storms, vascular endothelial dysfunction, reduced mobility in bedridden or isolated individuals, and resulting constipation. Additionally, cytokine storms and severe inflammation can lead to delirium in COVID-19 patients. The Taeyang blood retention pattern manifests as symptoms arising from delirium and an increased blood coagulation tendency in patients with a robust immune response. According to the Sanghan theory, certain herbal treatments can alleviate symptoms in patients with a tight lower abdomen who do not experience urinary issues. Studies show that components like Persicae Semen and Rhei Redix et Rhizoma in these prescriptions enhance blood circulation and reduce hypercoagulability. Additionally, these treatments aim to promote blood flow by relieving abdominal pressure through facilitating bowel movements. The excessive inflammation and heightened blood coagulation tendency in COVID-19 resemble the Taeyang blood retention pattern, although they are caused by different pathogens. Reinterpreting classical oriental medicine's principles in a modern context may enhance our understanding of traditional East Asian Medicine and foster future developments.