• Title/Summary/Keyword: Clinical neurology

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Radionuclide Cisternographic Findings in Patients with Spontaneous Intracranial Hypotension (자발성 두개내 저압 환자의 방사성 동위원소 뇌조조영술 소견)

  • Jung, Dong-Jin;Kim, Jae-Seung;Ryu, Jin-Sook;Shin, Jung-Woo;Im, Joo-Hyuk;Lee, Myoung-Chong;Jung, Sun-Joo;Moon, Dae-Hyuk;Lee, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.6
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    • pp.482-489
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    • 1998
  • Purpose: Radionuclide cisternography may be helpful in understanding pathophysiology of postural head-ache and low CSF pressure in patients with spontaneous intracranial hypotension. The purpose of this study was to characterize radionuclide cisternographic findings of spontaneous intracranial hypotension. Materials and Methods: The study population consists of 15 patients with spontaneous intracranial hypotension. Diagnosis was based on their clinical symptoms and results of lumbar puncture. All patients underwent radionuclide cisternography following injection of 111 to 222 MBq of Tc-99m DTPA into the lumbar subarachnoid space. Sequential images were obtained between 112 hour and 24 hour after the injection of Tc-99m DTPA. Radioactivity of the bladder, soft tissue uptake, migration of radionuclide in the subarachnoid space, and extradural leakage of radionuclide were evaluated according to the scan time. Results: Radionuclide cisternogram showed delayed migration of radionuclide into the cerebral convexity (14/15), increased soft tissue uptake (11/15), and early visualization of bladder activity at 30min (6/10) and 2hr (13/13). Cisternography also demonstrated leakage site of CSF in 4 cases and 2 of these were depicted at 30min. Epidural blood patch was done in 11 patients and headache was improved in all cases. Conclusion: The characteristic findings of spontaneous intracranial hypotension were delayed migration of radionuclide and early visualization of the soft tissue and bladder activity. These scintigraphic findings suggest that CSF leakage rather than increased CSF absorption or decreased production may be the main pathophysiology of spontaneous intracranial hypotension. Early and multiple imaging including the bladder and soft tissue is required to observe the entire dynamics of radionuclide migration.

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National Survey of Sarcoidosis in Korea (유육종증 전국실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.6
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    • pp.453-473
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    • 1992
  • Background: National survey was performed to estimate the incidence of sarcoidosis in Korea. The clinical data of confirmed cases were analysed for the practice of primary care physicians and pulmonary specialists. Methods: The period of study was from January 1991 to December 1992. Data were retrospectively collected by correspondence with physicians in departments of internal medicine, dermatology, ophthalmology and neurology of the hospitals having more than 100 beds using returning postcards. In confirmed and suspicious cases of sardoidosis, case record chart for clinical and laboratory findings were obtained in detail. Results: 1) Postcards were sent to 523 departments in 213 hospitals. Internal medicine composed 41%, dermatology 20%, ophthalmology 20% and neurology 19%. 2) Postcards were returned from 241 departments (replying rates was 48%). 3) There were 113 confirmed cases from 50 departments and 10 cases. The cases were composed from internal medicine (81%), dermatology (13%), ophthalmology (3%) and neurology (3%). 78 confirmed cases were analysed, which were composed from department of internal medicine (92%), dermatology (5%), and neurology (3%). 4) The time span for analysed cases was 1980 to 1992. one case was analysed in 1980 and the number gradually increased to 18 cases in 1991. 5) The majority of patients (84.4%) were in the age group of 20 to 49 years. 6) The ratio of male to female was 1 : 1.5. 7) The most common chief complains were respiratory symptoms, dermatologic symptoms, generalized discomforts, visual changes, arthralgia, abdominal pains, and swallowing difficulties in order. 16% of the patients were asymptomatic. 8) Mean duration between symptom onset and diagnosis was 2 months. 9) The most common symptoms were respiratory, general, dermatologic, ophthalmologic, neurologic and cardiac origin in order. 10) Hemoglobin, hematocrits and platelet were in normal range. 58% of the patients had lymphopenia measuring less than 30% of white cell count. The ratio of CD4 to CD8 lymphocytes was $1.73{\pm}1.16$ with range of 0.43 to 4.62. ESR was elevated in 43% of the cases. 11) Blood chemistry was normal in most cases. Serum angiotensin converting enzyme (S-ACE) was $66.8{\pm}58.6\;U/L$ with the range of 8.79 to 265 U /L. Proteinuria of more than 150 mg was found in 42. 9% of the patients. 12) Serum IgG was elevated in 43.5%, IgA in 45.5%, IgM in 59.1% and IgE in 46.7%. The levels of complement C3 and C4 were in the normal range. Anti-nuclear antibody was detected in 11% of the cases. Kweim test was performed in 3 cases, and in all cases the result was positive. 13) FVC was decreased in 17.3%, FEV1 in 11.5%, FEV1/FVC in 10%, TLC in 15.2%, and DLco in 64.7%. 14) PaO2 was decreased below 90 mmHg in 48.6% and PaCO2 was increased above 45 mmHg in 5.7%. 15) The percentage of macrophages in BAL fluid was $51.4{\pm}19.2%$, lymphocytes $44.4{\pm}21.1%$, and the ratio of CD4 to CD8 lymphocytes was $3.41{\pm}2.07$. 16) There was no difference in laboratory findings between male and female. 17) Hilar enlargement on chest PA was present in 87.9% (bilaterally in 78.8% and unilaterally in 9.1%). 18) According to Siltzbach's classification, stage 0 was 5%, stage 158.3%, stage 228.3%, and stage 38.3%. 19) Hilart enlargement on chest CT was present in 92.6% (bilaterally 76.4% and unilaterally in 16.2%). 20) HRCT was done in 16 cases. The most common findings were nodules, interlobular thickening, focal patchy infiltrations in order. Two cases was normal finding. 21) Other radiologic examinations showed bone change in one case and splenomegaly in two cases. 22) Gallium scan was done in 12 cases. Radioactivity was increased in hilar and mediastinal lymph nodes in 8 cases and in parenchyme in 2 cases. 23) The pathologic diagnosis was commonly performed by transbrochial lung biopsy (TBLB, 47.3%), skin and mediastinal lymph nodes biopsy (34.5%), peripheral lymph nodes biopsy (23.6%), open lung biopsy (18.2%) and bronchial biopsy in order. 24) The most common findings in pathology were non·caseating granuloma (100%), multi-nucleated giant cell (47.3%), hyalinized acellular scar (34.5%), reticulin fibrin network (20%), inclusion body (10.9%), necrosis (9.1%), and lymphangitic distribution of granuloma (1.8%) in order. Conclusion: Clinical, laboratory, radiologic and pathologic findings were summarized. This collected data will assist in finding a test for detection and staging of sarcoidosis in Korea in near future.

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The Reliability and Validity of Patient-Generated Subjective Global Assessment (PG-SGA) in Stroke Patients (뇌졸중 환자에서 '환자 주도적 총체적 영양사정' 도구의 신뢰도 및 타당도 평가)

  • Yoo, Sung-Hee;Oh, Eui-Guem;Youn, Mi-Jung
    • Korean Journal of Adult Nursing
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    • v.21 no.6
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    • pp.559-569
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    • 2009
  • Purpose: This study was to examine the reliability and validity of Patient-Generated Subjective Global Assessment (PG-SGA) as a nutritional measurement for stroke patients. Methods: This was a methodological study performed from May 6 to June 10, 2009 at a tertiary university hospital in Seoul. For reliability of PG-SGA, inter-rater reliability was used for statistics. For concurrent validity, BMI and biomarkers were compared between PG-SGA 0 ~ 8 and ${\geq}$ 9. In addition, sensitivity, specificity, and predictive value of PG-SGA compared with SGA were calculated using a contingency table. For predictive validity, hospital day, complications, and readmission within 1-month after discharge were compared between PG-SGA 0 ~ 8 and ${\geq}$ 9. Results: Correlation of PG-SGA score between two observers was 0.83, and kappa value for the agreement of severe malnutrition was 0.78(all $p_s$ < .001). The scored PG-SGA showed high sensitivity and specificity (100% and 96.7%, respectively). Severe undernourished patients (PG-SGA ${\geq}$ 9) had significantly low TLC, protein, albumin, and prealbumin (all $p_s$ < .01) compared with non-undernourished patients (PG-SGA 0 ~ 8). Also, in severe undernourished patients, complications and readmission (all $p_s$ = 0.01) were more often represented, and hospital days (p = .013) were significantly delayed. Conclusion: PG-SGA is a reliable and valid measurement to assess nutritional status for stroke patients.

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Current situation of Translational research on Acupuncture, Moxibustion and Pharmacopuncture (침구와 약침에 대한 중개연구 현황)

  • Sin, Dae Chul;Song, Ho Sueb
    • Journal of Acupuncture Research
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    • v.33 no.2
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    • pp.109-116
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    • 2016
  • Objectives : Our primary objective lies in understanding the current landscape of translational research on acupuncture, moxibustion and pharmacopuncture. Methods : We searched our own selection of keywords of acupuncture, moxibustion and pharmacopuncture and translational research from three overseas databases (Pubmed, Scopus, Medicine) and four domestic databases (DBpia, KISS, Riss4u, Korea Med). Results : We have chosen 41 articles in total-40 articles on acupunture, 6 article on moxibustion(5 articles were duplicated in use in each category). Origin-wise, 48.8 %/24.8 %/17.0 % of our articles pool came from USA/China/Korea, respectively. UK, Austria, Thailand and Italy contributed the rest of our article pool. For those articles written in USA and China, review articles were the most common type. For the US articles, all 10 review articles were non-systematic reviews, while, for China's contribution, one out of 4 review articles were systematic review. Type-wise, our research pool's breakdown is as follows ; 17 review articles, 11 experimental research, 2 randomized controlled trials(RCT), 1 clinical trial, 4 conference reports, 1 letter, 1 study protocol and 4 uncategorized. Topic-wise, brain-neurology was most frequently referred with 8 articles, followed by parkinson's disease (3 articles) and epilepsy (2 articles). Conclusion : 1. In terms of research submission articles, Korea appears to be lacking translational research on acupuncture, moxibustion and pharmacopuncture, compared to USA and China, in our view. 2. Unlike the cases of USA and China, most of Korean translational research is limited to doing a T1 level of translational research. In order to bring bench-to-bedside to light. we believe, there should be more studies, and thereby a certain level of activation, to the T2 level of translational research in Korea. 3. Further, in our view there should be more efforts to improve article quality at the T1 level of translational research, which eventually becomes the fundamentals of the next level of research (i.e. T2 research), as well as to increase the number of research submissions, going forward.

Roles of microRNA-206 in Osteosarcoma Pathogenesis and Progression

  • Bao, Yun-Ping;Yi, Yang;Peng, Li-Lin;Fang, Jing;Liu, Ke-Bin;Li, Wu-Zhou;Luo, Hua-Song
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3751-3755
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    • 2013
  • Backgroud and Aims: MicroRNA-206 has proven to be down-regulated in many human malignancies in correlation with tumour progression. Our study aimed to characterize miR-206 contributions to initiation and malignant progression of human osteosarcoma. Methods: MiR-206 expression was detected in human osteosarcoma cell 1ine MG63, human normal osteoblastic cell line hFOB 1.19, and paired osteosarcoma and normal adjacent tissues from 65 patients using quantitative RT-PCR. Relationships of miR-206 levels to clinicopathological characteristics were also investigated. Moreover, miR-206 mimics and negative control siRNA were transfected into MG63 cells to observe effects on cell viability, apoptosis, invasion and migration. Results: We found that miR-206 was down-regulated in the osteosarcoma cell line MG63 and primary tumor samples, and decreased miR-206 expression was significantly associated with advanced clinical stage, T classification, metastasis and poor histological differentiation. Additionally, transfection of miR-206 mimics could reduce MG-63 cell viability, promote cell apoptosis, and inhibit cell invasion and migration. Conclusions: These findings indicate that miR-206 may have a key role in osteosarcoma pathogenesis and development. It could serve as a useful biomarker for prediction of osteosarcoma progression, and provide a potential target for gene therapy.

Validation of Nafamostat Mesilate as an Anticoagulant in Extracorporeal Membrane Oxygenation: A Large-Animal Experiment

  • Han, Sung Joon;Han, Woosik;Song, Hee-Jung;Kim, Cuk-Seong;Jeong, Seong-Mok;Kang, Min Woong
    • Journal of Chest Surgery
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    • v.51 no.2
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    • pp.114-121
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    • 2018
  • Background: Unfractionated heparin is commonly used for anticoagulation in extracorporeal membrane oxygenation (ECMO). Several studies have shown that nafamostat mesilate (NM) has comparable clinical outcomes to unfractionated heparin. This study compared anticoagulation with NM and heparin in a large-animal model. Methods: Beagle dogs (n=8; weight, 6.5-9 kg) were placed on venovenous ECMO. Blood samples were taken every hour and the following parameters were compared: hemoglobin level, activated partial thromboplastin time (aPTT), thromboelastography (TEG) data, platelet function, and inflammatory cytokine levels. Results: In both groups, the aPTT was longer than the baseline value. Although the aPTT in the NM group was shorter than in the heparin group, the TEG parameters were similar between the 2 groups. Hemoglobin levels decreased in both groups, but the decrease was less with NM than with heparin (p=0.049). Interleukin $(IL)-1{\beta}$ levels significantly decreased in the NM group (p=0.01), but there was no difference in the levels of tumor necrosis factor alpha or IL-10 between the 2 groups. Conclusion: NM showed a similar anticoagulant effect to that of unfractionated heparin, with fewer bleeding complications. NM also had anti-inflammatory properties during ECMO. Based on this preclinical study, NM may be a good alternative candidate for anticoagulation in ECMO.

Clinical Study on Admission Patients of North Korean Refugees at a Department of Korean Internal Medicine (1개 한방병원 한방내과에 입원한 북한이탈주민 환자에 대한 임상적 분석)

  • Park, So-Im;Cho, A-Ram;Kang, Da-Hyun;Kim, Jin-Won
    • The Journal of Internal Korean Medicine
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    • v.35 no.4
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    • pp.407-415
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    • 2014
  • Objectives: The purpose of this study was to investigate the health status of hospitalized North Korean refugees in a department of Korean internal medicine. Methods: From March 1st, 2011 to June 30th, 2014, 57 North Korean refugee patients were hospitalized 96 times in a department of Korean internal medicine. Their demographic and medical information was approached retrospectively. Results: Among the 57 North Korean refugees, 46 (80.7%) were women, 11 (19.3%) were men and their average age was 49.7. Except for 3 people, the other 54 (94.7%) have been to an outpatient hospital of Department of Western Medicine, National Medical Center. Orthopedics, Neurology and Gastroenterology were most frequently visited and hospitalized. Among the total 96 times of hospitalization in a Department of Korean internal medicine, low back pain was the majority chief complaint. Among the 96, 78 (80.4%) took herbal medicine and tonifying and replenishing formula (補益劑) was most frequently prescribed. As western medication, 32 (33.0%) took ones related to the musculo-skeletal system and 30 (31.0%) took ones related to the nervous system. Qi stasis was highest among 8 types of pattern identification and Deficiency pattern (虛症) was more frequent than Excess pattern (實證). Conclusions: There are several factors that have aggravated the health status of North Korean refugees, and Korean medicine can perform a proper role to improve their health.

The Change of K-MMSE Following Donepezil Medication in Patients with Alzheimer's Disease and Small Vessel Dementia, and the Characteristics of Alzheimer's Disease with Meaningful K-MMSE Change (알쯔하이머병과 소혈관성 치매에서 Donepezil 복용 후 K-MMSE의 변화와 의미 있는 K-MMSE 변화를 보이는 알쯔하이머병 환자의 특징)

  • Kwak, Yong Tae;Han, Il-Woo;Kim, June;Lee, Yu-Sang
    • Korean Journal of Biological Psychiatry
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    • v.12 no.2
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    • pp.98-106
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    • 2005
  • Objectives:Donepezil is a widely used drug for the treatment of patients with Alzheimer's disease(AD). The aim of the present study was to clarify the efficacy and the characteristics of responders to donepezil. Methods:Patients with probable AD(n=80;75.7 years) and small vessel dementia(SVD)(n=18;77.8 years) who received donepezil were retrospectively analyzed using Alzheimer's registry, and three questions were asked:1) Does donepezil therapy improves cognitive symptoms in patients with dementia? 2) If donepezil improves cognitive symptoms, which items of the K-MMSE are improved? 3) What are the characteristics of responder to donepezil medication? Results:1) After donepezil medication, cognitive function measured by the K-MMSE was significantly improved in both types of dementia(AD and SVD), However, statistical differences were not found between these groups. 2) In a clinical trial of donepezil, the patients performed better than before mediation on K-MMSE items assessing orientation, recall, construction, concentration, calculation. 3) In AD, the K-MMSE score before medication was closely related with response of donepezil. Conclusion:This study suggests that donepezil improves various cognitive functions in both types of dementia, and the responsive group had significantly lower K-MMSE scores than the non-responsive group before medication.

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Skull Base Dermoid Cyst in the Right Infratemporal Fossa Diagnosed Using the Dixon Technique: a Case Report and Review of Literature

  • Kim, Seung Jin;Baek, Hye Jin;Ryu, Kyeong Hwa;Choi, Bo Hwa;Moon, Jin Il;Cho, Soo Buem;Park, Sung Eun;Bae, Kyungsoo;Jeon, Kyung Nyeo;Cho, Eun Bin;An, Hyo Jung
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.2
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    • pp.114-118
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    • 2017
  • Dermoid cysts are benign congenital tumors composed of keratinizing squamous epithelium and dermal derivatives. They account for less than 1% of all intracranial tumors and are rarely exhibited at the base of the skull. To the best of our knowledge, only one case report has presented computed tomography and conventional T1-weighted magnetic resonance (MR) findings that revealed an infratemporal dermoid cyst. In the present study, we report an unusual case of a dermoid cyst in the right infratemporal fossa, which was incidentally detected by MR imaging with the Dixon technique. This article also highlights the importance of meticulous radiological review and the usefulness of the Dixon technique in everyday clinical practice.

Study on a Single-Dose Toxicity Test of D-Amino Acid Oxidase (DAAO) Extracts Injected into the Tail Vein of Rats

  • Kang, Jungue;Lee, Eun-Yong;Song, Bong-Keun;Lee, Seung-Deok;Yook, Tae-Han;Ahn, Seong-Hun;Son, Il-Hong;Kim, Sungchul
    • Journal of Pharmacopuncture
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    • v.16 no.2
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    • pp.28-32
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    • 2013
  • Objective: This study was performed to analyze the single-dose toxicity of D-amino acid oxidase (DAAO) extracts. Methods: All experiments were conducted at the Korea Testing & Research Institute (KTR), an institution authorized to perform non-clinical studies, under the regulations of Good Laboratory Practice (GLP). Sprague-Dawley rats were chosen for the pilot study. Doses of DAAO extracts, 0.1 to 0.3 cc, were administered to the experimental group, and the same doses of normal saline solution were administered to the control group. This study was conducted under the approval of the Institutional Animal Ethics Committee. Results: In all 4 groups, no deaths occurred, and the $LD_{50}$ of DAAO extracts administered by IV was over 0.3 ml/kg. No significant changes in the weight between the control group and the experimental group were observed. To check for abnormalities in organs and tissues, we used microscopy to examine representative histological sections of each specified organ, the results showed no significant differences in any organs or tissues. Conclusion: The above findings suggest that treatment with D-amino acid oxidase extracts is relatively safe. Further studies on this subject should be conducted to yield more concrete evidence.