• Title/Summary/Keyword: Clinical neurology

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A Study of Jowiseungchungtang in patients with mild Dementia of Alzheimer type (조위승청탕(調胃升淸湯)이 초기 Dementia of Alzheimer type 환자의 인지기능 변화에 미치는 효과)

  • Cho, Seung-Hun;Kim, Jong-Woo;Kim, Hyun-Taek;Chung, Kyung-Chun;Whang, Wei-Wan
    • Journal of Oriental Neuropsychiatry
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    • v.14 no.1
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    • pp.17-26
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    • 2003
  • Objective : The clinical efficacy of Jowiseungchungtang(oriental herbal medication) over 6-month on the cognitive function in patients with mild Dementia of Alzheimer type(DAT) was investigated in this study. Method : The subjects for this study consisted of dementia patients who visited to the outpatient dementia department of Oriental Neuropsychiatry of the Kyunghee Oriental hospital. Patients were required to have at entry: a dignosis of mild DAT; Biochemical test, CBC, Urine analysis, Chest X -ray, EKG, Brain- MRI, Mini-Mental States-Korea(MMSE-K), Korean-Dementia Rating Scale(K-DRS), Samsung Dementia Questionaire(SDQ;to their caregiver). Patients(n=31) were assigned to treatment with Jowiseungchungtang (fourth/day for 6-month). The primary outcome measure was K-DRS. Result : 1. Patients' mean age was $71.4{\pm}6.6$ years(range 59 to 86 years). 2. Patients' mean education was $6.1{\pm}4.9$ years. K-DRS scores at baseline was $110.5{\pm}12.2$. K-DRS scores at 6-month was $109.0{\pm}17.0$. K-DRS scores at 6-month was not significantly different with K-DRS scores at baseline(t=.791 r=.435 p<.05). Conclusion : Treatment with Jowiseungchungtang for 6-month protected the cognitive function decline in patients with mild DAT.

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Electrodiagnostic study of Sympathetic Skin Response on Normal Korean Subjects

  • Kim, Dae-Sik;Yoo, Jong-Kyun;Kim, Byung-Weon
    • Proceedings of the KAIS Fall Conference
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    • 2009.12a
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    • pp.501-504
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    • 2009
  • Sympathetic skin response (SSR) is defined as a minute change of skin potential after electrical stimulation. This test measures the change in voltage that originates from the surface of the skin and is attributed to sudomotor activity. The aim of this study was to define the criteria for validation of the responses. 40 normal subjects (20-73 years of age) with non-sympathetic dysfunction were tested and SSR was generated form all subjects. SSR latency was 1331.22${\pm}$177.51ms in the right palm, 1331.74${\pm}$156.42ms in the left palm, 1851.79${\pm}$220.99ms in the right sole, and 1874.10${\pm}$215.01ms in the left sole. And SSR amplitude was 595.83${\pm}$221.16${\mu}$V in the right palm, 605.33${\pm}$226.45${\mu}$V in the left palm, 291.76${\pm}$133.36${\mu}$V in the right sole, and 288.77${\pm}$129.70${\mu}$ V in the left sole. SSR latency and amplitude had no significantly difference between the right and the left side. SSR latency was consistently shorter (p<0.001) and SSR amplitude higher (p<0.001) in feet than in hands. SSR waveforms were P-type (32 subjects, 75%) and N-type (8 subjects, 25%), respectively. The SSR latency and amplitude in palms/soles were closely correlated with age (p<0.05) and height (p<0.05). The SSR test is one of methods assessing impairment of sympathetic fibers in peripheral neuropathy as well as a disorder of sympathetic system in other diseases and so our results from normal healthy subjects can be used as clinical criteria for SSR test.

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Comparison of Vendor-Provided Volumetry Software and NeuroQuant Using 3D T1-Weighted Images in Subjects with Cognitive Impairment: How Large is the Inter-Method Discrepancy?

  • Chung, Jieun;Kim, Hayoung;Moon, Yeonsil;Moon, Won-Jin
    • Investigative Magnetic Resonance Imaging
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    • v.24 no.2
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    • pp.76-84
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    • 2020
  • Background: Determination of inter-method differences between clinically available volumetry methods are essential for the clinical application of brain volumetry in a wider context. Purpose: The purpose of this study was to examine the inter-method reliability and differences between the Siemens morphometry (SM) software and the NeuroQuant (NQ) software. Materials and Methods: MR images of 86 subjects with subjective or objective cognitive impairment were included in this retrospective study. For this study, 3D T1 volume images were obtained in all subjects using a 3T MR scanner (Skyra 3T, Siemens). Volumetric analysis of the 3D T1 volume images was performed using SM and NQ. To analyze the inter-method difference, correlation, and reliability, we used the paired t-test, Bland-Altman plot, Pearson's correlation coefficient, intraclass correlation coefficient (ICC), and effect size (ES) using the MedCalc and SPSS software. Results: SM and NQ showed excellent reliability for cortical gray matter, cerebral white matter, and cerebrospinal fluid; and good reliability for intracranial volume, whole brain volume, both thalami, and both hippocampi. In contrast, poor reliability was observed for both basal ganglia including the caudate nucleus, putamen, and pallidum. Paired comparison revealed that while the mean volume of the right hippocampus was not different between the two software, the mean difference in the left hippocampus volume between the two methods was 0.17 ml (P < 0.001). The other brain regions showed significant differences in terms of measured volumes between the two software. Conclusion: SM and NQ provided good-to-excellent reliability in evaluating most brain structures, except for the basal ganglia in patients with cognitive impairment. Researchers and clinicians should be aware of the potential differences in the measured volumes when using these two different software interchangeably.

Thalamic Syndrome with Related Cortical Hypoperfusion on $^{99m}Tc-HMPAO$ Brain SPECT (시상 증후군에 동반된 대뇌 피질 혈류 변화에 대한 $^{99m}Tc-HMPAO$ Brain SPECT)

  • Kim, Eun-Kyung;Chung, Tae-Sub;Suh, Jung-Ho;Kim, Dong-Ik;Lee, Jong-Doo;Park, Chang-Yoon;Hong, Yong-Kook;Lee, Myung-Sik
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.33-39
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    • 1992
  • Spontaneous pain and painful overreaction to external stimuli resulting from lesion confined central nervous system (CNS) were named as thalamic syndrome. Thalamic lesion and decreased regional cortical perfusion thought to the pathogenesis of thalamic syndrome due to decreased function of thalamocortical tract. We performed $^{99m}Tc-HMPAO$ regional cerebral perfusion in 10 patients with clinical diagnosis of thalamic syndrome due to thalamic lesion or near the thalamic lesion at Yonsei University Hospital, from January 1989 to August 1991. In contrast to five patients with lesions near the thalamus who did not show secondarily decreased perfusion at cerebral cortex, four among the five patients with thalamic lesions revealed decreased cortical perfusion in the ipsilateral cerebral cortex on brain SPECT. These phenomena may suggest the loss of afferent activating stimuli from the thalamus led to decreased neuronal activity and the followitng hypoperfusion of cerebral cortex, and might be one of the indirect signs for suggesting presence of the thalamocortical tract. A causal relationship between cortical hypoperfusion and neuropsychological deficit is strongly suggested.

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LncRNA MEG3 Regulates Imatinib Resistance in Chronic Myeloid Leukemia via Suppressing MicroRNA-21

  • Zhou, Xiangyu;Yuan, Ping;Liu, Qi;Liu, Zhiqiang
    • Biomolecules & Therapeutics
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    • v.25 no.5
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    • pp.490-496
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    • 2017
  • Imatinib resistance has become a major clinical problem for chronic myeloid leukemia. The aim of the present study was to investigate the involvement of MEG3, a lncRNA, in imatinib resistance and demonstrate its underlying mechanisms. RNAs were extracted from CML patients' peripheral blood cells and human leukemic K562 cells, and the expression of MEG3 was measured by RT-qPCR. Cell proliferation and cell apoptosis were evaluated. Western blotting was used to measure the protein expression of several multidrug resistant transporters. Luciferase reporter assay was performed to determine the binding between MEG3 and miR-21. Our results showed that MEG3 was significantly decreased in imatinib-resistant CML patients and imatinib-resistant K562 cells. Overexpression of MEG3 in imatinib-resistant K562 cells markedly decreased cell proliferation, increased cell apoptosis, reversed imatinib resistance, and reduced the expression of MRP1, MDR1, and ABCG2. Interestingly, MEG3 binds to miR-21. MEG3 and miR-21 were negatively correlated in CML patients. In addition, miR-21 mimics reversed the phenotype of MEG3-overexpression in imatinib-resistant K562 cells. Taken together, MEG3 is involved in imatinib resistance in CML and possibly contributes to imatinib resistance through regulating miR-21, and subsequent cell proliferation, apoptosis and expression of multidrug resistant transporters.

A Case of Psychotic Disorder as a Sequele of Central Pontine and Extrapontine Myelinolysis (중심성 뇌교 및 뇌교외 수초용해에 병발된 정신증적 장애)

  • Park, Si-Sung;Yoo, Bong-Goo;Rim, Hark
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.1
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    • pp.55-60
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    • 2002
  • Central pontine myelinolysis(CPM) and Extrapontine myelinolysis(EPM) are uncommon neurologic disorders associated with osmotic inequality between the extracellular fluid compartment and intracellular fluid compartment in the brain. Myelinolysis can occur in hyponatremia and after rapid correction of hyponatremia. It may be caused by various metabolic disturbances such as chronic alcoholism, malnourishment, cancer, chronic renal failure and organ transplantation. The authors reported a 43-year-old male patient who have received a kidney transplantation because of chronic renal failure due to diabetic nephropathy. The patient manifested psychotic symptoms such as delusion, loosened association, hallucination, inappropriate affect and aggressiveness as a sequele of CPM and EPM. He also showed neurocognitive impairment such as disorientation, memory impairment, decresed intelligence and aphasia. These manifestations are rare in CPM and EPM. We discuss the clinical features, diagnosis, course and management of the patient which may be clinically significant in the neuropsychiatric aspect especially at the consultation-liaison field.

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A Case of Epidural Blood Patch to Treat Headache Due to Spontaneous Intracranial Hypotension -A case report- (경막외 혈액봉합술을 이용한 자연성 두개내 저압성 두통 환자의 치험 1예 -증례 보고-)

  • Park, Soo-Seog;Jang, Yeon;Cho, Eun-Chung;Jee, Seung-Eun;Song, Ho-Kyung;Jung, Sung-Woo
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.338-342
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    • 1998
  • Postural headache due to spontaneous intracranial hypotension occurs without any diagnostic lumbar puncture, myelography, cranial or spinal injury, or spinal anesthesia. The clinical characteristics of the syndrome are disappearance of the headache or a notable decrease in its severity with recumbency, the finding of meningeal enhancement and subdural fluid collection on brain MRI, the pleocytosis and the increased CSF protein concentration. We report a case of a 40-year-old woman who exhibited the signs and symptoms of postural headache due to low CSF pressure. Her headache started suddenly at the occiput and radiated to frontal head. Magnetic resonance imaging (MRI) of her brain showed enhancement of the meninges and subdural fluid collection. Intrathecal radionuclide cisternography showed the delayed appearance of the isotope in the cranium and the minimal CSF leak at the left upper thoracic region. Her headache was relieved completely after a lumbar (L2-L3) epidural injection of 12 ml of autologous blood and remained asymptomatic.

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A Case of Cauda Equina Syndrome in Early-Onset Chronic Inflammatory Demyelinating Polyneuropathy Clinically Similar to Charcot-Marie-Tooth Disease Type 1

  • Lee, Seung Eun;Park, Seung Won;Ha, Sam Yeol;Nam, Taek Kyun
    • Journal of Korean Neurosurgical Society
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    • v.55 no.6
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    • pp.370-374
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    • 2014
  • To present a case of cauda equina syndrome (CES) caused by chronic inflammatory demyelinating polyneuropathy (CIDP) which seemed clinically similar to Charcot-Marie-Tooth disease type1 (CMT1). CIDP is an immune-mediated polyneuropathy, either progressive or relapsing-remitting. It is a non-hereditary disorder characterized by symmetrical motor and sensory deficits. Rarely, spinal nerve roots can be involved, leading to CES by hypertrophic cauda equina. A 34-year-old man presented with low back pain, radicular pain, bilateral lower-extremity weakness, urinary incontinence, and constipation. He had had musculoskeletal deformities, such as hammertoes and pes cavus, since age 10. Lumbar spine magnetic resonance imaging showed diffuse thickening of the cauda equina. Electrophysiological testing showed increased distal latency, conduction blocks, temporal dispersion, and severe nerve conduction velocity slowing (3 m/s). We were not able to find genetic mutations at the PMP 22, MPZ, PRX, and EGR2 genes. The pathologic findings of the sural nerve biopsy revealed thinly myelinated nerve fibers with Schwann cells proliferation. We performed a decompressive laminectomy, intravenous IgG (IV-IgG) and oral steroid. At 1 week after surgery, most of his symptoms showed marked improvements except foot deformities. There was no relapse or aggravation of disease for 3 years. We diagnosed the case as an early-onset CIDP with cauda equine syndrome, whose initial clinical findings were similar to those of CMT1, and successfully managed with decompressive laminectomy, IV-IgG and oral steroid.

The Relationship between Epileptic Focus and Psychiatric Symptoms of the Refractory Epileptic Patients (난치성 간질환자의 간질초점 위치와 정신증상과의 관련성)

  • Han, Wou-Sang;Kim, Jong-Hoon;Lee, Sang-Kun;Cho, Doo-Young;Kwon, Jun-Soo;Ha, Kyoo-Seob
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.1
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    • pp.64-70
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    • 1996
  • The prevalence rate of psychiatric symptoms of the refractory epileptic patients was evaluated according to the location of the epileptic focus. The subjects were 91 patients admitted to Epilepsy Monitoring Unit of Seoul National University Hospital. The psychiatric symptoms were assessed by Korean version of Symptom Checklist-90-R(SCL-90-R). The locus of epileptic focus was assessed by clinical features, 2-hour interictal EEG, long-term video-EEG monitoring, brain MRI, interictal and ictal brain SPECT, and interictal brain PET The subjects were divided into three groups according to the epileptic focus, non-temporal(N=29), left temporal (N=26), and right temporal(N=32). There were no statistical differences in demographic and seizure-related variables among groups. The number of patients with $T-score {\geq} 65$ at any subscale of the SCL-90-R were compared by $X^2-test$ among groups. The mean T-scores of each subscale of the SCL-90-R were compared by oneway-ANOVA among groups. The prevalence rate of psychiatric symptoms of the refractory epileptic patients was 38.5%. There was no statistical difference in the prevalence rate of psychiatric symptoms among groups. However, the patients with non-temporal or right temporal epileptic foci showed statistically significant higher mean T-scores of interpersonal sensitivity, depression, hostility, and phobic subscales than the patients with left temporal epileptic foci. These results suggest that the epileptic focus plays an important role in the production of interictal psychiatric symptoms of the refractory epileptics.

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Morphological Assessment of Cadaveric Radial, Brachial and Subclavian Arteries : A Neurointerventional Approach

  • Yilmaz, Ali;Ozkul, Ayca;Shin, Dong Seong;Im, Soo-Bin;Yoon, Seok-Mann;Kim, Bum-Tae
    • Journal of Korean Neurosurgical Society
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    • v.58 no.6
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    • pp.499-503
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    • 2015
  • Objective : The transradial catheterization (TRC) is becoming widespread, primarily for neurointerventions. Therefore, the evaluation of radial artery puncture in clinical practice and a better understanding of the anatomy are important to improve the safety of neuroendovascular surgery. Methods : Ten formalin-fixed adult Korean cadavers were dissected to expose radial artery (RA), brachial artery (BrA) and subclvian artery (ScA), bilaterally. Vessel lengths and diameters were meaured using a caliper and distance between the specific point of vessels and the anatomical landmarks including the radial styloid process, the medial epicondyle of the humerus, the sternoclavicular joint, and the vertebral artery orifice were also measured. Results : The average length between the radial (RAPS) and the BrA puncture sites (BrAPS) and between the vertebral artery orifice (VAO) and the BrA bifurcation (BrAB) did not differ between sides (p>0.05). The average length between the radial styloid process (RSP) and the RAPS was $13.41{\pm}2.19mm$, and the RSP was $26.85{\pm}2.47mm$ from the median nerve (MN). The mean length between the medial epicondyle (ME) and the BrAPS as $44.23{\pm}5.47mm$, whereas the distance between the ME and the MN was $42.23{\pm}4.77mm$. The average VAO-ScA angle was $70.94{\pm}6.12^{\circ}$, and the length between the ScA junction (SCJ) and the VAO was $60.30{\pm}8.48mm$. Conclusion : This study provides basic anatomical information about the radial artery and the brachial route and can help improving new techniques, selection of size and shape of catheters for TRC. This can help neurointerventionists who adopt a transradial neuroendovascular approach and offers comprehensive and safe care to their patients.