• Sleep Medicine and Psychophysiology
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• v.3 no.1
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• pp.56-67
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• 1996

Objectives : This study was designed to find clinical factors that could be differentiated by the lateralization of lesion and also find clinical factors to predict the lateralization of lesion. Methods : The subjects were 65 cooperative inpatients and outpatients with non-traumatic subcortical cerebrovascular disease without neurologic and psychiatric history from January 1995 to September 1995 ; 48 patients in Kyung Hee University, Oriental Medicine Hospital, 35 patients in Anam Hospital, Korea University were examined as subjects, but authors excluded 20 patients whose data were incomplete or who had uncertain lesions on brain CT or MRI. The 65 patients were divided into three groups-group with left hemispheric lesion, group with right hemispheric lesion, group with both hemispheric lesion-according to the finding of brain imaging study. Their cognitive functions were evaluated by the Benton Neuropsychological Assessment(BNA), their subjective neurobehavioral symptoms by Symptom Check List-90-R(SCL-90-R), their objective neurobehavioral symptoms by Neurobehavioral Rating Scale, and their daily living functions by Geriatric Evaluation by Relative's Rating Instrument(GERRl) and Instrumental Activities of Daily Living Scale(IADLs). Results : The results were as follows : 1) The results of cognitive function test indicated that the group with right hemispheric lesion showed low functions in Tactile Form Perception(left), the group with left hemispheric lesion showed low functions in Finger localization(right), the group with right hemispheric lesion showed low functions in Finger Localization(left). 2) Though, there were little significant differences in subjective neurobehavioral symptoms, the group with right hemispheric lesion showed higher scores in all symptoms except hostility. 3) Though, there were little significant differences in objective neurobehavioral symptoms, the group with both hemispheric lesion showed higher scores in cognition, guilty/disinhibition, the group with left hemispheric lesion showed higher scores in lability of mood, the group with right hemispheric lesion showed highest scores in psychotism, neurotism, agitation-hostility and decreased motivation/emotional withdrawal. 4) There were little significant differences among three groups in Daily Living Functions, but the group with right hemispheric lesion showed the lowest functions in Instrumental Activities of Daily Living. 5) As a result of discriminant analysis on each factor's contribution to the prediction of lesion, Finger Localization(left), Phoneme Discrimination and Tactile Form Perception(right) showed that they had the potentiality to predict lesion. Conclusion : The results suggest that there are little significant differences among the groups of three non-traumatic subcortical cerebrovascular disease in cognitive functions, but the group with right hemispheric lesion showed more serious and various changes in subjective and objective neurobehavioral symptoms, and showed low functions in Instrumental Activities of Daily Living. This results suggest the possibility that the decline of the daily living function in the group with right hemispheric lesion were due to various symptoms, not due to cognitive dysfunction. The confirmation of the possibility should be worked out through the follow-up study of some groups containing cortical lesion. Apart from these findings, Finger Localization, Tactile Form Perception(right) and Phoneme Discrimination suggest that they can be used as clinically valuable cognitive parameters that predict the lateralization of lesion in non-traumatic cerebrovascular disease.

• Journal of Life Science
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• v.29 no.7
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• pp.800-808
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• 2019

Charcot-Marie-Tooth disease (CMT) is a group of rare peripheral neuropathies characterized by progressive muscle weakness and atrophy and areflexia in the upper and lower extremities. The most common subtype of CMT is CMT1A, which is caused by a tandem duplication of the PMP22 gene in the 17p12 region. Patients with CMT1A show a loose genotype-phenotype correlation, which suggests the existence of secondary genetic or association factors. Recently, polymorphisms of rs71428439 (n.83A>G) and rs2292832 (n.86T>C) in the MIR149 have been reported to be associated with late onset and mild phenotypic CMT1A severity. The aim of this study was to examine the intrafamilial heterogeneities of clinical phenotypes according to the genotypes of these two SNPs in MIR149. For this study, we selected 6 large CMT1A families who showed a wide range of phenotypic variation. This study suggested that both SNPs were related to the onset age and severity in the dominant model. In particular, the AG+GG (n.83A>G) and TC+CC genotypes (n.86T>C) were associated to late onset and mild symptoms. Motor nerve conduction velocity (MNCV) was not related to the MIR149 genotypes. These results were consistent with the previous studies. Therefore, we suggest that the rs71428439 and rs2292832 variants in MIR149 may serve as genetic modifiers of CMT1A intrafamilial phenotypic heterogeneity, as they have a role in the unrelated patients. This is the first study to show an association using large families with variable clinical CMT1A phenotypes. The results will be helpful in the molecular diagnosis and treatment of patients with CMT1A.

• The Journal of Korean Medicine
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• v.43 no.2
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• pp.51-60
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• 2022

Objectives: Currently, Korea's medical services are divided into Western medicine and Korean medicine, and people who are not satisfied with the existing treatments are looking for complementary and alternative medicine(CAM). Therefore, this study attempted to confirm patients' perception of the ongoing collaborative treatment and integrated medical service that added CAM to collaborative treatment based on tertiary hospital users. So that we can confirm the expected advantage and disadvantage of integrated medical service system and the necessity of supporting medical expenses for it. Methods: The survey was conducted on 100 people who experienced tertiary hospital treatment and other 100 people who experienced both tertiary hospital treatment and Korean medicine treatment at the same period. The survey was conducted until the number of respondents in both group reached 100. The survey was conducted through e-mail and was conducted from September 27, 2021 to October 8, 2021. Results: For the advantages of collaborative treatment 'increased in psychological stability,' and for disadvantages 'longer time spent for treatment' were the most common. If integrated medical services are implemented in the future, expected advantages include 'consideration of various treatments.' and expected disadvantages include 'increased medical cost.' The needs to expand support for health insurance for integrated medical services were 75.5% among responders. Conclusions: We were able to find out the (expected) advantages and disadvantages of the collaborative medical care and the integrated medical system that medical users experienced or expected, also confirmed positive answers to the expansion of health insurance support for the integrated medical system.

• The Korean Journal of Pain
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• v.33 no.2
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• pp.99-107
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• 2020

Chronic severe pain results in a detrimental effect on the patient's quality of life. Such patients have to take a large number of medications, including opioids, often without satisfactory effect, sometimes leading to medication abuse and the pain worsening. Spinal cord stimulation (SCS) is one of the most effective technologies that, unlike other interventional pain treatment methods, achieves long-term results in patients suffering from chronic neuropathic pain. The first described mode of SCS was a conventional tonic stimulation, but now the novel modalities (high-frequency and burst), techniques (dorsal root ganglia stimulations), and technical development (wireless and implantable pulse generator-free systems) of SCS are becoming more popular. The improvement of SCS systems, their miniaturization, and the appearance of new mechanisms for anchoring electrodes results in a significant reduction in the rate of complications and revision surgeries, and the appearance of new waves of stimulation allows not only to avoid the phenomenon of addiction, but also to improve the long-term results of chronic SCS. The purpose of this review is to describe the current condition of SCS and up-to-date technical advances.

• Journal of Acupuncture Research
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• v.26 no.2
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• pp.59-70
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• 2009

Objectives : Although CTTH is one of the most common symptom in primary headache, the mechanism and treatment is not definite. The purpose of this study is to research about clinical characteristic and roentgenographic finding of the cervical spine in CTTH to determine relationship between the cervical spine and headache. Methods : This study was carried out on 93 patients with CTTH. By roentgenographic finding, they were classified into four groups - HNP, Spondylosis, Sprain, Normal. Then the HNP group was divided again into two groups - singer type and multiple type. Results: 1. Among 93 patients with CTTH, 69(74.19%) patients had abnormal cervical spine by roentgenographic finding. 2. There were HNP, spondylosis, sprain in abnormal roentgenographic finding. And a great majority of the patients were diagnosed as cervical sprain. 3. There were no significant difference between four groups on sex, weight, height, blood pressure, pulse, respiratory rate. But on ages, the HNP group showed the highest average while the sprain group showed the lowest. 4. The patients in HNP group had more frequent, severe pain, longer onset and higher onset-age than those of the other three group. 5. The patients in Multiple-type HNP group had severe pain, longer pain-duration, longer onset, more pre-symptoms and younger onset-age than those of the Single-type HNP group. Conclusions : A great majority of the patients with CTTH had abnormal cervical spines. Also, we found out that the worse the grade of HNP, heavier the level of headache.

• Tuberculosis and Respiratory Diseases
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• v.83 no.1
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• pp.96-103
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• 2020

Background: The aim of this study was to investigate the effectiveness of intravenous isoniazid (H) and ethambutol (E) administered in patients with new sputum positive drug-susceptible pulmonary tuberculosis (TB) with tuberculous meningoencephalitis (TM) and human immunodeficiency virus (HIV) co-infection in the intensive phase of treatment. Methods: Fifty-four patients with TB/TM and HIV co-infection were enrolled for this study. Group 1 comprised of 23 patients treated with E and H intravenously, while rifampicin and pyrazinamide were prescribed orally. Group 2 consisted of 31 patients treated with the first-line anti-TB drugs orally. The concentrations of H and E in blood serum were detected using a chromatographic method. Results: A significant improvement in the clinical symptoms and X-ray signs in patients treated intravenously with H and E was observed and compared to group 2. The sputum Mycobacterium tuberculosis positivity was observed during the second month of the treatment in 25.0% of patients from group 1 and 76.1% of the patients from the control group (p=0.003). In addition, nine patients (39.1%) died up to 6 months when H and E were prescribed intravenously compared with 22 (70.9%) in group 2 (p=0.023). Conclusion: In TB/TM with HIV, the intravenous H and E treatment was more effective than oral H and E treatment at 2 months of intensive treatment in sputum conversion as well as in clinical improvement, accompanied by significantly higher mean serum concentrations. In addition, the mortality rate was lower in intravenous H and E treatment compared to oral treatment.

• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.26-30
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• 1999

Background : The origin of P300 was still on debate nbut thought to be in the frontal, temporal or parietal lobe. As the transcranial doppler ultrasonography(TCD) gives us and opportunity to observe hemodynamic chaged dynamically and the middle cerebral artery feeds these ares of the hemisphere, we observed the change of mean flow velocity of MCA during the event related potential test(ERP) to determine the role of these structures in P300 generation. Method : Twenty normal subjects(male : 13, age : 24-29 years) performed ERP. An auditory oddball pardigm was used to elicit the ERPs. TCD examination was performed with 2-MHz probe monitoring the left MCA(Transscan, EME). After signal identification and adjustments to maximize the Doppler signal strength, the probe was mechanically locked during the monitoring. The changes of blood flow velocity of the left middle cerebral artery(MCA) induced by cognitive demands were monitored. The measurement of the meal flow velocities(MFV) of MCA were made while the subjects were prior to, during, and after ERP. We recorded the MFVs during ERP. Statistical analysis was performed using t-tests with SPSS-PC for windows release 6.0. Results : All subjects showed a relative increase in MFV of MCA during the task. The mean rise was about 3.2-4.2%(p <0.05). Although TCD does not measure absolute values of regional cerebral blood flow(rCBF) or absolute rCBF changes, changes of flow velocity can reflect relative rCBF changes. Conclusions : The generation site of P300 still remains unclear but the neocortical, thalamic and limbic region and temporal-parietal cortex have been proposed. The MCA supplies these anatomical structures. The Changes of flow veolocity of MCA during the ERP test suggest that the some part of the brain fed y the MCA activate of the temporal lobe or parietal lobes, we can deduce that some parts of brain fed by the MCA participate in the generation of P300.

• Korean Journal of Clinical Laboratory Science
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• v.49 no.3
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• pp.294-299
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• 2017

The aim of this study was to detect the status of epilepticus and seizure based on the initial patterns observed in the first 30 minutes of continuous electroencephalogram (cEEG) monitoring. An cEEG was recorded digitally using electrodes applied according to the International 10~20 System. The EEG data were reviewed from January 2014 to December 2015. The baselines of the EEG patterns were characterized by lateralized periodic discharges, generalized periodic discharges, burst suppression, focal epileptiform, asymmetric background, generalized slowing, and generalized periodic discharges with a triphagic wave. The etiology was classified into five categories. The subjects of this study were 128 patients (age: $56.9{\pm}17.5years$, male:female, 74:54). The mean cEEG monitoring duration was $5.5{\pm}5.1$ (min:max, 1:33) days. The EEG pattern categories included lateralized periodic discharges (N=7), generalized periodic discharges (N=10), burst suppression (N=6), focal epileptiform (N=19), asymmetric background (N=24), generalized slowing (N=51), and generalized periodic discharges with a triphagic wave (N=11). The etiological classifications of the patients with status epilepticus were remote symptomatic (N=4), remote symptomatic with acute precipitant (N=9), acute symptomatic (N=6), progressive encephalopathy (N=2), and febrile seizure (N=1). cEEG monitoring was found to be useful for the diagnosis of non-convulsive epileptic seizures or status epilepticus. The seizure was confirmed by the EEG pattern.

• Journal of Pharmacopuncture
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• v.13 no.4
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• pp.75-89
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• 2010

Objectives : The purpose of this study is to compare the effects of Sweet Bee Venom Pharmacopuncture and Scolopendrid Pharmacopuncture on Carpal Tunnel Syndrome. Methods : From February to September 2010, the number of patients with Carpal Tunnel Syndrome who volunteered for this clinical study was 16 and 7 out of 16 patients complained both hands. Total 23 cases of hands were randomly divided by 2 groups. We injected Sweet Bee Venom Pharmacopuncture on PC7(Daereung) twice a week for 4weeks for experimental group(n=11), and Scolopendrid Pharmacopuncture with the same methods for control group(n=12). One case was dropped out due to itchiness of allergic response in the experimental group. Improvement of the symptoms was evaluated by Visual Analogue Scale, Pain Rating Scale, Tinel's sign, Phalen's sign and Nerve Conduction Velocity. Nerve Conduction Velocity was checked at baseline and the end of the trial and others were checked at baseline, after 2 and 4 weeks. Results : Both groups showed significant improvement in Visual Analogue Scale, Pain Rating Scale, but no significant difference between two groups. Only the control group showed significant reduction of the 'poitive response' in the Tinel's sign and Phalen's sign. However, no groups improved in Nerve Conduction Velocity. Conclusions : These results showed that Sweet Bee Venom Pharmacopuncture and Scolopendrid Pharmacopuncture could decrease the symptoms of Carpal Tunnel Syndrome. Further studies will be required to examine more cases for the long period and use more various concentration and amount pharmacopuncture for the effect on Carpal Tunnel Syndrome.

• Clinical and Experimental Pediatrics
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• v.59 no.1
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• pp.24-29
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• 2016

Purpose: Mumps meningitis is a common complication of mumps infection; however, information on mumps meningitis in the postvaccine era is limited. The purpose of the present study was to determine factors associated with mumps meningitis and to discuss the effect of vaccination on this disease. Methods: We retrospectively reviewed patients younger than 19 years with mumps, diagnosed at a university hospital in Korea between 2003 and 2013. Patients were divided into groups with and without meningitis, and the clinical features of the 2 groups were compared. Results: The study enrolled 119 patients: 19 patients with meningitis and 100 patients without. Univariate analysis showed that older age (median: 15 years vs. 9.5 years, respectively), a longer interval from last vaccination (median: 10.2 years vs. 4.8 years, respectively), and febrile presentation (94.7% vs. 31.0%, respectively) were significantly associated with mumps meningitis. Sex, number of vaccination doses, bilateral parotitis, and the presence of complications other than meningitis did not differ between the 2 groups. In multivariate logistic regression analysis, age (odds ratio, 1.38; 95% confidence interval, 1.01-1.89; P=0.04) and fever (odds ratio, 30.46; 95% confidence interval, 3.27-283.61; P<0.01) remained independent factors for mumps meningitis. Conclusion: Clinicians in the postvaccine era should be aware of the possibility of mumps meningitis in febrile cases of mumps in adolescents, regardless of the number of vaccination doses. To establish the role of vaccination in mumps meningitis, further studies will be necessary.