• Animal cells and systems
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• v.5 no.2
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• pp.157-161
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• 2001

Mice homozygous for the lethal autosomal recessive anorexia mutation (anx) present with premature death around postnatal day 22. The anorexia mutant mice also present phenotypes such as reduced body weight, decreased food intake, and abnormal behavior characteristics such as body tremors, hyperactivity, uncoordinated gait, and head weaving. In order to investigate the expression of c-Fos in the hippocampus of anorexia mutant mice, the immunohistochemistry was performed in this study. The anorexia mutant mice exhibited lower expression of c-Fos in the hippocampus regions thBn the control group. In the CA3 and dentate gyrus, the number of c-Fos-positive cells in anorexia mutant mice was noticeably lower than that in control mice. However, no significant difference was found in the number of c-Fos-positive cells in CA1 of the two groups. The result suggests that the phenotypic characteristics of anorexia mutant mice may be associated with the hippocampal deficits of c-Fos expression.

• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.2
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• pp.104-109
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• 2008

Purpose: Unrefined tablets prepared from Aconitum tubers are occasionally used in Korean folk medicine. This study defines the potential sources, clinical toxicology, and treatment of aconitine poisoning. Methods: A retrospective survey was conducted in 63 patients in the ED of a tertiary University Hospital with suspected toxicity from an unrefined tablet prepared from Aconitum tubers from 1999 to 2007. Results: A total of 63 cases enrolled included 26 men and 37 women, aged 30 to 86 years. Forty-eight patients ingested aconitine tablets as digestives, 26 tablets on average. After a latent period of 30 to 450 minutes, patients developed a combination of neurologic (87.3%), gastrointestinal (82.5%), cardiopulmonary (41.3%), and other (28.6%) features typical of aconitine poisoning. Initial ECG abnormalities revealed dysrhythmia (61.9%), conduction disturbance (42.9%), and abnormal waveforms (39.7%), with 28.6% of patients having normal ECGs. All patients received supportive treatment or close observation regardless of ingestion amounts. Patients with hypotension or ventricular arrhythmia were treated with inotropic agents or amiodarone. Conclusion: Toxicologic signs and symptoms can occur after the consumption of aconitine tablets, regardless of ingestion amount. The risk occurs because of inadequately processed aconitine roots. This study will provide important data for public education and distribution regulations for Aconitum sp. in Korea.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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• pp.105-108
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• 2021

Background : Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare, autosomal recessive metabolic disorder which is caused by genetic mutations that disrupt the urea cycle. It is characterized by variable clinical presentation and the age of onset. Patients may present with gait disturbance and progressive paraplegia and muscle tightness in the lower extremities. The use of botulinum toxin in metabolic disease has rarely been discussed. We describe a case of a 14-year-old-boy with HHH syndrome, who presented with a several - month history of gait disturbance and lower extremity weakness. Case presentation : A 14-year old male had a history of recurrent upper respiratory tract infections, occasional vomiting, loss of appetite, and general weakness, all of which started since he was 10 months old. He was diagnosed with HHH syndrome at one year of age. At the age of 14, he was referred for the assessment and treatment of his gait disturbance and aggravated weakness of the lower extremities. Brain MRI, electrodiagnostic study and blood test were performed to exclude any lesions related to neurologic dysfunction. Botulinum toxin type A were injected into muscles of adductor longus, adductor magnus, lateral and medial hamstring, and lateral and medial gastrocnemius muscle heads under needle electromyography guidance to reduce lower limb spasticity. Intensive physical therapy including gait training and stretching exercise of adductor and calf muscles were also provided. After intensive physical therapy and botulinum toxin injection to reduce lower limb spasticity, he was able to ambulate for 20 meters independently without any walking aids. There were no adverse events after the injection. Conclusion : Botulinum toxin injection is a safe and effective therapy for patients with HHH syndrome who suffer from gait disturbance.

• International Neurourology Journal
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• v.22 no.4
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• pp.268-274
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• 2018

Purpose: To describe a technique for urodynamic diagnosis of detrusor sphincter dyssynergia (DSD) using urethral pressure measurements and examine potential associations between urethral pressure and bladder physiology among patients with DSD. Methods: Multiple sclerosis (MS) and spinal cord injured (SCI) patients with known DSD diagnosed on videourodynamics (via electromyography or voiding cystourethrography) were retrospectively identified. Data from SCI and MS patients with detrusor overactivity (DO) without DSD were abstracted as control group. Urodynamics tracings were reviewed and urethral pressure DSD was defined based on comparison of DSD and control groups. Results: Seventy-two patients with DSD were identified. Sixty-two (86%) had >20 cm $H_2O$ urethral pressure amplitude during detrusor contraction. By comparison, 5 of 23 (22%) of control group had amplitude of >20 cm $H_2O$ during episode of DO. Mean duration of urethral pressure DSD episode was 66 seconds (range, 10-500 seconds) and mean urethral pressure amplitude was 73 cm $H_2O$ (range, 1-256 cm $H_2O$). Longer (>30 seconds) DSD episodes were significantly associated with male sex (81% vs. 50%, P=0.013) and higher bladder capacity (389 mL vs. 219 mL, P=0.0004). Urethral pressure amplitude measurements during DSD were not associated with significant urodynamic variables or neurologic pathology. Conclusions: Urethral pressure amplitude of >20 cm $H_2O$ during detrusor contraction occurred in 86% of patients with known DSD. Longer DSD episodes were associated with larger bladder capacity. Further studies exploring the relationship between urethral pressure measurements and bladder physiology could phenotype DSD as a measurable variable rather than a categorical observation.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.2
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• pp.77-84
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• 2019

Purpose : Elastic taping is a therapeutic method, used for treatment of various musculoskeletal and neuromuscular deficits. However, there is limited evidence, of the effects of ankle elastic taping in neurologic patients. The purpose of this study, was to investigate the effect of elastic taping on gait, in the affected ankle area of chronic stroke patients. Methods : Subjects were randomized to receive 30 chronic stroke patients, who were 6 months old from the date of onset according to screening criteria. Group I showed ankle joint taping, and Group II had ankle muscle taping. Dynamic balance and temporal and spatial gait, were measured before taping application, and after 30 minutes of taping application. Results : Dynamic balance was measured using the Time up & Go test (TUG). There was statistically significant difference, between Group I and Group II (p<.05). There was no statistically significant difference, between Group I and Group II. Temporal and spatial gait were measured using GaitRite. In Group I, there was significant difference, before and after taping (p<.05). In Group II, there was no significant difference, before and after taping (p>.05). There was significant difference in Group I, between Group I and Group II (p<.05). Conclusion : Results suggest that intervention using elastic taping, may have a positive effect, on rehabilitation diversity and function in stroke patients. Based on this, it can be used for rehabilitation of stroke patients. Various studies on the application method, and effect of the application site as well as application time, should be continued with stroke patients.

• Clinical and Experimental Pediatrics
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• v.62 no.4
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• pp.131-137
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• 2019

Purpose: Respiratory syncytial virus (RSV) infection can cause various neurological complications. This study aimed to investigate the RSV-associated neurologic manifestations that present with seizures. Methods: We retrospectively reviewed the medical records of patients aged less than 15 years with laboratory-confirmed RSV infections and seizures between January 2011 and December 2016 in a regional hospital in South Korea. Results: During this period, 1,193 patients with laboratory-confirmed RSV infection were identified. Of these, 35 (35 of 1,193, 2.93%; boys, 19; girls, 16; mean age: $20.8{\pm}16.6months$) presented with seizure. Febrile seizure was the most common diagnosis (27 of 35, 77.1%); simple febrile seizures in 13 patients (13 of 27, 48.1%) and complex febrile seizures in 14 (14 of 27, 51.9%). Afebrile seizures without meningitis or encephalopathy were observed in 5 patients (5 of 35, 14.3%), seizures with meningitis in 2 (2 of 35, 5.7%), and seizure with encephalopathy in 1 (1 of 35, 2.9%) patient. Lower respiratory symptoms were not observed in 8 patients. In a patient with encephalopathy, brain diffusion-weighted magnetic resonance imaging revealed transient changes in white matter, suggesting cytotoxic edema as the mechanism underlying encephalopathy. Most patients recovered with general management, and progression to epilepsy was noted in only 1 patient. Conclusion: Although febrile seizures are the most common type of seizure associated with RSV infection, the proportion of patients with complex febrile seizures was higher than that of those with general febrile seizures. Transient cytotoxic edema may be a pathogenic mechanism in RSV-related encephalopathy with seizures.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.159-169
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• 2019

Purpose: The purpose of this study was to provide an effective method of exercise therapy for patients with cervicogenic headache. Methods: The subjects were divided into the following three groups according to the intervention received: cervix-stabilizing exercise (n=12, group 1), transcranial direct current stimulation (n=12, group 2), and cervix-stabilizing exercise combined with transcranial direct current stimulation (n=12, group 3). The intragroup and intergroup differences in muscle characteristics and neck disability index were compared and analyzed. Results: The comparison and analysis of the changes in muscle tone and post hoc analysis revealed statistically significant intragroup decreases in the upper trapezius and suboccipitals in groups I and III, and statistically significant intergroup differences in the upper trapezius, with greater changes in group III than in group II, and in the suboccipitals, with greater changes in groupIII than in groups Iand II. The comparison and analysis of the change in muscle stiffness and post hoc analysis revealed a statistically significanti ntra group decrease in the upper trapezius in group Iand suboccipitals in group III, and a statistically significant intergroup difference in both muscles, with greater change in group III than in group II. The comparison and analysis of change in neck disability index and post hoc analysis revealed a statistically significant intragroup decrease in all the three groups and a statistically significant intergroup difference, with greater change in group III than in groups I and II. Conclusion: The neck-stabilizing exercise and transcranial direct current stimulation were shown to be effective in decreasing the tone of the cervical muscles by stabilizing the cervical bone and improving muscle durability, and in improving the movement and limitation of joint range of motion by decreasing muscle tone and stiffness.

• Biomolecules & Therapeutics
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• v.27 no.4
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• pp.349-356
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• 2019

Behavioral analysis in mice provided important contributions in helping understand and treat numerous neurobehavioral and neuropsychiatric disorders. The behavioral performance of animals and humans is widely different among individuals but the neurobehavioral mechanism of the innate difference is seldom investigated. Many neurologic conditions share comorbid symptoms that may have common pathophysiology and therapeutic strategy. The forced swim test (FST) has been commonly used to evaluate the "antidepressant" properties of drugs yet the individual difference analysis of this test was left scantly investigated along with the possible connection among other behavioral domains. This study conducted an FST-screening in outbred CD-1 male mice and segregated them into three groups: high performers (HP) or the active swimmers, middle performers (MP), and low performers (LP) or floaters. After which, a series of behavioral experiments were performed to measure their behavioral responses in the open field, elevated plus maze, Y maze, three-chamber social assay, novel object recognition, delay discounting task, and cliff avoidance reaction. The behavioral tests battery revealed that the three groups displayed seemingly correlated differences in locomotor activity and novel object recognition but not in other behaviors. This study suggests that the HP group in FST has higher locomotor activity and novelty-seeking tendencies compared to the other groups. These results may have important implications in creating behavior database in animal models that could be used for predicting interconnections of various behavioral domains, which eventually helps to understand the neurobiological mechanism controlling the behaviors in individual subjects.

• Journal of Korean Neurosurgical Society
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• v.62 no.4
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• pp.467-475
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• 2019

Objective : There is a lack of knowledge regarding whether decompression is necessary in treating patients with epidural spinal cord compression (ESCC) grade 2. The purpose of this study was to compare the outcomes of minimally invasive surgery (MIS) without decompression and conventional open surgery (palliative laminectomy) for patients with hepatocellular carcinoma (HCC) spinal metastasis of ESCC grade 2. Methods : Patients with HCC spinal metastasis requiring surgery were retrospectively reviewed. Patients with ESCC grade 2, medically intractable mechanical back pain, a Nurick grade better than 3, 3-6 months of life expectancy, Tomita score ${\geq}5$, and Spinal Instability Neoplastic Score ${\geq}7$ were included. Patients with neurological deficits, other systemic illnesses and less than 1 month of life expectancy were excluded. Thirty patients were included in the study, including 17 in the open surgery group (until 2008) and 13 in the MIS group (since 2009). Results : The MIS group had a significantly shorter operative time ($94.2{\pm}48.2minutes$ vs. $162.9{\pm}52.3minutes$, p=0.001), less blood loss ($140.0{\pm}182.9mL$ vs. $1534.4{\pm}1484.2mL$, p=0.002), and less post-operative intensive care unit transfer (one patient vs. eight patients, p=0.042) than the open surgery group. The visual analogue scale for back pain at 3 months post-operation was significantly improved in the MIS group than in the open surgery group ($3.0{\pm}1.2$ vs. $4.3{\pm}1.2$, p=0.042). The MIS group had longer ambulation time ($183{\pm}33days$ vs. $166{\pm}36days$) and survival time ($216{\pm}38days$ vs. $204{\pm}43days$) than the open surgery group without significant difference (p=0.814 and 0.959, respectively). Conclusion : MIS without decompression would be a good choice for patients with HCC spinal metastasis of ESCC grade 2, especially those with limited prognosis, mechanical instability and no neurologic deficit.

• Journal of Trauma and Injury
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• v.34 no.2
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• pp.130-135
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• 2021

Celiac artery compression is a rare condition in which the celiac artery is compressed by the median arcuate ligament. Case reports of compression after trauma are hard to find. Blunt traumatic pericardium rupture is also a rare condition. We report a single patient who experienced both rare conditions from a single blunt injury. An 18-year-old woman was brought to the trauma center after a fatal motorcycle accident, in which she was a passenger. The driver was found dead. Her vital signs were stable, but she complained of mild abdominal pain, chest wall pain, and severe back pain. There were no definite neurologic deficits. Her initial computed tomography (CT) scan revealed multiple rib fractures, moderate lung contusions with hemothorax, moderate liver injury, and severe lumbar spine fracture and dislocation. She was brought to the angiography room to check for active bleeding in the liver, which was not apparent. However, the guide wire was not able to pass through the celiac trunk. A review of the initial CT revealed kinking of the celiac trunk, which was assumed to be due to altered anatomy of the median arcuate ligament caused by spine fractures. Immediate fixation of the vertebrae was performed. During recovery, her hemothorax remained loculated. Suspecting empyema, thoracotomy was performed at 3 weeks after admission, revealing organized hematoma without pus formation, as well as rupture of the pericardium, which was immediately sutured, and decortication was carried out. Five weeks after admission, she had recovered without complications and was discharged home.