Objective : The purpose of this reports is to describe the influence of continuous external ventricular drainage [EVD] on delayed ischemic neurologic deficit [DIND] after early surgery in ruptured aneurysmal patients. Methods : The authors reviewed 229 patients with aneurysmal subarachnoid hemorrhage [SAH] who had been treated with clipping at a single institution between 1998 and 2004. Of these, 121 patients underwent continuous EVD [Group A] postoperatively, whereas 108 patients did not [Group B]. EVD was performed at ipsilateral Kocher's point and maintained 2 to 14 days postoperatively. Results : DIND occurred in 15.7% [19 cases] of patients in Group A, 25% [27 cases] from Group B [P value=0.112]. Compared with Group A, Group B was more likely to suffer acute symptom of DIND and showed poor response to 3- H therapy. Major symptoms of DIND in Group A were mild confusion [36.8%] and mild deterioration of mental state [26.3%], contrary to weakness of extremities [59.2%] in Group B. At discharge, Glasgow Outcome Scales [GOS] of Group A were : good recovery [63.2%], moderately disabled [21%], severely disabled [10.5%], dead [5.3%] and Group B : good recovery [48.1%], moderately disabled [37%], severely disabled [14.8%] and dead [0%]. Of 121 patients from group A, 35 patients [28.9%] suffered ventriculitis. Conclusion : Continuous EVD after aneurysmal clipping in patients with SAH reduced the risk of DIND and its sequelae, relieved its symptoms, and improved the outcome.
Paraneoplastic neurologic syndrome is a group of assorted disorders resulting from damage to the nervous system in cancer, remote from primary site, and not related to metastasis, infection, or metabolic disorder associated with cancer. Patient with small cell lung cancer sometimes shows various neurological syndromes, but patient with non-small cell lung cancer rarely shows neurologic syndromes and few antineuronal antibodies have been found. Here, we report a case of 53-year-old male patient who developed ptosis and extraocular muscular limitation of left eye due to third and forth cranial nerve palsy in non-small cell lung cancer without brain metastasis. These neurologic symptoms improved after lobectomy without any other treatment immunotherapy.
Park, Young Hyuk;Yoo, Bong Goo;Kim, Kwang Soo;Yoo, Kyung Moo
Annals of Clinical Neurophysiology
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v.2
no.2
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pp.101-106
/
2000
Background and Purpose : Brainstem auditory evoked potentials(BAEPs) are responses of the brainstem by auditory stimulation. Vertebrobasilar transient ischemic attacks is the disease that occurs by insufficient circulation in the region of brainstem. The purpose of this study is to know the factors influencing the changes of BAEPs in vertebrobasilar transient ischemic attacks. Methods : The subject of study was 96 patients diagnosed as vertebrobasilar transient ischemic attacks. Patients were divided into two groups according to the BAEPs findings. Their age, sex, presence of hypertension, diabetes, hyperlipidemia, heart disease, neurologic findings, previous stroke, previous vertebrobasilar transient ischemic attacks, smoking and alcohol drinking, and time period between symptom onset and testing were compared. Results : There were no significant differences in age, sex, and presence of hypertension, diabetes, hyperlipidemia, heart disease, previous stroke history, previous vertebrobasilar transient ischemic attack, smoking, and alcohol drinking between two groups. The presence of abnormal neurologic findings in the first examination and time period between symptom onset and testing were significantly different between normal BAEPs group and abnormal BAEPs one(P<0.05). Conclusions : The factors influencing the changes of BAEPs were presence of abnormal neurologic findings and time period between symptom onset and testing. These findings suggest that BAEPs test should be performed in acute stage of ischemic attack.
Urinary tract infection(UTI) is one of the common complications in stroke patients. As it has negative effect on the recovery of stroke, it should be cured out immediately. But antibiotics might cause some adverse reactions such as diarrhea, eruption, anorexia, nausea and vomiting. so there have been several reports about treating urinary tract infection with Traditional Korean Medication. We treated a 54-year-old male patient with cerebral hemorrhage, who had had neurogenic bladder after stroke and had been urinated by intermittent catheterization. About 10 days later, he could void by himself without catheter, but showing the symptoms of UTI; Voiding pain, hematuria and yellowish pus. The pus culture grew Staphylococcus spp., which was resistant to most of antibiotics except vancomycin and teicoplanin. Based on accompanying symptoms of intermittent dizziness, headache, insomnia, nocturnal sweating, weak pulse, red tongue and urinary problem, we differentiated him as the deficiency of Yin of the Kidney[腎陰虛] and treated with Gagamyookmijihwang-tang (Jia-Jian-Liu-Wei-De- Huang-Tang), which improved his urinary symptoms and other general conditions without any side effect. In next follow-up culture, there was no pathogen. We conclude that Traditional Korean Medicine based on differentiation is useful in the treatment of urinary tract infection.
Objectives: The purpose of this study was to investigate the cardioprotective effect of the potent antioxidant properties of Scrophulariae Radix (SR) aqueous extracts by examining pressure overload (PO) heart failure (HF) induced by transverse aortic constriction (TAC) of C57BL/6 mice. Methods: SR (500, 250, 125 mg/kg) and resveratrol (10 mg/kg) were administered orally once a day for 14 days, after the TAC operation. Changes in mortality, the body and heart weights, histopathology of the heart, and antioxidant defense system of the heart were analyzed. Results: After the TAC operation, increases were observed in mortality, heart weights, left ventricular hypertrophy, and lytic and focal fibrotic histological change, and destruction of the heart antioxidant defense system. However, the HF signs showed dose-dependent inhibition following 14 days of continuous oral treatment with SR. A SR dose of 125 mg/kg gave a similar inhibition to that obtained with resveratrol at 10 mg/kg. Conclusions: Oral administration of SR beneficially improves PO-induced HF following TAC surgery by increasing the activity of the heart antioxidant defense system. The overall effect of SR at 125 mg/kg is similar to the effect of resveratrol at 10 mg/kg. However, more detailed mechanistic studies should be performed by screening of the biologically active compounds in SR.
Im, Sang-Hyuk;Jang, Dong-Kyu;Han, Young-Min;Kim, Jong-Tae;Chung, Dong Sup;Park, Young Sup
Journal of Korean Neurosurgical Society
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v.52
no.4
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pp.396-403
/
2012
Objective : The predictors of cranioplasty infection after decompressive craniectomy have not yet been fully characterized. The objective of the current study was to compare the long-term incidences of surgical site infection according to the graft material and cranioplasty timing after craniectomy, and to determine the associated factors of cranioplasty infection. Methods : A retrospective cohort study was conducted to assess graft infection in patients who underwent cranioplasty after decompressive craniectomy between 2001 and 2011 at a single-center. From a total of 197 eligible patients, 131 patients undergoing 134 cranioplasties were assessed for event-free survival according to graft material and cranioplasty timing after craniectomy. Kaplan-Meier survival analysis and Cox regression methods were employed, with cranioplasty infection identified as the primary outcome. Secondary outcomes were also evaluated, including autogenous bone resorption, epidural hematoma, subdural hematoma and brain contusion. Results : The median follow-up duration was 454 days (range 10 to 3900 days), during which 14 (10.7%) patients suffered cranioplasty infection. There was no significant difference between the two groups for event-free survival rate for cranioplasty infection with either a cryopreserved or artificial bone graft (p=0.074). Intergroup differences according to cranioplasty time after craniectomy were also not observed (p=0.083). Poor neurologic outcome at cranioplasty significantly affected the development of cranioplasty infection (hazard ratio 5.203, 95% CI 1.075 to 25.193, p=0.04). Conclusion : Neurologic status may influence cranioplasty infection after decompressive craniectomy. A further prospective study about predictors of cranioplasty infection including graft material and cranioplasty timing is necessary.
Objective : The purpose of this study was to determine the feasibility of screw fixation in previously augmented vertebrae with bone cement. We also investigated the influence of cement distribution pattern on the surgical technique. Methods : Fourteen patients who required screw fixation at the level of the previous percutaneous vertebroplasty or balloon kyphoplasty were enrolled in this study. The indications for screw fixation in the previously augmented vertebrae with bone cement included delayed complications, such as cement dislodgement, cement leakage with neurologic deficits, and various degenerative spinal diseases, such as spondylolisthesis or foraminal stenosis. Clinical outcomes, including pain scale scores, cement distribution pattern, and procedure-related complications were assessed. Results : Three patients underwent posterior screw fixation in previously cemented vertebrae due to cement dislodgement or progressive kyphosis. Three patients required posterior screw fixation for cement leakage or displacement of fracture fragments with neurologic deficits. Eight patients underwent posterior screw fixation due to various degenerative spinal diseases. It was possible to insert screws in the previously augmented vertebrae regardless of the cement distribution pattern; however, screw insertion was more difficult and changed directions in the patients with cemented vertebrae exhibiting a solid pattern rather than a trabecular pattern. All patients showed significant improvements in pain compared with the preoperative levels, and no patient experienced neurologic deterioration as seen at the final follow-up. Conclusion : For patients with vertebrae previously augmented with bone cement, posterior screw fixation is not a contraindication, but is a feasible option.
Objectives: Lonicerae flos (LF), a dried flower part of Lonicera japonica Thunb., has been widely used in Korean medicine as anti-inflammatory and antioxidative agent. The purpose of this study was to determine the cardioprotective effects of LF, through potential antioxidant effects, on the pressure overload (PO)-induced heart failure (HF) in C57BL/6 mice after transverse aortic constriction (TAC) surgery. Methods: Resveratrol (10 mg/kg body weight) or LF (125, 250 or 500 mg/kg body weight) was orally administered, once daily for 14 days, starting 14 days after TAC surgery. Changes in the mortality, body weights, heart weights, histopathology of the heart, and antioxidant defense systems of the heart were analyzed. Results: Marked and noticeable increases of heart weights, mortalities, and hypertrophic, focal, and lytic fibrotic histological changes in the LVs were observed, with destruction of heart antioxidant defense systems after surgery. However, HF signs, induced by TAC surgery through PO, and destruction of heart antioxidant defense systems were significantly and dose-dependently inhibited by 14 days of maintained oral treatment with LF 500, 250 or 125 mg/kg. Treatment with 250 mg/kg LF was comparable to treatment with 10 mg/kg resveratrol. Conclusions: The results in this study suggest that oral administration of LF favorably relieves PO-induced HF following TAC, through increase of heart antioxidant defense systems. The overall effects of 250 mg/kg LF were similar to those of 10 mg/kg resveratrol. More detailed mechanistic studies should be conducted in the future, with screening of the biologically active compounds in LF.
Objectives : The aim of this study was to investigate the effect of Peucedani Radix herbal acupuncture(PR-HA) at St36(joksamni) on ovalbumin-induced asthma in mice. Methods : C57BL/6 mice were sensitized and challenged with OVA(ovalbumin) for 12 weeks(once a week) C57BL/6 mice were injected, inhaled and sprayed with OVA for 12 weeks (3times a week). One of the two experimental groups was just treated with needle-prick on St36 and the other group was treated with 1% concentrations of PR-HAS at St36, for the later 8 weeks (3times /week). Results : 1. The weight and total cells of lung of the mice group treated with PR-HA decreased significantly compared with those of control group. 2. Total Leukocytes and Eosinophils in BALF of the mice group treated with PR-HA decreased significantly compared with those of control group. 3. Eosinophils in BALF of the mice group treated with PR-HA in Photomicrographs decreased significantly compared with those of control group. 4. According to Histological analysis of lung sections, it decreased significantly adhension of collagen in PR-HA than those of control group 5. The concentration of IgE, IL-4, IL-5, in BALF and IL-4, IL-5, Il-13 in serum of the mice group treated with PR-HA decreased significantly compared with that of control group. 6. The number of Gr-1+/CD11b+, CD11b+, CD3-/CCR3+, CD4+, CD3e+/CD69+ , CD23+B220+ cells in the lungs of the mice group treated with PR-HA decreased significantly compared with those of control group. 7. The cytokine's manifestation of mRNA of the mice group treated with PR-HA with RT-PCR decreased significantly compared with that of control group. Conclusion : We conclude that PR-HA is effective on OVA-induced asthma of C57BL/6 mouse.
Kim, Su-Il;Rah, Ueon-Woo;Kim, Deog-Young;Bae, Ha-Suk
Physical Therapy Korea
/
v.10
no.2
/
pp.71-84
/
2003
The purpose of this study was to provide information on driving characteristics in persons with spinal cord injury through basic statistic analysis of the survey results. The survey was administered to 44 drivers with spinal cord injury. The subjects' general, neurologic and driving characteristics were analyzed, as well as the degree of difficulty in using their vehicles between tetraplegia and paraplegia. The results were as follows: thirty-five (79.6%) of forty-four respondents was men. The average age was 35.0 years old and the age at the time of injury was 29.0 years old. Their neurologic characteristics were tetraplegics 12 (27.3%) and paraplegics 32 (72.2%). Among complete lesions, the highest level those who could drive independently was C7. All the vehicles were equipped with special devices, including "power steering", "automatic transmission" and "hand controls". The vehicles for cervical cord injury were equipped with "grip bars" as well as for the degree of difficulty in using their vehicles, all the subjects felt that "moving the wheelchair in and out of their vehicles" was too difficult for them to do. We suggest that the driver training should be an essential part of the rehabilitation program for patients with spinal cord injuries to maximize their mobility in the community. This training seems to be essential in order to modify the standards of the Handicapped Drivers Ability Test and to aid the driver rehabilitation program in the health insurance payment system. Also, the driver rehabilitation training program should include instruction in that moving wheelchairs in and out of vehicles.
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