• Title/Summary/Keyword: Neurologic Assessment

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Effectiveness of Bee Venom Acupuncture on Shoulder Pain after Stroke (뇌졸중 환자의 견관절 통증에 대한 봉독약침의 임상효과)

  • Ko, Chang-Nam;Park, Sung-Wook;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Min, In-Kyu
    • The Journal of Korean Medicine
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    • v.28 no.1 s.69
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    • pp.11-24
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    • 2007
  • Objectives : Hemiplegic shoulder pain is one of the common sequelae of stroke. Although many different methods of treatment are applied, none have yet been proved to be effective. In this study we assessed the effectiveness of bee venom in patients with shoulder pain after stroke. Methods : This study was a double blinded, randomized, placebo-controlled clinical trial. All subjects received either 0.6 ml bee venom injection (venom:saline = 1:10000) or 0.6ml physiological saline solution (placebo) at three acupoints. The effectiveness was assessed by visual analogue scale, pain rating score, Fugl-Meyer assessment and passive external rotation. Results : There were 24 patients in the venom group and 22 patients in the placebo group. The venom group5,hewed more effectiveness in VAS and PRS than the placebo group. Conclusions : This study suggests that bee venom injection has significant analgesic effect on hemiplegic shoulder pain. Further study based on multi-centers, larger population, and long term 1311ow-up is needed to confirm this suggestion.

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Clinical Study about Warning Signs of Patients with Acute Stroke (급성기(急性期) 중풍환자(中風患者)에 대한 중풍전조증(中風前兆症) 조묘(調杳) 연구(硏究))

  • Jung, Jae-Han;Sun, Jong-Joo;Choi, Chang-Min;Kim, Seok-Min;Kim, Chang-Hyun;Min, In-Gyu;Jeong, Dong-Won;Park, Sung-Uk;Jung, Woo-sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Kim, Young-Suk;Bae, Hyung-Sup;Cho, Ki-Ho
    • The Journal of Internal Korean Medicine
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    • v.28 no.1
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    • pp.47-67
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    • 2007
  • Objectives : This study was aimed to investigated the warning signs and its relationship with the other characteristics in acute stroke patients. Methods : 225 acute stroke patients were recruited at the Department of Cardiovascular and Neurologic Diseases (Stroke Center) of Kyung Hee University Oriental Hospital from October 2005 to September 2006. We evaluated their stroke type with brain MRI, their warning signs, and general characteristics such as age, sex, past history, risk factors, etc. Results : 225 subjects were included in the final analysis. In the subjects' general characteristics, the most common etiology of stroke was small vessel occlusion. In the assessment of the subjects' warning signs, the frequency of tension felt at the cervical area was highest followed by blepharospasm, sensory dysfunction (one side of numbness, tingling sensation, dead sensation), one side paralysis or weakness, etc. After analyzing etiology, cerebral hemorrhage had more facial spasm sign and hypertension than cerebral infarction. On the other hand, cerebral infarction had more diabetes and sensory dysfunction (one side of numbness, tingling sensation, dead sensation) than cerebral hemorrhage. Among stroke locations, subjects with their brain lesion in the cortex had more warning sings of motor dysfunction such as one side paralysis, or weakness. Multiple lesions showed a close relationship with smoking habit and were more common in males than in females. The under 65 years old group were more commonly associated with alcohol consumption, accidental mental stress and blepharospam than the over 65 years old group. In the group of under 65 years old, males more commonly had lesions in occipital lobe, alcohol consumption and smoking habit than females. Otherwise, females more commonly had vision dysfunction and blepharospasm than males. In the group of over 65 years old, males more commonly had cortex lesion than females. On the other hand, Females more commonly had accidental mental stress than males. Conclusions : We observed various warning signs and their distribution in acute stroke patients. The subjects' brainlesions and their etiology seemed to affect the features of the warning signs. Hypertension, diabetes and hyperlipidemia were also related to etiology of stroke and some habitual problems such as smoking and drinking seemed to reduce the age of stroke ictus. Although a concrete conclusion can hardly be drawn from this study, it reminds physicians of the importance of warning signs which appear among their patients.

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Clinical trial to evaluate the efficacy and safety of Tongxinluo in high risk group of cardiovascular diseases (심혈관질환 고위험군에 대한 통심락(通心絡)의 유효성 및 안전성 평가를 위한 임상시험)

  • Park, Seong Uk;Jung, Woo Sang;Moon, Sang Kwan;Go, Chang Nam;Cho, Ki Ho;Kim, Young Suk;Bae, Hyung Sup
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.6 no.1
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    • pp.25-32
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    • 2005
  • Background and purpose: Arterial stiffness is an important, independent determinant of cardiovascular risk. Pulse wave velocity (PWV) has been used as a valuable index of arterial stiffness and as a surrogate marker for atherosclerosis. The Framingham risk score was developed using categorized risk factors to predict the 10 year absolute risk of developing coronary heart disease (CHD). This algorithm is established using recommended guidelines for blood pressure, total cholesterol, and high density lipoprotein cholesterol in addition to age, smoking history and history of diabetes. Tongxinluo(TXL) has been shown to have anti hyperlipidemic activity and anti atherogenic effects. To determine its efficacy and safety, we examined whether TXL improves PWV, ABI, Framingham score, blood pressure, and lipid profile in high risk group of cardiovascular diseases. Subjects and methods: 49 subjects with the high risk of cardiovascular diseases were recruited. Subjects were administered TXL with the dose of 1110mg three times a day for 8 weeks. baPWV, ABI, Framingham risk score, Blood pressure and serum lipid profile were assessed at baseline and after 4 and 8weeks. Results: Total cholesterol, LDL cholesterol, triglyceride, total lipid and phospolipid significantly decreased after 4 weeks of medication. Total cholesterol, total lipid and phospolipid significantly decreased after 8 weeks of medication. There were no significant changes in Framingham risk scores, ABI, PWV and blood pressure. On safety assessment, there were no adverse effects, hepatic or renal toxicity. Conclusion: We suggest that TXL is a safe and useful herbal medicine for hyperlipidemia and as for anti-atherognic effects, further research would be necessary.

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Diamox-enhanced Brain SPECT in Cerebrovascular Diseases (뇌혈관질환에서 다이아목스부하 뇌 단일광자방출 전산화단층촬영)

  • Choi, Yun-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.2
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    • pp.85-90
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    • 2007
  • Acute event in cerebrovascular disease is the second most common cause of death in Korea following cancer, and it can also cause serious neurologic deficits. Understanding of perfusion status is important for clinical applications in management of patients with cerebrovascular diseases, and then the attacks of ischemic neurologic symptoms and the risk of acute events can be reduced. Therefore, the normal vascular anatomy of brain, various clinical applications of acetazolamide-enhanced brain perfusion SPECT, including meaning and role of assessment of vascular reserve in carotid stenosis before procedure, in pediatric Moyamoya disease before and after operation, in prediction of development of hyperperfusion syndrome before procedure, and in prediction of vasospasm and of prognosis in subarachnoid hemorrahge were reviewed in this paper.

The Relative Risk Assessment of Leptin for Stroke in Korea

  • Cho, Ki-Ho;Jung, Woo-Sang;Bae, Jong-Myon;Go, Chang-Nam;Bae, Hyung-Sup
    • The Journal of Korean Medicine
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    • v.24 no.4
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    • pp.1-5
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    • 2003
  • Leptin has a close correlation with obesity, which is known to be a major factor for stroke. This study was performed to determine whether serum leptin level would be an independent risk factor for stroke and whether it would change significantly early after stroke. Subjects were selected from those within I month after onset and non-stroke referents at Kyung Hee Oriental Medical Center in Seoul, Korea. We compared leptin and the other characteristics between stroke subjects and referents. Body mass index, hypertension history, presence of drinking and smoking, waist/hip ratio, total cholesterol and triglyceride were recorded. To assess odds ratio of leptin for stroke, we used logistic regression analysis. Leptin was rechecked 2 weeks later and compared with the former value in acute stroke subjects. In this study, serum leptin did not differ significantly between stroke subjects and referents, and its odds ratio was not significant in male (OR=0.52, 95% Cl; 0.13-2.08) and female (OR=1.57, 95% Cl; 0.53-4.67). In acute stroke subjects, leptin did not change significantly 2 weeks later. Hypertension had a significant odds ratio in male (OR=3.39, 95% Cl; 1.02-11.24) and female (OR=12.37, 95% Cl; 3.67-41.65). High waist/hip ratio was only in female (OR=6.70, 95% Cl; 1.73-26.02). In conclusion, leptin was not an independent risk factor for stroke and its serum level did not change significantly early after stroke. Hypertension and waist/hip ratio had significant relative risks.

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Treatment outcome of anaplastic ependymoma under the age of 3 treated by intensity-modulated radiotherapy

  • Lee, Joongyo;Chung, Seung Yeun;Han, Jung Woo;Kim, Dong-Seok;Kim, Jina;Moon, Jin Young;Yoon, Hong In;Suh, Chang-Ok
    • Radiation Oncology Journal
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    • v.38 no.1
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    • pp.26-34
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    • 2020
  • Purpose: Intensity-modulated radiotherapy (IMRT) allows for more precise treatment, reducing unwanted radiation to nearby structures. We investigated the safety and feasibility of IMRT for anaplastic ependymoma patients below 3 years of age. Materials and Methods: A total of 9 anaplastic ependymoma patients below 3 years of age, who received IMRT between October 2011 and December 2017 were retrospectively reviewed. The median equivalent dose in 2 Gy fractions was 52.0 Gy (range, 48.0 to 60.0 Gy). Treatment outcomes and neurologic morbidities were reviewed in detail. Results: The median patient age was 20.9 months (range, 12.1 to 31.2 months). All patients underwent surgery. The rates of 5-year overall survival, freedom from local recurrence, and progression-free survival were 40.6%, 53.3%, and 26.7%, respectively. Of the 9 patients, 5 experienced recurrences (3 had local recurrence, 1 had both local recurrence and cerebrospinal fluid [CSF] seeding, and 1 had CSF seeding alone). Five patients died because of disease progression. Assessment of neurologic morbidity revealed motor dysfunction in 3 patients, all of whom presented with hydrocephalus at initial diagnosis because of the location of the tumor and already had neurologic deficits before radiotherapy (RT). Conclusion: Neurologic morbidity is not caused by RT alone but may result from mass effects of the tumor and surgical sequelae. Administration of IMRT to anaplastic ependymoma patients below 3 years of age yielded encouraging local control and tolerable morbidities. High-precision modern RT such as IMRT can be considered for very young patients with anaplastic ependymoma.

Clinical Assessment of Pain and Sensory Function in Peripheral Nerve Injury and Recovery: A Systematic Review of Literature

  • John, Albin A.;Rossettie, Stephen;Rafael, John;Cox, Cameron T.;Ducic, Ivica;Mackay, Brendan J.
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.427-439
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    • 2022
  • Peripheral nerve injuries (PNIs) often present with variable symptoms, making them difficult to diagnose, treat, and monitor. When neurologic compromise is inadequately assessed, suboptimal treatment decisions can result in lasting functional deficits. There are many available tools for evaluating pain and functional status of peripheral nerves. However, the literature lacks a detailed, comprehensive view of the data comparing the clinical utility of these modalities, and there is no consensus on the optimal algorithm for sensory and pain assessment in PNIs. We performed a systematic review of the literature focused on clinical data, evaluating pain and sensory assessment methods in peripheral nerves. We searched through multiple databases, including PubMed/Medline, Embase, and Google Scholar, to identify studies that assessed assessment tools and explored their advantages and disadvantages. A total of 66 studies were selected that assessed various tools used to assess patient's pain and sensory recovery after a PNI. This review may serve as a guide to select the most appropriate assessment tools for monitoring nerve pain and/or sensory function both pre- and postoperatively. As the surgeons work to improve treatments for PNI and dysfunction, identifying the most appropriate existing measures of success and future directions for improved algorithms could lead to improved patient outcomes.

Occipital Dysplasia in Dogs (개의 후두골 이형성)

  • 윤정회;이회천;안용주;최호정;윤화영;권오경;남치주;성재기
    • Journal of Veterinary Clinics
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    • v.14 no.2
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    • pp.357-360
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    • 1997
  • Occipital dysplasias in five dogs showing various neurologic signs of unknown origin were diagnosed with clinical examination and skull radiographic assessment at this university teaching hospital. The severities of occipital dysplasia were Grade III in four dogs and Grade II in one dog. Major clinical signs were ataxia and convulsion. In skull radiographs, there were dorsal extents of the foramen magnum reached nuchal crest in all cases. Also, hydrocephalus or vertebral malformation was complicated in three cases.

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A Study of the Fluid Balance of the Patients on Soft Diets (유동식을 섭취하는 대상자의 수분 섭취와 배설의 균형 분석)

  • 양영희;최스미;김은경;성일순
    • Journal of Korean Academy of Nursing
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    • v.26 no.3
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    • pp.688-696
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    • 1996
  • The purpose of this study was to investigate the fluid balance of the patients who were either on soft fluid diet or total parenteral nutrition. We studied 19 patients with neurologic disorders and 22 patients with oromaxillary surgery who were admitted to either D university hospital in Choognam or S general hospital in Seoul between May and November 1995. The mean age for the patients who had oromaxillary surgery was 24 years and their average hospital stay was 9 days. The mean age of the patients with neurologic disorders was 54 years and they were bedridden for average of 71 days. For the maxillary bone surgery patients we did not limit the range of their activities in the ward during data collection period. The patients with neurological disorders were bedridden and did not move around the ward. They were all either on soft fluid diet, or total parenteral nutrition. The findings of this study are as follows ; 1) The difference of the triceps skinfold thickness between the baseline and the final measurement was 0.4cm for neurologic patient group and 0.5cm for oromaxillary surgery patient group. The difference was not statistically significant in each group. 2) In the oromaxillary surgery patient group, the daily intake of fluid in the form of pure water, other beverages, fluid diet as well as IV fluid was 4581m1 while urine output was 2979ml. The difference between fluid intake and output was statistically significant, indicating that fluid intake was far more than urine output. In neurologic patient group, the daily intake of fluid including water from fluid diet and IV fluid was 2701m1 whereas urine output was 2253m1 and they were statistically significant. 3) For a more accurate assessment we adjusted the fluid balance based on weight changes during data collection period. In the oromaxillary surgery patient group. the difference between fluid intake and output was 1238m1 after weight changes being adjusted. The difference was statistically significant, suggesting fluid overload in this patient group. In neurologic patient group, the difference between fluid intake and output considering weight changes was 124ml. The difference was not statistically significant, suggesting that the fluid intake and output was well balanced in this patient group.

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A Case Report of Complex Korean Medicine Treatment Including Modified Gamiguibi-tang in a Paraneoplastic Cerebellar Degeneration Patient with Dysarthria and Weakness of Distal Extremity (구음장애와 사지원위부 무력감을 호소하는 신생물딸림소뇌변성 환자에 대한 가미귀비탕가감방을 포함한 한의복합치료 1례)

  • Ji-hyeon Kang;Seo-hyun Kim;Chae-eun Kim;Hee-ju Won;Kyungmin Baek
    • The Journal of Internal Korean Medicine
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    • v.45 no.3
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    • pp.497-507
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    • 2024
  • Objectives: This study investigated the treatment response to Korean medicine of a paraneoplastic cerebellar degeneration (PCD) patient with dysarthria and weakness of distal extremity. Case presentation: A 53-year-old female diagnosed with PCD complained of dysarthria and weakness of distal extremity. During 32-day hospitalization, she was treated with Korean medicine, namely, herbal medicine (modified Gamiguibi-tang), acupuncture (15 minutes twice a day at CV23, HT7, LI4, LR3, ST36, SP6, GB20, TE17, PC6, GV20, Ex-HN1, GV24 etc.), moxibustion, and cupping, combined with Western medicine (prednisolone, azathioprine) and physical therapy. Post-treatment, the patient global assessment (PGA) score of dysarthria fell from 100 to 60; grasp power rose from 15 kg to 19 kg and 13 kg to 17 kg in the right and left hands, respectively; and the 5-level EQ-5D version (EQ-5D-5L), EQ visual analogue scale (EQ-VAS), and Beck depression inventory (BDI-II) scores changed from 10 to 8, 0 to 80, and 34 to 7 respectively. Follow-up visits continued for about a month after discharge, improvement in symptoms maintained, and there were no significant side effects. Conclusions: Given the lack of standard treatment for PCD, Korean medicine can be tried clinically for the treatment of PCD patients with dysarthria and weakness of distal extremity. However, further studies with control groups are needed.