• Title/Summary/Keyword: Neurologic dysfunction

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Clinical Significance of Brain SPECT in Zipeprol Abusers (Zipeprol 남용환자에서 뇌 단일광자방출 전산화단층촬영술의 임상적 의의)

  • Cho, Dai-Ok;Kim, Jae-Phil;Kim, Deog-Yoon;Yang, Hyung-In;Koh, Eun-Mi;Kim, Kwang-Won;Choi, Young-Kil
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.22-27
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    • 1993
  • Drug abuse is widespread in worldwide and has been associated with neurologic complication. Zipeprol is one of the drugs which been abused for psychological satisfaction in some adolescents. This agent is non-opioid antitussive agent, which is not legally considered as being capable of creating dependence or abuse liability at therapeutic serum levels. But it has been reported that acute or chronic overdose create neurologic complication such as convulsion as well as dependence. Recently we experienced six zipeprol abusers who admitted due to convulsion and variable neurologic symptoms. The aim of our study was to determine the role of $^{99m}Tc$-HMPAO brain SPECT in those patients. EEG and brain CT showed no abnormal finding, but brain SPECT showed focal or multiple perfusion abnormalities in frontal, parietal, occipital cortex, basal ganglia, thalamus and especially at temporal cortex. These results suggest that brain SPECT may be a useful diagnostic tool to evaluate the cerebral dysfunction infused by zipeprol abuse.

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Hydrogen Sulfide Poisoning (황화수소 중독 증례)

  • Choi, Young-Hee;Nam, Byung-Kuk;Kim, Hyo-Kyung;Park, Ji-Kang;Hong, Eun-Seog;Kim, Yang-Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.1
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    • pp.31-36
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    • 2004
  • Three workers, field operators in lubricating oil processing of petroleum refinery industry were found unconscious by other worker. One of them who were exposed to an high concentration of H2S was presented with Glasgow Coma Score of 5, severe hypoxemia on arterial blood gas analysis, normal chest radiography, and normal blood pressure. On hospital day 7, his mental state became clear, and neurologic examination showed quadriparesis, profound spasticity, increased tendon reflexes, abnormal Babinski response, and bradykinesia. He was also found to have decreased memory, attention deficits and blunted affect which suggest general cognitive dysfunction, which improved soon. MRI scan showed abnormal signals in both basal ganglia and motor cortex, compatible with clinical findings of motor dysfunction. Neuropsychologic testing showed deficits of cognitive functions. SPECT showed markedly decreased cortical perfusion in frontotemporoparietal area with deep white matter. Another case was recovered completely, but the other expired the next day.

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The Effect of Intradermal Acupuncture on The Patients suffering from Insomnia after Stroke (중풍환자(中風患者)의 불면증(不眠症)에 피내침(皮內針)의 유효성(有效性) 및 적응증(適應證) 평가(評價))

  • Lee Sang-Ho;Kim Eun-Ju;Kim Lee-Dong;Yun Sang-Pil;Lee Cha-Ro;Hong Jin-Woo;Jeong Dong-Won;Moon Sang-Kwan;Cho Ki-Ho;Kim Young-Suk
    • The Journal of Internal Korean Medicine
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    • v.25 no.1
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    • pp.138-148
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    • 2004
  • Objective : Insomnia is the disorder of initiation or maintenance in sleeping that results in daytime sleepiness and dysfunction, and it arises from multiple psychological, physiological and environmental factors. A number of stroke patients suffer from insomnia are classified as sleep disorder patients with physical illness. In addition, insomnia may have profound deleterious effects on the natural course of stroke. We are to assess the effectiveness of intradermal acupucture on stroke combined with insomnia. Methods : We recruited hospitalized patients with insomnia after stroke. Then, the subjects were allocated into a treatment group and a control group by randomization. The treatment group received intradermal acupuncture therapy at He-7(神門), EH-6(內關) correctly. However in control group, intradermal acupuncture were just attached to He-7(神門), EH-6(內關) without insertion. Treatment over time at first day and second day a various indexes were repeatedly checked such as sleep latency, total sleep time, sleep quality, condition on awakening, ability of concentration, morning sleepiness, Insomnia Severity Index, and Athens Insomnia Scale. In the second analysis, we divided the treatment group into a response and a non-response group by their response to intradermal acupuncture. With the acupuncture treatment, accompanied symptoms were checked Results : Among thirty two subjects, two of them were dropped out: One complained the pain from needle insertion, and the other underwent the change of his herbal medication. At baseline investigation with the residual 30 subjects, the control and the treatment group were assessed to have an equal comparability. In the treatment group, sleep latency, total sleeping time, a number of awakenings, sleep quality and ability of concentration showed improvement significantly compared with the control group. The non-response Group showed symptoms such as nausea and halitosis, belching and acid regurgitation, abundant expectoration, while Responder Group showed palpitation, oppressed feelings in chest and sleep disorder. Conclusions: The result of this clinical study suggests that the intradermal acupuncture at He-7(神門), EH-6(內關) is one of the effective treatments for the insomnia after stroke.

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A case of Posterior Cortical Atrophy Presenting with Features of Atypical Dementia (비전형적 치매양상을 보이는 후부대뇌피질위축 증례보고)

  • Park, Kee Hyung;Kim, Sung-Wan;Shin, Dong-Jin;Park, Hyun-Mi;Lee, Yeong-Bae;Seung, Young-Hee
    • Korean Journal of Biological Psychiatry
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    • v.15 no.1
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    • pp.46-53
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    • 2008
  • Posterior cortical atrophy(PCA) is a presenile dementia that presents primarily with signs and symptoms of cortical visual dysfunction, while memory is relatively preserved until the late stage of the disease. We report a patient with PCA, confirmed by brain magnetic resonance imaging (MRI) and $F^{18}$-fluorodeoxyglucose positron emission tomography(FDG PET). A 58-year-old right-handed woman presented initially with visual dimness and difficulty finding things around her. She had partial Balint's syndrome, partial Gerstmann syndrome, and idiomotor apraxia. She also had a mild memory disturbance, but preserved insight of her disease. Neuropsychological evaluation showed decreased parietal and left temporal functions bilaterally. Brain MRI and $F^{18}$-FDG PET revealed typical bilateral occipitoparietal atrophy and hypometabolism, which were slightly worse on the right side. Cholinesterase inhibitor administration for 6 months improved the memory impairment slightly, but not the cortical visual dysfunction. This is a typical case of PCA, confirmed by neurologic signs and imaging findings.

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Effectiveness of Korea Red Ginseng in Erectile Dysfunction-Multi-National Approach (발기부전 환자에서의 홍삼의 효능에 관한 연구 -동남아시아의 다국적 연구)

  • Choi Hyung Ki;Choi Young Deuk;Adaikan P. Ganesan;Jiang Yu
    • Journal of Ginseng Research
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    • v.23 no.4
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    • pp.247-256
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    • 1999
  • Ginseng has been used in maintaining physical vitality throughout the far-eastern countries and recently its metabolism and actions on neurologic, cardiovascular, and endocrinologic systems are studied. Korean red ginseng (KRG) has been used in various ailments, and to prove its efficacy for erectile dysfunction an international study on Asians other than Korean was performed. Patients with borderline organic and psychogenic erectile dysfunction were included. KRG were given daily, and placebo were given as controls. Treatment lasted a total of 3 months. Surveys including libido, erection, ejaculation, sexual activity, and sexual satisfaction were given. Serum testosterone and erectile function study were taken. Among the 64 patients, 37 patients were followed with KRG. Five had diabetes, 5 hypertension, 5 hypercholesterolemia, 6 low testosterone, 6 psychogenic, and 11 idiopathic. The improvement after KRG administration was $70.2\%$ on objective questionnaire and $75.7\%$ on subjective analysis. When KRG were given, all parameters surveyed have shown improvements compared to the placebo. The effects of KRG in Chinese and Singapores were similar to the Koreans. Serum testosterone levels were nonnalized in 6 patients with KRG, who's serum testosterone levels were reduced from pre-study. Two patient reported constipation, and 2 gastric upsets in the KRG group. In conclusion, KRG has beneficiary action on male erectile capabilities with little side effects. KRG is effective in Koreans and also Asians. The exact action mechanism and the active ingredients in KRG need to be studied.

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Functional MRI Study of Changes in Brain Activity by Manual Acupuncture at LI11 or ST36 (곡지, 족삼리 침자극이 뇌활성화에 미치는 영향에 대한 뇌기능적 자기공명영상을 이용한 연구)

  • Cho, Seung-Yeon;Jahng, Geon-Ho;Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Gho, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Park, Jung-Mi
    • The Journal of Korean Medicine
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    • v.31 no.1
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    • pp.81-92
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    • 2010
  • Objectives: The objective of this study was to assess bra in activation and difference by LI11 or ST36 acupuncture stimulation using functional MRI (fMRI). Methods: A total of 10 healthy right-handed volunteers were studied. LI11 acupuncture and ST36 acupuncture stimulations were applied in order on the left. The block design paradigm of RARARA was used for the task, with R representing rest and A representing stimulation, and each period lasted 30 seconds. fMRI data were analyzed using SPM2. Results: The left LI11 acupuncture stimulation activated both sides of the inferior parietal lobule, the left side of the extra-nuclear, culmen and inferior semi-lunar lobules. On the right side, the nodule and midbrain regions were activated by the left LI11 acupuncture stimulation. The left ST36 acupuncture stimulation activated the right side of the superior frontal gyrus, middle frontal gyrus, superior parietal lobule, inferior semi-lunar lobule and pyramis. On the left side, the sub-gyral, middle temporal gyrus, fusiform gyrus, supramarginal gyrus, extra-nuclear, cingulate gyrus and fastigium regions were activated by the left ST36 acupuncture stimulation. Besides, both sides of the paracentral lobule, inferior parietal lobule, culmen, cerebellar tonsil and midbrain regions were activated. Conclusions: In conclusion, brain signal activation patterns according to acupoints were observed to differ, and ST36 acupuncture stimulation activated more regions than LI11. It is supposed that LI11 and ST36 acupuncture stimulations have an influence on motor function and sensory aphasia, and these stimulations thus represent potential for ocular motor dysfunction, discriminative touch or position sense disorder. Moreover, ST36 acupuncture stimulation activated the cingulate gyrus of the limbic system, so it seems to have an influence over autonomic functions.

A Case of Tuberculous Meningitis Combined with Acute Cervical Epidural Abscess and Cervical Spondylitis (급성 경추 경막외 농양 및 경추척추염과 동반된 결핵성 수막염 1예)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.4 no.2
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    • pp.140-145
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    • 2002
  • Neurologic sequelae of tuberculous meningitis include hemiparesis, paraparesis, quadriparesis, aphasia, developmental delay, dementia, blindness, visual field defect, deafness, cranial nerve palsies, epilepsy, and hypothalamic and pituitary dysfunction. But cervical epidural abscess and cervical spondylitis are rare. A 64-year-old woman who was diagnosed as tuberculous meningitis presented a severe neck pain and stiffness after 3 weeks of anti-tuberculous medication. Electromyography and cervical X-ray showed a cervical spondylosis with polyradiculopathy. But cervical MRI showed an acute cervical epidural abscess and mild cervical spondylitis. After continuous anti-tuberculous medication with supportive care, she showed a slow clinical improvement. But about 1 month of anti-tuberculous therapy, she presented a more aggravation of neck pain, neck stiffness, radicular pain, and neck motion limitation. Follow-up cervical MRI showed an more advanced cervical spondylitis. Afterthen she has recovered slowly by cervical laminectomy with posterior stabilization and continuous anti-tuberculous medication.

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Clinical Report of two TGA cases (일과성 전기억상실증으로 진단된 환자 치험 2례)

  • Oh, Kyong-Min;Yang, Dong-Ho;Cho, Youn-Song;Kim, Bo-Kyong
    • Journal of Oriental Neuropsychiatry
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    • v.19 no.3
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    • pp.265-276
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    • 2008
  • Transient global amnesia(TGA) is a clinical syndrome characterized by sudden, temporary dysfunction of anterograde and recent retrograde memory without other neurologic deficits. Different hypotheses have been considered for its etiology, but it still remains obscure. Recently the diffusion-weighted magnetic resonance imaging(DWI), has been considered as the sensitive tool to detect small punctate hyperintense lesions in the hippocampus in transient global amnesia(TGA). We report two TGA cases, all of them answers to TGA clinical criteria, and one of them showed two dot like high signal intense foci in Rt. hippocampus on DWI.

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A Case of Streptococcus suis Infection Causing Pneumonia with Empyema in Korea

  • Oh, Yoon Jung;Song, Sung Heon
    • Tuberculosis and Respiratory Diseases
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    • v.73 no.3
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    • pp.178-181
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    • 2012
  • Streptococcus suis causes meningitis and sepsis in pigs, but human infection has increased over the past few years in those who are exposed to pigs or raw pork. Most cases have occurred in Southeast Asia, but only two cases have been reported in South Korea, presenting with arthritis and meningitis. Here, we report a rare case of S. suis infection, a 60-year-old sailor, who visited the emergency room presenting septicemia, pneumonia with empyema and meningitis, showed full recovery; however, neurologic sequale of severe cognitive dysfunction was present after the usage of antibiotics and percutaneous drainage. S. suis was isolated from blood and pleural fluid and the strain was susceptible to penicillin and vancomycin. Increased awareness of S. suis infection and prevention are warranted.

A Case of Delayed encephalopathy after Acute Carbon Monoxied Intoxication (일산화탄소 중독 후 발생된 지연성 뇌병증 환자의 치험 및 호전 1예)

  • 김동은;김경훈;김정석;신길조;이원철
    • The Journal of Korean Medicine
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    • v.22 no.3
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    • pp.169-178
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    • 2001
  • After initial recovery from acute carbon monoxide (CO) intoxication, some patients occasionally undergo severe neuropsychiatric deterioration, which is called postanoxic delayed encephalopathy (sequelae). This is the clinical report about one patient, a 73-year-old man, diagnosed with delayed encephalopathy after acute CO intoxication. The symptoms of the patient were mental dysfunction including memory impairment and disorientation, abnormal behavior, incontinence and mutism. He had completely recovered after an aonxic episode, but the neurological symptoms that developed were preceded by an interval of apparent normality (the 'lucid interval'). We characterized him as suffering deficiency syndrome of the heart and prescribed for him Bokreongbosim-tang and Guipi-tang, and thereafter his symptoms were remarkably improved. For the evaluation of clinical improvement, we use the Modified Barthel Index (MBI), Canadian Neurologic Scale (CNS), and the Korean version of the Mini-Mental State Examination (K-MMSE)

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