• 대한한의학회지
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• 제24권3호
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• pp.192-198
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• 2003

Diarrhea is defined as increased volume and frequency of stools, increased liquidity and decreased consistency of stools. Enteral nutrition is suited to the patient in a state of normal gastro-intestinal function but insufficient oral nutrition due to neurologic injury. Of many problems raised by enteral nutrition, diarrhea is the most common complication and raises severe clinical problems such as dehydration, disproportion of electrolytes, metabolic acidosis, bed sores, etc. We report two cases of diarrhea due to enteral nutrition treated with Dolichos lablab L. preparation added to herb-med prescription in stroke patients. After this treatment, the frequency of diarrhea decreased and general condition improved.

• The Korean Journal of Pain
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• 제26권1호
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• pp.76-79
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• 2013

During the early stage of postherpetic neuralgia, an epidural block on the affected segment is helpful in controlling pain and preventing progression to a chronic state. The main neurologic complication following an epidural block is cord compression symptom due to an epidural hematoma. When neurologic complications arise from an epidural block for the treatment of postherpetic neuralgia, it is important to determine whether the complications are due to the procedure or due to the herpes zoster itself. We report a case of a patient who was diagnosed with herpes zoster myelitis during treatment for postherpetic neuralgia. The patient complained of motor weakness in the lower extremities after receiving a thoracic epidural block six times. Although initially, we believed that the complications were due to the epidural block, it was ultimately determined to be from the herpes zoster myelitis.

• Journal of Korean Neurosurgical Society
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• 제41권2호
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• pp.95-99
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• 2007

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.

• Archives of Plastic Surgery
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• 제46권4호
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• pp.365-370
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• 2019

The syndrome of the trephined is a neurologic phenomenon that manifests as sudden decline in cognition, behavior, and sensorimotor function due to loss of intracranial domain. This scenario typically occurs in the setting of large craniectomy defects, resulting from trauma, infection, and/or oncologic extirpation. Cranioplasty has been shown to reverse these symptoms by normalizing cerebral hemodynamics and metabolism. However, successful reconstruction may be difficult in patients with complex and/or hostile calvarial defects. We present the case of a 48-year-old male with a large cranial bone defect, who failed autologous cranioplasty secondary to infection, and developed rapid neurologic deterioration leading to a near-vegetative state. Following debridement and antibiotic therapy, delayed cranioplasty was accomplished using a polyetheretherketone (PEEK) implant with free chimeric latissimus dorsi/serratus anterior myocutaneous flap transfer for vascularized resurfacing. Significant improvements in cognition and motor skill were noted in the early postoperative period. At 6-month follow-up, the patient had regained the ability to speak, ambulate and self-feed-correlating with evidence of cerebral/ventricular re-expansion on computed tomography. Based on our findings, we advocate delayed alloplastic implantation with total vascularized soft tissue coverage as a viable alternative for reconstructing extensive, hostile calvarial defects in patients with the syndrome of the trephined.

• Journal of Ginseng Research
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• 제15권1호
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• pp.6-12
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• 1991

The analgesic effect of morphine was antagonized in mice pretreated with ginseng total saponin intraperitoneally, intracerebrally and intrathecally. The antagonized effects of morphine analgesia were reversed predominantly by treatment with L-3, 4-dihydroxyphenylalanine in the tail pinch test and 5-hydroxytryptophan in the tail flick test respectively. These indicate that the antagonistic action of ginseng total saponin might be due to their inhibitions of the activation of descending ihibitory systems at the cerebral site as well as spinal. In addition, any appreciable changes of brain biogenic monoamine levels were not observed in mice pretreated with ginseng total saponin at various time intervals. These results obtained suggest that a newly equilibrated state of neurologic function could be found in mice pretreated with ginseng total saponin, and modification of neurologic function in the mechanism for the antagonism of morphine analgesia by ginseng total saponin was more important than the changes of brain biogenic monoamine levels.

• 대한핵의학회지
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• 제29권1호
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• pp.22-30
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• 1995

저자들은 두개 기저나 경부종괴 또는 내경동맥의 동맥류등으로 인하여 내경동맥의 결찰이 필요한 환자에 있어서 객관적인 관점에서 수술전에 영구적인 내경동맥의 결찰의 안전성에 관하여 $^{99m}Tc$-HMPAO 뇌 SPECT를 이용하여 보고자 하였다. 내경동맥의 결찰이 고려되는 24명의 두개기저나 경부종괴 환자를 대상으로 하였다. 저자들은 풍선 시험 결찰술 시행전과 시행중의 양측 중대뇌동맥 영역의 섭취정도를 $^{99m}Tc$-HMPAO 뇌 SPECT를 이용하여 비교해보았고 이러한 결과를 신경학적 검사, 경동맥 스텀프압 고리고 뇌전도검사등과 비교해 보았다. 대상환자중 19명의 환자에서는 풍선 시험 결찰술 동안 신경학적 이상등의 문제들을 경험하지 않았고 이들에 있어 중대뇌동맥영역의 섭취정도는 결찰술 시행전에 비교하여 95-101%에 해당하였다. 나머지 5명의 환자에서는 일과성 반신마비와 의식소실등의 심한 신경학적 증상을 보였고 이들에 있어 중대뇌동맥 영역의 섭취정도는 시행전에 비하여 77-85%에 해당하였으며 다른 검사결과와도 잘 부합되었다. 결론적으로 풍선시험결찰술 시행전과 시행중의 $^{99m}Tc$-HMPAO 뇌 SPECT는 중대뇌동맥영역의 섭취가 시행전에 비교하여 85%이하인 경우 영구적인 신경학적 결손을 예측할 수 있는 간단하고 객관적인 방법이 될 수 있을 것으로 생각한다.

• 대한바이러스학회지
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• 제30권3호
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• pp.171-178
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• 2000

Herpes simplex virus, Varicella zoster virus and Human herpes virus-6 caused central nervous system infections and latent infections but there is no data of the 3 viruses being tested from the same cerebrospinal fluid samples with aseptic meningitis or encephalitis in adults patients. These viruses produced similar neurologic symptoms but difficulties existed in differentiating of etiologic agents and therefore the viruses needed to be detected in the early state. Herpes simplex virus encephalitis (HSVE) in adults, if not treated promptly was fatal. If treated with antiviral drugs in the early phase of encephalitis, neurologic sequales decreased by 65%. Recently, a PCR method for detection of HSVE with CSF was developed. VZV primary and secondary infections caused neurologic symptoms of encephalitis or meningitis. The second frequency of adult encephalitis that caused VZV were reported. HHV-6 caused CNS latent infection that was studied with normal adults brains. But there is no data of HSV, VZV and HHV-6 for aseptic meningitis and encephalitis of Korean adults through etiologic study. We cultured CSFs on HEp-2 cells and simultaneously tested for HSV PCR, VZV nested PCR and HHV-6 PCR with 8 specific primers. The PCR results of CSF from meningitis Korean adults were 13/19 (68.4%) for HSV, 10/19 (52.6%) for VZV and 12/19 (63.2%) for HHV-67/19 (36.8%) cases were triple infected HSV PCR, VZV PCR and HHV-6 PCR positive; 3/19 (15.8%) cases were dual infected HSV PCR and HHV-6 PCR positive; 1119 (0.5%) cases was VZV PCR positive. Strong viral DNA amplification of CSF means a causative virus may be present in aseptic meningitis or encephalitis patients and may cause clinical neurologic symptoms. HSV and HHV-6 viruses detection rate were higher than VZV by PCR with CSFs.

• 대한한방내과학회지
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• 제34권2호
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• pp.113-121
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• 2013

목 적 : 본 연구에서는 침치료가 비만치료의 주요방법인 식욕억제에 효과적인지 알아보기 위하여 굶긴 쥐 시상하부에서 NPY와 LR의 발현 변화를 실험을 통하여 연구하였다. 방 법 : 생후 6주 Sprague-Dawley rats를 한 군에 다섯 마리씩 배정하여 대조군-무치료, 대조군-이침치료, 대조군-족삼리치료, 대조군-임의혈치료, 실험군-무치료, 실험군-이침치료, 실험군-족삼리치료, 실험군-임의혈치료의 8군으로 분류하여 실험하였다. 실험군은 3일간 물만 공급하고 사료를 금식시켰고, 침자극은 하루 2회 3일간 시행하였다. 침은 직경 0.3 mm 이었고, 양측혈을 사용하였고, 2-4 mm 깊이로 자입 하였으며, 20분 유침하였다. 3일 후 pentobarbital로 마취하여 사망시켰고, 4% paraformaldehyde로 조직을 고정한 후 뇌조직을 관상으로 $40{\mu}m$두께로 잘랐다. 식욕조절중후인 시상하부의 paraventricular nucleus(PVN)에서 NPY와 LR의 발현을 면역조직법으로 보았다. 결 과 : 굶기지 않은 대조군에 비하여 굶긴 실험군에서 시상하부 PVN 에서 NPY의 증가와 LR 감소가 나타났다. 굶긴 실험군에 이침, 족삼리, 임의혈 자침시 시상하부 PVN 에서 NPY의 감소가 나타났으며, 이침이 타침 자침에 비하여 NPY의 감소를 더욱 크게 나타냈다. 굶기지 않은 정상상태에서 이침, 족삼리, 임의혈 자침시 NPY의 증가가 있었으며 이는 자침에 의한 스트레스로 인한 것으로 보여진다. 굶긴 실험군에 이침 자침 시에만 시상하부 PVN에서 LR의 증가가 있었으며 정상상태에서 자침시 LR 발현의 변화는 없었다. 결 론 : 이상의 연구결과로서 이침치료가 식욕을 억제하는데 가장 유의한 효과가 있는 것으로 나타났다.

• Journal of Trauma and Injury
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• 제29권4호
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• pp.99-104
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• 2016

Purpose: There are many patients visited to ED in an alcohol intoxicated state. For these patients, it is difficult to predict by only clinical examination whether he/she would have brain lesion. The purpose of this study is to research whether it is possible to predict brain lesion by only clinical examination findings, with comparing patients with/without actual brain lesions. Methods: A retrospective study was performed at a university hospital for the period 11 months with the medical records. As for the inclusion group, head trauma patients with objectively proved drunk, judging by their blood ethanol concentration, and performed the brain CT were selected. In terms of medical record, Glasgow coma scale (GCS), the presence of neurologic abnormalities, the presence of lesion on brain CT of the patients, were examined. From laboratory results, blood ethanol concentration, platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT) and glucose concentration were identified. Results: For this study, there were total 80 patients of inclusion group. There was no statistically significant difference in terms of GCS score and neurological examination abnormalities, between the group with brain lesion and the group without brain lesion on brain CT. Conclusion: Alcohol intoxicated patient with head trauma visits the ED, it is not possible to distinguish or determine whether brain lesion exists or not by only clinical findings. In order to check the lesion existence, the image examination, therefore, should be considered and performed.

• Journal of Ginseng Research
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• 제15권3호
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• pp.179-182
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• 1991

The relationship between the brain monoamines and morphine tolerance was examined in ginseng total saponins treated mice. Ginseng total saponins (100 mg/kg, i.p.) did not antagonize morphine (10 mg/kg, s.c.) analgesia in mice. Daily treatment with ginseng total saponins (100 mg/kg) did not affect the brain levels of noradrenaline, dopamine and serotonin for 5 days but inhibited the development of morphine tolerance. This inhibition of the development of morphine tolerance was not attributed to the reductions of brain noradrenaline, dopamine and serotonin in mice treated with ginseng total saponins (100 mg/kg) daily. This result suggest that a newly equilibrated state of neurologic function may involve an underlying mechanism in mice treated with ginseng total saponins.