• Title/Summary/Keyword: Neurological

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The Clinical Applicability of Transoral Transpharyngeal Approach to the Craniovertebral Junction Lesions (두개 경추 이행부의 병소에 대한 경구적 접근법의 유용성)

  • Cho, Tae Goo;Park, Kwan;Cho, Yang-Sun;Baek, Chung-Hwan;Nam, Do Hyun;Kim, Jong Soo;Hong, Seung-Chyul;Shin, Hyung Jin;Eoh, Whan;Kim, Jong Hyun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.379-388
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    • 2000
  • Objective : Although transoral transpharyngeal approach is a very useful method for the lesions of craniovertebral junction, it is not frequently used because of anatomical unfamilarity, risk of cerebrospinal fluid(CSF) leakage, and resultant postoperative meningitis. To evaluate the usefulness of transoral transpharyngeal approach for various lesions of craniovertebral junction, clinical characteristics and the results of this approach are investigated. Methods : Transoral transpharyngeal approaches were performed in eight cases between 1996 and 1999. Among them, there were three basilar invaginations due to congenital anomalies, two odontoid type I fractures, two atlantoaxial dislocations, and one pseudotumor. Surgical methods included five cases of anterior decompression and posterior fusion, two anterior approaches for decompression and one transoral approach for biopsy. Results : This procedure allowed immediate clinical improvement in all cases. In seven patients with preoperative motor deficit showed a progressive neurological improvement. The follow-up plain x-rays demonstrated successful bony fusion in all patients. Only one patient suffered from postoperative wound dehiscence, but she completely recovered after wound revision. There was no complication of postoperative CSF leakages. Conclusions : Transoral transpharyngeal approach for the ventral lesions of craniovertebral junction, can be used as a relatively simple and effective method.

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The Communication Repair Strategy Characteristics According to Communication Breakdown of Elderly Man With Alzheimer's Dementia (알츠하이머 치매 노인의 의사소통 단절에 따른 의사소통 회복전략 특성)

  • Kim, Sun-Young;Park, Hee-June
    • Therapeutic Science for Rehabilitation
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    • v.8 no.4
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    • pp.53-63
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    • 2019
  • Objective : Many communication recovery strategies should be used when communication breakdowns occur for successful communication, however, communication problems increase due to inadequate use of such strategies in older people with dementia. The purpose of this study was to investigate the difference of recovery strategy between dementia and the elderly in conversational discourse. Method : The subjects were eight of Alzheimer's dementia and 10 general elderly. Conversation discourse tasks were conducted face-to-face with the subjects. Communication breakdown and communication recovery strategies were analyzed based on 200 utterances collected in the conversation discourse. Result : First, the AD group had more communication breakdown than the control group, but the recovery rate did not differ between the groups. Second, in the AD group, the nonspecific recovery strategy and the clarification demand strategy were used as the expression strategy. The recovery rate after using expressive strategy was more than 90% in explanation strategy, combined strategy, nonspecific repair strategy, and repetition confirmation strategy. The response strategy used a lot of paraphrase strategy and combined strategies, and the recovery rate after using the response strategy was 100% for the simplification strategy, repeat strategy and gesture strategy. Conclusion : The AD group showed more breakdown of research subjects and breakdown of researchers than control group, and it showed ability to use various expression strategy and response strategy though there was difference in repair rate between communication repair strategy. AD group used nonspecific repair strategy in expression strategy the most and paraphrase strategy in response strategy the most. This shows different characteristic from ordinary elderly people. Therefore, it is necessary to utilize this repair strategy for rehabilitation of AD elderly.

Difference of Somatic Symptoms between Anxiety Disorder and Major Depressive Disorder and Their Domainal Association with Suicidal Idealization, Plan and Attempts (불안 장애와 주요우울장애에서 나타나는 신체 증상과 증상군에 따른 자살 사고, 계획, 행동과의 관계 고찰)

  • Ahn, Jun Seok;Kim, Eun young;Cho, Maeng Je;Hong, Jin Pyo;Hahm, Bong-Jin;Chung, In-Won;Ahn, Joon-Ho;Jeon, Hong Jin;Seong, Su Jeong;Lee, Dong-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.2
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    • pp.174-183
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    • 2016
  • Objectives : The aim of this study is to evaluate difference of somatic symptoms of anxiety disorder and major depressive disorder and domainal association with suicidal idealization, plan, and attempts. Methods : A total of 359 adults diagnosed with major depressive disorder and anxiety disorder of last one year participated. Participants interviewed with certain sections of Korean version of Composite International Diagnostic interview of CIDI. Sections of interests includes questionnaires regarding somatic symptoms and suicidal idea, plan and attempts of last one year. Results : Chest pain shows more prevalence in major depressive disorder. Symptoms of Headache and loose stool are more prevalent in anxiety disorder. Difficulty in equilibrium and fainting spells are more common somatic complaints of co-diagnosis states of anxiety disorder and major depressive disorder. Comparing 3 domains of pain symptoms, gastrointestinal symptoms and pseudo-neurological symptoms, pain symptom domains, gastrointestinal symptoms domain shows significant statistic difference between diagnosis. Average somatic symptom numbers of each symptom domains increase through suicidal idealization, plan and attempt, accordingly. Conclusions : Our finding shows some of somatic symptoms are more prevalent at certain diagnosis. Since increasing numbers of somatic complaints of each symptom domains goes with the suicidal idealization to suicidal attempts, proper psychiatric evaluation and consultations are crucial for patients with numerous somatic complaints in non-psychiatric clinical settings.

Does the Gut Microbiota Regulate a Cognitive Function? (장내미생물과 인지기능은 서로 연관되어 있는가?)

  • Choi, Jeonghyun;Jin, Yunho;Kim, Joo-Heon;Hong, Yonggeun
    • Journal of Life Science
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    • v.29 no.6
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    • pp.747-753
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    • 2019
  • Cognitive decline is characterized by reduced long-/short-term memory and attention span, and increased depression and anxiety. Such decline is associated with various degenerative brain disorders, especially Alzheimer's disease (AD) and Parkinson's disease (PD). The increases in elderly populations suffering from cognitive decline create social problems and impose economic burdens, and also pose safety threats; all of these problems have been extensively researched over the past several decades. Possible causes of cognitive decline include metabolic and hormone imbalance, infection, medication abuse, and neuronal changes associated with aging. However, no treatment for cognitive decline is available. In neurodegenerative diseases, changes in the gut microbiota and gut metabolites can alter molecular expression and neurobehavioral symptoms. Changes in the gut microbiota affect memory loss in AD via the downregulation of NMDA receptor expression and increased glutamate levels. Furthermore, the use of probiotics resulted in neurological improvement in an AD model. PD and gut microbiota dysbiosis are linked directly. This interrelationship affected the development of constipation, a secondary symptom in PD. In a PD model, the administration of probiotics prevented neuron death by increasing butyrate levels. Dysfunction of the blood-brain barrier (BBB) has been identified in AD and PD. Increased BBB permeability is also associated with gut microbiota dysbiosis, which led to the destruction of microtubules via systemic inflammation. Notably, metabolites of the gut microbiota may trigger either the development or attenuation of neurodegenerative disease. Here, we discuss the correlation between cognitive decline and the gut microbiota.

Effects of a Short-term Multimodal Group Intervention Program on Cognitive Function and Depression of the Elderly (단기 집단 복합중재가 정상 노인의 인지기능 및 우울에 미치는 영향)

  • Jung, Beom-Jin;Choi, Yu-Jin
    • Therapeutic Science for Rehabilitation
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    • v.8 no.3
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    • pp.57-68
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    • 2019
  • Purpose: This study aimed to investigate the effects of a short-term group multimodal intervention program that mixes physical activity, cognitive motion, and social interaction, on the cognitive function and depression level of healthy over 75-year-old individuals. Method: This study used a one group pre-test-post-test design, and intervention was made for 70 minutes per session, once a week, for four sessions in total. To compare changes in cognitive function, depression level and physical function before and after intervention, this study used the Mini-Mental State Examination-Dementia Screening (MMSE-DS), Geriatric Depression Scale-Short Form (GDS-SF), and Berg Balance Scale (BBS). Result: After applying group multimodal interventions to healthy over 75-year-old individuals, there was a statistically significant improvement in their cognitive function (p < 0.01), and there was a statistically significant decrease in their depression level (p < 0.05). Also, there was an increase in the rating score of the degree of balance from $46.83{\pm}9.11$ points before the intervention, to $48.08{\pm}7.00$ points after the intervention; however, it was not statistically significant (p > 0.05). Conclusion: Short-term group multimodal intervention that mixes physical activity, cognitive motion, and social interaction had a significant effect on slowing down the deterioration of cognitive function in healthy over 75 year-old individuals, and decreased their depression level. This study is significant in that it presents a foundation for providing more systematic intervention for the prevention of dementia and depression in the healthy older individuals. Follow-up studies should verify the result through research on the effects of an occupational therapist's professional treatment, and experimental group-control research.

A Systematic Study on the Multifaceted Lifestyle Assessment Tools For Community-dwelling Elderly: Trend and Application Prospect (지역사회 거주 고령자의 라이프스타일 측정도구에 관한 조사: 경향과 활용전망)

  • Park, Kang-Hyun;Won, Kyung-A;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.8 no.3
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    • pp.7-29
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    • 2019
  • Objective: The purpose of this study is to analyze comprehensive lifestyle assessment and other assessments which evaluate essential lifestyle factors, including physical activity, nutrition and activity participation. Methods: To analyze the comprehensive lifestyle assessment, from January 2001 to June 2019, a literature search was conducted using the CINANL, NDSL, PubMed, and RISS databases. The search terms were 'lifestyle assessment' OR 'lifestyle profile' OR 'lifestyle test'. In terms of other assessments of essential factors of lifestyle, from January 2010 to June 2019, articles were searched using similar databases. The search terms were 'physical activity assessment' OR 'physical activity participation profile', 'nutrition assessment', 'activity participation assessment' OR 'activity participation and lifestyle'. Results: A total of 4,165 articles were obtained, and finally 31 articles were selected according to the inclusion criteria. Among 31 articles, there were five with comprehensive lifestyle assessments, and all of them were self-report questionnaires. The most popular assessments were the Health Enhancement Lifestyle Profile (HELP) and the Health-Promoting Lifestyle Profile (HPLP), which were used in three articles (33%). In terms of assessment of physical activity, the most frequently used evaluation method was the self-report questionnaire, which was used in seven articles (58%) followed by objective assessments, which were used in four articles (33%). It was demonstrated that the Mini-Nutritional Assessment (MNA) was the most frequently used for nutrition assessment in the elderly. There were five types of assessment tool used for activity participation. Among them, meaningful activity participation assessment (MAPA) was the most frequently used tool. Conclusion: As a result of the systematic review, it was found that there are 21 assessments related to the evaluation of lifestyle in the elderly. Most assessments employed the self-report questionnaire method and mainly evaluated frequency and duration of participation in drinking, smoking, exercise, nutrition and social activities. Assessments of essential lifestyle factors were the self-report questionnaire method and the participation and frequency of activity. Therefore, by analyzing assessment tools, types of items and measurement methods of comprehensive lifestyle assessments and other assessment of essential lifestyle factors, this study provides the basic data on which to develop a standardized assessment tool that can evaluate the multifaceted lifestyle profile of the elderly.

Predicting Healthy Lifestyle Patterns in Older Community Dwelling Adults: A Latent Profile Analysis (잠재프로파일 분석을 활용한 한국 노인 라이프스타일 유형화와 영향요인 분석)

  • Park, Kang-Hyun;Yang, Min Ah;Won, Kyung-A;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.10 no.2
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    • pp.75-93
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    • 2021
  • Objective : The aim of this study was to identify subgroups of older adults with respect to their lifestyle patterns and examine the characteristics of each subgroup in order to provide a basic evidence for improving the health and quality of life. Methods : This cross-sectional study was conducted in South Korea. Community-dwelling older adults (n=184) above the age of 65 years were surveyed from April 2019 to May 2019. This study used latent profile analysis to examine the subgroups. Chi-squared (χ2) and multinomial logistic regression measures were then used to analyze individual characteristics and influencing factors. Results : The pattern of physical activity which is one of the lifestyle domains in elderly was categorized into three types: 'passive exercise type (31.1%)', 'low intensity exercise type (54.5%)', and 'balanced exercise type(14.5%)'. Activity participation was divided into three patterns: 'inactive type (12%)', 'self-management type (61%)', and 'balanced activity participation type (27%)'. In terms of nutrition, there were only two groups: 'overall malnutrition type (13.5%)' and 'balanced nutrition type (86.5%)'. Furthermore, as a result of the multinomial logistic regression analysis to understand the effects of lifestyle types on the health and quality of life of the elderly, it was confirmed that the health and quality of life were higher in those following an active and balanced lifestyle. In addition, gender, education level and residential area were analyzed as predictive factors. Conclusion : The health and quality of life of the elderly can be improved when they have balanced lifestyle. Therefore, an empirical and policy intervention strategy should be developed and implemented to enhance the health and quality of life of the elderly.

Cross-cultural Adaptation and Psychometric Evaluation of the Korean Version of the A-ONE (한국판 일상생활활동중심 작업기반 신경행동평가(A-ONE)의 개발 및 평가)

  • Kang, Jaewon;Park, Hae Yean;Kim, Jung-Ran;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.10 no.2
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    • pp.109-128
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    • 2021
  • Objective : The purpose of this study was to develop a Korean version of the Activities of Daily Living (ADL)-focused Occupation-Based Neurobehavioral Evaluation (A-ONE) through cross-cultural adaptation and examine its validity and reliability. Methods : This study translated the A-ONE into Korean and performed cross-cultural adaptation for the Korean population. After the development of the Korean version of the A-ONE, cross-cultural and concurrent validities were analyzed. Internal consistency, test-retest reliability, and inter-rater reliability were also evaluated. Results : We adapted three items to the Korean culture. The Korean version of the A-ONE showed high cross-cultural validity with a content validity index (I-CVI) >0.9. It correlated with the Functional Independence Measure (FIM) (r=0.52-0.77, p<0.001), except for communication. Cronbach's α was 0.58-0.93 for the functional independence scale (FI) and 0.42-0.93 for the neurobehavioral specific impairment subscale (NBSIS). Intraclass correlation coefficients (ICCs) indicated high test-retest and inter-rater reliability for FI (ICC=0.79-1.00 and 0.75-1.00, respectively) and NBSIS (ICC=0.74-1.00 and 0.72-1.00, respectively). Conclusion : The Korean version of the A-ONE is well adapted to the Korean culture and has good validity and reliability. It is recommended to evaluate ADL performance skills and neurobehavioral impairments simultaneously in Korea.

Correlation Between Cognitive Impairment Screening Test (CIST), Korean-Mini Mental State Examination, 2nd Edition (K-MMSE~2) and Clinical Dementia Rating (CDR) of Patients with Stroke (뇌졸중 환자를 대상으로 한 인지선별검사(CIST), 한국판 간이정신상태검사 2판(K-MMSE~2) 및 임상치매척도(CDR)의 상관성)

  • Hwang, Do-Yeon;Ryu, Sung-Hyun;Kwon, Ki-Hyun;Choi, Cho-Rong;Kim, Soo-A
    • Therapeutic Science for Rehabilitation
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    • v.11 no.2
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    • pp.53-62
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    • 2022
  • Objective : This study aimed to present basic data that could help in selecting or using evaluation tools in clinical settings. Methods : This study included 51 patients with stroke. The Cognitive Impairment Screening Test (CIST), Korean-Mini Mental State Examination, 2nd Edition (K-MMSE~2), and Clinical Dementia Rating (CDR) were used as evaluation tools. The correlation between evaluation tool scores was analyzed using Spearman's rank correlation coefficient, and the comparison of total scores between the CIST and K-MMSE~2 according to global CDR scores was analyzed using the Wilcoxon signed-rank test. Results : The correlation between the total CIST and K-MMSE~2 scores and global CDR scores was statistically significant (p<.01). The correlation between the sub-scores of the CIST and K-MMSE~2 showed a statistically significant correlation for all sub-scores (p<.01). The comparison of total scores between the CIST and K-MMSE~2 according to global CDR scores showed no statistically significant differences in all global CDR scores. Conclusion : This study showed that there was a correlation between CIST, K-MMSE~2, and CDR in patients with stroke. In the future, we hope that the results of this study will help to select or use cognitive function evaluation tools in clinical settings.

A Safety Survey of Pesticide Residues on Agricultural Products Marketed in Incheon from 2019 to 2021 (인천광역시 유통 농산물의 잔류농약 안전성 조사)

  • Park, Byung-Kyu;Kwon, Sung-Hee;Yeom, Mi-Sook;Han, Se-Youn;Kang, Min-Jung;Joo, Kwang-Sig;Heo, Myung-Je;Kwon, Mun-Ju
    • Journal of Food Hygiene and Safety
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    • v.37 no.4
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    • pp.249-259
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    • 2022
  • This study investigated pesticide residues in 7,069 agricultural products distributed in the city of Incheon from 2019 to 2021. Ingestion of pesticides can cause serious carcinogenic, endocrine, neurological, and reproductive problems. Pesticide residues in the samples were analyzed using various multi-residue methods (GC-MS/MS, GC-ECD/NPD, LC-MS/MS, and HPLC-UVD) on the Korean Food Code. The violation rate of the samples exceeding the maximum residue level (MRL) of pesticide residues for the years 2019, 2020, and 2021 was 1.0%, 1.4%, and 1.1%, respectively. Diazinon, flubendiamide, procymidone, fluxametamide, and fluquinconazole were the most frequently reported violative pesticide residues. Most commonly encountered agricultural products exceeding MRLs were coriander leaves, chamnamul, chwinamul, welsh onion, and crown daisy. Agricultural products and pesticides frequently exceeding MRLs should be continuously inspected for food safety. Continuous monitoring of pesticide residues in agricultural products is indispensable to improve consumer safety by preventing the distribution of agricultural products exceeding MRLs.