• Korean Journal of Biological Psychiatry
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• v.23 no.4
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• pp.179-184
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• 2016

Objectives This study was conducted to investigate the possibility of neurological soft signs as an endophenotype for schizophrenia by examining neurological soft signs in patients, their unaffected siblings and normal comparison subjects. Methods The study sample consisted of 32 patients, 25 of their unaffected siblings and 30 normal comparison subjects. Neurological soft signs were evaluated using the Cambridge Neurological Inventory Part 2. soft sign assessment. Results The patients were significantly more impaired than normal comparison subjects (p = 0.047) on primitive reflex. The patients were significantly more impaired than siblings (p = 0.004) and normal comparison subjects (p = 0.021) on motor coordination. The siblings performed better on sensory integration than the patients (p = 0.020) and normal comparison subjects (p = 0.036). Conclusions This study suggests that neurological soft signs might be a potential biomarker for schizophrenia, but might not be an endophenotype for schizophrenia.

• Sleep Medicine and Psychophysiology
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• v.2 no.2
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• pp.115-128
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• 1995

Present study reviewed various standardized neuropsychological assessment methods for children that are widely used in Korean child-psychiatric clinic settings to evaluate neurological problems, especially soft neurological signs that could not be identified by neurological techniques like CT, MRI. The characteristics of those neuropsychological test responses in children with psychiatric disorders that neurological factors are thought to play more important role than psychological factors in their etiology were examined. It is more important and required to establish the developmental norms for interpreting the results of neuropsychological tests and for identifying the signs of brain damage in case of children than adults. There are many difficulties in diagnosing brain dysfunction and conducting research for neurological problems in psychiatric disordered children due to lack of the standardized Korean version of neuropsyhological test for children, Therefore, several issues on developing the Korean version of neuropsyhological tests for children were discussed.

• Korean Journal of Biological Psychiatry
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• v.15 no.2
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• pp.83-91
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• 2008

Objectives : Neurological soft signs have been regarded as endophenotypes associated with the genetic basis of schizophrenia. This study was to investigate the intra-familial correlations of the neurological soft signs according to their genetic loading. Methods : Schizophrenic patients(N=14) were included, who had one parent with a family history of schizophrenia and the other without it. Genetic loading was determined by the patient's family history of schizophrenia using the Family Interview for Genetic Studies(FIGS). These parents were subdivided into two groups. The first group was designated as 'presumed carriers'(N=9) of genetic loading, who had one or more schizophreic firstor second-degree relatives. The second group was designated as 'presumed non-carriers'(N=11) of genetic loading, who had no schizophrenic first- or second-degree relatives. Normal controls(N=12) consisted of people without schizophrenic relatives. NSS were evaluated using the Neurological Evaluation Scale-Korean Version (NES-K), and the intra-familial correlations of NSS were tested using the Intra-Class Coefficients(ICC) method. Results : The scores of Motor Coordination subdimension of NES-K were significantly correlated between the patients and their presumed carriers(ICC=.804, p=.016), but not significantly correlated between the patients and their presumed noncarriers. In other subdimensions of NES-K, no significant correlation were found between the patients and their parents regardless of the genetic loading. But, there were no statistically significant differences in the scores of Motor Coordination subdimension of NES-K between the patients and controls. Conclusion : This study did not prove that the neurological soft signs might be an endophenotype of schizophrenia that cosegregate with the genetic loading. The future study using more subjects than this would be needed.

• Korean Journal of Biological Psychiatry
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• v.2 no.1
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• pp.115-122
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• 1995

This study was performed to know the relationship between neurologic soft signs (NSS) and clinical variables such as psychopathology. history of illness, and premorbid social adjustment in patients with schizophrenia. The authors evaluated NSS in 31 patients with schizophrenia using the structured tool for measuring neurologic abnormalities, Neurological Evaluation Scale- Korean Version(NES-K). Relationships between NSS and clinical variables such as duration of illness, intensity of precipitating stressors, duration of outpatient treatment, schooling, peer relationship, total duration of unemployment, total days of psychiatric admission, age, total days of being medicated, age at the first psychiatric admission, frequency of admissions, content of treatment, social adjustment, and severity of symptoms were analyzed. Differences between paranoid and non-paranoid schizophrenics were examined. In addition, Differences between patients with schizophrenia who have predominant positive symptoms and who have predominant negative symptoms were examined too. Total scores of NES-K were correlated with lower schooling (${\gamma}$=0.44, p<0.01). Scores of motor coordination subcategory were correlated with poor peer relationship(${\gamma}$=0.67, p<0.001). Other clinical variables were not correlated with any scores of NES-K. Paranoid and non-paranoid schizophrenics were not different in scores of NES-K. Also positive and negative schizophrenics were not different in scores of NES-K. Most clinical variables except schooling and peer relationship were not related with NSS. This results indicated that the meaning of these signs was not fully be understood. Introduction of the new classification concepts such as deficit or non-deficit syndrome will be helpful to elucidate the meaning of NSS in patients with schizophrenia.

• Korean Journal of Biological Psychiatry
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• v.1 no.1
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• pp.117-123
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• 1994

This study was performed to examine the role of neuroleptics may in the development of neurologic soft signs in patients with schizophrenia. Neurologic soft signs were evaluated in 28 neuroleptic naive patients with schizophrenia or schizophreniform disorder and 31 neuroleptic non-naive patients with schizophrenia using a structured tool for measuring neurologic abnormalities, Neurological Evaluation Scale-Korean version(NES-K). Relationship to dose, duration and neurological side effects of neuroleptic treatment were also evaluated. Total scores of NES-K in neuroleptic naive group were significantly higher than those of non-naive group. Scores of motor coordination, sequencing of complex motor acts and others items in functional subcategories were also significantly higher in drug-naive patients. The sensory integration item was not different between two groups. After controlling covariates such ac dose of neuroleptics, age and sex, total scores, motor coordination and others items of NES-K were significantly higher in neuroleptic naive group. However there was no difference between drug naive and non-naive group in the sequencing of complex motor acts item due to effects of these covariates. In neuroleptic non-naive group the dosage of neuroleptics correlated with the motor coordination item, nor were there relationships between duration and side effects of neuroleptic treatment and neurologic soft signs. These findings suggest that neuroleptic treatment may play a only relative role in the development of neurologic soft signs in patients with schizophrenia and these abnormalities may be one of possible trait markers of schizophrenia. To elucidate this opinion, well-controlled, prospective study in same subjects will be helpful.

• Journal of Chest Surgery
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• v.27 no.6
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• pp.502-505
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• 1994

Neurogenic tumors of the mediastinum may have an intraspinal component connected by a narrowed segment of tumor in the intervertebral foramen,hence the descriptive term dumbbell.Recently we had an occasion to remove a dumbbell neurilemmoma in a 62 years old woman using an approach designed to allow wide posterolateral thoracotomy and concomitant laminectomy for a single stage removal of the entire tumor. The mass in the posterior mediastinum was discovered on routine chest roentgenography. CT scan demonstrated a dumbbell shaped soft tissue mass density compressing spinal canal but preserving spinal cord. There were no neurologic signs. A standard posterolateral thoracotomy incision was made to remove tumor mass and then T5 unilateral laminectomy has done by Neurosurgeon. 7 x 7 cm sized extrapleural neurilemmoma was round, cystic, soft mass which covered parietal pleural with invaded regional vertebrae. There was no postoperative neurological complication.

• Journal of Korean Neurosurgical Society
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• v.41 no.2
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• pp.130-133
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• 2007

Neurenteric cysts are rare congenital lesions of the spine that are lined with endodermal epithelium. Their most common location is the cervico-dorsal region, and the mass usually lies ventral to the spinal cord. However the conus medullaris area location is an uncommon location. Neurenteric cysts are best treated by decompression and as near total excision of cyst membrane as possible. We report a case of a 7 year-old-girl with a neurenteric cyst in the conus medullaris. The patient had a history of meningitis and a gait disturbance. Magnetic resonance imaging [MRI] showed an intramedullary mass lesion in the conus medullaris with syringomyelia. There was no associated bone or soft-tissue anomaly. The mass was subtotally removed through a posterior approach. However 4 months later, meningeal irritation signs developed and MRI showed recurrence of the cyst. At the second operation, the cystic membrane was totally removed and the patient's neurological symptoms improved postoperatively. We reports a case of recurred neurenteric cyst occurred in unusual location with the review of literature.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1577-1583
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• 2000

Objectives : Among the various types of minimally invasive spine surgeries, thoracoscopic surgery is becoming more widely accepted and increasingly utilized. This report delineates our clinical experience using thoracoscopy to resect herniated thoracic discs in 16 patients who suffered from myelopathy or intolerable radiculopathy. Patients and Methods : Between Mar. 1997 and Sep. 1999, 16 consecutive patients underwent thoracoscopic discectomy for treatment of herniated thoracic discs. There were 12 men and 4 women(mean age 43.5 years ; range 18-61 years). Eleven patients presented with myelopathic signs and symptoms from spinal cord compression and 5 patients had incapacitating thoracic radicular pain without myelopathy. The surgical level was varied between T3 and T12. The pathology of specimen were 11 hard discs and 5 soft discs herniations. Thoracoscopic techniques were performed with long narrow spine instruments and high speed drill through 3 or 4 ports under one lung ventilated general anesthesia. During the operation three patients were converted to open thoracotomy due to intolerable one lung ventilation, excessive bleeding and inadequate operation field. The mean operation time was 264min.(range : 100-420min.), and postoperative mean admission period was 11 days. Results : Clinical and neurological outcomes were good in all patients(mean follow-up period 20 months). Among the eleven myelopathic patients, 8 improved neurologically, and 3 stabilized. Among the five radiculopathic patients, 4 recovered completely and no patient had worsened. Postoperative complications were pleural effusion in one case, intercostal neuralgia in one, delayed hemopneumothorax in one, prolonged air leakage in one and pneumonia in one case. Conclusions : Thoracoscopic discectomy needs a steep learning curve to be familiar to anatomical space and handling of endoscopic instruments. However, it is technically feasible and can be effectively performed with acceptable results.

• Journal of Veterinary Clinics
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• v.31 no.6
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• pp.523-526
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• 2014

Three dogs were admitted for repair of bone fracture. Case 1 (Maltese, 1.8 kg, intact female, 5-month-old) and case 2 (poodle, 3.0 kg, intact female, 6-month-old) had non-weight bearing lameness in the left pelvic limb, and case 3 (mixed, 3.3 kg, intact female, age unknown) had non-weight-bearing lameness in the left thoracic limb. On orthopedic examination, there was pain, crepitus, palpable instability and substantial soft tissue swelling on the affected side. No neurological deficits were identified. Radiographs revealed left proximal metaphyseal tibial and fibular fractures in cases 1 and 2, and left proximal metaphyseal radial and ulnar fractures in case 3. All cases had closed long-bone fractures with short juxta-articular fracture segments. Under fluoroscopic guidance, proper placement of the ring fixation elements was confirmed during surgery. Two or three rings were used to stabilize fractures with traditional circular external skeletal fixators (CESF). Postoperative radiographs showed acceptable alignment and apposition of the previously identified fracture. Time to radiographic union ranged from 5 to 14 weeks and there were no signs of implant failure or pin tract infection. Functional outcomes were excellent in all cases. CESF can be successfully used to reduce short juxta-articular fractures in which bone plates or external skeletal fixation cannot be applied.

• Korean Journal of Biological Psychiatry
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• v.14 no.3
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• pp.184-193
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• 2007

Objectives:There is increasing evidence that the cerebellum plays an important role in cognition and psychiatric symptoms as well as motor coordination. The concept of cognitive dysmetria has been making cerebellar function in schizophrenia the focus of current studies. In other words, disruption in the corticocerebellum-thalamic -cortical circuit could lead to disordered cognition and clinical symptoms of schizophrenia. The purposes of this study were to determine cerebellar dysfunction in male schizophrenic patients semiquantitatively with ICARS and to investigate the clinical and cognitive correlates of ICARS in patients. Methods:We compared the scores of cerebellar neurologic sign using ICARS in 47 male patients with a DSM-IV-TR diagnosis of schizophrenia with 30 gender and age-matched healthy control subjects. The semiquantitative 100-point ICARS consists of 19 items divided into 4 unequally weighted subscores:posture and gait disturbances, kinetic functions, speech disorders and oculomotor disorders. All subjects were also assessed with cognitive function test. Cognitive functions were evaluated by Korean-Mini Mental Status Examination (K-MMSE), Verbal fluency test, and Clock drawing test. The patients were administered Korea version of Positive and Negative Symptom Scale(K-PANSS) to assess the symptom severity. Results:Schizophrenic patients had significantly higher scores on the ICARS than control subjects with posture and gait disturbances, kinetic functions, and oculomotor disorders. They also showed more significant impairments in cognitive function tests than control subjects. There was a significant correlation between ICARS and negative symptoms of patients. In cognitive function test, Clock drawing test was significantly associated with negative symptoms. In addition, Clock drawing test was negatively correlated with the total score of ICARS. Conclusion:In this study, we confirmed that schizophrenic patients have significant impairments in cognitive and cerebellar function, and that those were related with negative symptoms of schizophrenic patients. These results support a role of the cerebellum in schizophrenia. It is meaningful that we used a structured, and reliable procedure for rating neurological soft signs, ICARS. We hope that future prospective studies using a similar design help that rate of neurological sign should have been visible with the progression of illness.