• Journal of Korean Neurosurgical Society
• /
• 제47권4호
• /
• pp.258-264
• /
• 2010

Objective : The objectives of this study were to analyze the outcome and hemorrhagic risk of intravenous (IV) argatroban in patients with acute ischemic stroke presenting beyond six hours of ischemic symptom onset. Methods : Eighty patients with acute ischemic stroke who were admitted to the hospital beyond six hours from ischemic symptom onset were retrospectively analyzed. We could not perform IV thrombolysis or intra-arterial thrombolysis because of limited time window. So, IV argatroban was performed to prevent recurrent thrombosis and progression of infarcted area. The outcome was assessed by the National Institute of Health Stroke Scale (NIHSS) score and related hemorrhagic risk was analyzed. Also, each outcome was analyzed according to the initial stroke severity, subtype, and location. Results : The median NIHSS was 8.0 at admission, 4.1 upon discharge, and 3.3 after three months. A good outcome was achieved in 81% of patients upon discharge and 88% after three months. Symptomatic hemorrhage occurred in only two patients (3%). IV argatroban was effective regardless of initial stroke severity, subtype, and location. Conclusion : IV argatroban may be an effective and safe treatment modality for acute ischemic stroke presenting beyond six hours of ischemic symptom onset.

• Clinical and Experimental Pediatrics
• /
• 제54권1호
• /
• pp.22-28
• /
• 2011

Purpose: To investigate the clinical characteristics of late-onset epilepsy combined with autism spectrum disorder (ASD), and the relationship between certain types of electroencephalography (EEG) abnormalities in ASD and associated neuropsychological problems. Methods: Thirty patients diagnosed with ASD in early childhood and later developed clinical seizures were reviewed retrospectively. First, the clinical characteristics, language and behavioral regression, and EEG findings of these late-onset epilepsy patients with ASD were investigated. The patients were then classified into 2 groups according to the severity of the EEG abnormalities in the background rhythm and paroxysmal discharges. In the severe group, EEG showed persistent asymmetry, slow and disorganized background rhythms, and continuous sharp and slow waves during slow sleep (CSWS). Results: Between the two groups, there was no statistically significant difference in mean age (P=0.259), age of epilepsy diagnosis (P=0.237), associated family history (P=0.074), and positive abnormal magnetic resonance image (MRI) findings (P=0.084). The severe EEG group tended to have more neuropsychological problems (P=0.074). The severe group statistically showed more electrographic seizures in EEG (P=0.000). Rett syndrome was correlated with more severe EEG abnormalities (P=0.002). Although formal cognitive function tests were not performed, the parents reported an improvement in neuropsychological function on the follow up checkup according to a parent's questionnaire. Conclusion: Although some ASD patients with late-onset epilepsy showed severe EEG abnormalities, including CSWS, they generally showed an improvement in EEG and clinical symptoms in the longterm follow up. In addition, severe EEG abnormalities tended to be related to the neuropsychological function.

• 대한유전성대사질환학회지
• /
• 제3권1호
• /
• pp.32-37
• /
• 2003

저자들은 반복적이며 간헐적인 기면, 정신착란과 운동실조를 주소로 내원한 6세 여아에서, 고암모니아혈증과 혈장 glutamine, 요 orotic acid의 증가를 보여 지발형 OTC 결핍증으로 진단하고, 분자유전학적 검사상 exon 6에서 221번째 아미노산 lysine에 해당하는 염기 AAG가 AAT(asparagine)로 치환된 돌연변이를 이형접합자(heterozygote)로 보인하였던 1례를 경험하였기에 보고하는 바이다.

• Annals of Clinical Neurophysiology
• /
• 제3권2호
• /
• pp.128-135
• /
• 2001

Background : Tremor is uncommon manifestation of stroke. Therefore a few cases have been reported until now. There is still uncertainty about the characteristics of post-stroke tremor. Furthermore the pathogenesis and responsible structures of post-stroke tremor are not precisely known. We have recently experienced 34 cases of post-stroke tremor for the past 6 years. We analysed the clinical features and electrophysiologic findings of post-stroke tremor to evaluate the general characteristics and to analogize the possible pathogenetic mechanisms of post-stroke tremor. Methods : The clinical characteristics of post-stroke tremor were summarized in according to the onset time, involved body parts, types, tremor frequencies, neuroradiologic findings, and associated symptoms. The tremor frequencies were recorded by using a gyroscope. The spectral analysis of tremor frequencies were done automatically with Motus I soft ware. Results : Tremor onset were remarkably varied. Some patients showed a tremor appearing at the onset of a stroke and other patients showed delayed-onset tremor 10 years after a stroke. Tremor frequencies were also much varied. The range of hand tremor frequencies were from 1.5 to 12 Hz. Lesions were found in 31 cases(infarction 27, hemorrhage 4) on neuroimaging. In the cases of cerebral infarctions, 7 cases showed multiple small vessel diseases and 20 cases showed cerebral vessel lesions. The most commonly involved cerebral vessel lesion was the middle cerebral artery territory Several different clinical patterns of post-stroke tremor were identified. Conclusions : There are some evidences from the data summarized here to suggest that several pathogenetic mechanisms including central oscillators could be involved for the development of tremors and that tremor generating neural circuits could be more complex than previously suggested neural circuits.

• 한국지구과학회지
• /
• 제39권6호
• /
• pp.593-599
• /
• 2018

P파와 S파의 도착시간 정보는 지진 발생위치 결정, 1차원 및 3차원 지하구조 등 지진학 연구 수행에 중요한 정보이다. 최근 지진관측소의 수가 비약적으로 증가함에 따라 관측망을 운영하면서 수동으로 지진파의 도착시간을 측정하는 것은 상당한 시간이 소요되는 일이 되었다. 본 연구에서는 진원요소에 대한 사전정보(지진 발생위치와 시간)를 확보할 수 있는 경우 Akaike Information Criterion (AIC)을 적용하여 추가의 관측소에서 국지지진의 P파와 S파의 도착시간을 자동측정하였다. 해당 방법을 경산(DAG2) 지진관측소에 기록된 자료에 적용한 후 수동 측정한 값과 자동 측정한 값을 비교한 결과 P파의 경우 95.1%, S파의 경우 93.7%가 0.1초 이하의 차이를 보이면서 결정되는 것을 확인하였다. 자동측정결과의 높은 정확성은 향후 고밀도 지진관측망 운영에 성공적으로 적용될 수 있음을 시사한다.

• 성인간호학회지
• /
• 제19권2호
• /
• pp.167-177
• /
• 2007

Purpose: This cross-sectional survey research was undertaken to identify the factors influencing time from onset to hospital arrival of stroke patients and to provide basic information for the development of intervention programs for stroke patients. Methods: The data were collected using a convenient sampling method from three hospitals in Inchon. The subjects were 78 patients who were diagnosed as stroke by doctor and they voluntarily participated in the study. Results: On the average, subjects arrived at the hospitals by 16.72 hours after the onset of stroke events with the range from 0.17 hours to 72 hours. Thirty-four(43.6%) subjects arrived within 3 hours which can maximize treatment effects. There was significant difference in hospital presentation time according to the level of knowledge(${\chi}^2=18.629$, p=.0003). A negative correlation was found between the hospital presentation time and self-efficacy (r= -.320, p=.004). Stepwise multiple regression analysis revealed that the most powerful predictor was self-efficacy. Self-efficacy, the level of knowledge and physical symptoms were significant factors and accounted for 21.7% of the variance of hospital presentation time in stroke patients. Conclusion: According to the results, self-efficacy is a useful concept for reducing the hospital presentation time from onset of attack in stroke patients. Therefore, nurses should consider educational programs which include not only a knowledge of stroke and recurrence prevention but also the concept of self-efficacy.

• The Journal of Korean Physical Therapy
• /
• 제33권1호
• /
• pp.1-6
• /
• 2021

Purpose: This study examined the effects of heel insoles on the static balance and leg muscle activity and posture control strategy during external perturbation. Methods: Thirty healthy young men participated in the study. The subjects underwent two experimental conditions: 1) no heel insole condition (0cm) and 2) wearing heel insole condition (5cm). The static balance was measured using an I-Balance device, which measured the change in the center of gravity (COG). The onset time of muscle activation and muscle activation of the erector spinae (ES), hamstring (HAM), gastrocnemius (GCM) were measured using surface EMG electrodes to determine the change in posture control strategy during external perturbation. Results: The speed and distance of COG were significantly higher in the wearing heel insoles condition than the no heel insole condition (p<0.05). In addition, significant differences in the onset time of the GCM, HAM, and ES muscle activation were observed when there was no heel insole condition during external perturbation (p<0.017). On the other hand, no significant differences in the onset time of muscle activation were observed between GCM and HAM when wearing the heel insole condition during external perturbation (p<0.017). Moreover, muscle activation of the GCM was significantly higher in the wearing heel insoles condition than the no heel insole condition during external perturbation (p<0.05). Conclusion: These findings suggest that heel insoles may have disadvantages, and increased efforts are needed to maintain balance and change the posture control strategy during external perturbation.

• Journal of Acupuncture Research
• /
• 제25권3호
• /
• pp.163-177
• /
• 2008

Objectives : This study was designed to evaluate clinical prognosis factors of Bell's palsy patients. Methods : The 100 subjects were chosen from 262 patients over 20years old who was diagnosised Bell's palsy through Acupuncture & Moxibustion and ENT medical specialist after visiting the hospital within 8days of onset of peripheral facial palsy and after Oriental-Western Medicine Treatment, recovered completely or had over three months cares because of incomplete recovery Oriental-Western Medicine Treatment included Acupuncture Treatment, Herb med treatment, medicines treatment, Physical therapy and Electrodiagnostic Test was operated after 7 to 10days after outbreaks of the disease. Clinical prognosis factors were analyzed using House-Brackmann grading system(HBGS) as a measurement of the degree of Facial Palsy. Collected data were analyzed as Chi-Square test, ANOVA test, Independent-Samples t-test regression analysis using SPSS 12.0 WIN Program. Results : 1. There was a significant difference in the results of treatment according to site of palsy, degree of initial palsy, time of initial recovery and existence of recovery after 3weeks from onset as clinical prognosis factors of Bell's Palsy, However, a statistically significant difference was not shown in the results of treatment according to gender, age, existence of Post Auricular Pain, Hypertension, Diabetes and existence of relapse. 2. As a result of overall treatment, 85% of patients were recovered almost entirely and 15% were not recovered completely. 3. There was a significant difference in the onset of Post Auricular Pain and duration of Post Auricular Pain according to the degree of Post Auricular Pain. 4. There was a significant difference in the degree of initial palsy and degree of palsy after 3weeks from onset according to the existence of Post Auricular Pain. However, a statistically significant difference was not shown in the period of time until initial treatment, The time of initial recovery, (H-B), The period from onset to recovey, ENoG value. Conclusions : Based on the above results, prognosis of Bell's palsy was affected by degree of initial palsy, time of initial recovery and existence of recovery after 3weeks from onset.

• 대한후두음성언어의학회지
• /
• 제17권2호
• /
• pp.107-110
• /
• 2006

Background and Objeetives : There are few studies reported that specifically examined the voice onset time(VOT) in patients with bilateral vocal nodules. The purpose of this study was to study the characteristics of voice onset in patients with bilateral vocal nodules. Materials and Methods : 52 female patients with bilateral vocal nodules were examined, aged from 20 to 54 years, and were compared with 25 normal female control group. All subjects produced five repetitions of the voiceless stops $/p^h,\;t^h\;k^h/$ in vowel context /ai_a/. VOT was measured by the time between the release of the stops and the onset of voicing. Results : VOTs of the voiceless stops $/p^h/\;and\;/t^h/$ in patients with bilateral vocal nodules were significantly shorter than those of normal subjects. VOT of the $/k^h/$ in them was shorter than those of normals, but the difference was not significant. This results showed that VOTs of the voiceless stops in patients with bilateral vocal nodules were shorter than those of normal subjects. Conclusion : The rapid onset of voicing in patients with bilateral vocal nodules might be associated with increased laryngeal muscle tension by hard glottal attacks. We suggest that VOT can be a clinically useful acoustic parameter for evaluating voice in patients with bilateral vocal nodules.

• Journal of Korean Neurosurgical Society
• /
• 제62권5호
• /
• pp.519-525
• /
• 2019

Objective : The circadian pattern of the onset time of aneurysmal subarachnoid hemorrhage (aSAH) has been reported by various authors. However, the effect of the degree of physical exertion on the circadian pattern has not been studied in detail. Therefore, we conducted this study to investigate the effect of physical exertion on the circadian pattern of aSAH. Methods : Of the 335 patients presenting with aSAH from January 2012 to December 2017, 234 patients with identifiable onset time and metabolic equivalent (MET) values were enrolled. The onset time of aSAH was divided into 4-hour intervals. The patient's physical exertion was then assessed on a scale between 1 and 8 METs using generally accepted MET values, and categorized into two groups-light exertion (1 to 4 METs) and moderate to heavy exertion (5 to 8 METs)-to determine the effect of the degree of physical exertion on the onset time distribution of aSAH. Multivariate analysis was used to calculate the odds ratio (OR) between the two groups to determine the effect of the degree of physical exertion on each set of time periods. Results : There was a definite bimodal onset pattern that peaked at 08:00-12:00 hours followed by 16:00-20:00 hours (p<0.001). MET values at all time intervals were found to be significantly higher than the night time (00:00-04:00 hours) values (p<0.031). The MET value distribution showed a unimodal pattern that slightly differed from the bimodal distribution of the onset time of aSAH. There were no significant differences in the ORs of each time interval according to the degree of the MET value. Conclusion : This study reaffirmed that aSAH occurs in a bimodal pattern, especially showing the highest prevalence in the morning. Although aSAH could be related to daily activity, there were no significant changes in diurnal variations affected by the degree of physical exertion.