• Journal of Oriental Neuropsychiatry
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• v.7 no.1
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• pp.1-13
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• 1996

1. Out of 21 examples on a clinical base Alzheimer type dementia were 8 examples(38%), 11 vascular types(52%), 1 Alzheimer and vascular mixed type and rest 1 was secondary dementia type(NPH).2. Between the genders, there were 5 males and 3 females for Alzheimer types, 6 males and 5 females for the vascular types, 1 male for Alzheimer and vascular mixed type, and 1 female for secondary dementia type(NPH).3. For the degrees of Alzheimer type dementia there were 2 mild dementia, 4 moderate dementia, and 2 severe dementia. 4. Among the Alzheimer types 2 mild dementia were almost recovered back to normal in approximately 2 months, 2of 4 moderate dementia became significantly better in approximately 2 months and recovered to almost normal state in 3 to 5 months. The rest 2 have been under treatment for 3 months, but showed a little improvement. Out of 2 severe dementia examples, one showed a little improvement even if it has been under treatment over 2 years. The other example did not show any improvement, but dementia did not proceed any more.5. Among the 11 vascular examples, 7 recovered in 2 to 3 months, 1 in 5 months, 2 recovered in a year, and the treatment was stopped arbitrary for the last one.6 In the case of Alzheimer and vascular mixed type dementia, even the moderate dementia did not show any apparent result in 6 months.7. For NPHI (Normal Pressure Hydrocephalus), there was an improvement on dementia in 2 months after the treatment, but gait disturbance and urinary incontinence did not show any noticeable difference. As a conclusion, almost all the Alzheimer and vascular type patients recovered, but the treatment periods varied depending on the types of the dementia and the degree of seriousness, especially in the case of the severe Alzheimer patients, the treatment oniy suppression the progression of the dementia. The most important aspect from clinical point of view was even if almost all the patients were almost completely cired, they need to keep being cured for a long period of time. The method with respect to Four Constitutions is thought of the most desirable.

• Journal of Veterinary Clinics
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• v.28 no.3
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• pp.323-327
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• 2011

A Jindo dog (8-month-old, intact male) was referred for hind limb lameness on the right side. The dog was diagnosed with a simple femoral fracture by radiological examination. After surgical fixation of the femoral fracture, tramadol: a narcotic-like synthetic analgesic was intravenously administrated for post-operative analgesia. After injection of the tramadol, generalized tonic clonic seizure was immediately occurred in the dog. Seventeen hours later, the dog died despite intensive care. We suspected that tramadol might induce the seizurogenic effect resulted in death. A necropsy was performed to examine the cause of the death. In consequence, the dog was diagnosed as necrotizing meningoencephalitis (NME) based on histopathological examination. We would be concerned that tramadol may be related to seizure activity in the NME patient. From this case, it is known that although tramadol has been proven to be a safe and effective agent for the control of pain in veterinary medicine, it would be carefully used to patient with history of neurological diseases including meningoencephalitis, hydrocephalus, and encephalopathy.

• The Korean Journal of Food And Nutrition
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• v.28 no.4
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• pp.728-736
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• 2015

Cronobacter species (Cronobacter spp.), previously known as Enterobacter sakazakii, are gram negative food borne pathogenic bacteria. They pose a very high risk of infection to neonates and immuno-compromised individuals and can affect the human central nervous system. Consequently, survivors often suffer from severe neurological impairment including hydrocephalus, quadriplegia, and developmental delays. Cronobacter spp. were not only isolated from plant food and products such as cereals, fruits, vegetables, legume products, herbs, and spices but also from animal source foods such as milk, meat, fish, and products made from these foods. Therefore, rapid detection of Cronobacter spp. is essential for food safety. Many detection methods have been developed since the Cronobacter spp. were first reported. However, the development of more rapid, sensitive, and easy-to-use detection methods for the Cronobacter spp. is required. In this review, our aim was to study and compare the available detection methods for Cronobacter spp., including culture-based, molecular biology-based, and immunology-based methods. This study will contribute to the development of new and rapid detection method for Cronobacter spp.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.2
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• pp.77-81
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• 2016

The Dandy-Walker syndrome is a relatively rare congenital malformation occurring about one in 25,000-35,000 pregnancies. It is characterized by hydrocephalus, cystic dilatation of the fourth ventricle, complete or partial absence of the cerebellar vermis, and other various extra-CNS malformations. We report a dental caries treatment of a 4-year old girl with Dandy-Walker syndrome and partial trisomy 9q. The patient visited Seoul National University Dental Hospital due to multiple caries. The cause of multiple caries is mainly presumed as patient's eating habit caused by her general condition. She was still using milk bottle because she was having difficulties swallowing solid food due to breathing problem while eating. The treatment was performed under general anesthesia considering patient's condition; delayed development, very poor cooperation and respiratory problem. The dental procedure was successfully conducted and there were no postoperative complications. In consideration of her eating habit and oral hygiene problem, regular check appointment was recommended.

• Journal of Veterinary Clinics
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• v.31 no.6
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• pp.519-522
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• 2014

A 2-year-old, 2 kg Maltese dog was evaluated for progressive tetraparesis and neck pain. The dog had been treated with steroids for the preceding 2 weeks after unknown trauma but was deteriorating progressively and had become tetraparetic. The dog was presented with a non-ambulatory tetraparesis. Radiographic and computed tomographic examinations revealed a transverse C2 fracture with subluxation of the atlantoaxial joint and C2-C3. In addition, hydrocephalus was observed on magnetic resonance imaging. Stabilization of C1-C3 using screws, wires, and polymethyl methacrylate (PMMA) was performed. Application of ventral screws, wires, and PMMA resulted in improvement of the clinical signs after 4 weeks, and the dog could walk as before the tetraparesis 6 weeks after the operation. This stabilization method is an effective surgical treatment for management of cervical instability.

• Journal of Korean Neurosurgical Society
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• v.30 no.7
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• pp.831-841
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• 2001

Objective : Somatosensory evoked potentials(SSEPs) have been used widely both experimentally and clinically to monitor the function of central nervous system and peripheral nervous system. Studies of SSEPs have reported the various recording techniques and patterns of SSEP. The previous SSEP studies used scalp recording electrodes, showed mean vector potentials which included relatively constant brainstem potentials(far-field potentials) and unstable thalamocortical pathway potentials(near-field potentials). Even in invasive SSEP recording methods, thalamocortical potentials were variable according to the kinds, depths, and distance of two electrodes. So they were regarded improper method for monitoring of upper level of brainstem. The present study was conducted to investigate the characteristics of somatosensory evoked field potentials(SSEFPs) of the cerebral cortex that evoked by hindlimb stimulation using ball electrode and the pathways of SSEFP by recording the potentials simultaneously in the cortex, VPL nucleus of thalamus, and nucleus gracilis. Methods : In the first experiment, a specially designed recording electrode was inserted into the cerebral cortex perpendicular to the cortical surface in order to recording the constant cortical field potentials and SSEFPs mapped from different areas of somatosensory cortex were analyzed. In the second experiment, SSEPs were recorded in the ipsilateral nucleus gracilis, the contralateral ventroposterolateral thalamic nucleus(VPL), and the cerebral cortex along the conduction pathway of somatosensory information. Results : In the first experiment, we could constantly obtain the SSEFPs in cerebral cortex following the transcutaneous electrical stimulation of the hind limb, and it revealed that the first large positive and following negative waves were largest at the 2mm posterior and 2mm lateral to the bregma in the contralateral somatosensory cortex. The second experiment showed that the SSEPs were conducted by way of posterior column somatosensory pathway and thalamocortical pathway and that specific patterns of the SSEPs were recorded from the nucleus gracilis, VPL, and cerebral cortex. Conclusion : The specially designed recording electrode was found to be very useful in recording the localized SSEFPs and the transcutaneous electrical stimulation using ball electrode was effective in evoking SSEPs. The characteristic shapes, latencies, and conduction velocities of each potentials are expected to be used the fundamental data for the future study of brain functions, including the hydrocephalus model, middle cerebral artery ischemia model, and so forth.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.203-210
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• 2001

Objective : Paraclinoidal aneurysms termed that aneurysms arising from proximal internal carotid artery(ICA) between the site of emergence of the carotid artery from roof of the cavernous sinus and origin of the posterior communicating artery(PCoA). These aneurysms pose conceptual and technical surgical problems with regard to acquisition of proximal control and safe intracranial exposure. The efficiency of surgical technique according to the location of paraclinoidal aneurysm was studied for minimal exposure. Materials and Methods : Over the past four years, the authors treated surgically 171 cases of cerebral aneurysm, among them ten patients were paraclinoidal aneurysms with two patients unruptured aneurysms. Mean age was 47 years old, and all patients were female. Three patients were proximal posterior carotid artery wall aneurysms(one large, one giant), four patients carotid-ophthalmic artery aneurysms and three patients superior hypophyseal artery aneurysms. Results : There could be done clip in all cases, there were no deaths and no complication. And no patient developed sustained neurological deficits including visual function except hydrocephalus in one case. Four patients complained of visual disturbance but two patients had recovery after postoperation and two patient were not longer to bad. Conclusion : Our recent experience suggests that preoperative scrutiny of diagnostic angiography allows classification of all paraclinoidal aneurysms regardless of size and surgical technique which this classification has focused on operative approaches unique to each aneurysm projection was helpful to improve the operative outcome with good visual function and to shorten the operative time.

• Journal of Korean Neurosurgical Society
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• v.60 no.5
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• pp.584-590
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• 2017

Objective : Traumatic brain injury (TBI) in children under age 24 months has characteristic features because the brain at this age is rapidly growing and sutures are opened. Moreover, children this age are completely dependent on their parents. We analyzed the demographic data and risk factors for outcomes in TBI patients in this age group to elucidate their clinical characteristics. Methods : We retrospectively reviewed the medical records and radiological films of children under 24 months who were admitted to Kyungpook National University Hospital from January 2004 to December 2013 for TBI. Specifically, we analyzed age, cause of injury, initial Glasgow coma scale (GCS) score, radiological diagnosis, seizure, hydrocephalus, subdural hygroma, and Glasgow outcome scale (GOS) score, and we divided outcomes into good (GOS 4-5) or poor (GOS 1-3). We identified the risk factors for post-traumatic seizure (PTS) and outcomes using univariate and multivariate analyses. Results : The total number of patients was 60, 39 males and 21 females. Most common age group was between 0 to 5 months, and the median age was 6 months. Falls were the most common cause of injury (n=29, 48.3%); among them, 15 were falls from household furniture such as beds and chairs. Ten patients (16.7%) developed PTS, nine in one week; thirty-seven patients (61.7%) had skull fractures. Forty-eight patients had initial GCS scores of 13-15, 8 had scores of 12-8, and 4 had scored 3-7. The diagnoses were as follows : 26 acute subdural hematomas, 8 acute epidural hematomas, 7 focal contusional hemorrhages, 13 subdural hygromas, and 4 traumatic intracerebral hematomas larger than 2 cm in diameter. Among them, two patients underwent craniotomy for hematoma removal. Four patients were victims of child abuse, and all of them had PTS. Fifty-five patients improved to good-to-moderate disability. Child abuse, acute subdural hematoma, and subdural hygroma were risk factors for PTS in univariate analyses. Multivariate analysis found that the salient risk factor for a poor outcome was initial GCS on admission. Conclusion : The most common cause of traumatic head injury in individuals aged less than 24 months was falls, especially from household furniture. Child abuse, moderate to severe TBI, acute subdural hematoma, and subdural hygroma were risk factors for PTS. Most of the patients recovered with good outcomes, and the risk factor for a poor outcome was initial mental status.

• Journal of Korean Neurosurgical Society
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• v.60 no.5
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• pp.604-609
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• 2017

Objective : An adjustable Ghajar guide is presented to improve the accuracy of the original Ghajar guide technique. The accuracy of the adjustable Ghajar guide technique is also investigated. Methods : The coronal adjustment angle from the orthogonal catheter trajectory at Kocher's point is determined based on coronal head images using an electronic picture archiving and communication system. For the adjustable Ghajar guide, a protractor is mounted on a C-shaped basal plate that is placed in contact with the margin of a burrhole, keeping the central $0^{\circ}$ line of the protractor orthogonal to the calvarial surface. A catheter guide, which is moved along the protractor and fixed at the pre-determined adjustment angle, is then used to guide the ventricular catheter into the frontal horn adjacent to the foramen of Monro. The adjustable Ghajar guide technique was applied to 20 patients, while a freehand technique based on the surface anatomy of the head was applied to another 47 patients. The accuracy of the ventricular catheter placement was then evaluated using postoperative computed tomography scans. Results : For the adjustable Ghajar guide technique (AGT) patients, the bicaudate index ranged from 0.23 to 0.33 ($mean{\pm}standard$ deviation [SD] : $0.27{\pm}0.03$) and the adjustment angle ranged from $0^{\circ}$ to $10^{\circ}$ ($mean{\pm}SD:5.2^{\circ}{\pm}3.2^{\circ}$). All the AGT patients experienced successful cerebrospinal fluid diversion with only one pass of the catheter. Optimal placement of the ventricular catheter in the ipsilateral frontal horn approximating the foramen of Monro (grade 1) was achieved in 19 patients (95.0%), while a suboptimal trajectory into a lateral corner of the frontal horn passing along a lateral wall of the frontal horn (grade 3) occurred in 1 patient (5.0%). Thus, the AGT patients experienced a significantly higher incidence of optimal catheter placement than the freehand catheterized patients (95.0% vs. 68.3%, p=0.024). Moreover, none of the AGT patients experienced any tract hemorrhages along the catheter or procedure-related complications. Conclusion : The proposed adjustable Ghajar guide technique, using angular adjustment in the coronal plane from the orthogonal trajectory at Kocher's point, facilitates accurate freehand placement of a ventricular catheter for hydrocephalic patients.

• Parasites, Hosts and Diseases
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• v.57 no.3
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• pp.265-271
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• 2019

The prevalence of human taeniasis has decreased in Korea. The stool egg positive proportion decreased from 1.9% in 1971 to 0% in 2004 in nationwide surveys. The neurocysticercosis (NCC) is also presumed to decrease. However, detailed information regarding the recent status of NCC in Korea is lacking. We retrospectively reviewed NCC cases from 1990 to 2016 at Asan Medical Center, a 2700-bed tertiary referral hospital in Korea. We identified patients based on clinical symptoms, brain imaging, pathology and serological assay. The cases were classified as parenchymal, extraparenchymal, and mixed NCC. Eighty-one patients were included in the analysis. The mean age was 54.5 years, and 79.0% were male. The number of NCC cases was highest from 1995 to 1999, and continuously decreased thereafter. Forty (49.4%) patients had parenchymal NCC, while 25 (30.9%) patients had extraparenchymal NCC, and 16 (19.8%) patients had mixed NCC. The seizure and headache were most common symptom of parenchymal NCC and extraparenchymal NCC respectively. Hydrocephalus was more common in extraparenchymal NCC, and patients with extraparenchymal NCC were more likely to require a ventriculoperitoneal shunt. Cases of NCC are decreasing accordingly with human taeniasis and lesion location was the most important determinant of clinical presentation and outcome of NCC in Korea.