Increased death rate resulted from cardiovascular disease called for the study on the autonomic nervous system and cardiovascular system. It is known that an HRV (heart rate variability) spectrum analysis based on ECG (electrocardiograph) signals could be used to define activity of sympathetic and parasympathetic nervous system noninvasively. However, it is important to prove whether suggested HRV analysis method could provide the useful information for observing autonomic nervous system quantitatively and objectively before clinical application. In this study, 14 rats were used and divided into two groups, sympathectomy group and vagotomy group, respectively. During the experiment, ECGs of rats were collected three times at each experimental condition. After the application of Berger's series algorithm to the ECG raw data, HRV spectrum was obtained via FFT (fast Fourier transform). Power contents for each frequency bands were calculated from HRV waveforms. Two peak values, HF (high frequency) and LF(low frequency), representing autonomic nervous system status were used to extract the parameter, HF/LF ratio. Results showed that HF/LF values were increased for the sympathectomy group and decreased for the vagotomy group. It implies that the variations in HF/LF components exhibits the information for the classification of ANS(autonomic nervous system) function quantitatively. HRV analysis algorithm developed from this study could be expanded for the observation of autonomic nervous system variations in human.
Animals ; Autonomic Nervous System ; Cardiovascular Diseases ; Cardiovascular System ; Classification ; Electrocardiography ; Humans ; Mortality ; Parasympathetic Nervous System ; Rats ; Spectrum Analysis ; Sympathectomy* ; Vagotomy*

Heart rate variability (HRV) is a useful marker for predicting mortality and cardiovascular events in cardiac diseases. Various time- and frequency-domain parameters are used for assessing HRV. The time-domain measures include standard deviation of the NN intervals (SDNN), standard deviation of the average NN interval, root mean square of the successive differences SDNN index, NN50 count, and pNN50, while the power spectrum that is used the most widely in frequency-domain analyses is divided into low frequency (LF), high frequency (HF), LF norm, HF norm, and LF/HF. The HF band is modulated by the parasympathetic nervous system, while the LF band is modulated by both the sympathetic and parasympatheticnervous systems. Altered or reduced HRV parameters have been shown to be related to cardiovascular events in patients with various neurological disorders, such as parkinsonian syndromes, dementia, cerebrovascular disorder, and epilepsy. Furthermore, analyses of HRV have attempted to distinguish different diseases and evaluate the degree of disability. This article discusses the clinical use of HRV in the neurological field.
Cerebrovascular Disorders ; Dementia ; Epilepsy ; Heart Diseases ; Heart Rate* ; Heart* ; Humans ; Mortality ; Nervous System Diseases* ; Parasympathetic Nervous System ; Parkinsonian Disorders

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease that is a significant source of morbidity and mortality when it manifests in the central nervous system. The early detection and treatment of neuropsychiatric SLE (NPSLE) is very important, but a confirmative diagnostic tool has yet to be developed. CASE REPORT: We report here a case of neuropsychiatric manifestations in a patient that were associated with SLE, and evidence of reversal of bilateral amygdala and parahippocampal lesions in the brain revealed by 18fluorodeoxy glucose-positron emission tomography. CONCLUSIONS: We are suggestive of 18fluorodeoxy glucose-positron emission tomography appear to be more sensitive in detecting subtle brain changes in NPSLE.
Amygdala* ; Autoimmune Diseases ; Brain* ; Central Nervous System ; Humans ; Lupus Erythematosus, Systemic ; Lupus Vasculitis, Central Nervous System* ; Mortality

Tetanus is a neurologic disorder, characterized by increased muscle tone and spasms, that is caused by tetanospasmin, a powerful protein toxin elaborated by Clostridium tetani. In the modern society, tetanus is a rare disease, but it has a high mortality on attack and it 's diagnosis depends on the clinical symptoms. The treatment for tetanus is an injection of human tetanus immunoglobulin (HTIG) to neutralize the circulating tetanospasmin, to control breathing, and to provide systemic supportive care. Recently, the 500 unit of HTIG is recommended. We report one case of generalized tetanus that was treated with 500 units of HTIG. The patient was discharged without complications.
Clostridium tetani ; Diagnosis ; Humans* ; Immunoglobulins* ; Mortality ; Nervous System Diseases ; Rare Diseases ; Respiration ; Spasm ; Tetanus*

Advances in the antimicrobials lower the mortality rate in most infectious diseases. But bacterial infections of the CNS is still one of the life-threatening infections. Untreated acute bacterial meningitis is fatal in 70% to 100% of patients. With appropriate antibacterial therapy, the case-fatality rate had been greatly reduced with death occurring principally in the very young the very old, or those with potentially lethal underlying diseases. Early recognition and antimicrobial therapy is mostly desirable. The causes of acute bacterial meningitis vary with age and the clinical setting under which the infection occurs. Empirical antibiotic treatment was started immediately on suspicion of the bacterial meningitis prior to etiologic diagnosis. The most effective and least toxic bactericidal drugs should be selected on the basis of known or predicted susceptibility of the bacterial cause of the disease. After the identification of the specific organism and determination of susceptibilities, effective antimicrobial was administered parenterally at maximum dose. The third-generation cephalosporins(cefotaxime, ceftriaxone, and ceftzidime) offer new advantages in the treatment of meningitis because they are active at the CSF concentraions obtainable. Newer antimicrobials(monobactam and newer quinolones) with improved access and an appropriately focused spectrum for CNS infections will become available.
Bacterial Infections* ; Ceftriaxone ; Central Nervous System* ; Communicable Diseases ; Diagnosis ; Humans ; Meningitis ; Meningitis, Bacterial ; Mortality

The analysis of heart rate variability (HRV) has recently been established as a non-invasive measurement method for estimation of autonomic nervous system function in the cardiovascular system. HRV reflects the interaction of the sympathetic and parasympathetic nervous systems and the regulation of the cardiovascular system by the autonomic nervous system, and various measures of HRV, such as time-domain, frequency domain, and non-linear measures of HR variability, have been used in risk stratification of cardiovascular disease. Many studies have demonstrated that patients with reduced HRV have an increased risk of mortality after an acute myocardial infarction (AMI) or after a diagnosis of heart failure. HRV performed late after AMI (> 6 wks) better predicts sudden cardiac death and fatal arrhythmia than does HRV at the early phase after AMI, suggesting that impaired recovery of the autonomic nervous system and remodeling of the arrhythmia substrate after AMI may play critical roles in the mechanism of sudden cardiac death. Therefore, early measurement of HRV to identify high risk patients might be repeated later in order to investigate and follow the risk of sudden cardiac death. Future randomized trials using HRV as one of the inclusion criteria should determine whether routine measurement of HR variability can be a useful routine clinical tool for risk stratification in cardiovascular disease.
Arrhythmias, Cardiac ; Autonomic Nervous System ; Cardiovascular Diseases* ; Cardiovascular System ; Death, Sudden, Cardiac ; Diagnosis ; Heart Failure ; Heart Rate* ; Humans ; Mortality ; Myocardial Infarction ; Parasympathetic Nervous System

OBJECTIVES: Child mortality remains a critical problem even in developed countries due to low fertility. To plan effective interventions, investigation into the trends and causes of child mortality is necessary. Therefore, we analyzed these trends and causes of child deaths over the last 30 years in Korea. METHODS: Causes of death data were obtained from a nationwide vital registration managed by the Korean Statistical Information Service. The mortality rate among all children aged between one and four years and the causes of deaths were reviewed. Data from 1983-2012 and 1993-2012 were analyzed separately because the proportion of unspecified causes of death during 1983-1992 varied substantially from that during 1993-2012. RESULTS: The child (1-4 years) mortality rates substantially decreased during the past three decades. The trend analysis revealed that all the five major causes of death (infectious, neoplastic, neurologic, congenital, and external origins) have decreased significantly. However, the sex ratio of child mortality (boys to girls) slightly increased during the last 30 years. External causes of death remain the most frequent origin of child mortality, and the proportion of mortality due to child assault has significantly increased (from 1.02 in 1983 to 1.38 in 2012). CONCLUSIONS: In Korea, the major causes and rate of child mortality have changed and the sex ratio of child mortality has slightly increased since the early 1980s. Child mortality, especially due to preventable causes, requires public health intervention.
Cause of Death ; Child Mortality/*trends ; Child, Preschool ; Communicable Diseases/mortality ; Databases, Factual ; Female ; Humans ; Infant ; Male ; Neoplasms/mortality ; Nervous System Diseases/mortality ; Republic of Korea ; Sex Ratio ; Vital Statistics

OBJECTIVES: Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. There are few reports on the burden of disease of MS, worldwide. The authors aim to estimate burden of disease and estimate the epidemiologic indexes of MS in Korea using available epidemiologic data. METHODS: Epidemiologic indexes were computed using DISMOD II software based on prevalence from nationwide survey, incidence estimated from extrapolation, mortality from National Statistics Office, and duration of disease from literature as input indexes. We calculated disability-adjusted life year (DALY) as a measure of premature mortality and disability, equivalent to years of healthy life lost due to a given condition. RESULTS: The incidence of MS in Korea was 0.1 per 100,000, higher in female than in male. The highest incidence was estimated in the age group between 35 and 44 years in male and age group between 25 and 29 years in female. Total burden of disease of MS was 1,394 DALY, comprised of 292 (21%) years of life lost and 1,101 (79%) years lived with disability. The mean age at onset of MS was 33 years old in men and 32 years old in female. Estimated duration of disease was 35 years in men and 40 years in female. Most of the DALY of MS occurred in the adult population between 25 and 54 years of age. CONCLUSION: Although MS is a rare disease in Korea, most of the DALY arises from young people, which results in a major financial burden on the patient, family, health system and society.
Adult ; Central Nervous System ; Demyelinating Diseases ; Female ; Humans ; Incidence ; Korea ; Male ; Mortality, Premature ; Multiple Sclerosis ; Prevalence ; Quality of Life ; Rare Diseases

Infectious diseases of the central nervous system (CNS) cause inflammatory processes within the brain and spinal cord that can lead to morbidity and mortality in a high proportion of patients. Pharmacological strategies to dampen inflammation have been investigated, and steroids are one of the adjunctive treatments for bacterial meningitis, tuberculous meningitis, and herpes simplex virus encephalitis. In this paper, we review the recent literature that provides guidelines for the use of steroids in combination with appropriate antimicrobial therapy, and we discuss how systemic steroid treatment is an important aspect of treatment regimens for CNS infectious diseases.
Brain ; Central Nervous System Infections ; Central Nervous System ; Communicable Diseases ; Encephalitis ; Humans ; Inflammation ; Meningitis, Bacterial ; Mortality ; Simplexvirus ; Spinal Cord ; Steroids ; Tuberculosis ; Tuberculosis, Meningeal

PURPOSE: Recent neonatal care unit survival rates have improved. These increasing survival rates have resulted in increased neurologic disorders. So we investigated the sorts and frequency of neurologic disorders at neonatal intensive care unit, association between gestational age and birthweight, neonatal mortality and tendency of neurologic disorders in survivors. METHODS: Retrospective reviews were made on 156 cases with one or more neurologic disorder of 1,399 neonates, who were admitted to the neonatal intensive care unit, Soonchunhyang Hospital from January 1997 to December 2001. Neurologic disorders were categorized into five groups:intraventricular hemorrhage, neonatal seizures, hypoxic- ischemic encephalopathy, central nervous system infection and central nervous system congenital malformations and chromosomal aberrations. RESULTS: Over the study period, 156 cases with neurologic disorders had a total of 193 neurologic disorders. The frequency of neurologic disorders increased from 3.2% in 1997 to 11.5% in 2001, while the neonatal mortality rates in intensive care unit have declined from 4.8% in 1997 to 3.7% in 2001. In 156 neonates, 134 had intraventricular hemorrhage, 28 had seizures, 24 had hypoxic-ischemic encephalopathy, 2 had central nervous system infections and 5 had congenital central nervous system malformation and chromosomal aberration. Frequencies of intraventricular hemorrhage and seizure has increased, but, that of hypoxic-ischemic encephalopathy has not changed, for the 5 years. CONCLUSION: Neonatal intensive care unit survival rates have improved for 5 years, but, the neurologic morbidity rates have increased. Because neurologic disorders have great influence on the long-term neurologic disability, early detection and treatment of neurologic disorders is important.
Brain Ischemia ; Central Nervous System ; Central Nervous System Infections ; Chromosome Aberrations ; Gestational Age ; Hemorrhage ; Humans ; Hypoxia-Ischemia, Brain ; Infant ; Infant Mortality ; Infant, Newborn ; Intensive Care Units ; Intensive Care, Neonatal* ; Nervous System Diseases* ; Retrospective Studies ; Seizures ; Survival Rate ; Survivors