We reported two cases of amantadine treatment in traumatic brain injury patients and reviewed the literature of amantadine treatment of those patients. Problems with short-term memory, attention, planning, problem solving, impulsivity, disinhibition, poor motivation, and other behavioral and cognitive dificit could occur following traumatic brain injury or other types of acquired brain injury. this report described results of amantadine using in two patients with this type of symptom profile. Patients received neuropsychiatric examination as well as BPRS and Barthel index. These patients were improved, respectively from 57 point to 82 point(case 1), from 85 to 94(case 2) in Barthel index, and from 66 point to 35 point(case 1), from 55 to 32 point(case 2) in BPRS. These two patients did not reveal any other adverse effect. The rationale for using amantadine were discussed.
Amantadine* ; Brain Injuries* ; Dopamine Agonists ; Humans ; Impulsive Behavior ; Memory, Short-Term ; Motivation ; Problem Solving

PURPOSE: Mortality rate in the health services research field is frequently considered as a proxy for measuring healthcare quality. We compared the mortality rate and hospitalization levels among patients with poisoning. METHODS: A population-based study of hospital size and level based on the Korean health insurance and assessment service was conducted to identify the impact of hospital level on patient mortality. RESULTS: We analyzed a total of 16,416 patients, of which 7,607 were from tertiary hospitals, 8,490 were from general hospitals, and 319 were from hospitals. The highest mortality rate of diagnosis regarding poisoning was T60.31 (other herbicides and fungicides, 16%), followed by T60.0 (organophosphate and carbamate insecticides, 12.7%). There was no statistical difference in mortality among hospital levels for gender. Among age groups, tertiary hospitals had lower mortality than general hospitals and hospitals for patients aged more than 70 years (11.9% mortality at tertiary vs 14.2% at general and 23% at hospital; p=0.003, adjusted z score=−6.9), general hospitals had lower mortality than tertiary hospitals and hospitals for patients aged 18 to 29 (0.6% at general vs 2.4% at tertiary and 3.7% at hospital; p=0.01, adjusted z score=−4.3), and hospitals had lower mortality than tertiary hospitals and general hospitals for patients between 50 and 59 years of age (0% at hospital vs 6.4% at general and 8.3% at tertiary; p=0.004). CONCLUSION: Overall, there was no significant difference between mortality and hospital level among poisoned patients. However, to establish an efficient treatment system for patients with poisoning, further studies will be needed to identify the role of each facility according to hospital level.
Diagnosis ; Health Facility Size ; Health Services Research ; Herbicides ; Hospitalization ; Hospitals, General ; Humans ; Insecticides ; Insurance ; Insurance, Health ; Mortality ; Poisoning ; Proxy ; Quality of Health Care ; Tertiary Care Centers

Objectives: ：Delirium is a temporary brain dysfunction and systemic inflammation is important factor in its pathophysiology. Whether the neutrophil-lymphocyte ratio (NLR), one of the inflammatory markers, can be used as an inflammatory marker in delirium patients was investigated in comparison with C-reactive protein (CRP). Methods: ：We retrospectively reviewed the medical records of patients who were referred for consultation for delirium at hospital for one year. The NLR and CRP values at admission and delirium status were divided into the medical and the surgical treatment group, and the interaction between them was analyzed through repeated mea-sures ANOVA. Results: ：NLR was maintained without significant difference before and after delirium in the medical treat-ment group and the surgical treatment group, but CRP decreased in the medical treatment group and increased in the surgical treatment group during delirium, showing a significant interaction. Conclusions ：In delirium patients, the NLR remained constant, but the CRP differed according to the treatment group and the delirium state. This suggests the possibility that NLR could be used complementary to CRP as an in-flammatory marker in delirium patients.

Central cord syndrome (CCS) is extremely rare as a direct consequence of generalized epileptic seizure. CCS is associated with hyperextension of the spinal cord and has characteristic radiologic findings including posterior ligamentous injury and prevertebral hyperintensity following magnetic resonance imaging (MRI). We experienced the case of a 25-year-old man who suffered CCS after status epilepticus. Cervical spinal MRI revealed high signal intensity at the C1 level but with no signal or structural changes in other sites. After rehabilitation management, the patient significantly improved on the ASIA (American Spinal Injury Association) motor scale and bladder function. We proposed that epilepsy related CCS may be caused by muscle contractions during generalized seizure, which can induce traction injury of the spinal cord or relative narrowing of spinal canal via transient herniated nucleus pulposus or transient subluxation of vertebra. We also suggest CCS without radiologic findings of trauma has good prognosis compared with other CCS.
Adult ; Asia ; Central Cord Syndrome ; Epilepsy ; Humans ; Ligaments ; Magnetic Resonance Imaging ; Muscle Contraction ; Prognosis ; Seizures ; Spinal Canal ; Spinal Cord ; Spinal Injuries ; Spine ; Status Epilepticus ; Traction ; Urinary Bladder

Spinal accessory neuropathy is commonly caused by iatrogenic injury or secondary to trauma or infection. Nevertheless, the tumor related palsy is rare. We present a case of an 18-year-old male patient suffering from paralysis of his right trapezius and sternocleidomastoid muscle. An electrophysiologic diagnostic study confirmed the spinal accessory neuropathy of the proximal segment. In addition, magnetic resonance imaging showed the location of tumor on the jugular foramen. However, the type of the tumor was not confirmed through biopsy because the patient refused surgical procedure. Based on the study, it is hypothesized that the tumor located on the jugular foramen should be considered as a cause of the spinal accessory nerve of the proximal segment.
Accessory Nerve ; Biopsy ; Glomus Jugulare ; Humans ; Magnetic Resonance Imaging ; Male ; Muscles ; Paralysis ; Stress, Psychological

In the present study, the frequency of research misconduct in Korean medical papers was analyzed using the similarity check software iThenticate®. All Korean papers written in English that were published in 2009 and 2014 in KoreaMed Synapse were identified. In total, 23,848 papers were extracted. 4,050 original articles of them were randomly selected for similarity analysis. The average Similarity Index of the 4,050 papers decreased over time, particularly in 2013: in 2009 and 2014, it was 10.15% and 5.62%, respectively. And 357 (8.8%) had a Similarity Index of ≥ 20%. Authors considered a Similarity Index of ≥ 20% as suspected research misconduct. It was found that iThenticate® cannot functionally process citations without double quotation marks. Papers with a Similarity Index of ≥ 20% were thus individually checked for detecting such text-matching errors to accurately identify papers with suspected research misconduct. After correcting text-matching errors, 142 (3.5% of the 4,050 papers) were suspected of research misconduct. The annual frequency of these papers decreased over time, particularly in 2013: in 2009 and 2014, it was 5.2% and 1.7%, respectively. The decrease was associated with the introduction of CrossCheck by KoreaMed and the frequent use of similarity check software. The majority (81%) had Similarity Indices between 20% and 40%. The fact suggested that low Similarity index does not necessarily mean low possibility of research misconduct. It should be noted that, although iThenticate® provides a fundamental basis for detecting research misconduct, the final judgment should be made by experts.
Duplicate Publication as Topic ; Editorial Policies ; Ethics* ; Judgment ; Periodicals as Topic ; Plagiarism ; Publications* ; Scientific Misconduct ; Synapses

OBJECTIVES: The purpose of this study was to test stage model in Traumatic Brain Injury(TBI) patients. According to the stage model, attention deficits which is basic stage in information processing lead to memory disturbance and subsequently affect higher-order cognitive function such as memory, decision-making, abstract thinking, and judgement related to executive function. Therefore, it was hypothesized that attention affect recall(retrieval efficacy) related to executive function mostly relative to other cognitive function, in TBI patients with low executive function. METHODS: Participants were referred to a TBI clinic and then was rated on K-WAIS and Executive Intelligence Test(EXIT). Participants were divided into two groups according to Executive IQ(EIQ) score, which of high function group(N=67) was more than 80(above low average) and of low function group(N=52) was under 80 (under borderline). To test the stage model, using hierarchical regression analysis, recall(retrieval efficacy) was regressed on 3 subscales(attention, verbal, visuospatial scale) after controlling for IQ according to each group. Furthermore, the mediation effect of attention between retrieval efficacy and verbal, visuospatial score was analyzed. RESULTS: In the low function group, only attention area predicted significantly recall(retrieval efficacy), indicating that lower attention were related to lower EIQ after controlling for IQ. In the high function group, no area predicted significantly retrieval efficacy. In the low function group, verbal and visuospatial scale did not predicted significantly retrieval efficacy, indicating that there was no evidences supporting the mediation model. CONCLUSION: Only attention affect retrieval efficacy in TBI patients with low executive function. But, the mediation effect of attention between retrieval efficacy and verbal and visuospatial scale was not tested in the low function group. These results implied that stage model was tested partially. In treating cognitive deficit in TBI patients, it is necessary to develop cognitive rehabilitation program based on stage model. Furthermore, it is necessary to necessary to test mediation model in the future study.
Automatic Data Processing ; Brain ; Brain Injuries* ; Executive Function* ; Humans ; Intelligence ; Memory ; Negotiating ; Rehabilitation ; Thinking

OBJECTIVES: The purpose of this study is to evaluate the relationship between the severity of white matter changes (WMC), risk factors and cognitive domains, including executive function profiles. METHOD: Forty nine subjects over 55 years with subjective memory complaints were assessed with MRI and neuropsychological tests. The WMC were assessed by MRI T2-FLAIR images and divided into 3 groups of mild vs. moderate vs. severe and 2 groups of mild-moderate vs. severe by using Mantyla's criteria and Fazeka's criteria. The risk factors were examined in hypertension, heart disease history and chemistry Lab. Medical conditions which affect to cognitive dysfunction and definite dementia were also excluded. RESULTS: Comparing 3 groups, hypertension was identified as a risk factor of the WMC. Comparing 2 groups, total cholesterol and LDL were identified for as the risk factor of WMC. The severity of WMC was significantly associated with cognitive disturbances and their main effect on cognition was working memory and inhibition. CONCLUSION: The risk factors of the WMC in the elderly were hypertension, hyperlipidemia. The severity of WMC appears to be associated with executive dysfunction in the elderly.
Aged ; Cholesterol ; Cognition ; Dementia ; Executive Function ; Heart Diseases ; Humans ; Hyperlipidemias ; Hypertension ; Memory ; Memory, Short-Term ; Neuropsychological Tests ; Pyridines ; Risk Factors ; Thiazoles

This study was performed to investigate the effect of lecithin on lipid metabolism and antixidative capacity in 9-weekold rats. Forty-five male Sprague-Dawley rats weighing 249.8 g were blocked into three groups according to their body weight and raised for 8 weeks with experimental diets containing 1% (LM) or 5% lecithin (LH) and control (C) diet. Plasma and liver total lipids, triglyceride, total cholesterol and plasma HDL-cholesterol concenterations, and fecal total lipids, triglyceride, total cholesterol and bile acid excretions were measured. Malondialdehyde (MDA) levels in plasma, liver, superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) activities in red blood cell and liver, xanthine oxidase (XO) activities in plasma and liver, and total antioxidant status (TAS) in plasma were also measured. Effect of lecithin intake on antioxidative capacity was not significantly different among all the groups. Plasma total lipids, triglyceride and total cholesterol levels were lower in lecithin groups compared to control group, and these three lipid levels of lecithin groups were lowered dose-dependently as dietary lecithin level increased. But liver total lipids, triglyceride and total cholesterol levels were not different among all the groups. Also fecal total lipids, triglyceride and total cholesterol excretions were highest in high lecithin groups compared to two other groups. Thus it is plausible that lecithin intake decreases plasma lipid levels through increasing fecal lipid excretions, and may be beneficial for treatment and prevention of hyperlipidemia, but has no effect on antioxidative capacity.
Animals ; Bile ; Body Weight ; Catalase ; Cholesterol ; Diet ; Diet, High-Fat* ; Erythrocytes ; Glutathione Peroxidase ; Humans ; Hyperlipidemias ; Lecithins* ; Lipid Metabolism* ; Liver ; Male ; Malondialdehyde ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Superoxide Dismutase ; Triglycerides ; Xanthine Oxidase

In canine acute pancreatitis (AP), inappropriate release and activation of zymogen proteases within the pancreas results in the consumption of serum antiproteases. The aim of this study was to examine whether the serum concentrations of α₂-macroglobulin (A2MG), α₁-antitrypsin (A1AT), and C-reactive protein (CRP) differ between dogs with AP and healthy dogs. Twenty healthy dogs and 20 dogs with AP were included in this study. Concentrations of A2MG, A1AT, and CRP were measured in the sera of healthy dogs and dogs diagnosed with AP. Serum A2MG and A1AT concentrations were significantly lower in dogs with AP than in healthy dogs, whereas the serum CRP concentration was significantly higher. In addition, the concentrations of A2MG and A1AT were significantly higher in AP survivors than in AP non-survivors, while the CRP concentration was significantly lower. However, in both AP survivors and non-survivors, the CRP concentrations showed a negative correlation with A2MG concentrations but not with A1AT. These findings indicate that serum antiproteases and CRP concentrations might be associated with the mortality rate of AP in dogs.
Animals ; C-Reactive Protein ; Dogs ; Humans ; Mortality ; Pancreas ; Pancreatitis ; Peptide Hydrolases ; Protease Inhibitors ; Survivors ; Trypsin