1.A Case of Suspected Post-Irradiation Delayed Necrotizing Leukoencephalopathy.
Jeong Gyun NA ; Won Young JUNG ; Kyung Won CHO
Journal of the Korean Neurological Association 1994;12(3):534-541
Therapeutic irradiation may produce a variety of adverse side effects on the central and the peripheral nervous systems. These adverse effects are divided into two main groups; transient and permanent. Four major clinical syndromes have been described in relation to permanent radiation injury of the nervous system: encephalopathy, cranial neuropathy, myelopathy, and peripheral neuropathy. Among them, delayed encephalopathy represents the major hazard in CNS irradiation. The characteristic MR imaging pattern of radiation induced delayed necrotizing leukoencephalopathy is symmetric, high-signal foci on T2WI in the periventricular white matter. We report a case of suspected post-irradiation leukoencephalopathy showed progressive mental change, quadriparesis, and urinary incontinence with characteristic MR findings who had taken therapeutic irradiation 12 months ago.
Cranial Nerve Diseases
;
Leukoencephalopathies*
;
Magnetic Resonance Imaging
;
Nervous System
;
Peripheral Nervous System
;
Peripheral Nervous System Diseases
;
Quadriplegia
;
Radiation Injuries
;
Spinal Cord Diseases
;
Urinary Incontinence
2.Studies on the Morphological Changes of Neurons in Dorsal Root Ganglion and Spinal Dorsal Horn of the Rat with an Experimental Peripheral Neuropathy.
Won Taek LEE ; Min Gyun SON ; Gyung Seung JUNG ; Hong Suk LEE ; Gyung Ah PARK
Korean Journal of Anatomy 1997;30(5):495-510
Animal models for human chronic pain syndromes were developed and widely used for pain research. One of thsese neuropathic pain model by Kim and Chung[1992] has many advantages for operation and pain elicitation. We have examined the c-fos protein, substance P, CGRP immunoreactivity in dorsal root ganglia and dorsal horn in this neuropathic model. About 50 Sprague-Dawley rats were used for this study. L5 and L6 spinal nerve were ligated tightly to produce neuropathic pain model. After 2, 4, 8, 16, 24 hours and 1 week of surgery, rats were anesthesized and sacrificed by perfusion through the left ventricle with saline followed by 0.1M phosphate buffer[pH 7.4] containing 3% paraformaldehyde, 3% glutaraldehyde, and 0.1% picric acid. After confirmation of the roots transected by the surgery, the L5 and L6 dorsal root ganglion and spinal cord were removed and processed for immunohistochemistry. All tissue sections were immunohistochemically stained for substance P, CGRP and c-fos by using the peroxidase-antiperoxidase[PAP] method. Count the number of immunostained substance P and CGRP dorsal root ganglion cells and c-fos immunoreactive dorsal horn cells and analyzed statistically with Mann-Whitney U test. The results are as follows. 1. The number of c-fos protein immunoreactive neurons in the superficial layer of dorsal horn were increased markedly at 2 hours after operation, gradually decreased to normal level 1 week after operation. 2. The number of c-fos protein immunoreactive neurons in the deep layer of dorsal horn were gradually increased to the peak 24 hours after operation, decreased to normal level 1 week after operation. 3. The number of substance P and CGRP immunoreactive L5 and L6 dorsal root ganglion neurons were decreased markedly at 1 week after pain model operation. In conclusion, after neuropathic pain model operation, c-fos protein were immediately expressed in the superficial layer of spinal dorsal horn, thereafter c-fos protein in the deep layer of spinal dorsal horn were expressed. CGRP and substance P immunoreactive neurons were decreased markedly 1 week after neuropathic pain model operation.
Animals
;
Chronic Pain
;
Ganglia, Spinal*
;
Glutaral
;
Heart Ventricles
;
Horns*
;
Humans
;
Immunohistochemistry
;
Models, Animal
;
Neuralgia
;
Neurons*
;
Perfusion
;
Peripheral Nervous System Diseases*
;
Posterior Horn Cells
;
Rats*
;
Rats, Sprague-Dawley
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Spinal Cord
;
Spinal Nerve Roots*
;
Spinal Nerves
;
Substance P
3.Clinical study of open tibia fractures treated with external fracture.
Seung Gyun CHA ; Won Suck LEE ; Kyoung Hoon KIM ; Jin Yong JUNG
The Journal of the Korean Orthopaedic Association 1992;27(4):1024-1029
No abstract available.
Tibia*
4.Brainstem Encephalitis Mimicking Miller Fisher Syndrome.
Jeong Gyun NA ; Won Young JUNG ; Kyung WON ; Gun Han LIM
Journal of the Korean Neurological Association 1994;12(4):758-763
We report a 18 years old man of brainstem encephalitis with acute ataxia, areflexia and gaze evoked vertical and horizontal nystagmus which is mimicking Miller Fisher syndrome. He had evidences of both peripheral neuropathy in nerve conduction studies and a brainstem encephalitis in MR findings. The possible relationship of the Miller Fisher syndrome and brainstem encephalitis are discussed with brief review of literature.
Adolescent
;
Ataxia
;
Brain Stem*
;
Encephalitis*
;
Humans
;
Miller Fisher Syndrome*
;
Neural Conduction
;
Nystagmus, Pathologic
;
Peripheral Nervous System Diseases
5.Intravenous Immunoglobulin Therapy in Guillain-Barre Syndrome.
Kyung Won CHO ; Won Young JUNG ; Jeong Gyun NA ; Gun Han LIM
Journal of the Korean Neurological Association 1994;12(4):709-714
High dose intravenous immunoglobulin (IVIg) therapy can improve the clinical course of several immune mediciated diseases. We evaluated clinical effects and side effects of IVIg in Guillain-Barre syndrome (GBS). 19 Patients with GBS were studied prospectively in a placebo-controlled trial. 11 Patients were received high dose IVIg (400mg/kg for 5 days) and controls received only conservative treatment. The disability scores using modified Rankin scores before and after treatment of each group were compared. Four weaks later, mean Rankin Score of IVIg group was 2.5 + 0.7 and control group was 3.3+ 0.5which showed significant difference(p<0.05). There were no serious advers effer of promote early improvement with safety in acute phase of Guillan-Barre syndrome.
Guillain-Barre Syndrome*
;
Humans
;
Immunization, Passive*
;
Immunoglobulins*
;
Immunoglobulins, Intravenous
;
Prospective Studies
6.The Longterm Prognostic Factors After Acute Cerebral Infartion.
Won Young JUNG ; Gun Han LIM ; Hyung Gyun OH ; Seung Heon LEE ; Jeong Gyun NA
Journal of the Korean Neurological Association 1995;13(4):806-814
BACKGROUND & OBJECTIVES: There are few reports of affecting factors of the longterm prognosis after acute ischemic stroke. The aim of this prospective study was to determine which variables, of those easily measurable during the first 24 hours after stroke onset, would be predictors of longterm outcome. METHOD: Ninety-eight patients with an acute ischemic stroke were evaluated within 24 hours after symptom onset. The following potential affecting factors of outcome were prospectively collected : demographic datas, socioeconomic factors, risk factors of cerebrovascular accidents, clinical f indings as measured by the National Institute of Health (NIH) scale, laboratory findings and premorbid varibles rated according to modified Rankin score (mRS). We evaluated the outcome, assessed with mRS as good (mRS 3 or less) and poor (mRS 4, 5 or death) and follow up was undertaken at 6, 12, 18 and 24 months after onset. The statistical analysis was performed by means of SPSS/PC+package to determine the longterm prognostic factors. RESULTS: The multiple stepwise regression analysis revealed that the outcome depend on NIH scale(p<0.001), age (p<0.01), previous stroke(p<0.01), loss of consciousness (LOC) at onset (p
7.A Case of Acute Aortic Dissection with Dynamic ST Changes in Electrocardiogram.
Chung Mee YOUK ; Namho LEE ; Soo Hyun PARK ; Sam KIM ; Sung Won JUNG ; Jee Soo KIM ; Dae Gyun PARK
Korean Circulation Journal 2001;31(2):251-255
Acute aortic dissection is the most common catastrophic illness of the aorta. Left untreated, about 75% of patients with dissections involving the ascending aorta die within 2 weeks of an acute episode, but survival may be significantly improved by the timely institution of diagnostic modalities and appropriate medical and surgical therapy. But, approximately 10-20% of patients with acute aortic dissection present with a clinical picture of acute myocardial infarction. This sometimes can not only delay the diagnosis and adequate treatment of acute aortic dissection but also inappropriately treat with thrombolytic agents and anticoagulants which result in rapid deterioration of clinical condition of patient. We report a case of acute aortic dissection with dynamic ST changes in electrocardiogram which resulted in delay of accurate diagnosis and adequate treatment of acute aortic dissection.
Anticoagulants
;
Aorta
;
Catastrophic Illness
;
Diagnosis
;
Electrocardiography*
;
Fibrinolytic Agents
;
Humans
;
Myocardial Infarction
8.Recurrent Pulmonary Thromboembolism Treated with Urokinase.
Kyung Chang PARK ; Jee Soo KIM ; Sam KIM ; Chung Mi YOUK ; Sung Won JUNG ; Nam Ho LEE ; Dae Gyun PARK
Korean Circulation Journal 2000;30(10):1285-1290
The symptoms and signs of acute pulmonary arteries thrombosis are nonspecific. So clinical suspicion is the most important in the diagnosis. Treatment of pulmonary thromboembolism include anticoagulant, thrombolytic agent, or surgical intervention. We experienced a case of recurrent pulmonary thromboembolism without coagulation defect and any risk factor except old age and obese. Initially we treated with heparin, but clinical symptoms were aggravated. After we changed to urokinase (total 330 million IU/2 days), the pulmonary arteries obstruction were resolved and clinical symptoms were improved without any complications. So we report this clinical experience with review of articles.
Diagnosis
;
Heparin
;
Pulmonary Artery
;
Pulmonary Embolism*
;
Risk Factors
;
Thrombosis
;
Urokinase-Type Plasminogen Activator*
9.Torsion of the wandering spleen: a case report.
Tae Gyun KIM ; Seok Won SHIM ; Jin Han BAE ; Bong Wha CHUNG ; Jae Jung LEE ; Chul Jhe PARK
Journal of the Korean Surgical Society 1993;44(4):605-610
No abstract available.
Wandering Spleen*
10.Evaluation of the Outcomes according to Etiology in the Pediatric Pes Planovalgus after Lateral Column Lengthening: By Radiologic and Pedobarographic Measurements.
The Journal of the Korean Orthopaedic Association 2018;53(5):407-414
PURPOSE: Pes planovalgus is one of the most common foot deformities among pediatric orthopedic diseases and is divided into idiopathic and neuromuscular planovalgus according to its etiology. This study evaluated the radiologic and pedobarographic outcomes of the treatment for pes planovalgus in children treated with lateral column lengthening, compared the outcomes according to the etiology, and investigated the correlation between the radiologic and pedobarographic findings. MATERIALS AND METHODS: Sixty-three patients (97 feet), who underwent lateral column lengthening, were divided into groups of 30 patients (47 feet) with neuromuscular disease and 33 patients (50 feet) with idiopathic etiology. The preoperative, immediately postoperative, 1 year, and 3 year follow-up radiographic measurements on the plain radiograph antero-posterior (AP) and lateral view were compared. In pedobarography, the foot pressures were subdivided into 4 areas to measure the contact time, contact area, peak pressure, and maximum force. The pre- and postoperative pedobarographic measurements were compared and the correlations between the radiographic and pedobarographic measurements were evaluated. RESULTS: The radiographic index at the 1st postoperative year and 3rd postoperative follow-up did not show significant differences according to the etiology. In pedobarography, idiopathic planovalgus showed a significant increase in the maximum force in the hindfoot and forefoot. The correlation between the radiologic findings and pedobarographic findings was statistically significant between the tibiocalcaneal angle in the lateral view and the maximum force, and the contact area of hindfoot on pedobarography, between tibiocalcaneal angle in the lateral view and the contact area of the toes in idiopathic planovalgus. In neuromuscular planovalgus, the peak pressure in the hindfoot had a strong negative correlation with talonavicular coverage angle in the AP view and talo-1st metatarsal angle, and the talohorizontal angle in the lateral view. CONCLUSION: Lateral column lengthening is an effective surgical procedure for flatfoot patients. On the other hand, the radiographic examination has limitations for accurate assessments of the postoperative results and prognosis. Qualitative and quantitative evaluations are available by pedobarography and it is a useful instrument for an evaluation of planovalgus when used in conjunction with radiography.
Child
;
Evaluation Studies as Topic
;
Flatfoot
;
Follow-Up Studies
;
Foot
;
Foot Deformities
;
Hand
;
Humans
;
Metatarsal Bones
;
Neuromuscular Diseases
;
Orthopedics
;
Prognosis
;
Radiography
;
Toes