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강규식 대한뇌졸중학회 2006 Journal of stroke Vol.8 No.1
We report a patient with acute right corona radiata infarction and left caudate hemorrhage, which developed simultaneously. The patient was a 55-year-old man with a history of hypertension and diabetes. He was admitted to the hospital due to dysarthria and weakness in his left limbs. Besides of acute lesions, there were old lacunar infarcts and muliple microbleeds on brain imaging. The small vessel diseases caused by chronic hypertension might have predisposed him to both cerebral infarction and cerebral hemorrhage simultaneously.
강규식,김병건 대한신경과학회 2019 대한신경과학회지 Vol.37 No.2
Intracranial hypotension usually arises in the context of known or suspected leak of cerebrospinal fluid (CSF). This leakage leads to a fall in intracranial CSF pressure and CSF volume. The most common clinical manifestation of intracranial hypotension is orthostatic headache. Post-dural puncture headache and CSF fistula headache are classified along with headache attributed to spontaneous intracranial hypotension as headache attributed to low CSF pressure by the International Classification of Headache Disorders. Headache attributed to low CSF pressure is usually but not always orthostatic. The orthostatic features at its onset can become less prominent over time. Other manifestations of intracranial hypotension are nausea, spine pain, neck stiffness, photophobia, hearing abnormalities, tinnitus, dizziness, gait unsteadiness, cognitive and mental status changes, movement disorders and upper extremity radicular symptoms. There are two presumed pathophysiologic mechanisms behind the development of various manifestations of intracranial hypotension. Firstly, CSF loss leads to downward shift of the brain causing traction on the anchoring and supporting structures of the brain. Secondly, CSF loss results in compensatory meningeal venodilation. Headaches presenting acutely after an intervention or trauma that is known to cause CSF leakage are easy to diagnose. However, a high degree of suspicion is required to make the diagnosis of spontaneous intracranial hypotension and understanding various neurological symptoms of intracranial hypotension may help clinicians.
만성 근골격계 환자에서 Prolotherapy시 고농도 포도당용액에 첨가한 Sarapin^(®)의 효과
강규식,이호철,안기량 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1
Background: Musculoskeletal injury is a major cause of chronic pain due to a weakness of the tendons and ligaments. Currently, prolotherapy is used for treating chronic pain by strengthening the tendons and ligaments. This study was designed to evaluate the effects of prolotherapy using Sarapin^(®) in patients with chronic musculoskeletal diseases. Methods: Forty, chronic musculoskeletal disease patients were randomly divided into two groups. Group 1 (N=20) had been treated with a 15% dextrose solution, 0.2% lidocaine. Group 2 (N=20) had been treated with a 15% dextrose solution, 0.2% lidocaine and 25% Sarapin^(®). The VAS (visual analogue scales) were measured before the injection and two months after the injection. Incidence of side effect and complication were checked too. Results: Both groups showed that a post-prolotherapy VAS was significantly reduced compared to the pre-prolotherapy VAS in 80%, 85% but there was no significant difference. Side effect and complication were not significant difference between both groups such as dizziness during injection, new pain development, and a hematoma except pain after the injection. Conclusions: These results show that prolotherapy using Sarapin^(®) is another good method for treating chronic musculoskeletal diseases.
Nuss방법으로 오목가슴 수술을 받는 환아에서 desflurane 마취 후 각성 흥분에 대한 늑간신경차단과 fentanyl의 효과
강규식,서용한,안기량,김천숙,유시현,정지헌,정지원 순천향의학연구소 2008 Journal of Soonchunhyang Medical Science Vol.14 No.2
Background : The rapid recovery from desflurane anesthesia is likley to be accompanied by postoperative emergence agitation, which is considered due to the early appearance of pain. We aimed to evaluate the effect of IV fentanyl or intercostal nerve block for the prevention of emergence agitation. Methods : Fifty-four pediatric patients undergoing pectus excavatum repair by the Nuss procedure were randomly assigned to receive intavenously dose of 0.9% normal saline 0.1ml/kg (group 1, n=18), fentanyl 1.5 ㎍/kg (group 2, n=18) or intercostal nerve block (group 3 : 0.5% ropivacaine 1.5 ml × 3 level, both, n = 18) before skin closure. Emergence agitation was evaluated at arrival to postanesthetic care unit (PACU) 10, 20 and 30 min respectively. PACU time and incidence of severe emergence agitation, respiratory depression and vomiting were evaluated by a blinded observer at the PACU. Results : Agitation score in group 2 and group 3 were significantly lower than that of group 1 at arrival to PACU 10, 20 and 30 min (P < 0.05). Agitation score in group 3 was significantly lower than that of group 2 at arrival to PACU (P < 0.05). Incidence of severe emergence agitation in group 2 and group 3 were significantly lower than that of group 1. Incidence of respiratory depression and vomiting in group 1 and group 3 were significantly lower than that of group 2. Conclusions : For prevention of emergence agitation after desflurane anesthesia in pediatric patients undergoing pectus excavatum repair, we recommend using IV fentanyl or intercostal nerve block.
강규식,박종무,윤병우 대한신경과학회 2006 대한신경과학회지 Vol.24 No.6
Idiopathic thrombocytopenic purpura (ITP) is an immunologic disorder that destroys platelets and megakaryocytes. Hemorrhagic complications are common in patients with ITP. However, thrombotic complications such as coronary artery disease and cerebral infarctions are infrequent. We report a patient with ITP who developed a cerebral infarction despite thrombocytopenia after long-term danazol therapy and was negative for the antiphospholipid antibody.
액체-액체층을 보이는 결핵성 뇌농양의 확산강조영상과 수소자기공명분광분석
강규식,하재혁,이수호,이광우 대한신경과학회 2007 대한신경과학회지 Vol.25 No.2
We encountered a patient with tuberculous brain abscesses, which is very rare. Diffusion-weighted imaging showed high signal in the lower part of the large abscess cavity and low signal in the upper part of the cavity. Proton MRS showed resonances representing lactate. Combined studies with diffusion-weighted imaging and MRS are useful in the differential diagnosis of tuberculous abscess from other structures that feature ring-enhanced lesions.
일시적 국소 뇌허혈을 일으킨 수컷 쥐의 뇌에서는 프로락틴이 새로운 세포 생성을 촉진하지 못할 가능성이 있다: 예비 연구
강규식,이순태,권형민,김민정,김영주,이경미,박종무,주건,김만호,윤병우 대한신경과학회 2006 대한신경과학회지 Vol.24 No.2
Background: Production of neuronal progenitors is usually stimulated in the forebrain subventricular zone of mice after the intracerebroventricular infusion of prolactin. As a preliminary study, we infused prolactin to the male rat brain to test the hypothesis that prolactin promotes new cell proliferation in the brain and functional recovery after focal ischemia. Methods: Male rats were subjected to intraluminal middle cerebral artery occlusion. Prolactin was administered to the surface of the brain for 5 or 14 days starting 24 or 48 hours after stroke onset at doses of 6.4 µg per day. We administered the same volume of saline to the other ischemic rats used as a control group. Some rats were killed 6 or 17 days after stroke for analysis of infarct volume and newly generated cells within the subventricular zone and the striatum. The other rats were tested for neurological recovery 24 days after stroke. Results: There was no significant difference of infarct volume among the experiment groups. Treatment with prolactin did not increase the numbers of bromodeoxyuridine-immunoreactive cells in the subventricular zone and the striatum. Treatment with prolactin did not enhance neurological recovery in all tests performed. Conclusions: In this preliminary study, prolactin did not enhance new cell generation in the male rat brain nor reduce the neurological deficits after ischemic stroke.