• 제목/요약/키워드: Dementia Diagnosis

검색결과 148건 처리시간 0.028초

동의신경정신과학회지에 게재된 임상연구논문 동향분석 - 2001년부터 2010년까지 - (A Review of Clinical Studies for Journal of Oriental Neuropsychiatry - since 2001 to 2010 -)

  • 허은정;전원경;김우영;한창현
    • 동의신경정신과학회지
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    • 제22권3호
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    • pp.115-125
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    • 2011
  • Objectives : This study was aimed to review the trend of clinical studies in Journal of Oriental Neuropsychiatry since 2001 to 2010. Methods : We collected 260 clinical studies and analyzed them for publish year, sorts of disease or symptoms, pattern identification diagnosis, and classification of clinical studies. Among them, we selected 46 clinical experimental studies and these studies were further analyzed for publish year, research institution, sort of disease or symptoms, sorts of treatments, number of subject, and pattern identification diagnosis. Results : The number of clinical studies in Journal of Oriental Neuropsychiatry have increased since the year of 2001. There were 62 kinds of diseases and symptoms and Hwa-Byung had the highest number of studies followed by depression, headache, insomnia and so on. The clinical experimental studies, which took up 17% of the clinical studies, have increased since 2001 and was varied with year. There were 13 reserch institutions for clinical experimental studies and they studied about stress, dementia, Hwa-Byung, and so on. Most of studies researched treatment about acupuncture, herb medicine, and meditation treatment for persons under 144. There are only 22% of studies using pattern identification diagnosis. Conclusions : For the development of oriental medicine for psychiatric disease, we need more qualifying clinical studies like RCT. We hope more researchers for psychiatry disease of oriental medicine will be interested in the publication of clinical studies and this will serve to produce advance of oriental medicine as evidence based medecine.

알쯔하이머병에서 양전자방출단층촬영을 이용한 국소뇌포도당대사의 변화에 관한 연구 (Assessment of Metabolic Impairment in Alzheimer's Disease with [$^{18}F$]FDG PET: Validity and Role of Simplified Tissue Radioactivity Ratio Analysis)

  • 김상은;나덕렬;이정림;최용;이경한;최연성;김도관;김병태;이광호;김승태
    • 대한핵의학회지
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    • 제30권3호
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    • pp.299-314
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    • 1996
  • The purpose of the present study was to validate the use of tissue radioactivity ratios instead of regional metabolic rates for the assessment of regional metabolic changes in Alzheimer's disease(AD) with [$^{18}F$]FDG PET and to examine the correlation of ratio indices with the severity of cognitive impairment in AD. Thirty-seven AD Patients(age $68{\pm}9 yrs$, $mean{\pm}s.d.$; 36 probable and 1 definite AD), 28 patients with dementia of non-Alzheimer type(age $66{\pm}7 yrs$), and 17 healthy controls(age $66{\pm}4 yrs$) underwent [$^{18}F$]FDG PET imaging. Two simplified radioactivity ratio indices were calculated from 37-66 min image: region-to-cerebellar radioactivity ratio(RCR) and a composite radioactivity ratio(a ratio of radioactivity in the most typically affected regions over the least typically affected regions: CRR). Local cerebral metabolic rate for glucose(LCMRglu) was also measured using a three-compartment, five-parameter tracer kinetic model. The ratio indices were significantly lower in AD patients than in controls(RCR in temporoparietal cortex, $0.949{\pm}0.136$ vs. $1.238{\pm}0.129$, p=0.0004; RCR in frontal cortex, $1.027{\pm}0.128$ vs. $1.361{\pm}0.151$, p<0.0001; CRR, $0.886{\pm}0.096$ vs. $1.032{\pm}0.042$. p=0.0024). On the RCR analysis, 86% of AD patients showed a pattern of bilateral temporoparietal hypometabolism with or without frontal involvement; hypometabolism was unilateral in 11% of the patients. When bilateral temporoparietal hypometabolism was considered to be suggestive of AD, the sensitivity and specificity of the RCR analysis for the differential diagnosis of AD were 86% and 73%, respectively. The RCR was correlated significantly with the macroparameter K [$K_1k_3/(k_2+k_3)$] (r=0.775, p<0.0001) and LCMRglu(r=0.633, p=0.0002) measured using the kinetic model. In patients with AD, both average RCR of cortical association areas and CRR were correlated with Mini-Mental Status Examination(r=0.565, p=0.0145; r=0.642, p=0.0031, respectively), Clinical Dementia Rating(r=-0.576, p=0.0124; r=-0.591, p=0.0077), and total score of Mattis Dementia Rating Scale (r=0.574, p=0.0648; r=0.737, p=0.0096). There were also significant correlations between memory and language impairments and corresponding regional RCRs. The results suggest that the [$^{18}F$]FDG PET ratio indices, RCR and CRR, reflect global and regional metabolic rates and correlate with the severity of cognitive impairment in AD. The simplified ratio analysis may be clinically useful for the differential diagnosis and serial monitoring of the disease.

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Regulator of G-Protein Signaling 4 (RGS4) Controls Morphine Reward by Glutamate Receptor Activation in the Nucleus Accumbens of Mouse Brain

  • Kim, Juhwan;Lee, Sueun;Kang, Sohi;Jeon, Tae-Il;Kang, Man-Jong;Lee, Tae-Hoon;Kim, Yong Sik;Kim, Key-Sun;Im, Heh-In;Moon, Changjong
    • Molecules and Cells
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    • 제41권5호
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    • pp.454-464
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    • 2018
  • Crosstalk between G-protein signaling and glutamatergic transmission within the brain reward circuits is critical for long-term emotional effects (depression and anxiety), cravings, and negative withdrawal symptoms associated with opioid addiction. A previous study showed that Regulator of G-protein signaling 4 (RGS4) may be implicated in opiate action in the nucleus accumbens (NAc). However, the mechanism of the NAc-specific RGS4 actions that induce the behavioral responses to opiates remains largely unknown. The present study used a short hairpin RNA (shRNA)-mediated knock-down of RGS4 in the NAc of the mouse brain to investigate the relationship between the activation of ionotropic glutamate receptors and RGS4 in the NAc during morphine reward. Additionally, the shRNA-mediated RGS4 knock-down was implemented in NAc/striatal primary-cultured neurons to investigate the role that striatal neurons have in the morphine-induced activation of ionotropic glutamate receptors. The results of this study show that the NAc-specific knock-down of RGS4 significantly increased the behaviors associated with morphine and did so by phosphorylation of the GluR1 (Ser831) and NR2A (Tyr1325) glutamate receptors in the NAc. Furthermore, the knock-down of RGS4 enhanced the phosphorylation of the GluR1 and NR2A glutamate receptors in the primary NAc/striatal neurons during spontaneous morphine withdrawal. These findings show a novel molecular mechanism of RGS4 in glutamatergic transmission that underlies the negative symptoms associated with morphine administration.

라만 기반 치매 모델의 뇌조직 분광 특성 측정 (Ex Vivo Raman Spectroscopy Measurement of a Mouse Model of Alzheimer's Disease)

  • 고관휘;서영희;임성민;이홍기;박지영;장원석;김동현
    • 한국광학회지
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    • 제33권6호
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    • pp.331-337
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    • 2022
  • 비탄성적 산란에 의한 빛의 방출 현상을 이용한 라만 분광법 기술은 무표지 방식으로 분자를 식별하는 기술로 바이오 의학 및 재료 산업에 이르기까지 다양한 분야에서 연구되고 있다. 광프로브 기반 라만 분광기는 국소 부위의 화학 분석을 최소 침습 방식으로 측정할 수 있어 수술 중 실시간 진단 기술로 적용할 수 있는 가능성을 내포하고 있다. 본 연구에서는 화학 물질의 농도별 변화에 따른 라만 신호의 변화를 살펴보아 라만 실험 장치의 캘리브레이션을 진행하였으며, 정상 쥐와 아밀로이드 베타 플라크가 축적된 5xFAD 치매성 돌연변이 모델의 대뇌 조직을 대상으로 라만 신호 특성을 측정 및 비교 분석하여 알츠하이머씨 병의 진단을 위한 가능성을 탐구하였다. 또한 대표적인 치매 원인 물질인 아밀로이드 베타에 대한 라만 신호 측정을 병행하여 치매 진단에 대한 적용을 교차 검증하였다. 본 라만 분광법 연구를 통해 치매 진단에 있어 기존문진 검사 및 뇌 영상 진단을 대체하여 정밀하게 판별할 수 있는 하나의 진단 지표로서의 가능성을 보았으며, 추후 뇌신경계뿐만 아니라 인체의 다양한 장기 및 질병에 적용시켜 물리·공학·화학 등 다양한 연구분야에서의 원천기술로 활용될 수 있을 것으로 생각된다.

Metabolic Topography of Parkinsonism

  • 김재승
    • Nuclear Medicine and Molecular Imaging
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    • 제41권2호
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    • pp.141-151
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    • 2007
  • 파킨슨병은 노년층에 가장 흔한 퇴행성 뇌질환 중의 하나로 진행성핵상마비, 다중계 위축, 루이체 치매 등과 같은 비전형 파킨슨병과 임상적으로 감별이 어려울 수 있다. 파킨슨병과 비전형 파킨슨병의 감별은 치료방침 결정과 예후평가뿐만 아니라 파킨슨병의 원인과 병태생리를 연구하고 새로운 치료법 개발에 있어서도 매우 중요하다. 파킨슨병과 비전형 파킨슨병과 같이 파킨슨 증후군을 유발하는 질환은 선조체내 도파민 신경의 퇴행성 변화를 흔히 동반하지만 병태생리학적으로 서로 다른 뇌피질 및 피질하 구조물에서의 신경세포 소실을 동반하고 있다. 따라서 국소 시냅스 활성도와 신경 및 시냅스의 손상, 그리고 원발병변과 기능적으로 연결된 원격부위의 기능이상 등을 대변하는 뇌포도당 대사를 F-18FDG PET으로 평가하는 것은 파킨슨 병의 감별진단과 병태생리를 평가하는데 유용하다.

제주도에서 CADASIL 연구의 중요성: 역학, 진단 및 임상양상에 대한 고찰 (Importance of CADASIL research in Jeju: a review and update on epidemiology, diagnosis, and clinical spectrum)

  • 최재철;이정석;김기태
    • Journal of Medicine and Life Science
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    • 제17권3호
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    • pp.65-73
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    • 2020
  • Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a single-gene disease of the cerebral small blood vessels caused by mutations in the NOTCH3 gene on chromosome 19. Although CADASIL was known as a rare disease, recent research has suggested that the NOTCH variants could be found frequently even in the general population. The main clinical features included recurrent stroke, migraine, psychiatric symptoms, and progressive cognitive decline. On brain magnetic resonance imaging, patients with CADASIL showed multifocal white matter hyperintensity lesions, lacunar infarcts, microbleeds, and brain atrophy. Among them, lacunar infarcts and brain atrophy are important in predicting the clinical outcomes of patients with CADASIL. In the Jeju National University Hospital, we have diagnosed 213 CADASIL patients from 2004 to 2020. Most NOTCH3 mutations were located in exon 11 (94.4%), and p.Arg544Cys was the most common mutation. The mean age at diagnosis was 61.0±12.8 years. The most common presenting symptoms were ischemic stroke (24.4%), followed by cognitive impairment(15.0%), headache (8.9%), and dizziness(8.0%). Although the exact prevalence of CADASIL in Jeju is still unknown, the disease prevalence could be as high as 1% of the population considering the prevalence reported in Taiwan. Therefore, it is necessary to discover efficient biomarkers and genetic tests that can accurately screen and diagnose patients suspected of having CADASIL in this region. Ultimately, it is urgent to explore the exact pathogenesis of the disease to identify leading substances of treatment potential, and for this, multi-disciplinary research through active support from the Jeju provincial government as well as the national government is essential.

동적 양전자방출단층 영상 분석을 위한 소프트웨어 개발: DIA Tool (Software Development for Dynamic Positron Emission Tomography : Dynamic Image Analysis (DIA) Tool)

  • 편도영;김정수;정영진
    • 대한방사선기술학회지:방사선기술과학
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    • 제39권3호
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    • pp.369-376
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    • 2016
  • 양전자방출단영상(Positron Emission Tomography, PET)은 여러 화합물과 방사성 동위원소를 결합하여 인체 내에 주입하여 인체 내의 대사율을 정량적으로 측정할 수 있는 핵의학적 검사이다. 특히, 암 조직에서 포도당 대사가 증가되는 현상을 $^{18}F$-FDG(Fluorodeoxyglucose)를 사용하여 널리 암 진단에 활용하며, 현대에서 발병 빈도가 높은 뇌질환 중 치매 및 파킨슨 진단에도 높은 유용성을 보인다는 연구가 다수 진행되었다. 이러한 현재의 정적 정보에 시간의 동적 정보를 포함하는 동적 양전자방출단층영상(dynamic PET, dPET)을 이용할 경우, 진단을 위한 추가적인 정보가 제공되므로 진단의 정확도 향상에 기여할 수 있다. 이러한 이유로 임상 연구자 및 방사선사의 큰 관심을 받고 있으나 연구를 진행하기 위해 손쉽게 사용 가능한 도구가 부족한 실정이며, 다양하고 복잡한 수학적 알고리즘(algorithm)이나 프로그래밍(programming) 기술이 부족할 경우 연구의 활성화를 방해하는 높은 진입장벽으로 존재하게 되므로, 본 연구에서는 dPET 연구의 활성화와 손쉬운 사용을 위해서 MATLAB을 이용하여 그래픽 유저(GUI) 기반으로 하여 무료 소프트웨어를 개발하였으며, 개발된 소프트웨어인 DIA-Tool(Dynamic Image analysis-Tool)은 복잡한 수학적 영상 분석 알고리즘을 누구나 손쉽게 사용할 수 있도록 설계되었다. 향후, 많은 임상 연구자들이 DIA-Tool을 이용하여 국내의 dPET 연구 발전에 큰 도움이 될 것이라 기대된다.

교통사고로 인한 기억상실장애 환자 1례에 대한 증례 보고 (Clinical study on a case of a patient with memory disorders caused by traffic accident)

  • 이승기;최우진
    • 동의신경정신과학회지
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    • 제13권1호
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    • pp.117-125
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    • 2002
  • Objectives: The purpose of this study was to investigate the clinical application of oriental medical therapy to a patient with memory disorders and quadriparesis caused by traffic accident. Methods: This study was carried out on a patient who was admitted to the Sangji oriental medical hospital, from January 21st in 2002 to May 2nd in 2002. We used 4 kinds of diagnosis(watching, asking, hearing, and toughing) and treated the patient with herbal medication and acupuncture therapy. Then we estimated the effect of memory disorders through MMSE-K(Mini mental State Examination-Korea) and K-DRS(Korean-Dementia Rating Scale). The numerical effect demonstrated ability of movement through range of motion. Results: Following the treatment the patient's mental state and the ability of movement improved. Conclusions: The present results suggest that oriental medical therapy has the positive effects on a patient with memory disorders and quadriparesis which were caused by traffic accident.

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간성뇌증환자 3례에 대한 임상보고 (3 Cases of Hepatic Encephalopathy)

  • 안정조;임승민;조현경;김용진;유호룡;김윤식;설인찬;최영
    • 대한한방내과학회지
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    • 제22권4호
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    • pp.743-747
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    • 2001
  • Hepatic encephalopathy is caused by disorders affecting the liver. The exact cause of the disorder is unknown. It occurs changes in mental state, consciousness, behavior, personality and changes in mood include forgetfulness, confusion, disorientation, delirium, dementia, decreased alertness, daytime sleepiness, decreased responsiveness, progressive stupor, coma. As 3 admission patients into oriental hospital of daejeon university include 2 cases of cerebral infarction, 1 case of liver cirrhosis, we found those are all hepatic encephalopathy. But until the diagnosis is made, we have many mistakes to find correct. Among the mistackes, specialy mixed thing is to compare hepatic encephalopathy and cerebral infarction. So, we report these cases with a brief review of related literatures.

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Development of Inhibitors of $\beta$-Amyloid Plaque Formation

  • Kim, Dong-Jin
    • 한국응용약물학회:학술대회논문집
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    • 한국응용약물학회 2006년도 Spring Conference
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    • pp.123-135
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    • 2006
  • Alzheimer's disease (AD) is the most common form of dementia in the aging population and is clinically characterized by a progressive loss of cognitive abilities. Pathologically, it is defined by the appearance of senile plaques - extracellular insoluble, congophilic protein aggregates composed of amyloid $\beta$ (A$\beta$) and neurofibrillary tangles (NFTs) - inyracellular lesions consisting of paired helical filaments from hyperphosphorylated cytoskeletal tau protein as described by Alois Alzheimer a century ago. These hallmarks still serve as the major criteria for a definite diagnosis of the disease. Consequently, one of the key strategy for drug development in this disease area focuses on reducing the concentration of cerebral A$\beta$ plaque by using substances that inhibit A$\beta$ fibril formation. We focused on developing inhibitors by synthesizing several kinds of aromatic molecules. The synthetic compounds were initially screened to evaluate the effective compound by tioflavin T fluorescence assay. The selected effective compounds were tested cytotoxicity and protective effect from A$\beta$-induced neuronal toxicity by cell based MTT assay with HT22 hippocampal neurons. The BBB permeability on effectors was also tested in in vitro co-culture model(HUVEC/C6 cell line). The behavior test wea carried out in mutant APP/PS1 transgenic mouse model of Alzheimer's disease. And inhibition of A$\beta$ fibril formation by the effective compound was monitored with transmitted electron microscopic images.

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