• Annals of Clinical Neurophysiology
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• 제21권1호
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• pp.1-6
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• 2019

Anhidrosis refers to the condition in which the body does not respond appropriately to thermal stimuli by sweating. Sweating plays an important role in maintaining the body temperature, and its absence should not be overlooked since an elevated body temperature can cause various symptoms, even leading to death when uncontrolled. The various neurological disorders that can induce anhidrosis make a detailed neurological evaluation essential. The medication history of the patient should also be checked because anhidrosis can be caused by various drugs. The tests available for evaluating sweating include the quantitative sudomotor axon reflex sweat test, thermoregulatory sweat test, sympathetic skin response, and electrochemical skin conductance. Pathological findings can also be checked directly in a skin biopsy. This review discusses the differential diagnosis and evaluation of anhidrosis.

• Molecules and Cells
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• 제42권6호
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• pp.441-447
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• 2019

RAS gene mutations are frequently found in one third of human cancers. Affecting approximately 1 in 1,000 newborns, germline and somatic gain-of-function mutations in the components of RAS/mitogen-activated protein kinase (RAS/MAPK) pathway has been shown to cause developmental disorders, known as RASopathies. Since RAS-MAPK pathway plays essential roles in proliferation, differentiation and migration involving developmental processes, individuals with RASopathies show abnormalities in various organ systems including central nervous system. The frequently seen neurological defects are developmental delay, macrocephaly, seizures, neurocognitive deficits, and structural malformations. Some of the defects stemmed from dysregulation of molecular and cellular processes affecting early neurodevelopmental processes. In this review, we will discuss the implications of RAS-MAPK pathway components in neurodevelopmental processes and pathogenesis of RASopathies.

• Journal of Oral Medicine and Pain
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• 제46권4호
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• pp.155-160
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• 2021

The masticatory muscle disorder is the most common problem that patients with temporomandibular disorder often complain. For such complaints, treatment is directed towards reducing hyperactivity of muscles or effects of the central nervous system. However, if nonspecific occlusal change or pain persists, it is necessary to consider that muscle weakness might be the cause of the persistence of temporomandibular disorder. Stabilization of occlusion and improvement of the pain symptoms were achieved in both cases through the chewing gum exercise. This exercise may enable masticatory movements done in normal function by using muscle engram and achieve reinforcement of the masticatory muscles with balanced, simultaneous contacts of the teeth. In addition, it may be a viable method for treating temporomandibular disorders that do not respond well to conventional mandibular stabilization therapies.

• Molecules and Cells
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• 제45권2호
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• pp.53-64
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• 2022

Three-dimensional cultures of human neural tissue/organlike structures in vitro can be achieved by mimicking the developmental processes occurring in vivo. Rapid progress in the field of neural organoids has fueled the hope (and hype) for improved understanding of brain development and functions, modeling of neural diseases, discovery of new drugs, and supply of surrogate sources of transplantation. In this short review, we summarize the state-of-the-art applications of this fascinating tool in various research fields and discuss the reality of the technique hoping that the current limitations will soon be overcome by the efforts of ingenious researchers.

• 수면정신생리
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• 제12권1호
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• pp.58-63
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• 2005

목 적：중추신경계 질환의 병발 여부에 따라 렘수면 행동 장애 환자들을 두 군으로 나눈 후, 인구학적 특성, 임상양상, 수면 변인들을 비교하여 차이점과 특성을 관찰하고자 하였다. 방법：서울대학교병원에서 야간수면다원검사를 통해 렘수면 행동장애로 확진받은 81명을 대상으로 하였다. 의무기록과 수면다원검사 소견을 후향적으로 조사하였고 필요한 경우 전화문진을 통해 자료를 보완하였다. 중추신경계 질환력과 뇌 자기공명검사 소견을 근거로 전체 대상을 중추신경계 질환을 동반한 병발성 렘수면 행동장애군과 그렇지 않은 특발성 렘수면 행동장애군으로 이분하였다. 그 후 두 군 사이의 인구학적 특성, 임상양상, 수면 변인을 비교분석하였다. 결 과：전체 대상군 81명 중 남자는 64명, 여자는 17명이었다. 그리고 전체 대상중에 21명(25.9%)에서 중추신경계 질환이 동반되어 병발성 렘수면 행동장애군으로, 나머지 60명(74.1%)에서 그렇지 않아 특발성 렘수면 행동장애군으로 분류하였다. 동반된 중추신경계 질환은 파킨슨병(11명), 올리브뇌교소뇌위축(olivopontocerebellar atrophy)(3명), 다발신경계위축증(multiple system atrophy)(2명), 파킨슨병을 동반하지 않은 치매(2명), 뇌경색(1명), 뇌교부종(1명), 뇌종양(1명)이었다. 전체 대상에서 수면장애가 병발된 경우는 74.1%로서 주기성 사지운동증과 폐쇄성무호흡증이었다. 주기성 사지운동증(사지운동 지수>5)과 폐쇄성 수면무호흡증(호흡장애지수>5)의 유병율이 병발성 렘수면 행동장애군에서 유의하게 높았다(각각 p<0.001, p=0.0042, Fisher 검증). 심한 정도를 나타내는 주기성 사지운동지수와 호흡장애지수도 병발성 렘수면 행동장애군에서 유의하게 높았다(각각 p<0.001, p=0.017, 독립 t-test). 수면변인 중 서파수면분율과 수면효율은 병발성 렘수면 행동장애군에서 유의하게 낮았다(각각 p<0.001, p=0.017, 독립 t-test). 고 찰：렘수면 행동장애 환자의 25%에서 중추신경계 질환이 동반되어 있음을 확인하였다. 중추신경계 질환이 동반된 렘수면 행동장애에서는 주기성 사지운동증과 폐쇄성 수면 무호흡증 같은 다른 수면장애가 더 흔하게 병발하였고 그 정도 역시 더 심하게 나타났다. 수면구조에서도 특발성 렘수면 행동장애에 비해 서파수면과 수면효율이 모두 더 감소하는 소견을 보였다.

• IMMUNE NETWORK
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• 제4권1호
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• pp.60-64
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• 2004

Background: Microglial cells, major immune effector cells in the central nervous system, become activated in neurodegenerative disorders. Activated microglial cells produce proinflammatory mediators such as nitric oxide (NO), tumor necrosis factor-$\alpha$ and interleukin-$1{\beta}$(IL-$1{\beta}$). These proinflammatory mediators have been shown to be significantly increased in the neurodegenerative disorders such as Alzhimer's disease and Pakinson's disease. It was known that one of the neurodegeneration source is stress and it is important to elucidate mechanisms of the stress response for understanding the stress-related disorders and developing improved treatments. Because one of the neuropeptide which plays a main role in regulating the stress response is corticotropin-releasing hormone (CRH), we analyzed the regulation of NO release by CRH in BV2 murine microglial cell as macrophage in the brain. Methods: First, we tested the CRH receptor expression in the mRNA levels by RT-PCR. To test the regulation of NO release by CRH, cells were treated with CRH and then NO release was measured by Griess reagent assay. Results: Our study demonstrated that CRH receptor 1 was expressed in BV2 murine microglial cells and CRH treatment enhanced NO production. Furthermore, additive effects of lipopolysaccaride (LPS) and CRH were confirmed in NO production time dependantly. Conclusion: Taken together, these data indicated that CRH is an important mediator to regulate NO release on microglial cells in the brain during stress.

• 디지털융복합연구
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• 제13권12호
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• pp.259-268
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• 2015

청각처리장애는 정상 청력을 가졌음에도 불구하고 청각신경계에서 청각 정보를 처리하는 과정의 문제로 자신이 들은 소리를 이해하지 못한다. 본 연구는 최근 문헌들이 제시하는 청각처리장애의 중재 방법을 조사하여 청각 처리장애를 가진 아동을 위한 중재 안내도를 마련하고자 하였다. 청각처리장애를 가진 아동은 진단의 구체적 결함에 따라 Buffalo 모델과 Bellis/Ferre 모델의 유형으로 분류되고 결함을 치료하기 위한 문제중심 중재 전략과 결함의 영향을 관리하는 전반적 중재 전략이 결정된다. 그리고 문제중심 중재 전략은 두 모델의 유형별 특징에 따라 맞춤 전략으로 구성되고, 전반적 중재 전략은 보상 전략, 청능훈련, 환경수정 등이 추천된다. 이러한 중재가 진행되기 위해서는 다학문적 팀에 의해 아동의 청각 기능을 향상시킬 수 있는 다양한 중재 방법들을 선정하고 집중적이고 지속적으로 제공하여야 한다. 청각처리장애의 중재 안내도는 청각처리장애 확인, 중재, 재평가, 수정된 중재 단계로 구성되었다. 이 안내도를 통해 청각처리장애가 의심되거나 청각처리장애를 진단 받은 아동의 어려움을 줄이기 위하여 관련 임상가와 교사들이 적절한 중재 방법과 절차를 찾을 수 있도록 돕고자 하였다.

• Annals of Clinical Neurophysiology
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• 제20권2호
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• pp.71-78
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• 2018

Nerve conduction study (NCS) is an electrophysiological tool to assess the overall function of cranial and peripheral nervous system, therefore NCS has been diagnostically helpful in the identification and characterization of disorders involving nerve roots, peripheral nerves, muscle and neuromuscular junction, and are frequently accompanied by a needle Electromyography. Furthermore, NCS could provide valuable quantitative and qualitative results into neuromuscular function. Usually, motor, sensory, or mixed nerve studies can be performed with using NCS, stimulating the nerves with the recording electrodes placed over a distal muscle, a cutaneous sensory nerve, or the entire mixed nerve, respectively. And these findings of motor, sensory, and mixed nerve studies often show different and distinct patterns of specific abnormalities indicating the neuromuscular disorders. The purpose of this special article is to review the neurophysiologic usefulness of NCS, to outline the technical factors associated with the performance of NCS, and to demonstrate characteristic NCS changes in the setting of various neuromuscular conditions.

• 한국임상약학회지
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• 제15권2호
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• pp.149-159
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• 2005

Purpose: To determine the extent and rate of prescription drug therapy, especially polypharmacy and the prevalence of potentially inappropriate medication use in Korean elderly ambulatory patients based on an explicit criterion. Methods: Performed a retrospective study of 65 years or older ambulatory patients visiting a university hospital based clinic from January 2002 to April 2004. Study determined the patterns of drug prescription per Anatomical Therapeutic Chemical Classification and the potentially inappropriate medication usage based on explicit Beers criteria. Results: Of the 4,042 elderly patients the mean number of prescription was $2.2{\pm}2.0$, which was similar between genders and all age groups within the elderly. 10.7% of patients were prescribed with more than 5 medications concurrently. The most frequently prescribed medication was the drugs used for treating nervous system diseases (44.3%), followed by alimentary tract/metabolism disorders (27.6%), cardiovascular disease (10.7%), blood/blood forming disorders (4.3%), respiratory disorders (6.5%), and musculoskeletal diseases (3.2%). A total of 511 elderly (13%) was prescribed with medication that met the criteria for=1 potentially inappropriate drugs for the elderly. This proportion was similar between genders and all age groups within the elderly. Among these 511 elderly patients the mean number of potentially inappropriate drugs prescribed was $5.1{\pm}3.3$ drugs. Potentially inappropriately prescribed drugs included amitriptyline (76 cases), diazepam (69 cases), ketorolac (57 cases), short acting nifedipine (44 cases), triazolam (38 cases), and hydroxyzine (38 cases). Conclusion: Potentially inappropriate drug prescribing in Korean ambulatory elderly patients are common. Education programs and interventions aimed at optimizing the prescribing and dispensing of the most appropriate drugs are needed.

• 수면정신생리
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• 제3권2호
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• pp.65-76
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• 1996

Natural sleep pattern and its physiology in childhood are much different from those in adulthood. Several aspects of clinical evaluation for sleepiness in childhood are more difficult than in adulthood. These difficulties are due to several factors. First, excessive sleepiness in childhood do not always develop functional impairments. Second, objective test such as MSLT may not be reliable since it is hard to be certain that the child understand instructions. Third, sleepiness in children is often obscured by irritability. paradoxical hyperactivity, or behavioral disturbances. Anseguently, careful clinical evaluation is needed for the sleepy children. Usual causes of sleepiness in children are the disorders that induce insufficient sleep such as sleep apnea syndrome, schedule disorder, underlying medical and psychiatric disorder, and so forth. After excluding such factors, we can diagnose the hypersomnic disorders such as narcolepsy, Kleine-Levin syndrome, and idiopathic central nervous system hypersomnia. Among the variety of those causes of sleepiness, I reviewed the clinical difference of narcolepsy and obstructive sleep apnea syndrome in childhood compared with in adulthood. Recognition of the childhood narcolepsy is difficult because even severely sleepy children often do not develop pathognomic cataplexy and associated REM phenomena until much later. Since childhood narcolepsy give srise to many psychological, academical problem. Practicers should be concerned about these aspects. Childhood obstructive sleep apnea syndrome is different from adult obstructive sleep apnea syndrome too. Several aspects such as pathophysiology. clinical feature, diagnostic criteria, complication, management, and prognosis differ from those in the adult syndrome. An important feature of childhood obstructive sleep apnea syndrome is the variety of severe complications such as behavioral disorders, cognitive impairment, cardiovascular symptoms, developmental delay, and ever death. Fortunately, surgical interventions like adenotosillectomy or UPPP are more effective for Childhood OSA than adult form. CPAP is a "safe, effective, and well-tolerated" treatment modality too. So if early detection and proper management of childhood OSA were done, the severe complication would be prevented or ever cured.