• 정신신체의학
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• 제24권2호
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• pp.174-183
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• 2016

연구목적 본 연구에서는 불안장애와 주요우울장애 및 불안장애와 우울장애가 동반된 중복 진단군의 신체 증상의 빈도와 특성의 차이를 알아보고 여러 신체 증상군과 자살 사고, 자살 계획, 자살 시도와의 관련성에 대해 분석하고자 한다. 방 법 본 연구는 국가적 역학조사연구인 2011년 정신질환 실태 역학 조사 연구(Korean Epidemiologic Catchment Area Study-2011, KECA-2011)에 참여한 만 18세 이상에서 74세 이하의 참여자 6027명 중 지난 1 년 동안 주요우울장애 또는 불안장애의 진단 기준을 만족 하면서, 같은 시기에 최소 1가지 이상의 신체증상을 호소한 378명을 대상으로 하였다. 이후 조사된 신체 증상을 통증 증상군, 소화기 증상군, 가성신경학적 증상군의 세군으로 분류하여, 각 증상군에 따른 자살 사고, 자살 계획 및 자살 시도의 정도를 비교하였다. 면담 도구로는 한국어판 CIDI를 사용하였으며, 이 중 신체 증상에 대한 항목이 포함된 C장과 자살관련 항목이 포함된 S장의 일부 질문을 연구에 사용하였다. 결 과 진단별로 신체 증상의 차이를 비교하였을 때, 주요우울장애에서는 흉통(p=0.016, 95%CI)이, 불안장애에서는 두통(p=0.004, 95%CI)과 묽은 변이나 설사를 나타내는 증상(p=0.018, 95%CI)이, 주요우울장애와 불안 장애의 중복진단군에서는 균형을 잡기 힘든 것(p=0.006), 기절할 것 같은 느낌(p=0.020, 95%CI), 기억을 잃음(p=0.034, 95%CI)의 증상이 유의하게 많았다. 자살 계획의 경우 통증 증상군에서 자살 계획이 있었던 군의 증상의 평균 개수가 계획이 없는 군에 비해 유의하게 높았다(p=0.026, 95%CI). 자살 시도의 경우 소화기 증상군(p=0.004, 95%CI) 및 가성신경학적 증상군(p=0.013, 95%CI) 에서 자살 시도가 있었던 군의 증상의 개수가 시도가 없었던 군에 비해 유의하게 높았다. 자살 사고, 자살 계획, 자살 시도로 갈수록 각 증상군의 신체 증상의 평균의 개수는 증가하는 경향성을 보였다. 결 론 본 연구는 불안장애와 주요우울장애의 신체증상의 특성에 차이가 있음을 보여주었으며, 증상의 개수가 자살 사고에서 자살 계획, 자살 시도로 진행되는 단계로 갈수록 증가하며 일부 증상군에서는 자살 계획과 자살 시도의 유무의 유의한 차이를 보여주는 것으로 나타났다. 이 결과는 비 정신과적 임상 현장에서 다양하고 많은 숫자의 신체 증상을 호소하는 환자의 경우 정신과적인 적극적인 평가 및 자살 위험도에 대한 적극적인 평가가 필요함을 시사한다.

• Annals of Clinical Neurophysiology
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• 제1권1호
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• pp.1-9
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• 1999

Since Hans Berger reported the first paper on the human electroencephalogram in 1920s, huge technological advance have made it possible to use a number of electrophysiological approaches to neurological diagnosis in clinical neurology. In majority of the neurology training hospitals they have facilities of electroencephalography(EEG), electromyography(EMG), evoked potentials(EP), polysomnography(PSG), electronystagmography(ENG) and, transcranial doppler(TCD) ete. Clinicials and electrophysiologists should understand the technologic characteristics and general applications of each electrophysiological studies to get useful informations with using them in clinics. It is generally agreed that items of these tests are selected under the clinical examination, the tests are performed by the experts, and the test results are interpretated under the clinical background. Otherwise these tests are sometimes useless and lead clinicians to misunderstand the lesion site, the nature of disease, or the disease course. In this sense the clinical utility of neurophysiological tests could be summerized in the followings. First, the abnormal functioning of the nervous system and its environments can be demonstrated when the history and neurological examinations are equivocal. Second, the presence of clinically unsuspected malfunction in the nervous system can be revealed by those tests. Finally the objective changes can be monitored over time in the patient's status. Also intraoperative monitoring technique becomes one of the important procedures when the major operations in the posterior fossa or in the spinal cord are performed. In 1996, the Korean Society for Clinical Neurophysiology(KSCN) was founded with the hope that it will provide the members with the comfortable place for discussing their clinical and academic experience, exchanging new informations, and learning new techniques of the neurophysiological tests. The KSCN could collaborate with the International Federation of Clinical Neurophysiology(IFCN) to improve the level of the clinical neurophysiologic field in Korea as will as in Asian region.1 In this paper the clinical neurophysiological tests which are commonly used in clinical neurology and which will be delt with and educated by the KSCN in the future will be discussed briefly in order of EEG, EMG, EP, PSG, TCD, ENG, and Intraoperative monitoring.

• 대한한방내과학회지
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• 제32권3호
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• pp.435-443
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• 2011

Fahr disease (FD) is a rare neurological disorder characterized by presence of abnormal and associated cell loss in certain areas of the brain, mostly in basal ganglia, thalamus, cerebellum and subcortical areas. Approximately two-thirds of the patients are symptomatic. The most common neurological manifestations include movement disorders, cognitive impairment, cerebellar signs and speech disorders. We report one case of estimated FD through brain computed tomography (bilateral calcifications of basal ganglia, thalamus, centrum semiovale, subcortical white matter of occipital lobes, cerebellum). At the first time of treatment, he complained of tremors in his upper limbs. We diagnosed the patient as deficiency of qi (氣) and movement of phlegm-heat-wind (痰熱風動) type according to symptoms and treated by herbs and acupuncture of oriental medicine. During treatments, we evaluated how well the oriental medical treatments were working using visual analogue scale (VAS) and amplitude of hands. After the oriental medical treatments about tremor, VAS dropped from 10 to 2 and amplitude of hands from 20 mm to 2 mm, but the ratio of brain calcifications was not changed. This study suggests that oriental medical treatments can be applicable to improve FD.

• Clinical and Experimental Pediatrics
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• 제51권5호
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• pp.538-541
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• 2008

멘케스병은 성염색체 열성으로 유전되는 질환으로 APT7A 유전자의 돌연변이에 의해 발생한다. 기전은 장에서의 구리 흡수와 운반에 결손이 있는 것으로 혈청 구리 및 ceruloplasmin 이 낮다. 특징적인 임상양상은 경련발작, 근육긴장저하, 저체온증을 나타내며 얼굴은 특징적으로 통통하며 저색소 피부색, 꼬이고 윤택이 없고 잘 부스러지는 머리카락을 보인다. 성장장애를 보이는 경우가 흔하며 심한 정신지체와 발달장애를 동반한다. 멘케스병에서 간비대가 간병증을 보이는 경우는 현재까지 보고되지 않았다. 저자들은 유전자 검사를 통해 멘케스병으로 확진된 4개월 소아가 영아연축, 발달장애, 머리카락 이상 외에도 이전에 잘 알려져 있지 않은 간비대를 보인 1례를 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제30권1호
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• pp.25-30
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• 2013

Hyponatremia, the most common electrolyte disorder, has been rarely reported as causing rhabdomyolysis. Osmotic demyelination syndrome (ODS), a demyelinating disease of the central pons and/or other areas of the brain, is infrequently reported as associated with rapid correction of hyponatremia. This paper reports a case of ODS after correction of severe hyponatremia complicated by rhabdomyolysis. A 47-year-old female with a history of chronic alcoholism presented herself at the hospital with altered consciousness after three days of nausea and vomiting. She was on a thiazide diuretic for essential hypertension. Her blood tests upon her hospital admission showed hyponatremia ($Na^+$ 98 mEq/L), hypokalemia ($K^+$ 3.0 mEq/L), and elevation of her serum creatine phosphokinase (3,370 IU/L) with an increase in her serum myoglobin level 11,267 ng/mL). She was treated with intravenous fluid therapy that included isotonic and hypertonic salines along with potassium chloride. She became more alert, and her neurological condition gradually improved after the first five days of her therapy. On the ninth day after her admission, she developed progressive quadiaresis associated with dysarthria, dysphagia, and dystonia despite the resolution of her hyponatremia. Magnetic resonance imaging of her brain on 16th day revealed symmetrical areas of signal hyperintensity in her central pons, basal ganglia, and precentral gyrus in T2-weighted images, which are consistent with ODS. Her neurological symptoms steadily improved after six weeks with only supportive treatment and rehabilitation.

• 재활치료과학
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• 제6권1호
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• pp.11-23
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• 2017

편측 공간무시는 주로 우측 대뇌반구의 병변으로 인한 뇌졸중 이후 발생하는 신경학적 질환으로, 병변 반대 측 신체와 공간에 대한 처리 기능과 주의집중에 문제가 발생한다. 기능적 신경이미지 연구에서 편측 공간무시는 큰 수준의 중대뇌 동맥, 페리실비안 연결망, 주의집중 연결망의 손상과 연관성이 있다고 보고하였다. 편측 공간무시는 부정적인 예후와 관련이 있기 때문에 정확한 진단과 중재를 위해 편측 공간무시의 유형과 이론 그리고 전통적 평가와 기능적 평가를 포함한 임상적 평가가 고려되어야 한다. 편측 공간무시의 치료는 하향식 접근방법과 상향식 접근방법으로 구분하며, 두 접근방법을 결합하는 형태가 가장 효과적일 수 있다. 편측 공간무시의 모든 최신 중재방법 중에서 프리즘 적응이 가장 적절한 중재법으로 연구되고 있으나, 편측 공간무시의 유형과 병변 위치 등을 고려하여 환자에게 적절한 중재를 적용하는 것이 중요하다.

• 동의생리병리학회지
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• 제34권6호
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• pp.309-318
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• 2020

Besides respiratory infection, COVID-19 has many neurological symptoms not only loss of smell and taste but also fatigue and brain fog. But it is a challenge to treat the neurological symptoms especially of anosmia and ageusia. In order to search for the therapeutic methods, the geographical diversity and pathological mechanisms of the COVID-19 and two symptoms were investigated from the latest clinical studies. Because the environmental conditions of the monsoon climate zone of East Asia and the Mediterranean and Oceanic climate zone of Italy, Britain, United States and tropical Brazil are different, each of diverse etiology and internal milieu should be considered differently in the treatment. SARS-CoV-2 exhibits the dampness-like characteristics and the olfactory and gustatory disorders are particularly more common than other flu or cold. and it tends to show features of damaging the lung qi of olfaction and heart-spleen qi of gustation. The mechanisms of olfactory and gustatory loss are various according to precursory, inflammatory, non-inflammatory and sequelar forms, so the therapeutic method should be designed for each period and pathology. If the process of inflammation arises from nasal and respiratory, olfactory epithelium to the central nervous structure by way of blood brain barrier, the treatment should be corresponded with the stage and depth of pathogen place. And if the olfactory loss is asymptomatic or in the initial stage, it can be applied intranasal topical scent therapy to relieve temporary locking of qi movement, but maybe also used in parallel together with herbs of relieving dampness toxin latent in the lung parenchyma.

• Journal of Ginseng Research
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• 제46권2호
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• pp.275-282
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• 2022

Background: Stroke is a neurological disorder characterized by brain tissue damage following a decrease in oxygen supply to brain due to blocked blood vessels. Reportedly, 80% of all stroke cases are classified as cerebral infarction, and the incidence rate of this condition increases with age. Herein, we compared the efficacies of Korean White ginseng (WG) and Korean Red Ginseng (RG) extracts (WGex and RGex, respectively) in an ischemic stroke mouse model and confirmed the underlying mechanisms of action. Methods: Mice were orally administered WGex or RGex 1 h before middle cerebral artery occlusion (MCAO), for 2 h; the size of the infarct area was measured 24 h after MCAO induction. Then, the neurological deficit score was evaluated and the efficacies of the two extracts were compared. Finally, their mechanisms of action were confirmed with tissue staining and protein quantification. Results: In the MCAO-induced ischemic stroke mouse model, WGex and RGex showed neuroprotective effects in the cortical region, with RGex demonstrating superior efficacy than WGex. Ginsenoside Rg1, a representative indicator substance, was not involved in mediating the effects of WGex and RGex. Conclusion: WGex and RGex could alleviate the brain injury caused by ischemia/reperfusion, with RGex showing a more potent effect. At 1,000 mg/kg body weight, only RGex reduced cerebral infarction and edema, and both anti-inflammatory and anti-apoptotic pathways were involved in mediating these effects.

• Journal of Korean Neurosurgical Society
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• 제66권6호
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• pp.735-742
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• 2023

Nephrotic syndrome (NS) is associated with cerebral venous sinus thrombosis (CVST), which is a rare cerebrovascular disorder in children. Systemic anticoagulation with heparin is the standard therapy for CVST, and mechanical thrombectomy (MT) has been described as a salvage treatment for adult anticoagulant refractory CVST, However, it has never been reported in children. We describe a case of MT for refractory CVST in a child with NS. A 13-year-old boy with newly diagnosed NS presented to an emergency department with acute headache. A head computed tomography showed acute thrombus in the superior sagittal sinus, straight sinus and transverse sinus. The child was started on heparin therapy, but clinically deteriorated and became unresponsive. In view of the rapid deterioration of the condition after anticoagulation treatment, the patient received intravascular treatment. Several endovascular technologies, such as stent retriever and large bore suction catheter have been adopted. After endovascular treatment, the patient's neurological condition was improved within 24 hours, and magnetic resonance venography of the head demonstrated that the CVST was reduced. The child recovered with normal neurological function at discharge. This case highlights the importance of considering MT for refractory CVST, and we suggest that MT may be considered for refractory CVST with NS in children.

• 대한소아치과학회지
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• 제25권4호
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• pp.837-842
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• 1998

저자는 치아우식증을 주소로 경희의료원 소아치과에 내원한 레트 증후군 환아를 전신마취 하에서 치료를 시행하고 다음과 같은 치의학적 소견을 얻었다. 1. 본 증례에 보고된 레트 증후군 환아들은 비정상적인 저작, 이갈이, 과다한 타액분비, 높고 깊은 상악 구개, 혀의 전방 변위 등의 구강 증상을 보였다. 2. 본 증례에서 보고된 레트 증후군 환아들은 입과 손을 사용하는 습관-손깨물기, 손등을 핥거나 입술로 문지르기, 손가락빨기-을 갖고 있으며 흔히 손을 씻는 듯한 특징적인 상동증 사이에 이러한 동작을 반복하였다. 3. 이상과같은 진단적 요건을 숙지한다면 레트 증후군의 조기 발견에 도움이 될 수 있으며, 치과적 처치시에도 조기치료 및 예방술식을 시행할 수 있어 진정요법이나 전신마취의 필요성을 감소시킬 수 있을 것으로 판단된다.