• 대한한의학회지
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• 제38권3호
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• pp.96-102
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• 2017

Objectives: The purpose of this study was to investigate the effects of Korean Medicine on postural instability and gait difficulty(PIGD) in patient with parkinsonism. Methods: We reviewed the charts of patients with parkinsonism who were admitted to the department of Korean internal medicine, stroke and neurological disorders center, Kyung Hee University Hospital at Gangdong from October 2009 to May 2017. We analyzed the data of UPDRS (Unified Parkinson's disease rating scale) and calculated PIGD related UPDRS before and after the admission. Results: The average of PIGD score for the 23 patients of Parkinsonism significantly decreased from $8.35{\pm}5.13$ to $4.52{\pm}3.68$ after treatment. The average of PIGD score for the 16 patients of idiopathic parkinson's disease and 7 patients of atypical Parkinsonism decreased from $9.13{\pm}4.46$ to $4.63{\pm}4.15$ and from $6.57{\pm}6.45$ to $4.29{\pm}2.56$ after treatment, respectively. Conclusions: These results provide that Korean Medicine has an effect on the motor function of patients who suffer from Parkinsonism with Postural Instability and Gait Difficulty. Furthermore it could be effective for improving activities of daily life.

• Journal of Korean Neurosurgical Society
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• 제30권8호
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• pp.976-980
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• 2001

Objectives : For Parkinsonian patients who had not reacted favorably on drug therapy are good candidate for ventroposterolateral pallidotomy, although not curative. We studied these patients after unilateral pallidotomy, to confirm the effectiveness and safety of this procedure. Methods : We evaluated the 17 patients with idiopathic Parkinson's diesease who had undergone unilateral posteroventral pallidotomy. All patients responded to levodopa initially. Mean age was 55 years(38-75years), and mean duration of disease was 9.8 years(3-20years). Pre-and postoperative evaluation at 3 month intervals included Unified Parkinson's Disease Rating scale(UPDRS) scoring, Hoehn and Yahr(H & Y) staging, and neuropsychological examinations. Results : Pallidotomy significantly improved parkinsonian symptom(tremor, rigidity, bradykinesia, dyskinesia, sensory symptom). Nine of 10 patients who showed dyskinesia preoperatively significant improvement. The mean dose of levodopa in 9 patients was lowered. The mean H & Y score and UPDRS score were improved in on and/or off time in 15 patients. Among patients who were not improved, one patient worsened, and the others showed no change. The mean overall UPDRS off score changed from 76 preoperatively to 44(33%) at 6 months and from 70 to 52(25%) at 1 year. Transient surgical morbidity was showen in four patients and included dysarthria, hypotonia and confusion. Conclusion : We conclude that pallidotomy is safe and effective in patients who have levodopa-reponsive parkinsonism with severe symptom fluctuation. Unilateral pallidotomy also considered helpful to ipsilateral symptom. Unilateral pallidotomy can improve all of parkinsonian's symptom and allow to reduce the levodopa medication. Most of patients show satisfactory results.

• Journal of Acupuncture Research
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• 제22권1호
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• pp.91-97
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• 2005

2004 년 3월 9일부터 5월 15일까지 경희의료원 침구과 외래를 내원하여 8주간 연구과정을 마친 환자 29명의 환자를 관찰하여 뜸치료 전, 후의 파킨슨병 증상의 호전도를 여러 임상 척도를 이용하여 살펴 본 결과를 다음과 같이 보고하는 바이다. 1. UPDRS 점수는 침치료 전, 4주 후, 8주 후 각각 $35.41{\pm}22.98$, $31,93{\pm}23.44$, $30.75{\pm}24.55$로 나타나 통계적으로 매우 유의한 차이가 있었다 (p<0.01). 2. HY stage의 변화는 4주후(p=0.046)에는 유의한 변화가 있으나, 8주후에는 (0.063) 유의한 변화가 없었다. 3. Schwab과 England에 의한 ADL의 변화는 4 주후, 8주후 모두 유의한 변화가 없었다(p>0.05). 4. FOCQ의 변화는 치료 4주후에는 유의한 차이가 있었으나(p=0.05) 8주 후에는 유의한 차이가 없었다(p=0.13) 5. 뜸치료를 통해 환자에게서 파킨슨병 임상척도의 변화 외에 움직임의 유연성이나, 덜 피로함과 같은 다양한 변화가 나타났다.

• 턱관절균형의학회지
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• 제13권sup호
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• pp.1-8
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• 2023

Objectives: Parkinson's disease (PD) is currently the most rapidly increasing degenerative brain disease due to population aging and westernization of lifestyle. Levodopa is the most commonly used drug to manage PD symptoms. However, levodopa has a problem in that the wearing-off phenomenon occurs as the duration and dose of administration increase. In order to investigate the wearing-off phenomenon in PD patients and devise countermeasures, we conducted a questionnaire survey in Korea. Methods: For the study, a questionnaire with a total of seven items was prepared. Part IV of the MDS-UPDRS (Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale) and the WOQ-9 (9-symptom Wearing-off Questionnaire) were used as references. Results: Of the 48 patients who completed the questionnaire, all 47 patients who completed the questionnaire experienced the wearing-off phenomenon. Only one of the patients diagnosed with PD a year ago did not experience the wearing-off phenomenon. Patients frequently mentioned a lack of sleep and stress as aggravating factors for wearing-off. They also stated that in order to resolve the off-state, they walked, massaged, warmed up the body, stretched and exercised. Conclusions: Because wearing-off is such a common occurrence, it is thought necessary to develop wearing-off prevention and resolution measures that PD patients can use in their daily lives.

• Journal of Korean Neurosurgical Society
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• 제54권2호
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• pp.118-124
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• 2013

Objective : Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective treatment of choice for patients with advanced idiopathic Parkinson's disease (PD) who have motor complication with medication. The objectives of this study are to analyze long-term follow-up data of STN DBS cases and to identify the factors related to outcomes. Methods : Fifty-two PD patients who underwent STN DBS were followed-up for more than 3 years. The Unified Parkinson's Disease Rating Scale (UPDRS) and other clinical profiles were assessed preoperatively and during follow-up. A linear regression model was used to analyze whether factors predict the results of STN DBS. We divided the study individuals into subgroups according to several factors and compared subgroups. Results : Preoperative activity of daily living (ADL) and the magnitude of preoperative levodopa response were shown to predict the improvement in UPDRS part II without medication, and preoperative ADL and levodopa equivalent dose (LED) were shown to predict the improvement in UPDRS part II with medication. In UPDRS part III with medication, the magnitude of preoperative levodopa response was a predicting factor. Conclusion : The intensity of preoperative levodopa response was a strong factor for motor outcome. And preoperative ADL and LED were strong factors for ADL improvement. More vigorous studies should be conducted to elucidate how levodopa-induced motor complications are ameliorated after STN DBS.

• Journal of Acupuncture Research
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• 제21권5호
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• pp.59-68
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• 2004

Objective : This study was designed to evaluate the effect of electroacupuncture with various scales on symptoms of idiopathic Parkinson's disease. Methods : Subjects were voluntarily recruited by newspapers and internet. All the subjects are confirmed as idiopathic parkinson's disease by a neurologist. The acupuncture therapy was performed twice a week for 8 weeks. Acupuncture points for EA group were GB34, and LR3, electrical stimulation frequency was 120Hz, duration 15 minutes, and intensity is up to pain threshold according to patients. The patient's symptoms were assessed before, after 4 weeks and after 8 weeks treatments by unified Parkinson's disease rating scale(UPDRS), modified Hoehn-Yahr(H-Y) stage, Schwab & England activity of daily living and freezing of gait questionnaire(FOGQ). Results : UPDRS I, II, III, IV and total UPDRS scores were significantly improved after 4 weeks(p<0.05) and after 8 weeks(p<0.05) compared to the pre-treatment. The scores of ADL were significantly improved after 4 weeks(p<0.05) and after 8 weeks(p<0.05). There were significant changes in H-Y stage after 4 weeks(p<0.05), but There were no significant changes in H-Y stage after 8 weeks. There were significant changes in FOGQ scale after 4 weeks(p<0.05) and after 8 weeks(p<0.05). Conclusion : This study suggests that electroacupuncutre treatments can be applicable to improve symptoms in the patients with idiopathic Parkinson's disease.

• 대한중풍순환신경학회지
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• 제8권1호
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• pp.34-39
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• 2007

Objective : To report cases of patients with Parkinson's syndrome. Design : Case-series Patients and methods : 35 of patients with Parkinson's syndrome who visited Department of Cardiovascular and Neurologic Diseases of Kyunghee Oriental Medical Center were treated by acupuncture and herbal medicine from May until December 2007. 35 patients were participated in this study. 21 patients were dropped out during the trial, and we evaluated symptom progress of 14 patients by using several questionnaires such as Unified Parkinson's Disease Rating Scale(UPDRS), modified Hoehn & Yahr stage (H&Y stage) and Schwab & England ADL scale(S&E ADL scale). Results : The whole group consists of 14 male patients and 21 female patients. Mean±SD age range is 64.5±8.4. There were no significant differences of the demographic and clinical characteristics between the case group and drop-out group. The mean±SD medical treatment period of the Case group were 8.4±6.3weeks, the mean±SD of the total score in first medical treatment UPDRS section 1~3 were 29.6±11.0, the mean±SD of the final score were 27.1±12.6, all of which showed significant improvement(p=0.007). There were no significant changes on the H&Y stage and S&E ADL scale. Conclusion : Patients with Parkinson's syndrome who visited Department of Cardiovascular and Neurologic diseases of Kyunghee Oriental Medical Center had a tendency of showing improvement in clinical symptoms.

• 대한한방내과학회지
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• 제40권2호
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• pp.220-227
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• 2019

Objectives: Parkinson's disease is the neurodegenerative disease that affects both motor and non-motor function, including postural instability. Camptocormia is an abnormal condition in which the thoracolumbar spine bends forward during walking or standing. However, the treatment options are limited and often not effective. The purpose of this study was to report on the Korean medical treatment of a Parkinson's disease patient with postural instability who presented with camptocormia. Methods: We used Korean medical treatment including herbal medicine (Jemageopung-tang), acupuncture and pharmacopuncture therapy to the patient who was admitted to the hospital for 21 days. The clinical symptoms were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS) and walking time without assistance. Results: After treatment, the UPDRS Parts 2 and 3 scores were decreased from 5 to 3 and 20 to 9, respectively. Also, the walking time without assistance was improved. Conclusion: This study suggested that Korean medical treatment could be an effective option for treating Parkinson's disease with postural instability.

• 대한의용생체공학회:의공학회지
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• 제40권5호
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• pp.189-196
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• 2019

We investigated differences in ventricular and hippocampal volumes between CSF tap test (CSFTT) responders and non-responders in idiopathic normal-pressure hydrocephalus (INPH) patients and compared these parameters in INPH patients with that of age- and gender-matched healthy controls. We also evaluated relationships between ventricular and hippocampal volumes and clinical profiles in INPH patients. We enrolled 48 patients with INPH and 29 healthy controls. Ventricular and hippocampal volumes were measured on MRI, including 3-dimensional volumetric images. INPH patients, when compared to healthy controls, had significantly larger ventricular and smaller hippocampal volumes. No difference in ventricular and hippocampal volumes was found between CSFTT responders and non-responders in INPH patients. And hippocampal volumes showed significant negative correlations with Clinical Dementia Rating Scale scores, INPH grading scale cognitive scores, Timed Up and Go Test scores, and Unified Parkinson's Disease Rating Scale motor scores in INPH patients. Volumetric assessment of ventricular and hippocampal regions may have no predictive value in differentiating between CSFTT responders and non-responders in INPH patients. Our findings may help us understand the potential pathophysiology of unique symptoms associated with INPH.

• 정신신체의학
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• 제11권1호
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• pp.25-35
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• 2003

연구목적: 파킨슨병 환자에서 다양한 정신증상이 동반되는 것으로 보고되고 있으며, 특히 우울증상의 동반율이 매우 높다고 보고되고 있다. 특히 파킨슨병은 완치가 어렵고, 치료의 초점이 질병의 진행 억제나 증상의 완화에 있기 때문에 파킨슨병 환자에서의 우울증상에 대한 관심과 치료는 중요하다. 본 연구는 통원치료 중인 파킨슨병 환자들을 대상으로 파킨슨병 관련 임상요인들과 우울증상 사이의 관련성을 조사하는데 목적이 있다. 연구대상 및 방법: 일 대학교병원 신경과 파킨슨병 클리닉에서 특발성 파킨슨병으로 진단 받고 치료중인 환자들 중 본 연구에 참여하기로 동의한 118명의 환자를 대상으로 하였다. 일반적인 인구통계학적 자료, 파킨슨병 관련 자료[발병연령, 치료약물 용량, 임상양상, Hoehn과 Yahr의 단계(Hoehn and Yahr stage, H&Y stage), 일상생활 평가척도(Modified Schwab and England Activities of Daily Living, ADL)], 파킨슨병 환자의 삶의 질 설문지(Parkinson's Disease quality of Life questionnaire, PDQL), 스필버그 상태/특성 불안척도, 간이정신 검사 등을 조사하였고, 우울증상의 평가는 Beck 우울척도(Beck Depression Inventory, BDI)를 이용하였다. 결 과: 대상군의 평균 연령은 $60.4\pm7.1$세(범위:34-73세)였고, 남성이 56명(47.5%), 여성이 62명(52.5%)이었다. 대상군은 BDI 점수에 따라 비우울군 39명(33.1%), 경도 우울군 15명(12.7%), 중등도 우울군 16명(13.6%), 중증 우울군 48명(40.7%)으로 분류되었다. 파킨슨병 환자의 우울증상은 H & Y stage(r=0.34, p<0.001) 및 파킨슨병 증상의 정도(r=0.35, p<0.001), 스필버그 특성 불안 척도(TAI)(r=0.33, p<0.001)와 양의 상관관계가 있었고, 교육정도(r=-0.34, p<0.001), ADL(r=-0.37, p<0.001), PDQL(r=-0.69, p<0.001)과 음의 상관관계를 보였다. 본 연구에서 사용한 검사도구 중 우울증을 예측하는데 가장 의미있는 척도는 PDQL(p<0.005)이었다. 결 론: Beck 우울척도를 이용한 평가에 의하면 본 연구 대상 환자 118명 중 79명(67%)이 주관적인 우울증상을 호소하고 있었다. 본 연구 결과는 파킨슨병 증상이 심할수록, 그리고 H & Y stage가 높을수록 우울증상이 심각함을 보여준다. 또한 BDI 점수가 높을수록 일상생활에서의 활동에 제한이 많으며, 삶의 질이 저하되어 있음을 시사한다. 따라서 본 연구결과는 파킨슨병 환자의 신체증상에 대한 치료 이외 우울증상에 대한 정신의학적 관심과 치료가 중요함을 뒷받침한다.