• The Journal of Korean Medicine
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• v.38 no.3
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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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• v.30 no.8
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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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• v.22 no.1
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• pp.91-97
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• 2005

Objective : This study was designed to evaluate the effect of moxibustion 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 moxibustion therapy was performed 5 times a week by patient's family at home and once a week by oriental medical doctor at hospital. Moxibustion points were GV2O, CV12, ST36, BL18, BL2O. Intensity was up to pain threshold according to patients not to get burned. The patient's symptoms were assessed before, after 4 weeks and after 8 weeks treatment 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 : Total UPDRS scores were significantly improved after 4 weeks(p<0.01) and after 8 weeks(p<0.01) compared to the pre-treatment. 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. The scores of ADL were not significantly improved after 4 weeks(p>0.05) and after 8 weeks(p>0.05). There were significant changes in FOGQ scale after 4 weeks(p=0.05) and but there were no significant changes in FOGQ scale after 8 weeks(p=0.13). Conclusion : This study suggests that moxibustion treatments can be applicable to improve symptoms in the patients with idiopathic Parkinson's disease.

• Journal of TMJ Balancing Medicine
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• v.13 no.sup
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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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• v.54 no.2
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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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• v.21 no.5
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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.

• The Journal of the Society of Stroke on Korean Medicine
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• v.8 no.1
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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.

• Journal of Biomedical Engineering Research
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• v.40 no.5
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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.

• Korean Journal of Acupuncture
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• v.31 no.1
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• pp.40-47
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• 2014

Objectives : Postural instability and gait difficulty(PIGD) can develop in all Parkinson's disease patients, especially late in the disease course, but does not respond well to conventional dopamine treatment. This study aimed to report three cases of PIGD in Parkinson's disease patients treated with Korean and Western medicine treatment. Methods : We used acupuncture, bee venom acupuncture, herbal medicine and moxibustion to treat patients during hospitalization. They continued Western medication and received rehabilitation treatment. We observed the changes of PIGD using the Unified Parkinson's Disease Rating Scale(UPDRS). Results : After treatment, PIGD symptoms improved and UPDRS scores were decreased. Especially, scores of falling, walking, gait and postural stability subsections related with PIGD were decreased. In addition, general conditions of patients were improved. Conclusions : This study suggests that Korean medicine treatment could be effective in the treatment of PIGD in Parkinson's disease patients.

• The Journal of Internal Korean Medicine
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• v.40 no.2
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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.