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5-HT 수용체 길항제를 이용한 파킨슨 환자의 정신 증상의 치료
고성범,박건우,이대희,Koh, Seong-Beom,Park, Kun-Woo,Lee, Dae-Hie 대한생물정신의학회 1997 생물정신의학 Vol.4 No.1
Current treatment strategies for levodopa-induced psychosis in advanced Parkinson's disease have had limited success. Reduction or discontinuation of levodopa and coadministration with dopamine-blocking neuroleptics may attenuate the psychotic symptoms, but these strategies are associated with worsening of parkinsonian symptoms. Administration of 5-HT3 receptor antagonist ; ondansetron, a newer strategy to attenuate psychosis of Parkinson'disease without motor deterioration was introduced. A 41-year-old young-onset male, who was diagnosed as Parkinson's disease 7 years ago, was treated with levodopa therapy, and had levodopa-induced psychosis(delusion, hallucination, paranoid, insomnia). After trial of ondansetron, he showed improvement in the Brief Psychiatric Rating Scale(from 21 points to 9 points) in spite of increasing the dosage of levodopa. With ondansetron, we could increase the dosage of levodopa without psychotic complications(esp, hallucination), and he showed improvement in the motor fluctuation.
이종문,권도영,고성범,김병조,박민규,박건우,이대희,Lee, Jong-Mun,Kwon, Do-Young,Koh, Seong-Beom,Kim, Byung-Jo,Park, Min-Kyu,Park, Kun-Woo,Lee, Dae-Hie 대한임상신경생리학회 2002 Annals of Clinical Neurophysiology Vol.4 No.1
Acute autonomic neuropathy is a rare disease. Since the first case was reported by Young et.al., in 1969, a number of similar cases have been described, with some variation of the accompanied neurologic deficits. Acute autonomic and sensory neuropathy(AASN) is characterized by the acute onset of autonomic dysfunction and sensory disturbances. A 16-year-old girl experienced high fever($40^{\circ}C$) and erythematous rash on whole trunk and face followed by pain and sensory loss over the whole body, dysphagia, ataxia, urinary retention, and postural hypotension. There was no evidence of limb weakness. The electrophysiologic studies of this patient revealed sensory polyneuropathy and the various autonomic function test showed autonomic dysfunction. The recovery of her autonomic and sensory symptoms is incomplete, three months after the onset of the symptoms. The etiology of the acute autonomic and sensory neuropathy is not known. Most previous authors have suggested the dysautonomia may be an acute immunological damage to peripheral fibers of the autonomic nervous system. We report a case of acute autonomic and sensory neuropathy.
경부 종물로 유발된 Collet-Sicard Syndrome 2례
권도영,이종문,고성범,김병조,박민규,박건우,이대희,Kwon, Do-Young,Lee, Jong-Mun,Koh, Seong-Beom,Kim, Byung-Jo,Park, Min-Kyu,Park, Kun-Woo,Lee, Dae-Hie 대한임상신경생리학회 2002 Annals of Clinical Neurophysiology Vol.4 No.1
Collet-Sicard Syndrome is one of the variant of the jugular foramen syndromes in which the last four cranial nerves are involved whereas the sympathetic plexus is spared. The possible causes of these multiple lower cranial nerve palsy are variable, including metastasis of systemic malignancy to the base of skull, primary tumor of head and neck, vascular complication, trauma and so on. We experienced two men visited to our clinic with symptoms of headache, hoarsness, swallowing difficulty and showed the evidence of cranial nerve palsy on neurologic examination. Magnetic resonance imaging and computed tomography demonstrated oropharyngeal and hypopharyngeal tumor and electrodiagnostic study supported the diagnosis.
이재호,김지원,권유리,엄광문,고성범,김형식,이정한,이정환,Lee, Jae-Ho,Kim, Ji-Won,Kwon, Yu-Ri,Eom, Gwang-Moon,Koh, Seong-Beom,Kim, Hyung-Sik,Yi, Jeong-Han,Lee, Jeong-Whan 대한의용생체공학회 2010 의공학회지 Vol.31 No.4
The purpose of this study was to quantify the clinical assessment of rigidity at wrist in patients with Parkinson's disease. The experimental system was designed that the effect of gravity was negated by restricting motion at the horizontal plane and inertia was predetermined from a biomechanical measurement. Forty five patients with Parkinson's disease participated in this study. Viscoelastic properties were calculated from the experimental data acquired during intermittent passive movement of wrist. Viscoelastic constants correlated well with the rigidity scores of UPDRS, i.e., Spearman's r=0.733 and 0.905 for spring and damping constants, respectively. The results suggest that viscoelastic properties can be used as quantitative measures of rigidity.
국소적 전도차단을 보인 n-Hexane induced neuropathy 1례
서우근,박범식,조성진,전형준,고성범,김병조,박종태,박민규,박건우,이대희,Seo, Wookeun,Park, Beom-Sik,Cho, Seong Jin,Jhun, Hyung-Jun,Koh, Seong-Beom,Kim, Byung-Jo,Park, Jong-Tae,Park, Min-Kyu,Park, Kun-Woo,Lee, Dae-Hie 대한임상신경생리학회 2002 Annals of Clinical Neurophysiology Vol.4 No.1
A 32-year-old man who had worked at aluminum processing plant for 4 months visited us. He complained of numbness and paresthesia of both foot and hands and weakness of all extremities. Electrophysiologic study showed motorsensory polyneuropathy of diffuse axonal type with focal conduction block. And we discovered higher concentration of n-Hexane in his workplace. On sural nerve biopsy, bubbly enlarged nerve fibers in light microscope and thick myelin sheath and axonal degeneration on electron microscope were found. We diagnosed it as n-Hexane induced neuropathy.
파킨슨성 완서증의 손가락 마주치기 속도와 크기에 대한 약물과 뇌심부자극의 효과
김지원,권유리,박상훈,엄광문,고성범,장지완,이혜미,Kim, Ji-Won,Kwon, Yu-Ri,Park, Sang-Hoon,Eom, Gwang-Moon,Koh, Seong-Beom,Jang, Ji-Wan,Lee, Hye-Mi 대한의용생체공학회 2012 의공학회지 Vol.33 No.1
The purpose of this study is to investigate whether medication and deep brain stimulation (DBS) have differential effects on the speed and amplitude of bradykinesia in patients with Parkinson's disease (PD). Five PD patients with implanted DBS electrodes (age: $60.6{\pm}7.4yrs$, H&Y stage: $3.1{\pm}0.2$) participated in this study. FT (finger tapping) movement was measured using a gyrosensor system in four treatment conditions: Med (Medication)-off/DBS-off, Med-off/DBS-on, Med-on/DBS-off and Med-on/DBS-on. Quantitative measures representing average speed and amplitude of FT movement included root-mean-squared (RMS) angular velocity and RMS angle. One-way repeated measures ANOVA showed that RMS angular velocity of Med-on/DBS-on was significantly greater than those of Med-off/DBS-off and Med-off/DBS-on (p < 0.01) whereas RMS angle was not different among conditions (p = 0.06). Two way repeated measures ANOVA showed that only medication improved RMS angular velocity (p < 0.01), whereas both medication and DBS had no significant effect on RMS angle (p > 0.02). Effect size of RMS angular velocity was greater than that of RMS angle in both medication and DBS. This suggests that medication and DBS have differential effects on FT bradykinesia and velocity and amplitude impairments may be associated with different functional aspects in PD.
자이로센서를 이용한 특발성 파킨슨병 환자와 정상인의 손가락 벌렸다 오므리기 동작의 측정과 비교
김지원,권유리,이재호,엄광문,권도영,고성범,박병규,홍정화,Kim, Ji-Won,Kwon, Yu-Ri,Lee, Jae-Ho,Eom, Gwang-Moon,Kwon, Do-Young,Koh, Seong-Beom,Park, Byung-Kyu,Hong, Jung-Hwa 대한의용생체공학회 2010 의공학회지 Vol.31 No.3
The purpose of this study is to compare finger tapping (FT) movement of patients with Parkinson's disease (PD) with normal subjects. A gyrosensor system was used for the measurement of FT movement, because it provides angular velocity free from the gravitational artifact and it can be used during clinical FT test listed in unified PD rating scale (UPDRS). Forty PD patients (age: 65.7 ${\pm}$ 11.1 yrs, H&Y stage:2.3 ${\pm}$ 0.5), 14 age-matched elderly subjects (65${\pm}$3.9 yrs) and 17 healthy young subjects (24${\pm}$2.1yrs) participated in this study. Angular velocity of finger tapping movement was measured in both right and left index finger. As quantitative measures, root-mean-squared (RMS) angular velocity, RMS angle, peak power and total power were used. ANOVA showed that all measures were significantly different among three groups (p<0.001) in all quantitative measures. Post-hoc test revealed that all quantitative measures except peak power in patients with PD were significantly smaller than in both healthy elderly and young subjects (p<0.01). This suggests that the measures developed in this study can distinguish patients with PD from normal subjects.
이승환(Seung-Hwan Lee),최윤선(Youn Seon Choi),고성범(Seong-Beom Koh) 대한임상노인의학회 2011 대한임상노인의학회지 Vol.12 No.2
연구배경: 파킨슨병의 운동계 증상은 잘 알려져 있으나, 운동계 증상 이외에 다른 여러 증상에 대해서는 많은 연구가 부족한 상황이다. 본 연구에서는 파킨슨병의 환자에서 폐 기능 이상 여부를 알아보며, 폐기능 이상과 파킨슨병의 주된 운동계 증상과의 관련성을 알아보고자 한다. 방법: 76명의 파킨슨병 환자를 대상으로 하였다. 환자 군을 떨림이 주증상인 군(33명)과 자세불안정 및 강직이 주증상인 군(43명)으로 나누어 폐 기능 검사를 시행하였다. 파킨슨병의 임상 정도는 호엔-야병기와 통합파킨슨척도검사를 이용하여 평가하였다. 결과: 떨림 주증상군과 자세불안정 및 강직 주증상군 사이에 폐 기능검사상 차이는 없었다. 파킨슨병의 임상 척도가 나쁠수록 강제폐활량(FVC)과 강제폐활량 검사 중 처음 1초 동안 호기량(FEV1)이 유의하게 감소하였다(P<0.05). FEV1/FVC비는 통합파킨슨척도 검사 결과 및 호엔야병기와 유의한 상관관계를 보였다. 결론: FVC와 FEV1은 파킨슨병 환자에서 주된 운동계 증상의 종류와 무관하게 병의 심한 정도를 반영하는 인자가 될 수 있을 것으로 생각된다. 본 연구를 통해서 폐 기능검사 결과가 파킨슨병의 운동기능 심각도를 평가하는 데 유용한 지표가 될 수 있을 것으로 생각한다. Background: Motor deficits associated with Parkinson’s disease (PD) have been well described, yet little attention has been paid to non-motor miscellaneous symptoms. In this study, we identified pulmonary dysfunction in patients with PD. We also investigated the relationship between pulmonary function and parkinsonian motor signs. Methods: A total 76 patients were recruited. We enrolled 33 patients with tremor dominant (TD) PD patients and 43 patients with postural instability and gait disturbances dominant (PIGD) PD patients without symptoms of pulmonary dysfunction. A pulmonary function test (PFT) was performed in all patients. The Hoehn & Yahr stage was determined and the degree of disease severity was quantified by activities of daily living and motor score of the Unified Parkinson’s Disease Rating Scale (UPDRS). Results: There was no significant difference in PFT between patients with TD motor abnormalities and patients with PIGD. Individual clinical disability scales showed a strong negative correlation with forced vital capacity (FVC) and volume of air expired during the first second of the FVC test (FEV1) (P<0.05). The FEV1/FVC ratio showed a significant correlation with motor score of the UPDRS and the Hoehn-Yahr stage. Conclusion: We suggest that the FVC and FEV1 could reflect a subject’s clinical disability regardless of dominant clinical features. Additionally, the FEV1/FVC ratio could be an indicator for motor score of the UPDRS or disease stages in general. Therefore, we suggest that PFT could be used to evaluate the clinical disability of patients with PD or prevent them from developing pulmonary complications.
각속도 측정시스템을 이용한 특발성 파킨슨병 환자와 정상인의 빠른 손놀림 동작의 비교
김지원(Ji-Won Kim),권유리(Yu-Ri Kwon),엄광문(Gwang-Moon Eom),전재훈(Jae-Hoon Jun),이정한(Jeong-Han Yi),권도영(Do-Young Kwon),이정환(Jeong-Whan Lee),고성범(Seong-Beom Koh),박병규(Byung Kyu Park) 대한전기학회 2010 전기학회논문지 Vol.59 No.3
The purpose of this study was to analyze bradykinesia of forearm movement in patients with Parkinson's disease (PD) as compared to those of normal subjects. A gyrosensor was selected for the measurement of forearm movement, because it can provide angular velocity signal which is free from the gravitational artifact and also because it can be conveniently used during clinical test of bradykinesia. Forty PD patients (age: 65.7 ± 11.1 yrs, H&Y stage:2.3 ± 0.5), 14 age-matched elderly subjects (65±3.9 yrs) and 17 healthy young subjects (24±2.1 yrs) participated in this study. Angular velocity during forearm movement of pronation/supination was measured in both arms. Suggested quantitative measures of bradykinesia were root-mean-squared (RMS) angular velocity, RMS angle, peak power and total power which were derived from the angular velocity. ANOVA showed that all measures were significantly different among three groups (p<0.001). Subsequent post-hoc test revealed that all measures in PD patients were significantly smaller than in healthy elderly and healthy young subjects (p<0.05). This results suggest that PD patients can be differentiated from normal subjects using suggested measures.