우리나라에서 소아기 교대성 편마비

노영일(Young-Il, Rho),우영종(Young-Jong, Woo),남상욱(Sang-Ook, Nam),김영창(Young-Chang, Kim),문한구(Han-Ku, Moon),이준수(Jun-Su, Lee),김원섭(Won-Seop, Kim) 대한소아신경학회 2009 대한소아신경학회지 Vol.17 No.2

목적:소아기 교대성 편마비는 매우 드물고 임상 증상도 매우 다양하게 보고되고 있고, 운동 이상과 간질이 많이 흔하게 동반되기 때문에 진단하는데 어려움이 있으며, 적절한 치료가 늦어져 불량한 예후를 초래하게 된다. 우리나라에서는 아직 소아기 교대성 편마비에 대한 보고가 없는 실정이다. 이에 저자는 우리나라의 소아 교대성 편마비의 빈도, 임상 특징, 치료와 예후에 대해 알아보고 문헌고찰과 함께 조기진단과 적절한 치료를 제시하고자 하였다. 방법:규정화된 설문지를 118명의 대한 소아신경학회 회원들에게 전자메일을 통해 배포하였다. 설문지는 2004년 국제두통분류 제 2판에 근거하여 소아기 교대성 편마비를 진단할 수 있도록 만들었으며, 소아신경 전문의가 후향적으로 의무 기록지를 분석하여 작성하도록 하였다. 7개 병원에서 11명의 환자에 대한 정보를 보내왔으며, 2004년 국제 두통분류 2판에 근거하여 소아기 교대성 편마비를 진단하고 임상적 특징, 치료의 종류와 효과에 대하여 분석하였다. 결과:소아기 교대성 편마비 환자는 11명(남자 6명, 여자 5명)이었고, 자료 수집 당시 평균 연령은 6.13±5.23세 이었다. 편마비 발생 시기는 9.80±6.67개월이었으며, 월 평균 빈도는 10.73±11.44회, 평균 지속 기간은 3.1±2.5일 이었다. 교대성 편마비는 100%에서 관찰되었고, 긴장이상, 이상 안구 운동과 발달 장애는 81.8%, 간질 발작은 72.7%, 자율신경 증상 54.5%, 보행실조와 사지마비 45.5%, 무도무정위운동과 말 더듬증은 각각 9.1%에서 동반되었다. 환자의 81.8%에서 유발 인자에 의해 발작이 시작되었고, 가장 흔한 유발 인자는 심리적 스트레스이었다. 뇌파검사에서 간질 발작이 있는 환자 8명 중 5명에서 이상 소견을 보였으며 주로 후두부에서 서파 혹은 쎄타 배경파가 관찰되었고, 2명에서 오른쪽 전두부에서 극파가 관찰되었으며 1명에서는 왼쪽 전두부에서 예파가 보였다. 뇌 MRI는 모두 정상이었고 단일광자방출단층촬영술(SPECT)는 5명에서 시행하였고 간질 발작이 없는 2명에서 혈류저하를 보였으며, 1명은 양측 전두부에서 1명은 오른쪽 전두부에서 보였다. Flunarizine은 대부분의 환자에서 사용하였고 모든 환자에서 항경련제를 함께 사용하였다. 2명에서 약간 효과가 있었고, 3명에서는 비교적 좋은 결과를 보였다. 고용량의 topiramte를 사용한 2명에서는 매우 좋은 효과를 보였다. 정신운동 지체는 간질 발작이 있는 환자에서 더 심하였다. 결론:우리나라에서 소아기 교대성 편마비는 매우 드물고, 치료에 대한 효과는 별로 좋지 않았으나 고용량의 topiramate와 flunarizine 병합요법을 한 경우에는 매우 좋은 효과를 보였다. 간질 발작이 있는 경우에 정신운동 장애가 심하므로 조기에 정확하게 진단하고 적절한 치료를 적극적으로 함으로써 좋은 결과를 초래할 수 있을 것으로 생각된다. Purpose:Alternating hemiplegia of childhood(AHC) is a rare neurologic syndrome of unknown pathophysiology. The typical clinical features are characterized by recurrent hemiplegic attacks shifting from one side to the other, beginning before 18 months, dystonia, strabismus, nystagmus, epilepsy, and immediate resolution of all symptoms during sleep. This study is to access clinical features and outcome of treatment of AHC in Korea. Methods:We sent standardized questionnaires by e-mail to 118 council members of the Korean Society of Child Neurology. We received it through e-mail from 7 centers and analyzed clinical characteristics, treatment, and outcomes. Results:We collected 11 AHC patients(male 6, female 5). The mean age was 6.13±5.23 years. The mean age of onset of hemiplegia was 9.80±6.67 months. The mean frequency of episode was 10.73±11.44 per month and mean duration was 3.10±2.50 days. The manifestations were hemiplegia in 100%, dystonia in 81.8%, abnormal eye movements in 81.8%, developmental delay in 81.8%, seizure in 72.7%, autonomic phenomena in 54.5%, ataxia 45.5%, and episodes of quadriparesis in 45.5%. The onset age of seizure was 3-84 months. Psychomotor retardation was more severe in patients with seizures than in those without seizures. Magnetic resonance imaging of brain and cerebral angiography were normal in all patients. Interictal SPECT shows hypoperfusion in the frontal in 2 of 5 patients. Nine patients received flunarizine and antiepileptic drugs but two patients received antiepileptic drugs only. A favorable response was reported in 45.5%, which included excellent response to the combination therapy of flunarizine and high dose topiramate. Conclusions:Patients with seizures faired the poorer psychomotor retardation. The com-bination of flunarizine and high dose topiramate was very effective in AHC.

Bickerstaff 뇌줄기 뇌염 양상으로 발현된 신경정신성 전신 홍반성 루푸스 1례

최하영(Ha Yeong Choe),송태양(Tae Yang Song),천경렬(Kyeong Ryeol Cheon),정금희(Ku Mi Jeong),박수민(Soo Min Park),우영종(Young Jong Woo),김영옥(Young Ok Kim) 대한소아신경학회 2015 대한소아신경학회지 Vol.23 No.3

신경정신성 전신 홍반성 루푸스는 소아 루푸스 환자에서 빈번하게 발생하며, 예후 및 사망률과 밀접한 관련이 있다. 전신홍반성루푸스는 대부분 중추신경계를 침범하며 말초신경계 침범은 드문 것으로 알려져 있다. 저자들은 하지 및 안면의 근력 저하와 기면으로 내원하였던 12세 여아에서 감염성 수막뇌염 혹은 자가면역성 뇌줄기 뇌염을 의심 하였다. 환자는 구강 궤양과 건조증, 사지 망상형 홍반을 보였고, 뇌자 기공명영상 및 뇌자기공명혈관촬영술은 정상이었으나 뇌척수액 검사에서 백혈구 증가증을 보였다. 내원 직후 항생제, 항바이러스제, 저용량 덱사메타손과 면역글로불린을 투여하였으나 증상 호전이 없다가, 내원 3일 째 안면 홍조와 함께 혈청 항핵항체 및 anti­dsDNA 양성 소견을 보여 신경정신성 전신 홍반성 루푸스로 진단하고 고용량 스테 로이드 투여한 후 환자의 임상경과는 호전되었으며, 안과검진, 침샘 스캔검사 및 소타액샘 조직검사에서 쇼그렌 증후군으로 추가 진단되었다. 이에 저자들은 Bickerstaff 뇌줄기 뇌염 양상으로 발현된, 쇼그렌 증후군을 동반한 소아 신경정신성 전신 홍반성 루푸스 환아에서 고용량 스테로이드 사용 후 성공적으로 치료된 증례를 보고하는 바이다. Neuropsychiatric events are commonly reported in patients with systemic lupus erythematosus and they are an important contributor to both morbidity and mortality. Neuropsychiatric systemic lupus erythematosus (NPSLE) mainly involves the central nervous system, and rarely invades the peripheral nervous system. A 12-year-old girl presented with sudden-onset motor weakness in her lower extremities and face, as well as drowsiness. Brain magnetic resonance imaging and angiography produced no abnormal findings, and a cerebrospinal fluid examination revealed only pleocytosis. Reticular erythema in the extremities, oral ulcers, and a dry mouth were noted at her first visit, but a malar rash appeared on the third day with positivity for serum antinuclear and anti-dsDNA antibodies. Therefore a high-dose steroid was administered based on a diagnosis of NPSLE. An ophthalmologic examination, salivary gland scan, and biopsy of minor salivary gland resulted in the additional diagnosis of Sjögren’s syndrome. The reported patient represents a rare pediatric case of NPSLE accompanied with Sjögren’s syndrome, presenting as Bickerstaff’s brainstem encephalitis and being successfully treated with early steroid pulse therapy.

사회체육활성화를 위한 스포츠클럽 조직관리

구우영 ( Woo Young Ku ) 동의대학교 스포츠과학연구소 2003 스포츠과학연구논문집 Vol.2 No.-

스포츠클럽 관리에 있어 조직 구조론은 운동조직 및 형태뿐만 아니라 선택적 방법에 의한 지도를 상정한 경우에도 그 조직에 대한 방법론적 지식을 제공해 준다. 따라서 현 단계에서는 경영에 관한 이론이나 지식을 체육지도에 그대로 적용하기보다는 경영학적 인식, 관념, 태도, 현상파악, 방법, 고찰 등을 적용하여 이를 둘러 싼 제 문제에 대하여 재검토가 이루어 져야 한다. 이러한 경영학적 접근방법은 다소 수학적, 확률적 Model에 적용하는 데 유효하며 성취모텔을 설계할 수 있는 의사결정, 경영의 문제해결 등에 유효한 실마리를 제공해 줄 수 있기 때문이다. 그러나 개념의 정확한 사용 등을 포함한 이론적 틀의 미비점, 그리고 경영방법의 정밀화와 연구성과의 저적 등은 앞으로의 연구활동 등을 통해서 검토되어야 할 과제이다. 스포츠 사업은 의료사업과 같은 맥락에서 공익성을 추구해야한다. 인간의 삶의 질 향상을 위한 근본적 접근이 필요하다. 사회체육에서 스포츠클럽의 활성화는 건강하고 건전한 시민 육성이 목적이므로 이윤추구나 비생산적이라는 관점에서 탈피해야 하다. 그러므로 공공 부문의 예산은 국민 복리 증진적 차원에서 사회체육 활성화 사업에 충분히 투자되어야 한다.

여성 고령자들의 신체특성과 운동능력ㆍ심폐기능에 관한 연구

구우영(Ku Woo-Young) 한국체육과학회 2000 한국체육과학회지 Vol.9 No.2

This study investigated the physical characteristic, physical fitness and cardiopulmonary of senior citizens-r-the young elderly aged 60-64years, the middle aged 65-69years and the old elderly over 70years. The purpose of this study was to develop the sports programs, considering the physical characteristic of them, which can be easily accessible by causing interest in life and are their proper play models which can be performed in life, and represent basic materials to increase their health and physical fitness and a points table to the old women's Vo₂max. The conclusions of this study were as follows: 1. Height in physique were not found significant differences in first group(153.35㎝), second group(154.21㎝) and third group(153.99㎝). 2. %fat was not found significant differences in first group(32.56%), second group(31.35%) and third group(31.72%). 3. Muscle endurance(sit-up) decreased in age groups, but was not found significant differences. Muscle strength(grip strength), flexibility(standing trunk flexion), power(standing long jump) and agility(modified shuttle run) decreased in age ones and remarkably decreased much more third group than other ones and were found significant differences (p<.001, p<.005). 4. Systic blood pressure decreased in age ones (p<.05), and HRmax, VEmax, Vo₂max clearly decreased in age ones and were found significant differences(p<.001).

비만정도가 성인 여성들의 신체조성 운동기능 및 심폐기능에 미치는 영향

구우영(Ku Woo-Young),강순광(Kang Soon-Kwang) 한국체육과학회 2003 한국체육과학회지 Vol.12 No.1

The purpose of this study was to verify the effects of adult women's obesity condition on Body composition, Fitness ability and Cardiopulmonary, This study used the materials of adult 302women who took a physical prescription test from 1997 to 1999 at exercise prescription laboratory in Busan. Subjects divided three groups on %Fat - Standard weight group(29%below), Overweight group(30~34%), and Obesity group(35%Over). The results of this study were as follows; According to analysis of Body composition on obesity condition, Triceps and Subscapular very showed significant increases(p<.001). %Fat, Fat, and %LBM very showed significant differences(p<.001). LBM showed significant difference at obesity group(p<.01). According to analysis of Fitness ability on obesity condition, Muscle Strength(Grip Strength) significantly increased at overweight group(p<.01). Muscle Strength (Back Strength), Flexibility(Trunk Flexion), and Balance(Closed Eyes One-Foot) showed no significant differences. Power(Standing Broad Jump), Agility(Side Step Test), and Muscle Endurance(Sit-Up) showed significant decreases on obesity condition. Cardiopulmonary on obesity condition According to analysis of Pulmonary Function at rest on obesity condition, FVC significantly increased at overweight group. FEV₁ and MVV showed no signigicant differences. HRmax significantly increased at standard weight group. VO₂, max showed significant decrease on obesity condition(p<.05, p<.001).

심상훈련이 남ㆍ여 하키선수의 Penalty Stroke 정확도에 미치는 효과 분석

구우영(Woo-Young Ku),곽이섭(Yi-Sub Kwak),김민식(Min-Sik Kim) 한국생활환경학회 2006 한국생활환경학회지 Vol.13 No.3

The purpose of the study was to identify the imagery training on penalty stroke in men and women middle school hockey players. For this study, 48 hockey players were recruited form the K middle school in K city. 48 subjects were randomly divided into four group the same number of each sex; control group (CG, n=I2), physical training group (PTG, n=I2), imagery training group (ITG, n=I2), and physical & imagery training group (PITG, n=12). After the pre-test, three experimental groups performed 6 weeks of imagery or physical training program to improve hockey stroke performance. And also, after the 6 weeks, the participants were retested using the same methods to investigate the effects of the imagery training and physical training on the penalty stroke. All data were expressed as mean and standard deviation by using SPSS package program (win 12.0) and the ANOVA method was used to see the difference of effect in each groups. Tukey computation was used for post-hoc test. The conclusions were as follows: 1. After 6 weeks, in the post-test of penalty stroke trial, men had significant differences among PTG, ITG, and PITG compare to CG Women had significant differences among PITG compared to CG 2. After 6 weeks, both men and women had significant differences among PITG compared to ITG following the physical & imagery training. 3. On the pre-test, women showed higher hockey stroke performance among CG and PTG than in men. 4. After 6 weeks, women showed higher hockey stroke performance among CG following the physical & imagery training.

단전호흡 수련이 중학생의 체력과 신체적 자기효능감에 미치는 영향

구우영 ( Woo Young Ku ),한태준 ( Tae Joon Han ),김영모 ( Young Mo Kim ) 동의대학교 스포츠과학연구소 2002 스포츠과학연구논문집 Vol.1 No.-

The purpose of this study was to examine the effect of Dan-jeon breathing on the physical fitness and physical self-efficacy in junior high school students Subjects were second-grade students and program was composed of each session lasted for 60minutes, 3days a week during 12 weeks. The test item were sit-up, push-up, standing long jump, 50m shuttle run, trunk flexion, 1600m running and walking and physical self-efficacy. The conclusions of this study were as follows ; 1. Physical fitness : The Dan-jeon breathing group showed improved at the mean score. The amount of improvement was 0.62sec in 50m shuttle run, 0.37cm in standing long jump, 5.9beats per min. in sit-up, 9.8cm in trunk flexion, but decreased 3.06beats per min. in push-up and delayed 13.21sec in 1600m running and walking. 2. Physical self-efficacy : The physical activity(climb mountain) group and the Dan-jeon breathing group was higher than control group on perceived physical ability, on the other hand, physical self-efficacy was improved but there is no significant. 3. Due to the short period of this training program, the shorta ge of participants, there was no significant different any test item among the group. but this study shows the possibility the our traditional Dan-jeon breath will be helpful to education for the students. I suggest Dna-jeon as a practical approach to physical education which emphasizes both body and mental and a way to attain spiritual enlightment.

정보화기술(IT)을 통한 스포츠 활성화 대응 방안

구우영 ( Woo Young Ku ),김광석 ( Kwang Seok Kim ) 동의대학교 스포츠과학연구소 2002 스포츠과학연구논문집 Vol.1 No.-

Sports Information in 21C is increasing it`s demanding because of the development of IT industry. To satisfy this the needs of the times a research institution or state administrative branch that are related to information industry need the coordinative information management system of the pan-national level and the intensive investment of software that is suited to sports information demander`s request and innovative development will. A condition precedents to achieve that are in a word as follows: 1. Application-oriented information must change the information system of ‘search-coming style’ of the existing pivot of information technique from the information of ‘search-going style’ of the pivot of customer claim, information exchange and Public-oriented information. 2. The object of sports information must select the concrete and gradual subject, and establish a practice-oriented unit business to achieve the strategic object or a unit system. 3. The business areas of sports information must classify knowledge information strategic area, statistics information area, information standard and internet business area. 4. The program business areas must devide and develop the professional sports that have a strong mutual independence, sports science area to improve competition ability, physical and fitness area, sports industry area, sports training information or study area, sports management or administration area. 5. The input stage of information system must be realized information related association and compatiblity between the system of organ, information classification system and standard of code. 6. The electronic information authentication system that has the legal effect, the electronic sanction, and the electronic commerce must urgently legislate. 7. The analysis stage of information must develop DSS or ERP or Data Ware Housing-high grade information management and analysis system-that analyzes and processes a creating information by various object and use. 8. The application stage of knowledge information must construct the overall control skill and achieve the integrated network looks like Karls Project. 9. Sports knowledge in formation must create information infra and practical system, and Factors-the existing compatibility of system, information system application, manpower cultivation for information, system and consolidation of law must adjust and consolidate. 10. In the sports knowledge information all people must equally and conveniently get the sports service of quantity or quality for their`s past-information.

시청각 피드백 제시가 평행유지 과제의 파지와 전이에 미치는 효과

구우영 ( Woo Young Ku ) 한국스포츠심리학회 1997 한국스포츠심리학회 학술발표논문집 Vol.- No.2

골프동호인의 골프 참여 동기에 관한 문화 기술적 연구

구우영 ( Woo Young Ku ),서병세 ( Byung She Suh ),김찬룡 ( Chan Ryong Kim ) 동의대학교 스포츠과학연구소 2003 스포츠과학연구논문집 Vol.2 No.-

This research adopted an ethnographical method, one of the commonly used qualitative research methods, in order to get an comprehensive analysis on motives of golf involvement in Korean fraternal golfers. The informants of this research consist of the members of X and Y golf club which were organized on internet web-site with members around Busan and Gyung-nam area. Those club members not only use internet web-sites as their communication media, but also have frequent off-line gatherings. I joined and have been actively engaged in those clubs, so as to be in rapport with the members and to make an intensive investigation on the characteristics of their subculture both on-line and off-line. Fraternal golfers(n=17) were chosen as interviewees, and 5 assistant informers including semi-professional golfers, country club employees and caddies were selected as participants in this research in order to get mutual compensation for the limits of the actual observation and in-depth interviews. For 4 months from May 1, 2003 through Aug 31, 2003, various activities of those clubs were personally observed including regular meetings, periodical golf rounds, instant gatherings, and irregular golf rounds. In-depth interviews with 22 people were conducted in the final stage of this research. In addition, several instruments such as digital cameras, digital cam-corders, and the web-site bulletin board of each club were used to collect data needed. On the basis of those data collected, contents analysis and classification analysis were performed. Various methods were made efficient uses in order to obtain validity and reliability, such as concentrative observation, reflective subjectivity, thick description, inquiry on fellow researchers, triangulation, member check and so on. The conclusions were drawn based on results and there are as follows; First, Korean fraternal golfers participated in golf, in order to promote their heath. Thus, they participate in golf in order to enhance both physical and psychological health, and to diminish stress. Second, Korean fraternal golfers participated in golf, in order to enhance the quality of their social life. Thus, they intend to organize various social gatherings both regular and irregular in order to get compassion regardless of each member`s social status or age, so one of such opportunities they enjoy is the overseas golf tour. Third, Korean fraternal golfers participated in golf, in order to be ostentations. Thus, they are willing to purchase expensive country club membership, golf equipments and furthermore luxury cars in order to show off their economic ability.