결핵성뇌막염에서 발생한 경부 근긴장이상증 2예

김후원,조은미,문창종,임건한,김진호 대한신경과학회 2004 대한신경과학회지 Vol.22 No.1

Secondary cervical dystonia caused by tuberculous meningitis is extremely rare. Sixteen year-old female and 56 year-old male were admitted with fever, headache and mental change. Several days after admission they presented neck deviation and polygraphic study revealed prolonged muscular contraction of sterocleidomastoid and trapezius muscles without EEG changes. Their MRI revealed bilateral lesions in the basal ganglia. Recognition of dyskinesias associated with meningitis may be helpful in the diagnosis of tuberculous meningitis.

수면호흡장애

김후원 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

내경동맥의 이상과 동반된 동안신경 마비 I 예

김후원,조은미,김진호 朝鮮大學校 附設 醫學硏究所 2002 The Medical Journal of Chosun University Vol.27 No.2

A 30-year-old woman was admitted with sudden onset of diplopia and ptosis of left eye. The Brain MRI, MRA, and conventional angiography showed no intracranial lesion but mild and focal stenotic and aberrant left internal carotid artery. After 2 months ofantiplatelet medication her eye symptoms were disappeared except slight ptosis.

Pathobiolgy and Management of Alzheimer’s Disease

김후원,정지연 전남대학교 의과학연구소 2021 전남의대학술지 Vol.57 No.2

Amyloid and tau protein abnormalities have been identified as the main causes of Alzheimer’s disease but exact mechanisms remain to be revealed. Especially, amyloid beta and tau protein coupling and neuroinflammatory and neurovascular contributions to Alzheimer disease are quite mysterious. Many animal models and basic biological research are trying to solve these puzzles. Known as aging processes, autophagy, mitochondrial degeneration with generation of reactive oxygen species, and age-related epigenetic modifications are also known to be associated with development of Alzheimer’s disease. Environmental factors such as bacterial and viral infections, heavy metal ions, diet, sleep, stress, and gut microbiota are also risk factors of Alzheimer’s disease. Future development of preventive and therapeutic modalities may be dependent on the pathobiology of Alzheimer’s disease.

인지기능장애

김후원 대한내과학회 2020 대한내과학회 춘계학술대회 Vol.2020 No.-

간질의 보조치료요법 : 대뇌자극법

김후원 朝鮮大學校 附設 醫學硏究所 2009 The Medical Journal of Chosun University Vol.33 No.S

Treatment of refractory epilepsy is very challenging. Despite of recent advances of surgical treatment, needs for other therapeutic modalities have been growing. Among them neural stimulation is a promising new technology. Vagal nerve stimulation is firstly introduced method and licenced as an adjuvant therapy in many countries. It is as effective as antiepileptic drug therapy. Deep brain stimulation has been applied to many brain areas such as cerebellum, thalamus, subthalamus, hippocampus, and other neocortical epileptic foci. Yet it has preliminary encouraging results, further multi-institutional study may confirm the therapeutic effectiveness. Repetitive transcranial magnetic stimulation is simple, non-invasive method. But its effect seems short-lived and weak so far. Therapeutic evidence of the brain stimulation is still insufficient now but its future is bright.

S-nitroso-N-acetylpenicillamine이 내측 전정핵 신경세포 흥분도에 미치는 영향

김후원,조기현,장수정,정한성,박종성 대한신경과학회 2007 대한신경과학회지 Vol.25 No.2

Background: The medial vestibular nucleus is the largest one among the vestibular nuclei and known to play important roles not only in normal vestibular information processing but also in vestibular compensation. Glutamate is known to have a key role in vestibular compensation via long term potentiation and depression. But the action of nitric oxide related with glutamate is poorly studied. This experiment was designed to explore the effects of nitric oxide on the neuronal activity of a rat medial vestibular nuclear neuron using a nitric oxide enhancing drug, S-nitroso-N-acetylpenicillamine (SNAP). Methods: Experiments were carried out on Sprague-Dawley rats aged 14 to 17 days. Neurons of MVN were obtained via enzymatic dissociation of a microtomized rat brainstem. Whole-cell membrane potentials were recorded at room temperature by using standard patch-clamp techniques. Action potentials were obtained after administration of SNAP. Changes of potassium currents were recorded using SNAP and ODQ (1H-[1, 2, 4] oxadiazolo [4, 3-a] quinozalin-1-one), an inhibitor of guanylyl cyclase. Results: The mean spike frequency of action potentials was increased by adding SNAP. The mean amplitude of afterhyperpolarization was decreased by adding SNAP. The mean potassium current of medial vestibular nuclear neurons was decreased by SNAP. ODQ inhibited the SNAP-induced potassium currents. Conclusions: These results suggest that nitric oxide increases the neuronal activity of rat medial vestibular nuclear neurons by inhibiting potassium currents via a cGMP dependent mechanism.

일측성 해마부위경색에 의한 급성 기억장애 1예

김후원,천대웅,주성민,김병기,안병철,오건세 대한신경과학회 1999 대한신경과학회지 Vol.17 No.2

수면무호흡증과 상기도저항 증후군에서 Nasal Airflow의 압력측정 및 상기도 압력변화에 대한 연구

김후원,홍승봉,Kim, Hoo-Won,Hong, Seung-Bong 대한수면의학회 2000 수면·정신생리 Vol.7 No.1

수면 중 나타나는 호흡장애를 좀 더 정확하게 측정하기 위해 고안된 비강 공기압 측정기의 민감도를 온도감지 센서와 비교하기 위해 30명의 수면무호흡 증후군 환자와 6명의 상기도 저항증후군 환자에서 저호흡-무호흡 지수와 각성지수를 비교하였다. 그리고 상기도 저항 증후군에서 각성을 일으키는 상기도 압력변화에 대해 알아보기 위하여 온도감지 센서에서 발견되지 않은 저호흡-무호흡과 관련된 각성에서 상기도의 압력을 측정하였다. 비강 공기압 측정기가 기존의 온도감지 센서보다 훨씬 더 민감한 방법임을 알 수 있었다(p<0.05). 비강 공기압 측정기로 검사하여 저호흡-무호흡지수가 평균 41%가 증가되었고 호흡장애가 심하지 않은 경증의 수면무호흡 증후군이나 상기도 저항 증후군에서 더 많이 증가하였다. 비강 공기압 측정기로 검사한 저호흡-무호흡지수를 비교하면 상기도 저항 증후군이 수면무호흡 증후군의 가장 경미한 형태라는 것을 알 수 있었다. 상기도 저항 증후군에서 나타나는 각성에서 상기도의 압력 변화는 일정한 범위에서 나타나지 않았고 다양한 압력 분포를 보였으며 수면 중 호흡장애의 정도가 심해질수록 압력변화의 폭이 더 커지는 양상을 보였다. 비강 공기압 측정기가 기존의 온도감지 센서보다 더 민감하지만 아직까지 해결해야 할 문제가 일부 남아 있어서 온도 감지 센서를 완전히 대체하기는 어려울 것으로 보인다. 그러나 경증의 수면무호흡 증후군이나 상기도 저항 증후군을 진단하는 데에는 많은 도움이 될 것이다. 특히 상기도 저항 증후군의 진단에 기존에는 상기도 압력 측정이 필요하다고 하였으나 비강 공기압 측정기를 이용하면 불편한 상기도 압력 측정은 필요 없을 것으로 생각된다. Objectives: The sensitivity and accuracy of thermistor airflow signal has been debated. The purposes of this study were to compare apnea-hypopnea index(AHI) detected from a conventional thermistor signal and a nasal pressure transducer of airflow(NPT), to evaluate the value of NPT for the diagnosis of upper airway resistance syndrome(UARS), and to measure airway pressure fluctuations which produced respiratory arousals in UARS by naso-oro-esophageal manometer catheter. The subjects were 30 patients with obstructive sleep apnea syndrome [mild(5<AHI<20), 10; moderate(20<AHI<40), 10; severe(AHI>40), 10), and 6 UARS patients. Airway resistance arousal in this study was defined as arousals which were not associated with apnea or hypopnea of thermistor signal, but showed significant decrease of nasal airflow pressure just before arousal and a prompt recovery of nasal airflow pressure after arousal. The airway pressure fluctuations were measured during 260 airway resistance arousals observed in 10 patients with OSAS, 2 with UARS. Results: Mean AHIs of patients with OSAS were 33.4 by thermistor and 48.4 by NPT. The AHIs of mild, moderate and severe OSAS groups were 10.2, 32.1, 65.4 respectively by thermistor and 23.1, 45.9, 76.4 by NPT. The mean AHI of patients with UARS was 3.2 by thermistor and 10.8 by NPT. The mean AHI of patients with nonspecific arousals was 2.7 by thermistor and 4.4 by NPT. The mean airway pressure changes during respiratory arousals of different groups were $8.7\;cmH_2O$ in mild OSAS, $11.4\;cmH_2O$ in moderate OSAS, $24.7\;cmH_2O$ in severe OSAS and $6.6\;cmH_2O$ in UARS. Conclusion: The nasal pressure transducer of airflow was more sensitive and accurate for assessing respiratory disturbances of patients with OSAS and was extremely helpful for the diagnosis of UARS without esophageal pressure monitoring. From the results, we would like to propose carefully the NPT diagnostic criteria for sleep disordered breathing as follows: NPT-AHI 5-15 $\rightarrow$ UARS, 15-35 $\rightarrow$ mild OSAS, 35-55 $\rightarrow$ moderate OSAS and >55 $\rightarrow$ severe OSAS.

사혈요법과 관련된 경계성 뇌경색 1 례

김후원 대한뇌졸중학회 2003 Journal of stroke Vol.5 No.2

Venesection is well-known folk medicine. Although many people believe that it is easy, safe and useful, its adverse reaction may be quite harmful. We report a patient with cerebral infarction who had a history of regular, one-year long venesection. He had microcytic and hypochromic anemia. Magnetic resonance image showed multiple frontoparietal infarction and MRA disclosed focal stenosis in the left middle cerebral artery. He was treated with blood transfusion, antiplatelet agents and iron replacement. Venesection-induced anemia may be a causative factor of the cerebral infarction.