한국인 치매환자에서의 리바스티그민 패취 사용 경험; 예비 연구

나해리,강현석,김상석,한설희 대한치매학회 2009 Dementia and Neurocognitive Disorders Vol.8 No.1

While rivastigmine transdermal patch has consistently demonstrated better tolerability and similar efficacy compared to conventional rivastigmine capsules in clinical studies; it has not been specifically evaluated in Korean dementia patients. From February to November 2008, 94 patients with dementia and mild cognitive impairment (MCI) were treated with rivastigmine transdermal patch at Konkuk University Hospital and Bobath Memorial Hospital. To evaluate the safety and tolerability in Korean patients with dementia and MCI, we reviewed the clinical data of the patients. The participating subjects were diagnosed as Alzheimer’s disease (n= 34), mild cognitive impairment (n=5), vascular dementia (n=26), Parkinson’s disease dementia (n=13), dementia with Lewy body (n=3), frontotemporal dementia (n=2) and other types of dementia (n=11). All of the patients were followed within 3 months (90±14 days), in terms of evaluating adverse events. Adverse events occurred in 11 cases (11.7%) and adherence of the patch was good in 91 cases (96.8%). Most of the participants showed clinical improvement similar to other acetylcholinesterase inhibitors (AchEIs). The most common adverse effects were skin-related problems including simple skin irritation, itching sensation, erythematous lesion, patch marks (contact dermatitis) and even severe symptoms mixed with all of the above (allergic contact dermatitis), occurred in eight cases (8.5%). Gastrointestinal (GI) discomfort was reported in two cases (2.1%). Among patients who stopped rivastigmine transdermal patch, six patients (6.3%) withdrew due to adverse events. Rivastigmine transdermal patch provides a good tolerability profile in treating Korean patients with the various subtypes of dementia and may be effective for the improvement of cognitive function in Korean patients with Alzheimer’s disease. While rivastigmine transdermal patch has consistently demonstrated better tolerability and similar efficacy compared to conventional rivastigmine capsules in clinical studies; it has not been specifically evaluated in Korean dementia patients. From February to November 2008, 94 patients with dementia and mild cognitive impairment (MCI) were treated with rivastigmine transdermal patch at Konkuk University Hospital and Bobath Memorial Hospital. To evaluate the safety and tolerability in Korean patients with dementia and MCI, we reviewed the clinical data of the patients. The participating subjects were diagnosed as Alzheimer’s disease (n= 34), mild cognitive impairment (n=5), vascular dementia (n=26), Parkinson’s disease dementia (n=13), dementia with Lewy body (n=3), frontotemporal dementia (n=2) and other types of dementia (n=11). All of the patients were followed within 3 months (90±14 days), in terms of evaluating adverse events. Adverse events occurred in 11 cases (11.7%) and adherence of the patch was good in 91 cases (96.8%). Most of the participants showed clinical improvement similar to other acetylcholinesterase inhibitors (AchEIs). The most common adverse effects were skin-related problems including simple skin irritation, itching sensation, erythematous lesion, patch marks (contact dermatitis) and even severe symptoms mixed with all of the above (allergic contact dermatitis), occurred in eight cases (8.5%). Gastrointestinal (GI) discomfort was reported in two cases (2.1%). Among patients who stopped rivastigmine transdermal patch, six patients (6.3%) withdrew due to adverse events. Rivastigmine transdermal patch provides a good tolerability profile in treating Korean patients with the various subtypes of dementia and may be effective for the improvement of cognitive function in Korean patients with Alzheimer’s disease.

이중언어자에서 보인 두 형태의 실어증 : 증례보고 A Case Report

나해리,이정욱,박성민,박수열,권순용,이현정 대한치매학회 2004 Dementia and Neurocognitive Disorders Vol.3 No.2

Since many people in Korea know more than one language, bilingual aphasia is an important line of research in clinical and theoretical neurolinguistics. Nowadays we meet many people who speak other languages along with Korean, who are immigrants from foreign countries, especially from China. Differential recovery of language affected by an aphasic deficit is documented. In the present work, we introduced a patient with bilingual aphasia who showed different recovery patterns in Korean and Chinese. A 66-year-old man was presented with language disturbance and right hemiplegia. On past medical history, he had received a hematoma evacuation through burr-hole due to left basal ganglia hemorrhage. After the event, he showed nearly global aphasia in Korean, but he showed minimally preserved language function on comprehension and fluency in Chinese. This result suggests that aphasia in bilingual subject may show different pat-terns of recovery between two languages.

연탄재를 활용한 도자기 소지 개발

나해리,이현수,이지연 한국폐기물자원순환학회 2017 한국폐기물자원순환학회지 Vol.34 No.5

Coal briquette ash is an inorganic and non-combustible material. Although coal briquette ash is mainly composed of SiO2, Al2O3, and is an acceptable raw industrial material (containing Fe2O3, K2O, MgO, CaO, TiO2, and Na2O), it is merely considered waste and is exploited as a building material for concrete admixtures and bricks. Because mullite (3Al2O3 2SiO2), which coal briquette ash contains, is a stable compound with a crystalline structure, it plays essential roles in its fracture strength and bending strength. This study serves the purpose of developing environmentally friendly, economical clay bodies through the use of coal briquette ash as a substitute for kaolin to provide Al2O3 and SiO2. We also investigated the seed effects during sintering process by feeding mullite directly into clay bodies. The results show that in 1,300°C heat, a mixture of 40% coal briquette ash, 40% feldspar/limestone (8 : 2), and 20% clay indicates a fracture strength value of 525 kgf/cm2, an absorption rate of 0.72%, burning shrinkage of 11.5%, and an average bending strength of 0.6 cm, which is superior to other clay bodies. The addition of coral briquette ash in clay bodies promoted mullite formation and grew as mullite acted as a seed. In addition to the developing clay bodies, it can also make an oatmeal-colored glaze to widen the spectrum of its usability. This study will help resolve waste problems, reduce environmental pollution, and raise economic value by using coal briquette ash as a raw material for ceramics. Clay bodies made with coal briquette ash are expected to continuously contribute to the development of the ceramics industry with upcycling effects.

사설

나해리 신학지남사 1920 신학지남 Vol.3 No.3

Factors Influencing Skin Tolerability to the Rivastigmine Patch in Patients with Alzheimer’s Disease

나해리,박문호,김상윤,양동원,최성혜,양현덕,양영순,한현정,이정석,윤영철,고성호,김정은,구본대,김희진,박경원,김은주,윤보라,박기정 대한치매학회 2015 Dementia and Neurocognitive Disorders Vol.14 No.1

Background and Purpose The one-day rivastigmine patch is reportedly well tolerated and has minimal side effects. However, Asian patientsshow more side effects than those in Western countries. We evaluated tolerability of the rivastigmine patch in South Korean patientswith Alzheimer’s disease (AD) and the specific factors affecting adverse events of the skin. Methods A 6-month, open labeled, multi-centered, observational study was carried out in 440 patients with probable AD from July 2009to September 2010 (NCT01312363). Results A total of 25.9% of the patients experienced adverse skin events at the rivastigmine patch application site and 17.0% discontinuedtreatment due to adverse events at the skin application site. The most common adverse events were itching and erythema. Patients with an allergichistory and users of electric heating appliances reported skin discomfort. Older age was associated with discontinuing treatment. Conclusions These results suggest that the rivastigmine patch induced some adverse skin events and may contribute to understanding andimproving skin tolerability to the rivastigmine patch.

Cognitive Therapy Combined with Drug Treatment in Patients with Alzheimer’s Disease: A Neuropsychological and Positron Emission Tomography Investigation, a Pilot Study

나해리,김상윤,Yu Kyeong Kim,박문호,Sung Tae Cho,Woo Jung Kim 대한치매학회 2015 Dementia and Neurocognitive Disorders Vol.14 No.2

BackgroundCognitive therapy may have therapeutic benefit in patients with early Alzheimer’s disease (AD). Case ReportThis was a 12-week, single-blind pilot study of 4 patients with AD. The cognitive therapy included exercises for orientation to time and place; memory training, including face-name association, object recall training, and spaced retrieval; visuo-motor organization using software; similarity and ruled based categorization; and behavior modification and sequencing (e.g., making change, paying bills). The regional cerebral metabolic abnormalities and the effects of treatment on cortical metabolic responses were evaluated using 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography (PET). After 12 weeks, the participants showed slight improvement in some neuropsychological measures, and three of them showed increased regional cortical metabolism on brain PET studies. ConclusionsCognitive therapy may stabilize or improve cognitive and functional performance of patients with early AD and increase regional cortical metabolism of the patients’ brain. Background Cognitive therapy may have therapeutic benefit in patients with early Alzheimer’s disease (AD). Case ReportThis was a 12-week, single-blind pilot study of 4 patients with AD. The cognitive therapy included exercises for orientation to time and place; memory training, including face-name association, object recall training, and spaced retrieval; visuo-motor organization using software; similarity and ruled based categorization; and behavior modification and sequencing (e.g., making change, paying bills). The regional cerebral metabolic abnormalities and the effects of treatment on cortical metabolic responses were evaluated using 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography (PET). After 12 weeks, the participants showed slight improvement in some neuropsychological measures, and three of them showed increased regional cortical metabolism on brain PET studies. ConclusionsCognitive therapy may stabilize or improve cognitive and functional performance of patients with early AD and increase regional cortical metabolism of the patients’ brain.

중증 대뇌반구경색 환자의 사망률과 초기 예후인자

나해리,강우열,정승철,유경호,마효일,이병철 대한노인병학회 2001 대한노인병학회지 Vol.5 No.2

방사선 치료 후 발생한 모야모야현상을 동반한 뇌혈관폐색증

나해리 대한뇌졸중학회 2000 Journal of stroke Vol.2 No.2

Background : The radiation-induced occlusive vasculopathy has been known as the one of the side effects of radiation therapy but rarely involves intracranial large arteries. We present a case of acute stroke with progressive occlusive disease of the intracranial large arteries with Moyamoya phenomena induced by radiation therapy. Case Report : A 40 year-old man presented with left hemiparesis. He had no risk factors for stroke except having undergone radiation therapy for pituitary adenoma 6 years ago. On T2WI, multiple hyperintense lesions were noted in right MCA territory. Cerebral angiography revealed complete occlusion of both middle cerebral arteries which were patent on the previous MRI performed at the time of surgery abnormal vascular networks. Conclusion : We suggest that irradiation is a possible cause of progressive cerebrovascular occlusive disease. Therefore, careful consideration for radiation therapy is needed especially in benign natured tumor and cerebral angiography is indicated, when the patient develops cerebral ischemic symptoms. Korean Jourmal of Stroke 2000;2(2): 221~224

Multimodal Assessment of Neural Substrates in Computerized Cognitive Training: A Preliminary Study

나해리,임재성,김우정,장재원,백민정,김정은,박영호,박소영,김상윤 대한신경과학회 2018 Journal of Clinical Neurology Vol.14 No.4

Background and Purpose Several studies have validated the clinical efficacy of computerized cognitive training applications. However, few studies have investigated the neural substrates of these training applications using simultaneous multimodal neuroimaging modalities. We aimed to determine the effectiveness of computerized cognitive training and corresponding neural substrates through a multimodal approach. Methods Ten patients with mild cognitive impairment (MCI), six patients with subjective memory impairment (SMI), and 10 normal controls received custom-developed computerized cognitive training in the memory clinic of a university hospital. All of the participants completed 24 sessions of computerized cognitive training, each lasting 40 minutes and performed twice weekly. They were assessed using neuropsychological tests (both computerized and conventional), electroencephalography, fluorodeoxyglucose positron-emission tomography (FDGPET), volumetric magnetic resonance imaging (MRI), and diffusion-tensor imaging (DTI) at pre- and posttraining. Results The patients with MCI exhibited significant improvements in the trail-making test– black & white-B, and memory domain of the computerized cognitive assessment. Subjects with normal cognition exhibited significant improvements in scores in the language and attention-/ psychomotor-speed domains. There were no significant changes in subjects with SMI. In the pre- and posttraining evaluations of the MCI group, FDG-PET showed focal activation in the left anterior insula and anterior cingulate after training. Volumetric MRI showed a focal increase in the cortical thickness in the rostral anterior cingulate. DTI revealed increased fractional anisotropy in several regions, including the anterior cingulate. Conclusions The anterior cingulate and anterior insula, which are parts of the salience network, may be substrates for the improvements in cognitive function induced by computerized cognitive training.

Urology and Geriatrics in Korea: Present Status and Future Directions

조성태,나해리 대한배뇨장애요실금학회 2022 International Neurourology Journal Vol.26 No.1

Globally, the population aged 65 years and over is growing faster than all other age groups. South Korea, in particular, is one of the most rapidly aging societies worldwide. With the increase in the older population, the incidence of urologic diseases has increased significantly along with that of chronic diseases. Urologic diseases are an important component of the health problems faced by an aging society. Among those, urinary incontinence and voiding dysfunction cause significant health and quality of life problems in older adults. To properly manage these diseases, especially in the field of urology, it is necessary to propose appropriate policies for the health care of older people. Accordingly, the significance of geriatrics, particularly geriatric urology, has increased. Although geriatric urology in South Korea began relatively recently, the founding of the Korean Society of Geriatric Urological Care represents a significant step in the development of geriatric urology as a subspecialty. The goal of this review is to elaborate on the concept of geriatrics and to provide an overview of geriatric urology with a focus on its current status in South Korea. Furthermore, future challenges in the face of rapid demographic changes are reviewed.