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도진국(Jin Kuk Do) 대한생물치료정신의학회 2004 생물치료정신의학 Vol.10 No.2
두통환자의 임상적 평가는 이상에서 간단히 살펴본 것처럼 여러 가지 면에서 접근 할 수 있다. 임상에서는 일차두통이 이차두통보다는 흔한 것이 사실이다. 하지만 법의학적인 문제에서나 환자를 위해서나 이차두통을 배제하기 위한 노력을 게을리 하지 말아야 한다. 두통환자를 대하면서 섬세한 문진과 검사를 통한 접근이야말로 해결의 열쇠라는 것을 잊지 말아야 할 것이다. Headache is one of the most common reasons for neurologic consultation. We should always distinguish primary from secondary headaches. In the absence of secondary headache, the clinician proceeds to diagnosing a primary headache disorder. The clinician must remain vigilant concerning secondary and alert to the "red flags". Headache management starts with diagnosis and this begins with a good history and physical examination. This clinical process provides clear information for the clinician and sets patients at ease in the knowledge that the doctor is interested in their problem. With the publication of the second edition of The International Classification of Headache Disorders(ICHD-2) in January 2004, clinicians who treat headache should become familiar with the revised criteria, which will become the standard for treatment and research. I offer orderly approach to primary headache diagnosis based on attack frequency and duration, using the ICHD-2. In this article, clinical evaluation of headache and differential diagnosis between primary and secondary headache will be reviewed.
안 침범이 동반된 전신성 일광 육아종 환자에서 발생한 측두 동맥염
장효찬 ( Hyo Chan Jang ),김희정 ( Hee Jeung Kim ),박근 ( Gun Park ),정현 ( Hyun Chung ),도진국 ( Jin Kuk Do ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.8
A 63-year-old Korean man presented with generalized, asymptomatic, discrete papules and coalescent annular plaques for one year. Interestingly, the patient complained of conjunctival congestion, concurrently with aggravation of the skin lesion. Histopathologic findings of the skin lesion and conjunctiva revealed giant cells engulfing fragmented elastic fibers, and a diagnosis of actinic granuloma with ocular involvement was made. Ten months later, the patient revisited with a two-week history of bilateral temporal headache, neck pain, intermittent jaw claudication, and blurred vision. Biopsy of the temporal artery confirmed the clinical diagnosis of temporal arteritis. Both actinic granuloma and temporal arteritis show similar pathologic process, and this case supports the hypothesis that actinically degenerated elastic tissue is likely to be the antigenic basis of actinic granuloma of the skin and temporal arteritis. (Korean J Dermatol 2007;45(8):814∼817)
오희종,도진국,이동국,곽규호 啓明大學校 醫科大學 1996 계명의대학술지 Vol.15 No.3
The cause of Parkinson's disease(PD) is unknown. Research has concentrated on genetics, exogenous toxins, and endogenous toxins from cellular oxidative reactions. Familial occurrence of PD has been reported, but the role of genetics in the etiology of PD has long been controversial. We presented a case of married couple who acquired the PD at the age of around 60.
Guillain-Barre 증후군에서 변종, 동통과 혈청 Creatine Kinase 증가
오희종,도진국,서상일,곽규호,김태일,이동국 啓明大學校 醫科大學 1999 계명의대학술지 Vol.18 No.1
The Guillain-Barre syndrome (GBS) is often regarded as a predominantly motor neuropathy with few sensory features. But there are many variants in GBS. However, pain is a common symptom, and that is often a diagnostic and therapeutic problem in GBS patients. Although pain is acknowledged as a common symptom, the various pain syndromes seen in GBS often go unrecognized and may be undertreated. Serum creatine kinase (CK) elevation is seen in approximately one third of patients in the first week of GBS. Although the CK rise has been associated with the presence of pain, this was not always the case. We have seen 3 GBS patients with classic symptoms or not, with or without pain and serum CK elevation or not.
이동국,도진국,곽규호,오희종 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.1
WEBINO syndrome refers to the condition of bilateral internuclear ophthalmoplegia with exotropia in the primary position. The pathophysiology of the exotropia is uncertain and this type of INO has no specific anatomical correlate. This condition was reported in the patients with multiple sclerosis, occlusive vascular disease, tuberculous granuloma, and small cell lung carcinoma. We report a 41-year-old man who manifested bilateral exotropia, bilateral INO, and paralysis of convergence without structural lesion on brain MRI.
Two Cases of Spontaneous Intracranial Hypotension
Kim, Tae-Il,Seo, Sang-Il,Kwak, Kyu-Ho,Do, Jin-Kuk,Oh, Hee-Jong,Lee, Dong-Kuck,Sung, Nak-Kwan,Cho, Sung-Kyoung 啓明大學校 醫科大學 1998 계명의대학술지 Vol.17 No.4
Spontaneous intracranial hypotension(SIH) is a rare syndrome which causes postural headaches associated with low CSF pressure. Headaches are usually accompanied by on rare occasions diplopia, and transient visual obscuration as well as nausea, vomiting, tinnitus, neck stiffness, vertigo, photophobia, and phonophobia. CSF leakage from a spinal meningeal defect may be the most common cause of this syndrome. Downward sagging of the brain due to lw CSF pressure may produce headaches by traction of intracranial and meningeal pain-sensitive structures. Lumbar puncture reveals low opening pressure. CSF protein and cell count may be slightly elevated. Brain and cervical MRI may show diffuse and continuous pachymeningeal enhancement with gadolinium, subdural effusion, or downward displacement of the brain. We present two patients with SIH, in whom epidural blood patch produced an immediate and complete resolution of the symptoms. We couldn't identify CSF leakage site in either of them.