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비판막성 심방세동환자에서 뇌경색의 유형과 자기공명 뇌혈관촬영 소견
류상효 대한뇌졸중학회 2003 Journal of stroke Vol.5 No.2
Background: In clinical practice, some patients with non-valvular atrial fibrillation (NVAF) presented with acute stroke might be considered as a cardioembolic infarction, regardless of the presence of large artery atherosclerosis or small vessel disease. The aims of this study were to elucidate the clinical and pathophysiologic implications of cerebral infarction in the patient with NVAF on the basis of clinical and neuroimaing data. Methods: We reviewed medical records and brain images of consecutive 71 patients with acute ischemic stroke having N VAF registered to Hallym Stroke Registry between Jan. 1999 and Feb. 2002. The risk factor, the pattern of infarcts and concomitant arterial stenosis were analyzed. Results: Smoking (p=0.04) and hyperlipidemia (p=0.02) were more common in control group, who have acute ischemic stroke with normal sinus rhythm and without potential cardioembolic source, than in NVAF group. MCA territory infarct involving cortex was most common. Nine (12.7%) of 71 patients with NVAF were presented with small deep subcortical infarction (SDSCI). Twentyone (35.5%) of severe stenosis (〉50%) were noted, and 9 (15.3%) of them were located at the corresponding artery to acute infarct. Conclusions: At present, as any clinical criteria of stroke subtype, is not capable of revealing actual pathophysiologic mechanism, strokes with NVAF may be partly misclassified as cardioembolic infarct even if they caused by concomitant arterial stenosis or small vessel disease. This study suggests that the exact cause of stroke in patient with NVAF be carefully considered before initiating antithrombotic therapy for secondary prevention.
갈락토세레브로시다아제 유전자 분석으로 확진된 크라베(Krabbe)병 1예
남경식,류상효,성영희,오미선,정헤원,이병철,이기형,민기식,한성희,기창석,김종원 대한신경과학회 2004 대한신경과학회지 Vol.22 No.2
Krabbe disease is an autosomal recessive disorder involving white matter caused by deficient activity of the lysosomal galactocerebrosidase (GALC). A typical infantile-onset patient shows developmental regression, spasticity, and seizure before 6 months of age, and dies within 2 years. Previously, one case was confirmed by an enzyme test in Korea. We herein report a 2 year-old girl who showed the characteristic clinical course and neuroimaging features of infantile-onset Krabbe disease. Genetic testing identified the compound heterozygote mutations in the GALC gene; NLWE212_ 215TP/302A.
한병인,이호원,류상효,김지수 대한신경과학회 2021 Journal of Clinical Neurology Vol.17 No.1
This article provides an update on tinnitus for audiologists and other clinicians who provide tinnitus-specific services. Tinnitus can be attributable to hearing loss, somatosensory system dysfunction, or auditory cortex dysfunction, with hearing loss being the most common cause and serious underlying pathologies being rare. Hearing loss does not always lead to tinnitus, and patients with tinnitus do not always suffer from hearing loss. The first scenario is explained by a so-called inhibitory gating mechanism, whereas the second assumes that all tinnitus sufferers have some degree of hearing impairment, which might not be detected in standard audiological examinations. The treatments should aim at symptomatic relief and management of associated distress. Current treatment options include pharmacotherapy, education, counseling, cognitive behavioral therapy, and sound therapy.
뇌졸중 환자에서 관찰되는 대뇌백질변성과 이에 관련된 위험인자
박종호,유경호,송홍기,이병철,강우열,류상효 대한신경과학회 2004 대한신경과학회지 Vol.22 No.2
Background:Cerebral white matter change (WMC) is usually seen in stroke patients. This study was aimed at determining whether there might be a relationship between the extent of WMC and whether to control hypertension or not and the frequency of previous stroke lesion. Stroke subtypes were also analyzed to elucidate WMC distribution. Methods:We investigated demographic features, vascular risk factors, subtypes, and WMC in 339 ischemic stroke patients over forty years of age who had brain MRI from the Hallym Stroke Registry between January 1998 and December 2001. In hypertension, it was divided into with therapy and with no therapy. In frequency of previous stroke lesion, we subdivided the patients into three groups by number of frequency: 0, 1, and ≥2. Stroke subtypes were classified into large artery atherosclerosis (LAA), small artery occlusion (SAO), cardioembolism (CE), and stroke of undetermined etiology (SUE). WMC was quantitatively estimated by subdividing into 5 grades (0~IV). Results:Age, female, hypertension, previous stroke lesion, and SAO correlated significantly with prevalence of WMC (p<0.001, =0.002, <0.001, <0.001 and <0.001, respectively). In hypertension, there was significant difference between normotensive and hypertensive (p=0.001). But there was no statistical difference between with therapy and with no therapy (p>0.05). In previous stroke lesion, it showed significant difference between 0 and (1 and ≥2) (p<0.001) and between 1 and ≥2 (p<0.001). In subtype, CE also correlated significantly with prevalence of WMC as well as SAO than LAA (p<0.001). Conclusions:WMC seen in patients with stroke is related with small-vessel disease and is mainly affected by age, female, hypertension, and previous stroke lesion.