노인장기요양보험서비스의 현황 및 나아갈 방향: 설문조사 및 국민 건강보험서비스 자료

송은향,문연실,박정현,주병억,한호성,이찬녕,한현정,김재문 대한신경과학회 2024 대한신경과학회지 Vol.42 No.1

The continuing growth of population aged 65 years and above, the socioeconomic burden of long-term care insurance has consistently increased. This study aimed to review the current system and efficiently develop long-term care insurance services according to changes in socioeconomic situations. First, a 21 items questionnaire survey was conducted from August 16 to August 31, 2022, for all members of the Korean Neurological Association. The survey was divided into seven areas, and individualized results were analyzed. Second, cumulative data on long-term care insurance services were collected and analyzed from July 1, 2008 to December 31, 2021, for the National Health Insurance system, and the results were summarized. In the survey, approximately 21% of the neurologists answered a web-based questionnaire survey on current doctors’ referral slips for long-term insurance services. Most (94%) had doctor referral slips for long-term insurance services. However, the authors estimated that doctors’ referral slips did not sufficiently affect the grading of longterm insurance services. The long-term care insurance services data according to several categories were classified and then, we statistically analyzed the socioeconomic burden of long-term insurance. Those cumulative data showed a gradual increase in the recipient number, diversity of geriatric diseases, and socioeconomic burden. We suggested that it is necessary for the government and academic society to continue to cooperate to develop the long-term care insurance systems for elderly.

경두개 자기자극을 이용한 편두통 및 만성 긴장성 두통에서의 발작간 운동피질 흥분성

송은향,이정석,최용석,김정미,감우정,김두응,한정호 대한신경과학회 2002 대한신경과학회지 Vol.20 No.3

순수 소뇌실조증의 임상 양상으로 SCA 1의 과도학 CAG 반복서열을 보인 유전성 소뇌실조증 가족 1례

송은향,이정석,김우정,김두응 대한임상신경생리학회 2001 Annals of Clinical Neurophysiology Vol.3 No.2

SCA 1 is an autosomal dominant disorder. The phenotypic manifestations of SCA 1 are not specific, and thus, the diagnosis of SCA 1 rests on molecular genetic testing. The number of CAG repeats ranges from 6-44 in normal alleles and from 39-81 repeats in disease-causing alleles(chromosomal locus 6p22-23). The main clinical features of SCA 1 are ataxia, dysarthria, ophthalmoparesis, extrapyramidal signs without retinal degeneration. A 24-years old woman with suspected family history presented with progressive cerebellar ataxia, dysarthria, ptosis, titubation and general weakness. Brain MRI revealed a moderate cerebellar atrophy. A genomic polymerase chain reaction(PCR) analysis showed 66 repeats at the SCA 1 locus.

경부 2, 3번 피부절을 침범한 Ramsay-Hunt 증후군 1례

이정석,최용석,송은향,김정미,한정호,김두응,Lee, Chung Seok,Choi, Yong Seok,Song, Eun Hyang,Kim, Jeung Mee,Han, Jeong Ho,Kim, Doo Eung 대한임상신경생리학회 2002 Annals of Clinical Neurophysiology Vol.4 No.1

Ramsay-Hunt syndrome is a viral disease associated with peripheral facial nerve paralysis accompany by erythematous vesicular rashs on the ear(zoster oticus) or in the mouth. Based on clinical presentations that indicated involvement of more than one ganglion, the gasserian, geniculate, petrous, accessory, jugular and second and third dorsal root ganglia comprised a chain in which inflammation of a single ganglion could extend to nearby ganglia. A 71-year-old man presented with left. peripheral facial palsy with otalgia, vesicular eruption in $V_2$, $V_3$, C2, C3 dermatome, tinnitus, and hearing loss.

원발성 연수 출혈증 1예

하현욱,한정호,이정석,송은향,김우정,김두응,최진영 건국대학교 의과학연구소 2000 건국의과학학술지 Vol.10 No.-

Pure primary medullary hemorrhage is a rare condition, which is characterized by ipsilateral hypoglossal nerve palsy and contralateral hemiparesis. The hemorrhage usually extended to medial and ventral medulla, these two characteristic signs distinguished from the classical presentation of Wallenberg's lateral medullary syndrome. A 53-years-old man was admitted with sudden onset left sides weakness and vertigo. Neurologic examination showed dysarthria, mild dysphagia, Horner syndrome of right side, spontaneous horizontal jerking nystagmus to left side and right deviation of tongue at protrusion. Pain and temperature sensation of left trunk, left extremity and right face were decreased. Brain CT scan and brain MRI revealed focal hemorrhage in the right medulla. We report a case of pure primary medullary hemorrhage with undetermined etiology.

위 전절제술을 받았던 환자에서 아급성 연합성 변성 1예

한정호,하현욱,이정석,송은향,김우정,김두응,최진영 건국대학교 의과학연구소 2000 건국의과학학술지 Vol.10 No.-

Subacute combined degeneration is a metabolic disorder of the spinal cord caused by vitamin B12 deficiency. A 72-year old man was admitted with weakness and tingling sensation of the bosh upper extremities. 9 years ago, he was diagnosed as having stomach cancer. So total gastrectomy with splenectomy was done at that time. The complete blood cell counts and morphology revealed megaloblastic anemia. Nerve conduction velocity study(NCV), electoromyography(EMG) and somatosensory evoked potentials(SEP) showed diffuse sensorimotor peripheral neuropathy. Magnetic resonance imaging(MRI) showed an increased T2-weighted signal, mild decreased T1-weighted signal, and slight contrast enhancement of the posterior columns of the cord in the cervical and upper thoracic spinal region. He was treated with vitamin B12 supplements and improved gradually. If abnormal sensation and muscle weakness was developed after gastrointestinal surgery, subacute combined degeneration should be considered in the differential diagnosis. We describe MRI findings of a typical case of subacute combined degeneration, which was induced by total gastrectomy.

CTX-M형 Extended-Spectrum -Lactamase 생성 Escherichia coli의 확산 및 CTX-M-12의 출현

오지은,홍종식,배일권,송은향,장석훈,이경원,용동은,이종욱,이위교,강정옥,안지영,홍성근,신종희,어영,박연준,김의종,곽효선,우건조 대한진단검사의학회 2005 Annals of Laboratory Medicine Vol.25 No.4

배경 : 국내에서 분리되는 Escherichia coli의 Ambler class Aextended-spectrum -lactamase (ESBL) 생성 현황을 알아보고자 하였다.방법: 2004년 2월부터 7월까지 전국 12개 병원에서 분리된cefotaxime 혹은 ceftazidime에 중간 혹은 내성인E. coli를 수 집하였다. 항균제 감수성은 디스크 확산법으로 시험하였고, ESBL생성은 double-disk synergy 시험으로 확인하였다. 한천희석법으로 -lactam 항균제의 최소억제 농도를 측정하였다. 중합연쇄반응으로 TEM형, SHV형, CTX-M형, PER-1형, VEB형, IBC형, GES형 및 TLA형 유전자를 검출하였고, 중합연쇄반응 산물의 염기서열을 양방향으로 분석하였다.결과: 국내 12개 병원에서 수집한 cefotaxime 혹은 ceftazidime에 중 간 혹 은 내 성 인E. coli의 90.9% (149/164)가 double-disksynergy 양성 소견을 보였다. E. coli에서 가장 흔한 Ambler classA ESBL은 CTX-M-15 (53주)와 CTX-M-14 (24주)였으며,CTX-M-3, CTX-M-9 및 CTX-M-12가 9주, 3주 및 3주 검출되었고, SHV-2a, SHV-12 및 TEM-52 유전자를 지닌 균주가CTX-M형 ESBL 확산 2571 주 , 5 주 및 3 주 검 출 되 었 다 . 결론: 본 연구를 통하여 CTX-M형 ESBL을 생성하는 E. coli가 국내에서 확산중이며 CTX-M-12 생성균주가 출현하였음을 확인할 수 있었다. Background : Clinical isolates of Escherichia coli were evaluated to determine the prevalence and genotypes of Ambler class A extended-spectrum -lactamases (ESBLs). Methods : Clinical isolates of E. coli were collected from 12 hospitals from February through July, 2004. Antimicrobial susceptibility was tested by disk diffusion and agar dilution methods, and ESBLproduction was determined by double-disk synergy test. TEM, SHV, CTX-M, PER-1, VEB, IBC, GES, and TLA type ESBL genes were detected by PCR amplifications, and the PCR products were subjected to direct sequencing. Results : The double-disk synergy test was positive in 90.9% (149 in 164) of the ceftazidime- or cefotaxime-resistant E. coli isolates. The most prevalent types of Ambler class A ESBLs in E. coli isolates were CTX-M-15 (n=53). CTX-M-14 (n=24), CTX-M-3 (n=9), CTX-M-9 (n=3), CTX-M-12 (n=3), SHV-2a (n=1), SHV-12 (n=5) and TEM-52 (n=3) were also found. CTX-M-12 ESBL had never been reported before in Korea. Conclusions : CTX-M type ESBL-producing E. coli isolates are spreading and CTX-M-12 is emerging in Korea.

2014년 일상예찬 캠페인 “일상생활지침서” 사용 효과 연구

최호진,문연실,이찬녕,양영순,송은향,김희진,나해리,심용수,박경원,정지향,양동원,김상윤,박기형 대한치매학회 2014 Dementia and Neurocognitive Disorders Vol.13 No.4

Background: Activities daily living (ADL) disability has a direct influence on the patients’ quality of life and on the amount of care needed. It is major factor of care in dementia patients. So Korean Dementia Association suggested guideline about activities of daily living in dementia patients in 2013. The purpose of this article is to investigate the effect of this. Methods: A total of 110 subjects were enrolled. Assessments included age, sex, education level of patients and caregiver, the duration of disease, pattern of family, economic status. We divided “active practice” group and “passive practice” group by recognition of guideline contents after study. We compared two groups before and after by Korean Mini-Mental State Examination (K-MMSE), Short form of Geriatric Depression Scale- Korean version (S-GDS), Korean version of Zarit’s Burden Interview (ZBI-K), Alzheimer’s Disease Cooperative Study-Activities of Daily Living scale (ADCS-ADL). Finally, we investigate the level of satisfaction about our guideline. Results: Age of patients, the duration of disease was lower and education level of caregiver and economic status was higher in “active practice group”. The pattern of family also differed from two groups. It was observed distinct difference between the variations of two groups in S-GDS, ZBI-K, and ADCS-ADL. The level of satisfaction about our guideline was very high. Conclusions: Considering these results, our guideline about activities of daily living is effective to manage dementia patient. Active application of it is needed in clinic or center for dementia.

편두통 환자의 형태변환성 시각유발전위에서의 신경원성 과반응

김우정,한정호,하현욱,송은향,이정석,김두응 대한신경과학회 2001 대한신경과학회지 Vol.19 No.3