초점성 무긴장성 발작으로 의심되는 적하 발작 1례

하성래(Sung Rae Ha),양광익(Kwang Ik Yang),오형근(Hyung Guen Oh),정두신(Du Shin Jeong),박형국(Hyung Kook Park),이인규(In Kyu Lee),김영창(Young Chang Kim) 대한소아신경학회 2006 대한소아신경학회지 Vol.14 No.2

저자들은 정상적인 발달을 보이다가 12세경부터 하루에 수차례 걸친 양 하지 근력 저하로 인한 낙상으로 내원한 환아의 각성 뇌파에서 발작간 간질파를 관찰함으로써 비록 비디오-뇌파-근전도 모니터 및 침습적 뇌파 소견을 얻지 못하였으나 임상적으로 환아의 반복적 낙상의 원인이 하지에 국한된 초점성 무긴장성 간질 발작으로 사료되어 문헌고찰과 함께 보고 하고자 한다. Atonic seizures exhibits loss of postural tone, resulting in head drops or falling. When this event is extremely brief, It has been known as a drop attack. Atonic seizure are firmly placed under the category of generalized seizures. However, a various phenomena satisfying the above description has been recognized in patients with partial seizures. A 13-year-old girl had brief episodes of drop attacks. She complained of weakness of both legs in the absence of consciousness loss. These episodes occurred at a frequency of 4 or 5 time per day for 1 year. Her developmental and physical examinations were normal. Also, the brain MRI was normal. However, her Interictal EEG showed the repetitive spike and wave complexes on Cz electrode. She was controlled completedly by antiepileptic drungs. We report a patient who suffered from focal atonic seizures characterized by drop attack.

임신에 의해 악화된 원발성 하지불안증후군(restless leg syndrome)의 치료

김시선 ( Shi Sun Kim ),안치옥 ( Chi Ok Ann ),조은규 ( Eun Kyu Cho ),심현진 ( Hyun Jin Shim ),김윤숙 ( Yun Sook Kim ),배동한 ( Dong Han Bae ),양광익 ( Kwang Ik Yang ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.10

Restless leg syndrome (RLS) is characterized by intense restlessness and unpleasant creeping sensations deep inside the lower legs, occurring during periods of rest, evening and night. These symptoms can be improved by movement. There are two different phenotypes of RLS. One early-onset form starts before 36 years old. It has mostly a familial history, severe symptoms, and highly genetically determined. And it is a highly dependent to iron level of the brain. The other delayed-onset form starts after 36 years old, mostly secondary, without familial history, with a rapid evolution in two or three years. And it is associated with frequent low ferritin level of serum. Pathophysiology of RLS remains incompletely understood. However, advanced studies suggest that RLS may be generated by dopamine dysfunction locally within the central nervous system. Dopaminergic agonists are the treatment of choice, if the symptoms are severe. And iron therapy improves RLS symptoms in iron deprived patients. Early detection during pregnancy is needed because RLS gives an important impact on sleep efficiency and quality of life. Recently we have experienced a case of primary RLS patient diagnosed at 24+3 weeks, treated by dopaminergic agonist ropinirole and iron. We describe this case with a brief review of the literature.

급성 말초 전정신경병증 소견을 보인 후하부소뇌동맥의 내측 분지 경색 1례

양광익 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

A "pseudolabyrinthine" syndrome caused by acute infarction in the territory of the medial branch of the posterior inferior cerebellar artery (mPICA) has rarely been reported. The infarct also involved the lateral and dorsal medulla when the mPICA supplied all or part of these regions. A 53-year-old man of mPICA infarction developed with vertigo, nausea, vomiting, and imbalance. On examination, they fell to the lesion side on attempts to stand with eyes open. He had not nystagmus, limb ataxia, opthalmoparesis, visual tilting of the environment, and other abnormal neurologic signs. MRI showed a recent infarct involving medial part of inferior cerebellum. Vertgio, nausea, and vomiting resolved within 1-2 days. But, imbalance improved within 1-2 weeks. We report a case of mPICA infarction mimicking clinical sings of APV. So, we suggest that absent nystagmus and longstanding imbalance were point of differential diagnosis from APV.

Olivopontocerebellar Atrophy 환자의 MRI에서 보인 뇌교 십자모양 징후 1례

양광익,김수아,배원경 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Multiple systemic atrophy (MSA) is a progressive sporadic neurodegenerative disease of undetermined etiology that causes parkinsonism and cerebellar, autonomic, and pyramidal dysfunction in varying combinations. Clinically, the syndrome is difficult to distinguish from other neurodegenerative disorders such as idiopathic Parkinson's disease or other types of cerebellar ataxia. Pontine signal abnormalities on MRI (the cross sign) have been shown to be a typical feature of MSA as compared to controls and idiopathic Parkinson's disease, while their specificity had not yet been clearly established with regard to cerebellar degenerations. A 73-year-old man presented with a gait disturbance, dysarthria and dizziness during 2 years. He complained additional urinary incontinence. His past medical and family history were nonspecific. On neurologic examination, there were cerebellar ataxia, bradykinesia and rigidity. There were no other focal neurologic signs. Routine laboratory parameters were not remarkable. Axial T2-weighted and sagittal T1-weighted MRI showed pontine hyperintesity and cerebellar atrophy. We diagnosed possible OPCA by the criteria of Quinn. We present the pontine cross singn in a case with the clinically diagnosed as possible OPCA.

본태성 고혈압이 동반된 당뇨병환자의 혈중 인슐린 농도

양동호,홍세용,성기범,안무영,윤신구,박형국,양광익,황주호,신현길 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.1

Multiple lines of evidence link elevated blood pressure with diabetes mellitus. Specifically, it has been proposed that resistance to insulin-stimulated glucose uptake and hyperinsulinemia may play a central role in the cause and clinical course of hypertension. In diabetes mellitus, insulin resistance and/or hyperinsulinemia is an common finding and it is interesting whether the hyperinsulinemia may play a signigicant role in hypertension with DM in the same way as in essential hypertension without diabetes mellitus. The object of this study was to compare insulin and c-peptide levels between age, sex, and obesity matched two groups(DM with DM without hypertension). Method The study group consisted of 55 male diabetes mellitus patients, aged between 45-55 (years). Patients with obesity (body mass index · 30 ㎏/m2), renal disease (proteinuria · 300 ㎎/24hr urine), and secondary hypertension were excluded. Insulin and c-peptide were measured in overnight fasting state and after oral administration of glucose(75 gm). In the fasting, venous plasma glucose levels were similar in the hypertensive and control group(132 ±7 ㎎/dl vs 135 ±8 ㎎/dl). In the fasting, venous plasma insulin levels were higher in the hypertensive than in the control group (10.9 ±5.3 μIU/ml vs 5.5 ±3.9 μIU/ml, p = 0.0001). After loading with 75 gm glucose, venous plasma insulin level seems to be higher in the hypertensive patients than in the control patients, but the difference was not signigicant statistically (27.2 ±17.5 μIU/ml vs 19.9 ±18.9 μIU/ml, p = 0.1297). The mean insulin concentration of the essential hypertensive patients with diabetes mellitus was twice that of the normotensive patients with diabetes mellitus. In control group, there was a direct relations between insulin level and c-peptide, in both fasting state (R = 0.617, p = 0.0001) and glucose-loaded state (R = 0.531, p = 0.001). But in hypertensive group, there was no relations between insulin level and c-peptide, in both fasting state (R = 0.257, p = 0.2738) and glucose-loaded state (R = 0.307, p = 0.1885).

이차 전기영동을 이용한 프로테오믹 접근을 통한 정맥 압박이 혈장 프로테옴에 미치는 영향

양광익,박선아,오형근,정두신,박형국,성기범,안무영,홍세용 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

The human proteomics-based approaches, which examine the expressed proteins of a tissue or cell type, are increasingly being used. Venous occlusion is commonly employed for stimulating tissue-plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-l) release from venous endothelial cells, and this has been regarded as a parameter of the individual fibrinolytic capacity of plasma. The present work involved a detailed investigation of the plasma proteome and fibrinolytic activity in normal subjects, with the aim of determining whether correlations exist between various parameters of the fibhnolytic system before and after venous occlusion. We analyzed fibhnolytic parameters and plasma proteome before and after 15-min periods of venous occlusion in the forearm in 10 healthy 3rd-decade volunteers. Proteome analysis was performed using two-dimensional gels. The tryptic digests of some proteins were confirmed by MALDI-TOF and the MS-Fit algorithm. The fibrinolytic response as measured by the absolute amount of t-PA after venous occlusion was increased by venous occlusion (5.5 vs 9.6 ng/㎗, p<0.05), as was PAI-l (46.8 vs 56.1 ng/㎗, p<0.05). However, two-dimensional electrophoresis finding was virtually nonspecific and inconsistent after venous occlusion in healthy male subjects. Venous occlusion does not influence plasma proteome in healthy males. Although the fibhnolytic response to venous occlusion is attributed to an increase in free tUPA antigen, this change is not correlated with plasma proteome.

본태성 고혈압 환자에서 양측 신혈류의 비교

양광익,양동호,홍세용 대한고혈압학회 1997 대한고혈압학회지 Vol.3 No.1

편측 미각소실을 보인 뇌교경색 1예

양광익,남상원,정두신,방차옥,안무영,박형국 대한신경과학회 2001 대한신경과학회지 Vol.19 No.6

알코올 금단 발작 환자에서 진전 섬망 예방에 대한 Nimodipine과 Chlordiazepoxide의 효과 비교

정두신,양광익,이보람,방차옥,이태경,성기범,안무영,박형국 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Background & objectives : An increase of calcium influx during alcohol withdrawal state may contribute to neuronal hyperexitability, which cause delirium tremens(DT). Some investigators have found calcium channel blockers effects in prevention of DT in experimental animals. Therefore we evaluated the preventive effects of calcium channel blocker(nimodipine) and benzodiazepine(chlordiazepoxide) on the development of DT in alcohol withdrawal seizure(AWS) patients. Method : A total 59 patients with AWS were divided into three groups according to the management nimodipine-treated, chlordiazepoxide-treated, and control(no specific medication) groups. We compared the incidence rates of DT in the three groups. Results : Total incidence rate of DT was 30.5%(18 of 59 patients). There were 6 DTs of 18 patients(33.5%) in nimodipine-treated group, 4 of 21 patients(22.5%) in chlordiazpoxide-treated group, and 8 of 20 patients(44.0%) in control. Conclusion : The control group(44.0%) showed the highest incidence rate of DT. And nimodipine-treated(33.5%) and chlordiazepoxide-treated group(22.5%) were followed. However, this result failed to demonstrated statistically significant differences due to small numbers size.

다른 국소 신경학적 측위 징후 없이 발생한 전실어증 1예

송운욱,정두신,양광익,이태경,박형국,안무영 대한노인병학회 2001 대한노인병학회지 Vol.5 No.3