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Decreased Vasomotor Reactivity in Alzheimer’s Disease
이순태,정근화,이용석 대한신경과학회 2007 Journal of Clinical Neurology Vol.3 No.1
Background: Reduced cerebral blood flow and microvascular abnormalities have been suggested as the vascular pathogenesis of Alzheimer’s disease (AD). Transcranial Doppler sonography (TCD) can be used as a noninvasive method for measuring cerebral vasomotor reactivity (VMR) which represent the capability of arterioles to dilate and constrict in order to maintain cerebral blood flow. Objective: The objective of this study was to determine whether VMR is decreased in AD patients. Methods: Seventeen consecutive patients who met NINDS-ADRDA criteria for AD, and 17 age- and sex- matched controls were included in this study. MRI and MRA were performed for the grading of white-matter lesions. Patients with cerebral infarct or stenosis of the middle cerebral artery (MCA) were excluded. The fixed TCD probe was used to monitor the mean flow velocity (MFV) in the MCA. A 6-L rebreathing bag was applied to patients for at least 5 minutes to elevate the CO2 concentration, which was continuously monitored with a capnometer. VMR was calculated as the percentage change in the MFV. Results: Baseline characteristics - including cerebrovascular risk factors, grades of white-matter lesions, baseline MFV, and pulsatility index - did not differ between the two groups. Mini-Mental State Examination score was significantly low in AD group (20.5 vs. 27.5, p<0.05). VMR was significantly reduced in AD group both in the right- side (24.5% vs. 36.6%, p<0.05) and left-side (20.7% vs. 34.1%, p<0.05) MCAs. Conclusions: Our finding that VMR is reduced in AD may be suggestive of underlying microangiopathic mechanism in AD patients. Future studies should check the validity of these experimental and hypothesis-generating pilot results.
알츠하이머병 환자의 말초혈액 내 CD34 양성세포 수치의 변화
이순태,주건,정근화,심지영,오민정,박명희,김만호 대한치매학회 2010 Dementia and Neurocognitive Disorders Vol.9 No.3
Background: Circulating CD34-positive cells constitute the endothelial progenitor cell population,differentiate into endothelial cells, and contribute to mammalian brain regeneration. Given the vascular endothelial pathogenesis of Alzheimer’s disease (AD), we investigated the levels of CD34+ cells in AD patients. Methods: Sixty-six consecutive patients with probable AD (clinical dementia rating scale 1) and 22 age-matched control subjects were enrolled. CD34+cells were counted in their peripheral blood samples and analyzed in comparison with their clinical characteristics. Results: The AD patients had significantly lower numbers of CD34-positive cells than control subjects. However, the number of CD34-positive cells was not correlated with clinical characteristics of AD patients, including Mini Mental State Examination (MMSE)score, Framingham risk score, body-mass index, and changes in MMSE during 3 months. Conclusions: AD patients have diminished circulating CD34-positive cells, suggesting the reduced regenerative support from the peripheral blood in AD patients.
콜라겐 분해효소를 이용한 뇌출혈 백서 모델에서의 신경학적 결손 평가를 위한 행동 검사
이순태 대한뇌졸중학회 2003 Journal of stroke Vol.5 No.2
Department of Neurology, College of medicine Seoul National UniversityDepartment of Neurology, Seoul National Hospital*Department of Neurology, Ilsan Paik Hospital, Inje University**Background: Experimental intracerebral hemorrhage (ICH) in rats made by collagenase, causes focal, asymmetrical neurologic deficits. However, the time course of the neurologic deficit in these models have not been quantified yet. Variable behavioral tests without verification are being used. Objectives: To evaluate the time course of the sensorimotor deficits in experimental ICH and to examine the consistency of variable behavioral tests. Methods: Experimental ICH was induced by stereotactic, intrastriatal administration of bacterial collagenase in adult male, Sprague-Dawley rats (weight, 200-220 g, n=13). Control had only a needle insertion (SHAM group, n=5). Rats were tested before ICH, and after ICH, from 1 day to 35 days (every week) using modified limb placing test, cylinder test, swimming test, and rotarod test. Results: Rats with ICH had marked neurologic deficits from day 1, which remained persistent up to 5 weeks after ICH, in Rotarod test, modified limb placing test, cylinder test, and swimming test. Initial behavioral scores were below 50 percent of that of the pre-ICH status, and the neurologic deficits occurred in the bilateral sides initially. The abnormal neurologic score ipsilateral to the ICH side, improved over time. Some rats of the SHAM group showed the asymmetry in cylinder test, modified limb placing test and swimming test. Conclusions: In this study, experimental ICH caused long-term functional changes in rats. Some functional improvement and the neurologic deficit from needle insertion itself should be considered in the use of this model.
불안증을 동반한 편두통 환자에서 부스피론의 편두통 감소 효과에 대한 무작위배정 이중맹검 위약 대조 연구
이순태,김만호 대한신경과학회 2004 대한신경과학회지 Vol.22 No.4
Background: Migraine is commonly associated with anxiety disorder. However, whether anxiolytic medicine or changes in anxiety levels affect the migraine attack is unclear. Buspirone, the agonist for 5-HT1A receptor, is effective in treating generalized anxiety disorder. In this study, we attempted to test the efficacy of buspirone for migraine combined with anxiety disorder. Methods: 111 outpatients aged 20 to 70 years (mean, 46.4; SD, 12.8), were analyzed. The diagnosis of migraine was made according to the HIS (International Headache Society) criteria, and the level of anxiety was rated by the Hamiton Anxiety Rating Scale (HAM-A). The migraineurs were randomly assigned to treatment with either buspirone (15 mg/day) or placebo for 6 weeks. The efficacy variables included changes in headache frequency, headache intensity, Headache Index, Headache Management Self-Efficacy Scale (HMSE), Headache Disability Inventory (HDI), and the Hamilton Anxiety Rating Scale (HAM-A). The correlation between headache improvement and the anxiolytic effect were analyzed. Results: Headache frequency showed a 43.3% reduction (from 6.7/2 weeks to 3.8/2 weeks) in the buspirone-treated group, whereas a 10.3% reduction (from 6.8 to 6.1/2 weeks) in the placebo group. The Headache Index, HDI, and HAM-A were also significantly lowered in buspirone-treated patients than in placebo-treated patients. However, the headache intensity or the HMSE score were not changed. Correlation analysis between the change of Headache Index and that of HAM-A revealed no significant association. Conclusions: Buspirone is an effective prophylactic agent in migraine combined with anxiety disorder. This prophylactic effect is not secondary to the anxiolytic effect. This suggests that the agonistic action for 5-HT1A is primarily effective in migraine prophylaxis.
Haptic 시스템을 이용한 뇌졸중 환자의 상지 재활 효과 분석
이순태,김영탁,이호규,송민섭,Lee, Soon-Tae,Kim, Young-Tark,Lee, Ho-Kyoo,Song, Min-Sub 한국생산제조학회 2010 한국생산제조학회지 Vol.26 No.1
For rehabilitation of stroke patients the repeat training is needed. However it is difficult to keep up the training for the patients because it is boring. Even if the patients continue the training there is no objective way to evaluate the remedial value. Recently there is a new attempt to apply the haptic system to the rehabilitation of the stroke patients. In this study a haptic system is applied to the rehabilitation of the stroke patients. Through the comparative analysis of the experimental data for the normal people and patients, the validity of the proposed rehabilitation was verified. In conclusion, the patient's condition at 8 days after the experiment has demonstrated the level of ADL.