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이웅우,양미화,장명숙,김욱주,고영채,한문구,배희준,신채원,박정현 대한신경과학회 2009 대한신경과학회지 Vol.27 No.4
Background: Acute intracranial large-artery occlusions (AILAOs) are detected frequently and cause severe neurological disabilities. Most studies in this field do not focus on the natural history of AILAOs, but on the individual prognosis for each intervention. The aim of this study was to elucidate the clinical profiles and outcomes of AILAOs. Methods: A consecutive series of patients hospitalized between January 2004 and October 2007 due to AILAO within 24 hours from onset were recruited. Based on a prospective stroke registry, their clinical profiles were collected. AILAO was defined as an intracranial internal carotid artery (ICA), middle cerebral artery (MCA), or basilar artery (BA) occlusion that could be confirmed by angiography, with relevant lesions on diffusion-weighted imaging (DWI). The modified Rankin Scale (MRS) score at 3 months and the recanalization rate within 14 days were recorded as outcomes. Results: Among 1,047 patients with acute ischemic stroke who were examined within 24 hours of onset, 189 [18.1%; 101 men, 88 women; age 68.6±13.0 years (mean±SD); median National Institutes of Health Stroke Scale (NIHSS) score=11]. Occlusion sites were MCA M1, MCA M2, distal ICA, and BA in 99 (52.4%), 50 (26.5%), 20 (10.6%), and 20 (10.6%) of cases, respectively. Embolic sources were found in 103 (54.5%) cases. MRS scores were available for 184 (97.4%) of the patients, of which 78 had a favorable outcome (MRS: 0–2). Follow-up angiography was performed in 122 (64.6%) cases, with recanalization observed in 88 (72.1%) of these. Thrombolysis, occlusion site, presence of an embolic source, and initial glucose level were predictors of early recanalization (p<0.001). Recanalization status and initial NIHSS score were strongly correlated with a favorable outcome (p<0.005). Conclusions: This is the first report of the clinical profiles, outcomes, and their predictors in a cohort of Korean patients with AILAO.
이웅우,전범석,김률 대한의학회 2018 Journal of Korean medical science Vol.33 No.28
Previously, we defined DRD as a syndrome of selective nigrostriatal dopamine deficiency caused by genetic defects in the dopamine synthetic pathway without nigral cell loss. DRD-plus also has the same etiologic background with DRD, but DRD-plus patients have more severe features that are not seen in DRD because of the severity of the genetic defect. However, there have been many reports of dystonia responsive to dopaminergic drugs that do not fit into DRD or DRD-plus (genetic defects in the dopamine synthetic pathway withou nigral cell loss). We reframed the concept of DRD/DRD-plus and proposed the concept of DRD look-alike to include the additional cases described above. Examples of dystonia that is responsive to dopaminergic drugs include the following: transportopathies (dopamine transporter deficiency; vesicular monoamine transporter 2 deficiency); SOX6 mutation resulting in a developmentally decreased number of nigral cells; degenerative disorders with progressive loss of nigral cells (juvenile Parkinson's disease; pallidopyramidal syndrome; spinocerebellar ataxia type 3), and disorders that are not known to affect the nigrostriatal dopaminergic system (DYT1; GLUT1 deficiency; myoclonus-dystonia; ataxia telangiectasia) This classification will help with an etiologic diagnosis as well as planning the work up and guiding the therapy.
가속도계를 이용한 진전현상의 분석을 통한 파킨슨병과 본태성 진전의 판별
이홍지,이웅우,전효선,김상경,김한별,전범석,박광석,Lee, Hongji,Lee, Woongwoo,Jeon, Hyoseon,Kim, Sangkyong,Kim, Hanbyul,Jeon, Beom S.,Park, Kwangsuk 대한의용생체공학회 2015 의공학회지 Vol.36 No.4
Discrimination of Parkinson's disease (PD) from Essential tremor (ET) is often misdiagnosed in clinical practice. Since tremor is time-varying signal, and dominant and harmonic frequencies are shown in tremor only with moderate or severe symptom, there are some limitations to use frequency related features. Moreover, patients with PD or ET can suffer from both resting tremor and postural tremor. In this study, 28 patients with PD and 17 patients with ET were enrolled. Tremor was measured with accelerations on the more affected hand during resting and postural conditions. The ratio of root mean square (RMS) of resting tremor to RMS of postural tremor, the mean coefficients of autocorrelation function (ACF), and the mean of differences of two adjacent coefficients of ACF at resting and postural were calculated and compared between PD and ET. The performance showed 98% accuracy with support vector machine and leave-one-out cross validation. In addition, the method accurately differentiated the patients with tremor-dominant PD from patients with ET, with 100% accuracy. Therefore, the developed algorithm can assist clinicians in diagnosing and categorizing patients with tremor, especially, patients with mild symptom or the early stage of a disease, for proper treatment.
제1형 당뇨병, 소뇌 실조, 진행성 난청을 수반하는 MELAS 증후군 환자 1예
강순성,이웅우,최정호,심현준 대한이비인후과학회 2023 대한이비인후과학회지 두경부외과학 Vol.66 No.6
Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndromeis a maternally inherited mitochondrial disorder. MELAS syndrome manifests different clini-cal symptoms due to mitochondrial heteroplasmy and individual susceptibility and tends to beaggravated by metabolic events. It presents various clinical manifestations including hearingimpairment, diabetes mellitus, and stroke like episodes. However, to date, only a few cases ofMELAS syndrome accompanied with cerebellar ataxia have been reported in Korea. Wehereby present an unusual case of a patient diagnosed with MELAS syndrome involving dia-betes mellitus, cerebellar ataxia and sensorineural hearing loss, which were aggravated bymetabolic stresses such as pregnancy and hypoglycemic shock.
뇌혈류 감소를 동반한 급성 중간대뇌동맥 폐색 환자에서 응급으로 시행한 얕은 관자-중간대뇌동맥 연결술
배은기,유위선,이웅우,고영채,김욱주,박석규,김정은,배희준,오창완,한문구 대한신경과학회 2008 대한신경과학회지 Vol.26 No.4
The role of surgical revascularization for patients with ischemic stroke remains controversial. During acute phase of large artery occlusive ischemic stroke, extracranial–intracranial (EC-IC) bypass, such as superficial temporal-middle cerebral aretery (STA-MCA) bypass sugery, has been rarely performed. We report a case of successful emergency STA-MCA bypass surgery to stop the neurologic deterioration and improve the hemodynamic compromise in a patient with acute symptomatic MCA occlusion associated with hypoperfusion.
단독편측설하신경마비로 발현된 전이전립샘암: 임상-영상의학 연관성 입증
박수민,이정주,김병건,강규식,이웅우 대한신경과학회 2023 대한신경과학회지 Vol.41 No.2
Isolated unilateral hypoglossal nerve palsy (IUHNP) is rare because of its complex course and close adjacent structures. Prostate cancer is a very rare cause of hypoglossal nerve palsy and reported scarcely. We herein report the first case of metastatic prostate cancer presented with IUHNP in Korea, which shows good clinico-radiological correlation.
Musculoskeletal problems affect quality of life in Parkinson’s disease
김영은,김한준,윤지영,이웅우,양희준,김종민,전범석 대한파킨슨병및이상운동질환학회 2018 Journal Of Movement Disorders Vol.11 No.3
Objective Musculoskeletal problems are more common in patients with Parkinson’s disease (PD) than in normal elderly, but the impact of musculoskeletal problems on health-related quality of life (HRQoL) in patients with PD is unknown. Methods Four hundred consecutive patients with PD were enrolled for the evaluation of musculoskeletal problems and HRQoL. HRQoL was assessed by the 36-Item Short Form Health Survey, which comprised physical health and mental health. Results Of the total patients, 265 patients had musculoskeletal problems, and 135 patients did not have musculoskeletal problems. Patients with musculoskeletal problems reported lower levels of HRQoL in terms of physical health than did patients without musculoskeletal problems (p < 0.05). In women, all components of physical health were lower in patients with musculoskeletal problems than in patients without musculoskeletal problems (p < 0.05). Meanwhile, in men, only the bodily pain score of physical health was lower in patients with musculoskeletal problems than in patients without musculoskeletal problems. Mental health and physical health were negatively correlated with depression, Unified Parkinson’s Disease Rating Scale I & II scores, and pain severity from musculoskeletal problems, in that order (p < 0.01 for all). Conclusion These results suggest that musculoskeletal problems in patients with PD affect HRQoL significantly, mainly in terms of physical health rather than mental health and especially in women rather than men. Musculoskeletal problems should not be overlooked in the care of patients with PD.