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치매를 나타내지 않는 인슐린 비의존성 당뇨환자에서 인지유발전위
윤영철,하삼열,신동선,한승호,권오상 대한치매학회 2002 Dementia and Neurocognitive Disorders Vol.1 No.2
Background : Cognitive impairment has been recognized as a possible complication of diabetes mathtus (DM). It is well known that event-related potentials (ERPs) and Hopkins verbal Leaming Test (HVLT) are clinical tools in the evaluation of the patients who suffer from disorders of congnition. The present study was designed to investigate the effect of diabetes meltus and its complications on the ERPs nad HVLT. Methods : A cross sectional comparative study of the 51 normal controls and the 40 non-demented NIDDM patients who had no neurologic deficits was performed. The study consisted of a neurologic examination. Short form-Samsung Dementia Questionnaire brain CT. ERPs, HVLT, nerve conduction study, fundus examination and biochemical study Results : The P300 latencies of the DM patients and the normal control groups were well correlated with age Compared with controls, the P300 latencies of the patients were signficantly prolonged In NIDDM patients, prolonged P300 latencies were not associated with neuropathy but with retinopathy (p<.05) P300 latencies of NIDDM were correlated with immediate free recail of HVLT. There were no significant differences in scores of HVLT components between NIDDM and normal control group Conclusions : NIDDM patients without overt dementia or other CNS disorders may have a subtle cerebral malfunction, which can be detected by ERPs but not by verbal learning test. Therefore ERPs might be a useful tool to evaluate subtle cognitive dysfunction It is suggested that the factors responsible for genesis of this cerebral malfunction are not influenced by short-term metabolic dysfunction and may be different from those responsible for the DM neuropathy.
Predictors of Excessive Daytime Sleepiness in Korean Snoring Patients
신경진,김성은,하삼열,박진세,박봉수,손정협,박강민 대한비과학회 2014 Journal of rhinology Vol.21 No.2
Background : Excessive daytime sleepiness is one of the most common symptoms in snoring patients. How-ever, the reason why some individuals complain of daytime sleepiness and others do not is unclear. In this study,we evaluated snoring individuals and examined several demographic and polysomnographic profiles in an attemptto identify predictors of excessive daytime sleepiness. Methods : The inclusion criteria for patients were the fol-lowing: 1) patients who underwent an overnight polysomnograph, 2) patients with the chief complaint of snoring,and 3) patients who completed the Korean version of the Epworth sleepiness scale. We used the Epworth sleepi-ness scale to estimate excessive daytime sleepiness. We quantified correlations between the Epworth sleepinessscale and the demographic/polysomnographic parameters. We also analyzed the parameters affecting excessivedaytime sleepiness using multiple linear regression analysis. Results : One hundred nineteen patients met theinclusion criteria for this study. Multiple regression analysis showed that young age was the only independentvariable showing statistical significance for predicting excessive daytime sleepiness, and was well-correlated withthe Epworth sleepiness scale. However, there were no polysomnographic parameters that were predictive. Con-clusions : Clinicians need to be cautious when using the Epworth sleepiness scale for the diagnosis of obstructivesleep apnea and determining the response to treatment
Significance of Triphasic Waves in Metabolic Encephalopathy
박강민,신경진,하삼열,박진세,김시은,김형찬,김성은 대한임상신경생리학회 2014 Annals of Clinical Neurophysiology Vol.16 No.1
Background: Triphasic waves are one of the electroencephalographic patterns that can be usually seen in metabolicencephalopathy. The aim of this study is to compare the clinical and electrophysiologic profiles between patients withand without triphasic waves in metabolic encephalopathy, and reassess the significance of triphasic waves in metabolicencephalopathy. Methods: We recruited 127 patients with metabolic encephalopathy, who were admitted to our hospital. We divided these admitted patients into two groups; those with and without triphasic waves. We analyzed the differenceof duration of hospitalization, mortality rate during admission, Glasgow Coma Scale, severity of electroencephalographicalteration, and presence of acute symptomatic seizures between these two groups. Results: Of the 127 patients withmetabolic encephalopathy, we excluded 67 patients who did not have EEG, and 60 patients finally met the inclusioncriteria for this study. Patients with triphasic waves had more severe electroencephalographic alterations, lower GlasgowComa Scale, and more acute symptomatic seizures than those without triphasic waves. After adjusting the clinicalvariables, Glasgow Coma Scale and acute symptomatic seizures were only significantly different between patients withand without triphasic waves. Conclusions: We demonstrated that patients with triphasic waves in metabolic encephalopathyhad more significant impairment of the brain function. (Korean J Clin Neurophysiol 2014;16:15-20)
박강민,신경진,하삼열,박진세,박봉수,김성은 대한임상신경생리학회 2014 Annals of Clinical Neurophysiology Vol.16 No.2
Background: Viruses can cause either meningitis or encephalitis. It is unclear why some people suffer from aseptic meningitis,and others acquire aseptic encephalitis when infected with the same viral pathogens. The aim of this study wasto compare demographic and laboratory factors between patients with aseptic meningitis and encephalitis. Methods: Thedemographic and laboratory differences were analyzed according to age, sex, diabetes, hypertension, C-reactive proteinin the blood, white blood cell and protein in the cerebrospinal fluid, and glucose ratio (cerebrospinal fluid/blood). Additionally, we analyzed the nation-wide differencesin age between the patients with aseptic meningitis and those withencephalitis in Korea. Results: The patients with aseptic encephalitis were older, more likely to have hypertension, andhad higher levels of C-reactive protein than did the patients with aseptic meningitis. However, the numbers of whiteblood cells in the cerebrospinal fluid were significantly higher in the patients with meningitis than in the patients withencephalitis. Multivariable analysis revealed that age >49 years, hypertension and a C-reactive protein level >5.81mg/dL were independent and significant variables in the prediction of aseptic encephalitis. Additionally, the patientswith aseptic encephalitis were older than those with aseptic meningitis in the nation-wide Korean database. Conclusions:Older age, hypertension, and higher levels of C-reactive protein are useful factors for the prediction of asepticencephalitis.(Korean J Clin Neurophysiol 2014;16:55-61)
A Case of Atypical Isolated Nodular Infarction: Nystagmus with a Reverse Direction
박강민,신경진,하삼열,박진세,김성은 대한뇌졸중학회 2012 Journal of stroke Vol.14 No.3
A cerebral infarction involving the nodulus usually produce contralateral lateropulsion and ipsilateral spontaneous nystagmus to the lesion. Here, we report a case of atypical isolated nodular infarction showed ipsilateral lateropulsion and contralateral spontaneous nystagmus to the lesion with a normal head impulse test. A right-handed 70-year-old man developed sudden vertigo with an unsteady gait. Neurologic examination revealed spontaneous left-beating nystagmus with a torsional component. He also displayed imbalance of walking and axial lateropulsion to the right side. Head impulse test was normal. Magnetic resonance imaging indicated acute infarction in the right nodulus on diffusion-weighted images.
김시은,박강민,박진세,하삼열,김성은,김종국,신경진 대한임상신경생리학회 2013 Annals of Clinical Neurophysiology Vol.15 No.1
It was sometimes difficult to differentiate between acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) and subacute inflammatory demyelinating polyneuropathy (SIDP). The CNS involvement of these polyneuropathies has rarely reported in the literature. We present the case of a 42-year-old man who developed rapidly developing inflammatory demyelinating polyneuropathy followed by right optic neuritis. This case showed progressive motor weakness and sensory dysfunction with time to nadir at 8 weeks, demyelination in nerve conduction study, no other etiology of neuropathy, no relapse during follow-up of 18 months, good response to steroid and complete recovery which favor SIDP more than A-CIDP. We experienced the case of SIDP associated with optic neuritis.