저혈당에 의해 유발된 몽유병

한선정,김지현 대한수면연구학회 2015 Journal of sleep medicine Vol.12 No.2

Sleepwalking is a rare parasomnia in the elderly. We report two cases of the patients who presented complex motor behaviors during sleep triggered by hypoglycemia. A 76-year-old male patient with diabetes mellitus presented to the sleep clinic for recurrent sleepwalking with amnesia. Night polysomnogram showed REM sleep without atonia with sleep talking and distal arm movements. While taking clonazepam, he had a few more episodes of sleepwalking. The last episode finally revealed severe hypoglycemia when he was found very far from his house. The second patient, a 67-year-old male showed four episodes of nocturnal confusion and sleepwalking lasting 20 minutes during sleep. His blood glucose and HbA1C were low. After decrease of the dose of oral hypoglycemic agent, no more recurrent sleepwalking occurred. Our cases showed hypoglycemia can induce sleepwalking in the older adults, rather than decreased mentality. Metabolic workup should perform for evaluation of sleepwalking, especially in the elderly.

일주기 리듬 수면장애

한선정,주은연 대한수면연구학회 2008 Journal of sleep medicine Vol.5 No.2

Circadian rhythm sleep disorders are characterized by an alteration of the phase relationship between the intrinsic circadian system and the extrinsic light- dark cycle that results in complaints of insomnia and excessive sleepiness. Under entrainment to the 24-hour day-night cycle, the sleep-wake pattern may assume various phase relationships to the circadian pacemaker by abnormally long or short intervals between the dim light melatonin onset (DLMO) or the core body temperature (peak time) and wake-up time. Delayed and advanced sleep phase disorders may be associated with shifted circadian rhythms (body clock). Those with ‘weak’ circadian rhythms need a very bright stimulus of light to reset their body clock every day. Treatments include sleep hygiene education, timed exposure to bright light as well as avoidance of bright light at the wrong time of the day and pharmacologic approaches, such as melatonin. This article introduces the clinical approach to the diagnosis and management of the various circadian rhythm sleep disorders, including delayed and advanced sleep phase disorders, shift worker, and jet lag.

해체주의 이후 아방가르드 건축의 특성과 성격 규명에 관한 연구

한선정,심우갑 대한건축학회 1998 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.18 No.2

기면증 환자의 진단에서 반복적 다중수면잠복기검사의 유용성

한선정,주은연,조재욱,홍승봉 대한수면연구학회 2008 Journal of sleep medicine Vol.5 No.1

Background: Multiple Sleep Latency Test (MSLT) has been used as an objective measure of daytime sleepiness and for the diagnosis of narcolepsy. However, the MSLT’s current criteria for narcolepsy may miss narcolepsy. To investigate the usefulness of repeated MSLT for increasing the sensitivity of narcolepsy diagnosis, we performed the second MSLT in patients whose clinical history includes excessive daytime sleepiness with or without cataplexy but the first MSLT result did not meet the criteria for narcolepsy. Method: MSLT was repeated in 27 patients with excessive daytime sleepiness. Each patient had an overnight polysomnography and the first MSLT in next day. The 2nd MSLT was performed 1-3 months after the first MSLT. Five nap trials were done in each MSLT. Result: In the 2nd MSLT, nine of 27 patients (33%) with an initial MSLT that did not satisfy the diagnostic criteria of narcolepsy, met the MSLT criteria for narcolepsy (Mean sleep latency < 8 min and two or more sleep-onset REM periods). The other 16 patients were diagnosed as idiopathic hypersomnia. Four patients whose history has excessive daytime sleepiness with cataplexy didn’t meet the MSLT criteria for narcolepsy in both first and second MSLTs. Conclusion: Our findings suggest that repeated MSLT is valuable for the diagnosis of narcolepsy in patients with suspected narcolepsy but insufficient result of the first MSLT for narcolepsy criteria.

Suppression of Motor Evoked Potential and H-reflex during Cataplexy in Narcolepsy

한선정,주은연,김선하,정소희,홍승봉 대한수면연구학회 2007 Journal of sleep medicine Vol.4 No.2

Objectives: To investigate the electrophysiologic mechanism of cataplexy, the authors measured motor evoked potential (MEP) and H-reflex during asymptomatic, cataplectic and post-cataplectic periods in a narcolepsy patient. Methods: For MEP recording, transcranial magnetic stimulation (TMS) was applied to the right and left hemispheres using a Magstim 200 stimulator and a figure of 8-shaped coil. MEP amplitudes in resting state were measured at stimulus intensities of 120 and 150% of resting motor threshold (rMT). H-reflex was elicited by electrical stimuli on a tibial nerve. Results: rMT at baseline was 43% in the right and 39% in the left hemisphere. Mean MEP amplitude at baseline was 1.15 mV at a stimulation intensity of 120% rMT and 1.77 mV at 150% rMT. During a cataplectic episode, MEP amplitude abruptly decreased to 0.15 mV at 120% rMT and 0.18 mV at 150% rMT when the patient began to feel facial weakness and experience difficulty talking; subsequently no MEP was evoked during loss of whole body muscle tone. H-reflexes were well elicited during asymptomatic periods (mean amplitude: 2.55 mV at 10.0 mA) whereas H-reflex amplitude abruptly decreased and then disappeared after a cataplectic attack started. Conclusion: Suppression of both MEP and H-reflex during cataplexy indicates that postsynaptic spinal motor neuron inhibition is the main pathomechanism underlying cataplexy.

TV와 YouTube의 과학영상물 비교연구

한선정 한국언론정보학회 2020 한국언론정보학회 학술대회 Vol.2020 No.11

본 연구에서는 지난 반세기동안 과학 대중화를 위한 커뮤니케이션의 첨병 역할을 해왔던 TV의 위상이 급격히 추락하고, 이탈한 시청자들이 유튜브로 이동하는 현재, 유튜브를 통해 과학기술 이라는 이름으로 제작 유통 소비되는 콘텐츠들은 어떤 메시지를 전달하고 있으며, 그것은 TV시 대의 메시지와 어떻게 달라지고 있는가를 탐구한다. 이를 위해 2020년 상반기에 방송된 TV 과 학프로그램으로 <신기한 과학나라>(tvN)와 <뇌로 보는 인간>(EBS) 시리즈를, 유튜브 콘텐츠로 는 구독자 순 상위 30위 이내 과학기술채널의 인기 동영상 가운데 주제적합도가 높은 176개 영 상을 선정해 과학기술의 맥락과 활동에 따라 비평형, 활동형, 해설형으로 분류하고 다중사례연 구와 내용분석을 실시하였다. 분석 결과 유튜브 영상물은 기존TV 과학영상물의 범주를 부분적 으로 확장하고 있었으나 이들 가운데 절반은 단순 생활 정보이며, 특정 주제와 소재가 여러 채널 에서 반복 소개되고, 직접 생산한 과학지식이 매우 제한적이라는 점이 발견되었다. 이는 유튜브 를 통해 ‘과학기술’의 외연은 확장되었지만 내용은 축소되었다는 사실을 시사한다. 또한 과학기 술 채널에서 제공하는 비 과학 콘텐츠가 20%에 달했는데 이들의 조회수가 전체 조회수의 48% 를 차지하고 있다는 점은 과학기술 채널의 전문성에 의문을 제기하게 한다. 이러한 내용을 탐구하는 과정에서 유튜브 과학기술 콘텐츠를 정확하게 이해함으로써 TV 프로 그램이 어떻게 차별화된 경험을 제공할 것인가에 대한 전략의 단초를 제공하며, 한발 더 나아가 유튜브를 활용해 올바른 과학적 태도와 심도 있는 과학지식을 전달하고자하는 관련기관, 과학문 화의 지평을 넓히고자 하는 과학단체에게도 실용적인 제언을 제공할 것이다.

한림 뇌졸중 등록 자료에서 후방 순환계 뇌졸중의 임상양상

한선정 대한뇌졸중학회 2003 Journal of stroke Vol.5 No.2

Department of Neurology, Hallym University College of MedicineBackground & Objective: Studies of the subtypes and etiologies of cerebral infarction have been largely limited to the anterior circulation. To better understand clinical patterns, risk factors and subtypes of posterior circulation disease, we analyzed both clinical and imaging data of Hallym Stroke Registry. Methods: We investigated demographic features, risk factors, stroke subtypes, lesion distributions and clinical outcomes of 542 cases (36.5%) of ischemic stroke in posterior circulation enrolled at Hallym Stroke Registry between January 1996 and July 2002, which included totally 1,486 cases with acute ischemic stroke. Stroke subtypes were categorized as large-artery atherosclerosis (LAA), small vessel occlusion SVO), cardioembolism(CE), stroke of other determined etiology(SOE), and stroke of undetermined etiology(SUE). The location of brain lesion was categorized as proximal, middle, and distal intracranial posterior circulation territory. Results: Age and gender of ischemic stroke in posterior circulation were comparable to those of ischemic stroke in anterior circulation. The most frequent stroke subtype in posterior circulation disease was LAA(51.8%), followed by SVO(32.7%), SUE(8.5%), CE 5.0%) and SOE(2.0%). Hypertension was found in 68.8%, smoking in 32.1%, diabetes mellitus in 29.7%, a history of previous stroke in 20.8%, hyperlipidemia in 24.4%, cardioembolic sources in 10.7%, respectively. The most common location of infarcts was in the middle territory (40.0%), followed by distal (28.1%), proximal (20.2%), and multiple territories (11.7%). The outcomes at discharge and in-hospital mortality of posterior circulation disease were similar to those of anterior circulation disease. Conclusion: In Hallym Stroke Registry, posterior circulation disease comprised of 36.5%. The distribution of stroke mechanisms and lesion location of posterior circulation disease were different from those of the western country. The clinical outcome of posterior circulation disease was not worse than that of anterior circulation disease.

로컬 아카이브 구현을 위한 미술의 공공성과 지역성

한선정 ( Seon Jeong Han ) 한국기초조형학회 2016 기초조형학연구 Vol.17 No.1

냉전체제가 무너진 이후 일련의 사건들은 기존 가치에 대한 재논의를 요구하고 있다. 그리고 그 논의의 중심에는 기존의 아카이브에 대한 재고와 공감의식, 주목받지 못한 지역(local)의 문제들이 자리하고 있다. 이러한 가운데 예술계 역시 예술이 단순한 자본의 교환가치나 소유가치를 넘어 지역이 직면한 문제에 대해 고민하고, 삶의 현장 안에서 보다 더 많은 이들과 공감하며 공공의 역할을 수행하고 지역의 정체성을 확인시키기 위해 노력하여야 한다는 입장을 취하고 있다. 이에본 연구는 미술이 자본의 교환가치를 넘어 삶을 투영하고, 많은 이들과 소통하며 보다 더 객관화된 공적의미를 만들어 낼수 있다는 전제에서 출발해 로컬 아카이브를 구성하는데 있어 부드럽지만 강한 통로가 될 어 줄 수 있음을 확인하려 하였다. 그 사례로 필자가 생활하고 있는 대구와 그 인근 생활권의 문제를 다루고 있는 CMCP프로젝트, Navigation ID, 방천시장예술프로젝트를 살펴보았다. 이러한 예를 통해 아카이브 구성과정의 중요성을 확인하였고 미술이 당연한 듯 여겼던 내 주변의 일상적 사물들, 완전한 것처럼 마무리 된 지역의 사건의 결과들에 대해 멈추어 들여다보게 하고, 새롭게 사유하도록 이끄는 것은 물론이며, 아카이브 구성에 유연하게 접근해 시민들과 함께 많은 층리를 만들어 낼 수 있음을 확인하였다. 결과적으로 본 연구를 통해 자본주의가 주도하는 세계화의 흐름 안에서 미술이 자본의 교환 가치가 아닌 우리가 생활하는 지역 사회를 바르게 이해하는 통로로서의 기능을 피력함으로서 미술이 사회를 이해하고 견재하는 하나의 성명서(statement)가 되어줄 필요성을 상기 시키는데 의의를 갖는다. The sequence of events with the cold war over asks us to discuss the existing values. In the center of the discussion are a concern of re-evaluating about the existing archives and locality that has not been considered. In this circumstance, art scene today has an attitude, in which people care more about problems that their community faces and about establishing the identity of their community while empathizing with others than they care about economic value and value in possession. My study starts with a premise that art in the flow of globalization reflects our lives and is a means to communicate with one another. Therefore, it can function as a tender, but strong passage, through which an objective, public meaning can be created to establish a good local archives. In my thesis I’ve given examples, such as Bangcheon Art Market Project in Daegu where I live, CMCP Project, and Navigation ID as good cases that have been developed as a good local archives. Through these examples, I’ve pointed out that the process of establishing a good archives is very important. Also, I’ve been able to examine my daily lives, in which I’ve taken art for granted, and local events that seemed to have been finished successfully. Moreover, I’ve found out that I could lead local people to put a new perspective on art and that there are ways to establish an archives more flexibly. As a result, through my thesis, I try to focus on a function of art featuring with understanding our community better beyond capitalistic economic value, so that I can remind people of the need for art as a good statement to keep the society in check.

임상 추론: 간헐적인 의식 손상 때문에 내원한 23세 남자

신용원,한선정,정기영 대한신경과학회 2019 대한신경과학회지 Vol.37 No.3

저혈당성 뇌증환자에서 보인 복합 간질성 안구운동

김영진,한선정,양현덕 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

간질성 경련 환자에서 보이는 이상 안구운동으로는 안진, 공액성 안구 편위, 및 스큐변위 등이 있다. 대뇌의 일측성 병변에 의한 간질에서 나타나는 전형적인 수평성 안진과는 달리, 양측성 대뇌 병변에 따른 추적운동명령의 이상 조합은 다양한 방향으로 무질서한 안구 운동을 일으킬 수 있으나 이러한 안구 운동은 아직까지 문헌에 보고된 바는 없어 이를 보고하고자 한다. 당뇨를 앓고 있는 75세 여자 환자가 반복적인 전신성 강직간대 발작에 이은 반 혼수 상태로 내원하였다. 환자의 안구는 여러 방향으로 무질서하게 움직이는 공액성 운동을 간헐적으로 보였으며, 이러한 안구 운동은 페니토인 정주 후에 현저히 감소하였다. 뇌파검사에서 주기성 간질성 방전을 보였다. 대뇌의 추적운동 영역을 자극하면 서상의 안구 운동을 발생시킬 수 있으므로, 복합성 안구운동이 나타나는 기전은 양측 대뇌에서의 추적운동명령이 부적절한 조합을 이루기 때문이라고 유추할 수 있다. Epileptic eye movements usually occurs as nystagmus. Although it is theoretically possible that abnormal combination of pursuit commands from both hemispheres can generate multidirectional chaotic eye movements, this form of epileptic eye movement has not yet been described. We report an unusual case of complex epileptic eye movements associated with hypoglycemia. A 75-year-old diabetic woman presented with repeated episodes of generalized tonic-clonic seizures due to hypoglycemia. The patient's eyes showed conjugate, multidirectional and chaotic movements which occurred intermittently and ceased after infusion of phenytoin.