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Aryun Kim(Aryun Kim),Jeonghwan Lee(Jeonghwan Lee),Hansol Moon(Hansol Moon),Chulhan Kim(Chulhan Kim),Min Young Yoo(Min Young Yoo),Woo Yoon Park(Woo Yoon Park),Won Dong Kim(Won Dong Kim),Young-Seok Seo( 대한방사선종양학회 2023 Radiation Oncology Journal Vol.41 No.2
Purpose: We aimed to determine whether low-dose radiotherapy (LDRT) is effective in patients with Alzheimer disease (AD). Materials and Methods: We included patients according to the following criteria: probable Alzheimer's dementia according to the New Diagnostic Criteria for Alzheimer’s Disease; confirmation of amyloid plaque deposits on baseline amyloid positron emission tomography (PET); a Korean Mini-Mental State Examination 2nd edition (K-MMSE-2) score of 13–26; and a Global Clinical Dementia Rating (CDR) score of 0.5–2 points. LDRT was performed six times at 0.5 Gy each. Post-treatment cognitive function tests and PET-CT examinations were performed to evaluate efficacy. The medication for AD treatment was maintained throughout the study period. Results: At 6 months after LDRT, neurological improvement was seen in 20% of patients. Patient #2 showed improvement in all domains of the Seoul Neuropsychological Screening Battery II (SNSB-II). Moreover, the K-MMSE-2 and Geriatric Depression Score-Short Form scores improved from 20 to 23 and from 8 to 2, respectively. For patient #3, the CDR score (sum of box score) improved from 1 (4.0) to 1 (3.5) at 3 months follow-up. Moreover, the Z scores for language and related functions, memory, and frontal executive function improved to -2.56, -1.86, and -1.32, respectively at the 6-month follow-up. Two patients complained of mild nausea and mild hair loss during LDRT, which improved after treatment. Conclusion: One of the five patients with AD treated with LDRT experienced a temporary improvement in SNSB-II. LDRT is tolerable in patients with AD. We are currently under follow-up and will conduct cognitive function tests after 12 months after LDRT. A large-scale randomized controlled trial with a longer follow-up period is warranted to determine the effect of LDRT on patients with AD.
Park, Hee Sue,Kim, Aryun,Shin, Kyeong Seob,Son, Bo Ra Korean Society of Medical Genetics and Genomics 2021 대한의학유전학회지 Vol.18 No.1
Purpose: To summarize the results of chromosomal microarray analysis (CMA) for copy number variants (CNVs) detection and clinical utility in a single tertiary hospital. Materials and Methods: We performed CMA in 46 patients over the course of two years. Detected CNVs were classified into five categories according to the American College of Medical Genetics and Genomics guidelines and correlated with clinical manifestations. Results: A total of 31 CNVs were detected in 19 patients, with a median CNV number per patient of two CNVs. Among these, 16 CNVs were classified as pathogenic (n=3) or likely pathogenic (LP) (n=11) or variant of uncertain significance (n=4). The 16p11.2 deletion and 16p13.11 deletion classified as LP were most often detected in 6.5% (3/46), retrospectively. CMA diagnostic yield was 24.3% (9/37 patients) for symptomatic patients. The CNVs results of the commercial newborn screening test using next generation sequencing platforms showed high concordance with CMA results. Conclusion: CMA seems useful as a first-tier test for developmental delay with or without congenital anomalies. However, the classification and interpretation of CMA still remained a challenge. Further research is needed for evidence-based interpretation.
Yu Jin Jung,Aryun Kim,Luis E. Okamoto,Woi-Hyun Hong 대한신경과학회 2023 Journal of Clinical Neurology Vol.19 No.2
Background and Purpose Neurogenic orthostatic hypotension (nOH) is one of the most important nonmotor symptoms in patients with α-synucleinopathies. Atomoxetine is a selective norepinephrine transporter blocker that is a treatment option for nOH. This systematic review and expert focus-group study was designed to obtain evidence from published data and clinical experiences of Korean movement-disorder specialists about the efficacy and safety of atomoxetine for the pharmacological treatment of nOH in patients with α-synucleinopathies. Methods The study comprised a systematic review and a focus-group discussion with clinicians. For the systematic review, multiple comprehensive databases including MEDLINE, Embase, Cochrane Library, CINAHL, PsycInfo, and KoreaMed were searched to retrieve articles that assessed the outcomes of atomoxetine therapy. A focus-group discussion was additionally performed to solicit opinions from experts with experience in managing nOH. Results The literature review process yielded only four randomized controlled trials on atomoxetine matching the inclusion criteria. Atomoxetine effectively increased systolic blood pressure and improved OH-related symptoms as monotherapy or in combination with other drugs. Its effects were pronounced in cases with central autonomic failure, including multiple-system atrophy (MSA). Atomoxetine might be a safe monotherapy regarding the risk of supine hypertension. Conclusions Atomoxetine is an effective and safe option for short-term nOH management, which could be more evident in patients with central autonomic dysfunction such as MSA. However, there is a paucity of evidence in the literature, and data from the focus-group discussion were inadequate, and so further investigation is warranted.
리슈만편모충은 어떻게 ‘하나의 유럽’에 균열을 가했는가?: ‘인간 너머의 위험경관’의 시각에서 바라본 코스모폴리타니즘의 한계
황진태(Jin-Tae Hwang),김민영(Minyoung Kim),배예진(Yejin Bae),윤찬희(Chanhee Yoon),장아련(Aryun Chang) 대한지리학회 2019 대한지리학회지 Vol.54 No.3
본 연구는 ‘인간 너머의 위험경관’의 시각에 기반하여 인간과 비인간 간의 역동적인 상호작용에 의하여 오늘날 유럽사회가 ‘하나의 유럽’을 구축하기 어렵게 만드는 균열과 긴장을 밝히고자 리슈만편모충증 논란을 탐색한다. 구체적인 연구초점은 다음과 같다. 첫째, 인간과 비인간(nonhuman)의 상호작용에 주목하는 인간 너머의 지리학의 시각에서 리슈만편모충증을 발병하게 한 다중적 원인과 발생경로를 파악한다. 둘째, 유럽사회에서 발생한 관련 전염병의 원인을 난민으로만 귀속하려는 특정한 위험경관이 정치적, 사회적으로 구성되었음을 밝힌다. 결론적으로 유럽사회가 지향해왔던 코스모폴리타니즘의 실현을 위해서 인간은 인간중심주의로부터 벗어나 인간과 비인간 사이에 벌어져 있는 인식론, 존재론적 틈을 줄여나가려는 긴 여정을 밟아야 하며, 그 여정에서는 비인간에 대한 관심뿐만 아니라 특정 사회집단을 타자화하려는 인간 내부의 비인간성에 대한 성찰이 요구되어야 함을 강조한다. Through the lens of more-than-human riskscapes, this paper aims to reveal that European society has a difficult time constructing ‘One Europe’ due to unexpected human-nonhuman interactions beyond anthropocentrism such as a controversy surrounding leishmaniasis disease in Europe after Syrian refugees. Detailed research focuses are as follows. First, through the more-than-human perspective that recognizes the world that is incessantly composed by dialectic interactions between human and nonhuman actors at multiple scales, we track the causes and spread of the disease. Second, we ascertain that a dominant riskscape that attributes the cause of the disease to Syrian refugees alone is politically and socially constructed by particular social forces. Consequently, we argue that the concept of more-than-human riskscapes must be considered carefully for realizing cosmopolitanism while recognizing not only nonhuman actors but also the aspect of less-than-human geographies within us.