운동신경원성 질환에 대한 임상적 고찰

임정근,이동국,김광수,이상도,박영춘 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3

Clinical features, electromyographic findings and the prognosis were observed in 51 patients (33 men and 18 women) who were diagnosed as acquired motor neuron disease at Keimyung University Dongsan Hospital between Jan. 1985 and Aug. 1992. The mean age at onset in our study was similar to that in several other domestic studies but was younger than that in western studies. The therapeutic effect of L-threonine couldn't be evaluated correctly, but L-threonine may have no effect on the course of MND.

요 통

임정근 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.2

혼합치열기의 miniscrew를 이용한 교정치료

임수민,양연미,김재곤,백병주,이용훈,신정근 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.2

Anchorage plays an important role in orthodontic treatment, Skeletal anchorage like the miniscrew is considered a more effective method in anchorage control than conventional anchorage which needs much patient s cooperation. The miniscrew offers many advantages. 1) It is easy to insert and to remove. 2) It can endure the force needed for moving teeth. 3) It can be immediately loaded and 4) Patient cooperation is not needed. 5) It is economic compared to other skeletal anchorage systems, In comparison to adult's bones, children s bones have comparatively poor bone quality and quantity. Therefore, it is hard to obtain primary stability in younger patients. However, if the miniscrew can be retained successfully, it will be effective in many orthodontic treatments. In these cases we used the miniscrew in correcting of diastema, in aligning dental midline, and in rendering a forced eruption of impacted tooth in mixed dentition patient. We obtained satisfactory results. 교정치료 시 고정원은 항상 염두에 두면서 치료를 진행해야 하는 중요한 요소이다. 전통적인 고정원을 이용한 치료는 환자의 적극적인 협조를 필요로 하고 원하는 치아이동에 대한 반작용이 나타날 수 있는 등의 부작용을 가지고 있다. 그러므로 보다 견고한 구강 내 고정원이 요구되어져 왔으며 이를 위해 miniscrew가 임상에서 흔히 이용되고 있다. Miniscrew를 통한 고정원의 확보는 구외력 의존도 감소,치료기간의 단축,식립 후 즉시 교정력 적용,환자의 협조도 불필요,식립의 간편성,저렴한 비용 등의 장점을 가지고 있다. 그러나 성장기 환자는 성인에 비해 골질이 좋지 않아 miniscrew의 성공률이 성인에 비해 낮다. 그러나 일단 고정에 성공하면 많은 교정치료 시 매우 유용하게 이용할 수 있다. 본 증례는 흔합치열기 환자를 miniscrew를 이용하여 정중이개 및 정중선 불일치,매복치에 대한 양호한 교정치료를 하였기에 보고하는 바이다.

교흔으로 인해 발생한 Eikenella corrodens 간농양 1예

고근준,이은재,최형섭,김상수,최정은,임환섭,김준명,이꽃실 대한감염학회 2004 감염과 화학요법 Vol.36 No.2

E. corrodens는 면역저하 환자에서 주로 문제를 일으키며, 감염시 두경부, 폐, 복부 등에 위험을 초래할 수 있어 치료의 적절성에 대한 중요성이 부각되고 있다. Eikenella corrodens는 균 동정을 위해 CO₂의 공급을 필요로 하며 서서히 자라는 특성상 까다로운 배양조건을 필요로 하는 균주이다. 혐기성 균주이지만 metronidazole이나 clindamycin과 같은 항균제에는 반응을 안하는 특이한 항생제 감수성에 의해 보편적인 구강내 상재균에 대한 경험적 치료에 실패할 수 있다. 치료에 있어 잘못된 초기 항생제 선택이나 외과적 시술이 적절히 시행되지 않은 경우에 치료실패의 요인이 될 수 있으므로 적절한 항생제 사용과 함께 외과적 처치가 동반되어야 한다. 저자들은 정상 면역력을 가진 성인에서 사람에게 물리고 난 후 발생한 E. corrodens에 의한 간농양의 적절한 치료의 결과를 문헌고찰과 함께 보고하는 바이다. Eikenella corrodens is a slow growing, facultatively anaerobic gram-negative rod that is part of the normal flora of the oral cavity and upper respiratory tracts. In most patients with E. corrodens infections, host defenses are compromised due to surgery, or chronic debilitating illness such as malignancies, or immunosuppressive therapy. This organism causes abscesses and infections that are at times fatal. We experienced a case of E. corrodens isolated from liver abscess in an immunocompetent patient. A 50-year-old man who is a dentist, was hospitalized because of fever and myalgia of 10 days' duration. Abdominal ultrasonography showed non-septated, 3.8×4.6 ㎝ sized abscess in the segment 6/7 of the liver. E. corrodens was isolated from aspiration of liver abscess. This organism was presumably acquired from his patient's oral cavity during dental procedure. We hope that increased awareness to E. corrodens will raise the index of suspicion, and contribute to optimal management of these infections, minimizing the significant morbidity associated with this organism.

한국인 파킨슨병에서 Monoamine Oxidase B 유전자와 Cytochrome P450IID6 유전자의 다형성

이용희,임정근,이상도,이영재 대한신경과학회 1999 대한신경과학회지 Vol.17 No.1

장기간 항경련제 투여 환자에게서의 신경전도 속도

박영춘,이동국,임정근,이상도,이형 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3

This study was performed to verify whether or not chronic anticonvulsants therapy(≥12 months ) is associated with peripheral nerve dysfunction in epileptics. Nerve conduction studies were done to 51 epileptics who had been taking long term anticonvulsants therapy over 12 months. The mean age of epileptics was 23 years, and was composed of 29 men and 22 women. The mean nerve conduction velocity(NCV) was not significantly different between epileptics and controls. Compared phenytoin or carbamazepine monotherapy group with controls, the NCV was not significantly different in two groups respectively. In epileptics, the mean NCV was not significantly different between phenytoin and carbamazepine monotherapy group. There was no significant relationship between NCV and duration of therapy with either phenytoin or carbamazepine. In epileptics with phenytoin combined therapy, the mean median sensory NCV was significantly delayed than in those with phenytoin monotherapy.

뇌자기공명영상촬영술상 병변을 관찰할 수 없는 허혈성 뇌경색

김진석,김태완,임정근 啓明大學校 醫科大學 1998 계명의대학술지 Vol.17 No.4

1. 임상적으로 뇌졸중이 의심되어 증상 발생후 24시간에서 2개월까지 Brain MRI을 실시한 722명의 환자들 중 결과가 가음성인 환자는 모두 22명 (3.1%)이었다. 2. Brain MRI상 병변은 관찰되지 않으나 임상 양상 및 신경학적 이상 소견으로 추정되는 병변의 위치를 구분해 보면 뇌간부가 13명 (59%)으로 가장 많았고, 피질하부 8명 (36%), 피질 1명 (4.5%)의 순 이었다. 3. 대뇌혈관 (large cerebral artery)폐쇄 보다는 분지 동맥 (branch artery)이나 소 관통동맥 (small perforating artery)의 폐쇄에 의한 것으로 추정되는 허혈성 뇌경색의 병변의 빈도가 높았다. 4. 병력, 뇌졸증 위험 인자, 임상 양상, 심전도 검사, 심초음파 검사 및 뇌혈관조영술등에서 혈전성 뇌경색은 12명 (55%), 색전성 뇌경색은 3명 (13%), 원인이 확실하지 않은 경우는 7명(32%)으로 혈전성 뇌경색의 빈도가 뚜렷하게 높았다. 5. T1강조 영상, T2,강조 영상 및 FLAIR sequence를 같이 실시함으로써 허혈성 뇌경색의 조기 발견은 과거의 연구 보고에 비하여 상당히 높아졌으나 계속적으로 Brain MRI상 가음성인 허혈성 뇌경색이 있음으로, 허혈성 뇌경색의 조기 진단에는 새로운 기법인 확산강조 자기공명영상, 관류강조 자기공명영상, 자기공명 분광경 등의 다른 특수한 Brain MRI이 필요할 것으로 생각되며, 항상 신경학적인 검사를 통한 임상적인 진단이 선행되어야 한다. Background : Brain magnetic resonance imaging (MRI) is more sensitive than computed tomography in the diagnosis of acute ischemic stroke, but may not visualize all acute ischemic stroke. For deeper understanding of MRI negative strokes, we reviewed case histories, abnormal neurological finding, and localized ischemic lesions presumedly which were not present in brain MRI scans. Methods : Patients with a clinically definite first ischemic stroke and absence of corresponding lesion in brain MRI scans were studied retrospectively with hospital records dating from January 1994 to November 1996 and prospectively from December 1996 to August 1997. Patient with transient ischemic stroke, postictal paralysis, central nervous system infection, demyelinating disease, hemiplegic migraine, functional or hysterical cause, multiple cerebral infarction, scans within 24 hours and equivocal findings were excluded. Brain MRI was scanned with T2WI, T1WI and FLAIR sequence. Results: We studied 722 patients with clinically diagnosed definite acute ischemic stroke during the study period and identified 22 patients (3.1%) with the absence of corresponding lesion in brain MRI scan. The ischemic strokes without brain lesions on MRI scan were clinically localized to the brain stem (n=13, 59%), subcortex (n=8, 36%) and in the cortex (n=1, 4.5%). Perforating arterial and thrombotic ischemic lesions seemed to be more common than large arterial & embolic lesions. Risk factors was not different between MRI positive and MRI negative ischemic stroke. Summary: Acute ischemic stroke with absence of brain lesion in MRI scans is more common in brain stem and subcortex than in the cortex. There is some potential limitation of standard MRI scan for diagnosis of acute ischemic stroke, therefore further scans with new imaging studies such as perfusion/diffusion weighted magnetic resonance imaging are required in selected cases.

간질환자에서 장기간 항 경련제 치료시 뇌간청각유발전위의 변동

박영춘,이동국,임정근,이상도,이형 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.2

저자들은 만성적인 항경련제 투여가 간질환자들의 청신경계에 미치는 영향을 조사하기 위하여 장기간(12개월 이상)항경련제를 복용한 간질환자 51례를 대상으로 이학적 진찰 및 BAEP검사를 실시하고 정상인의 성적과 비교하여 다음과 같은 결과를 얻었다. 장기간 항경련제를 복용한 간질환자의 BAEP검사의 평균 절대 및 파간잠복기는 대조군과 비교하여 유의한 차이가 없었다. Phenytoin단독투여군의 절대 및 파간잠복기는 대조군에 비해 유의한 차이가 없었다. Carbamazepine단독투여군의 I-III파간잠복기는 대조군과 phenytoin단독투여군에 비해 유의하게 연장되었다(p 0.01). Phenytoin단독투여군과 carbamazepine단독투여군에서 항경련제의 복용기간과 BAEP의 절대 및 파간잠복기사이에는 유의한 관계가 없었다. Phenytoin단독투여군과 phenytoin병합투여군에서 각파의 절대 및 파간잠복기는 서로 유의한 차이가 없었다. 이상의 결과로 볼 때 장기간 항경련제를 복용한 간질환자에서 BAEP의 평균 절대 및 파간잠복기는 정상대조군과 비교하여 유의한 차이가 없었고, 항 경련제의 복용기간에 따른 절대 및 파간잠복기의 유의한 변화가 없는 것으로 생각되었다. This study was performed to verify whether or not chronic anticonvulsansts therapy(≥12 months) is associated with brainstem auditory pathway dysfunction in epileptics. Brainstem auditory evoked potentials were done to 51 epileptics who had been taking long term anticonvulasant. The results were summarized as follows. The mean absolute and interpeak latencies were not significantly different between epileptics and controls. The mean absolute and interpeak latencies were not significantly different between epileptics with phenytoin monotherapy and controls. The mean Ⅰ-Ⅲ interpeak latency of carbamazepine monotherapy was significantly delayed than that of phenytoin monotherapy or controls. There was no significant relationship between latency of BAEP and duration of therapy with either phenytoin or carbamazepine. In epileptics with phenytoin combined therapy, the mean absolute and interpeak latencies were not significantly delayed than those of phenytoin monortherapy.

한번의 간질발작 후 혈청 Neuron-Specific Enolase 농도 변화

최승호,박영춘,이장준,임정근,김지언,이상도 啓明大學校 醫科大學 1999 계명의대학술지 Vol.18 No.4

An increase in neuron-specific enolase (NSE) levels in serum and CSF has been shown to be an useful marker of brain damage after stroke, global ischemia, and coma. We report the changes of serum NSE levels after seizure attacks in epileptic patients compared with the levels in normal controls and epileptic patients without seizure attack at least 7 days (epileptic controls). Twenty-four seizures were included in this study. Blood was drawn within 1 hour, at 12 hour, 24 hour, and 48 hour after seizure attack. Serum NSE levels were measured with radioimmunoassay. The mean NSE levels for normal controls and epileptic controls were 6.94 ng/ml and 7.46 ng/ml, respectively. There were significant increase in level of serum NSE measured within 1 hour after seizure attack in epileptics compared with the level in normal controls (15.10ng/ml versus 6.94ng/ml, p<0.05) and epileptic controls (15.10ng/ml versus 7.46ng/ml, p<0.05). Serum NSE measured at 12 hours after seizure also increased compared with normal controls (12.32ng/ml versus 6.94ng/ml, p<0.05) and epileptic controls (12.43ng/ml versus 7.46ng/ml, p<0.05). Between normal controls and epileptic controls, there were no significant difference in serum NSE levels. We conclude that serum NSE level was elevated in epileptic patients who had seizure attack within 12 hours. Serum NSE levels can be useful marker for seizure within 12 hours after onser. The elevated serum NSE level after single seizure attack may suggest that the brain was injured in single seizure.

후두부 발작성 간질파와 동반된 양성 소아기 간질의 임상적 연구

유영수,이상도,김지언,임정근,박영춘 대한신경과학회 1996 대한신경과학회지 Vol.14 No.4