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적절한 치료를 받은 결핵성 뇌막염 환자에게서 하지마비로 나타난 신경근 척수염 1예
신대수,이영주,김진석,박현영,장혁,김요식,조광호 대한임상신경생리학회 2005 Annals of Clinical Neurophysiology Vol.7 No.1
Tuberculous radiculomyelitis (TBRM) is a complication of tuberculous meningitis (TBM), which has been reported rarely in the modern medical literature. We describe a case of TBRM, which developed during the treatment of TBM. A 28-year-old man suddenly developed lower back pain, flaccid paraparesis, urinary incontinence, while the TBM was improving with the treatment at 9th day after admission. Spinal MRI revealed leptomeningeal enhancement along with thoracolumbar spinal canal, thickening of nerve roots, spinal meninges and intramedullary high signal lesion in T2 level
신대수 대한뇌졸중학회 2002 Journal of stroke Vol.4 No.1
Background : Predictors of recurrence after ischemic stroke are well known, but factors influencing on severity of recurrent stroke are not well known. The determinants of recurrent stroke severity will be of increasing importance because the frequency of ischemic stroke survivors increases in our population. Methods : Our, subjects included recurrent stroke patients who were admitted to the Chonnam Stroke Center between January 1997 and April 2001. Patients who had intracranial hemorrhage, vertebrobasilar insufficiency or transient ischemic attack were excluded. The severity of recurrent stroke was measured on admission by National Institutes of Health Stroke Scale(NIHSS) score and Modified-Barthel Index(MBI) score. We analyzed association of severity of recurrent stroke with confounders such as the way of secondary prevention, lesion laterality, type of ischemic stroke, risk factors of ischemic stroke by multiple linear regression. Results : Subjects were 63 patients(43 men and 20 women, aged 61.8¡¾11.5). The significant predictors of severity were medication of antiplatelet agent or anticoagulant(p〈0.01) and lesion laterality of recurrent stroke(p〈0.01). The severity of recurrent stroke was milder in patients who sustained medication(N=42) than who quitted medication(N=21). The severity of patients who had ipsilateral lesion(N=32) was milder than with had contralateral lesion N=31). Conclusions : The most significant independent predictor of the severity of recurrent stroke was whether medication was sustained or not. There fore, secondary prevention is extremely important for long term functional outcome of stroke victims. Korean Journal of Stroke 2002;4(1): 30~35
『삼국사기』를 통해 본4∼5세기 중부지역 삼국 영역변천에 관한 연구
신대수 강원대학교 인문과학연구소 2022 인문과학연구 Vol.- No.73
The 4th and 5th centuries were a very important period for Silla, Goguryeo, andBaekje to grow as a nation on the Korean Peninsula. Therefore, there are manyprevious research achievements. However, most of the studies are for the purpose ofdetermining the name of the event or the old place name, and it is insufficient tounderstand the change of the Three Kingdoms or the flow of the times. In this study,based on the record of 『Samguksagi』, we intend to investigate the phenomenon ofterritorial change in the central region. The area where Goguryeo and Baekje had a fierce territorial dispute in the earlydays was between the Yeseonggang and the Imjingang, but it is judged that theterritory of Goguryeo did not come down to the south of the Yesonggang until the4th century, and that it expanded to the Namhangang in the 5th century. Baekje’s national power grew under the control of Malgal and Nakrang, and afterthe fall of Daebanggun, there was a battle with Goguryeo to occupy the territory inearnest. There was a dispute over power territory, and from the middle of the 4thcentury, when Goguryeo began to move south, Baekje blocked the power ofGoguryeo, but until the 4th century, the territory did not go beyond the Imjingang,and in the 5th century, it dominated the Namhangang and the Chungbuk region. It was not until the 5th century that the area was extended to the Namhangang. In this study, we tried to examine the changes in the central region of the ThreeKingdoms by reviewing the views so far and judging the regions by dividing the 4thto 5th centuries. 4∼5세기는 신라·고구려·백제가 국가로 성장하는 매우 중요한 시기였다. 따라서 많은 선행연구 성과도 있다. 그러나 대부분의 연구가 사건 또는 고지명을비정하기 위한 연구 등 부분적 연구로 삼국의 변화를 파악하는데 부족하다. 본 연구에서는 『삼국사기』 기록을 바탕으로 중부지역의 영역변천에 관한 현상을 알아보고자 한다. 고구려와 백제가 초기 영유권 다툼이 심했던 지역은 예성강과 임진강 사이였지만 4세기까지 고구려의 영역은 예성강 이남으로 내려오지 못했던 것으로 판단되고, 5세기에는 고구려의 영역이 남한강까지 확장되었던 것으로 판단된다. 백제는 말갈과 낙랑의 견제를 받으며 국력이 성장 되었고 대방군이 멸망한이후 고구려와 본격적으로 영역을 차지하기 위한 전투가 있었지만, 고구려와백제가 충돌하기 전에 백제는 낙랑이나 말갈하고 지금의 임진강과 한강을 사이에 두고 영역 다툼이 있었고, 고구려가 남하하기 시작한 4세기 중반 이후부터 백제는 고구려와 대치하였으나 4세기까지 백제의 영역은 임진강을 크게 넘지 못하였고 5세기에는 충북지역을 지배했었다. 신라는 남쪽에 위치하여 백제와는 마한이 멸망한 이후 충돌이 많아 4세기에는 고구려와 화친하였고, 5세기에는 백제와 화친하여 고구려의 남하에 공동으로 대응하였다. 신라는 5세기가 되어서야 남한강까지 영역을 확장하였다. 이러한 변천 과정을 4∼5세기로 구분하여 영역을 판단함으로써 삼국의 중부지역에 대한 영역변천을 알아보고자 하였다.
증상이 있는 중대뇌동맥 협착/폐색 질환을 가진 환자의 경두개 초음파에서 관찰되는 혈류전환과 연수막 측부순환의 연관성
신대수,남태승,김태학,박만석,이학승,박현영,김요식,조광호,조기현 대한신경과학회 2007 대한신경과학회지 Vol.25 No.2
Backgroud: To investigate the clinical significance of flow diversion (FD) of the anterior cerebral artery (ACA) or posterior cerebral artery (PCA), a transcranial doppler (TCD) was used in patients with middle cerebral artery (MCA) occlusive disorders. Methods: This is a retrospective study of 51 patients from 1999 to 2001. FD was determined using TCD. Leptomeningeal collateral channels (LMCs) were identified by conventional angiography. The author analyzed the sensitivity, specificity, positive and negative predictability of FD of ACA or PCA to predict the LMCs, and also evaluated the relationship between FD and leptomeningeal collateral circulation. Results: LMC was noted in 41% of patients with M1 (MCA) occlusive disorders. It showed a tendency of increasing prevalence with an increasing degree of M1 MCA stenosis (rho=0.605, p<0.001). FD was noted in 47% of patients with MCA occlusive diseases. It also had a tendency of high prevalence with an increasing degree of M1 MCA stenosis (rho=0.382, p=0.006). To predict the presence of LMCs, FD of ACA or PCA had a sensitivity of 81%, specificity of 76%, positive predictive value of 71% and negative predictive value of 85%. FD of ACA or PCA had a good correlation with LMCs in patients with MCA occlusive disorders (rho=0.568, p<0.001). Conclusions: These results suggest that FD had good sensitivity and specificity to predict the LMCs, and demonstrated that FD was a reliable source of evidence of LMCs in patients with M1 MCA occlusive disorders. Patients with M1 MCA stenosis had heterogeneous hemodynamics in the development of collateral circulation.
박현영,신대수,장혁,김요식,조광호 대한신경과학회 2006 대한신경과학회지 Vol.24 No.4
Acute sensory neuropathy (ASN) is rare and is characterized by acute onset of sensory ataxia, loss of deep tendon reflexes and impaired vibratory and joint position sensations. Similar to Guillain-Barre syndrome (GBS) with prominent sensory ataxia, a few cases of ASN associated with antiganglioside antibodies have been reported. This suggests that a common autoimmue mechanism operates in some cases of ASN and of GBS with sensory ataxia. We report a patient with ASN associated with anti-GD1b IgG antibody.