철결핍성 빈혈과 동반된 심부뇌정맥 혈전증

정필욱,홍석찬,이광호,정진상 대한신경과학회 1999 대한신경과학회지 Vol.17 No.5

25-Hydroxyvitamin D Status Is Associated With Chronic Cerebral Small Vessel Disease

Chung, Pil-Wook,Park, Kwang-Yeol,Kim, Jeong-Min,Shin, Dong-Woo,Park, Moo-Seok,Chung, Yun Jae,Ha, Sam-Yeol,Ahn, Suk-Won,Shin, Hae-Won,Kim, Yong Bum,Moon, Heui-Soo American Heart Association, Inc. 2015 Stroke Vol.46 No.1

<P><B>Background and Purpose—</B></P><P>The aim of this study was to determine the association between 25-hydroxyvitamin D (25(OH)D) and neuroimaging correlates of cerebral small vessel disease.</P><P><B>Methods—</B></P><P>We identified 759 consecutive patients with acute ischemic stroke or transient ischemic attack. Lacunes, white matter hyperintensity, and cerebral microbleed (CMB) were assessed using MR images. Deep CMB was defined as the presence of CMB in basal ganglia, thalamus, or brain stem. The association between 25(OH)D and small vessel disease was tested using linear and logistic regression analyses.</P><P><B>Results—</B></P><P>Mean age was 68 (±13) years. Mean level of 25(OH)D was 34.1±17.8 nmol/L. On bivariate analysis, a 25-nmol/L decrease in 25(OH)D was associated with lacunes (regression coefficient, 0.23; 95% confidence interval [CI], 0.02–0.45), severe white matter hyperintensity (odds ratio, 2.05; 95% CI, 1.41–3.08), and deep CMB (odds ratio, 1.28; 95% CI, 1.01–1.63). Also, 25(OH)D deficiency (≤25 nmol/L) was associated with lacunes (regression coefficient, 0.5; 95% CI, 0.04–0.95), severe white matter hyperintensity (odds ratio, 2.74; 95% CI, 1.31–6.45), and deep CMB (odds ratio, 1.68; 95% CI, 1.03–2.78). The association remained significant even after multivariable adjustment and in the subgroup of previously healthy patients.</P><P><B>Conclusions—</B></P><P>25(OH)D is inversely associated with lacunes, white matter hyperintensity, and deep CMB. Our findings suggest that 25(OH)D is linked to small vessel disease, and in future trials it should be tested whether 25(OH)D supplementation can prevent small vessel disease.</P>

Restless legs syndrome and tension-type headache: a population-based study

Chung, Pil-Wook,Cho, Soo-Jin,Kim, Won-Joo,Yang, Kwang Ik,Yun, Chang-Ho,Chu, Min Kyung Springer Milan 2017 The journal of headache and pain Vol.18 No.1

<P><B>Background</B></P><P>Recent studies have shown a significant association between restless legs syndrome (RLS) and primary headache disorders. Nevertheless, information regarding the association between tension-type headache (TTH) and RLS is limited. This study aimed to investigate the association between RLS and TTH in a population-based sample.</P><P><B>Methods</B></P><P>We selected a stratified random population sample of Koreans aged 19–69 years and assessed them using a semi-structured interview designed to identify RLS, headache type, and clinical characteristics of TTH. We determined the prevalence and clinical impact of RLS in participants with TTH.</P><P><B>Results</B></P><P>Of the 2695 participants, 570 (21.2%) and 142 (5.3%) were classified as having TTH and RLS, respectively. Among the 570 individuals with TTH, 113 (19.8%) also met the criteria for probable migraine (PM). The prevalence of RLS was significantly higher among individuals with TTH than among those with non-headache (6.0% vs 3.6%, <I>p</I> = 0.018). The prevalence of RLS was significantly higher in subjects with TTH who fulfilled PM criteria than in those with non-headache participants (8.0% vs. 3.6%, <I>p</I> = 0.018). However, RLS prevalence in individuals with TTH who did not fulfil PM criteria did not differ from that of participants with non-headache (5.5% vs. 3.6%, <I>p</I> = 0.063). TTH participants with RLS had higher visual analogue scale scores for headache intensity (5.1 ± 2.0 vs. 4.3 ± 1.8, <I>p</I> = 0.038), and higher prevalence of anxiety (20.6% vs. 8.8%, <I>p</I> = 0.022) and depression (14.7% vs. 3.5%, <I>p</I> = 0.002) than TTH participants without RLS. Multivariable analyses revealed that headache aggravation by movement (odds ratio [OR] = 2.4, 95% confidence interval [CI] = 1.1–5.2) and depression (OR = 3.5, 95% CI = 1.1–11.4) were significant indicators of RLS among individuals with TTH.</P><P><B>Conclusions</B></P><P>The prevalence of RLS was higher among individuals with TTH than among those with non-headache. Some clinical presentations varied in accordance with the presence of RLS among participants with TTH.</P><P><B>Electronic supplementary material</B></P><P>The online version of this article (doi:10.1186/s10194-017-0754-x) contains supplementary material, which is available to authorized users.</P>

Carotid Artery Calcification Is Associated with Deep Cerebral Microbleeds

Chung, Pil-Wook,Park, Kwang-Yeol,Kim, Jeong-Min,Shin, Dong-Woo,Ha, Sam-Yeol S. Karger AG 2014 European neurology Vol.72 No.1

<P>Abstract</P><P><B><I>Background/Aims:</I></B> The aim of the present study was to determine the association between arterial calcification and cerebral microbleeds (CMB) relative to their distribution. <B><I>Methods:</I></B> We identified 834 consecutive patients with acute ischemic stroke or transient ischemic attack who underwent CT angiography and susceptibility-weighted imaging. <B><I>Results:</I></B> Internal carotid artery (ICA) calcification and CMB were found in 660 patients (79.1%) and 335 patients (40.2%), respectively. ICA calcification was independently associated with CMB of any location (odds ratio, OR, 2.86, 95% CI 2.01-4.08, p < 0.0001). The association between calcification and deep CMB was stronger (OR 3.51, 95% CI 2.39-5.14, p < 0.0001). However, ICA calcification was not associated with CMB in a strictly lobar area. <B><I>Conclusion:</I></B> ICA calcification is an independent risk factor for deep CMB but not for a strictly lobar CMB. Our findings might contribute to the elucidation of the pathogenesis of cerebral small vessel disease.</P><P>© 2014 S. Karger AG, Basel</P>

Cerebral Arterial Stenosis in Patients with Spontaneous Intracerebral Hemorrhage

Chung, Pil-Wook,Won, Yu Sam The Korean Neurosurgical Society 2017 Journal of Korean neurosurgical society Vol.60 No.5

Objective : Spontaneous intracerebral hemorrhage (ICH) and ischemic stroke share common vascular risk factors such as aging and hypertension. Previous studies suggested that the rate of recurrent ICH and ischemic stroke might be similar after ICH. Presence of cerebral arterial stenosis is a potential risk factor for future ischemic stroke. This study investigated the prevalence and factors associated with cerebral arterial stenosis in Korean patients with spontaneous ICH. Methods : A total of 167 patients with spontaneous ICH were enrolled. Intracranial arterial stenosis (ICAS) and extracranial arterial stenosis (ECAS) were assessed by computed tomography angiography. Presence of ICAS was defined if patients had arterial stenosis in at least one intracranial artery. ECAS was assessed in the extracranial carotid artery. More than 50% luminal stenosis was defined as presence of stenosis. Prevalence and factors associated with presence of ICAS and cerebral arterial stenosis (presence of ICAS and/or ECAS) were investigated by multivariable logistic regression analysis. Results : Thirty-two (19.2%) patients had ICAS, 7.2% had ECAS, and 39 (23.4%) patients had any cerebral arterial stenosis. Frequency of ICAS and ECAS did not differ among ganglionic ICH, lobar ICH, and brainstem ICH. Age was higher in patients with ICAS ($67.6{\pm}11.8$ vs. $58.9{\pm}13.6years$ p=0.004) and cerebral arterial stenosis ($67.9{\pm}11.6$ vs. $59.3{\pm}13.5years$, p<0.001) compared to those without stenosis. Patients with ICAS were older, more frequently had diabetes, had a higher serum glucose level, and had a lower hemoglobin level than those without ICAS. Patients with cerebral arterial stenosis were older, had diabetes and lower hemoglobin level, which was consistent with findings in patients with ICAS. However, patients with cerebral arterial stenosis showed higher prevalence of hypertension and decreased kidney function compared to those without cerebral arterial stenosis. Multivariable logistic regression analyses showed that aging and presence of diabetes independently predicted the presence of ICAS, and aging, diabetes, and hypertension were independently associated with presence of cerebral arterial stenosis. Conclusion : 19.2% of patients with spontaneous ICH had ICAS, but the prevalence of ECAS was relatively lower (7.2%) compared with ICAS. Aging and diabetes were independent factors for the presence of ICAS, whereas aging, hypertension, and diabetes were factors for the cerebral arterial stenosis.

Initial Troponin Level as a Predictor of Prognosis in Patients with Intracerebral Hemorrhage

Chung, Pil-Wook,Won, Yu-Sam,Kwon, Young-Joon,Choi, Chun-Sik,Kim, Byung-Moon The Korean Neurosurgical Society 2009 Journal of Korean neurosurgical society Vol.45 No.6

Objective : It has been suggested that elevated cardiac troponin T (cTnT) level is a marker of increased risk of mortality in acute ischemic stroke and subarachnoid hemorrhage (SAH). However, the association of serum cTnT level and prognosis of intracerebral hemorrhage (ICH) has been sparsely investigated. The aim of this study was to identify the relationship between cTnT level and the outcome in patients with spontaneous ICH. Methods : We retrospectively investigated 253 patients identified by a database search from records of patients admitted in our department for ICH between January 1, 2003 and December 31, 2007. The patients were divided into 2 groups; the patients in group 1 (n=225) with serum cTnT values of 0.01 ng/mL or less, and those in group 2 (n=28) with serum cTnT values greater than 0.01 ng/mL. Results : The serum cTnT level was elevated in 28 patients. There were significant differences in sex, hypertension, creatine kinase-myocardial band, midline shift, side of hematoma, and presence of intraventricular hemorrhage between the 2 groups. Logistic regression analysis identified the level of consciousness on admission, cTnT and midline shift as independent predictors of hospital mortality. Conclusion : Theses results suggest that increased serum cTnT level at admission is associated with in-hospital mortality and the addition of a serum cTnT assay to routine admission testing should be considered in patients with ICH.

재건 금속판 및 골편간 PDS 봉합사 결박술을 이용한 쇄골 간부 골절의 수술적 치료

정필현 ( Phil Hyun Chung ),강석 ( Suk Kang ),황정수 ( Chung Soo Hwang ),김종필 ( Jong Pil Kim ),김영성 ( Young Sung Kim ),박승복 ( Sung Pock Park ),정진욱 ( Jin Wook Chung ) 대한골절학회 2006 대한골절학회지 Vol.19 No.3

목적: 쇄골 간부 골절을 재건금속판으로 고정하고 유리골편에 대해 연부 조직 박리를 최소화하면서 조작이 용이한 골편간 PDS 결박술을 이용하는 치료의 유용성에 대해 알아보고자 하였다. 대상 및 방법: 2001년 3월부터 2004년 5월까지 본원에서 쇄골 간부 전위성 골절에 대해 수술적 치료를 시행한 환자 42예를 대상으로 골절의 분류는 Robinson 등의 분류를 참고하여 단순골절을 A형, 분쇄골절을 B형으로 분류하였으며 A형은 재건금속판을 이용한 내고정을 시행하였고, B형은 부가적으로 PDS를 이용한 골편간 결박술을 시행하였다. 각 골절 형태에 따라 골유합 기간, 견관절 기능 평가, 합병증 등에 대해 후향적으로 조사하였다. 결과: 모든 예에서 골유합이 이루어졌으며 골유합 시기는 A형 골절군에서는 평균 8.6주, B형 골절군에서는 평균 8.9주에 골유합을 보였다. 최종 추시상 Weitzman의 견관절의 기능 평가에서는 양 군에서 통계학적인 유의성은 없었다. 결론: 쇄골 간부의 분쇄골절에서 나비형 골편에 대한 골편간 PDS 봉합사 결박술은 조작이 쉽고 유리 골편의 연부 조직 손상을 최소화하여 골이식술의 필요성을 줄이면서 골유합을 얻을 수 있는 유용한 방법중 하나라고 생각된다. Purpose: We are reporting the result of comminuted midshaft fractures of clavicle treated by reconstruction plate fixation and PDS augmentation easily fixing butterfly fragments with minimal soft tissue dissection. Materials and Methods: We reviewed 42 cases of operatively treated displaced comminuted midshaft fractures of clavicle at our hospital from March, 2001 to May 2004 whom were followed up for more than one year after the operation. According to Robinson classification, we grouped simple fractures as group A, and comminuted fractures as group B. Internal fixation using reconstruction plate has been chosen for type A fracture. Type B has been treated by reconstruction plate fixation with PDS augmentations. Shoulder function, union time and complications has been studied according to the fracture type retrospectively. Results: All cases had complete bone union with average union time of 8.6 weeks for type A and 8.9 weeks for type B. Weitzman functional evaluation did not show significant differences. Conclusion: PDS augmentation in comminuted midshaft fracture of clavicle easily fix the butterfly fragments with least soft tissue damage and lessen the bone graft. Therefore it considered to be one of the available treatment methods for comminuted midshaft fracture of clavicle.

The Effect of Leisure Participation on the Relationship between the Leisure Satisfaction and Perceived Stress : Perspective of US College Students

Chung, Jin-Wook(정진욱),Rhee, Yong-Chae(이용재),Boyd, Joni,Choi, Woong-Bin(최웅빈),Ha, Jae-Pil(하재필) 한국체육과학회 2020 한국체육과학회지 Vol.29 No.4

The purpose of this study was to examine the impact of leisure satisfaction on perceived stress amongst college students. In addition, the moderating effect of the leisure participation level on the relationship between the two variables was examined. A total of 203 usable surveys were collected from college students at mid-size public southeast university in the United States. The results of this study indicated that leisure satisfaction has a negative impact on perceived stress. For the moderating effect of leisure participation level, leisure satisfaction did not have significant negative impact on perceived stress with high-level leisure participation group, whereas it had significant negative impact on perceived stress with low-level leisure participation. The findings of the study would provide meaningful implications for practitioners at college leisure industry as to how to moderate the level of leisure participation.

Free Paper Session : Hepatitis C ; Frequency of killer cell immunoglobulin-Like receptors (KIRs) in Korean patients with chronic HCV infection (초)

( Pil Soo Sung ),( Hee Baeg Choi ),( Su Yeon Kim ),( Sung Woo Hong ),( Chung Hwa Park ),( Myeong Jun Song ),( Chan Ran Yoo ),( Sang Wook Choi ),( Nam Ik Han ),( Tai Gyu Kim ),( Seung Kew Yoon ) 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.3(S)

Methotrexate 저용량 정맥 요법 후 발생된 미만성 백질뇌병증 1예

정필욱,오경미,김한영,문소영,서대원 대한신경과학회 2000 대한신경과학회지 Vol.18 No.1