Metronidazole 중독증: 임상-신경영상 소견의 불일치를 보인 2예

권겸일,이대균,이가현,조경희,이유진,정선주 대한신경과학회 2006 대한신경과학회지 Vol.24 No.6

Metronidazole is an antimicrobial agent widely used for the treatment of trichomoniasis, giardiasis, amebiasis, and anaerobic bacterial infections. It has been reported that metronidazole-induced neurotoxicity is associated with responsible lesions on brain MRI. We report 2 patients with metronidazole-induced neurotoxicity, who had no responsible lesions on brain MRI for their neurological deficits. The pathogenic mechanisms are discussed.

Risk Factors for Falls in Patients with de novo Parkinson’s Disease: A Focus on Motor and Non-Motor Symptoms

권겸일,Mina Lee,Hyunjin Ju,Kayeong Im 대한파킨슨병및이상운동질환학회 2020 Journal Of Movement Disorders Vol.13 No.2

ObjectiveaaWe aimed to identify risk factors for falls in patients with de novo Parkinson’s disease (PD). MethodsaaForty-six patients with de novo PD were retrospectively included in the study. We assessed details on the patients’ motorsymptoms as well as non-motor symptoms using several representative scales for global cognition, depression, fatigue, anddysautonomia. Fallers and non-fallers were identified according to their history of falls during the preceding year. ResultsaaTwenty-two patients (45.8%) with de novo PD had a history of falls. Compared with the non-faller group, the fallergroup exhibited higher scores for postural instability/gait difficulty (PIGD), anxiety, fatigue, total dysautonomia, gastrointestinaldysfunction, and thermoregulatory dysfunction. Moreover, logistic regression analysis showed that falling was positively correlatedwith anxiety and gastrointestinal symptoms but negatively associated with the tremor scores. ConclusionaaOur findings suggest that falling in patients with de novo PD is significantly associated with PIGD/non-tremorsymptoms, anxiety, and gastrointestinal dysfunction.

Clinical Characteristics of Involuntary Movement in Hospitalized Patients

권겸일,이혜미,이선민,고성범 대한파킨슨병및이상운동질환학회 2019 Journal Of Movement Disorders Vol.12 No.1

Objective Neurological symptoms in hospitalized patients are not rare, and neurological consultation for movement disorders is especially important in evaluating or managing those with various movement disorders. Therefore, we investigated a clinical pattern of in-hospital consultations for various movement disorders in a tertiary care university hospital. Methods Over two years, a total of 202 patients (70.7 ± 11.8 years of age) presenting with movement disorders referred to movement disorder specialists were investigated. Results The main symptoms referred by nonneurologists were tremor (56.9%), parkinsonism (16.8%), and gait disturbance (8.9%). The most frequent diagnostic category was toxic/metabolic-caused movement disorder (T/MCMD) (35%) with regard to medications, followed by Parkinson’s disease (PD) (16%). Regarding the mode of onset, T/MCMD was the leading cause for acute (68%) and subacute onset (46%), while PD was the leading disorder (31%) for chronic onset. Conclusion The current study showed a characteristic pattern of inpatients presenting with movement disorders. Furthermore, our findings highlighted the clinical significance of drug use or metabolic problems for treating this patient population. Key Words: Consultation; hospital; inpatients; movement disorder; tremor

Cognition and Visit-to-Visit Variability of Blood Pressure and Heart Rate in De Novo Patients with Parkinson’s Disease

권겸일,표선종,이혜미,서우근,고성범 대한파킨슨병및이상운동질환학회 2016 Journal Of Movement Disorders Vol.9 No.3

Objective We sought to identify whether the characteristics of long-term visit-to-visit blood pressure (BP) and heart rate (HR) are related to baseline cognitive profiles in, Parkinson’s disease (PD). Methods We selected drug-naïve PD patients who visited our hospital at least 10 times with a baseline assessment of the Seoul neuropsychological battery. BP and HR were measured at each visit, and the variability of the systolic BP/diastolic BP (DBP) and HR was derived from the parameters of serial 10 office visits. Mild cognitive impairment (MCI) in PD patients was determined according to the proposed criteria with a cut-off value of z-score ≤ -2. Results Forty-seven patients with PD (mean follow-up duration = 22.3 months) were enrolled in the study. Compared with non-MCI PD patients, MCI PD patients revealed a significant increase in HR and/or variability in DBP. Conclusion This exploratory study showed that baseline cognition in drug-naïve PD patients might be related to the visit-to-visit variability of DBP and/or HR.

Hand Tremor Questionnaire: A Useful Screening Tool for Differentiating Patients with Hand Tremor between Parkinson’s Disease and Essential Tremor

권겸일,유호성,이혜미,김미정,신혜원,박희경,유수연,성영희,정선주,고성범 대한신경과학회 2018 Journal of Clinical Neurology Vol.14 No.3

Background and Purpose Hand tremor is one of the most frequent symptoms in movement disorders, and differential diagnoses for hand tremor include Parkinson’s disease (PD) and essential tremor (ET). However, accurately differentiating between PD and ET in clinical practice remains challenging in patients presenting with hand tremor. We investigated whether a questionnaire-based survey could be useful as a screening tool in patients with hand tremor. Methods A questionnaire related to hand tremor consisting of 12 items was prospectively applied to patients with PD or ET in three movement-disorder clinics. Each question was analyzed, and a query-based scoring system was evaluated for differentiating hand tremors between PD and ET. Results This study enrolled 24 patients with PD and 25 patients with ET. Nine of the 12 questions differed significantly between PD and ET: 1 about resting tremor, 4 questions about action tremor, and 4 about asymmetry. A receiver operating characteristics curve analysis revealed that the 9-item questionnaire showed a good discrimination ability, with a sensitivity of 88% and a specificity of 84%. Conclusions The developed Hand Tremor Questionnaire might be a good screening tool for hand tremors in patients with PD and ET.

Backward Gait is Associated with Motor Symptoms and Fear of Falling in Patients with De Novo Parkinson’s Disease

권겸일,박수연,이혜미,박영민,김진희,김재환,고성범 대한신경과학회 2019 Journal of Clinical Neurology Vol.15 No.4

Background and Purpose Many previous studies have investigated forward gait (FG), backward gait (BG), and dual-task gait (DG) in patients with Parkinson’s disease (PD). However, it remains uncertain whether gait parameters are implicated in motor symptoms or the risk of falling, especially in patients with de novo PD. Methods Demographic and clinical characteristics including the Fear of Falling Measure (FFM) were assessed in patients with de novo PD and in healthy subjects. A computerized gait analysis using the GAITRite system was performed for FG, BG, and DG. Te Unifed Parkinson’s Disease Rating Scale Part III was assessed in patients with PD. Results Tis prospective study included 24 patients with de novo PD and 27 controls. Compared with controls, patients with de novo PD showed a slower gait and shorter stride in all three gaits. Patients with de novo PD also exhibited increases in the stride-to-stride variability in the stride time and stride length of the gait for BG, increased length for DG, and no increase for FG. Moreover, the BG speed in de novo PD patients was signifcantly associated with their motor symptoms (bradykinesia, postural instability, gait difculty, and total motor score) and negatively correlated with the FFM score. Conclusions Te BG dynamics were more impaired and more closely related to motor symptoms and fear of falling than were the FG or DG dynamics in patients with de novo PD, indicating that BG parameters are potential biomarkers for the progression of PD.

비전형적인 경막외출혈을 보인 다발골수종

권겸일 대한신경과학회 2017 대한신경과학회지 Vol.35 No.3

한·일 공항비상계획 비교 및 체크인카운터의 항공사 직원 비상대응 실태조사

권겸,권병화,정종수,Kwon, Kyum,Kwon, Byung Hwa,Cheung, ChongSoo 한국방재안전학회 2020 한국방재안전학회 논문집 Vol.13 No.2

본 연구는 공항여객터미널 일반구역에서 재난상황 발생에 대한 대응능력을 향상하기 위한 기초적인 연구로서, 공항비상계획과 재난 발생 시 항공사 지상직원의 비상대응 실태를 조사하였다. 첫째, 공항비상계획은 한국의 김포공항과 일본의 국토교통성의 공항피난계획을 조사하여, 국내 공항비상계획이 구체적이지 않음을 확인하였다. 둘째, 체크인카운터에서 근무하는 항공사 지상직원 100명을 대상으로 설문조사를 실시한 결과 응답자의 69%가 재난상황에서 본인의 역할을 인지하지 못하고 있었으며, 90%가 비상대응에 관한 교육을 받지 않았고, 98%가 일반구역에서의 재난훈련을 받지 않았다. 교차분석을 통해 근속연수가 근무하고 있는 공항의 체감안전도와 재난발생 시 역할인지에 유의미한 결과가 확인되었다. 따라서 향후 공항여객터미널 일반구역의 재난현장 대응능력 향상을 위한 공항 비상대응계획의 개선과 항공사 지상직원에 대한 재난대응 강화 교육 및 훈련을 진행할 것을 제언한다. This study is a basic study to improve responsiveness in the event of a disaster in the landside area of the Airport Passenger Terminal, and it investigated the airport emergency plan and the status of emergency response in the event of a disaster by the airline's ground staff. The Airport Emergency Plan examined the airport evacuation plan of Korea's Gimpo Airport and Japan's Ministry of Land, Infrastructure, and Transport, confirming that the domestic airport emergency plan was not specific. In addition, a survey of 100 airline ground employees working at check-in counters found that 69% of the respondents were unaware of their role in disaster situations, 90% were not educated in emergency response and 98% were not trained in disaster training in landside areas. Cross-analysis confirmed significant results in the safety of the airport where the service life worked and whether it was a role in the event of a disaster. Therefore, it is suggested that the airport emergency response plan should be improved to improve the ability to respond to disaster sites in the landside area of the airport passenger terminal and that the airline's ground staff should be educated and trained to enhance disaster response.

편측 내측두엽 병터로 발현한 일본뇌염

이정윤,권겸일,이경복,노학재,안무영,선우준상 대한신경과학회 2019 대한신경과학회지 Vol.37 No.1

조기발현 알츠하이머병과 유사한 내측두엽위축을 보인 신경매독

안병준,권겸일 대한신경과학회 2022 대한신경과학회지 Vol.40 No.2