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백종삼,박재현 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.3
Posterior cortical atrophy is a subgroup of focal cortical atrophy with progressive degenerative dementia that begins with higher visual dysfunction. A 51-year-old man presented with visual disturbance for several months. He was a taxi driver and when he came to hospital, he couldn't drive a taxi because of geographical disorientation, impairment of calculation and writing. So he experienced car accident frequently. On examination, he had a Balint syndrome, visuospatial dysfunction, prosopagnosia, apraxia and Gerstmann's syndrome. Brain MRI showed marked atrophy especially both occipito-parietal areas, more pronounced on the left. SPECT with HMPAO disclosed hypometabolism on bilateral occipito-parietal area, more marked on the left rather than right. We think that these findings consistent with posterior cortical atrophy which is variant of Alzheimer's disease.
백종삼,김정연,박재현 대한신경과학회 2005 대한신경과학회지 Vol.23 No.1
Background: Sleep disturbances in Parkinson's disease (PD) are common and symptoms can be broadly categorized into insomnia, motor, urinary and neuropsychiatry. However, there are no formal instruments available for quantifying sleep problems in Parkinson's disease. Methods: We studied 15 items of sleep related symptoms on the Parkinson's disease sleep scale (PDSS) for 50 patients with PD and 50 age healthy matched subjects. Test-retest reliability was assessed in a subgroup of the subjects. Results: The PD patients group had impaired scores compared with age healthy matched group in PDSS scores. Within the PD group, it was different between the mild and moderate group in PDSS scores. It showed a discriminatory power in all individual items of scale, except item 14 (sleep refreshment). In test retest reliable score, it showed good reliability. Conclusions: We suggest that PDSS is a simple instrument for evaluating sleep disturbances in PD and it could be used to help targeted treatment strategies for nocturnal problems in PD.
Patients and Their Caregivers’ Burdens for Parkinson’s Disease in Korea
백종삼,김중석,고성범,조진환,이필휴,마효일,김윤중,안태범,김상진,최성민,이호원,김희태 대한파킨슨병및이상운동질환학회 2017 Journal Of Movement Disorders Vol.10 No.3
Objective: Many patients with Parkinson’s disease (PD) suffer from motor and non-motor symptoms. According to these variable symptoms of PD, patients or caregivers have a poorer quality of life than patients with other neurodegenerative diseases. Since the difficulties are varied for all patients, prioritizing their difficulties differs among all cases. The goal of this study was to investigate the burdens of PD among the caregivers as well as patients and to identify areas requiring aid from the government. Methods: We surveyed the awareness and perceptions of PD in patients and caregivers of PD by a face-to-face questionnaire. The questionnaire was divided into three sections: symptoms of PD (part A), desire for policies (part B), and difficulties faced by their caregivers (part C). Part A comprised 8 questions, Part B had 2 questions, and Part C had 3 questions. Results: In total, 853 subjects (702 patients and 151 caregivers) were enrolled in this study. The major difficulties experienced by PD patients were physical (67%), psychiatric (60%) and socio-economic (52%). Assessing the physical difficulties, more than half the patients experienced severe difficulties (29% very severe, 39% severe). Psychiatric difficulties were assessed as severe (35%) and very severe (21%) among the patients. Severe difficulties were also experienced socio-economically, at 52% in patients and 49% in caregivers, especially among patients in their fifties (58%) and those with their spouse (65%) as caregivers. The topmost need was the introduction of new technology for treatment of PD (62%), followed by relief of costs for treatment (38%) and a family support system (31%). The majority (91%) of the patients were diagnosed with PD within two years after onset of symptoms. Conclusion: We know that the difficulties of PD and the needs for government assistance are different between patients and caregivers. These results emphasize that perceiving the difficulties and needs of patients and caregivers early can help to prevent and ameliorate the burden of disease.
백종삼,박재현,김정연 대한신경과학회 2004 대한신경과학회지 Vol.22 No.2
We describe two patients with speech-induced oromandibular dystonia. One patient showed mainly jaw dystonia, while the other patient had lingual dystonia. A brain MRI revealed acute cerebral infarctions in the midbrain near the substantia nigra in the patient with jaw dystonia, while the patient with the lingual dystonia showed no structural lesions. Symptoms in both patients were partly improved with sensory tricks, such as chewing gum or holding a candy in their mouths. Their symptoms were completely recovered with anticholinergic therapy.
Scoliosis in Patients with Parkinson’s Disease
백종삼,김정연,박중현,한상원,박재현,이명식 대한신경과학회 2009 Journal of Clinical Neurology Vol.5 No.2
(PD) than in the general elderly population. We compared clinical characteristics between PD patients with and without scoliosis, to identify the relationship between the direction of scoliosis and the laterality of the dominant symptoms of PD. We also studied the associations between dopaminergic pharmacotherapy and scoliosis (defined by a spinal curvature deviation of 10° or larger). MethodsaaThe study population comprised 97 patients (42 men and 55 women) with idiopathic PD. All of the patients submitted to a whole-spine scanograph to allow measurement of the degree of scoliosis by Cobb’s method. ResultsaaTrue scoliosis was found in 32 of the 97 PD patients, and was observed more frequently in women than in men (28 vs. 4, respectively; p=0.006). The age of patients without scoliosis was significantly lower than that of those with scoliosis (66.5±9.2 years vs. 72.8±7.3 years, respectively, mean±SD, p<0.001). There was no correlation between PD symptom laterality and scoliosis. The rate of occurrence of scoliosis did not differ between de novo and levodopa (Ldopa)- treated patients. ConclusionsaaWe suggest that neither L-dopa treatment nor the laterality of the initial symptoms of PD is related to the appearance of scoliosis.