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- 저자 : 서정규 ( Chung Kyu Suh ) (검색결과 26 건)
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A case of generalized tetanus with characteristic neurophysiological findings
김정일,이지만,김종열,박성파,서정규,Kim, Jung-Il,Lee, Ji-Man,Kim, Jong-Yeol,Park, Sung-Pa,Suh, Chung-Kyu Korean Society of Clinical Neurophysiology 2002 Annals of Clinical Neurophysiology Vol.4 No.1
Tetanus is a disorder known to interfere with inhibitory modulation of the motor system in humans. In this report, we describe the characteristic neurophysiological findings in a 52-year-old patient with generalized tetanus. The cutaneous silent period was absent and the silent period evoked in distal upper limb muscles by transcranial magnetic stimulation was shortened. These findings can be interpreted as evidence of impaired inhibitory mechanisms at multiple levels of the nervous system.
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약년(若年) 성인의 경골신경 체감각 유발전위의 정상치 및 자극빈도의 변동에 따른 유발전위의 변화
서순천,서정규 啓明大學校 醫科大學 1989 계명의대학술지 Vol.8 No.2
This study was done in order to have normal data of tibial somatosensory evoked potentials in our own laboratory and to examine the significance of the effects of the stimulus rate on the evoked responses. Observation was made on 30 young adult volunteers (21 males and 9 females0 ranging in age from 18 to 39 years (height: 150 to 180 cm) without enurologic disease. The stimulation electrodes were placed over the tibial nerve at the ankle with the cathode 3 cm proximal to the anode. Recording electrodes were placed over the popliteal fossa, L4, L2, T12, T10 spinous process and Cz, Fpz for channel 1, 2, 3 and 4, respectively. The ground electrode was placed over the upper sternum. Using a Medelec ST10 Sensor, the input from the recording electrode was led to differential amplifiers and the output was summated by an average system and then recorded by an X-Y plotter. Analysis time, low filter, high filter, display gain and stimulus intensity were adjusted to 100 msec, 10 Hz, 600 Hz, 500 nV ∼3000 nV and 15∼20 mA, respectively, and 2048 responses were summated. Nrmal data of a peripheral nerve (pop), spinal (L4, T12) and cortical evoked responses (P38, N47, P59, N75) were established by electrucal stimulation at the rate of two per second. To examine the significance of the effects of the stimulus rate between 0.5 and 10/sec on latency and amplitude of each of the components, each evoked response and the recording time were measured in 10 healthy young adults (9 males and 1 female) ranging in age from 24 to 38 years (height: 161 to 180 cm) at rates of 0.5, 1, 2, 5 and 10/sec stimulus rate. The absolute latencies of evoked responses in pop, L4, T12 and Cz were 8.2, 17.8, 20.9 and 38.0 msec, respectively and were delayed in proportion to the length from the stimulation site. The amplitudes of evoked potentials in pop, L4, T12 and Cz were 1.5, 0.4, 0.7, and 1.9㎶, respectively. The central conduction velocity was 34.3 m/sec. The differences of the absolute latencies of each component were not significant at rates of 1, 2, 5 and 10/sec compared to the 0.5/sec stimulus rate. But the amplitudes were gradually decreased in proprtion to the increase of the stimulus rate. The amplitudes of spinal evoked potentials particularly were not changed at rates of 1 and 2/sec, but were decreased significantly at rates of 5 and 10/sec compared to the 0.5/sec stimulus rates. Recording times required in a single session were 53, 27, 13, 6 and 4 minutes at the stimulus rates of 0.5, 1, 2, 5 and 10/sec, respectively. Therefore, 1 and 2/sec stimulus rates were thought to be efficient rates in the tibial somatosensory evoked potential test as a clinical diagnostic tool, for efficient spinal evoked responses and adequate recording time.
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서정규,박성파,김종열 慶北大學校 醫科大學 1992 慶北醫大誌 Vol.33 No.3
저자들은 diabetic PN의 신경분절 침범양상을 알아보기 위하여 59례의 당뇨병환자에서 F파의 지표들을 측정하고 그 성적을 원위부 MNCV와 비교하여 다음과 같은 결과를 얻었다. Diabetic PN과 CTS 환자에서 대조군에 비해 정중신경의 FWL는 의의있게 증가하고 F ratio와 MNCV는 의의있게 감소하였으며, 경골신경의 FWL는 의의있게 증가하였고 FWCV와 MNCV는 의의있게 감소하였다. FWL는 F파의 지표들 중에서 diabetic PN을 가장 잘 반영해 주는 검사였다. Diabetic PN 환자의 NCV 검사상 이상소견의 빈도를 보면 정중 및 경골신경의 MNCV는 동일신경의 FWCV보다 의의있게 증가하였으며, 경골신경의 MNCV는 정중신경의 MNCV보다 의의있게 증가하였다. Diabetic PN 환자에서 근위신경분절의 이상을 반영하는 FWCV의 감소와 F ratio의 증가는 정중신경에서 각각 2%와 5%, 경골신경에서 8%와 3%를 차지하였다. The authors conducted a study on fifty-nine diabetic patients through measurement of the F wave parameters and comparison of the results with the distal motor nerve conduction velocity(MNCV) to grasp the nature of the segmental involvement in diabetic polyneuropathy (diabetic PN). In the patients with diabetic PN and carpal tunnel syndrome, in contrast to the control subjects, the following significant differences in increase and decrease were found: median F wave latency(FWL)-increase; F ratio and MNCV-decrease, tibial FWL-increase; F wave conduction velocity(FWCV) and MNCV-decrease. The FWL, among the F wave parameters, most usefully reflected the diabetic PN. In the incidence of abnormality of the nerve conduction study in patients with diabetic PN, the median and tibial MNCV were far more frequent than the FWCV in the same nerves, and the tibial MNCV was much more frequent than the median MNCV. The incidence of the decrease of FWCV and the increase of F ratio that reflect the abnormality of the proximal segment of the nerve in patients with diabetic PN were 2% and 5% in the median nerve, and 8% and 3% in the tibial nerve, respectively.
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朴永春,徐正揆,李相度 啓明大學校 醫科大學 1986 계명의대학술지 Vol.5 No.1
Since the early 1970, evoked potentials (somatosensory evoked potential, SEP; visual evoked potential, VEP and brainstem auditory evoked potential, BAEP) have rapidly developed into useful clinical tools. Now it has been used widely as reliable diagnostic tools in most of neurological service. This study was done in order to have normal data of median and ulnar nerve somatosensory evoked potentials in our own laboratory. Observations were made on 42 normal Korean volunteers (28 males and 14 females) ranging in age from 13 to 62 years, using Medelec MS6G Type. Stimulating electrodes were placed over the right and left median and ulnar nerves just proximal to the wrist. Stimulation rate; 5/sec, stimulus intensity was adjusted to produce a small twitch of the thumb. Recordings were made from tin disc electrodes(7mm in diameter) attached to Fz for reference, EP, C2 and Cc (2cm behind to the C3 or C4 contralateral to the stimulation limb) recording electrodes. Input from recording electrodes was led to differential amplifiers and the output was summated by averager system and then recorded by X-Y plotter. Analysis time, low filter and high filter are adjusted 50msc., 10Hz and 600Hz respectively, and 1024 responses were summated. Normal SEP responses after median and ulnar nerve stimulations were shown Fig.1. and Fig. 2. Normal datea for median and ulnar nerve SEPs were shown table 1. and table 2. Absolute latencies and amplitudes in each waves (EP, N11, N13, N19 and P22) were slightly delayed in ulnar SEP than median nerve SEP.
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朴永春,徐正揆,金炳俊,朴俊祜,朴成培 啓明大學校 醫科大學 1984 계명의대학술지 Vol.3 No.1
저자들은 1981년 夏節期에 AHC의 대유행이 있은후 격렬한 神經根痛, 非對稱性弛緩性筋痲痺, 筋萎縮 및 腱反射 소실을 主訴로 계명의대 동산병원 내과에 내원하여 AHC의 신경학적 합병증으로 생각된 8예의 임상적소견을 분석하였던 바 그 결과를 요약하면 다음과 같다. 1) 성별빈도는 총 8예중 남자가 7예 여자가 1예로 남자에 호발하였고, 연령별분포는 40대가 4예로 가장 많고 30대가 2예, 50대가 1예였고 소아에서는 1예도 없었으며 AHC 발병후 弛緩性筋痲痺가 나타날때까지의 기간은 평균 21일이었다. 2) 前驅症狀으로서 四肢疼痛이 8예 背部疼痛, 頭痛, 發熱, 惡寒, 倦怠 및 筋肉痛이 각각 5예, 排尿因難이 3예 惡心 및 嘔吐가 2예였다. 그리고 격렬한 神經根痛에 뒤따른 筋痲痺는 全例에서 下肢에, 1예서 上肢에 관찰되었으며 내원당시 筋萎縮은 6예에서 볼 수 있었고 이들의 정도는 近位部가 遠位部보다 현저하였으며 深部腱反射는 전예에서 소실되거나 감소되었다. 3) 腦脊髓液所見은 蛋白과 白血球數가 조기에 증가하였고 운동신경전도속도를 측정한 6예중 5예에서는 정상범위내에 있었다. 그리고 AHC 바이러스에 대한 中和抗體反應檢査를 실행한 6예중 그 力價가 1:32인 예가 1예, 1:8이 3예, 1:4이하가 2예였다. 8예중 7예에서 prednisolone을 투여한 결과 神經根痛은 호전하였으나 筋痲痺 및 筋萎縮은 뚜렷한 호전이 없었다. In 1969, Chatterjee at al reported new type of epidemic conjunctivitis called acute hemorrhagic conjunctivitis (AHC) or Apollo 11 disease. During 1970 and 1971 there were great outbreaks of AHC in the area of North Africa, Europe, middle east, and south east Asia and far East. In 1972 Kono et al isolated etiological agent from conjunctival swab named enterovirus 70. Wadia et al and Bharucha were reported clinical studies on neurological complications of AHC in 1972. We were presented clinical studies on 8 cases of neruological complications of acute hemorrhagic conjunctivitis, these were seen at Keimyung University hospital after prevalence of AHC during summer time in 1981 in the area of Taegu, Korea. Clinical features of these neurological complications of AHC are summarized in table 1. Prodromal symptoms consisted of fever, headache, nausea, vomiting, general malaise, myalgia, backache, pain on extremities and urinary incontinence. Duration between the onset of AHC and the onset of prodromal symptoms were 12 to 40 days (mean 20 days). During or after the prodromal symptoms patients presented severe root pain involving part of the bodies, most involved lower extremities, followed by motor weakness, which are asymmetric, more often and severe on lower extremities than upper, more prominent on proximal, than distal, muscle atrophy and decreased or absent deep tendon relfexes and flexor plantar reflex (rarely extensor plantar reflex). Duration between the onset of prodromal symptoms and the onset of motor weakness were 0-7 days (mean 3.4 days). Cerebrospinal fluid examination showed marked elevated protein and slight pleocytosis. Motor nerve condustion velocity showed normal except one who had delayed motor nerve conduction velocity of bilateral posterior tibial nerve. Titers of neutralizing antibody test revealed one patient had 1:32 which was confirmative, three had 1:8 which were doubtful and two had 1:4 which were not significant.
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