Association Between Suggestive Symptom of Restless Legs Syndrome and COVID-19 Vaccination: A Pilot Study

석진명,나은진,김슬기,박종규,박은경,SONGPAMELA,양광익 대한수면연구학회 2022 Journal of sleep medicine Vol.19 No.1

Objectives: Various sensory symptoms have been recognized after COVID-19 vaccination. Here, we aimed to explore the association between the suggestive symptom of restless legs syndrome (RLSss) and COVID-19 vaccination using an online survey.Methods: We prospectively studied participants who were working in our hospital after at least the first dose of the ChAdOx1 or BNT162b2 mRNA vaccine. The participants were invited via smartphone messages and voluntarily filled out an online questionnaire that included adverse events after vaccination. We considered the participants as having RLSss if they reported that they had three or more symptoms in the restless legs syndrome (RLS) diagnostic criteria.Results: A total of 628 participants (506 female; mean age, 37.7±12.4 years) responded fully to our online survey. 588 participants (93.6%) received the first dose of the ChAdOx1 vaccine (BNT162b2 mRNA vaccine for 40 participants). A total of 44 out of the 628 participants (7.0%) reported that they had RLSss. Myalgia was more common in participants with RLSss than in those without RLSss (97.7% vs. 67.3%, p<0.001). Multivariate testing showed that age (odds ratio, 1.037 per 1 year increase; 95% CI, 1.004–1.071) and the presence of myalgia (odds ratio, 20.479; 95% CI, 4.266–368.206) were associated with the presence of RLSss.Conclusions: This pilot study explored RLSss after COVID-19 vaccination and the results suggested that RLS might be one of the causes of adverse symptoms after COVID-19 vaccination. Further studies are required to confirm the relationship between RLS and COVID-19 vaccination.

Relapse After Cessation of Immunosuppressants in Seropositive Neuromyelitis Optica Spectrum Disorder With Long-Term Remission

석진명,박민수 대한신경과학회 2021 Journal of Clinical Neurology Vol.17 No.4

고등학교 <인공지능 수학> 교사 연수가 교사 개인의 교수효능감에 미치는 효과

류상주,석진명,강우혁,박재현 대한수학교육학회 2024 학교수학 Vol.26 No.1

본 연구에서는 2021년부터 진행된 고등학교 <인공지능 수학> 과목 교사 연수가 효능감에 미친 영향에 대한 효과와 인과적메커니즘을 분석하려 한다. 인과관계를 식별하는 방법으로 Pearl, J.가 창안한 인과추론 이론을 적용하였다. 선행연구를 참고하여처치변수와 결과변수에 영향을 미치는 변수들을 찾고 방향성 비순환 그래프를 작성하여 표본집단 전체에서 효과를 확인하였다. 또한, 세부 집단 간 효과의 차이를 분석함으로써 인과적 메커니즘을 유추하였다. 이를 바탕으로 <인공지능 수학> 과목 연수를위한 시사점을 제언하였다. This paper studies the effects and causal mechanism of teacher training in the high school <Artificial Intelligence Mathematics> course from 2021 on efficacy. We apply the theory of causal inference developed by Pearl, J. as a method for identifying causal mechanism. Based on previous studies, we search for variables that affect the treatment and outcome variables and draw a directed acyclic graph to confirm the effects among the whole sample. Moreover, we infer the causal mechanism by analyzing the differences in effects among the subgroups of the whole sample space. Based on this study, we suggest implications for teacher training in the <Artificial Intelligence Mathematics> course.

Ischemic Stroke and Cancer: Stroke Severely Impacts Cancer Patients, While Cancer Increases the Number of Strokes

방오영,석진명,김선경,홍지만,김한영,이준,정필욱,박광열,김경문,정진상,이광호 대한신경과학회 2011 Journal of Clinical Neurology Vol.7 No.2

BackgroundzzCancer and ischemic stroke are two of the most common causes of death among the elderly, and associations between them have been reported. However, the main pathomechanisms of stroke in cancer patients are not well known, and can only be established based on accurate knowledge of the characteristics of cancer-related strokes. We review herein recent studies concerning the clinical, laboratory, and radiological features of patients with cancer-related stroke. Main ContentszzThis review covers the epidemiology, underlying mechanisms, and acute and preventive treatments for cancer-related stroke. First, the characteristics of stroke (clinical and radiological features) and systemic cancer (type and extent) in patients with cancer-specific stroke are discussed. Second, the role of laboratory tests in the early identification of patients with cancer-specific stroke is discussed. Specifically, serum D-dimer levels (as a marker of a hypercoagulable state) and embolic signals on transcranial Doppler (suggestive of embolic origin) may provide clues regarding changes in the levels of coagulopathy related to cancer and anticoagulation. Finally, strategies for stroke treatment in cancer patients are discussed, emphasizing the importance of preventive strategies (i.e., the use of anticoagulants) over acute revascularization therapy in cancer-related stroke. ConclusionzzRecent studies have revealed that the characteristics of cancer-related stroke are distinct from those of conventional stroke. Our understanding of the characteristics of cancer-related stroke is essential to the correct management of these patients. The studies presented in this review highlight the importance of a personalized approach in treating stroke patients with cancer.

‘Sirim’ (Cold) Pain as a Common Symptom in Korean Patients with Clinically Suspected Small-Fiber Neuropathy

조은빈,석진명,민주홍,서범천,박기종,김병준 대한신경과학회 2019 Journal of Clinical Neurology Vol.15 No.4

Background and Purpose Diagnosing small-fber neuropathy (SFN) is challenging because there is no gold-standard test and few diagnostic tests. This study investigated the clinical symptom profle and its associations with the results of quantitative sensory testing (QST) and the quantitative sudomotor axon refex test (QSART) as well as the quality of life (QOL) in patients with clinically suspected SFN. Methods Tis study involved 63 patients with clinically suspected length-dependent SFN. Assessments were performed using QST, QSART, SFN Symptoms Inventory Questionnaire, Neuropathic Pain Symptom Inventory, ‘Sirim’ frequency and ‘Sirim’ (cold) pain severity, and 36-item Short-Form Health Survey. Multiple logistic and linear regression analyses were performed to predict risk factors for QST or QSART abnormalities and QOL, respectively. Results ‘Sirim’ and ‘Sirim’ pain was the most-common (84%) and the most-severe complaint (mean score of 6.3 on a numerical rating scale ranging from 0 to 10) in patients with clinically suspected SFN. Te fndings of QST [cold detection threshold (CDT)] and QSART were abnormal in 71% (n=45/57) and 62% (n=39/56) of the patients, respectively. An abnormal CDT was correlated with more-severe stabbing pain (odds ratio=2.23, 95% CI=1.02– 4.87, p=0.045). Restless-leg symptoms (β=-7.077) and pressure-evoked pain (β=-5.034) were independent predictors of the physical aspects of QOL. Conclusions ‘Sirim’ pain, similar to cold pain, should be considered a major neuropathic pain in SFN. Among pain characteristics, stabbing pain of a spontaneous paroxysmal nature may be more pronounced in the setting of dysfunctional Aδ fbers with functional autonomic C fbers.

자기공명영상에서 병터가 관찰되지 않는 말이집희소돌기아교세포당단백질 자가항체 관련 척수염 증례

박종규,김형기,석진명 대한신경과학회 2022 대한신경과학회지 Vol.40 No.1

스마트폰을 이용한 심호흡 기반 자율신경계 테스트

하상호,추창우,석진명,박종규,박상흠,Sangho Ha,Chang Woo Choo,Jin Myoung Seok,Jongkyu Park,Sang-Heum Park 한국정보처리학회 2023 정보처리학회논문지. 컴퓨터 및 통신시스템 Vol.12 No.7

심호흡을 통해서 심박수 변이를 측정하고, 이를 이용하여 자율신경계를 평가하는 것은 잘 알려진 방법으로 다양한 임상 분야에서 널리 이용되고 있다. 병원에서는 이를 위해서 고가의 장비가 설치되고 전문가에 의해서 운용되고 있다. 논문에서는 스마트폰을 이용하여 언제 어디서나 간편하게 심호흡을 통해서 자율신경계를 테스트할 수 있는 앱을 개발하고, 실험을 통해서 개발된 앱을 검증하였다. 실험은 지원자 8명에 대해서 순천향대학교 천안병원 신경과 임상실에서 진행되었다. 지원자에 대한 자율신경계 테스트를 다음 두 가지 방법으로 진행하였다. 먼저 병원에 설치된 근전도 검사기를 이용하였고, 다음에 동일한 조건에서 개발된 앱을 적용하였다. Pearson 방법을 이용하여 이 두 가지 방법의 실험 결과간에 상관 분석을 수행하였고, 분석 결과는 0.98의 매우 높은 상관관계를 보여준다. Measuring heart rate variability by deep breathing and using this to evaluate the autonomic nervous system is a well-known method widely used in various clinical fields. In hospitals, expensive equipment is installed and managed by experts for this purpose. This paper discusses an app we developed that can easily test the autonomic nervous system by deep breathing anytime, anywhere using a smartphone, and then reviews experiments performed to verify the results. The experiments were conducted in the clinical room of the Department of Neurology at Soonchunhyang University Cheonan Hospital on eight volunteers. We tested the autonomic nervous systems of the volunteers first with an electromyography device installed in the hospital and then with the app under identical conditions. We performed a correlation analysis on the results of these two methods using the Pearson method, and this yielded a very high correlation of 0.98.

Results of a Survey on Diagnostic Procedures and Treatment Choices for Neuromyelitis Optica Spectrum Disorder in Korea: Beyond the Context of Current Clinical Guidelines

이혜림,김수현,석진명,김병조,김호진,김병준 대한신경과학회 2022 Journal of Clinical Neurology Vol.18 No.2

Background and Purpose Neuromyelitis optica spectrum disorder (NMOSD) is a rare demyelinating disease of the central nervous system (CNS). We investigated the medical behaviors of experts in Korea when they are diagnosing and treating NMOSD. Methods An anonymous questionnaire on the diagnosis and treatment of NMOSD was distributed to experts in CNS demyelinating diseases. Results Most respondents used the 2015 diagnostic criteria for NMOSD and applied a cerebrospinal fluid examination, magnetic resonance imaging (MRI) of the brain and spine, and anti-aquaporin-4 antibody testing to all suspected cases of NMOSD. All respondents prescribed steroid pulse therapy as an first-line therapy in the acute phase of NMOSD, and 67% prescribed azathioprine for maintenance therapy in NMOSD. However, details regarding monitoring, the tapering period of oral steroids, second-line therapy use in refractory cases, management during pregnancy, and schedule of follow-up MRI differed according to the circumstances of individual patients. We analyzed the differences in response rates between two groups of respondents according to the annual number of NMOSD patients that they treated. The group that had been treating ≥10 NMOSD patients annually preferred rituximab more often as the second-line therapy (p=0.011) and had more experience with rituximab treatment (p=0.015) compared with the group that had been treating <10 NMOSD patients. Conclusions This study has revealed that NMOSD experts in Korea principally follow the available treatment guidelines. However, the differences in specific clinical practices applied to uncertain cases that have been revealed will need to be investigated further in order to formulate suitable recommendations.

Central Sleep Apnea without Cheyne-Stokes Breathing Following an Acute Cerebral Infarction

오혜정,우호걸,석진명,양광익 대한수면연구학회 2019 Journal of sleep medicine Vol.16 No.1

Central sleep apnea (CSA) is attributed to medical or neurological conditions including stroke. The association of lesion location and CSA in patients with ischemic stroke has not been well elucidated. A 69-year-old man with a history of hypertension and diabetes mellitus was admitted due to stroke. The brain magnetic resonance imaging showed an acute ischemic stroke in the right ventral thalamus and adjacent hypothalamus. During hospitalization, polysomnography (PSG) was performed because repetitive cessation of respiration during sleep was observed by chance. PSG showed severe CSA; the apnea-hypopnea index (AHI) was 73.5 with a minimum oxygen saturation of 89% and central apnea index (CAI) was 63.0. Two years later, follow-up PSG showed that AHI was 7.2 with a minimum oxygen saturation of 91% and CAI was 1.0. We report the patient with CSA after ischemic stroke with right thalamus and adjacent hypothalamus, which resolved spontaneously with time.

Clinical Characteristics and Treatment Response of Peripheral Neuropathy in the Presence of Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome): Experience at a Single Tertiary Center

조혜진,윤세효,석진명,조은빈,민주홍,서연림,이병재,김병준,최동철 대한신경과학회 2017 Journal of Clinical Neurology Vol.13 No.1

Background and Purpose Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic small-vessel vasculitis accompanied by asthma, eosinophilia, and eosinophilic inflammation of various tissues including the peripheral nerves. This study investigated the clinical course and long-term outcomes of peripheral neuropathy in patients with EGPA. Methods Seventy-one patients with physician-diagnosed EGPA were identified at Samsung Medical Center between January 1995 and April 2014. Sixty-one of these patients were followed-up for more than 1 year and received corticosteroid therapy with or without intravenous cyclophosphamide pulse therapy for 6 to 18 months. Medical records of the 61 patients including demographic data, clinical features, laboratory and pathological findings, treatments, and outcomes were reviewed. Results Peripheral neuropathy as a manifestation of EGPA was present in 46 (75%) of the 61 patients. The mean follow-up duration of the patients with neuropathy was 6.4 years (range 1.2–18.8 years). The scores on the neurological functional disability scale before and after the combination treatment with corticosteroid and cyclophosphamide were 2.43±0.86 and 0.54±0.95 (mean±SD; p<0.001), respectively. The peripheral neuropathy relapsed in one patient. Conclusions The long-term clinical outcome of peripheral neuropathy in patients with EGPA receiving initial corticosteroid and cyclophosphamide combination therapy was favorable with a very low relapse rate.