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이진산,정나연,장영경,김희진,서상원,이주연,김여진,이재홍,김병채,박경원,윤수진,정지향,김상윤,김승현,김은주,박기정,David S. Knopman,나덕렬 대한신경과학회 2017 Journal of Clinical Neurology Vol.13 No.3
Background and Purpose Only a few studies have investigated the relationship between different subtypes and disease progression or prognosis in patients with behavioral variant frontotemporal dementia (bvFTD). Since a localized injury often produces more focal signs than a diffuse injury, we hypothesized that the clinical characteristics differ between patients with bvFTD who show diffuse frontal lobe atrophy (D-type) on axial magnetic resonance imaging (MRI) scans versus those with focal or circumscribed frontal lobe atrophy (F-type). Methods In total, 94 MRI scans (74 scans from bvFTD and 20 scans from age-matched normal controls) were classified into 35 D- and 39 F-type bvFTD cases based on an axial MRI visual rating scale. We compared baseline clinical characteristics, progression in motor and cognitive symptoms, and survival times between D- and F-types. Survival analyses were performed for 62 of the 74 patients. Results While D-type performed better on neuropsychological tests than F-type at baseline, D-type had higher baseline scores on the Unified Parkinson’s Disease Rating Scale (UPDRS) Part III. Evaluations of motor progression showed that the disease duration with motor symptoms was shorter in D-type than F-type. Moreover, the survival time was shorter in D-type (6.9 years) than F-type (9.4 years). Cox regression analyses revealed that a high UPDRS Part III score at baseline contributed to an increased risk of mortality, regardless of the pattern of atrophy. Conclusions The prognosis is worse for D-type than for those with F-type. Shorter survival in D-type may be associated with the earlier appearance of motor symptoms.
Central Neurocytoma Presenting as Symptomatic Cataplexy
이진산,윤지환,황경진 대한수면연구학회 2020 Journal of sleep medicine Vol.17 No.1
Central neurocytomas are well-differentiated tumors and are typically found in intraventriculat lesion in adult. We report a rare case of central neurocytoma presenting as symptomatic cataplexy. A 50-year-old man visited our hospital due to repetitive drop down triggered by emotional changes and was diagnosed of central neurocytoma at right lateral ventricles and head of caudate nucleus. Alterations of striatal dopaminergic system in narcolepsy with cataplexy have been reported, but there are no reports associated with single lesion. This case suggests the striatal lesion plays a role in cataplexy.
불면 증상으로 내원한 65세 이상 노인 환자들의 임상적 양상
이진산,신원철,유라영,성민지,남효정,권영남,조한아,차현극 대한수면연구학회 2013 Journal of sleep medicine Vol.10 No.1
Objective: Sleeping problems and disorders generally increase with aging, and these changes influence elderly functioning and well-being. We studied the clinical characteristics of the elderly patients with insomnia symptoms for the appropriate diagnosis in Korea. Methods: Patients with insomnia symptoms aged over 65 years were recruited from who visited the Sleep center of Kyung Hee University Hospital at Gangdong, from January 2010 to April 2013. General characteristics of sleep patterns, past medical history, previous medication related sleep, sleep diary, and the Minnesota Multiphasic Personality Inventory-2(MMPI-2) were analyzed to understand the sleep pattern and the clinical characteristics in the elderly patients with insomnia symptoms. Results: The study population included 143 patients(45 men, 98 female), and their mean age was 71.41± 5.32 years. These patients were classified according to the cause of insomnia symptoms, the primary cause was 39.1%(92.8% psychophysiological insomnia, 7.2% paradoxical insomnia), the secondary cause was 34.2%(depression, anxiety, associated medical illness, obstructive sleep apnea syndrome, restless legs syndrome), and circadian rhythm sleep disorder was 26.6%. The MMPI-2 profiles were not significant differences in the study population. Conclusion: The clinical characteristics in our study population were different in variable parameters from the general population. It is necessary to understand these differences in the elderly patients for approaching the appropriate diagnosis and medical care.
이상화,이진산,남효정,허성혁,장대일 대한신경과학회 2013 대한신경과학회지 Vol.31 No.4
Polycythemia vera (PV) is a chronic myeloproliferative disorder that is characterized by increased production of leukocytes, erythrocytes, and platelets. Arterial and venous thromobotic complications are common in the clinical course of this disorder. There have been a few reports of acute ischemic stroke with PV. A case of PV associated with progression of middle cerebral artery stenosis and recurrent ischemic stroke is presented herein.
폐쇄수면무호흡에서 수면시간의 과소 평가와 관련 요인: 수면다원검사 결과를 이용한 후향 연구
황경진,이진산,손환준,김경혜,이명준,김지영 대한신경과학회 2019 대한신경과학회지 Vol.37 No.2
Background: The perception of sleep time in obstructive sleep apnea (OSA) is not well understood, some studies have reported that subjects with OSA have abnormal sleep perception. We hypothesized that the severity of OSA would affect the sleep perception of patients with OSA and investigated the associated factors that affect the sleep perception in OSA. Methods: Four hundred and sixty eight subjects with OSA were included in present study. Subjects with OSA were divided, depending upon their sleep perception. The first group included individuals who underestimated their time spent sleeping, the second group included those who did not underestimate their sleep time. The underestimation of sleep time is defined as the perceived total sleep time being less than 80% of that measured in polysomnography (PSG). All participants were analyzed their demographics, PSG parameter and questionnaires such as Beck Depression Inventory, Epworth Sleepiness Scale. Results: Of 468 participants, 179 (38.2%) subjects were included in the group that underestimating sleep. Gender (female, odds ratio [OR]=2.01, 95% confidence interval [CI]=1.25-3.22), depression (OR=1.75, 95% CI=1.03-2.97) and proportion of slow wave sleep (OR=0.98, 95% CI=0.96-0.99) were related to the underestimation of sleep. Conclusions: The underestimation of sleep in OSA is not directly related to OSA severity. Gender, psychiatric disorder, and sleep architecture are associated with the underestimating sleep in OSA.