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지기환,이정,윤창호,하충건,Ji, Ki-Hwan,Lee, Jeong,Yun, Chang-Ho,Ha, Choong-Kun 대한임상독성학회 2006 대한임상독성학회지 Vol.4 No.2
Metronidazole is an antimicrobial drug widely used against various types of infectious agents, including protozoa, amoeba, Helicobacter pylori, and anaerobes. Metronidazole may produce some adverse effects on hematologic, immunologic, neurologic and other systems. We report a case of reversible metronidazole-induced encephalopathy. The toxic dose of metronidazole and the onset of encephalopathy were variable. Two patients showed abnormally high signal intensity in the bilateral dentate nucleus of cerebellum, and characteristic abnormalities were detected by brain magnetic resonance imaging (MRI) and T2-weighted images, fluid-attenuated inversion recovery images and/or diffusion weighted imaging (DWI). Discontinuation of metronidazole resulted in the improvement of the neurologic symptoms over a period of two to three weeks. We followed up the brain MRI with DWI in one case following obvious clinical improvement, and the previously detected lesion had disappeared.
A Sleepy Man with Chronic Obstructive Pulmonary Disease-Obstructive Sleep Apnea Overlap Syndrome
지기환 대한수면연구학회 2017 Journal of sleep medicine Vol.14 No.2
Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are prevalent and commonly co-occur as overlap syndrome. Patients with an overlap syndrome have a worse prognosis than those with COPD or OSA alone. Here we report a middle-aged man with overlap syndrome who had multiple comorbidities, managed with continuous positive airway pressure and oxygen therapy.
지기환,최원철,서정화,정은주,김상진,김응규,배종석 대한임상신경생리학회 2013 Annals of Clinical Neurophysiology Vol.15 No.2
Atopic myelitis (AM) is a relatively mild form of myelitis associated with allergic diathesis, and present with predominant sensory manifestations. Lhermitte’s sign has been considered as a relatively non-specific clinical sign suggesting demyelinating lesion in cervical cord. Here we report a patient with recurrent AM who presented with isolated Lhermitte’s sign, both in first and second attacks. This report suggests that either the diagnosis or recurrence of AM can be frequently underdiagnosed because of its predominant sensory manifestations.
Sleep and Respiration of perry syndrome: polysomnographic and pathological Correlations
지기환,Mi-Ri Kang,정은주,Sang Jin Kim 대한수면학회 2018 sleep medicine research Vol.9 No.2
Perry syndrome is a rare, adult-onset, autosomal dominant, progressive neurodegenerative disorder that is characterized by parkinsonism, weight loss, psychiatric symptoms, and central hypoventila- tion. We report the case of a 51-year-old man, whose condition was genetically identi ed as Perry syndrome. Here we focus the polysomnographic (PSG) ndings and discuss the correlations be- tween PSG and neuropathological ndings Perry syndrome is a rare, adult-onset, autosomal dominant, progressive neurodegenerative disorder that is characterized by parkinsonism, weight loss, psychiatric symptoms, and central hypoventila- tion. We report the case of a 51-year-old man, whose condition was genetically identi ed as Perry syndrome. Here we focus the polysomnographic (PSG) ndings and discuss the correlations be- tween PSG and neuropathological ndings.
렘수면 행동장애로 진단된 53명의 인구학적, 임상적, 수면다원검사적 특징
지기환,주은연,홍승봉 대한수면연구학회 2012 Journal of sleep medicine Vol.9 No.2
We investigated the demographic, clinical and polysomnographic features in rapid eye movement (REM) sleep behavior disorder (RBD). Methods: We enrolled the consecutive 53 patients with untreated RBD confirmed by ICSD-2 criteria. All patients showed typical sleep related injurious or disruptive behavior on history and REM sleep without atonia was revealed in polysomnography (PSG). Results: Male (n=38) to female (n=15) ratio was 2.53 : 1. Mean age of RBD onset and age of diagnosis was 58.9 yrs and 62.9 yrs, respectively. The age of diagnosis was not different but the age of onset was younger in female. Twenty two (41.5%) showed sleep-related injury to self or bed partner in history. Twenty seven (50.9%) showed dream acting out using proximal muscle in PSG. Among them, 12 (44.4%) could recall their dream. Two patients with RBD met the diagnostic criteria of Parkinson’s disease. Nine patients who underwent the University of Pennsylvania Smell Identification test in any reason showed anosomia (n=1) or hyposomia (n=8). PSG showed increased N1, normal N2, decreased N3 and preserved REM sleep. Twenty-two (41.5%) patients could be diagnosed with obstructive sleep apnea (OSA). Conclusions: We identified 53 patients with RBD confirmed with both clinical history and polysomnography. This study shows a higher proportion of female cases, and less association with neurodegenerative disease than earlier reports. OSA prevalence in RBD seems to be higher in this study compared with general population
지기환,홍승봉 대한수면연구학회 2012 Journal of sleep medicine Vol.9 No.2
Many patients with headaches complain of various sleep symptoms and have obstructive sleep apnea. Usually, treatment of sleep apnea with nasal continuous positive airway pressure (CPAP) may improve or resolve headache in a subset of patients. We report a case of new-onset headache after nasal CPAP therapy in an obstructive sleep apnea syndrome patient.