뚜렛 증후군에서 보툴리눔 톡신의 임상 효과

현정근(Jung Keun Hyun),이준형(Jun Hyung Lee),이창민(Chang Min Lee),임명호(Myung Ho Lim) 대한소아청소년정신의학회 2013 소아청소년정신의학 Vol.24 No.2

Botulinum toxin, a neurotoxin, is known to be an inhibitor of cholinergic neuromuscular transmission. Recently, it was reported that the administration of botulinum toxin is effective for the treatment of focal neurological motor disorders such as cervical dystonia, blepharospasm, hemifacial spasm, spasmodic dysphonia, and writer’s cramp. Several case studies reported that the botulinum toxin was administered for the treatment of motor tic or vocal tic. It was found that this toxin reduces the frequency and severity of the tic as well as the premonitory urge and symptoms. In our case study, a noticeable decrease of motor tic symptom was observed after an intramuscular injection of 300㎎ of botulinum toxin in an 18-year-old patient with Tourette’s disorder who showed only a little improvement of motor tic and vocal tic symptoms after treatment with antipsychotic drugs for several years. This case is reported in our study and literature survey was undertaken for reviewing similar cases. In our study, an 18-year-old boy diagnosed with Tourette’s disorder based on Diagnostic and Statistical Manual of Mental Disorders, fourth edition presented with the following scores : the Clinical Global Impression scale, Yale Global Tic Severity Scale (motor/vocal/severity), Premonitory Urge Score, Korean Attention-Deficit Hyperactivity Disorder Rating scale, and Kovac Depression scale which were performed prior to the treatment were 5, 21/5/50, 100, 17, and 18 points, respectively. Two weeks after the injection of botulinum toxin, the scores were 4, 17/5/40, 50, 16, and 19 points, respectively. Eight weeks after the injection of botulinum toxin, they had become 3, 15/5/30, 25, 16, and 20 points, respectively, which clearly indicates a noticeable decrease of motor tic symptom.

신티그라피를 이용한 연하곤란증의 정량적 평가

박석건,현정근,이성재 ( Seok Gun Park,Jung Keun Hyun,Seong Jae Lee ) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.3

Purpose: To evaluate dysphagia objectively and quantitatively, and ta clarify the effect of neck position and viscosity changes in patients with aspiration and laryngeal penetration. Materials and Methods: We studied 35 patients with dysphagia and 21 normal controls using videofluoroscopy and scintigraphy. Videofluoroscopy was performed with barium with three different viscosity, and scintigraphy was done, with water, yogurt, and steamed egg mixed with Tc-99m tin colloid. 1f aspiration was found during videofluoroscopic examination, patients neck position was changed and study repeated. Videofluoroscopy was analyzed qualitatively. We calculated 7 quantitative parameters from scintigraphy. According to the videofluoroscopic findings, we divided patients into 3 subgroups; aspiration, laryngeal penetration, and no-aspiration group. Results: The result of videofluoroscopy revealed that the most cornmon finding was the delay in triggering pharyngeal swallow. Pharyrigeal transit time (PTT) and pharyngeal swallowing efficiency(PSE) in patients with aspiration were significantly different from other groups. After neck position change, aspiration could be reduced in all of 7 patients, and laryngeal penetration reduced hy about 82%. PTT ancl PSE were also improved after position change. Aspiration and laryngeal penetration occurred more frequently in thin liquid swallowing than in thick liquid and solid swallowing. Conclusion: PTT and PSE were useful for the evaluation of dysphagia. Aspiration and laryngeal penetration could be reduced when appropriate position assumed, We could decrease the chance of aspiration by changing the patient diet consisIency. Scintigraphy might be useful tool to quantitate and follow up these changes. (Korean J Nucl Med 1998;32:276-89)

흰쥐 척수손상(spinal cord injury) 동물모델에서 뇨역동 (urodynamics)의 변화와 연관된 BDNF의 발현변화

이영일(Young-Il Lee),현정근(Jung-Keun Hyun) 대한해부학회 2007 Anatomy & Cell Biology Vol.40 No.2

본 연구의 목적은 척수의 손상에 따른 방광의 기능적 변화와 척수에서의 신경화학적 변화, 그리고 운동기능의 소실과 회복에 대해 시기별로 동시에 비교분석하는 데 있다. 먼저 실험동물의 척수에 가해지는 충격의 양을 표준화할 수 있는 MASCIS 충격기(Multicenter Animal Spinal Cord Injury Study impactor, Rutgers university of New Jersey, USA)를 사용하여 흰쥐의 척수에 타박손상을 가하였다. 손상 후에는 시기별로 1) 행동학적 변화 관찰, 2) 뇨역동학검사(urodynamic study)를 통한 방광의 기능변화 관찰, 3) BDNF의 발현변화를 모두 한 개체에서 각각 시행하였으며, 결과는 다음과 같다. 1) BBB (Basso, Beattie, Bresnahan) 이동평가척도(locomotor rating scale)를 기준으로 척수손상 후에 나타난 운동기능의 상실과 회복을 측정한 결과, 손상 후 약 한 달 정도의 시간을 거치면서 서서히 회복되는 양상을 보였다. 2) 뇨역동학검사를 통해 척수손상 후의 방광기능을 측정한 결과, 운동기능이 회복되는 시점에서도 여전히 강직마비(spastic paralysis)의 양상을 보여 자율신경계통은 회복되지 않은 것으로 나타났다. 3) 척수손상 후 BDNF의 발현은 손상 후의 시간에 따라 점차 감소하였으며, 손상부위의 머리쪽(rostral)보다 꼬리쪽(caudal) 부위에서의 감소가 더욱 현저하였다. 결론적으로 척수 손상 후의 자율신경기능의 회복은 이와 관련된 신경화학적 변화와 더불어 운동기능의 회복보다 더디게 진행되는 것을 확인하였다. 척수손상 후의 운동기능 변화와 방광기능의 변화, 그리고 척수에서의 신경화학적 변화에 대한 신뢰성 있는 비교분석을 통해 얻은 본 연구의 결과는 척수손상 동물모델을 통한 병태생리적 기전과 치료법 연구를 활성화하는 계기가 될 것이다. Spinal cord injury results in dramatic changes in the neurochemistry of peripheral and central micturition reflex pathways. We studied an animal model of spinal cord contusion injury using Sprague Dawley rats. Recoveries of motor and bladder functions were recorded, along with the changes in brain-derived neurotrophic factor (BDNF) in regions rostral and caudal to the injury site. Results are as follows: 1. Motor functions examined by the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale were fully recovered 28 d after spinal cord injury. 2. Bladder functions, monitored urodynamically, changed from flaccid paralysis at 4 d after spinal cord injury to spastic paralysis at 14, 18, and 28 d. 3. BDNF immunoreactive neurons and glial cells were found in both gray and white matters of the normal spinal cord, and the numbers decreased gradually after spinal cord injury 4. BDNF enzyme linked immunosorbent assay (ELISA) results were almost the same as for immunohistochemistry, but the intensity of decrease was more prominent in the caudal than in the rostral regions. Distinguishing between the beneficial or detrimental effects of neurotrophic factors in the context of micturition reflexes or regenerative responses will be a challenge, but is essential to understanding the effects of therapies directed at blocking the effects of neuroactive compounds or neurotrophic factors.

근막 동통 증후군과 동반된 견관절 충돌 증후군

박진영(Jin-Young Park),현정근(Jung-Keun Hyun),박홍근(Hong-Keun Park) 대한정형외과학회 2005 대한정형외과학회지 Vol.40 No.7

목적: 근막 동통 증후군이 동반된 견관절 충돌 증후군 환자에서 근막 동통 증후군의 발생부위와 그 빈도를 알아보고, 충돌 증후군의 치료가 근막 동통 증후군의 동통 개선에 효과가 있는지를 알아보고자 하였다. 대상 및 방법: 근막 동통 증후군으로 진단된 견관절 충돌 증후군 환자 중 외래에서 견갑골 주위 근육에 통증을 호소한 환자 53명을 대상으로 하였다. 치료 방법에 따라 대상 환자는 세 군으로 나누었다. 견봉하 주사를 시행한 군, 견갑골 주위 근육과 회전근 개의 등장성 근력강화 운동만 실시한 군, 보존적 치료에 실패하여 수술적 가료를 시행한 군. 대상 환자 모두 치료 전에 이학적 검사를 통해서 근막 동통 증후군의 위치를 확인하였고 관절 주위 동통 및 견관절의 운동범위를 측정하였으며 기능적 평가는 ASES 견관절 점수를 이용하였다. 결과: 근막 동통 증후군의 발생 부위, 연령, 성별, 충돌 징후, 관절 주위 압통은 운동범위 및 기능적 정도와 연관성을 보이지 않았다. 동통의 정도는 VAS가 치료 전 6.2±2.3에서 치료 후 1.2±1.5로 의미 있게 감소하였고(p<0.01), ASES 견관절 점수도 치료 전 32.1±15.3에서 치료 후 87.5±17.7로 의미 있게 증가되었다(p<0.05). 그러나 동통 및 ASES 견관절 점수 모두 치료 방법을 달리한 세 군간에 차이를 보이지는 않았다(p>0.05). 결론: 견관절 충돌 증후군의 치료로 근막 동통 증후군의 증상이 호전되는 결과로 볼 때 견관절 충돌 증후군이 근막 동통 증후군의 원인으로 작용할 가능성이 있는 것으로 생각된다. Purpose: In order to study the frequency and the site of pain with shoulder impingement syndrome accompanied by myofascial pain syndrome (MPS), and to see how the treatment of impingement syndrome effects the improvement in myofascial pain. Materials and Methods: Among patients diagnosed with shoulder impingement syndrome with MPS and who complained around of shoulder muscle pain 53 subjects were selected as subjects for this study. Patients were divided into three groups according to method of treatment; the first group was the cases who received impingement injection test, the second group were only carried out isometric strengthening exercise of the periscapular muscles and the rotator cuff, and the third group was the cases who failed conservative treatment and had a surgical operation. All subjects had a physical examination before treatment to see if the MPS was present in the muscles around the shoulder, the range of motion of shoulder, and the American Shoulder and Elbow Society (ASES) shoulder score were measured. Results: There was no relation to between age, gender, impingement signs, tenderness around the joints, the range of motion and ASES shoulder score. The VAS was reduced from 6.2±2.3 to 1.2±1.5 (p<0.01), and ASES shoulder score increased from 32.1±15.3 to 87.5±17.7 (p<0.05). The differences among treatments of the three groups were not significant in pain and treatment outcome (p>0.05). Conclusion: Treatment of shoulder impingement syndrome reduced the symptoms of MPS, thus shoulder impingement syndrome can be the one of the causes of MPS.

그래프 신경망을 통한 욕창 발생 판별 모델에 관한 연구

정호열(Ho-Youl Jung),김연희(Yeonhee Kim),최장환(Jang-Hwan Choi),현정근(Jung Keun Hyun) 한국통신학회 2022 한국통신학회 학술대회논문집 Vol.2022 No.6

흰쥐 시상하부에서 BDNF(Brain Derived Neurotrophic Factor)의 발현 및 분포에 관한 연구

이영일(Young-Il Lee),현정근(Jung-Keun Hyun) 대한해부학회 2009 Anatomy & Cell Biology Vol.42 No.2

BDNF belongs to the neurotrophin family and important molecular mediator of functional and structural plasticity. The highest levels of BDNF are found in the hippocampus and hypothalamus of the adult rat. Hypothalamus is important because of its high degree of plasticity, but little is known about distribution of BDNF in hypothalamic nuclei. Therefore, it is necessary to study distribution and expression pattern of BDNF in each hypothalamic nuclei to understand changes of BDNF through various neural damages including spinal cord injury. Through this experiment, we found specific BDNF expression pattern in some regions of hypothalamus and the results are as follows. 1) BDNF expressions were found in median eminence, arcuate nucleus, supraoptic nucleus, and periventricular nucleus of rat hypothalamus. 2) BDNF immunoreactive cells and nerve fibers were of various shapes and sizes. 3) Glial cells also express BDNF in certain hypothalamic nuclei. These results seem to be useful for future investigations of neurochemical changes in the hypothalamus induced by various neural trauma or degenerative changes. 본 연구에서는 흰쥐 시상하부에서 신경영양인자인 BDNF의 발현양상을 부위별로 분석함은 물론, 이중면역형광염색을 통해 신경세포뿐만 아니라 아교세포에서의 발현여부도 함께 살펴보았다. BDNF는 중추신경계통에서 특히 해마와 시상하부에 많이 분포하는 특징이 있으며, 본 연구의 결과로 나타난 시상하부에서의 발현양상은 다음과 같다. 1) 정중융기, 활꼴핵, 시각로위핵, 그리고 뇌실주위핵에서 BDNF의 발현이 확인되었다. 2) BDNF의 발현양상은 다양한 형태의 세포와 신경섬유를 통해 나타났다. 3) 시각로위핵과 활꼴핵의 일부분에서는 BDNF의 발현이 아교세포에서도 나타났다. 시상하부는 내외부적인 생리적 자극들에 끊임없이 대처해야 하므로 중추신경계통에서도 기능적 유연성이 많이 요구된다. 그리고 신경영양인자들 중에서도 BDNF는 특히 이에 관여하는 중요한 요소임에도 불구하고 시상하부에서의 부위별 발현양상에 대한 연구는 아직 미비한 상태이다. 따라서 다양한 크기와 형태로 존재하는 각각의 시상하부핵에 대해 BDNF의 발현양상을 명확히 밝히는 것이 무엇보다 중요하다.

회귀 모델을 이용한 인공 고관절 전치환술(THRA) 이후 보행 회복 예측

최서영(Seoyoung Choi),현정근(Jung Keun Hyun),김유나(Yuna Kim),오세종(Sejong Oh) 한국정보기술학회 2023 Proceedings of KIIT Conference Vol.2023 No.11

제 1천수 신경근병증에서 H 반사와 체성 감각 유발전위의 진단적 가치

이성재,현정근,정선근 大韓再活醫學會 1998 Annals of Rehabilitation Medicine Vol.22 No.3

신티그라피를 이용한 연하곤란의 정량적 평가

권범선,이성재,현정근,정인성,박승태,정선용 大韓再活醫學會 1999 Annals of Rehabilitation Medicine Vol.23 No.4