• 대한유전성대사질환학회지
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• 제20권1호
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• pp.1-13
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• 2020

Gaucher disease (GD)는 glucocerebrosidase 유전자(GBA)의 돌연변이에 의하여 발병하는 전세계적으로 가장 유병율이 높은 리소좀 축적질환이다. GD는 신경학적인 증상의 유무에 따라 3가지 임상형으로 구분된다. 신경병증 GD인 2형과 3형의 경우는 대뇌에서 glucosylceramide (GlcCer)와 glucosylsphingosine (GlcSph)의 농도가 증가하면서 신경세포의 심각한 손실이 야기되는 특징을 보인다. 신경교종에서 유래한 H4 세포를 GD에서 증가하는 기질인 GluCer와 GlcSph를 첨가하여 배양하였을 때, 심각한 DNA손상과 더불어 세포의 사멸이 야기되는 것과 이러한 신경세포의 사멸은 GluCer 보다는 GlcSph을 처리하였을 때 더 현저하게 증가하는 것을 관찰하였다. H4 세포에 히스톤 탈아세틸화 효소(HDAC) 6의 저해제인 tubacin과 GlcSph을 함께 처리하였을 경우에는 DNA손상은 물론 GlcSph에 의하여 유도된 세포사멸과 관련된 단백질 인자들의 발현이 모두 감소되었다. 본 연구를 통해 GlcSph이 세포사멸을 통하여 신경병증 GD의 발병에 주요한 역할을 한다는 것을 알 수 있었고, HDAC6 저해제가 신경병증 GD 환자를 위한 치료제 후보물질로 제시될 수 있는 가능성을 확인하였다.

• 재활치료과학
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• 제3권2호
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• pp.71-81
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• 2014

목적: 본 연구의 목적은 CPM (Continuous Passive Motion)을 뇌졸중 환자의 손 기능 및 수부 근력 재활에 사용하고 그 영향을 살펴보는데 있다. 연구방법 : 본 연구의 대상자는 뇌졸중으로 인한 편마비 증상을 가진, Brunnstrom 4-6단계에 해당하는 치료후 18개월 이내의 급성기 환자 3명이다 연구방법은 3명의 대상자에 대하여 단일사례 (A-B) 실험설계를 사용하였으며 CPM의 영향을 검사하기 위해 젭슨수지기능, 퍼듀페그보드, 수부근력 세 가지를 측정하였다. CPM 적용기간은 3주였으며, 적용회수는 하루 2회, 매회 20분씩, 총 30회기였다. 연구결과: 수부근력 측정 중 손끝잡기에서 대상자 2명의 값이 변화가 없었다. 그 외의 젭슨수지기능, 퍼듀페그보드, 수부근력 검사에서는 CPM 적용 후의 검사 결과가 향상되었다. 결과의 유효성 검증을 위하여 비모수적 통계방법인 Wilcoxon signed ranks test를 실시한 결과 모든 항목에 대한 P-Value가 0. 05 보다 큰 값이 나와 처치 전 후 값의 차이가 통계적으로는 유의미하지 않다는 결과를 얻었다. 결론: 참여 대상자 수가 적고 프로그램 적용 기간이 짧은 제한점이 있으나, 수부 재활을 위해 실시한 CPM이 연구대상자 전원의 손 기능 및 근력 향상에 영향을 주었다는 것을 확인하였다. 이는 주로 하지 기능과 근력 향상을 위해 사용되는 CPM이 급성기 뇌졸중 환자의 수부 치료에도 유용하게 사용될 수 있음을 보여준다.

• 한국임상수의학회지
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• 제27권2호
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• pp.186-189
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• 2010

14년 령의 암컷 치와와견이 발작증세 및 좌측으로의 선회운동 증상을 보여 내원하였다. 신경검사결과 좌측 대뇌 병변이 의심되어 자기공명영상 촬영을 실시하여 좌측 비강에서 좌측 대뇌로 파급된 병변을 확인하였다. 영상 분석 상에서 비강 내에서 유래된 2차적인 뇌종양이 강력하게 의심되었다. 환자의 증상은 프레드니솔론과 로무스틴의 혼합치료 후 상당히 개선되었고 진단 후 2개월간 생존하였다. 조직 검사 결과 비강에서 유래한 신경내분비암종으로 확진되었다. 본 증례보고는 개에서 발생한 비강유래 신경내분비암종의 침윤에 의한 2차적인 뇌종양의 임상적인 특징, 영상 진단 결과, 그리고 조직학적인 특성을 잘 보여주고 있다.

• Tuberculosis and Respiratory Diseases
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• 제45권3호
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• pp.596-603
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• 1998

소세포 폐암에 동반된 LEMS는 부종양성 증후군의 일종으로 LEMS가 진단된 환자의 50% 이상에서 소세포 폐암이 동반되는데 특히 흡연력이 있는 고령에서 잠재성암을 진단하기 위한 적극적인 노력이 필요하다. 저자 등은 기괸지경 검사상 조직학적으로 진단되지 않았으나 폐암이 강력히 의심되어 적극적으로 수술적 치료를 시행하여 소세포 폐암을 진단하였고, 수술 후 LEMS의 임상양상이 호전되었으며 항암 화학요법후 추가로 호전된 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• 제59권6호
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• pp.637-642
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• 2016

Objective : Although many treatment modalities have been introduced for trigeminal neuralgia (TN), the long-term clinical results remain unsatisfactory. It has been particularly challenging to determine an appropriate treatment strategy for patients who have responded poorly to initial therapies. We analyzed the surgical outcomes in TN patients who failed prior treatments. Methods : We performed a retrospective analysis of 37 patients with recurrent or persistent TN symptoms who underwent surgery at our hospital between January 2010 and December 2014. Patients with follow-up data of at least one year were included. The prior treatment modalities of the 37 patients included microvascular decompression (MVD), gamma knife radiosurgery (GKRS), and percutaneous procedures such as radiofrequency rhizotomy (RFR), balloon compression, and glycerol rhizotomy (GR). The mean follow-up period was 69.9 months (range : 16-173). The mean interval between the prior treatment and second surgery was 26 months (range : 7-123). We evaluated the surgical outcomes using the Barrow Neurological Institute (BNI) pain intensity scale. Results : Among the 37 recurrent or persistent TN patients, 22 underwent MVD with partial sensory rhizotomy (PSR), 8 received MVD alone, and 7 had PSR alone. Monitoring of the surgical treatment outcomes via the BNI pain intensity scale revealed 8 (21.6%) patients with a score of I, 13 (35.1%) scoring II, 13 (35.1%) scoring III, and 3 (8.2%) scoring IV at the end of the follow-up period. Overall, 91.8% of patients had good surgical outcomes. With regard to postoperative complications, 1 patient had transient cerebrospinal fluid rhinorrhea (2.7%), another had a subdural hematoma (2.7%), and facial sensory changes were noted in 8 (21.1%) patients after surgery. Conclusion : Surgical interventions, such as MVD and PSR, are safe and very effective treatment modalities in TN patients who failed initial or prior treatments. We presume that the combination of MVD with PSR enabled us to obtain good short- and long-term surgical outcomes. Therefore, aggressive surgical treatment should be considered in patients with recurrent TN despite failure of various treatment modalities.

• The Korean Journal of Pain
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• 제29권4호
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• pp.239-248
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• 2016

Background: The present study was undertaken to evaluate the incidence of chronic persistent post-surgical pain (CPPP) and the role of signal transduction genes in patients undergoing staging laparotomy for carcinoma ovary. Methods: The present observational study was undertaken following institutional ethical committee approval and informed consent from all the participants. A total 21 patients of ASA grade I to III with age 20-70 years, scheduled for elective staging laparotomy for carcinoma ovary were included. Patients were excluded if had other causes of pain, cognitive dysfunction or chronic neurological disorders. Statistical analysis of pool data was done using SPSS version-17. For various scales like GPE, PDQ, NPSI, the visual analogue scale (VAS), global perceived effect (GPE), the pain DETECT questionnaire (PDQ), and neuropathic pain symptoms inventory (NPSI), one factor repaeted measure ANOVA applied with simple contrast with baseline as on post-operative day 1 (considered as reference and compared with subsequent time-interval), and the P values were adjusted according to "Bonferroni adjustments". In patients with CPPP, the ${\Delta}ct$ values of mRNA expressions of genes at the end of postoperative day 90 were compared with the baseline control values by one factor repeated ANOVA. P value < 0.005 significant. Results: The present study demonstrates 38.1% (8 out of 21 patients) incidence of CPPP. The functional status and quality of life as were observed to be significantly diminished in all patients with chronic pain. An up-regulation in the mRNA expression of signal transduction and a positive correlation was noted between the mRNA expression of signal transduction genes and VAS score in all patients with CPPP at the end of postoperative day 90. Conclusions: The reported incidence of CPPP in patients with carcinoma ovary was 38.1%. An up-regulation and positive correlation between mRNA expression of signal transduction genes and VAS score depicts its potential role in the pathogenesis of CPPP.

• Journal of Korean Neurosurgical Society
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• 제29권6호
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• pp.748-753
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• 2000

Objectives : A 10-year retrospective clinical study was undertaken to determine the differences between two groups according to age at presentation(group A, under 50 ; B, over 50). Methods : We analyzed 468 cases with chronic subdural hematoma admitted to the department of neurosurgery in our hospital from January 1987 to December 1996. The patients were divided into two groups according to age at presentation(group A, under 50 ; B, over 50). Results : 1) The number of group A was 126 cases(26.9%) and that of group B was 342 cases(73.1%), respectively. Males were more frequently involved than females in each group. 2) There noted a history of head trauma in 88.9% of group A and 92.4% of group B. Forty-nine patients(38.9%) of group A and 103 cases(30.1%) of group B revealed a history of alcoholism. 3) Group A patients presented with symptoms of increased intracranial pressure such as headache(75.% ), nausea and vomiting(68.0%). However, Group B patients had more frequent mental changes(84.0%) and focal neurological deficits such as hemiparesis(76.5%). 4) Onset of symptom and its duration was shorter in group A than group B. 5) Six patients among 441 cases(1.4%) treated with burr hole drainage and two patients of 27 cases(5.4%) with craniotomy died, and all of these were group B patients. The two cases among six patients with burr hole drainage developed huge intracerebral hemorrhage and brain stem hemorrhage, respectively. Conclusion : In treating patients with chronic subdural hematoma, distinguishing between two age groups is quite helpful to determine treatment strategies.

• 한국임상수의학회지
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• 제34권6호
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• pp.449-453
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• 2017

A 3-year-old castrated male Maltese dog, weighing 4.8 kg was referred with hindlimb ataxia and right forelimb proprioceptive deficits were shown for 20 months. Chiari-like malformation and syringomyelia diagnosed through MRI at a local animal hospital and Knuckling of right forelimb and reluctance to walk were managed with steroid. The medical management was getting ineffective to manage for the symptoms one month before referred. Physical and neurological examinations, radiography, computed tomography, and magnetic resonance imaging were performed and diagnoses of caudal occipital malformation syndrome (COMS) and subsequent syringomyelia (SM) were made. Given that pharmacological treatment was previously ineffective, surgical intervention was recommended. Foramen magnum decompression with duraplasty using $Lyoplant^{(R)}$ was performed. Three days post-surgery, the dog showed improved gait and activity. After 2 months, the dog received no additional prescription medications. At the 12-month follow-up after surgery, the dog showed no clinical problems or recurrences, despite complete cessation of pharmacological treatment. In present report, we applied $Lyoplant^{(R)}$ as a dural graft has been carried out in a dog with COMS. Surgical decompression with $Lyoplant^{(R)}$ was an effective long-term (12-month) treatment for COMS without the need for any pharmacological treatment.

• 혜화의학회지
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• 제8권2호
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• pp.245-257
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• 2000

A clinical study was done 40 patients of chronic prostatitis who was treated in Dept. of Internal Medicine, Oriental Medicine Hospital, Taejon University, from 1 Mar. 1999 to 31 Oct. 1999. The results were as follows. 1. In distribution of age, 30's and 40's were 57.5% the most, 20's and 60's were 35.0%, 50's was 7.5%. 2. In distribution of past history, the urethritis(45.0%) was the most. 3. In distribution of ocupation, a white-collar worker was 35.0%, a business man was 22.5%, a public servant was 12.5%, etc. 4. Sitting the mean time of day were distributed 5~7 hours, above 7 hours, 3~5 hours, under 3 hours, etc. 5. The resting interval of a long distance drive were distributed 2 hours(35.0%), 3 hours(32.5%), etc. 6. The habit of enduring ejaculation during sexual intercourse was showed 45.0%. 7. The habit of enduring urination was showed 20.0%. 8. Influency of mental stress was showed 90.0%. 9. Ten cases(25.0%) were showed riding horse or riding bicycle. 10. Four cases(10.0%) were showed wearing tight trousers. 11. The habit of put a wallet his hip pocket was showed 57.5%. 12. The most common symptom was distributed the others symp-tom(66.8%) and the voiding symptom(63.3%) more than pain-neuro-logical symptom(37.5%) and symptom related with sexual function (26.6%). 13. In distribution of palpation, lower abdominal pain, lumbar pain, perineal or parascrotal pain were mostly showed right side. Moreover diagnosis of pulsation was weakly showed chi pulse of right. 14. Duration of disease were distributed above 1 year(82.5%), under 1 year(17.5%). Degree of prostatitis was severe showed adove 1 year. 15. The distribution of WBC count of the prostatic secretion, com-paring with before therapy and after therapy, were showed from 5 cases to 0 case in very many/HPF, from 23 cases to 13 cases in many/HPF, from 12 cases to 13 cases in 10~30/HPF, from 0 case to 13 cases in under 10/HPF. 16. Therapeutic improvement of symptom were distributed pain-neurological symptom(94.8%), the others symptom(90.8%), the void-ing symptom(89.6%) and symptom related with sexual function(67.5%). 17. Differentiation of symptoms and signs were distributed dificiency of spleen-lung vital energy, wetness-heat of lower warmer, dificiency of spleen-kidney yang, dificiency of kidney yin, wetness-phlegm, dificiency of vital energy and blood. The prescriptions were Bojungikgitang(44.6%), Yukmijihwangtang(20.7%), Palmijihwangtang(12.0%), etc.

• 성인간호학회지
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• 제12권2호
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• pp.196-208
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• 2000

The purpose of the study was to explore the effect of 2 hour infusion of vancomycin(1g) in 200ml of isotonic saline every 12 hour on the frequency of "red man syndrome", phlebitis and length of peripheral catheter placement of infected patients, in order to provide safe infusion method for reducing vancomycinin-duced RMS and phlebitis. The subjects of the study consisted of 16 hospitalized patients; 3 oncology and gastro-intestinal patients, 1 neurological patient, 6 thoracic surgical patients and 6 orthopedic patients, who had received vancomycin from July to October in 1999 at S-hospital. The dependent variables were the incidence of RMS, phlebitis and the length of peripheral catheter placement. The incidence of RMS was checked by an inspector at the first night whenever the infusion method of vancomycin was changed. RMS was observed every 15 minutes during an hour for symptoms of RMS such as itching, erythema, chest pain and systolic blood pressure. Incidence of phlebitis was assessed by inspector twice a day from the insertion of peripheral catheter to the removal of the catheter. The data were analyzed by percentage, mean, $X^2$-test, t-test, repeated ANOVA, and logistic regression analysis using the SPSSWIN program. The results are summarized as follows; 1. No significant difference was identified in frequency of RMS between the experimental group and control group. 2. There was no significant difference in the change of systolic blood pressure as the time goes on between the experimental group and control group. 3. The incidence of phlebitis was significantly lower in the experimental group than in the control group. 4. The length of peripheral catheter placement was significantly longer in the experimental group than in the control group. 5. Other drugs administrated with vancomycin didn't influence the occurrence of phlebitis. However, the infusion method of vancomycin influenced the occurrence of phlebitis. The results suggest that 2 hour infusion of vancomycin(1g) in 200ml of isotonic saline every 12 hours may decrease the incidence of phlebitis and increase the length of peripheral catheter placement compared to 1 hour infusion of vancomycin(1g) in 100ml of isotonic saline every 12 hours. However, it does not reduce the incidence of RMS.