• Journal of Korean Neurosurgical Society
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• 제29권8호
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• pp.1024-1029
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• 2000

Objectives : With recent improvements in neuroimaging and the development of third and fourth-generation radiosurgical dose-planning soft ware, came a renewed interest in using radiosurgery for the treatment of movement disorders. Radiosurgery involves no opening of the cranium and no incisions, eliminating both the risk of hemorrhage from passing an electrode to the depths of meningitis from operative infection. It is for these reasons stereotactic radiosurgical treatment of movement disorders has value in a small subgroup of patients. The authors report four cases of Parkinson's disease and one case of dystonia that were treated by Gamma knife. Methods : Radiosurgical nucleus ventralis intermedius thalamotomy using the gamma knife unit was performed to make lesion in two Parkinson's disease patients. A radiation dose of 120Gy was delivered to nucleus using a single 4-mm collimator plug pattern following classic anatomical landmarks. Patients were followed for a median of 10.5 months(range 9-12 months). An independent neurological evaluation of tremor, based on the change in the United Parkinson's Disease Rating Scale tremor score(UPDRS), was correlated with a subjective evaluation. Gamma knife ventrolateral(V.O.P) thalamotomy was performed in one case of dystonia. A central dose of 150Gy was delivered and the patient was followed for 18 months. Gamma knife globus pallidus interna pallidotomy was performed in two Parkinson's disease patients. A radiation dose of 130Gy(range 120-140Gy) was delivered. Patients were followed for a median of 13 months(range 9-14 months). Result : Ventrolateral thalamotomy in dystonia produced regained left hand usage in order to be able to use the telephone. Ventralis intermedius thalamotomy produced an excellent improvement of the tremor in one case, mild improvement of the tremor in the other case of Parkinson's disease. A globus pallidus internalis(GPi) pallidotomy produced improvement of rigidity and dyskinesia : one other showed no change. There were no neurological complications. Conclusion : Gamma Knife thalamotomy considered a safe and effective technique for the treatment of tremor in Parkinson's disease. Although the results from Longer follow-up is not available yet, the short-term results seem to be encouraging.

• 트랜스-
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• 제14권
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• pp.35-63
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• 2023

파킨슨병은 신체 움직임을 담당하는 도파민의 부족으로 신체 기능의 장애로 기본적인 일상생활까지 영향을 미치는 퇴행성 신경질환이다. 현재 의술로는 완치가 힘들어 병의 지연과 예방 차원으로 운동치료에 관심을 모으고 있다. 이에 본 연구에서는 펠든크라이스 기법®을 파킨슨병 환자에게 적용하여 심신의 상태를 스스로 돌볼 수 있는 신체 움직임 프로그램을 설계하고 보급하는데 목적을 갖는다. 펠든크라이스 기법®은 신체 움직임을 이용한 심신 자각 학습 방법으로 신경가소성의 기능인 뇌와 행동을 연결하여 신경계를 재교육하는 방법론이다. 본 연구에서는 연구자가 개발하고 검증한 신체 움직임 프로그램을 펠든크라이스 기법®의 자각(⾃覺)에 초점을 맞추어 수정·보완하였다. 24회기의 신체 움직임 프로그램은 파킨슨병 환자의 자기관리능력을 향상하기 위해 5단계로 구성하였다. 첫 번째 단계는 자기 인식이고 두 번째 단계는 자기 관찰이다. 셋째, 자기조직화, 넷째, 자기 통제. 그리고 다섯 번째 단계는 자기 관리다. 전반적인 변화는 자신의 상태를 인식하고 내적 감각과 외적 환경의 변화를 감지하는 능력을 향상시킨다. 결론적으로 파킨슨병 환자에게 심신 기능의 향상과 자기관리가 가능한 신체 움직임 프로그램을 펠든크라이스 기법을 적용하여 설계하였다. 앞으로 설계된 프로그램을 현장 적용 가능성 여부는 후속과제로 남긴다. 나아가 노년층의 웰니스를 위한 움직임의 참고자료로 메타버스를 적용한 과학분야와의 융합적 협력을 통해 보다 폭넓게 확산될 수 있도록 체계적 구조를 구축할 필요가 있다.

• 말소리와 음성과학
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• 제4권3호
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• pp.161-169
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• 2012

The purpose of this study was to investigate the characteristics of speech intelligibility of spontaneous speech and the vowel space parameters in patients with Parkinson's disease. Ten PD patients (M=5, F=5) and a corresponding control group of ten normal adults participated in this study. Firstly, subjects were asked to tell a story about their hometown and youth in order to analyze speech intelligibility. Secondly, the subjects were also asked to repeat four vowels (/a/, /i/, /u/, /e/) five times in order to compare their vowel spaces. The results were as follows: (1) the speech intelligibility of the PD group was lower than that of the control group. (2) Four parameters including vowel area, vowel articulatory index, formant centralization ratio, F2i/F1u ratio were significantly different in each group. For instance, vowel area and F2 ratio were wider and higher, respectively. As a result, a decrease in speech intelligibility of patients with PD is likely to show different types of errors from the normal group. The results of this research are meaningful in a sense that they could provide the objective standard of speech intelligibility and vowel space parameters.

• 대한한방내과학회지
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• 제27권4호
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• pp.954-961
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• 2006

As society ages, the seriousness of Parkinson's disease in the elderly increases. This study was performed in order to evaluate the effect of Korean medical treatments on Parkinson's symptoms. An elderly patient was diagnosed with Parkinson's disease by clinical symptoms, which were resting tremor, pill-rolling tremor and mild bradykinesia. We treated her disease with Korean medical treatment, including herbal medicine and acupuncture therapy and excluding western medication. For the herbal medicine, Insamyangyeong-tang (人參養榮湯), Bobi-tang (補脾湯), Dokhwaljihwang-tang (獨活地黃湯) and Sipimijihwang-tang (十二味地黃湯) were primarily used. In result, the clinical symptoms, measured by unified Parkinson's disease rating scale (UPDRS) and modified Hoehn and Yahr stage (H-Y stage), of Parkinson's disease in this patient had improved after the Korean medical treatment. This study suggests that Korean medical treatments can be applicable to improve symptoms in patients with Parkinson's disease.

• 재활간호학회지
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• 제13권2호
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• pp.140-150
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• 2010

Purpose: This study aims to find the factors that affect the degree of self-care performance in Parkinson's disease (PD) patients. Method: This study used a descriptive correlational design. The data were collected using a sample of 80 PD patients, from the university affiliated Parkinson Center in Busan. Pearson's correlations and multiple regression analyses were conducted using the SPSS 18.0. Results: The mean score of the self-care performance was 3.61 (${\pm}0.40$). The highest score observed of self-care performance subscale was medication subscale ($4.55{\pm}0.50$) and the lowest score was observed in the exercise subscale ($3.03{\pm}0.64$). The self-care performance had significant correlations with depression (r=-.32, p<.01), self-care knowledge (r=.28, p<.05), function of motion (r=.25, p<.05), ability of daily activity (r=.22, p<.05), self-efficacy (r=.24, p<.05), and support from medical staff (r=.24, p<.05). The significant predictors of self-care performance included depression (${\beta}=-.28$), status of employment (${\beta}=-.27$), self-care knowledge (${\beta}=-.21$), support from medical staff (${\beta}=-.28$), and educational level (${\beta}=-.28$), accounting for 34% of the variance in the self-care performance. Conclusion: Depression, self-care knowledge, medical support are significant predictors which affect the self-care performance with PD patients.

• 대한물리의학회지
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• 제7권3호
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• pp.259-265
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• 2012

Purpose : Patients with Parkionson's disease have a temporal and spatial restriction for their's exercise treatment. The aim of this study is to verify the effectiveness of e-exercise program on balance, gait, and endurance ability in people with Parkinson's disease. Methods : Eighteen participants, with Parkinson's disease that ranged from stage to on the Hoehn & Yahr scale, were assigned to two group. Two group were divided into on-line group that exercised in home by computer video, and off-line group that exercised in clinical center. Exercise program that included 3 sections (warm-up, main exercise, cool down)-5 parts(stretch, strength, balance, gait, stretch) was used to train for participants. We used the functional reach test for balance ability, timed up and go test for gait ability, 6 minute walking test for endurance ability. Wilkoxon sign lank tests were used to assess the difference of balance, gait, and endurance ability in pre-and post test each groups. Mann-whitney tests were used to assess the difference of balance, gait, and endurance ability between groups. Results : Wilkoxon sign lank tests revealed that both group were improved the balance, gait and endurance agility by e-exercise program intervention. Mann-whitney tests showed that there were no differences between groups in the variation of balance, gait, endurance ability. Conclusion : We believe that exercise program with on-line(e-exercise program) is an effective intervention for people with Parkinson's disease and is no different than off-line exercise group in the variation of balance, gait, endurance ability.

• 대한한방내과학회지
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• 제44권5호
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• pp.846-854
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• 2023

Objectives: The purpose of this study is to report the case of a patient with Parkinson's disease experiencing anxiety and insomnia treated with Korean medicine therapies. Methods: A patient diagnosed with Parkinson's disease with anxiety and insomnia was treated with Korean medicine therapies, including herbal medication (Gyejigayonggolmolye-tang), acupuncture, electro-acupuncture, and moxibustion, for 18 days. To evaluate the therapeutic effect, we checked the Beck Anxiety Inventory (BAI) and Insomnia Severity Index (ISI) scores to monitor anxiety and insomnia. Results: After treatment, the patient's BAI and ISI scores for anxiety and insomnia decreased. Further, the patient and her protector mentioned that their quality of life had improved. Conclusion: These results suggest that Korean medicine therapies with Gyejigayonggolmolye-tang have a beneficial effect on anxiety and insomnia in patients with Parkinson's disease.

• Journal of Acupuncture Research
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• 제24권3호
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• pp.163-174
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• 2007

Objectives : This study was designed to evaluate the effect of acupuncture on Heart Rate Variability(HRV) of patients with Parkinson's disease. Methods: Subjects were voluntarily recruited through newspaper and internet advertisement. All the subjects were confirmed as idiopathic Parkinson's disease by a neurologist. Patients were divided into three groups. Experimental group was acupunctured based on Sasang Constitution. Standard group was acupunctured on $LR_3$, $GB_{34}$ and $ST_{36}$. Control group was sham-acupunctured. Acupuncture was applied 2 times a week for four weeks by an oriental medical doctor at Kyung-hee Oriental Medical Hospital. The patients were assessed by HRV before and 4 weeks after the treatment. Results : The results were as follows 1. In experimental group, increase in SDNN, TP, LF, HF Nonn were statistically significant after 4 weeks compared to the pre-treatment. 2. In standard group, increase in SDNN, TP, LF were statistically significant after 4 weeks compared to the pre-treatment. 3. After 4 weeks of treatment SDNN, LF showed statistically significant cufferences among three groups. Conclusions : This study suggests that acupuncture treatment based on Sasang Constitution and other specific acupuncture treatment can be beneficial for patients with idiopathic Parkinson's disease. Further study on various acupuncture treatment for Parkinson's disease is required.

• 대한간호학회지
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• 제43권5호
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• pp.636-648
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• 2013

Purpose: The purpose of this study was to explore the health-illness transition of patients with Young-Onset Parkinson's Disease (YOPD). Methods: From June to November 2011, 17 patients with YOPD who visited a neurologic clinic in a tertiary hospital participated in the study. Data were collected through in-depth interviews and analyzed using the grounded theory of Strauss and Corbin. Results: The core category of the participants' health-illness transition emerged as 'reshaping identity following uncontrollable changes'. The participants' health-illness transition process consisted of six phases in sequence: ego withdrawal, loss of role, frustration, change of thought, modification of life tract, and second life. Although most participants proceeded through the six phases chronologically, some returned to the frustration phase and then took up the remaining phases. Conclusion: The study results provide an in-depth understanding of health-illness transition experiences in the participants. These findings suggest a need to develop appropriate nursing intervention strategies according to the different phases in the health-illness transition of patients with YOPD.

• 대한간호학회지
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• 제37권2호
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• pp.242-248
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• 2007

Purpose. Parkinson's disease (PD) is a common neurodegenerative disorder characterized by motor disabilities and increasing dependence on others for daily life activities with consequent impact on patients' and caregivers' quality of life. The aim of this study was to elucidate the burden on primary caregivers of patients with PD, and identify related factors. Methods. A cross-sectional descriptive study. Seventy-six primary caregivers of PD patients in a neurology out-patient clinic, Seoul, Korea completed structured questionnaires, of which 68 were analyzed. The structured self-report questionnaire included (1) demographic information on the caregivers, (2) information regarding the disease characteristics of the patients, and (3) the subjective and objective caregiver burdens as assessed on Montgomery, Gonyea, & Hooyman's scale. Results. The mean age of the caregivers was 54.56 years, and spouses represented the largest proportion (47.0%). Caregivers of PD patients experienced high levels of burden (mean scores on the subjective and objective burdens were 45.22 and 34.90, respectively), which were comparable to the caregiver burdens in stroke, and higher than the caregiver burdens in general chronic disease. Older caregivers and spousal caregivers experienced significantly higher burdens (p=.004 and p=.019, respectively). A greater motor disability and higher modified Hoehn and Yahr grade were related to higher caregiver burden (p=.001 and p=.018, respectively). Conclusion. Caring for PD patients is associated with a high level of caregiver burden. Therefore, healthcare professionals should identify the burden of caregivers who look after PD patients and develop comprehensive management strategies both for patients and their caregivers.