• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.275-285
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• 2011

Purpose: Head-up position during sleep is one of the non-pharmacologic interventions for the treatment of orthostatic hypotension. Because the head-up position causes discomfort in many patients, this approach may not be acceptable to all patients. We compared the systolic blood pressure in erect position, orthostatic hypotension, orthostatic disability score, and the improvement rates of orthostatic hypotension between the 20 cm head-up group and the 10 cm head-up group. Methods: A control pre/post-test design was used. Between August 1, 2009 and November 15, 2010, we consecutively enrolled patients who showed orthostatic hypotension in patients with Parkinsonian disorders. Sixty-seven patients were prospectively enrolled and forty-four patients were completed the study. Results: There were no statistically significant differences found in the systolic blood pressure in erect position, orthostatic hypotension, and orthostatic disability scores between the two groups. However, five patients showed improvement in 20 cm head-up group and one patient was showed improvement in 10 cm head-up Group. Conclusion: Orthostatic hypotension is decreased with 20 cm head-up position in some patients with Parkinsonian disorders (p=.034). Further research investigating the relationships between orthostatic hypotension and head-up position are warranted.

• Journal of Sasang Constitutional Medicine
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• v.34 no.3
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• pp.69-80
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• 2022

A 52-year-old female diagnosed with Atypical Parkinsonian Disorders (APD) about one year ago suffered from dizziness and gait disturbance. The patient was identified as Taeeumin esophagus-cold lung-dry symptomatology pattern and was treated with Jowisengcheong-tang. The patient's symptoms of dizziness and night sweats were assessed using Global Assessment Scale (GAS). And, the Unified Multiple System Atrophy Rating Scale (UMSARS) and the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) were used to assess the overall function of the patient. The patient's symptoms of dizziness and night sweats were significantly improved, and UMSARS and MDS-UPDRS scores were decreased. This case showed that Sasang constitutional medicine treatment can improve APD symptoms and improve the quality of life of the patient.

• Speech Sciences
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• v.11 no.4
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• pp.129-141
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• 2004

An auditory-perceptual evaluation has long been utilized in assessing dysarthric speech. The process involves subjective judgement and the results might vary depending on clinical experiences or training of listeners. This study aimed to investigate reliability of the auditory-perceptual evaluation of 22 multi -dimensional variables on 6 patients with Parkinsonian speech disorders. Listeners were divided into two groups: one consisted of 6 speech therapists with clinical experiences for three years or more, and the other 6 graduate students without any previous clinical background. The results showed that the former evaluated dysarthric speech with higher inter-rater and intra-rater reliabilities than the latter. Furthermore, such speech variables as 'precise consonant: 'speech intelligibility: and 'SMR regularity' were more influenced than others by clinical experiences. We, therefore, postulated that a reliable auditory-perceptual evaluation of dysarthric speech may require adequate amount of clinical training of listeners.

• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.13-20
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• 2011

Neuro-ophthalmological findings are common and occasionally prominent features in movement disorders. Accordingly, careful evaluation of the ocular motor functions may provide valuable information in early detection of the diseases and monitoring of the progression. Furthermore, accurate assessment of the abnormal ocular motor findings aids in understanding the pathophysiology and mechanisms of the movement disorders, and in their differential diagnosis. Ocular motility examination should include bedside evaluation and laboratory recording of the fixational abnormalities, saccades, smooth pursuit, the vestibulo-ocular reflex, optokinetic nystagmus, and vergence eye movements. In this review, we will discuss various ocular motor findings in ataxia and parkinsonian syndromes, and hyperkinetic movement disorders.

• Speech Sciences
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• v.11 no.2
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• pp.39-49
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• 2004

An auditory-perceptual rating scale has long been utilized in an evaluation procedure of Parkinsonian speech. This study attempted to investigate various variables and appropriate equal-interval rating scale for each variable. We collected speech samples from 27 patients with Parkinsonian speech disorders. A total of 25 variables and descriptions for each variable across phonatory, resonatory, and articulatory dimensions were included in the rating scale. The descriptive parts of each variable could increase the objectivity of the rating scale.

• Phonetics and Speech Sciences
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• v.7 no.2
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• pp.55-62
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• 2015

It is widely accepted that Parkinson's disease(PD) is the most common cause of hypokinetic dysarthria, and its characteristics of 'short rushes of speech' have become more evident along with the severity of motor disorders. Speech alternate motion rates (AMRs) are particularly useful for observing not only rate abnormalities but also deviant speech. However, relatively little is known about the characteristics of 'short rushes of speech' in terms of AMRs of PD except for the perceptual characteristics. The purpose of this study was to examine which acoustic features of 'short rushes of speech' in terms of AMRs are a robust indicator of Parkinsonian speech. Numbers of syllabic repetitions (/pə/, /tə/, /kə/) in AMR tasks were analyzed through acoustic methods observing a spectrogram of the Computerized Speech Lab in 9 patients with PD. Acoustically, we found three characteristics of 'short rushes of speech': 1) Vocalized consonants without closure duration(VC) 76.3%; 2) No consonant segmentation(NC) 18.6%; 3) No vowel formant frequency(NV) 5.1%. Based on these results, 'short rushes of speech' may affect the failure to reach and maintain the phonatory targets. In order to best achieve the therapeutic goals, and to make the treatment most efficacious, it is important to incorporate training methods which are based on both phonation and articulation.

• The Journal of Korean Medicine
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• v.44 no.4
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• pp.104-120
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• 2023

Objectives: The purpose of this study was to explore the therapeutic mechanism of acupuncture and bee venom acupuncture (BVA) in patients with idiopathic Parkinson's disease (IPD) using positron emission tomography (PET) and arterial spin labeling (ASL). Methods: Patients with IPD who received a stable dose of anti-parkinsonian medication for at least 4 weeks were recruited and randomly divided into one of two groups: treatment and control. The treatment group (11 subjects) received acupuncture and BVA at acupoints, and the control group (9 subjects) received sham acupuncture and normal saline injections at non-acupoints, twice per week for 12 weeks. The patients were examined using PET and ASL at baseline and after the 12-week treatment. In addition, age- and sex-matched healthy subjects without neurological symptoms and history were recruited to compare ASL data of patients with IPD. Results: PET results revealed that striatal dopamine transporter binding increased in each group after 12 weeks. Although the change was larger in the treatment group, the difference was not statistically significant. In ASL results, the treatment group exhibited hyperperfusion in specific regions compared with the healthy control group. After 12 weeks' intervention, hyperperfusion regions were recovered only in the treatment group. In contrast, significant changes were not found in hyperperfusion regions in the control group after 12 weeks. Conclusions: Our findings suggest that the therapeutic mechanisms of acupuncture and BVA in IPD are different from placebo and operate by altering dopamine availability and recovering hyperactivity in cerebral blood flow.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.10-18
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• 2009

Purpose: We investigated quantification of dopaminergic transporter (DAT) and serotonergic transporter (SERT) on $^{123}I$-FP-CIT SPECT for differentiating between multiple systemic atrophy (MSA) and idiopathic Parkinson's disease (IPD). Materials and Methods: N-fluoropropyl-$2{\beta}$-carbomethoxy-$3{\beta}$-4-[$^{123}I$]-iodophenylnortropane SPECT ($^{123}I$-FP-CIT SPECT) was performed in 8 patients with MSA (mean age: $64.0{\pm}4.5yrs$, m:f=6:2), 13 with early IPD (mean age: $65.5{\pm}5.3yrs$, m:f=9:4), and 12 healthy controls (mean age: $63.3{\pm}5.7yrs$, m:f=8:4). Standard regions of interests (ROls) of striatum to evaluate DAT, and hypothalamus and midbrain for SERT were drawn on standard template images and applied to each image taken 4 hours after radiotracer injection. Striatal specific binding for DAT and hypothalamic and midbrain specific binding for SERT were calculated using region/reference ratio based on the transient equilibrium method. Group differences were tested using ANOVA with the postHoc analysis. Results: DAT in the whole striatum and striatal subregions were significantly decreased in both patient groups with MSA and early IPD, compared with healthy control (p<0.05 in all). In early IPD, a significant increase in the uptake ratio in anterior and posterior putamen and a trend of increase in caudate to putamen ratio was observed. In MSA, the decrease of DAT was accompanied with no difference in the striatal uptake pattern compared with healthy controls. Regarding the brain regions where $^{123}I$-FP-CIT binding was predominant by SERT, MSA patients showed a decrease in the binding of $^{123}I$-FP-CIT in the pons compared with controls as well as early IPD patients (MSA: $0.22{\pm}0.1$ healthy controls: $0.33{\pm}0.19$, IPD: $0.29{\pm}0.19$), however, it did not reach the statistical significance. Conclusion: In this study, the differential patterns in the reduction of DAT in the striatum and the reduction of pontine $^{123}I$-FP-CIT binding predominant by SERT could be observed in MSA patients on $^{123}I$-FP-CIT SPECT. We suggest that the quantification of SERT as well as DAT using $^{123}I$-FP-CIT SPECT is helpful to differentiate parkinsonian disorders in early stage.