• 제목/요약/키워드: Parkinsonian disorders

검색결과 8건 처리시간 0.022초

파킨슨증 환자에서 수면 시 두부거상 정도에 따른 기립성 저혈압의 변화 (Changes in Orthostatic Hypotension According to the Levels of Head-up Position during Sleep in Patients with Parkinsonian Disorders)

  • 김성렬;채현숙;윤미정;박수영;정다희;이향희;정선주;안영희;김경옥
    • 임상간호연구
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    • 제17권2호
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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.

비정형파킨슨증후군 태음인의 어지럼증과 보행장애 치험례 (A Case-Study of Taeeumin Patient with Atypical Parkinsonian Disorders Having Dizziness and Gait Disturbance)

  • 박지은;김국화;이슬;이용재;이정윤
    • 사상체질의학회지
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    • 제34권3호
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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.

파킨슨증으로 인한 마비말장애의 청지각적 평가에 대한 신뢰도 연구 (A Reliability Study on the Auditory-perceptual Evaluation of Parkinsonian Dysarthria)

  • 김향희;이미숙;김선우;이원용
    • 음성과학
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    • 제11권4호
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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.

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이상운동질환에서의 안구운동장애 (Abnormal Ocular Motilities in Movement Disorders)

  • 박홍균;김지수
    • Annals of Clinical Neurophysiology
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    • 제13권1호
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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.

파킨슨증으로 인한 마비말장애에 대한 청지각적 평가척도 (An Auditory-perceptual Rating Scale of Dysarthric Speech of Patients with Parkinsonism)

  • 김향희;이미숙;김선우;최성희;이원용
    • 음성과학
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    • 제11권2호
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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.

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파킨슨병 환자의 교대운동속도 과제에서 관찰된 '말 뭉침'의 음향학적 특성 (Acoustic Characteristics of 'Short Rushes of Speech' using Alternate Motion Rates in Patients with Parkinson's Disease)

  • 김선우;윤지혜;이승진
    • 말소리와 음성과학
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    • 제7권2호
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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.

Neuroimaging Assessment of the Therapeutic Mechanism of Acupuncture and Bee Venom Acupuncture in Patients with Idiopathic Parkinson's Disease: A Double-blind Randomized Controlled Trial

  • Young-Eun Lee;Seung-Yeon Cho;Han-Gyul Lee;Seungwon Kwon;Woo-Sang Jung;Sang-Kwan Moon;Jung-Mi Park;Chang-Nam Ko;Seong-Uk Park
    • 대한한의학회지
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    • 제44권4호
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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.

$^{123)I$-FP-CIT SPECT를 이용한 다중계위축증 및 조기 파킨슨병에서의 평가 (Evaluation of Multiple System Atrophy and Early Parkinson's Disease Using $^{123)I$-FP-CIT SPECT)

  • 오소원;김유경;이병철;김범산;김지선;김종민;김상은
    • Nuclear Medicine and Molecular Imaging
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    • 제43권1호
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    • pp.10-18
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    • 2009
  • 목적: 본 연구는 다중계위축증(MSA)과 원발성 파킨슨병(IPD)의 감별 진단을 위하여 $^{123}I$-FP-CIT SPECT를 사용하여 선조체내 도파민신경시스템 및 선조체외의 모노아민시스템을 평가하였다. 대상 및 방법: 총 13명의 IPD 환자(남:여=9:4, $65.5{\pm}5.3$세), 8명의 MSA 환자(남:여=6:2, $64.0{\pm}4.5$세), 정상인 12명(남:여=8:4, $63.3{\pm}5.7$세)에게 $^{123}I$-FP-CIT SPECT를 시행하였다. 도파민 운반체 분석을 위해 선조체내 미상핵과 전, 후피각에 관심영역을 설정하고 세로토닌 운반체 분석을 위해 시상하부와 뇌교에 관심영역을 각각 정한 뒤 각 부위에서 $^{123}I$-FP-CIT의 결합잠재능(binding potential, BP=V3")을 계산하였다. V3"는 비특이적 결합에 대한 특이 결합의 비율을 이용하여 구하였고 비특이적 결합 부위는 후두엽 영역에서 계수를 측정하였다. 결과: 선조체 전체 및 미상핵과 전후피각 각각에서의 도파민 운반체의 농도는 MSA와 IPD환자 모두에서 정상인에 비해 현저한 감소를 나타내었다(p<0.05). 특히 IPD환자 군에서는 후측 피각에서의 도파민 운반체 농도에 심한 감소를 보여 전후피각비가 정상군에 비하여 유의하게 증가되었으며($1.55{\pm}0.34$ vs. $1.29{\pm}0.06$, p=0.026), 미상핵/피각비은 증가된 양상을 보였으나 유의수준에 도달하지는 못하였다($1.24{\pm}0.20$ vs. $1.11{\pm}0.06$, p=0.23). MSA의 경우 전후피각비($1.32{\pm}0.19$)와 미상핵/피각비($1.07{\pm}0.25$)에서 정상군과 차이가 없었다. 세로토닌 운반체에 의한 뇌교에서의 섭취는 MSA환자군에서 정상군 및 IPD환자군에 비하여 감소되어 있는 경향을 나타내었으며(정상:$0.33{\pm}0.19$, IPD: $0.29{\pm}0.19$, MSA: $0.22{\pm}0.1$) 시상하부에서는 각 군에서 뚜렷한 차이가 없었다. 결론: 본 연구에서 $^{123}I$-FP-CIT SPECT 영상을 이용하여 IPD와 MSA환자의 선조체 도파민 운반체의 감소정도와 양상을 평가하고, 뇌교 및 시상하부에서의 세로토닌 운반체 섭취의 감소를 평가하였다. $^{123}I$-FP-CIT SPECT에 의한 선조체내 도파민 운반체 변화 및 뇌교에서의 세로토닌 운반체의 변화의 가시화 및 정량화는 MSA와 IPD의 조기 감별에 도움이 유용할 것이다.