• 턱관절균형의학회지
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• 제13권sup호
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• pp.1-8
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• 2023

Objectives: Parkinson's disease (PD) is currently the most rapidly increasing degenerative brain disease due to population aging and westernization of lifestyle. Levodopa is the most commonly used drug to manage PD symptoms. However, levodopa has a problem in that the wearing-off phenomenon occurs as the duration and dose of administration increase. In order to investigate the wearing-off phenomenon in PD patients and devise countermeasures, we conducted a questionnaire survey in Korea. Methods: For the study, a questionnaire with a total of seven items was prepared. Part IV of the MDS-UPDRS (Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale) and the WOQ-9 (9-symptom Wearing-off Questionnaire) were used as references. Results: Of the 48 patients who completed the questionnaire, all 47 patients who completed the questionnaire experienced the wearing-off phenomenon. Only one of the patients diagnosed with PD a year ago did not experience the wearing-off phenomenon. Patients frequently mentioned a lack of sleep and stress as aggravating factors for wearing-off. They also stated that in order to resolve the off-state, they walked, massaged, warmed up the body, stretched and exercised. Conclusions: Because wearing-off is such a common occurrence, it is thought necessary to develop wearing-off prevention and resolution measures that PD patients can use in their daily lives.

• 대한한의학회지
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• 제17권1호
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• pp.48-83
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• 1996

Our conclusions for function evaluation tools of Stroke patients are as follows. 1. Evaluating tools of Activities of Daily Living, Katz Index, Barthel Index, Modified Barthel Index have high validity and reliability because of ease of measuring, high accuracy, consistency, sensitivity and sufficient stastistics, but they mainly measure motor function except sense, mentation, language, and social conception. Therefore cerebrovascular disease and brain injury in trauma patients with lacked acknowledgement and sensation, we are not able to apply these tools. 2. PULSES Profile is a useful scale for measuring the patient's over-all status, upper and lower limb functions, sensory components, excretary functions, and intellectual and emotional adaptabilities. It is recognized as a good, useful tool to evaluate patient's whole function. 3. Motor Assessment Scale was designed to measure the progress of stroke patients. The scale was supplemented with upper arm function items. We believe that the Motor Assessment Scale could be a useful evaluation tool with inter-rater reliability ,test-retest reliability. 4. The existing evaluation tools, Katz Index, Barthel Index, Modified Barthel Index, PULSES Profile, Motor Assessment Scale, mainly measured the rehabilitational motor function of sequela of cerebrovascular patients. On the other hand CNS & INH stroke scale can measure cerebrovascular disease patient's neurologic deficits and over-all stautus, which are recognition ability, speech status, motor function, sensory function, activities of daily living. Those scales have been recognized as useful tools to measure function of cerebrovascular disease patients and have increased in use. 5. Every function evaluation tool was recognized to have some validity and inter-rater, test-retest reliability in items of each evaluation tool and total scores of each evaluation tools, but it is thought that none of these scales have been fully validated and proved reliable. Therefore afterward, the development of a highly reliable rating system may best be accomplished by a careful comparison of several tools, using the same patients and the same observers in order to choose the most reliable items from each. 6. Ideal evaluation tools must have the following conditions; (1) It should show the objective functional statues at the same time. (2) It should be repeated consecutively to know changed function status. (3) It should be easy to observe the treatment program. (4) It should have the same result with another rater to help rater exchange information with treatment team members. (5) It should be practical and simple. (6) The patient should not suffer from the observer.

• Journal of Acupuncture Research
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• 제21권5호
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• pp.59-68
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• 2004

Objective : This study was designed to evaluate the effect of electroacupuncture with various scales on symptoms of idiopathic Parkinson's disease. Methods : Subjects were voluntarily recruited by newspapers and internet. All the subjects are confirmed as idiopathic parkinson's disease by a neurologist. The acupuncture therapy was performed twice a week for 8 weeks. Acupuncture points for EA group were GB34, and LR3, electrical stimulation frequency was 120Hz, duration 15 minutes, and intensity is up to pain threshold according to patients. The patient's symptoms were assessed before, after 4 weeks and after 8 weeks treatments by unified Parkinson's disease rating scale(UPDRS), modified Hoehn-Yahr(H-Y) stage, Schwab & England activity of daily living and freezing of gait questionnaire(FOGQ). Results : UPDRS I, II, III, IV and total UPDRS scores were significantly improved after 4 weeks(p<0.05) and after 8 weeks(p<0.05) compared to the pre-treatment. The scores of ADL were significantly improved after 4 weeks(p<0.05) and after 8 weeks(p<0.05). There were significant changes in H-Y stage after 4 weeks(p<0.05), but There were no significant changes in H-Y stage after 8 weeks. There were significant changes in FOGQ scale after 4 weeks(p<0.05) and after 8 weeks(p<0.05). Conclusion : This study suggests that electroacupuncutre treatments can be applicable to improve symptoms in the patients with idiopathic Parkinson's disease.

• 대한한방내과학회지
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• 제38권2호
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• pp.276-283
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• 2017

Objective: This case study describes the use of traditional Korean medicine to relieve chest pain and headaches in a patient with ischemic heart disease. Methods: The patient was treated with a range of traditional Korean medicine, including acupuncture, moxibustion, and herbal medicines (Gamiondam-tang and Cheonmabanhwa-tang-gagambang). The Numerical Rating Scale (NRS) was used to measure the patient's status and improvements in the frequency of symptoms. Results: After the treatment, the NRS score for chest pain and headaches decreased from 6 to 0. In addition, chest discomfort and palpitations almost subsided. Conclusion: This clinical case study suggested that Gamiondam-tang and Cheonmabanhwa-tang-gagambang could be effective in relieving chest discomfort and headaches.

• 대한상한금궤의학회지
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• 제8권1호
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• pp.53-65
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• 2016

Objective : The purpose of this paper is to report the improved contact dermatitis(CD) treated with the herbal medication based on Shanghanlun disease pattern identification diagnostic system. The level V steroid ointments were no use to the patient 3weeks before the treatment. Methods : In this case, the patient was diagnosed according to 'Disease Pattern Identification Diagnostic System based on Shanghanlun Provisions' and took Mahwang-tang for 36days since the final diagnosis was Taeyang-byung, number 46 provision. The photographs of patient's hands were taken to observe the process of the skin status and the discomfort from CD was measured with DLQI(Dermatologic Life Quality Index) and NRS(Numeric Rating Scale). Results : The DLQI score changed from 24 to 7 and NRS of itching changed form 8 to under 4. Conclusions : This case report shows that the herbal medication through the diagnostic system could be a remedy on CD, dealing with the skin status with no use of the level V steroid ointments. It is needed proving an alternative possibility of Korean Medicine, on other skin diseases, with later studies since there are many reports on the side-effects after some long-term steroid treatments.

• Journal of Korean Biological Nursing Science
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• 제4권2호
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• pp.5-18
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• 2002

Purpose: Women have been often underdiagnosed and undertreated when they have as high mortality as men of ischemic heart disease, such as angina. One of the reasons of women's under treatment is associated with either vague, non-traditional symptoms or longer delay in seeking professional help when they experience ischemic heart disease. This study was conducted to investigate the characteristics of women's anginal pain induced by the treadmill test and to explore the potential relationship(s) between anginal pain and other psycho-physiologic factors. Methods: Of 22 female patients referred to treadmill test, 7 with positive finding participated in this study. Anginal pain in the past was analyzed by Rose questionnaire, whereas anginal pain induced by the treadmill test was identified by McGill pain scale, visual analogue scale and present pain index. Results: Women expressed more heaviness than sharp pain, and complained splitting more often than subjects in previous study that included both men and women. Pain intensity by VAS $3.64{\pm}3.94$, Pain rating index was $5.14{\pm}7.29$, present pain index was $1.57{\pm}1.81$, duration of pain was $5.14{\pm}4.8$ min. Exercise intensity was $6.0{\pm}4.63$ METs, exercise duration was $364.29{\pm}141.39$ sec, ST change was -2.0mm and rate of perceived exertion was $16.29{\pm}2.06$. The relationships between pain intensity and pain duration, ST segment changes were significant. Correlation among pain measures was significant. Conclusion: Generalization of these pilot findings may be inappropriate, and therefore, further larger study is needed.

• 대한한방내과학회지
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• 제43권2호
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• pp.130-143
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• 2022

Objective: This case report presents the effects of traditional Korean medical treatment for a patient with symptoms of the upper burner due to Beçhet's disease. Methods: A 42-year-old male patient was treated with traditional Korean herbal medicine (herbal formulas and patent medicines), acupuncture, and cupping therapy. Neck, ocular, and right wrist pain and xerostomia were assessed daily with a numeric rating scale (NRS) and grading assessment tool for subjective symptoms. Results: For a total of 20 days over two hospitalizations, the patient's neck pain was relieved from NRS 4 to 1, the ocular pain from NRS 5 to 1, the right wrist pain from NRS 7 to 1, and the xerostomia from grade 8 to 1. Conclusion: These results show that Beçhet's disease symptoms of the upper burner can be relieved with traditional Korean medical treatment, although additional well-designed studies are required to confirm these findings.

• Journal of Korean Neurosurgical Society
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• 제54권2호
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• pp.118-124
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• 2013

Objective : Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective treatment of choice for patients with advanced idiopathic Parkinson's disease (PD) who have motor complication with medication. The objectives of this study are to analyze long-term follow-up data of STN DBS cases and to identify the factors related to outcomes. Methods : Fifty-two PD patients who underwent STN DBS were followed-up for more than 3 years. The Unified Parkinson's Disease Rating Scale (UPDRS) and other clinical profiles were assessed preoperatively and during follow-up. A linear regression model was used to analyze whether factors predict the results of STN DBS. We divided the study individuals into subgroups according to several factors and compared subgroups. Results : Preoperative activity of daily living (ADL) and the magnitude of preoperative levodopa response were shown to predict the improvement in UPDRS part II without medication, and preoperative ADL and levodopa equivalent dose (LED) were shown to predict the improvement in UPDRS part II with medication. In UPDRS part III with medication, the magnitude of preoperative levodopa response was a predicting factor. Conclusion : The intensity of preoperative levodopa response was a strong factor for motor outcome. And preoperative ADL and LED were strong factors for ADL improvement. More vigorous studies should be conducted to elucidate how levodopa-induced motor complications are ameliorated after STN DBS.

• 정신신체의학
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• 제27권1호
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• pp.60-68
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• 2019

연구목적 갑상선관련 호르몬과 인지기능의 상관 유무는 논란이 되고 있다. 알츠하이머병과 경도인지장애 환자에서 갑상선관련 호르몬 농도에 차이가 있는지 비교해 보고, 나아가 갑상선관련 호르몬 농도가 인지기능의 어떠한 영역과 관련이 있는지에 대해 연구해보고자 하였다. 방 법 2011년 1월부터 2018년 12월까지 기억력 저하를 주소로 일산백병원 정신건강의학과 치매클리닉을 방문하여 알츠하이머병(NINCDS-ADRDA 진단기준)과 경도인지장애(Petersen 진단기준) 으로 진단된 105명의 환자를 대상으로 한 후향적 연구이다. 갑상선관련 호르몬[삼요오드티로닌(Triiodothyronine, T3), 티록신(Thyroxine, T4), 갑상선 자극 호르몬(Thyroid stimulating hormone, TSH)]의 측정은 화학발광면역측정법을 사용하여 검사하였다. 알츠하이머병군과 경도인지장애군 간의 갑상선관련 호르몬의 평균치 분석을 위하여 독립표본 t-검정을 시행하였다. 갑상선관련 호르몬이 전반적 퇴화 척도(Global deterioration scale, GDS), 치매임상평가척도(Clinical dementia rating, CDR) 및 한국형 임상치매평가척도(The Korean version of the consortium to establish a registry for Alzheimer's disease, CERAD-K)의 각 항목 별 점수들과 유의한 상관이 있는지 알아보기 위하여 한국판 노인우울척도(Geriatric depression scale-Korean version, GDS-K)를 통제변수로하여 편상관분석을 시행하였다. 결 과 총 105명의 환자 중 알츠하이머병군은 74명, 경도인지장애군은 31명이었다. 알츠하이머병군과 경도인지장애군 간 혈청 T3, T4, TSH 농도의 평균은 모두 유의한 차이가 없었으나, CERAD-K 항목 중 구성행동 검사(Construction praxis test, CPT)가 혈청 TSH 농도와 유의한 양의 상관 관계를 보였다(p-value=0.004). 결 론 본 연구에서 실행기능과 연관된 CPT가 혈청 TSH 농도와 유의한 양의 상관 관계를 보인 것은 갑상선관련 호르몬과 치매의 병태생리와의 연관성에 대한 이해에 도움을 줄 수 있다고 생각한다. 향후 갑상선관련 호르몬이 인지기능에 미치는 병태생리 기전에 관한 전향적 연구들이 필요할 것으로 사료된다.

• 정신신체의학
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• 제22권1호
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• pp.40-45
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• 2014

연구목적 경도인지장애와 치매는 인지기능의 퇴행과 우울 등과 같은 신경정신증상을 나타낸다. 이들의 진단에 도움을 줄 수 있는 다양한 진단 도구 중 혈중 호모시스테인 농도를 측정하는 방법이 있으며, 연구에 따르면 혈중 호모시스테인 농도의 증가는 알쯔하이머병, 우울증 그리고 다른 신경정신질환의 발생위험을 증가시킨다. 본 연구는 혈중 호모시스테인이 인지기능장애와 연관된다는 사실을 기초로 경도인지장애와 알쯔하이머형 치매에서 우울증상 유무에 따른 혈중 호모시스테인 농도를 분석해보았다. 방법 경도인지장애, 알쯔하이머형 치매로 진단된 환자 86명이 참여하였고 혈액검사를 통해 혈중 호모시스테인 농도를 측정하였다. 환자들의 전반적인 인지기능 및 심각도의 단계 평가는 한국판 간이정신상태검사(MMSE-KC)와 전반적 퇴화척도(Global Deterioration Scale, GDS), 치매임상평가척도(Clinical dementia rating, CDR)를 이용하여 측정하였고, 우울증상 유무에 대한 평가는 한국판 노인우울척도(Korean version of Geriatric Depression Scale, K-GDS)를 통해 측정하였다. 결과 혈중 호모시스테인 농도는 경도인지장애군 중 우울증상이 있는 군에서 우울증상이 없는 군보다 통계적으로 유의한 높은 수치를 보였다. 치매환자군에서는 우울증상이 있는 군과 우울증상이 없는 군사이에 통계적으로 유의한 차이는 없었다. 상관분석에서 혈중 호모시스테인 농도와 MMSE-KC는 유의한 음의 상관 관계를 보였고, CDR, GDS는 유의한 양의 상관 관계를 보였다. 결론 이러한 결과는 혈중 호모시스테인 농도의 증가가 인지기능저하와 우울증의 위험인자라는 사실을 나타낸다. 특히 본 연구에서는 경도인지장애 환자군에서 혈중 호모시스테인 농도와 우울증상 간의 의미있는 연관성을 제시하였다. 본 연구 중의 몇 가지 제한점을 보완한 좀 더 대규모의 연구가 필요하다.