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허혈성 뇌졸중의 진단, 치료 및 예후 예측에 대한 기계 학습의 응용: 서술적 고찰
은미연,전은태,정진만,Mi-Yeon Eun,Eun-Tae Jeon,Jin-Man Jung 제주대학교 의과학연구소 2023 The Journal of Medicine and Life Science Vol.20 No.4
Stroke is a leading cause of disability and death. The condition requires prompt diagnosis and treatment. The quality of care provided to patients with stroke can vary depending on the availability of medical resources, which in turn, can affect prognosis. Recently, there has been growing interest in using machine learning (ML) to support stroke diagnosis and treatment decisions based on large medical data sets. Current ML applications in stroke care can be divided into two categories: analysis of neuroimaging data and clinical information-based predictive models. Using ML to analyze neuroimaging data can increase the efficiency and accuracy of diagnoses. Commercial software that uses ML algorithms is already being used in the medical field. Additionally, the accuracy of predictive ML models is improving with the integration of radiomics and clinical data. is expected to be important for improving the quality of care for patients with stroke.
항Hu 및 항SOX1자가항체가 동시에 확인된 아테졸리주맙 연관 자가면역뇌염
은미연,하형석,황재춘 대한신경과학회 2024 대한신경과학회지 Vol.42 No.1
Although immune checkpoint inhibitor-related encephalitis has been reported, its underlying mechanism and treatment strategies remain unclear. Here, we present the case of a 60-yearold male patient with small cell lung cancer who developed autoimmune encephalitis during treatment with atezolizumab. Notably, this case involved the concurrent detection of two paraneoplastic autoantibodies (anti-Hu and anti-SOX1). Encephalitis was treated by discontinuing atezolizumab and administering steroids, despite the persistence of the antibodies. This case provides insights into the interaction between immune checkpoint inhibitors and paraneoplastic autoantibodies.
권두혁,도영록,은미연,이준,박형종,손성일,홍정호 대한의학회 2020 Journal of Korean medical science Vol.35 No.35
Coronavirus disease 2019 (COVID-19) is an ongoing pandemic infection associated with high morbidity and mortality. The Korean city of Daegu endured the first large COVID-19 outbreak outside of China. Since the report of the first confirmed case in Daegu on February 18, 2020, a total of 6,880 patients have been reported until May 29, 2020. We experienced five patients with ischemic stroke and COVID-19 during this period in four tertiary hospitals in Daegu. The D-dimer levels were high in all three patients in whom D-dimer blood testing was performed. Multiple embolic infarctions were observed in three patients and suspected in one. The mean time from stroke symptom onset to emergency room arrival was 22 hours. As a result, acute treatment for ischemic stroke was delayed. The present case series report raises the possibility that the coronavirus responsible for COVID-19 causes or worsens stroke, perhaps by inducing inflammation. The control of COVID-19 is very important; however, early and proper management of stroke should not be neglected during the epidemic.
Transient Increase in Intrathoracic Pressure as a Contributing Factor to Cardioembolic Stroke
석흥열,서우근,은미연,권도영,박문호,오경미 대한신경과학회 2010 Journal of Clinical Neurology Vol.6 No.4
Background:The hemodynamic effects of increased intrathoracic pressure (ITP) have been the focus of many investigations. However, very little is known about the effects of elevated ITP on the occurrence of stroke. Case Report:Four young patients with a cardioembolic source of stroke were examined. In all cases the stroke was preceded by an increase in ITP that occurred during coughing, vomiting, or sexual intercourse. Conclusions:We suggest that cardioembolic stroke is facilitated by situations in which ITP is elevated.
좌측 후두엽-측두엽의 경색으로 인해 발생한 Balint 증후군 1예
이상민(Sang Min Lee),이승혜(Seung Hye Lee),최윤선(Youn Seon Choi),은미연(Mi-Yeon Eun),오경미(Kyungmi Oh) 대한임상노인의학회 2009 대한임상노인의학회지 Vol.10 No.4
Balint 증후군은 1909년에 Balint에 의해 보고된 것으로 안실행증(optic ataxia), 시각 실조증(ocular apraxia), 동시실인(simultanagnosia)을 3대 증상으로 한다. 이러한 3가지 임상증상은 양측 두정엽-후두엽(parientooccipital lobe)의 병변과 관련되어 있으며, 이 부위의 뇌경색이 가장 흔한 원인으로 보고되어 있다. 저자들은 양측 두정엽-후두엽 부위의 경색은 아니나 Balint 증후군의 증상을 나타내는 환자가 있어 보고하는 바이다. 68세 남자 환자로 갑자기 발생한 우측 상하지 쇠약감주소로 내원하였다. 환자는 Balint 증후군의 3대 증상을 보였으나 뇌 자기공명상에서 좌측 후두엽-측두엽의 내측과 좌측 시상부위에 경색 소견이 관찰되었다. Balint syndrome, first described by Balint in 1909, is a triad of visual perceptual difficulty including optic ataxia, ocular apraxia, and simultanagnosis. These three clinical symptoms are related to lesions in the partieto-occipital lobe in which cerebral infarction is the most common cause that has been reported. We described a patient that had symptoms consistent with Balint syndrome where a cerebral infarction in both parieto-occipital lobes did not exist. A 68-year-old man presented with sudden development of right-sided weakness. Although the patient displayed the classical clinical triad in Balint syndrome, a brain MRI illustrated an infarction in the medial portion of left temporo-occipital lobe and in the left thalamus.