Investigate of Administration Reform under the Plight of Parkinson

Qianxia YUE 위기관리 이론과 실천 2016 위기관리 이론과 실천 학술대회 Vol.2016 No.08

All along, our Chinese government’s internal administrative organization has been conducting reforms to strengthen the organization system. However, there are still complexities in the organizations and personnel, leading to organizational inefficiency and other issues. This article from the perspective of Parkinson's Law to study it. Firstly, analyze the meaning and applying condition of Parkinson's Law; Then analyze whether Parkinson's Law can explain the problems existing in the administrative organization; Secondly, management mechanism for coping with Parkinson's Law are designed and related interpretations of Parkinson's Law in the field of emergency management will be made; Finally, suggestions will be made by comparing the experience of developed countries in dealing with Parkinson's plight to guide our country get out of the cycle of Parkinson .

Clinical characteristics of parkinsonism in frontotemporal dementia according to subtypes

Park, Hee Kyung,Park, Kee Hyung,Yoon, Bora,Lee, Jae-Hong,Choi, Seong Hye,Joung, Jee H.,Yoon, Soo Jin,Kim, Byeong C.,Kim, Seung Hyun,Kim, Eun-Joo,Na, Duk L.,Park, Kyung Won Elsevier Pub. Co 2017 Journal of the neurological sciences Vol.372 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>We investigated the prevalence of parkinsonism in frontotemporal dementia (FTD) subtypes and the cognitive and behavioral differences between FTD with and without parkinsonism in a well-structured, prospective cohort.</P> <P><B>Methods</B></P> <P>One hundred and ninety-one FTD patients were enrolled and all patients underwent comprehensive neurological evaluations, neuropsychological tests, and the Unified Parkinson's Disease Rating Scale.</P> <P><B>Results</B></P> <P>The prevalence of parkinsonism was 38.7% (74 patients), and included 33 (46.5%) behavioral variant FTD (bvFTD), 16 (24.2%) semantic dementia (SD), 19 (45.2%) progressive nonfluent aphasia (PNFA), and 6 (50%) FTD associated with motor neuron disease (FTD-MND). SD patients with parkinsonism had higher CDR sum of boxes scores (9.7±4.5 vs 6.2±4.5, <I>p</I> =0.024), frontal behavioral inventory total score (33.7±20.5 vs 24.3±14.5, <I>p</I> =0.045), and executive function score of frontal executive dysfunction, disinhibition, and apathy (28.9±13.7 vs 19.2±12.9, <I>p</I> =0.021) than those without parkinsonism. Seoul Instrumental Activities of Daily Living score (bvFTD: 23.5±11.7 vs 17.3±11.3, <I>p</I> =0.031, SD: 23.1±11.1 vs 11.3±9.3, <I>p</I> =0.005) was higher for bvFTD and SD with parkinsonism than for those without parkinsonism.</P> <P><B>Conclusions</B></P> <P>Parkinsonism is found to be more common in patients with bvFTD, PNFA, and FTD-MND patients than those with SD. Behavioral disturbances were more prominent in SD with parkinsonism than without. Additional studies are needed to determine the pathomechanism and optimal treatment of parkinsonism in different FTD subtypes.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Parkinsonism was present in about 40% of FTD and in all FTD subtypes. </LI> <LI> Global cognitive deficits did not differ between FTD with and without parkinsonism. </LI> <LI> Behavioral disturbances were more severe in SD patients with parkinsonism than in those without. </LI> <LI> Instrumental ADL index was more impaired in bvFTD and SD patients with parkinsonism than in those without. </LI> <LI> Parkinsonism may serve as an important clue to the diagnosis of FTD. </LI> </UL> </P>

Investigate of Administration Reform under the Plight of Parkinson

Qianxia YUE 위기관리 이론과 실천 2016 위기관리 이론과 실천 세미나발표논문집 Vol.2016 No.-

All along, our Chinese government’s internal administrative organization has been conducting reforms to strengthen the organization system. However, there are still complexities in the organizations and personnel, leading to organizational inefficiency and other issues. This article from the perspective of Parkinson’s Law to study it. Firstly, analyze the meaning and applying condition of Parkinson’s Law; Then analyze whether Parkinson’s Law can explain the problems existing in the administrative organization; Secondly, management mechanism for coping with Parkinson’s Law are designed and related interpretations of Parkinson’s Law in the field of emergency management will be made; Finally, suggestions will be made by comparing the experience of developed countries in dealing with Parkinson’s plight to guide our country get out of the cycle of Parkinson.

Clinical Aspects of the Differential Diagnosis of Parkinson’s Disease and Parkinsonism

신혜원,홍상욱,윤영철 대한신경과학회 2022 Journal of Clinical Neurology Vol.18 No.3

Parkinsonism is a clinical syndrome presenting with bradykinesia, tremor, rigidity, and postural instability. Nonmotor symptoms have recently been included in the parkinsonian syndrome, which was traditionally associated with motor symptoms only. Various pathologically distinct and unrelated diseases have the same clinical manifestations as parkinsonism or parkinsonian syndrome. The etiologies of parkinsonism are classified as neurodegenerative diseases related to the accumulation of toxic protein molecules or diseases that are not neurodegenerative. The former class includes Parkinson’s disease (PD), multiple-system atrophy, progressive supranuclear palsy, and corticobasal degeneration. Over the past decade, clinical diagnostic criteria have been validated and updated to improve the accuracy of diagnosing these diseases. The latter class of disorders unrelated to neurodegenerative diseases are classified as secondary parkinsonism, and include drug-induced parkinsonism (DIP), vascular parkinsonism, and idiopathic normal-pressure hydrocephalus (iNPH). DIP and iNPH are regarded as reversible and treatable forms of parkinsonism. However, studies have suggested that the absence of protein accumulation in the nervous system as well as managing the underlying causes do not guarantee recovery. Here we review the differential diagnosis of PD and parkinsonism, mainly focusing on the clinical aspects. In addition, we describe recent updates to the clinical criteria of various disorders sharing clinical symptoms with parkinsonism.

Alpha-Synuclein Expression in Patients with Parkinson’s Disease: A Clinician’s Perspective

김한준 한국뇌신경과학회 2013 Experimental Neurobiology Vol.22 No.2

Although physiological function of alpha-synuclein is not yet clearly understood, accumulating evidence strongly suggests it plays a crucial role in the pathogenesis of Parkinson disease. Pathologically, alpha-synuclein is a major component of Lewy bodies, which is the pathological hallmark of Parkinson disease. Alpha-synuclein pathology is observed in the brainstem nuclei, including the dorsal motor nucleus of the vagus nerve, the locus ceruleus, and the substantia nigra in the early phase of Parkinson disease and it may ‘spread’ to cerebral cortical areas in the advanced Parkinson disease and appears to have a role in the cognitive decline in Parkinson disease. Recently, it is suggested that alpha-synuclein pathology in Parkinson disease starts in the olfactory bulb or enteric nervous system and then spreads to the brainstem. In accordance with this hypothesis, alpha-synuclein pathology has been found in gastric mucosa and colonic mucosa of patients with Parkinson disease. Genetically, SNCA mutations including point mutation and copy number variation are known to cause familial Parkinson disease, further supporting the assumption that alpha-synuclein plays a crucial role in Parkinson disease pathogenesis. In addition, recent GWAS studies consistently show that the SNPs in SNCA genes are associated with risk for sporadic Parkinson disease. It is also known that variations in the promoter region or 3’UTR of SNCA, which increases the expression of SNCA, are associated with the risk for Parkinson disease. Collectively, these findings suggest that further studies on alpha-synuclein will lead to the elucidation of the mechanism of and therapy for Parkinson disease.

파킨슨병, 파킨슨 의증 환자 2례에서 추나치료에 대한 증례보고

김창연,민지연,최영규,고영탁,정영훈,김태수,Kim, Chang-Yeon,Min, Ji-Yeon,Choi, Young-Gui,Koh, Young-Tak,Jung, Young-Hoon,Cho, In-Hee,Kim, Tae-Soo 척추신경추나의학회 2005 대한추나의학회지 Vol.6 No.1

Object : To discuss the Use of Chuna treatment in managing two patients with Parkinson's disease and/or Parkinson' syndrome Methods : This clinical study was carried out of 2 cases with confirmed by certified neurologist Parkinson's disease and/or Parkinson' syndrome. One case had been admitted from 2004.09.16 to 2004.09.24 and treated from 2004.09.26 to 2004.10.15 and the other case had been admitted from 2004.10.21 to 2004.11.06 and treated from 2004.11.08 to 2004.11.15 in the department of acupuncture and moxibustion of Ha-na oriental medical center. Results : There was significant improvement in condition of the two patients treated by Chuna treatment(upper cervical to promote CSF circulation) on Parkinson's disease or Parkinson' syndrome. Conclusion: In the case, we treated two patients of Parkinson's disease and/or Parkinson' syndrome. Chuna treatment efficiently relieved the symptoms including tremor and bradykinesia.

Femur Fractures in Parkinsonism: Analysis of a National Sample Cohort in South Korea

안수정,이승환,이서영,권재우,이승준,김영주 대한신경과학회 2017 Journal of Clinical Neurology Vol.13 No.4

Background and Purpose Falling with a femur fracture is a serious event that negatively affects the quality of life of elderly individuals as well as patients with parkinsonism. This study investigated the association between parkinsonism and femur fracture and compared the risk of femur fracture between subjects with and without parkinsonism. Methods This study examined a population-based matched cohort constructed using the National Sample Cohort data set, which comprises approximately one million subscribers to medical insurance and aid in South Korea. Subjects with parkinsonism during 2003–2013 were identified as the exposed group, and up to five individuals matched for age, sex, and index years were identified as the controls for each parkinsonism subject. The risk of femur fracture for parkinsonism was evaluated using Cox regression. Results The incidence of femur fracture according to age, sex, and body mass index varied significantly between subjects with parkinsonism and controls (p<0.001). The presence of parkinsonism was associated with a higher risk of femur fractures for males [hazard ratio (HR)= 2.85, 95% confidence interval [CI]=1.87–4.34], subjects younger than 65 years (HR=2.89, 95% CI=1.64–5.11), and underweight subjects (HR=3.90, 95% CI=1.82–8.35). The adjusted HR for femur fracture with parkinsonism was highest within 2 years of the disease diagnosis (HR= 3.10, 95% CI=2.12–4.53). Conclusions Our study found that the presence of parkinsonism is more strongly related to femur fracture in males, and increases the influence of traditional risk factors on femur fracture. It is necessary to consider how factors associated with the amount of ambulatory activity–even in an early diagnosed state–can play an important role in femur fracture in subjects with parkinsonism.

Risk for Parkinson’s disease in patients with Behcet’s Disease: A nationwide population-based dynamic cohort study in Korea

( Min Ji Kang ),( Ji Min Seo ),( Joo Hee Lee ),( Dong Soo Yu ),( Young Bok Lee ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Although several studies have reported a correlation between Behcet’s disease and Parkinson’s disease, this association has not yet been clarified. Objectives: The aim of this study is to determine the risk of Parkinson’s disease in patients with Behcet’s disease. Methods: Behcet’s disease patients (n = 17,179; mean age, 51.12±8.09 years; male, 34.95%) without known previous diagnosis of Parkinson’s disease were selected from the Korean National Health Insurance Database between 2010 and 2013. An age and gender-matched control population of individuals without Behcet’s disease was randomly sampled at a ratio of 3:1 (n = 34,575). Both cohorts were followed for development of Parkinson’s disease until 2015. Results: Among a total of 11,525 Behcet’s disease patients, 50 (0.43%) developed Parkinson’s disease, whereas only 51 among the 34,575 individuals in the non- Behcet’s disease group developed Parkinson’s (0.15%, P < 0.0001). The incidence of Parkinson’s disease was significantly higher in Behcet’s disease patients than in controls. In addition, during the follow-up period, patients with Behcet’s disease were more likely to be diagnosed with Parkinson’s disease than those in the non- Behcet’s disease group. Conclusion: Behcet’s disease patients had a higher risk of Parkinson’s disease compared to non- Behcet’s disease controls. Physicians should carefully monitor patients with Behcet’s disease for potential development of Parkinson’s disease.

Optimal Protocol and Clinical Usefulness of 123 I-MIBG Cardiac Scintigraphy for Differentiation of Parkinson’s Disease and Dementia with Lewy Body from Non-Parkinson’s Diseases

천인국 대한핵의학회 2023 핵의학 분자영상 Vol.57 No.3

Purpose 123I-metaiodobenzylguanidine (MIBG) cardiac scintigraphy was a useful imaging modality for the diagnosis ofParkinson’s disease, but its diagnostic performances were variably reported. This retrospective study compared the diagnosticperformances and investigated the optimal imaging protocol of 123I-MIBG cardiac scintigraphy at various imaging timepoints in patients suspected of Parkinson’s disease in clinical practice. Methods In patients suspected of Parkinson’s disease, clinical records, autonomic function tests, and 123I-MIBG cardiacscintigraphy were retrospectively reviewed. Semi-quantitative parameters such as heart-to-mediastinum ratio (HMR) andwashout rate (WR) were calculated and compared at 15 min, 1 h, 2 h, 3 h, and 4 h post-injection (p.i.). of 123I-MIBG cardiacscintigraphy. Group A consisted of Parkinson’s disease (PD), Parkinson’s disease dementia (PDD), and dementia withLewy body (DLB), and group B consisted of non-Parkinson’s diseases such as multiple system atrophy (MSA), progressivesupranuclear palsy (PSP), drug-induced parkinsonism (DIP), essential tremor (ET), Parkinson-plus syndrome (PPS), andunspecified secondary parkinsonism (NA). The diagnostic performances of HMR and WR were compared for differentiationof group A from group B, and their clinical usefulness and optimal imaging time points were explored. Results Seventy-eight patients were included in group A (67 PD, 7 PDD, 4 DLB), and 18 patients were included in groupB (5 MSA, 3 PSP, 2 DIP, 2 ET, 1 PPS, and 1 NA). Sensitivity, specificity, accuracy, positive predictive value (PPV), andnegative predictive value of HMR and WR were maximized at 4 h p.i., (82.1%, 85.7%, 82.6%, 97.0%, and 46.2%; cutoffthreshold < 1.717; area under curve 0.8086) and at the time interval between 1 and 4 h p.i. (65.4%, 85.7%, 68.5%, 96.2%,and 30.8%; cutoff threshold > 24.1%; area under curve 0.8246), respectively, and PPVs of both HMR and WR persistentlyshowed greater than 92.7% at earlier time points and shorter time intervals. Conclusion This study reassured that 4-h-delayed imaging is recommended for the best diagnostic performances in 123I-MIBGcardiac scintigraphy. Although it showed suboptimal diagnostic performances to differentiate PD, PDD, and DLB fromnon-Parkinson’s diseases, it can be useful as an auxiliary measure for the differential diagnosis in usual clinical practice.

Family Functioning and Communication in Spouses of Patients with Parkinsonism

강서영,양명화,이정아,장우영,이종식,김영식 대한가정의학회 2017 Korean Journal of Family Medicine Vol.38 No.1

Background: Patients with parkinsonism exhibit motor symptoms, cognitive impairment, and neuropsychiatric changes, and these symptoms increase caregiver burden. Family dynamics can be influenced by the presence of comorbidities, which is especially important in diseases causing caregiver burden. We investigated the effects of spousal parkinsonism on family functioning and communication.Methods: Couples without parkinsonism, who visited hospital-based family practices, were recruited by 28 family physicians from 22 hospitals between April 2009 and June 2011; patients with parkinsonism and their spouses were recruited from a single institution. The participants completed questionnaires on demographic characteristics, life-style factors, family functioning (the Korean version of the Family Adaptation and Cohesion Evaluation Scale [FAC-ES] III), and family communication (the Family Communication Scale of the FACES-IV). We compared family functioning and communication between spouses of the patients with and without parkinsonism.Results: The mean family adaptability and cohesion scores of the spouses of the patients with parkinsonism were 23.09±6.48 and 32.40±8.43, respectively, whereas those of the control group were 23.84±5.88 and 34.89±7.59, re-spectively. Family functioning and family communication were significantly different between the spouses of indi-viduals with and without parkinsonism. After adjusting for age, sex, income, and cardiovascular disease in the lo-gistic regression analysis, family functioning was found to significantly deteriorate in the spouses of patients with parkinsonism but not the control group. Family communication decreased significantly in spouses of patients with parkinsonism.Conclusion: Family functioning and family communication significantly deteriorated in spouses of patients with parkinsonism.