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염규선,이기욱,나상준 대한신경과학회 2008 대한신경과학회지 Vol.26 No.3
Although aseptic meningitis is a common neurological disorder, a combination of acute urinary retention and aseptic meningitis has been recognized rarely. To our knowledge, only a few case reports are available on this combination and the underlying pathology remains unclear. We reported on a patient showing acute urinary retention and aseptic meningitis with a review of the literatures.
2급 및 3급 치근이개부 병변에서 합성골이식의 효과에 대한 임상적 및 방사선학적 연구
염규선,김병옥,한경윤,Yum, Kyu-Sun,Kim, Byung-Ok,Han, Kyung-Yoon 대한치주과학회 1993 Journal of Periodontal & Implant Science Vol.23 No.3
The effect of synthetic bone materials was assessed in the patients with pure periodontal class II and III furcation defects. The buccal aspects of the maxillary and mandilular first and second molars were surgically exposed, and synthetic bone materials were interposed between the gingival flap and the furcation defects in the experimental group. The control group were treated without the use of synthetic bone materials by same operator. Probing pocket depth, gingival recession, and loss of attachment, were measured by Michigan O-probe and tooth mobility was evaluated by an electronic mobility tester(Periotest(R), Siemens co. Germany) at preoperation and 3-, 6-, and 12-month postoperation. Standardized radiogrphs were taken at preoperation and 6-month and 12-month postoperation. The postoperative change of clinical parameters and the difference between experimental group and control group were statistically analyzed by Student, t-test. The results were as follows: 1. The probing pocket depth at the 3-, 6-, and 12-month postoperative examination was significantly decreased, compared to that at preoperative examination in both experimental group and control group(P<0.005), but there was no significantly difference between experimental group and control group. 2. The amount of gingival recession at the 3-, 6-, and 12-month postoperative examination was increased, compared to that at the preoperative examination in both experimental and control group(P<0.005). In the case of the class III furcation involvement, the amount of gingival recession at the 3-, 6-, and 12-month postoperative examination was more significantly increased in control group than experimental group(P<0.05). 3. The amount of loss of attachment at the 3-, 6-, and 12-month postoperative examination was significantly decreased, compared to that at the preoperative examination in both experimental and control group in the case of class II furcation involvement, and in experimental group only in the case of furcation III involvement(P<0.005). The amount of loss of attachment at, the 3-, 6-, and 12-month postoperative examination was more significantly decreased in experimental group than control group in the case of the class III furcation involvement(P<0.05), but in the case of class II furcation involvement there was no significant difference between experimental group and control group. 4. The tooth mobility at the 3-, 6-, and 12-month postoperative examination was significantly decreased, compared to that at the preoperative examination in both experimental and control group(P<0.005), but there was no significant difference between experimental group and control group. 5. Radiopacity of furcation area was greatly increased in the experiment group, but there was no radiographic change in the control group.
Transient splenial lesions of the corpus callosum and infectious diseases
염규선,신동익 대한중환자의학회 2022 Acute and Critical Care Vol.37 No.3
Transient splenial lesion of the corpus callosum can be observed in various diseases such as cancer, drug use, metabolic disorders, and cerebrovascular disorders, as well as in patients with infectious diseases. During the coronavirus disease 2019 (COVID-19) pandemic, there were increasing reports of these lesions being detected on brain imaging tests performed in patients with neurological symptoms. On brain magnetic resonance imaging, findings suggestive of cytotoxic edema are observed in the splenium; these are known to disappear with improvement of clinical symptoms. Cytokinopathy caused by infection increases the permeability of the blood–brain barrier and activates the glial cells of the brain to induce cytotoxic edema. Most patients have a good prognosis. The causes, mechanism, diagnosis, treatment and prognosis of transient splenial lesions of the corpus callosum will be summarized in this review.
동안신경마비 환자에서 고용량 메칠프레드니솔론 정주 후 발생한 난치성 딸꾹질 1예
나상준,염규선,이기욱 대한임상신경생리학회 2008 Annals of Clinical Neurophysiology Vol.10 No.1
The etiology of intractable hiccups is most commonly idiopathic. However, they are occasionally associated with some underlying disorders including gastro-esophageal reflux disease. There are a few previous reports describing the association of intractable hiccups with high dose corticosteroid. We experienced an unusual case of intractable hiccups following a high dose intravenous methylprednisolone therapy in a patient with right third nerve palsy. Since methylprednisolone is commonly used in various neurological problems, physicians should be aware of its possible side effect including intractable hiccups.
Impact of Neurointensivist Co-Management in a Semiclosed Neurocritical-Care Unit
김상화,염규선,정진헌,최재형,박현석,송영진,김대현,차재관,한문구 대한신경과학회 2020 Journal of Clinical Neurology Vol.16 No.4
Background and Purpose The importance of the specialized management of neurocritical patients is being increasingly recognized. We evaluated the impact of neurointensivist comanagement on the clinical outcomes (particularly the mortality rate) of neurocritical patients admitted to a semiclosed neurocritical-care unit (NCU). Methods We retrospectively included neurocritical patients admitted to the NCU between March 2015 and February 2018. We analyzed the clinical data and compared the outcomes between patients admitted before and after the initiation of neurointensivist co-management in March 2016. Results There were 1,785 patients admitted to the NCU during the study period. Patients younger than 18 years (n=28) or discharged within 48 hours (n=200) were excluded. The 1,557 remaining patients comprised 590 and 967 who were admitted to the NCU before and after the initiation of co-management, respectively. Patients admitted under neurointensivist co-management were older and had higher Acute Physiologic Assessment and Chronic Health Evaluation II scores. The 30-day mortality rate was significantly lower after neurointensivist co-management (p=0.042). A multivariate logistic regression analysis demonstrated that neurointensivist co-management significantly reduced mortality rates in the NCU and in the hospital overall [odds ratio=0.590 (p=0.002) and 0.585 (p=0.001), respectively]. Conclusions Despite the higher severity of the condition during neurointensivist co-management, co-management significantly improved clinical outcomes (including the mortality rate) in neurocritical patients.
24 시간 혈압 측정과 피질하 허혈성 혈관성 인지장애와의 관계- 예비적 연구-
김정은,염규선,김용덕,나상준,이기욱,윤현주 대한치매학회 2007 Dementia and Neurocognitive Disorders Vol.6 No.1
Background: Twenty-four-hour blood pressure (BP) readings have been found to correlate with hypertensive target organ damage. White matter lesions (WML) probably represent manifestations of cerebral hypertensive target organ damage. Recent findings of a linkage between high blood pressure (BP) and later development of dementia have given new prospects on cerebral target-organ damage in hypertension. Little has been studied about the differences in the pattern of 24-hour blood pressure readings between subcortical ischemic vascular cognitive impairment (VCI) and cognitively normal control with hypertension. We aimed to assess the differences in the pattern of 24-hour blood pressure readings in subcortical ischemic VCI compared with cognitively normal controls without subcortical ischemic lesion and delineate the relationship between 24-hour BP measurements and cognitive impairment/WML. Methods: Two subject groups (14 SIVCI patients, 10 normal) participated in this study and were examined with 24-hour BP monitoring. All patients were evaluated by the K-MMSE and Brain MRI. WML were subdivided into periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWH). Results: The patients with subcortical ischemic VCI had significantly greater daytime systolic blood pressure, systolic blood pressure variability, and nondipping status (p< 0.05). Among the patients with subcortical ischemic VCI, absence of dipping status was associated with attention and calculation scores (p< 0.05) and was significantly associated with PVH and DWH (p< 0.05). Conclusion: Non-dipping and reverse-dipping were relatively common in subcortical ischemic VCI patients. A nondipping status appears to be directly associated with decline of attention and WML. This study indicates the need for further studies to investigate whether or not controlling nighttime BP will help reduce the risk for subcortical ischemic VCI.