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Biomedical subjects

Joong-Seok Kim

Publications and source records attributed to Joong-Seok Kim.

At least 19 recordsLinked to original sources
PubMed2006

Early pathological changes in the cerebellum of patients with pure cerebellar syndrome demonstrated by diffusion-tensor imaging.

We evaluated the early pathological changes in patients with sporadic cerebellar ataxia by measuring fractional anisotropy (FA) values in diffusion tensor MRIs (DTI). FA and apparent diffusion coefficient (ADC) values were compared in the brain stem and cerebellum of 5 patients with idiopathic cerebellar ataxia-C and 7 age-matched controls. Patients with sporadic cerebellar ataxia had decreased FA values in the bilateral cerebellar peduncle and cerebellar hemisphere, but normal FA values in the basis pontes. Assuming that the loss in FA parallels neuronal changes, our results suggest that the derangement and altered fiber integrity of the cerebellum are present regardless of the presence of morphological alterations on conventional MRI. Therefore, DTI may be superior to conventional MRI in the evaluation of early pathological changes in patients with sporadic cerebellar ataxia.

Adult↗
PubMed2006

Pisa syndrome as a motor complication of Parkinson's disease.

We describe two elderly patients with a convincing clinical diagnosis of Parkinson's disease (PD) who developed axial end-of-dose/off dystonia, also referred to as Pisa syndrome (PS). The worsening of symptoms in the "off" period, and a favorable response of the dystonia to an increase of levodopa suggests that PS in our patients may be primarily related to a manifestation of motor fluctuations in PD.

Aged↗
PubMed2006

Disappearance of essential tremor after frontal cortical infarct.

We present a patient with essential tremor who spontaneously improved after a sensorimotor stroke related to a small cortical infarct near by the left precentral region of the brain. This finding supports the presence of cortical or transcortical motor loops that are likely involved in essential tremor and suggests a possible link with the cerebellar-thalamic-cortical pathway.

Cerebral Infarction↗
PubMed2006

Cardiac [123I]metaiodobenzylguanidine scintigraphy for vascular Parkinsonism.

The purpose of our study was to prospectively evaluate cardiac [(123)I]metaiodobenzylguanidine (MIBG) uptake in patients with cerebrovascular disease (CVD) who develop clinical symptoms of vascular Parkinsonism (VP). A total of 19 consecutive patients who developed Parkinsonism during the course of their CVD were enrolled in the study; 16 age-matched subjects, and 30 patients with Parkinson's disease (PD) were also evaluated with cardiac MIBG uptake. MIBG uptake was assessed using the ratio of the heart to the upper mediastinum (H/M) according to planar scintigraphic data. The mean H/M ratio was significantly higher in patients with VP than in those with PD (2.28 +/- 0.41 vs. 1.27 +/- 0.13; P < 0.001). MIBG uptake did not differ between VP and controls (2.46 +/- 0.33; P > 0.05). Our findings suggest that myocardial postganglionic sympathetic dysfunction found in PD is absent in most patients with VP. MIBG single photon emission computed tomography imaging may be useful to help distinguish between PD and VP patients in clinical practice.

3-Iodobenzylguanidine↗
PubMed2005

Association of vitamin D receptor gene polymorphism and Parkinson's disease in Koreans.

1alpha,25-dihydroxyvitamin D3 (1,25(OH)2D3), which is the biologically active form of vitamin D, has anti-inflammatory effects and can prevent experimental Parkinson's disease (PD). 1,25(OH)2D3 exerts most of its actions only after it binds to its specific nuclear receptors. Eighty-five Korean patients with PD and 231 unrelated healthy individuals were evaluated to determine if vitamin D receptor gene (VDRG) BsmI polymorphisms were markers for the susceptibility to PD in Korean patients. Each polymorphism was detected using polymerase chain reaction (PCR)-based restriction analysis. In addition, the relationship between the BsmI polymorphisms and the clinical manifestations of PD was evaluated. Overexpression of the b allele (91.2 vs. 85.7%; p=0.069) and homozygote bb (84.7 vs. 72.7%; p=0.043) was found in the PD patients compared with the controls. These results show for the first time an association between PD and a VDRG polymorphism, which might be involved in the pathogenesis of PD, or in the linkage disequilibrium of the VDRG to another pathogenic gene locus.

Aged↗
PubMed2004

A randomized crossover comparative study of aspirin, cilostazol and clopidogrel in normal controls: analysis with quantitative bleeding time and platelet aggregation test.

The effects of three antiplatelet drugs, aspirin, clopidogrel and cilostazol, were examined and compared using a quantitative bleeding time (QBT) test apparatus. In 12 healthy adult male subjects, a QBT test and platelet aggregation test were performed before and after medication. Cilostazol was found to be as effective as aspirin and clopidogrel in inhibiting platelet aggregation. Following the oral administration of aspirin and clopidogrel for 7 days, the bleeding time was significantly prolonged. In contrast, none of these QBT parameters were altered by the cilostazol treatment. This suggests that cilostazol has potent efficacy in inhibiting platelet aggregation without prolonging the bleeding time and changing the bleeding pattern.

Adult↗
PubMed2003

Homozygous exon 4 deletion in parkin gene in a Korean family with autosomal recessive early onset parkinsonism.

The gene responsible for autosomal recessive parkinsonism, parkin, has recently been identified on chromosome 6q. It has been shown to be mutated in Japanese and European families, most of whom had early-onset parkinsonism. Here, we present a family with young-onset parkinsonism of an autosomal recessive inheritance. A homozygous exon 4 deletion in the parkin gene was found in 3 family members. To the best of the authors' knowledge, this is the first report in Korea of familial parkinsonism with the parkin gene mutation.

Exons↗
PubMed2003

The apolipoprotein E epsilon4 haplotype is an important predictor for recurrence in ischemic cerebrovascular disease.

OBJECTIVE: To determine whether a specific apolipoprotein E (APOE) allele is a predictor for ischemic cerebrovascular disease (ICVD). BACKGROUND: The role of APOE in atherosclerosis has been a focus of intensive research. The APOE epsilon4 allele is overrepresented in Alzheimer's disease, atherosclerosis, ischemic heart disease, and ICVD. Also, epsilon4 carriers have higher cholesterol levels than non-epsilon4 carriers. METHODS: We performed a prospective, longitudinal study on patients who have ICVD. The patients were recruited from St. Mary Hospital, Korea, and investigated for ICVD through interviews and by reviewing their medical records and neuroimaging studies. APOE genotypes were determined for each patient. RESULTS: 20 of the 91 enrolled patients had recurrent ICVD, yielding a 3-year cumulative recurrence rate of 22%. Carriers of the epsilon4 allele had a 3-year recurrence rate of 53%, as compared with only 16% for patients who had the APOE non-epsilon4 allele (the risk ratio was 4.11; the 95% CI was 1.49-11.32; P<0.01). CONCLUSIONS: Our results make possible the identification of patients with ICVD who are at high risk for recurrence by assessing their APOE genotype. Also, this data might be clinically useful in methods for assessing potential strategies for prevention.

Aged↗
PubMed2003

Decreased striatal dopamine transporter binding in a patient with extrapontine myelinolysis.

We describe the case of a 61-year-old woman who developed extrapontine myelinolysis (EPM) with parkinsonism. Decreased striatal dopamine transporter binding assessed by [(123)I]N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane and single photon emission computed tomography ([(123)I]IPT) SPECT) were observed in the patient, suggesting that osmotic injury causes the demyelination of nigrostriatal dopaminergic neurons and that such injury may be involved in the pathogenesis of EPM with parkinsonism.

Antiparkinson Agents↗
PubMed2003

Periodic limb movement during sleep developed after pontine lesion.

We describe 2 patients who suffered a pontine infarction and subsequently developed periodic leg movement (PLM). The temporal relationship between a stroke and subsequent PLM, as well as the absence of sleep-related disorders in patients' histories, favors the argument of a cause-and-effect relationship, with the observed association providing evidence for an anatomic substrate for PLM.

Female↗
PubMed2003

Diffusion weighted MR imaging of acute Wernicke's encephalopathy.

We report a case of Wernicke's encephalopathy in which diffusion-weighted MR images demonstrated symmetrical hyperintense lesions in the paraventricular area of the third ventricles and medial thalami. Apparent diffusion coefficient mapping showed isointensity in the aforementioned areas. Diffusion-weighted MR images may provide evidence of vasogenic edema associated with thiamine deficiency, proven in the histopathology of experimental animals. In addition, diffusion-weighted MRI has many advantages over T2 or FLARE-weighted brain MRI in detecting structural and functional abnormalities in Wernicke's encephalopathy.

Acute Disease↗
PubMed2003

Idiopathic foot dystonia treated with intramuscular phenol injection.

We describe a patient who developed involuntary, painless, dystonic contraction of the left foot on walking. The patient had been treated with botulinum toxin A without benefit. Examination showed that walking brought on a spasmodic twisting of the left foot, with extension and eversion of the ankle. The patient underwent an intramuscular phenol injection, which abolished the foot dystonia. This case suggests that intramuscular phenol treatment may be an alternative for patients where botulinum toxin was unable to relieve the dystonias.

Botulinum Toxins, Type A↗
PubMed2003

A multicenter randomized crossover multiple-dose comparison study of arotinolol and propranolol in essential tremor.

BACKGROUND: A new medication is needed to treat essential tremor. Preliminary evidence suggests that arotinolol may be effective in the treatment of this disorder. OBJECTIVE: To study the effect of arotinolol and propranolol in a crossover, multiple dose comparative trial of patients with essential tremor. PATIENTS AND METHODS: One hundred and seventy-five outpatients, with essential tremor were included in the study; 161 patients completed the study. Patients were identically evaluated at eight consecutive visits. The study consisted of two treatments, which were arranged according to a crossover design that evaluated the dose of each (arotinolol 10 mg per day and propranolol 40 mg per day, arotinolol 20 mg per day and propranolol 80 mg per day, arotinolol 30 mg per day and propranolol 160 mg per day). Each course of treatment lasted 6 weeks. Major outcome evaluations consisted of a self-reported disability scale, and motor performance score obtained before drug intake and 14 days after each treatment. The treatment effects were evaluated by analysis of variance using the Hills-Armitage test. RESULTS: Arotinolol was found to be as effective as propranolol at reducing tremor. Drug effects as evaluated using motor-task performance scores revealed that arotinolol had a more significant effect than propranolol. CONCLUSIONS: Arotinolol may be more useful than propranolol for the treatment of essential tremor.

Adrenergic beta-Antagonists↗
PubMed2003

Flumazenil-induced ballism.

Flumazenil, an imidazobenzodiazepine, is the first benzodiazepine antagonist and is being used to reverse the adverse pharmacological effects of benzodiazepine. There have been a few reports on the central nevous system side effects with its use. We report a patient with generalized ballism following administration of flumazenil. The mechanism through which flumazenil induced this symptom is unknown. It is conceivable that flumazenil may antagonize the GABA-benzodiazepine receptor complex and induce dopamine hypersensitivity, thus induce dyskinesic symptoms.

Diagnosis, Differential↗