- Clinical Characteristics of Migraine Subjects with Nausea and Vomiting:An Analysis of Data from the Korean Headache Survey
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Byung-Su Kim, Chin-Sang Chung, Chung-Bin Lee, Min Kyung Chu
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Published online December 31, 2013
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- 구역, 구토를 가진 편두통 환자의 임상적 특성: Korean Headache Survey 자료 분석
- 만성매일두통: 변형편두통, 만성긴장형두통, 약물과용두통
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Chin-Sang Chung
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Korean J Headache. 2009;10(1):59-65. Published online June 30, 2009
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- About one out of 25 adults suffers headache almost everyday, which is called chronic daily headache (CDH). The term ‘CDH’ represents a combination of various kinds of headache disorders, including primary chronic migraine or transformed migraine, chronic tension-type headache, new daily persistent headache, hemicrania continua, and so on. The patients are usually refractory to standard treatments and have a strong tendency to overuse or abuse medications. To provide an updated insight on CDH, the author has reviewed the pathomechanisms, clinical diagnosis and general and specific principles of management of the individual types of CDH.
- Characteristics of Headache Sufferers Who Seeking a Tertiary Medical Care
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Kyungmi Oh, Byung-Jo Kim, Ki-Young Jung, Chin-Sang Chung
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Published online December 31, 2008
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- 3차 진료기관을 방문하는 두통 환자의 특징
- 편두통과 우-좌단락
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Kyungmi Oh, Chin-Sang Chung
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Korean J Headache. 2007;8(2):61-68. Published online December 31, 2007
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- The prevalence of migraine with aura in the general population is 12%, but was 3.5 times higher(42%) in patients with right-to-left shunt caused by patent foramen ovale, atrial septal defect, or pulmonary arteriovenous malformations. Many studies have reported the efficacy of percutaneous closure of shunt for reducing the prevalence of migraine with aura. However, a recent prospective controlled study did not show the efficacy of percutaneus shunt closure as a treatment of migraine. There are still many debating issues about this topic. The author would review that association of right-to-left shunt to migraine, relating phathophysiological mechanisms, and management of shunts in migraneurs.
- 일반연제-Epidemiology of Headache Disorders in Korea 2004
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Chin-Sang Chung, Hyung In Cho, Ki-Young Jung, Hui-Soo Moon, Kyung-Mi Oh, Tae Hoon Kim , Hwan Ho Ha
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Korean J Headache. 2005;6(1):101-101. Published online June 30, 2005
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- Background
There have been only a few epidemiologic studies on migraine in Korea. In Asian count- ries Korea is one of the blank spots on the migraine map. No official data have been reported in Korea. This study is the first Korean government-supported project that surveyed the headache disorders in Korea. Objectives: To investigate the 1-year prevalence of migraine in Korea using the new operational diagnostic criteria of the International Classification of Headache Disorder 2004(ICHD-II) proposed by the International Headache Society(IHS). Methods: A door-to-door survey of headache was conducted by personal face-to-face interviews among the people aged between 15 and 65 years in the Korea except the Cheju island during October 2004. Stra- tified systematic household sampling was performed and the subjects were recruited from 2,038 house- holds. In this study a standardized questionnaire and a diagnostic algorithm applied by lay interviewers were used as the method of data collection. The algorithm was based on the diagnostic criteria of the ICHD-II. This study was supported by a grant of the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea(A020163). Results: The life-time prevalence of headache in Koreans was 31.4%(640/2038, M 27.6%, F 35.3%). The sex- and age-specific 1-year prevalence rate of headache was 21.5%(M 17.1%, F 26.1%). The point prevalence of headache suffering at the time of interview was 12.0%(245/2,038). The 1-year prevalence of migraine was 12.0%(M 9.3%, F 14.7%). The peak prevalence rate was observed in the 30s of age in both genders(M 11.3%, F 16.0%). Another minor peak prevalence was observed in the 50s of age in women but not in men. Conclusions: We conclude that the prevalence rate of migraine in Korea is quite comparable to that observed in other countries except the presence of second minor peak in the 50s in women. Further studies are necessary to elucidate the satisfaction with treatment and overall effectiveness of the medical care system in Korea.
- Single Nucleotide Polymorphisms of the TNF Region in Migraine
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Sue-Yon Jang, Chin-Sang Chung, Jong-Won Kim
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Korean J Headache. 2004;5(1):105-105. Published online June 30, 2004
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- Background
and Objectives: Migraine is a benign and recurring syndrome of headache, nausea, vomi- ting, or other symptoms of neurologic dysfunction in varying admixtures; also migraine is as common neurological disorder as prevalence of patients is 9.7% of the female and 3.2% of the male in Korean population. However, the pathogenesis of migraine is still largely unknown. Migraine has a strong(up to 50%) genetic component, which is higher in migraine with aura: MA than migraine without aura: MO, with a probable multifactorial polygenic inheritance. Tumor necrosis factors(TNF: TNFA and TNFB) are major pro-inflammatory cytokines that are thought to be significant in the pathogenesis of migraine. Thus, we scrutinized an association of TNFA and TNFB gene with the risk of migraine. TNF-308 and LTA+252 polymorphisms have been previously reported to be associated with migraine patients without aura in Caucasian population. Such findings are not extensively studied in Asian population including Koreans. Method: We investigated the genetic association study of polymorphisms in the diverse SNPs of tumor necrosis factor(TNF) as well as the promoter region of the TNFA gene and the first intron region of the TNFB gene. 410 female patients with migraine and 383 healthy controls were genotyped with massarray, snapshot and direct sequencing. Results: Significant difference of allele frequency was observed between SNP that located in the pro- moter region of LTA gene and MA patients, but allele frequency of MO patients was significantly diffe- rent from those of the control. Conclusions: These findings suggest that the LTA gene influence susceptibility of migraine with aura, but TNFA gene doesn't influence two most clinical subtype of migraine. Korean Journal of Headache 5(1):105-105, 2004
- Upregulation of Tumor Necrosis Factor-alpha and Matrix Metalloproteinase-9 in Nitric Oxide-induced Animal Model of Migraine
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Gyeong-Moon Kim, Kyung-Sil Jin, Ki-Jung Choi, Chin-Sang Chung
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Korean J Headache. 2004;5(1):103-103. Published online June 30, 2004
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- Objectives
We sought to evaluate the expression of two key inflammatory mediators, tumor necrosis factor-alpha(TNF-α) and matrix metalloproteinase-9(MMP-9) in a nitric oxide(NO) mediated animal model of migraine and investigated the effect of glucocorticoid on MMP-9 activation. Background: Migraine is thought to result from neuronal nociceptive activity in the trigeminovascular system, which results in meningeal inflammatory reaction. Despite considerable research into the patho- genesis of migraine, signaling pathways mediating neurogenic inflammation are poorly understood. TNF-α and MMP-9, which are regulated by transcription factor nuclear factor-kB(NF-kB), have been known to play important roles in many physiologic processes of immune and inflammatory responses. Method: TNF-α and MMP-9 expression were investigated in the meningeal blood vessels following continuous intravenous infusion of NO donor, glyceryl trinitrate(GTN, 10mg/kg/min), for 30 minutes in rats. Time course of TNF-α expression was evaluated by Western blot at 1, 3, 6, and 18 hours and the activity of MMP-9 was analysed by enzyme zymography. Expression of TNF-α and MMP-9 in the meningeal blood vessels was investigated using double immunofluorescence staining with endothelial cell marker vWF. To evaluate the effect of glucocorticoid on the inhibition of MMP-9 activation, methylpred- nisolone(MP, 30mg/kg) was administerd after GTN infusion. Furthermore, to understand whether the transcriptional modulation of MMP-9 activation, glucocorticoid receptor(GR) antagonist(RU486, 15mg/ kg) was pretreated before GTN infusion. Results: By Western blot analysis, TNF-α expression was increased at 3-6 hr after GTN infusion. MMP-9 activity was upregulated at 3 hr and reached the peak at 6 hr. Furthermore, TNF-α and MMP-9 immunoreactivity was extensively detected in the meningeal blood vessels in GTN-infused group as com- pared to controls. MP treatment inhibited MMP-9 activation and pretreatment with RU486 successfully reversed this MP effect. Conclusion: These results indicate TNF-α and MMP-9 are involved in NO-mediated inflammation in meningeal blood vessels. In addition, MMP-9 activation was affected by modulation of GR. Inhibition and blockade of proimflammatory transcription factors or their downstream effectors might have therapeutic implications for preventing migraneous headache. Korean Journal of Headache 5(1):103-103, 2004
- 편두통과 뇌혈관질환
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Chin-Sang Chung
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Korean J Headache. 2004;5(1):75-82. Published online June 30, 2004
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- Migraine can be defined as a neurovascular pain disorder and is occasionally associated with various cerebrovascular events as a cause of stroke or as a result of stroke-so-called 'migraine-stroke connec- tion'. This may be categorized as ① migrainous infarction as defined in the IHS classification, ② migraine as a risk factor for cerebral infarction, ③ cerebral infarction associated with comorbid conditions of migraine, ④ cerebral infarction of other cause presenting with symptoms resembling migraine with aura, ⑤ drug-induced migraine-related stroke, and ⑥ hereditary conditions that cause migraine and stroke. Korean Journal of Headache 5(1):75-82, 2004
- 국제두통학회 두통 분류법 개정판: 무엇이 새로운가?
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Chin-Sang Chung
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Korean J Headache. 2003;4(2):101-108. Published online December 31, 2003
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- The International Headache Society (IHS) has revised the International Classification of Headache Disorders (ICHD-II) recently. They added some new disorders and new section for headache disorders associated with psychiatric diseases to first edition of the classification. They also modified and added some new diagnostic criteria. For research purposes they attached an appendix that included some alternative diagnostic criteria or provisional new entities. In this review new features and clinical utility of the ICHD-II will be discussed. Korean Journal of Headache 4(2):101-108, 2003
- 편두통 발작 예방 요법의 근거
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Chin-Sang Chung
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Korean J Headache. 2003;4(1):37-40. Published online June 30, 2003
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- Currently a migraine attack is considered as originating in the brain. Triggers initiate depolarizing neu- roelectric and metabolic events resulting in spreading depression of Leao. This activates the headache and associated features of the attack by mechanisms involving either peripheral trigeminovascular or brains- tem pathways, or both. Interictal excitability of cell membranes that is in part genetically determined is the brain's susceptibility to attacks. Factors that increase or decrease neuronal excitability constitute the threshold for triggering attacks. Susceptibility to migraine attacks appears related to brain hyperexcitabi- lity. Recent functional neuroimaging techniques have shown the primary neural basis of migraine attack with secondary vascular changes(neuro-vascular mechanism). On this basis the prophylaxis for migraine should reduce the hyperexcitability and enhance the inhibitory activity of the sensitive migraine brain, thereby reducing the frequency, intensity, and duration of migraine attacks and enhancing the quality of life of migraine patients. Korean Journal of Headache 4(1):37-40, 2003
- Diagnostic Pitfalls in Migraine
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Chin-Sang Chung
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Korean J Headache. 2002;3(1):25-30. Published online June 30, 2002
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- 급성기 편두통 치료: Triptan계 약물
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Chin-Sang Chung
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Korean J Headache. 2001;2(1):27-40. Published online June 30, 2001
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- Traditional therapies like simple analgesics, the nonsteroidal anti-inflammatory drugs and prokinetic and antiemetic compounds are nonspecific drugs for acute migraine attacks. And then ergotamine tartrate and dihydroergotamine(DHE) have been developed but because they have high affinities for a wide range of receptors, including dopamine, α- and β-adrenoceptors and serotonin receptors, clinical use of these drugs have been limited due to many side effects. Thus, the need for development of antimigraine drugs with higher specificity for serotonin receptors and with less side effects was recognized in the 1980s. The first specific 5-HT1B/1D agonist, injection form of sumatriptan, became clinically available in early 1990s. Its introduction prompted the search for new medications based on the neuropharmacology of sumatriptan. Very recently many new triptan drugs(zolmitriptan, naratriptan, rizatriptan, etc.) have been developed and seem to offer greater oral efficacy, a better adverse-events profile, a more rapid onset of action, and a better res- ponse consistency within patients from attack to attack, which could reduce migraine-associated symptoms. But their actual clinical data are limited so far, particularly in Koreans. In this review I will discuss the neuropharmacology and available clinical data of the triptans that are currently available or seem to become available in Korea. Korean Journal of Headache 2(1):27-40, 2001
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