• Title/Summary/Keyword: 제 4뇌실

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The Study on the Ultrastructure and Distribution of Dopaminergic Cells in the Brain of Mongolian Gerbil after Water Deprivation (절수에 의한 Mongolain gerbil 뇌 Dopamine성 면역반응세포의 분포와 미세구조의 변화에 관한 연구)

  • Song, Chi-Won;Lee, Kyoung-Youl;Park, Il-Kwon;Kwon, Hyo-Jung;Kim, Moo-Kang;Lee, Kang-Lee
    • Applied Microscopy
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    • v.30 no.2
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    • pp.193-204
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    • 2000
  • Nowadays, mongolian gerbil is widely utilized in the research of brain and water deprivation because of congenitally incomplete Willis' circle, audiogenic seizure in low noise, and special cholesterol metabolism without water absorption for a long time. In this study, we intended to identify the time lapse changes in the general morphoogy and ultrastructure of the catecholaminergic neurons of mongolian gerbil brain in after long-term water deprivation. Fifteen mongolian gerbils were divided into 3 groups (5, 10, and 20-day water deprivation groups), each with 5 mongolian gerbils. Additional 5 mongolian gerbils which received water without limitation were used as a control. The brain sections were immunostained using tyrosine hysroxylase (TH), $ dopamine-\beta-hydroxylase$ (DBH), and phenylethanolamine-N-methyltrasferase (PMNT) antibodies. And immunoreactive cells were observed by electromicroscopy for the ultrastructural changes . The TH-immunoreactive (TH-IR) nerve cells were observed in the para- and peri-ventricular nucleus of the 3 rd ventricle in the hypothalamus and the substantia nigra. The number of TH-IR neurons in these areas was decreased from the 5th day of the water deprivation to the 10 th day and reincreased until 20 th day water deprivation. The shape and density of the dopamine-secreting cells identified by immunohistochemistry showed changes in the continuous water deprivation. Electron microscopy revealed a round nucleus in the neurons of control group but 5-day water deprivation group showed a dense and irregularly shaped nucleus. Also in the 5-day water-deprived group, mitochondria was decreased in number and junctins were disappered. Endoplasmic reticulum, Golgi complex did not show changes after water-deprivation. In this results, we can conclude that dopamine are involved in the water metabolism in mongolian gerbil, and mongolian gerbil could be used as an animal model for the researches of water deprivation.

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Clinical features of children's brain tumors according to location (소아 뇌종양 발생위치에 따른 임상양상 고찰)

  • Han, Seung Jeong;Kim, Yun Hee;Kwon, Young Se;Jun, Yong Hoon;Kim, Soon Ki;Son, Byong Kwan
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.76-81
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    • 2006
  • Purpose : This study evaluated the clinical characteristics of brain tumors in children according to their location, the parental delay and the doctor's delay between the onset of symptoms and the diagnosis of a pediatric brain tumor. In addition, this study compared the relationship between the pre-diagnostic symptomatic interval and the tumor location. Methods : A retrospective study was undertaken of 45 children with primary brain tumors admitted to Inha Hospital from July, 1986 to June, 2004. A diagnosis of the tumor location was made using brain MRI. Results : The male to female ratio was 1 : 0.67. The median age at diagnosis was 6.0 years in supratentorial tumors, 7.0 years in infratentorial tumors. Twenty four cases(53.3 percent) were located in the supratentorial area, 21 cases(46.6 percent) were located in the infratentorial area. The distribution of supratentorial tumors were 14(58.3 percent) in the cerebral hemisphere and temporal lobe, seven (29.1 percent) in the suprasellar area, and three(12.5 percent) in the pineal gland and posterial lateral ventricle. The distributions of the infratentorial tumors were 12(57.1 percent) in the cerebellar vermis and fourth ventricle, four(19.1 percent) in the brain stem, and five(23.8 percent) in the cerebellar hemisphere. The most common initial symptom was seizure(37.5 percent) in the supratentorial tumor and headache(38.0 percent) in infratentorial tumors. The median pre-diagnostic symptomatic interval (PSI) was 21 days(range 0-240 days). The median PSI with a parental delay in supratentorial tumor was six days(range 1-240 days), and 30 days(range 1-40 days) in the infratentorial tumor. We immediately diagnosed most cases after visiting the hospital. There was no significant relationship between the tumor location and the pre-diagnostic symptomatic interval. Conclusion : The most common symptom of supratentorial tumors and infratentorial tumors was seizure and headache, respectively. Although, the median pre-diagnostic symptomatic interval was shorter than in previous studies, a detailed medical history and a correctly interpreted neurological examination should lead to an earlier diagnosis of pediatric brain tumors.

Clinical Study of CT-diagnosed Olivopontocerebellar Atrophies (Olivopontocerebellar Atrophy의 임상상과 전산화단층뇌촬영 소견)

  • Park, Mee-Yeong;O, Khyoung-Yhun;Hah, Jung-Sang;Byun, Yeung-Ju;Park, Choong-Suh
    • Journal of Yeungnam Medical Science
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    • v.5 no.2
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    • pp.87-93
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    • 1988
  • The diagnosis of OPCA could be made clinically with important aid of brain CT scanning, although the definite and conclusive diagnosis only by postmortem pathological determination. We reviewed, clinically and with brain CT examination, 12 cases of patients with OPCA who were admitted to the Yeungnam University Hospital for a recent 5 years. The result were as following. : 1. The distribution of age is from 49 to 72, mainly 50 to 60. Man is more frequent than women at the 4.5 times. 2. The interval period from Sx. onset to diagnosis is 1 year to 6 years. 3. The usual initial Sxs. were dizziness(58%), ataxia(33%), and other less frequent Sxs. were weakness of low extremities, dysarthria, headache and urinary incontinence. The clinical manifestations at the initial diagnosis were cerebellar disturbance(100%), dysarthria(83%), and increased deep tendon reflexes(58%). 4. The results of brain CT finding are like this : ${\cdot}$ the width of cerebellar sulci is more than 1mm, other 4 cases more than 2mm. ${\cdot}$ the width of cerebellar pontine cistern of the patient if usually 3 to 4mm, other 2 cases extended to the 5mm. ${\cdot}$ the A. P and lateral lengths of 4th. ventricle is 4mm and 4 to 8mm respectively. ${\cdot}$ 6 cases of whole patients show coincidentally cerebral atrophy.

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Magnetic Resonance Imaging Feature of Bacterial Meningitis in a Neonate Hanwoo Calf (한우 송아지에서 세균성 뇌막염의 자기공명영상)

  • Cho, Young-Kwon;Kim, Jin-Won;Kim, Jae-Hoon;Kim, Jae-Hoon;Lee, Ki-Chang
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.650-654
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    • 2009
  • A 1-week-old, male Korean native calf with acute clinical signs of depression, mild diarrhea, ataxia, recumbency and tremor was referred to Chonbuk Veterinary Medical Center of Chonbuk National University. Vision loss and cornea edema were also observed on physical examination. The patient had been deteriorated with nystagumus, strabisumus and opisthtonus. Blood cell count test and blood biochemistry test revealed remarkable leukocytosis, and hypoalbuminemia and increased blood urea nitrogen. No remarkable findings were observed on radiography. On magnetic resonance imaging study, there were enlarge lateral, third, and forth ventricles. The cortical grey and subcortical white matter of left temporal lobe showed hypointense on T1-weighted images and hyperintense on T2-weighted images, and slightly enhanced on contrast-enhanced T1-weighted images. Escherichia coli strain was identified from cerebrospinal fluid sample. Palliative treatment was attempted but the neonatal calve was expired three days after admission. Severe multifocal fibrino-suppurative meningitis with Escherichia coli infection was confirmed histopathologically.

Comparison of Clinical Progress between Single- and Multiple-dose Surfactant Treatment in Neonatal Respiratory Distress Syndrome (신생아 호흡곤란증후군에서 폐 표면활성제 단일 투여군과 재투여군의 임상경과 비교)

  • Kil, Chang Hee;Jeon, Ho Sang;Bae, Chong Woo
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1090-1095
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    • 2005
  • Purpose : In the case of serious respiratory distress syndrome(RDS) or relapse of clinical appearances after single treatment, we obtained more effective results with multiple-dose surfactant replacement therapy. We carried out this investigation for comparing and observing clinical progress between single-dose(group S) and multiple-dose(group M) pulmonary surfactant treatment group of neonatal RDS. Methods : We investigated 48 neonates who were diagnosed as RDS and treated with pulmonary surfactant(PS) replacement therapy in NICU of Kyunghee University hospital from January 2002 to March 2004, then we compared and verified clinical progress of 32 neonates in group S with that of 16 neonates in group M. Results : There were no significant statistical differences in average birth weights, average gestational periods, initial pH values of birth, whether operation of resuscitation at that time of birth was made or not, whether prenatal steroid prescription for mother, RDS classification standardized by Bomsel, and ventilation index(VI) before instillation of PS of two groups. However, there was significant statistical difference in a/A $PO_2$(P<0.05). We could observe changes of VI and a/A $PO_2$ within 72 hours have been continuously improved at group S rather than group M. In spite of relapses, group M changed for the better after second dose. There were also no significant differences between the two groups in duration of ventilator therapy, mortality within 28 days after birth, intraventricular hemorrhage by complication, retinopathy of premature, necrotizing enterocolitis, chronic lung diseases, sepsis, and DIC. Conclusion : In these relapse cases, as there were no significant differences in the mortality rate and the occurence of complication between group S and group M, the requirement of multiple-dose PS replacement therapy which brought improvement of prognosis was emphasized.

The Optimal Pulse Oxygen Saturation in Very Low Birth Weight or Very Preterm Infants (극소 저체중 출생아에서 경피적 산소포화도의 적정 범위)

  • You, Sun-Young;Kang, Hye-Jin;Kim, Min-Jung;Chang, Mea-Young
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.320-327
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    • 2011
  • Purpose: To determine the effect of changing practice guidelines designed to avoid hyperoxia or hypoxia in very low birth weight or very preterm infants. Methods: We analyzed a database of <1,500 g birth weight or <32 weeks of gestation infants who were born and admitted to the neonatal intensive care unit of Chungnam National University Hospital from January 2007 to July 2010. First, we defined the relationship between arterial partial pressure of oxygen ($PaO_2$) and pulse oxygen saturation ($SpO_2$). When we evaluated 96 pairs of $PaO_2$ and $SpO_2$ measurements, oxygen saturation was 90-94% at a $PaO_2$ of 43-79 mmHg on the oxyhemoglobin dissociation curve, according to pulse oximetry. Based on this observation, a change in practice was instituted in August 2008 with the objective of avoiding hypoxia and hyperoxia in preterm infants with targeting a $SpO_2$ 90-94% (period II). Before the change in practice, high alarms for $SpO_2$ were set at 100% and low alarms at 95% (period I). Results: Sixty-eight infants the met enrollment criteria and 38 (56%) were born during period II, after the change in $SpO_2$ targets. Demographic characteristics, except gender, were similar between the infants born in both periods. After correcting for the effect of confounding factors, the rates for mortality, severe retinopathy of prematurity, and IVH attended to be lower than those for infants in period II. No difference in the rate of patent ductus arteriosus needed to treat was observed. Conclusion: A change in the practice guidelines aimed at avoiding low oxygen saturation and hyperoxia did not increase neonatal complication rates and showed promising results, suggesting decreased mortality and improvements in short term morbidity. It is still unclear what range of oxygen saturation is appropriate for very preterm infants but the more careful saturation targeting guideline should be considered to prevent hypoxemic events and hyperoxia.

MRI of Hydrosyringomyelia Combined to Hydrocephalus and Occipital Dysplasia in a Dog (개에서 뇌수두증과 후두골 이형성증을 동반한 척수공동증의 자기공명영상학적 평가 1례)

  • Choi Chi-Bong;Bae Chun-Sik;Kim Hwi-Yool
    • Journal of Life Science
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    • v.15 no.4 s.71
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    • pp.664-667
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    • 2005
  • Hydrosyringomyelia is a dilation of the spinal cord central canal. In human it may be caused by congenital malformations such as Dandy-Walker syndrome and Chiari malformations or may be acquired as a result of infection, trauma or neoplasia. Hydrocephalus is an excessive accumulation of cerebrospinal fluid within the ventricles and occipital dysplasia is the dorsal extension of the foramen magnum. Hydrosyringomyelia and hydrocephalus can be confirmed by computed tomography or magnetic resonance imaging (MRI). A 3-year-old male maltese was presented with a history of long-term seizure. Blood examination was all unremarkable. On rostrodorsal-caudoventral oblique radiograph of the skull showed severe occipital dysplasia. On brain sonography through the persistent fontanelle, severe lateral ventriculomegaly was revealed. MRI examination revealed hydrocephalus and hydrosyringomyelia. Diuretic therapy didn't reduce clinical symptoms and surgical decompression was conducted. The dog responded well with ventriculo-peritoneal shunting. MRI is the most superior modality to diagnose hydrocephalus and hydrosyringomyelia, to plan therapy and to determine the prognosis.

Comparison of the Therapeutic Effects of $Curosurf^{(R)}$ and $Newfactan^{(R)}$ in Respiratory Distress Syndrome (신생아 호흡 곤란 증후군에서 $Curosurf^{(R)}$$Newfactan^{(R)}$의 치료 효과 비교)

  • Hong, Suk-Woo;Lee, Eun-Ho;Kim, Seung-Yeon;Park, Ho-Jin
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.142-151
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    • 2008
  • Purpose : The aim of this study was to compare the clinical effects of modified porcine (Curosurf$^{(R)}$) and bovine (Newfactan$^{(R)}$) surfactants in the treatment of neonatal respiratory distress syndrome. Methods : Between April 2004 and December 2006, 65 neonates (birth weight ${\leq}$2,500 g and gestational age ${\leq}$35 weeks) with neonatal respiratory distress syndrome were treated in our neonatal intensive care unit with surfactant. Thirty-one neonates received Curosurf$^{(R)}$ and 34 neonates received Newfactan$^{(R)}$. The neonates were not enrolled if they had major congenital anomalies or meconium aspiration syndrome. We compared the changes in respiratory parameters after surfactant instillation, the incidences of acute and chronic complications, and the mortality between the two treatment groups. Results : Neonatal and maternal demographic characteristics were not different between the groups. The patterns of change in the respiratory parameters after surfactant instillation were not statistically different between the groups. The incidences of surfactant reinstillation and acute complications, such as pneumothorax, patent ductus arteriosus, pulmonary hemorrhage, and grade 3-4 intraventricular hemorrhage, were not different between the neonates who received Curosurf$^{(R)}$ and the neonates who received Newfactan$^{(R)}$. There were no statistically significant differences in the duration of mechanical ventilation, oxygen therapy, hospitalization, prevalence of bronchopulmonary dysplasia, periventricular leukomalacia, retinopathy of prematurity, necrotizing enterocolitis, and mortality between the groups. Conclusion : In the present comparative study, no significant differences in the clinical effects of Curosurf$^{(R)}$ and Newfactan$^{(R)}$ were observed.

Comparative study of typical and atypical benign epilepsy with centrotemporal spikes (Rolandic epilepsy) (중심 측두부 극파를 보이는 전형적 및 비전형적 양성 부분 간진의 비교 연구)

  • Song, Junhyuk;Lee, Kyuha;Chung, Sajun
    • Clinical and Experimental Pediatrics
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    • v.51 no.10
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    • pp.1085-1089
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    • 2008
  • Purpose : This study aims to examine and compare the features of rolandic epilepsy. Methods : Of 158 patients selected retrospectively, 116 had typical (group A) and 42 had atypical (group B) rolandic epilepsy, as defined by Worrall's criteria. Results : The age at onset of the seizures in group A was $8.6{\pm}2.0y$ and $6.2{\pm}1.7y$ in group B (P>0.05). Among the 40 patients who underwent neuroimaging studies (25 patients in group A and 15 patients in group B), abnormal findings in group B included ventricular dilatation, mild cortical atrophy, and partial agenesis of corpus callosum. group A had no abnormal findings. The frequency of seizures was $2.0{\pm}1.0$ and $2.3{\pm}1.2$ per month in groups A and B respectively. Seizure control from the initial anticonvulsant treatment was achieved within 3 months in group A, and 3 to 12 months in group B. A 2-year remission rate was noted in 105 patients in group A and in 38 patients in group B. Of these, the recurrence rate after 2 y was 13 in group A and 12 in group B. Conclusion : Age of onset of seizures, gender, frequency of seizures before therapy, and 2-y remission rate were not significantly different in the 2 groups. However, neuroimaging abnormalities, the time to achieving seizure control from the initial anticonvulsant treatment, and the recurrence rate after being seizure-free for 2 y were significantly different in the 2 groups.

Growth and clinical efficacy of fortified human milk and premature formula on very low birth weight infants (극소 저체중출생아에서 강화된 모유와 미숙아 전용분유가 성장 및 임상에 미치는 효과)

  • Chueh, Heewon;Kim, Myo Jing;Lee, Young-A;Jung, Jin-A
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.704-712
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    • 2008
  • Purpose : A prospective, controlled trial was conducted to evaluate growth, efficacy, safety and nutritional status for very low birth weight infants fed with human milk fortified with Maeil human milk fortifier (Maeil $HMF^{(R)}$; Maeil Dairies Co., Ltd.). Methods : We enrolled 45 premature infants with a birth weight <1,500 g and gestational age <33 weeks, who were born at Dong-A University Hospital from October, 2006 through December, 2007. They were divided into 2 groups: infants in one group were fed with human milk fortified with $HMF^{(R)}$, and the second were fed with preterm formula. Growth, biochemical indices, feeding tolerance, and other adverse events in each group were assessed serially and compared relatively. Follow-up data were also collected after discharge at 1, 3, and 6 months corrected age. Results : Characteristics of the 2 groups including average gestational age, birth weight, sex, respiratory distress syndrome, patent ductus arteriosus, and other adverse events (sepsis, retinopathy of prematurity, and intraventricular hemorrhage) showed no significant difference. Average feeding start day ($8.00{\pm}3.27d$ vs. $8.86{\pm}5.37d$) (P=0.99) and the number of days required to reach full feeding after start feeding ($41.78{\pm}20.47d$ vs $36.86{\pm}20.63d$) (P=0.55) were not significantly different in the group fed human milk fortified with $HMF^{(R)}$ when compared with the group that was fed preterm formula. The duration of total parenteral nutrition and the incidence of feeding intolerance also showed no differences between the 2 groups. Although infants fed with human milk fortified with $HMF^{(R)}$ showed faster weight gain than those fed with preterm formula at the end stage of the admission period, other growth indices of the two groups showed no significant difference. No significant correlations were found between the 2 groups with regard to weight gain velocity, height gain velocity, head circumference velocity, and post-discharge follow up growth indices. Conclusion : Premature infants fed human milk fortified with $HMF^{(R)}$ showed no significant difference compared with those fed preterm formula in growth, biochemical indices, and adverse events. Using human milk fortifier can be an alternative choice for very low birth weight infants, who need high levels nutritional support even after discharge from NICU.