• Title/Summary/Keyword: Brain Lesion

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Effect of Dynamic Trunk Equilibrium Exercise on Neglect, Balance, Activities of Daily Living in Stroke Patients With Hemi-Spatial Neglect (편측무시를 가진 뇌졸중 환자를 위한 동적 체간 평형 훈련이 편측무시, 균형, 일상생활수행능력에 미치는 효과)

  • Kang, Tae-woo;Oh, Duck-won
    • Physical Therapy Korea
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    • v.25 no.2
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    • pp.30-43
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    • 2018
  • Background: Hemispatial neglect is defined as the failure to attend, report, respond, or orient toward meaningful stimuli provided in the contralateral side of a brain lesion. Objects: This study was conducted to find out the effect of dynamic trunk equilibirum exercise for stroke patients with hemi-spatial neglect. Methods: This study included 21 stroke subjects, randomly assigned to either the experimental group or the control group. The exercise program consisted of 5 sessions of 20 minutes per week during 4 weeks. The line-bisection test, the Albert test, the balance function score, the Berg balance scale, the postural assessment scale for stroke and the modified Barthel index were measured before and after training. All data were analyzed using SPSS 12.0 for Windows. Between-group and within-group comparison was analyzed by using Independent t-test and Paired t-test respectively. Results: The results of study were as follows: There were significant differences between before and after intervention in both group (p<.05). There were significant differences in the line-bisection test, Albert test, balance function score, Berg balance scale, postural assessment scale for stroke and modified Barthel index between the experimental group and the control group (p<.05). Conclusion: Dynamic trunk equilibrium exercise had a positive effect on patients' neglect, balance ability and activities of daily living. Further studies are required to generalize the results of this study.

Prognostic factors in breast cancer with extracranial oligometastases and the appropriate role of radiation therapy

  • Yoo, Gyu Sang;Yu, Jeong Il;Park, Won;Huh, Seung Jae;Choi, Doo Ho
    • Radiation Oncology Journal
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    • v.33 no.4
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    • pp.301-309
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    • 2015
  • Purpose: To identify prognostic factors for disease progression and survival of patients with extracranial oligometastatic breast cancer (EOMBC), and to investigate the role of radiation therapy (RT) for metastatic lesions. Materials and Methods: We retrospectively reviewed the medical records of 50 patients who had been diagnosed with EOMBC following standard treatment for primary breast cancer initially, and received RT for metastatic lesions, with or without other systemic therapy between January 2004 and December 2008. EOMBC was defined as breast cancer with five or less metastases involving any organs except the brain. All patients had bone metastasis (BM) and seven patients had pulmonary, hepatic, or lymph node metastasis. Median RT dose applied to metastatic lesions was 30 Gy (range, 20 to 60 Gy). Results: The 5-year tumor local control (LC) and 3-year distant progression-free survival (DPFS) rate were 66.1% and 36.8%, respectively. High RT dose (${\geq}50Gy_{10}$) was significantly associated with improved LC. The 5-year overall survival (OS) rate was 49%. Positive hormone receptor status, pathologic nodal stage of primary cancer, solitary BM, and whole-lesion RT (WLRT), defined as RT whose field encompassed entire extent of disease, were associated with better survival. On analysis for subgroup of solitary BM, high RT dose was significantly associated with improved LC and DPFS, shorter metastasis-to-RT interval (${\leq}1month$) with improved DPFS, and WLRT with improved DPFS and OS, respectively. Conclusion: High-dose RT in solitary BM status and WLRT have the potential to improve the progression-free survival and OS of patients with EOMBC.

Increase of Synapsin I, Phosphosynapsin (ser-9), and GAP-43 in the Rat Hippocampus after Middle Cerebral Artery Occlusion

  • Jung, Yeon-Joo;Huh, Pil-Woo;Park, Su-Jin;Park, Jung-Sun;Lee, Kyung-Eun
    • The Korean Journal of Physiology and Pharmacology
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    • v.8 no.2
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    • pp.77-81
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    • 2004
  • The loss of neurons and synaptic contacts following cerebral ischemia may lead to a synaptic plastic modification, which may contribute to the functional recovery after a brain lesion. Using synapsin I and GAP-43 as markers, we investigated the neuronal cell death and the synaptic plastic modification in the rat hippocampus of a middle cerebral artery occlusion (MCAO) model. Cresyl violet staining revealed that neuronal cell damage occurred after 2 h of MCAO, which progressed during reperfusion for 2 weeks. The immunoreactivity of synapsin I and GAP-43 was increased in the stratum lucidum in the CA3 subfield as well as in the inner and outer molecular layers of dentate gyrus in the hippocampus at reperfusion for 2 weeks. The immunoreactivity of phosphosynapsin was increased in the stratum lucidum in the CA3 subfield during reperfusion for 1 week. Our data suggest that the increase in the synapsin I and GAP-43 immunoreactivity probably mediates either the functional adaptation of the neurons through reactive synaptogenesis from the pre-existing presynaptic nerve terminals or the structural remodeling of their axonal connections in the areas with ischemic loss of target cells. Furthermore, phosphosynapsin may play some role in the synaptic plastic adaptations before or during reactive synaptogenesis after the MCAO.

MALIGNANT LYMPHOMA IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENT (전신성 홍반성 루푸스 환자에서의 악성임파종 치험례)

  • Woo, Soon-Seop;Kang, Hag-Soo;Lee, Young-Soo;Shim, Kwang-Sup;Yoo, Kwang-Hee
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.2
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    • pp.97-100
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    • 1998
  • Systemic lupus erythematosus is a severe cutaneous-systemic disorder of unknown etiology, It is represented with erythematous patches on the face in a so-called butterfly distribution, and characteristically classified as an autoimmune disease with antinuclear antibodies. The autoimmune diseases such as systemic lupus erythematosus, $Sj{\ddot{o}}gren$ syndrome, rheumatoid arthritis have been associated with lymphoid malignancy - leukemia, malignant lymphoma - which could involve various organs(spleen, liver, brain, mediastinal lymph node, supraclavicular lymph node, inguinal lymph node, cervical lymph node etc.). Many authors have studied about the association of systemic lupus erythematosus and malignant lymphoma, but exact etiology is still unknown. A common viral etioloty for systemic lupus erythematosus has been suggested since virus-like particles have been found in the glomerular endothelium of patients with systemic lupus erythematosus. These oncogenic viruses may be responsible for the higher frequency of malignant lymphoma in patients with systemic lupus erythematosus. In the other theory, the causes of malignant lymphoma are the defect of immune system due to systemic lupus erythematosus and the long-term use of therapeutics for treatment of systemic lupus erythematosus. When the cellular immune system(delayed hypersensitivity) is impaired by immunosuppressive drugs, it is likely that the body is no longer able to recognize and reject malignant cells as they arise; they continue to grow and divide unhindered. The impairment of the cellular immune system may allow growth of oncogenic virus or the survival of neoplatic tissues. 47-year old female patient treated systemic lupus erythematosus with steroid and immunosuppressive drugs for 5 years visited to our hospital due to elevated mass on left upper anterior maxilla area. By performing biopsy, we diagnosed this lesion as malignant lymphoma and referred to oncologist for chemotherapy. So we report a case of malignant lymphoma due to systemic lupus erythematosus with review of literatures.

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Experimental Study on the Expression of Striatal Dopamine Receptors in the Rat Model of Parkinsonism (파킨슨씨병 모델 흰쥐에서 줄무늬체 도파민 수용체의 발현에 대한 연구)

  • Oh, Chang-Wan;Han, Dae Hee;Chung, Chun Kee;Cho, Sa-Sun;Park, Kyeong-Han;Kim, Yong-Sik;Park, Chan-Woong
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.155-166
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    • 2000
  • This study was designed to investigate the underlying mechanisms for the temporal changes of the striatal dopamine D2 receptors in the rat model of parkinsonism. After injection of the 6-hydroxydopamine into the substantia nigra of adult rats, we measured the receptor binding capacity(Bmax), mRNA and protein of the D2 receptor at 2, 4 and 8 weeks. Following the lesion, mRNA and protein were elevated simultaneously on both sides of the striata. They showed more increase on the normal side at 2 and 4 weeks, and then they were almost equally abundant on both sides at 8 weeks. We also observed their increased production in the diffuse cortical and subcortical regions. The Bmax value also increased bilaterally in both striata, and was higher on the normal side at 2 weeks and then on the lesioned side at 4 and 8 weeks. These findings suggest that production of the striatal D2 receptor is regulated at the transcriptional level in this animal model. They also imply that this control may be mediated through a pathway which can have influence on the whole brain, rather than the local control of the dopamine content alone. The measured functional activity(Bmax) of the D2 receptor was not proportional to the amount of the receptor mRNA and proteins produced. This difference may be explained by the post-translational modification of the receptor proteins, which may be controlled by such factor as the local concentration of dopamine.

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A Case of Acute Disseminated Encephalomyelitis by Enterovirus 71 (Enterovirus 71에 의한 급성 파종성 뇌척수염 1례)

  • Hwang, Hui Sung;Cho, Sung Hee;Kim, Sun Mi;Jung, Dae Chul;Chung, Seung Yun;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.10 no.1
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    • pp.114-122
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    • 2003
  • Acute transverse myelitis is a focal inflammatory disorder of the spinal cord, resulting in motor, sensory, and autonomic dysfunction which would be the initial manifestation of acute disseminated encephalomyelitis. A 7-year-old boy developed weakness of lower extremities associated with dizziness and urinary dysfunction after upper respiratory infection. He showed gradual decreased mental status with respiratory difficulty. Spinal MRI showed diffuse spinal cord swelling from C3 to C7 levels with high signal intensity lesion on T2-weighted image, which is involved central gray matter of spinal cord from C3 to C7, proximal portion to cervicomedullary junction, and distal portion to the cornus medullaris. After the supplement of high dose intravenous methylprednisolone therapy with ventilator care, he showed gradual improvement. The brain MRI after extubation showed multifocal high signal intensity lesions in bilateral cerebral white matter on axial T2-weighted image. Immunoserologic test(neutral antibody test) for enterovirus 71 was positive. Dysfunction of the bladder lasted for 33 days. We report a case of transverse myelitis which progressed to acute disseminated encephalomyelitis by enterovirus 71 in a 7-year-old boy with related literatures.

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Clinico-pathology of Lung Cancer in a Regional Cancer Center in Northeastern India

  • Mandal, Sanjeet Kumar;Singh, Thaudem Tomcha;Sharma, Takhenchangbam Dhaneshor;Amrithalingam, Venkatesan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7277-7281
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    • 2013
  • Background: Globally, there have been important changes in trends amongst gender, histology and smoking patterns of lung cancer cases. Materials and Methods: This retrospective study was conducted on 466 patients with lung cancer who were registered in Regional Cancer Center, Regional Institute of Medical Sciences, Manipur from January 2008 to December 2012. Results: Most were more than 60 years of age (67.8%) with a male: female ratio of 1.09:1. Some 78.8% of patients were chronic smokers with male smoker to female smoker ratio of 1.43:1. Consumption of alcohol was found in 29.4%, both smoking and alcohol in 27.5%, betel nut chewing in 37.9% and tobacco chewing in 25.3%. A history of tuberculosis was present in 16.3% of patients. The most frequent symptom was coughing (36.6%) and most common radiological presentation was a mass lesion (70%). Most of the patients had primary lung cancer in the right lung (60.3%). The most common histological subtype was squamous cell carcinoma (49.1%), also in the 40-60 year age group (45.9%), more than 60 year age group (51.6%), males (58.1%) and females (41.8%). As many as 91.9% of squamous cell carcinoma patients had a history of smoking. About 32.5% of patients had distant metastasis at presentation with brain (23.8%) and positive malignant cells in pleural effusions (23.1%) as common sites. The majority of patients were in stage III (34.4%), stage IV (32.5%) and stage II (30.2%). Conclusions: Our analysis suggests that the gender gap has been narrowed such that about half of the patients diagnosed with lung cancer are women in this part of India. This alarming rise in female incidence is mainly attributed to an increased smoking pattern. Squamous cell carcinoma still remains the commonest histological subtype. Most of the patients were elderly aged and presented at locally or distantly advanced stages.

Clinical Uses of Diffusion Tensor Imaging Fiber Tracking Merged Neuronavigation with Lesions Adjacent to Corticospinal Tract : A Retrospective Cohort Study

  • Yu, Qi;Lin, Kun;Liu, Yunhui;Li, Xinxing
    • Journal of Korean Neurosurgical Society
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    • v.63 no.2
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    • pp.248-260
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    • 2020
  • Objective : To investigate the efficiency of diffusion tensor imaging (DTI) fiber-tracking based neuronavigation and assess its usefulness in the preoperative surgical planning, prognostic prediction, intraoperative course and outcome improvement. Methods : Seventeen patients with cerebral masses adjacent to corticospinal tract (CST) were given standard magnetic resonance imaging and DTI examination. By incorporation of DTI data, the relation between tumor and adjacent white matter tracts was reconstructed and assessed in the neuronavigation system. Distance from tumor border to CST was measured. Results : The sub-portion of CST in closest proximity to tumor was found displaced in all patients. The chief disruptive changes were classified as follows : complete interruption, partial interruption, or simple displacement. Partial interruption was evident in seven patients (41.2%) whose lesions were close to cortex. In the other 10 patients (58.8%), delineated CSTs were intact but distorted. No complete CST interruption was identified. Overall, the mean distance from resection border to CST was 6.12 mm (range, 0-21), as opposed to 8.18 mm (range, 2-21) with simple displacement and 2.33 mm (range, 0-5) with partial interruption. The clinical outcomes were analyzed in groups stratified by intervening distances (close, <5 mm; moderated, 5-10 mm; far, >10 mm). For the primary brain tumor patients, the proportion of completely resected tumors increased progressively from close to far grouping (42.9%, 50%, and 100%, respectively). Five patients out of seven (71.4%) experienced new neurologic deficits postoperatively in the close group. At meantime, motor deterioration was found in six cases in the close group. All patients in the far and moderate groups received excellent (modified Rankin Scale [mRS] score, 0-1) or good (mRS score, 2-3) rankings, but only 57.1% of patients in the close group earned good outcome scores. Conclusion : DTI fiber tracking based neuronavigation has merit in assessing the relation between lesions and adjacent white matter tracts, allowing prediction of patient outcomes based on lesion-CST distance. It has also proven beneficial in formulating surgical strategies.

The Magnetic Resonance Images and Clinical Features of the Asymptomatic Pineal Cysts (무증상 송과체 낭종의 임상적 양상 및 자기공명영상 소견)

  • Lim, Kang-Taek;Park, Se-Hyuck;Shin, Dong-Ik;Cho, Byung Moon;Oh, Sae Moon;Hwang, Do Yun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.1
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    • pp.113-117
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    • 2000
  • Objective : Asymptomatic cyst of the pineal gland is a common incidental finding in adults on computerized tomography or magnetic resonance image(MRI) or at postmortem examination. This study was conducted to identify MRI findings of the benign pineal cysts and to determine the proper management of asymptomatic pineal cysts. Methods : From January 1995 to March 1999, 13 cases of asymptomatic pineal cysts were diagnosed incidentally on MRI. The mean age of the patients at diagnosis was 43 years(ranged 8 to 69 years). Five patients were females and eight patients were males. We analyzed the clinical presentations and MRI findings. Results : Clincal features were not related to pineal cysts in all 13 cases included posttraumatic headache in seven cases, headache related to brain tumor in two cases, one of facial palsy, one of diabetic neuropathy, and two of other diseases. MRI demonstrated a well-demarcated mass lesion(mean 1.3cm in diameter) of low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. Gadolinium-enhanced MRI, performed in 10 cases, demonstrated a rim enhancement. Hydrocephalus was not present in all cases. Follow-up MRI(ranged 12 to 36 months) obtained in 3 of the 13 patients showed stability of cyst size. After symptomatic treatment, presenting symptoms were resolved in all patients and symptom related to pineal cysts have not been developed during follow up period(mean 27 months). Conclusion : The long-term behavior of asymptomatic pineal cysts is still unknown. But we advocate conservative management of these benign pineal cysts that may be developmental variants of normal pineal gland.

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Acute Spontaneous Subdural Hematoma due to Rupture of a Tiny Cortical Arteriovenous Malformation

  • Choi, Hyuk Jin;Lee, Jae Il;Nam, Kyoung Hyup;Ko, Jun Kyeung
    • Journal of Korean Neurosurgical Society
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    • v.58 no.6
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    • pp.547-549
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    • 2015
  • Acute subdural hematoma (SDH) of arterial origin is rare, especially SDH associated with an arteriovenous malformation (AVM) is extremely rare. The authors report a case of acute spontaneous SDH due to rupture of a tiny cortical AVM. A 51-year-old male presented with sudden onset headache and mentality deterioration without a history of trauma. Brain CT revealed a large volume acute SDH compressing the right cerebral hemisphere with subfalcine and tentorial herniation. Emergency decompressive craniectomy was performed to remove the hematoma and during surgery a small (5 mm sized) conglomerated aciniform mass with two surrounding enlarged vessels was identified on the parietal cortex. After warm saline irrigation of the mass, active bleeding developed from a one of the vessel. The bleeding was stopped by coagulation and the vessels were removed. Histopathological examination confirmed the lesion as an AVM. We concluded that a small cortical AVM existed at this area, and that the cortical AVM had caused the acute SDH. Follow up conventional angiography confirmed the absence of remnant AVM or any other vascular abnormality. This report demonstrates rupture of a cortical AVM is worth considering when a patient presents with non-traumatic SDH without intracerebral hemorrhage or subarachnoid hemorrhage.