• Clinical and Experimental Pediatrics
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• 제52권7호
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• pp.824-831
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• 2009

목 적 : HIE의 치료법으로 줄기 세포가 대안으로 떠오르고 있다. mMSC가 성인 동물 모델에서의 뇌졸중 및 퇴행성 뇌질환에 유의한 기능 회복을 보인다는 보고가 많이 있으나 미성숙 동물 모델에서의 연구 보고는 거의 없는 상태이다. 이에 HIE가 유발된 미성숙뇌에 mMSC를 투여하여 기능 회복에 대한 효과를 평가하고자 본 연구를 시행하였다. 방 법 : 생후 7일된 수컷 Sprague-Dawley 흰쥐를 sham 대조군, 뇌 손상 대조군, 고용량 mMSC 이식군 및 저용량 mMSC 이식군으로 나누었으며 저산소 허혈 뇌 손상 유도 2주 후에 mMSC를 병변부 국소 이식을 시행하였다. 세포 이식 2, 4, 6 및 8주째에 개방장 시험을 시행하여 운동 기능 회복 정도를 평가하였고, 이후 1주일 동안 Morris 수중 미로 시험을 3개 부문으로 시행하여 학습 및 기억력 회복 정도를 평가하였다. 결 과 : 개방장 시험 결과 네 군간에서 통계적으로 유의한 차이는 없었다(F=0.412, P=0.745). 공간 획득 검사에서 네 군간 평균 탈출 시간에 서로 차이가 있었고(F=380.319, P<0.01), 고용량 mMSC 이식군 및 sham 대조군은 뇌 손상 대조군에 비해 검사 2일째부터 5일째까지 각각 평균 탈출 시간이 감소하였으며(P<0.05), 시간이 갈수록 더 유의하게 차이를 보였다(F=16.034, P<0.01). 참조 기억 검사에서는 네 군간 차이는 없었으며 시각 검사에서는 다섯번째 시행 검사에서만 고용량 mMSC 이식군과 뇌 손상 대조군간에 통계적으로 유의한 차이가 있었다(P<0.05). 결 론 : 일부 검사에서만 고용량 mMSC 이식의 효과가 뚜렷하였고 그 외의 검사에는 통계적으로 유의한 결과는 보이지는 않았으나 산술적인 호전을 보이는 것을 확인할 수 있었다. 향후 최적의 효과를 보이는 줄기 세포의 농도와 이식 시기를 결정하는 연구가 필요할 것으로 보이며 HIE에서 mMSC가 대안적인 치료 수단으로 이용될 수 있다고 생각된다.

• 한국식품과학회지
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• 제33권1호
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• pp.128-134
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• 2001

콜레스테롤 함유식이(대조군)에 뽕나무(M군) 및 꾸지뽕나무(C군) 줄기껍질 수용성 추출물을 첨가하여 흰쥐에 급여시킨 후 혈청과 간장 지질 농도 및 각 조직중의 지질과산화물 함량에 미치는 영향을 검토하였다. 혈청 중성지질 농도는 대조군에 비교해서 M군에서는 유의적으로 감소하였고, C군에서는 감소경향을 보였다. C군에서 혈청 총 콜레스테롤 및 인지질 농도 및 M군에서 혈청 중성지질 농도는 대조군에 비해서 각각 저하하였다. 간장 콜레스테롤 농도는 대조군에 비해 C군 및 M군에서 저하경향을 나타내었으나, 중성지질 및 인지질 농도는 각군간에 유의적인 차이는 없었다. 흰쥐 각 조직의 생체막 지질과산화물 생성 정도의 지표인 TBARS의 상대적 농도는 뇌, 신장, 심장, 간장의 순으로 나타났다. 신장의 지질 과산화물 함량은 대조군에 비교해서 C군 및 M군에서는 유의적으로 감소하였으나, 뇌 및 간장의 지질 과산화물 농도는 오히려 유의적으로 증가하였다. 간장의 비헴철 함량은 대조군에 비해서 C군 및 M군에서 유의적으로 증가하였으며, 이러한 증가는 간장 지질 과산화물 함량 증가와 깊이 관련되는 것으로 시사되었다. 흰쥐 조직으로부터 분획한 microsome에 $Fe^{2+}$/ascorbate를 첨가하여 $37^{\circ}C$에서 반응을 시키지 않은 것(0 hr)으로부터 지질 과산화물을 측정한 결과에서는 각 군간에 유의적인 차이는 없었으나, $Fe^{2+}$/ascorbate를 첨가하여 1시간 반응시킨 간장 및 뇌 조직 microsome의 지질 과산화물은 대조구에서 현저히 증가하였다. 한편 간장 microsome에 $Fe^{2+}$/ascorbate 첨가 1시간 반응에서는 대조군에 비해 C군 및 M군에서 유의적으로 감소하였으나, 뇌 조직에서는 이러한 효과가 없었다. 이상의 결과에서 뽕나무 및 꾸지뽕나무 줄기껍질 수용성 추출물에는 혈청 중성지질 저하 작용 뿐만아니라 신장 및 간장 microsome의 지질과산화물 농도 저하작용이 인정되었다.

• Clinical and Experimental Pediatrics
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• 제49권1호
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• pp.76-81
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• 2006

목 적 : 뇌종양에 의한 임상증상은 뇌종양 발생의 발생위치와 밀접한 관계를 가지는 것으로 알려져 있다. 본 연구에서는 소아 뇌종양 환자에서 발생위치에 따라 증상의 차이와 증상 발현시부터 보호자와 의료진이 종양을 의심하고 진단하기까지 걸리는 시간의 차이에 대해 조사하였다. 방 법 : 1996년 7월부터 2004년 6월까지 인하대학교병원 소아과에서 뇌종양으로 진단받은 15세 이하의 환아를 대상으로 종양의 위치와 증상, 보호자와 의료진이 증상이 나타나기부터 진단을 하기까지 얼마의 시간이 경과했는지에 관해 후향적 고찰을 시행하였다. 발생위치는 방사선검사상(자기공명영상)에서 나타난 위치에 따른 진단을 근거로 분류하였다. 결 과 : 뇌종양으로 진단 받은 환아는 모두 45명이었고 남아가 27명, 여아가 18명이었다. 대상 환아에서 발병연령의 중앙값은 천막상부는 6.0세, 천막하부는 7.0세로 두 군간의 유의한 차이는 없었다. 발생위치는 천막상부에 24명(53.3%), 천막하부에 21명(46.6%) 발생하였고 천막상부 종양에서는 대뇌반구 및 측뇌실 종양이 14명(58.3%), 터키안 상부 종양이 7명(29.1%), 송과체 및 제3 뇌실 후반부종양이 3명(12.5%)을 각각 차지하였으며 천막하부 종양에서는 소뇌충부 및 제4 뇌실종양이 12명(57.1%), 소뇌 반구종양이 4명(19.1%), 뇌간 종양이 5명(23.8%)을 차지하였다. 종양으로 진단시 환아들의 주증상은 천막상부 종양에서는 경련이 9명(37.5%)으로 가장 많았고 두통은 3명(12.5%)을 차지한 반면 천막하부 종양에서는 두통이 8명(38.0%)으로 가장 많았고 경련이 1명(4.8%)으로 조사되어 천막상부 종양에서는 경련이 천막하부에 비하여 많이 나타났고(P=0.012) 천막하부 종양에서는 두통이 천막상부에 비하여 많은 것으로 나타났다(P=0.046). 이밖에도 천막상부 종양에서는 성장지연(2명), 성조숙증(2명) 등이, 천막하부 종양에서는 운동실조(3명), 구토(3명) 등이 우세하게 나타났으나 통계학적으로 유의성은 없었다. 보호자가 증상 인식 후 병원을 내원하기까지 기간은 천막상부는 중앙값이 6일(즉시-8개월), 천막 하부는 중앙값이 30일(즉시-2개월)로 나타났으나 두 군간의 유의한 차이는 없었다(P=0.088). 병원에 내원 후 의료진이 진단하기까지 기간은 천막상부와 하부에서 모두 내원 즉시 의심을 하여 방사선검사로 확진된 경우가 대부분 이었으나 천막상부의 경우 6년, 하부의 경우 7개월까지 지연된 예가 있었다. 결 론 : 소아에서 뇌종양이 진단될 때 천막상부 종양에서는 경련이 천막하부 종양에서는 두통이 각각 가장 많은 비중을 차지하였다. 보호자가 증상을 발견하고 내원하는 기간과 병원에 내원 후 종양이 진단되기까지 기간은 오래 걸리지 않는 경향을 보였지만, 두통이나 경련으로 내원하는 소아환자에서 자세한 병력청취와 신경학적 검사 및 두개 방사선 영상검사를 통해 뇌종양을 의심하는 것이 중요하다.

• Parasites, Hosts and Diseases
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• 제50권1호
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• pp.63-67
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• 2012

Congenital $Neospora$ $caninum$ infection was diagnosed in two Saanen goat kids from two distinct herds with a history of abortion and weak newborn goat kids in the Southern region of the State of Minas Gerais, Brazil. The first kid was weak at birth, had difficulty to rise and was unable to nurse. Gross lesions of porencephaly and hydrocephalus ex vacuo were seen. Multifocal necrosis, gliosis and non-supurative encephalitis were observed in the brain. Several parasitic cysts with a thick wall that reacted strongly only with polyclonal antiserum to $Neospora$ $caninum$ were seen in the cerebral cortex, brain stem and cerebellum. The second kid was born from a $Neospora$ $caninum$ seropositive mother that aborted in the last pregnancy. It was born without clinical signs. The diagnosis of neosporosis was based on antibody titer of 1:800 to $N.$ $caninum$ by indirect fluorescence antibody test obtained from blood collected before the goat kid ingested the colostrum and $Neospora$ $caninum$ DNA was detected by polymerase chain reaction and sequenced from placenta. This is the first report of neosporosis in goats in the southeast region of Brazil.

• Radiation Oncology Journal
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• 제34권4호
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• pp.313-321
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• 2016

Purpose: Total scalp irradiation (TSI) is a rare but challenging indication. We previously reported that non-coplanar intensity-modulated radiotherapy (IMRT) was superior to coplanar IMRT in organ-at-risk (OAR) protection and target dose distribution. This consecutive treatment planning study compared IMRT with volumetric-modulated arc therapy (VMAT). Materials and Methods: A retrospective treatment plan databank search was performed and 5 patient cases were randomly selected. Cranial imaging was restored from the initial planning computed tomography (CT) and target volumes and OAR were redelineated. For each patients, three treatment plans were calculated (coplanar/non-coplanar IMRT, VMAT; prescribed dose 50 Gy, single dose 2 Gy). Conformity, homogeneity and dose volume histograms were used for plan. Results: VMAT featured the lowest monitor units and the sharpest dose gradient (1.6 Gy/mm). Planning target volume (PTV) coverage and homogeneity was better in VMAT (coverage, 0.95; homogeneity index [HI], 0.118) compared to IMRT (coverage, 0.94; HI, 0.119) but coplanar IMRT produced the most conformal plans (conformity index [CI], 0.43). Minimum PTV dose range was 66.8%-88.4% in coplanar, 77.5%-88.2% in non-coplanar IMRT and 82.8%-90.3% in VMAT. Mean dose to the brain, brain stem, optic system (maximum dose) and lenses were 18.6, 13.2, 9.1, and 5.2 Gy for VMAT, 21.9, 13.4, 14.5, and 6.3 Gy for non-coplanar and 22.8, 16.5, 11.5, and 5.9 Gy for coplanar IMRT. Maximum optic chiasm dose was 7.7, 8.4, and 11.1 Gy (non-coplanar IMRT, VMAT, and coplanar IMRT). Conclusion: Target coverage, homogeneity and OAR protection, was slightly superior in VMAT plans which also produced the sharpest dose gradient towards healthy tissue.

• Journal of Preventive Medicine and Public Health
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• 제26권4호
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• pp.565-573
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• 1993

Noise is not only affecting the ear and the auditory cortex locally, but its influence is widely spread throughout the brain structures, e. g., the reticular formation, the brain stem nuclei or the subcortical forebrain area. Hence, any of the organism's activities can be hindered or stimulated by noise. High noise is a stressor and the catecholamine level can be used both as a stress marker and as an indicator of modified sympathetic nervous system activity. Several recent studies have found that the urinary excretion of catecholamines is increased due to high noise intensity, especially unexpectedly high and long lasting noise. The present study was conducted in order to examine the effects of noise stress on urinary excretion of ctecholamines in rats and humans. Rats were exposed to 90 dB noise for 10, 30, and 60 minutes, 3 and 12 hours. 24 hour . urinary samples were collected and the catecholamones were extracted by alumina and analyzed by HPLC-ECD. Catecholamine levels increased with time of exposure up to 60 minutes : norepinephrine concentration at 60 min of noise=1.038 ng/ml, epinephrine=0.636 ng/ml. Urine catecholamines of blue collar workers exposed to 90 dB of noise at the work place were collected between 2 and 4 p.m. and compared to that of white collar workers exposed to 70 dB. Mean norepinephrine level of the blue collar workers was 0.89 ng/ml (${\pm}0.25$), epinephrine 0.24ng/m1 (${\pm}0.09$), and that of the white collar workers 0.48 ng/ml (${\pm}0.12$), epinephrine 0.19 ng/ml(${\pm}0.05$). It was concluded that noise acts as a stressor and increases the catecholamine levels in both rats and humans.

• Archives of Plastic Surgery
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• 제36권3호
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• pp.277-282
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• 2009

Purpose: The vegetative state is a clinical condition with complete unawareness of self and environment, but with preservation of brain - stem functions. Vegetative patients may have nosocomial infections in their wounds, like pressure sores and infected craniums after cranioplasties. Usually flap surgery is necessary for those wounds, but decision of undergoing surgery is difficult because of various adverse conditions of vegetative patients. We share our experience of several successful flap surgeries in vegetative patients, and evaluate obstacles and requirements to get satisfactory results. Methods: From December 2005 to September 2008, a total of 4 vegetative patients underwent surgeries. In 2 patients with infected artificial craniums, scalp reconstructions with free flaps were performed. In other 2 patients with huge pressure sores with sepsis, island flap coverage of wounds was done. Retrospective study was done on hospital day, vegetative period, number of surgeries done, underlying diseases, causative bacteria, and contents of informed consent. Results: Mean hospital day was 14 months and mean vegetative period was 17.5 months. Patients underwent average of 4.5 surgeries under general anesthesia. There were several underlying diseases like hypertension, DM, CHF and chronic anemia. MRSA(Methicilin - resistant Staphylococcus Aureus) was cultured from every patient's wounds. Informed consent included a warning for high mortality and a need of attentive familial cooperation. Conclusion: There are three requirements for doing flap surgeries in vegetative patients. First, to prevent aggravation of brain damage and underlying diseases by general anesthesia, multidisciplinary team approach is needed. Second, operation should be beneficial for prolonging patient's lifespan. Third, because postoperative care is very difficult and long hospitalization is needed, detailed informed consent and highly cooperative attitude of family should be confirmed before operation.

• Journal of Korean Neurosurgical Society
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• 제30권3호
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• pp.278-283
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• 2001

Objective : Massive cerebral infarction could be accompanied by severe brain swelling and death secondary to transtentorial herniation. Approximately 10% to 15% of middle cerebral artery infarctions are associated with this phenomenon. However, the effectiveness and timing of decompressive surgery are still controversial. In this study, we present our results on the effect of decompressive craniectomy in life threatening cerebral infarction. Method : We retrospectively analyzed 15 patients who underwent decompressive craniectomy for massive cerebral infarction from January 1997 to April 1999. Surgical indication was based on the clinical signs such as neurological deterioration, pupillary reflex, and radiological findings. Clinical outcome was assessed by Glasgow Outcome Scale (GOS). Results : All 15 patients(five men, ten women ; mean age, 52.3 years ; right 11, left 4) were treated with wide craniectomy and duroplasty. The average time interval between onset of symptom and surgical decompression was 2.9 days. Clinical signs of uncal herniation(anisocoria, or fixed and dilated pupils) were presented in 13 of 15 patients. Mean Glasgow coma scale(GCS) was 12.4 points on admission, 8.1 points on preoperative state and 11.8 points postoperatively. Overall outcomes were favorable in 5 cases(Glasgow outcome scale : GOS I, II), unfavorable in 6 cases(Glasgow outcome scale : GOS III, IV) and dead in 4 cases. Conclusion : Early decompressive craniectomy before brain stem compression is considered as an effective lifesaving procedure for massive cerebral infarction unresponsive to aggressive medical therapy.

• 동의생리병리학회지
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• 제16권6호
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• pp.1291-1296
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• 2002

Blood circulation of brain is divided into two major categories; anterior one from carotid artery and posterior one from vertebrobasilar artery. In stroke patients, it is important to diagnose which is involved, because there is many difference in the aspects of clinical menifestations and prognosis, especially in the acute stage. In some cases of vertebrobasilar infarction, such as Wallenberg's syndrome, charicteristic cranial nerve signs, eye movement disorders and cerebellar signs are appeared. And in Dejerine's syndrome, only pure motor or sensory defecits can be appeared without any brainstem signs. So It shoud be differenciated by Brain MRI from those of the cerebral hemisphere lesions. And in the cases that nausea, vomitting and dysphagia are the first menifestations, it is frequently misdiagnosed as internal medical disease, causing appropriate treatment delayed. In this case report, we are to describe the clinical menifestations and progresses of two cases of brainstem infarctions, review previously published case reports about them and compare them to our cases. The first is Dejerine's syndrome i.e. medial medullary infarction, the second is Wallenberg's syndrome i.e. lateral medullary infarction. Simultaneously we are to investigate the oriental medical approach in the bran stem infarctions.

• Molecules and Cells
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• 제28권2호
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• pp.111-117
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• 2009

The CHRM3 gene is a member of the muscarinic acetylcholine receptor family that plays important roles in the regulation of fundamental physiological functions. The evolutionary mechanism of exon-acquisition and alternative splicing of the CHRM3 gene in relation to transposable elements (TEs) were analyzed using experimental approaches and in silico analysis. Five different transcript variants (T1, T2, T3, T3-1, and T4) derived from three distinct promoter regions (T1: L1HS, T2, T4: original, T3, T3-1: THE1C) were identified. A placenta (T1) and testis (T3 and T3-1)-dominated expression pattern appeared to be controlled by different TEs (L1HS and THE1C) that were integrated into the common ancestor genome during primate evolution. Remarkably, the T1 transcript was formed by the integration event of the human specific L1HS element. Among the 12 different brain regions, the brain stem, olfactory region, and cerebellum showed decreased expression patterns. Evolutionary analysis of splicing sites and alternative splicing suggested that the exon-acquisition event was determined by a selection and conservation mechanism. Furthermore, continuous integration events of transposable elements could produce lineage specific alternative transcripts by providing novel promoters and splicing sites. Taken together, exon-acquisition and alternative splicing events of CHRM3 genes were shown to have occurred through the continuous integration of transposable elements following conservation.