• The Korean Journal of Physiology and Pharmacology
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• v.9 no.3
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• pp.137-141
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• 2005

This study was undertaken to investigate the effects of [$D-Ala^2$, D-Leu^5$]-enkephalin (DADLE) on the spontaneous activity of medial vestibular nuclear neurons of the rat. Sprague-Dawley rats, aged 14 to 16 days, were anesthetized with ether and decapitated. After enzymatic digestion, the brain stem portion of medial vestibular nuclear neuron was obtained by micropunching. The dissociated neurons were transferred to a recording chamber mounted on an inverted microscope, and spontaneous action potentials were recorded by standard patch-clamp techniques. The spontaneous action potentials were increased by DADLE in 12 cells and decreased in 3 cells. The spike frequency and resting membrane potential of these cells were increased by DADLE. The depth of afterhyperpolarization was not affected by DADLE. The potassium currents were decreased in 20 cells and increased in 5 cells. These results suggest that DADLE increases the neuronal activity of the medial vestibular nuclear neurons by altering resting membrane potential.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.4
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• pp.107-115
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• 2016

The occurrence of brain stem stroke after lumbar selective nerve root block seem to be an uncommon event comparing it to after cervical selective nerve root block. We recently experienced a 60-year-old man who were diagnosed as left lateral medullary infarction (Wallenberg's syndrome) after lumbar selective nerve root block. He was treated by traditional Korean medicine with acupunture, Pulsed electromagetic therapy (PEMT), herb medicine. The range of motion of upper and lower extremity, manual muscle test, Korean version of Berg balance scale (K-BBS) and Korean version of Barthel index (K-MBI) were adopted to measure the resulting recovery after 4 weeks treatment. Traditional Korean medicine was effective for rehabilitation of patient. Further studies are needed to set up and Korean medical protocol for Wallenberg's syndrome.

• Journal of Veterinary Clinics
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• v.29 no.4
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• pp.328-330
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• 2012

A 13-year-old, neutered male, chihuahua was referred to the Veterinary Medical Teaching Hospital of Chungnam National University with a history of a bilateral mandibular mass, intermittent vomiting, cough, and left sided staggering starting ten days prior. Clinical examination along with radiography, neurologic examination and magnetic resonance imaging (MRI) demonstrated a well-circumscribed and solitary mass in the brain stem. The dura mater was thickened with marked linear enhancement after contrast administration. Based on diagnostic image analysis and histopathologic examination, this case was diagnosed as intracranial meningioma. The patient's symptoms were controlled for 18 months by a combination therapy of prednisolone and lomustine (CCNU), and then he died of at home.

• Journal of Korean Neurosurgical Society
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• v.54 no.4
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• pp.359-362
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• 2013

Chronic hypoventilation due to injury to the brain stem respiratory center or high cervical cord (above the C3 level) can result in dependence to prolonged mechanical ventilation with tracheostomy, frequent nosocomial pneumonia, and prolonged hospitalization. Diaphragm pacing through electrical stimulation of the phrenic nerve is an established treatment for central hypoventilation syndrome. We performed chronic phrenic nerve stimulation for diaphragm pacing with the spinal cord stimulator for pain control in a quadriplegic patient with central apnea due to complete spinal cord injury at the level of C2 from cervical epidural hematoma. After diaphragmatic pacing, the patient who was completely dependent on the mechanical ventilator could ambulate up to three hours every day without aid of mechanical ventilation during the 12 months of follow-up. Diaphragm pacing through unilateral phrenic nerve stimulation with spinal cord stimulator was feasible in an apneic patient with complete quadriplegia who was completely dependent on mechanical ventilation. Diaphragm pacing with the spinal cord stimulator is feasible and effective for the treatment of the central hypoventilation syndrome.

• Clinical and Experimental Pediatrics
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• v.59 no.10
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• pp.395-401
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• 2016

Since the outbreak of the enterovirus 71 (EV71) infection in Malaysia in 1997, large epidemics of EV71 have occurred in the Asia-Pacific region. Many children and infants have died from serious neurological complications during these epidemics, and EV71 infection has become a serious public health problem in these areas. EV71 infection causes hand, foot and mouth disease (HFMD) in children, and usually resolves spontaneously. However, EV71 occasionally involves the central nervous system (CNS), and induces diverse neurological complications such as brainstem encephalitis, aseptic meningitis, and acute flaccid paralysis. Among those complications, brainstem encephalitis is the most critical neurological manifestation because it can cause neurogenic pulmonary hemorrhage/edema leading to death. The characteristic clinical symptoms such as myoclonus and ataxia, cerebrospinal fluid (CSF) pleocytosis, and brainstem lesions on magnetic resonance imaging, in conjunction with the skin rash of HFMD and the isolation of EV71 from a stool, throat-swab, or CSF sample are typical findings indicating CNS involvement of EV71 infection. Treatment with intravenous immunoglobulin and milrinone are recommended in cases with severe neurological complications from EV71 infection, such as brainstem encephalitis. Despite the recent discovery of receptors for EV71 in human cells, such as the scavenger receptor B2 and P-selection glycoprotein ligand 1, it is not known why EV71 infection predominantly involves the brainstem. Recently, 3 companies in China have completed phase III clinical trials of EV71 vaccines. However, the promotion and approval of these vaccines in various countries are problems yet to be resolved.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.14 no.1
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• pp.29-36
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• 2014

Mucopolysaccharidoses (MPSs) are a group of rare inherited metabolic diseases caused by deficiency of lysosomal enzymes. MPSs are clinically heterogeneous and characterized by progressive deterioration in visceral, skeletal and neurological functions. The aim of this article is to review the treatment of MPSs, the unmet needs of current treatments and vision for the future including recent clinical trials. Until recently, supportive care was the only option available for the management of MPSs. Hematopoietic stem cell transplantation (HSCT), another potentially curative treatment, is not routinely advocated in clinical practice due to its high risk profile and lack of evidence for efficacy. From the early 2000s, enzyme replacement therapy (ERT) was approved and available for the treatment of MPS I, II and VI. ERT is effective for the treatment of many somatic symptoms, particularly walking ability and respiratory function, and remains the mainstay of MPS treatment. However, no benefit was found in the neurological symptoms because the enzymes do not readily cross the blood-brain barrier (BBB). In recent years, intrathecal (IT) ERT, substrate reduction therapy (SRT) and gene therapy have been rapidly gaining greater recognition as potential therapeutic avenues. Although still under investigation, IT ERT, SRT and gene therapy are promising MPS treatments that may prevent the neurodegeneration not improved by ERT.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.131-134
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• 1995

Hiccup is characterized by a myoclonus in the diaphragm, resulting in a sudden inspiration associated with an audible closure of the glottis. The reflex arc in hiccups comprises three pars: an afferent, a central and an efferent part. The afferent portion of the neural pathway of hiccup formation is composed of the vagus nerve, the phrenic nerve, and the sympathetic chain arising from T6 to T12. The hiccup center is localised in the brain stem and the efferent limb comprises phrenic pathways. All stimuli affecting the above mentioned reflex arc may produce hiccups. The pathogenesis of persistent hiccups is not known. Hiccup can present a symptom of a subphrenic abscess or gastric distention, and metabolic alterations may also cause hiccups. Numerous treatment modalities have been tried but with questionable success. We describe a patient whose persistant hiccups was treated successfully by a cervical epidural block.

• The Korean Journal of Physiology and Pharmacology
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• v.11 no.3
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• pp.79-84
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• 2007

Because synaptic refinement of medial nucleus of trapezoid body (MNTB) - lateral superior olive (LSO) synapses is most active during the first postnatal week and the long term depression (LTD) has been suggested as one of its mechanisms, LTD of MNTB-LSO synapses was investigated in neonatal rat brain stem slices with the whole cell voltage clamp technique. In $Mg^{2+}$ free condition, tetanus (10 stimuli at 10 Hz for 2 min) in the current clamp mode induced a robust LTD of isolated D, L-APV-sensitive postsynaptic currents (PSCs) for more than 30 min ($n=6,\;2.4{\pm}0.4%$ of the control), while isolated CNQX-sensitive PSCs were not suppressed ($n=6,\;95.3{\pm}1.6%$). Tetanus also elicited similar LTD in the isolated GABAergic/glycinergic PSCs ($n=6,\;3.6{\pm}0.5%$) and mixed PSCs (GABAergic/glycinergic/glutamatergic) ($n=4,\;2.2{\pm}0.7%$). However, such a strong LTD was not observed in the mixed PSCs when 10 mM EGTA was added in the internal solution (n=10), indicating that postsynaptic $Ca^{2+}$ rise is needed for the strong LTD. This robust LTD might contribute to the active synaptic refinement occurring during the first postnatal week.

• Korean Journal of Veterinary Service
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• v.37 no.1
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• pp.67-71
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• 2014

In November 2012, a 4-month-old foal with anorexia, neurologic signs with ataxia and death was submitted for necropsy to the diagnostic laboratory of Jeju Self-Governing Provincial Veterinary Research Institute. Grossly, yellowish-white fibrinous materials were seen on the ventral cerebrum, cerebellum, medulla oblongata and cervical spinal cord of the foal. Histologically, severe fibrino-purulent meningitis characterized by the infiltration of neutrophils and fibrionous exudates with bacterial colonies were presented in cerebrum, cerebellum, brain stem and cervical spinal cord. In the bacterial isolation using meningeal exudate, the small white colonies on blood agar plate with ${\beta}$-hemolysis were observed. Isolated bacteria were Gram-positive cocci and confirmed as Streptococcus (S.) equi subsp. zooepidemicus by VITEK 2 system. Based on the histopathological features and the bacterial test, this case was diagnosed as meningitis associated with S. equi subsp. zooepidemicus infection in a foal. In our best knowledge, this is the first report for fibrino-purulent meningitis caused by S. equi subsp. zooepidemicus infection in Jeju.

• Journal of Korean Neurosurgical Society
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• v.66 no.4
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• pp.356-381
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• 2023

Although immunotherapy has been broadly successful in the treatment of hematologic malignancies and a subset of solid tumors, its clinical outcomes for glioblastoma are still inadequate. The results could be due to neuroanatomical structures such as the blood-brain-barrier, antigenic heterogeneity, and the highly immunosuppressive microenvironment of glioblastomas. The antitumor efficacy of endogenously activated effector cells induced by peptide or dendritic cell vaccines in particular has been insufficient to control tumors. Effector cells, such as T cells and natural killer (NK) cells can be expanded rapidly ex vivo and transferred to patients. The identification of neoantigens derived from tumor-specific mutations is expanding the list of tumor-specific antigens for glioblastoma. Moreover, recent advances in gene-editing technologies enable the effector cells to not only have multiple biological functionalities, such as cytokine production, multiple antigen recognition, and increased cell trafficking, but also relieve the immunosuppressive nature of the glioblastoma microenvironment by blocking immune inhibitory molecules, which together improve their cytotoxicity, persistence, and safety. Allogeneic chimeric antigen receptor (CAR) T cells edited to reduce graft-versus-host disease and allorejection, or induced pluripotent stem cell-derived NK cells expressing CARs that use NK-specific signaling domain can be a good candidate for off-the-shelf products of glioblastoma immunotherapy. We here discuss current progress and future directions for T cell and NK cell therapy in glioblastoma.