• Journal of Korean Neurosurgical Society
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• v.29 no.6
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• pp.815-821
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• 2000

Parasplenial arteriovenous malformations(AVMs) are rare vascular malformations which have distinct clinical and anatomical features. They are situated at the confluence of the hippocampus, isthmus of the cingulate gyrus and the gyrus occipitotemporalis medialis. These lesions are anterior to the calcarine sulcus and their apex extends towards the medial surface of the trigonum. Posterolaterally, these lesions are in close proximity to the visual cortex and optic radiation. The objectives in the surgery of parasplenial AVMs are complete resection of the lesions and preservation of vision. These objectives must be achieved with comprehensive understanding of the following anatomical features :1) the deep central location of the lesions within eloquent brain tissue ; 2) the lack of cortical representation of the AVMs that requires retraction of visual cortex ; 3) deep arterial supply ; 4) deep venous drainage ; 5) juxtaposition to the choroid plexus with which arterial supply and venous drainage are shared. A 16-year-old female student presented with intraventricular hemorrhage from a right parasplenial-subtrigonal AVM. The lesion, fed by posterior cerebral artery and drained into the vein of Galen, was successfully treated by the inter-hemispheric parietooccipital approach. To avoid visual field defect a small incision was made on precuneus anterior to the calcarine sulcus. In this report, the authors describe a surgical approach with special consideration on preservation of visual field.

• Journal of Korean Neurosurgical Society
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• v.40 no.2
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• pp.117-121
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• 2006

The surgical removal of solid deep-seated hemangioblastomas remains challenging, because treatment of these lesions is often complicated by severe bleeding associated with the rich vascularity of this tumor, and by severe neural tissue injury associated with the difficulty of en bloc resection, especially when the tumor is located at the cervicomedullary junction. Therefore, preoperative embolization of deep-seated solid hemangioblastomas may play an important role in successful surgical removal by reducing major bleeding and neural tissue damage. A 24-year-old woman, 28-weeks pregnant, was admitted to our hospital for the evaluation of quadriparesis, and brain magnetic resonance imaging[MRI] revealed intra-axial mass lesion in the cervicomedullary junction. After delivery, her neurologic symptoms became aggravated, and we decided to operate. Preoperative angiography revealed a hypervascular tumor in the posterior fossa, and embolization of the main feeding artery using gelfoam and microcoil, resulted in marked reduction of tumor vascularity. She underwent a midline suboccipital craniotomy involving the removal of the arch of C-1. The tumor was totally removed through a midline myelotomy, and at her 6-month follow-up she walked independently. We report on the combined use of the preoperative embolization of feeding vessels and subsequent operative resection in a patient with a solid hemangioblastoma at the cervicomedullary junction immediately after delivery.

• Journal of Korean Neurosurgical Society
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• v.45 no.2
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• pp.99-102
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• 2009

Inflammatory pseudotumor is an uncommon lesion with unknown etiology characterized by sclerosing inflammation which clinically and radiographically mimics a neoplastic lesion. A 47-year-old man presented with sudden headache and dysarthria. Brain CT scan revealed a $2.6{\times}2.2\;cm$ sized, round, and hyperdense mass in the anterolateral wall of the left lateral ventricular trigone. On MR imaging studies, the mass showed low signal intensity in the wall of the trigone on T2-weighted image, central mixed (iso- and high-) signal intensity with peripheral low-signal intensity on T1-weighted image. Subtle staining of left choroid plexus with irregular shaped distal branch of anterior choroidal artery was found on the cerebral angiography. These findings suggested a small tumorous lesion originated from the left choroid plexus. During the hospital days, the mass manifested as repeated hemorrhages. The mass was successfully removed via left occipital transcortical approach. The histopathological report of the specimen was hemorrhage and fibrosis, with dense lymphoplasma cell infiltration, suggestive of an inflammatory pseudotumor.

• Toxicological Research
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• v.15 no.1
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• pp.1-8
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• 1999

This study was performed to investigate the antitoxic effect of Oenanthe javanica extracts on orally administered mercury compound. Adult male ICR mice were exposed to methylmercuric chloride (CH3HgCl)through drinking water. The control, mercury treated and Oenanthe javanica treated groups not showed significant differences in mean body and organ weights of mice. The distribution of mercury in the cerebellum, kidney, liver and spleen of the mouse were examined according to a histochemical mathod. Grains of mercury traces were located in the purkinje cell and granular layers of the cerebellum and cortex of kidney respectively. Lesser staining of the grains was seen in the collecting tubules of medulla. in the liver, mercury accumulations were present primarily in the hepatocytes around portal area containing interlobular bile duct, artery and portal vein. Also grains of mercury traces were accumulated in the white pulp of the spleen. In the group of Oenanthe javanica extracts, staining intensity of mercury was decreased in the Purkinje cell layer of cerebellum and in the portal area of liver respectively. Staining patterns in kidney and spleen of extracts group were similar to that of only mercury treated group.

• Journal of Chest Surgery
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• v.37 no.2
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• pp.176-179
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• 2004

A 30 year-old female patient was admitted for dizziness and palpitation. Pulsation of the both upper extremities and both common carotid arteries were absent. Innominate artery and both common carotid arteries were severely narrowed and both subclavian arteries were completely obstructed on aortogram. The patient was diagnosed as tvue Ⅰ Takayasu's arteritis, and operation was peformed to increase blood flow to the brain and both upper extremities. Ascending aorta, both carotid arteries, both subclavian arteries, and both axillary arteries were exposed by four separate incision, and we performed an aorto-bicarotid-biaxillary bypass with Hemashield graft. Previous dizziness and palpation were disappeared after the operation.

• Biomedical Science Letters
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• v.11 no.2
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• pp.221-225
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• 2005

To investigate the spectroscopic findings of embolized lesions induced with a fat-emulsion technique with magnetic resonance images (MRI). A fat emulsion was made with 0.1 ml of triolein and 20 ml of normal saline. In 12 cats, the internal carotid artery was infused with the fat emulsion. Contrast-enhanced T1-weighted MRI and multivoxel spectroscopy were obtained at 1 hour, 1 and 4 days, and 1 week after embolization. NAA (N-acetylaspartate), Cr (creatine) and Cho (choline) were evaluated on the spectroscopy. Statitistical analysis wsperformed at the embolized and contralateral normal hemisphere in the integral and amplitude of NAA, Cr and Nho in time course. Also NAA/Cr and Cho/Cr were compared in both hemisphere and in time course. The emboli zed lesions showed contrast enhance ments on Gd-enhanced Tl-weighted i~ages at 1 hour. This contrast enhancement was decreased at day 1, and id not appear agter day 4. In spectroscopy, the embolized hemisphere showed no statistical difference to the normal contralateral side at 1 hour and in time course. NAA/Cr and Cho/Cr were not significantly different in both hemispheres at 1 hour and in time course. Cerebral-fat embolism induced by a triolein emulsion in cats revealed no statistical difference on MR spectroscopy. Triolein-emulsion can be used in the study of blood-brain barrier.

• Clinical and Experimental Pediatrics
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• v.54 no.1
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• pp.40-44
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• 2011

We present a case of tacrolimus-induced encephalopathy after successful kidney transplantation. An 11-year-old girl presented with sudden onset of neurologic symptoms, hypertension, and psychiatric symptoms, with normal kidney function, after kidney transplantation. The symptoms improved after cessation of tacrolimus. Magnetic resonance imaging (MRI) showed acute infarction of the middle cerebral artery (MCA) territory in the right frontal lobe. Three days later, she had normal mental function and maintained normal blood pressure with left hemiparesis. Follow-up MRI was performed on D19, showing new infarct lesions at both cerebral hemispheres. Ten days later, MRI showed further improvement, but brain single photon emission computed tomography (SPECT) showed mild reduction of uptake in both the anterior cingulate gyrus and the left thalamus. One month after onset of symptoms, angiography showed complete resolution of stenosis. However, presenting as a mild fine motor disability of both hands and mild dysarthria, what had been atrophy at both centrum semiovale at 4 months now showed progression to encephalomalacia. There are two points of interest in this case. First, encephalopathy occurred after administration of tacrolimus and improved after discontinuation of the drug. Second, the development of right-side hemiplegia could not be explained by conventional MRI; but through diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) of white matter tract, visualization was possible.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.3
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• pp.596-602
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• 2006

This study evaluated neuroprotective effect of Sunghyangjungki-San (SHS) on the focal cerebral ischemia. The rats were induced infarct in cerebral cortex and caudoputamen by using temporal occlussion of the middle cerebral artery (MCAO), then water extract of SHS was treated for MCAO rats. Neuroprotective effect was evaluated by neurological score, infarct sizes and total volume, positive neurons against Bax, Caspase-3, HSP-72, and $HIF-1{\alpha}$ in infarct area with immunohistochemistry. The results obtained were as follows: Treatment of SHS improved neurological score of MCAO rats, but there was not a statistical significance. Treatment of SHS reduced significantly infarct sizes in the brain sections of MCAO rats. Treatment of SHS reduced significantly total volume of infarct of MCAO rats. Treatment of SHS reduced significantly Bax positive neurons in penumbra of cerebral cortex of MCAO rats. Treatment of SHS reduced significantly Caspase-3 positive neurons in caudoputamen and penumbra of cerebral cortex of MCAO rats. Treatment of SHS reduced significantly HSP-72 positive neurons in penumbra of cerebral cortex of MCAO rats. Treatment of SHS reduced significantly $IF-1{\alpha}$ positive neurons in penumbra of cerebral cortex of MCAO rats.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.2
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• pp.403-409
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• 2008

In Oriental medicine daeseungki-tang is one of the prescription that is used clinically for constipation of paralytics. The objective of the study was to observe the effect of daeseungki-tang on apoptotic neuronal cell death. In the present study, middle cerebral artery occlusion(MCAO) rats were treated with daeseungi-tang for 5 days and the edema percentage of cerebral hemisphere of MCAO rats were investigated primary. Secondary, appearances of Bax, Bcl-2,-factors that is related to apoptotic neuronal cell death - and HSP72 in the brain of MCAO rats were investigated via immunohistochemistry. Daeseungki-tang significantly decreased edema percentage of the cerebral hemisphere of MCAO rats. Daeseungki-tang significantly decreased Bax positive cells, but did not change the apperances of Bcl-2 positive cells in the penumbra of the cerebral cortex and the caudoputamen of MCAO rats. Daeseungki-tang significantly decreased HSP72 positive cells in the penumbra of the cerebral cortex, but not in the caudoputamen of MCAO rats. Based on the present results, it can be suggested that treatment with daeseungki-tang may decrease edema of the cerebral hemisphere and restrain apoptotic neuronal cell death in the penumbra of the cerebral cortex.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.2
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• pp.321-327
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• 2008

This study evaluated neuroprotective effects of Yanggyuksanhwa-tang (YST) on global cerebral ischemia of diabetic rats. On primary experiment, diabetic condition in rats was induced by streptozotocin injection. Secondarily, global cerebral ischemia was induced by bilateral occlusion of the common carotid artery with hypotension (BCAO) under the diabetic condition. Then neuroprotective effect of YST was observed with changes of neuronal c-Fos and Bax expressions, and GFAP expression in the brain tissues by using immunohistochemistry. YST treatment was resulted significant decrease of c-Fos expression in CA1 hippocampus induced by BCAO on diabetic rats. YST treatment was resulted significant decrease of Bax expression in CA1 hippocampus induced by BCAO on diabetic rats. YST treatment was resulted significant decrease of c-Fos expression in cerebral cortex and caudoputamen induced by BCAO on diabetic rats. YST treatment was resulted significant decrease of GFAP expression in cerebral cortex induced by BCAO on diabetic rats. These results suggest that YST has effects on neuroprotection against cerebral ischemic damage under diabetic condition. And it is supposed that neuroprotective effect of YST reveals by anti-apoptosis mechanism.