• Toxicological Research
• /
• 제17권
• /
• pp.47-57
• /
• 2001

Alzheimer's disease (AD) is the most common cause of dementia in the elderly, and its pathology is characterized by the presence of numerous numbers of senile plaques and neurofibrillary tangles. Several genetic and transgenic studies have indicated that excess amount of $\beta$-amyloid protein (A$\beta$) is produced by mutations of $\beta$TEX>$\beta$-amyloid precursor protein and causes learning impairment. Moreover, $A\beta$ has a toxic effect on cultured nerve cells. To prepare AD model animals, we have examined continuous (2 weeks) infusion of $A\beta$ into the cerebral ventricle of rats. Continuous infusion of $A\beta$ induces learning impairment in water maze and passive avoidance tasks, and decreases choline acetyltransferase activity in the frontal cortex and hippocampus. Immunohistochemical analysis revealed diffuse depositions of $A\beta$ in the cerebral cortex and hippocampus around the ventricle. Furthermore, the nicotine-evoked release of acetylcholine and dopamine in the frontal cortex/hippocampus and striatum, respectively, is decreased in the $A\beta$-infused group. Perfusion of nicotine (50 $\mu\textrm{M}$) reduced the amplitude of electrically evoked population spikes in the CA1 pyramidal cells of the control group, but not in those of the $A\beta$-infused group, suggesting the impairment of nicotinic signaling in the $A\beta$-infused group. In fact, Kd, but not Bmax, values for ［$^3H$］ cytisine binding in the hippocampus significantly increased in the $A\beta$-infused rats. suggesting the decrease in affinity of nicotinic acetylcholine receptors. Long-term potentiation (LTP) induced by tetanic stimulations in CA1 pyramidal cells, which is thought to be an essential mechanism underlying learning and memory, was readily observed in the control group, whereas it was impaired in the $A\beta$-infused group. Taken together, these results suggest that $A\beta$ infusion impairs the signal transduction mechanisms via nicotinic acetylcholine receptors. This dysfunction may be responsible, at least in part, for the impairment of LTP induction and may lead to learning and memory impairment. We also found the reduction of glutathione- and Mn-superoxide dismutase-like immunoreactivity in the brains of $A\beta$-infused rats. Administration of antioxidants or nootropics alleviated learning and memory impairment induced by $A\beta$ infusion. We believe that investigation of currently available transgenic and non-transgenic animal models for AD will help to clarify the pathogenic mechanisms and allow assessment of new therapeutic strategies.

• 대한임상검사과학회지
• /
• 제48권4호
• /
• pp.388-393
• /
• 2016

뇌전증의 개념은 간질발작이 지속적으로 발생하는 뇌변병으로 2005년에 정의 되었다. 2014년 국제항뇌전증연맹에서는 새로운 정의를 내렸으며, 10년 이내 재발 위험이 높다고 하였다. 뇌전증 발작재발의 중요한 위험인자로서 뇌파에서 IEDs의 존재는 발작 증상이 높게 나타날 수 있다는 것을 반영한다. 본 연구는 뇌전증 환자에서 뇌파검사 소견과 IEDs에 따른 발작재발의 상관관계를 분석하여 뇌전증 환자의 예후를 예측하기 위한 뇌파검사의 기초자료로 활용하고자 실시하였다. 연구결과, 뇌전증 질환의 남녀 차이는 없었으며, 연령의 분포 차이는 있었다. 상관관계 분석결과 연령에 따라 발작재발은 음의 상관관계였으며, IEDs에 따라 발작재발은 양의 상관관계를 나타내었다. 또한 통계적으로 연령은 발작재발에 10.9%의 영향을 나타내었고, IEDs는 발작재발에 15%의 설명력을 나타내었다. 따라서 뇌파검사는 임상에서 사용하는 뇌전증 진단에 매우 중요한 검사로 판단되며, 향후 보다 의미 있는 임상 자료가 되기 위하여 발병률에 따른 뇌파결과와 치료 중 뇌파결과와 발작재발 그리고 치료 후 발작재발 등을 지속적으로 연구해야 할 것으로 생각된다.

• 정신신체의학
• /
• 제7권2호
• /
• pp.263-273
• /
• 1999

두통은 인류의 가장 흔한 호소 중의 하나로 임상에서 흔히 보는 장애이다. 두통은 뇌막염, 뇌출혈, 또는 뇌종양과 같은 다른 질환의 증상일수 있으나, 또한 편두통이나 군발두통 등과 같은 질병 자체로 표현된다. 일차적으로 두통 장애의 역학이나 국제 두통학회의 진단기준을 이해하고 흔치 않으나 심각한 이차적인 두통장애와 감별에 관심을 둬야 한다. 환자가 일차 두통장애의 기준에 맞으면 신경학적 진단검사의 보충이 없어도 치료를 시작한다. 두통 유형, 표현 양상, 동통기간과 강도 등에 따라 진통소염제나 혼합진통제, 혈관작용의 항편두통 약물 또는 신경이완제나 corticosteroid등을 선택한다. 편두통의 빈도와 강도에 따라 예방치료가 보통 4~6개월간 조절한다. 긴장형 두통은 발작성과 만성두통으로 구분되나 치료적으로는 급성완화와 예방치료로 시도된다. 많은 만성매일두통 환자들이 진통제나 ergotamine을 과용하고 있으며 그들의 의존성과 내재된 갈등조절, 수면장애, 우울등으로 과용된 약물의 제한이 쉽지 않다. 치료의 첫단계는 약물을 끊고 조심스럽게 대치요법을 시행한다.

• 대한물리치료과학회지
• /
• 제8권1호
• /
• pp.787-798
• /
• 2001

This study was performed to investigate the necessity and the features of adequate services of home visiting physical therapy for chronic ill patients. The study subjects were physical therapist visited in Taejon for Korea Physical Therapy Association Seminar on March 19, 2000. Authors developed questionnaire and distributed it to each physical therapist attended at the Seminar. The number of distributed questionnaire was 1,500, and 487 questionnaire were collected and 388 questionnaire analysed finally. 1. The rate of necessity for home visiting physical therapy by kinds of disease was 70.6% in cerebral palsy, 84.3% in spinal cord injury, 89.7% in cerebral vascular accident and traumatic brain injury, 20.1 % in other diseases. 2. The rate of necessity of education for home visiting physical therapy was 94.5% of men, 97.3% of women. 54.4% of answerer replied that the best education method was that developed clinical program. 3. In the general features of adequate service for home visiting physical therapy, 70.9% of men and 69.1 % of women want special isolated physical therapy center, 61.8% of men and 63.7% of women want distance of 15minutes-29minutes by car. 59.4% of men and 47.5% of women want 3 times per week in frequency(P<0.05), 70.9% of men and 61.0% of women want 30-60minutes in treatment duration. and 47.2% of men and 51.6% of women want to teach only evaluation and treatment method. 4. In the payment of adequate service for home visiting physical therapy, 47.9% of men and 49.3% of women want insurance with private charge (P<0.05), 58.8% of men and 55.2% of women want insurance direct charge and traffic fee and visiting fee for the private charge. 37.0% of men wants 4,000won-4,900won and 32.7% of women wants 2,000won-2,900won for the traffic fee. 43.0% of men wants 5,000won-9,900won and 48.0% of women wants 5,000won-5,900won for the visiting fee. 5. In the qualifications for home visiting physical therapy, 44.8% of men wants to have license and learn home treatment method but 47.1% of women wants to have license and career and learn home treatment method(P<0.05). In the career, 38.8% of men wants above 5 years, 39.5% of women wants above 3 years(P<0.01). 63.0% of men and 66.4% of women answered with unconcern but 18.8% of men wants physical therapist worked in general hospital and 20.6% of women wants in welfare center(P<0.01). 92.7% of men and 92.4% of women answered no interested in physical therapist's gender. The most preferential age of home visiting physical therapist was also no interested in physical therapist's age.

• Journal of Korean Neurosurgical Society
• /
• 제30권3호
• /
• pp.334-341
• /
• 2001

Objective : We have currently changed treatment strategies to methotrexate(MTX)-based preirradiation chemotherapy with subsequent planned radiation for the initial therapy of primary central nervous system lymphoma (PCNSL). The aim of this study was to evaluate the results of treating PCNSL with chemotherapy plus radiotherapy (CRT) or radiotherapy(RT) alone. Method and Material : This study involved 10 females and 3 males patients with a mean age of 54.2 years. All patients underwent surgery, open(8 cases) or stereotactic biopsy(5 cases) for histological diagnosis. Eleven tumors were diffuse large B-cell lymphomas. Tumor volume change in the follow-up images and survival time were evaluated in patients treated with CRT and RT alone. In the beginning, two patients received ProMACE-Cytabom chemotherapeutic regimen, but did not complete the course and died of progressive tumor 8 and 9 months after diagnosis, respectively. One patient died at 6 months before chemotherapy. These three were excluded from the survival analysis. Five patients(RT group) completed full courses of cranial irradiation with or without boost. For the current combined modality treatment, high-dose MTXbased chemotherapy(systemic and intrathecal MTX, IV vincristine, and oral procarbazine) followed by whole brain irrdiation to 45Gy to tumor was introduced in 5 patients of CRT group. Result : A complete response was achieved in three of five who received RT only and in all of five who received CRT. All patients in CRT groups are in disease free status at a mean 23 months following therapy. The RT group patients refused any additional salvage therapy at tumor relapse and survived at mean 20 months from diagnosis. The Karnofsky performance status improved in eight of ten patients with treatment. The treatment toxicity included leukoencephalopathy in RT group and severe leukopenia, transient hepatitis, avascular necrosis of femoral head, hearing loss, and amenorrhea in CRT group, respectively. Conclusion : The combined modality therapy of MTX-based chemotherapy plus radiotherapy for PCNSL may enhance tumor response and improve patient survival. The patients who received CRT should be carefully followed up because of the higher risk of treatment-induced late neurotoxicity.

• 대한약리학회지
• /
• 제30권3호
• /
• pp.343-349
• /
• 1994

정신병치료제들을 장기투여하여 치료를 시도하였을 때에 생기는 여러 부작용은 그 정도 또한 매우 심각하기 때문에 그들의 치료효과와 함께 야기되는 부작용들을 따로 생각할 수가 없게 되었다. 특히 정신병치료는 그 자체에 대한 병인적 원인을 정확히 알 수 없기에 증상에 따른 대중요법이 일괄적으로 사용되므로, 이러한 현재의 치료방법으로는 부작용들이 더 치명적이 될 수 있기 때문에 일차적으로 이들의 공통적약리작용기전들을 연구하는 것은 매우 필요하다. 최근 NO(Nitric oxide)에 대한 많은 연구들에 의하면, 이들이 중추신경계에서 중요한 second messenger 또는 mediator로 신경활동에 영향을 나타내는 것으로 보고되고 있다. 그러므로 저자들은 먼저 이들 약물들과 NO와의 관계를 연구하고자, 중요한 몇종의 정신병치료제들을 택하여 NO생성에 어떤 영향을 미치는 가를 검색하여 다음과 같은 일차 결과를 얻었다 1. 정신병치료제 수종(chlorpromazine, trifluoperazine promazine, pimozide, clozapine, chlorprothixene, haloperidol)을 택하여 쥐의 소내에서 $[^3H]L-arginine$으로부터 $[^3H]L-citrulline$의 생성양을 측정하여 calmodulin antagonist(calmidazolium)와 비교하였다. 2. 이들을 N1E-115 cell에 투여하여 $[^3H]cyclic$ GMP양을 측정하고 그 결과를 calmida-zolium 과 비교하였다. 3. 이들 약물들은 citrulline과 cyclic GMP 모두의 생성양을 의의있게 억제하였으며 그 기전은 calmidazolium과 매우 유사하였다. 위의 일차적 검색결과에 의하면, 정신병치료약물들의 약리작용 기전중에 일부는 중추신경계내의 NO생성 및 cyclic GMP생성에 영향을 나타내는 것으로 사료되며, 이에는 calcium ion이 상당히 중요한 역할을 하는데, 특히 소뇌에서의 NO생성의 감소는 이들 약물들의 치명적 부작용인 tardive dyskinesia와 매우 깊은 관련을 추측할 수 있다. 그러나, 더 많은 약물들의 검색으로 일관적인 기본 결과가 필요 되고 또 각개 약물의 특정적 기전이 연구되기 위하여 현재 실험중이다.

• 대한방사선기술학회지:방사선기술과학
• /
• 제39권2호
• /
• pp.227-236
• /
• 2016

동적 양전자방출단층 촬영은 3차원의 공간적 정보와 추가적인 1차원의 시계열 정보가 함께 존재하는 시공간 정보(4차원)의 데이터를 활용할 수 있어서 전통적인 영상기법에 비해 임상 진단 및 분석에 활용할 수 있는 정보의 양이 급격히 증가된 의료영상 촬영기법이다. 그러나, 인체에 주입할 수 있는 방사성 동위원소의 양의 제한 및 검출기 특징에 따른 감마선 검출의 제한 등이 영상을 재구성 하는 것에 제약사항으로 존재하여, 고화질 의료 영상의 획득에 어려움이 존재하여 임상적 활용의 제한사항이 되어왔다. 본 연구에서는, 4차원 영상의 적극적인 임상 활용을 위해서 영상의 화질을 개선하고 정량적인 평가를 할 수 있는 영상 기법을 연구하였다. 이를 위해, Matlab을 이용하여 영상의 여러 독립적인 신호원을 분리하여 영상의 신호와 노이즈로 구분할 수 있도록, 선형 대수학의 기법 중 하나인 특이값 분해를 활용하였다. 이를 통해, 개선된 동적 양전자방출단층 영상은 정량적인 평가를 통하여, 원래 영상에 비해 SNR이 최소 5%에서 최대 30%까지 증가하는 것을 확인하였다. 이러한 연구 결과는 향후 dynamic PET 연구의 기초적인 도구로 활용될 것이라 기대된다.

• 사상체질의학회지
• /
• 제16권1호
• /
• pp.120-129
• /
• 2004

Yangkyuk-Sanhwa-Tang(YST) has been widely used as a formula for the Soyangin cerebral infarction (CI) patients according to Sasang constitutional philosophy. Brain cells produce cytokines and chemokines during the inflammatory process after stroke both in animal models and in patients. Previously, regulation of serum cytokine levels by YSThas been observed in individuals at the acute stage of CI disease, but there have not been other scientific investigations on YST. The author investigated the effect of YST on theproduction of various cytokines using peripheral blood mononuclear cells (PBMCs)from the Soyangin (CI) patients, and Soyangin normal group. The cytokine production was analyzed using enzyme-linked immunosorbent assay (ELISA). The amount of interleukin (IL)-1, IL-1, IL-6, IL-8, and tumor necrosis factor (TNF)- in culture supernatant significantly increased in the LPS-treated cells compared with unstimulated-cells (P < 0.05). However, in LPS-stimulated PBMCs, cytokines level in CI patients group was higher than that of normal group. YST (1 mg/ml) significantly inhibited IL-1, IL-1, and IL-8 production in PBMCs stimulated with LPS (about 85% for IL-1, 87% for IL-1, and 53% for IL-8, P < 0.05), but did not significantly inhibit IL-6 and TNF- production in the CI patients group. We also show that YST significantly increased LPS-induced IL-1, IL-6, and TNF- production in the normal group. Thesedata suggest that YST has a regulatoryeffect on the cytokine production, which might explain its beneficial effect in the treatment of CI.

• Journal of Acupuncture Research
• /
• 제29권5호
• /
• pp.187-195
• /
• 2012

Objectives : Amyotrophic lateral sclerosis(ALS) is a progressive and incurable disease that causes degeneration of the motor neurons of the brain stem and spinal cord. The purpose of this study was to report the effectiveness of Sa-am acupuncture treatment on ALS patient. Methods : Following the stabilization period, a ALS patient respiratory figures(Et $C_{O2}$, Sp $_{O2}$, RR, pulse) were measured by using capnography & pulse oximetry for 30 minutes before acupuncture treatment. Acupuncture treatment such as lung tonification($SP_3(+){\cdot}LU_9(+){\cdot}HT_8(-){\cdot}LU_{10}(-)$), heart tonification($HT_9(+){\cdot}LR_1(+){\cdot}SI_8(-){\cdot}KI_{10}(-)$), liver tonification ($KI_{10}(+){\cdot}LR_8(+){\cdot}LU_8(-){\cdot}LR_4(-)$) were conducted for 5 days. Each Sa-am acupuncture treatment conducted at AM 7 : 00, AM 11 : 00, PM 4 : 30 of the day. During acupuncture treatment, the patient respiratory figures were measured equally for 30 minutes. The patient was treated by using Dong-bang acupuncture needles($0.30{\times}4.0$) and also stimulated using infra red. Results : The value of Et $C_{O2}$ has decreased more after Sa-am acupuncture lung tonification treatment than others. The value of pulse has decreased more after Sa-am acupuncture heart tonification treatment than others. The value of raspiration rate has decreased more after Sa-am acupuncture liver tonification treatment than others. And the value of Sp $O_2$ has increased more after Sa-am acupuncture liver tonification treatment than others. Conclusions : Although this study was subject to a few limitations, but it shows that Sa-am acupuncture treatment for ALS patients has a meaningful effect. This study needs to be developed further using a larger sample size to obtain more valuable and meaningful data.

• 대한장애인치과학회지
• /
• 제2권1호
• /
• pp.39-44
• /
• 2006

Cerebral palsy(CP) is one of the most common motor disease, due to brain injury during fetal and neonatal development which results in neuromotor paralysis and associated neuromuscular symptoms. Features of CP include motor disability due to the lack of muscle control, often accompanied by sensory disorders, mental retardation, speech disorders, hearing loss, epilepsy, behavior disorders, etc. There are increasing chances of treatment of dental patients with cerebral palsy, as the occurrence of CP is increasing with the decrease in infant mortality and an increase in immature birth and premature birth and also, there is a trend to pursue of higher quality of life. Reports on the relationship between CP and maxillofacial deformity are uncommon, but it is well known that the unbalance and discontrol of the facial muscles, lip, tongue and the jaws leads to malocclusion and temporomandibular joint disorders, and statistics show that class 2 relationship of the jaws and open bite is frequently reported. However, it is difficult to perform maxillofacial deformity treatment, which consists of orthodontic treatment, maxillofacial surgery and muscle adaptation training, due to difficulties in communication and problems of muscle adaptation caused by difficulties in motor control which leads to a high recurrence rate. This case report is to trearment of maxillofacial deformity in CP patient. A 26 year old female patient came to the department with the chief complaint of prognathism of the mandible and facial asymmetry. According to the past medical history, she was diagnosed as cerebral palsy 1 week after birth, classified as GMFC, classII accompanied with left side torticollis. The patient's intelligence was moderate, and there were no serious problems in communication. For two years time, the patient underwent lingual frenectomy, pre-operation orthodontic treatment and then bimaxillary orthognathic surgery to treat mandibular prognathism and facial asymmetry followed by rehabilitatory exercise of facial muscle. After 6 months of follow up, there was a good result. This is to report to the typical signs and symptoms of DFD in CP patient and the limitation of the usual method of the treatment of DFD in CP patient with literature review.