• Journal of Korean Neurosurgical Society
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• v.54 no.4
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• pp.329-335
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• 2013

Objective : Brain metastases in primary breast cancer patients are considerable sources of morbidity and mortality. Gamma knife radiosurgery (GKRS) has gained popularity as an up-front therapy in treating such metastases over traditional radiation therapy due to better neurocognitive function preservation. The aim of this study was to clarify the prognostic factors for local tumor control and survival in radiosurgery for brain metastases from primary breast cancer. Methods : From March 2001 to May 2011, 124 women with metastatic brain lesions originating from a primary breast cancer underwent GKRS at a tertiary medical center in Seoul, Korea. All patients had radiosurgery as a primary treatment or salvage therapy. We retrospectively reviewed their clinical outcomes and radiological responses. The end point of this study was the date of patient's death or the last follow-up examination. Results : In total, 106 patients (268 lesions) were available for follow-up imaging. The median follow-up time was 7.5 months. The mean treated tumor volume at the time of GKRS was 6273 $mm^3$ (range, 4.5-27745 mm3) and the median dose delivered to the tumor margin was 22 Gy (range, 20-25 Gy). Local recurrence was assessed in 86 patients (216 lesions) and found to have occurred in 36 patients (83 lesions, 38.6%) with a median time of 6 months (range, 4-16 months). A treated tumor volume >5000 $mm^3$ was significantly correlated with poor local tumor control through a multivariate analysis (hazard risk=7.091, p=0.01). Overall survival was 79.9%, 48.3%, and 15.3% at 6, 12, and 24 months, respectively. The median overall survival was 11 months after GKRS (range, 6 days-113 months). Multivariate analysis showed that the pre-GKRS Karnofsky performance status, leptomeningeal seeding prior to initial GKRS, and multiple metastatic lesions were significant prognostic factors for reduced overall survival (hazard risk=1.94, p=0.001, hazard risk=7.13, p<0.001, and hazard risk=1.46, p=0.046, respectively). Conclusion : GKRS has shown to be an effective and safe treatment modality for treating brain metastases of primary breast cancer. Most metastatic brain lesions initially respond to GKRS, though, many patients have further CNS progression in subsequent periods. Patients with poor Karnofsky performance status and multiple metastatic lesions are at risk of CNS progression and poor survival, and a more frequent and strict surveillance protocol is suggested in such high-risk groups.

• Applied Microscopy
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• v.40 no.4
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• pp.211-218
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• 2010

The mammalian ovary is innervated by sympathetic and sensory neurons which contribute to regulating several aspects of ovarian function, including blood flow, steroidogenesis and follicular development. The existence of a neural connection between central neurons and the ovary has been rarely reported, but the mechanism underlying integration of ovarian activity to broader neuroendocrine responses has not been reported. We have now used a viral transneuronal tracing technique combined with a conventional retrograde labeling procedure of CT-HRP to demonstrate that oxytocin-producing neurons of the hypothalamus are synaptically connected to the ovary. Since ovarian activity is suppressed but the activity of oxytocin neurons is increased during breast feeding. Our finding that the oxytocinergic neural connection is likely to provide a direct transsynaptic mechanism by which the central nervous system maintains the state of infertility that accompanies lactation in mammals.

• Applied Biological Chemistry
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• v.41 no.2
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• pp.187-190
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• 1998

The cytotoxic activity of MeOH extracts of the freeze-dried silkworm (Bombyx mori)-derived materials (4th instar larvae, female and mate pupae, virgin female and male adult), dried Beauveria bassiana-infected silkworm larvae, dried feces from the 4th instar larvae B. mori, and dried mulberry (Morus alba)-derived materials (leaves, fruits, root barks) in vitro was evaluated by sulforhodamine B assay, using the five human solid A 549 lung, SK-OV-2 ovarian, SK-MEL-2 melanoma, XF-498 CNS and HCT-15 colon tumor cell lines. The responses varied with both cell line and material used. The 70% hot MeOH extract of B. mori feces (BFH) revealed potent cytotoxic activity against model tumor cell lines whereas moderate activity was observed from the MeOH extract of B. mori feces. M. alba root barks, and M. alba fruits. The other test materials were ineffective. Because of its potent cytotoxic activity, the activity of each solvent fraction from the BFH was determined. Chloroform and ethyl acetate fractions showed the most potent cytotoxic activity. In conclusion, our results may be an indication of at least one of the pharmacological actions of B. mori feces. M. alba root barks, and M. alba fruits.

• The Journal of Korean Medicine
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• v.20 no.3 s.39
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• pp.36-44
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• 1999

Objectives: It has been well known that electroacupuncture(EA) has an analgesic effect and there is a pain control system in the central nervous system(CNS). The pain control system is composed of three major nuclei, which are periaqueductal gray(PAG), raphe nuclei, and the pain inhibitory complex located in the spinal cord. It has been suggested that the analgesic effect of EA might be the result of activation of the pain control system in the CNS. However, there may be a possibility that other nuclei are also involved in this pain modulation. Thus, we investigated whether the posterior intralaminar thalamic nuclei (PTIN) are involved in the pain modulation. Methods: To measure the level of pain, the jaw opening reflex (JOR) was used as a pain index. The magnitude of JOR is estimated by averaging the area of 10 successive responses. JOR was evoked by tooth-pulp stimulation with bipolar electrode carrying stimulus with the following parameters: intensity ranging from 420uA to 680ulA, 0.3ms duration of square pulse, and 0.5 Hz. Hapkog($LI_4$) and Taechung ($LR_3$) were the chosen acupoints. The Hapkog point was stimulated ipsilaterally at 5V, 3 Hz, for 15min in total, and the Taechung was stimulated at 2-3 V, 3 Hz, and for a total of 15 or 30 minutes. Different intensities of stimulation were given the PITN; one was given at $300{\mu}A$ and the other was at 500uA. The position stimulated in these nuclei by Paxinos Atlas was AP; from bregma $-4.0{\sim}-4.3mm,\;L; 0.5{\sim}1.8mm,\;D;\;4.8{\sim}6.3mm$. Results: The Hapkog point had a significant analgesic effect (P<0.05). However, the Taechung point had no effect. Both types of stimulation in the PITN did not reveal any analgesic effects. Conclusions: From these results, it was suggested that the posterior intralaminar thalamic nuclei are not involved in the modulation of pain.

• Science of Emotion and Sensibility
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• v.24 no.2
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• pp.39-48
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• 2021

According to International Associating for the Study of Pain (IASP) definition, neuropathic pain is a disorder characterized by dysfunction of the nervous system that, under normal conditions, mediates virulent information to the central nervous system (CNS). This pain can be divided into a disease with provable lesions in the peripheral or central nervous system and states with an incorporeal lesion of any nerves. Both conditions undergo long-term and chronic processes of change, which can eventually develop into chronic pain syndrome, that is, nervous system is inappropriately adapted and difficult to heal. However, the treatment of neuropathic pain itself is incurable from diagnosis to treatment process, and there is still a lack of notable solutions. Recently, several studies have observed the responses of CNS to harmful stimuli using image analysis technologies, such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and optical imaging. These techniques have confirmed that the change in synaptic-plasticity was generated in brain regions which perceive and handle pain information. Furthermore, these techniques helped in understanding the interaction of learning mechanisms and chronic pain, including neuropathic pain. The study aims to describe recent findings that revealed the mechanisms of pathological pain and the structural and functional changes in the brain. Reflecting on the definition of chronic pain and inspecting the latest reports will help develop approaches to alleviate pain.

• Journal of Life Science
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• v.31 no.2
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• pp.237-247
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• 2021

Immune responses in the central nervous system (CNS) function as the host's defense system against pathogens and usually help with repair and regeneration. However, chronic and exaggerated neuroinflammation is detrimental and may create neuronal damage in many cases. The NOD-, LRR-, and pyrin domain―containing 3 (NLRP3) inflammasome, a kind of NOD-like receptor, is a cytosolic multiprotein complex that consists of sensors (NLRP3), adaptors (apoptosis-associated speck like protein containing a caspase recruitment domain, ASC) and effectors (caspase 1). It can detect a broad range of microbial pathogens along with foreign and host-derived danger signals, resulting in the assembly and activation of the NLRP3 inflammasome. Upon activation, NLRP3 inflammasome leads to caspase 1-dependent secretion of the pro-inflammatory cytokines IL-1β and IL-18, as well as to gasdermin D-mediated pyroptotic cell death. NLRP3 inflammasome is highly expressed in CNS-resident cell types, including microglia and astrocytes, and growing evidence suggests that NLRP3 inflammasome is a crucial player in the pathophysiology of several neuroinflammatory and psychiatric diseases, such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, stroke, traumatic brain injury, amyotrophic lateral sclerosis, and major depressive disorder. Thus, this review describes the molecular mechanisms of NLRP3 inflammasome activation and its crucial roles in the pathogenesis of neurological disorders.

• Journal of Life Science
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• v.21 no.6
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• pp.796-804
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• 2011

Microglia are central nervous system (CNS)-resident professional macrophages that function as the principal immune cells responding to pathological stimulations in the CNS. Activation of microglia, induced by various pathogens, protects neurons and maintains homeostasis in the CNS, but severe activation causes inflammatory responses secreting various neurotoxic molecules such as nitric oxide (NO), prostaglandin $E_2$ ($PGE_2$) and pro-inflammatory cytokines. Allium fistulosum, a member of the onion family, is mainly cultivated for consumption, as well as medicinal use in Oriental medicine. It has been reported that A. fistulosum has various biological effects such as anti-oxidant, anti-platelet aggregation, anti-fungus and anti-cholesterol synthesis, however there has been no research about the anti-inflammatory effects of A. fistulosum extracts. In this study, it was undertaken to explore the functions of A. fistulosum as a suppressor of neuronal inflammation by using BV2 microglia cells. As a result, it was found that four kinds of extracts of A. fistulosum effectively reduced the expressions of inducible NO synthase (iNOS) and cyclooxygenase-2 (COX-2) at both mRNA and protein levels, and also attenuated pro-inflammatory cytokines such as tumor necrosis alpha (TNF-${\alpha}$), interleukin-$1{\beta}$ (IL-$1{\beta}$) and interleukin-6 (IL-6) at the mRNA level in BV2 stimulated by lipopolysaccharide (LPS). In addition, the extracts of A. fistulosum attenuated the release of NO markedly, as well as resulting in slight decreases of TNF-${\alpha}$ and IL-6 production, the effects of which were most significant when treated with ethyl alcohol extract from the whole A. fistulosum. In conclusion, the data indicated that the anti-inflammatory actions of A. fistulosum against BV2 microglia cells is through the down-regulation of iNOS, COX2 and pro-inflammatory cytokines such as TNF-${\alpha}$ and IL-6, and these effects are expected to help in the protection of nerve tissues by suppressions of neuronal inflammation in various neurodegenerative diseases.

• Journal of Acupuncture Research
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• v.20 no.5
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• pp.172-186
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• 2003

Acupuncture therapy has demonstrated efficacy in several clinical areas, and of these areas the understanding of pain has progressed immensely in the last two decades. The underlying mechanisms of acupuncture in general and the analgesic effect in particular are still not clearly delineated. The leading hypothesis include the effects of local stimulation, neuronal gating, release of endogenous opiates, and the placebo effect. Accumulating evidence suggests that the central nervous system(CNS) is essential for the processing of these effects, via its modulation of the autonomic nervous system, neuro-immune system, and hormonal regulation. These processes tap into basic survival mechanisms. As such, understanding the effects of acupuncture within a neuroscience-based framework becomes vital. We propose a model which incorporates the stress-induced hypothalamus-pituitary-adrenal axis(HPA-axis) model of Akil et al., the cholinergic anti-inflamatory observations of Tracey et al., and Petrovic et al.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.235-240
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• 1998

Background: Preoperative blocking of surgical nociceptive inputs may prevent sensitization of CNS and reduce postoperative pain. The stress responses to surgical trauma consist of increase in catabolic hormones and decrease in anabolic hormones. We studied whether preoperative intravenous morphine could affect postoperative pain and change plasma cortisol and serum glucose levels. Methods: Thirty eight patients undergoing total abdominal hysterectomy were randomly assigned to one of three groups. Control group (n=11) did not received intravenous morphine, preoperative group (n=13) received intravenous morphine (0.1 mg/kg as a bolus 10 min before operation and followed by 1.5 mg/hr for 10 hours), postoperative group (n=14) received the same doses and method of intravenous morphine of preoperative group postoperatively. Postoperative pain relief was provided with i.v. fentanyl through Patient-Controlled-Analgesia Pump. Postoperative visual analogue scores (VAS), analgesic requirement (first request time, total amounts used), side effects, plasma cortisol and serum glucose levels were compared. Results: VAS were different between control group and the other two goups, but were not different between preoperative and postoperative group. Total amounts of used fentanyl were not different among groups, but first request time were significantly delayed in the preoperative group compared with the other two groups ($66.2{\pm}33.9$ vs $39.0{\pm}15.4$ and $45.0{\pm}14.9$ min respectively, p<0.05). Plasma cortisol and serum glucose levels were not different among groups. Conclusions: Above dosage of preoperative and postoperative morphine has analgesic effect, but could not block surgical stress induced plasma cortisol and serum glucose increase.

• Natural Product Sciences
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• v.9 no.1
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• pp.22-27
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• 2003

This study was designed to investigate the effects of main constituents of Nigella sativa (NS) seed on the survival and CNS responses in experimental animals. The toxicological investigations were conducted for the determination of median lethal doses $(LD_{50})$ of NS seed constituents [i.e. aqueous extract (AE), fixed oil (FO), volatile oil (VO)] and main components of its VO [i.e. thymoquinone (TQ), ${\alpha}-pinene$ (AP) and p-cymene (PC)]. A part of this study includes evaluation NS constituents in the induction of minimal neurological deficit (MND) as a parameter for neurotoxicity using chimney test. In this study, the i.p. $LD_{50}$ values of AE, FO, VO, TQ (suspended In 0.5%CMC), TQ (dissolved in corn oil), AP and PC, were 3020, 3371, 1853, 616.6, 90.3, 1726 and 1523 mg/kg, respectively. All the NS constituents can be considered moderately toxic ($LD_{50}$ ranged from 616.6 to 3371 mg/kg), except the oily solution of TQ, which was very toxic ($LD_{50}$ was 90.3 mg/kg). It appeared that the toxicity of the whole VO is mainly due to its content of TQ and to some extent PC. All the NS constituents induced different degrees of MND at certain dose levels. The median neurotoxic (or sedating) doses $(TD_{50})$ of AE, FO, VO, TQ (suspended in CMC) and AP and PC, were 950, 1403, 306, 88.1, >173 and 368 mg/kg, respectively. TQ was the most potent component in inducing MND, whereas the FO and AE were the least. Neurotoxicity induced by the VO in the chimney test may refer basically to its contents of TQ and to some extent PC and AP.