• The Journal of Internal Korean Medicine
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• v.33 no.1
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• pp.102-110
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• 2012

Multiple system atrophy (MSA) is a sporadic progressive neurodegenerative disorder characterized clinically by various combinations of parkinsonian, autonomic, cerebellar, or pyramidal signs and pathologically by cell loss, gliosis, and ${\alpha}$-synuclein-positive glial cytoplasmic inclusions in several brain and spinal cord structures. This is a clinical report about a 69-year-old female who had MSA treated by oriental medical treatment and evaluated by Unified Multiple System Atrophy Rating Scale (UMSARS). The patient was treated with herb medicine Chungsimyeonj-aeumgami(淸心蓮子飮加味), acupuncture, moxibustion and cupping. After treatment, the patient's symptoms improved meaningfully and the score decreased in UMSARS Part I, II. This suggests that oriental medical treatment could be effective to improve MSA patients' symptoms. It is necessary to have more observations and many cases of patients with MSA.

• The Journal of Internal Korean Medicine
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• v.32 no.3
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• pp.435-443
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• 2011

Fahr disease (FD) is a rare neurological disorder characterized by presence of abnormal and associated cell loss in certain areas of the brain, mostly in basal ganglia, thalamus, cerebellum and subcortical areas. Approximately two-thirds of the patients are symptomatic. The most common neurological manifestations include movement disorders, cognitive impairment, cerebellar signs and speech disorders. We report one case of estimated FD through brain computed tomography (bilateral calcifications of basal ganglia, thalamus, centrum semiovale, subcortical white matter of occipital lobes, cerebellum). At the first time of treatment, he complained of tremors in his upper limbs. We diagnosed the patient as deficiency of qi (氣) and movement of phlegm-heat-wind (痰熱風動) type according to symptoms and treated by herbs and acupuncture of oriental medicine. During treatments, we evaluated how well the oriental medical treatments were working using visual analogue scale (VAS) and amplitude of hands. After the oriental medical treatments about tremor, VAS dropped from 10 to 2 and amplitude of hands from 20 mm to 2 mm, but the ratio of brain calcifications was not changed. This study suggests that oriental medical treatments can be applicable to improve FD.

• Toxicological Research
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• v.17 no.2
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• pp.73-82
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• 2001

The incidence and distribution of necrotic and apoptotic neural cells, and activated astrocytes in the brain of rats intoxicated intra peritoneally with diisopropylfluorophosphate were investigated. Pyridostigmine bromide (0.1 mg/kg) and atropine methylnitrate (20 mg/kg) were pretreated intramuscularly 30 min and 10 min, respectively, prior to diisopropylfluorophosphate (4-10 mg/kg) administration. Diisopropylfluorophosphate induced severe limbic seizures, early necrotic and delayed apoptotic brain injuries, and rapid astrocytic responses. The necrosis, which was closely related to seizure intensity, was observed as early as 1 hr after intoxication predominently in hippocampal pyramidal cells, cerebellar Purkinje cells and neurons in pyriform/entorhinal cortices, showing malacia of neurophils. In contrast, apoptosis started to appear 12 hr after intoxication in neurons in thalamus, amygdala and neocortex, and ephendymal cells surrounding the 4th ventricle. Since marked apoptosis was induced in rats exhibiting relatively-low seizure intensity, the degree of necrosis and apoptosis was shifted to each type of injury according to the seizure intensity. Activated astrocytes, observed within 1 hr along the limbic system, were suggested to affect the neural injury patterns by producing high level of nitric oxide. However, the distribution of activated astrocytes was not in parallel with those of necrotic or apoptotic injuries, implying that the astrocytic responses resulted from seizure activity rather than neural injuries. Furthermore, astrocytes in malacic tissues disappeared during the severe limbic seizures. Therefore, it would be one of the cautionary notes on the expression of glial fibrillary acidic protein in astrocytes as a biochemical marker of brain injuries following acute exposure to organophosphates.

• Science of Emotion and Sensibility
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• v.21 no.3
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• pp.83-102
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• 2018

The process model of emotion regulation suggests that cognitive reappraisal and expressive suppression engage at different time points in the regulation process. Although multiple brain regions and networks have been identified for each strategy, no articles have explored changes in network characteristics or network connectivity over time. The present study examined (a) the whole-brain network and six other resting-state networks, (b) their modularity and global efficiency, which is an index of the efficiency of information exchange across the network, (c) the degree and betweenness centrality for 160 brain regions to identify the hub nodes with the most control over the entire network, and (d) the intra-network and inter-network functional connectivity (FC). Such investigations were performed using a traditional large-scale FC analysis and a relatively recent sliding window correlation analysis. The results showed that the right inferior orbitofrontal cortex was the hub region of the whole-brain network for both strategies. The present findings of temporally altering functional activity of the networks revealed that the default mode network (DMN) activated at the early stage of reappraisal, followed by the task-positive networks (cingulo-opercular network and fronto-parietal network), emotion-processing networks (the cerebellar network and DMN), and sensorimotor network (SMN) that activated at the early stage of suppression, followed by the greater recruitment of task-positive networks and their functional connection with the emotional response-related networks (SMN and occipital network). This is the first study that provides neuroimaging evidence supporting the process model of emotion regulation by revealing the temporally varying network efficiency and intra- and inter-network functional connections of reappraisal and suppression.

• Journal of Korean Neurosurgical Society
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• v.44 no.5
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• pp.314-319
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• 2008

Objective: For patients with giant or dissecting aneurysm, multimodal treatment consisting extracranial-intracranial bypass surgery plus clip or coil for parent artery occlusion may be necessary. In this study, the safety and efficacy of multimodal treatment in 15 patients with complex aneurysms were evaluated retrospectively. Methods: From January 1995 to June 2007, the authors treated 15 complex aneurysms that were unable to be clipped or coiled. Among them, nine patitents had unruptured aneurysms and 6 had ruptured aneurysms. Aneurysms were located in the internal cerebral artery (ICA) in 11 patients (4 in the dorsal wall. 4 in the terminal ICA, 1 in the paraclinoid, and 2 in the cavernous ICA), in the middle cerebral artery (MCA) in 2, and in the posterior circulation in two patients Results: Fifteen patients with complex aneurysms were treated with bypass surgery previously. Thirteen patients were treated with external carotid middle cerebral artery (ECA-MCA) anastomosis, and one patient with superficial temporal to posterior cerebral artery (STA-PCA) and another patient with occipital artery to posterior inferior cerebellar artery (OA-PICA) anastomosis. Parent artery occlusion was then performed with a clip in 9 patients, with a coil in 4, with balloon plus coil in one patient. All 15 aneurysms were successfully treated with clip or coil combined with bypass surgery. Follow-up angiograms showed good patency of anastomotic site in 10 out of 11 patients, and perfusion study showed sufficient perfusion in 6 out of 9 patients. Conclusion: These findings indicate that for patients with complex aneurysms, clip or coil for parent vessel occlusion with additive bypass surgery can successfully exclude the aneurysm from the neurovascular circulatory system.

• Journal of Korean Neurosurgical Society
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• v.53 no.3
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• pp.194-196
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• 2013

Isolated abducens nerve paresis related to ruptured vertebral artery (VA) aneurysm is rare. It usually occurs bilaterally or ipsilaterally to the pathologic lesions. We report the case of a contralateral sixth nerve palsy following ruptured dissecting VA aneurysm. A 38-year-old man was admitted for the evaluation of a 6-day history of headache. Abnormalities were not seen on initial computed tomography (CT). On admission, the patient was alert and no signs reflecting neurologic deficits were noted. Time of flight magnetic resonance angiography revealed a fusiform dilatation of the right VA involving origin of the posterior inferior cerebellar artery. The patient suddenly suffered from severe headache with diplopia the day before the scheduled cerebral angiography. Neurologic examination disclosed nuchal rigidity and isolated left abducens nerve palsy. Emergent CT scan showed high density in the basal and prepontine cistern compatible with ruptured aneurismal hemorrhage. Right vertebral angiography illustrated a right VA dissecting aneurysm with prominent displaced vertebrobasilar artery to inferiorly on left side. Double-stent placement was conducted for the treatment of ruptured dissecting VA aneurysm. No diffusion restriction signals were observed in follow-up magnetic resonance imaging of the brain stem. Eleven weeks later, full recovery of left sixth nerve palsy was documented photographically. In conclusion, isolated contralateral abducens nerve palsy associated with ruptured VA aneurysm may develop due to direct nerve compression by displaced verterobasilar artery triggered by primary thick clot in the prepontine cistern.

• Journal of Korean Neurosurgical Society
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• v.37 no.6
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• pp.436-442
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• 2005

Objective: The detection rate of traumatic subdural hygroma(TSH) has increased after the development of computed tomography and magnetic resonance imaging. The treatment method and the mechanism of development of the TSH have been investigated, but they are still uncertain. This study is performed to evaluate the effectiveness of subduroperitoneal shunt in traumatic subdural hygroma. Methods: Five hundred thirty six patients were diagnosed as TSH from 1996 to 2002, among them, 55 patients were operated with subduroperitoneal shunt. We analyzed shunt effect on the basis of clinical indetails, including the patient's symptoms at the diagnosis, duration from diagnosis to operation, changes of GCS, hygroma types. We classified the TSH into five types (frontal, frontocoronal, coronal, parietal and cerebellar type) according to the location of the thickest portion of TSH. Results: The patients who have symptoms or signs related to frontal lobe compression (irritability, confusion) or increased intracranial pressure (headache, mental change), had symptomatic recovery rate above 80%. However, the patients who have focal neurological sign (hemiparesis, seizure and rigidity), showed recovery rate below 30%. The improvement rate was very low in the case of the slowly progressing TSH for over 6weeks. We experienced complications such as enlarged ventricle, chronic subdural hematoma, subdural empyema and acute SDH. Conclusion: Subduroperitoneal shunt appears to be effective in traumatic subdural hygroma when the patients who have symptoms or signs related to frontal lobe compression or increased ICP and progressing within 5weeks.

• Journal of Korean Neurosurgical Society
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• v.60 no.6
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• pp.738-748
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• 2017

Objective : We present our experience of microvascular decompression (MVD) for glossopharyngeal neuralgia (GPN) and evaluate the postoperative outcomes in accordance with four different operative techniques during MVD. Methods : In total, 30 patients with intractable primary typical GPN who underwent MVD without rhizotomy and were followed for more than 2 years were included in the analysis. Each MVD was performed using one of four different surgical techniques : interposition of Teflon pieces, transposition of offending vessels using Teflon pieces, transposition of offending vessels using a fibrin-glue-coated Teflon sling, and removal of offending veins. Results : The posterior inferior cerebellar artery was responsible for neurovascular compression in 27 of 30 (90%) patients, either by itself or in combination with other vessels. The location of compression on the glossopharyngeal nerve varied; the root entry zone (REZ) only (63.3%) was most common, followed by both the REZ and distal portion (26.7%) and the distal portion alone (10.0%). In terms of detailed surgical techniques during MVD, the offending vessels were transposed in 24 (80%) patients, either using additional insulation, offered by Teflon pieces (15 patients), or using a fibrin glue-coated Teflon sling (9 patients). Simple insertion of Teflon pieces and removal of a small vein were also performed in five and one patient, respectively. During the 2 years following MVD, 29 of 30 (96.7%) patients were asymptomatic or experienced only occasional pain that did not require medication. Temporary hemodynamic instability occurred in two patients during MVD, and seven patients experienced transient postoperative complications. Neither persistent morbidity nor mortality was reported. Conclusion : This study demonstrates that MVD without rhizotomy is a safe and effective treatment option for GPN.

• Proceedings of the Korean Society of Veterinary Clinics Conference
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• 2006.05a
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• pp.96-96
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• 2006

• Korean Journal of Veterinary Research
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• v.49 no.4
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• pp.291-295
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• 2009

A dead stray cat was necropsied for zoonotic feline disease monitoring. Grossly, there were no specific lesions. Major microscopic lesions included lymphocytic meningoencephalitis, malacia, and tissue cysts in the cerebral and cerebellar cortex. The size and shape of tissue cysts were identical to those of Apicomplexa including Toxoplasma (T.) gondii. Bradyzoites in the tissue cyst were strongly positive for T. gondii by immunohistochemistry. Electron microscopy revealed that bradyzoites within the tissue cyst were similar to the morphological features of T. gondii. Fresh tissue samples were examined by a polymerase chain reaction assay and resulted in a specific band of T. gondii only in the brain. Based on the results, this case was diagnosed as toxoplasmosis. This is the first case of toxoplasmic meningoencephalitis in a cat in Korea.