• Journal of Korean Neurosurgical Society
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• 제30권2호
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• pp.207-210
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• 2001

Objective : The prognosis of spontaneous intracerebral hemorrhage often depends on initial neurologic condition, size and location of hemorrhage and associated intraventricular hemorrhage. However, age of patient, coagulation state and other associated vascular diseases may also play a role when present. In recent years, the geriatric population has been increasing. The age distribution of the patients with intracerebral hemorrhages also has been increased, accordingly. However, such patients, especially when associated with poor initial conditions often tend to be managed rather conservatively. The authors analyzed retrospectively on forty-five patients with spontaneous intracerebral hemorrhage over the seventies with poor initial condition to find out whether there exists a difference of outcome between surgery and non-surgery group. Material and Method : A total of 45 patients over seventies with spontaneous intracerebral hemorrhage with Glasgow Coma Scale(GCS) 4-8 treated over last six years were included. The validity of surgical management for these patients as well as clinical variables which might have been operated on the outcome of these patients were evaluated. The Glasgow Outcome Scale(GOS) after three months was used for comparison of outcome. Results : In surgical group(19 cases), mean age was 74.5 years old, mean hematoma volume 67.2ml and mean GCS score 5.7 points. In nonsurgical group(26 cases), mean age was 79.3 years old, mean hematoma volume 32.1ml, and mean GCS score 6.8 points. Mortality rate in surgical group was 47.4%(9 patients), including 2 cases of post-operative rebleeding, while that in nonsurgical group was 46.2%. However, when patients with initial GCS 4-6 points and over 30ml in hematoma volume were regrouped, mortality rate in surgical group was 46.2%, whereas mortality rate in nonsurgical group was 66.7%. Conclusion : It is concluded that the mortality rate is much low in surgery group with initial GCS less than 6 points and hematoma volume over 30cc. There was no significant difference of outcome in patients with basal ganglia and thalamic hemorrhage. However, surgical treatment lowered the mortality and morbidity rate in patients with subcortical and cerebellar hemorrhage.

• 한국전문물리치료학회지
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• 제10권3호
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• pp.17-27
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• 2003

Repetitive transcranial magnetic stimulation (rTMS) modulates cortical excitability beyond the duration of the rTMS trains themselves. Depending on rTMS parameters, a lasting inhibition or facilitation of cortical excitability can be induced. Therefore, rTMS of high or low frequency over motor cortex may change certain aspects of motor learning performance and cortical activation. This study investigated the effect of high and low frequency subthreshold rTMS applied to the motor cortex on motor learning of sequential finger movements and brain activation using functional MRI (fMRI). Three healthy right-handed subjects (mean age 23.3) were enrolled. All subjects were trained with sequences of seven-digit rapid sequential finger movements, 30 minutes per day for 5 consecutive days using their left hand. 10 Hz (high frequency) and 1 Hz (low frequency) trains of rTMS with 80% of resting motor threshold and sham stimulation were applied for each subject during the period of motor learning. rTMS was delivered on the scalp over the right primary motor cortex using a figure-eight shaped coil and a Rapid(R) stimulator with two Booster Modules (Magstim Co. Ltd, UK). Functional MRI (fMRI) was performed on a 3T ISOL Forte scanner before and after training in all subjects (35 slices per one brain volume TR/TE = 3000/30 ms, Flip angle $60^{\circ}$, FOV 220 mm, $64{\times}64$ matrix, slice thickness 4 mm). Response time (RT) and target scores (TS) of sequential finger movements were monitored during the training period and fMRl scanning. All subjects showed decreased RT and increased TS which reflecting learning effects over the training session. The subject who received high frequency rTMS showed better performance in TS and RT than those of the subjects with low frequency or sham stimulation of rTMS. In fMRI, the subject who received high frequency rTMS showed increased activation of primary motor cortex, premotor, and medial cerebellar areas after the motor sequence learning after the training, but the subject with low frequency rTMS showed decreased activation in above areas. High frequency subthreshold rTMS on the motor cortex may facilitate the excitability of motor cortex and improve the performance of motor sequence learning in normal subject.

• 한국수정란이식학회지
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• 제29권3호
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• pp.249-255
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• 2014

Programmed cell death or apoptosis is associated with changes in $K^+$ concentration in many cell types. Recent studies have demonstrated that two-pore domain $K^+$ ($K_{2P}$) channels are involved in mouse embryonic development and apoptotic volume decrease of mammalian cells. In cerebellar granule neurons that normally undergo apoptosis during the early developmental stage, TASK-1 and TASK-3, members of $K_{2P}$ channels, were found to be critical for cell death. This study was performed to identify the role of $K^+$ channels in the $H_2O_2$-induced or cryo-induced cell death of mouse and bovine embryos. Mouse and bovine two-cell stage embryos (2-cells) exposed to $H_2O_2$ for 4 h suffered from apoptosis. The 2-cells showed positive TUNEL staining. Treatment with high concentration of KCl (25mM) inhibited $H_2O_2$-induced apoptosis of 2-cells by 19%. Cryo-induced death in bovine blastocysts showed positive TUNEL staining only in the cells near the plasma membrane. Cryoprotectant supplemented with 25 mM KCl reduced apoptosis slightly compared to cryoprotectant supplemented with 5 mM KCl. However, the combination of antioxidants (${\beta}$-mercaptoethanol) with 25 mM KCl significantly decreased the rate of $H_2O_2$-induced and cryo-induced apoptosis compared to treatments with only antioxidants or 25 mM KCl. These results show that blockage of $K^+$ channel efflux for a short-time reduces $H_2O_2$- and cryo-induced apoptosis in mouse and bovine embryos. Our findings suggest that apoptosis in mouse and bovine embryos might be controlled by modulation of $K^+$ channels which are highly expressed in a given cell type.