• Title/Summary/Keyword: Cerebral Edema

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Recurrent Extraventricular Neurocytoma with Malignant Glial Differentiation - Case Report - (악성신경교 분화를 보이는 재발성 뇌실외 신경세포종 - 증례보고-)

  • Chang, In-Bok;Park, Se-Hyuck;Hwang, Hyung-Sik;Kim, Duck-Hwan;Nam, Eun Sook;Cho, Byung-Moon;Shin, Dong-Ik;Oh, Sae-Moon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.522-527
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    • 2001
  • We present a case of recurrent extraventricular neurocytoma with malignant glial differentiation in left temporoparietal area. A 37-year-old man with presentation of generalized seizure had undergone biopsy of brain tumor in left parietal area in 1987, which revealed extraventricular neurocytoma and radiotherapy was followed. Postoperative course was uneventful until eleven years after biopsy, when he became gradually aphasic and right hemiplegic. Brain CT and MRI revealed enlargement of tumor with peritumoral edema and calcifications. He underwent subtotal tumor removal in 1998. Microscopic examination of second biopsy specimen revealed presence of large areas composed of anaplastic glial cells with frequent mitosis, nuclear pleomorphism, large eosinophilic cytoplasm and eccentric nuclei, resembling gemistocytes, which were strongly immunoreactive to glial fibrillary acidic protein(GFAP) but not to synaptophysin(SNP). Also focal areas of neuronal cells were found, which were immunoreactive to SNP but not to GFAP. These histologic findings imply that this recurred tumor was a high grade, mixed tumor with divergent differentiation of neuronal and astrocyte lineage. We report a rare case of extraventricular cerebral neurocytoma with malignant glial differentiation with review of the literature.

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The Effect of Dodamtang(DDT) on Brain damage and Hypertension (도담탕(導痰湯)이 뇌손상(腦損傷) 및 고혈압(高血壓)에 미치는 영향(影響))

  • Lim, Seong-Min;An, Joung-Jo;Choi, Young;Kim, Yong-Jin;Yoo, Ho-Ryoung;Park, Yang-Chun;Seol, In-Chan;Hwang, Chi-Won;Cho, Hyun-Kyung
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.503-512
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    • 2001
  • Objective : This study was carried out to investigate the effects of DDT on the brain damage and hypertension. Methods : We observed the effect of Dodamtang(DDT) extract on KCN-induced coma, focal brain ischemia by MCA occlusion, cytotoxicity and protection of PC12 cells and B103 cells induced by amyloid ${\beta}$ protein(25-35). To prove the effect of DDT as a blood pressure depressant, we measured aldosterone, renin activity, catecholamine, sodium and NO density using the seperated blood plasma. Results : DDT showed a protective effect on cytotoxicity of PC12 cells and B103 cells induced by amyloid ${\beta}$ protein(25-35) in a dose dependent manner and proved the significant abridgement of brain ischemic area and edema induced by MCA occlusion, a critical decrease of neurologic deficitic grade in the fore-limbs. DDT didn't reduce the duration of KCN(1.87mg/kg iv.)-induced coma and prolonged the survival rate in the case of KCN(3.0mg/kg iv.)-induced coma by the ratio of 20%. While DDT increased the value of NO in SHR, it significantly decreased the blood pressure of SHR and the value of aldosterone& epinephrine in SHR. Conclusions : These results suggested that DDT might be usefully applied for treatment of hypertension, cerebral infarction, and brain damage.

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A Study on The Excessive Liver-Symptoms(肝實證) in The Analysis of Five Visceral Symptoms By The Five Pathogenic Factors(五邪) (오장변증중(五臟辨證中) 간실증(肝實證)의 오사(五邪)에 의한 연구)

  • Kim, Jae-Hong;Kim, Tae-Hee
    • The Journal of Internal Korean Medicine
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    • v.15 no.1
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    • pp.176-209
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    • 1994
  • 1. The Jung-Sa(正邪) of the Excessive Liver-Symptoms belongs to the eleven symptoms, there are blue face, blue thin fingernail, anger, fancy of larg body, dizziness, eye flame, Bell's palsy, hard swelling pain at braest, side pain going on the belly from the side, side pain and movement at the left side. 2. The Mi-Sa(微邪) of the Excessive Liver-Symptoms belongs to the four symptoms, there are meat in eye, edema in cheek, lack of appetite and diarrhea. 3. The Juk-Sa(賊邪) of the Excessive Liver-Symptoms belongs to the only one symptom, this is nosebleeding. 4. The Hu-Sa(虛邪) of the Excessive Liver-Symptoms belongs to the three symptoms, there are scrotum constraction, strain in belly and constipation. 5. The Sil-Sa(實邪) of the Excessive Liver-Symptoms belongs to the twenty eight symptoms, there are red eye, raised eyes(兩眼上?), spitting blood, sternocostal turgid pain, turgidity in belly, drooping testis, vomiting water acid, sickening, belching, confusion, impatience, frequent forgetfulness, headache, giddness, eye pain, deaf, ringing in the ear, feeling inverse, drying mouth, stuffiness sensation in the chest, chest pain, stuffiness sensation in the belly, bellyache, quadriplegia, spasm of extremities, tremor, alternate spells of fever and chills, high fever and strain in muscle. 6. Those symptoms, Red corner of the eye, red face, swelling on the forehead, stiff-neck and back strong, opisthotonos, constracture of the limbs, vomiting yellow bitter water, speech impediment, epilepsy, depression, strong tongue, different thing in throat, fullness and distention of the gastric region, feeling sick and tenesmus, have no connected with the Excessive Liver-Symptoms(肝實證) 7. The Excessive Liver-Symptoms(肝實證) is connected with the ganjabyoung(肝自病) and Hwa(火) which the pathology is, than because Mock(木) is excessive and Mock-Saeng-Hwa(木生火), the ganjabyoung(肝自病) and Sil-Sa(實邪) are many. 8. There are the sixteen symptoms with the exception of The Excessive Liver-Symptoms(肝實證), because supposed that the scholars in medicine included the union syndroms(合病), the combine syndroms(兼病) and the analysis of symptoms(辨證) in The Analysis of Five Visceral Symptoms. 9. During consideration of the symptoms at the above statements, where are many causes by Gan-Pung(肝風), there is difficult of distinction between the excessive Liver-Symptoms(肝實證) and C.V.A(Cerebral Vascular Attack). Because than NaeKyung(內經) distinguished between the excessive Liver-Symptoms(肝實證) and C.V.A., the future medical specialists connected with the excessive Liver-Symptoms(肝實證) and C.V.A.. 10. An appearance of Sang-Hwa(相火) that the liver possessed is divided into an appearance of Hwa(火), there will be making a study att the more necessary. 11. The cuases of each syndroms are consist of the origins of syndroms, its pathology and the positions where the syndroms appeared, I consider that is the various ways how judge the syndroms except the Five Pathogenic Factors(五邪). 12. If more than study will be achieved in all, the new definition will be standed about the Excessive and Deficient Five Visceral Syndroms(五臟虛實證), I consider this will be the foundation data that study the Oriental Medicine and the important data that is a judgement standard of clininc.

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Protective Effects of Traditional Korean Medicine Preparations, Herbs, and Active Compounds on the Blood-brain Barrier in Ischemic Stroke Models (허혈성 뇌졸중 모델에서 혈액-뇌 장벽에 보호효과를 나타내는 한약처방, 한약재 및 활성화합물)

  • Shin, Su Bin;Jang, Seok Ju;Lee, Na Gyeong;Choi, Byung Tae;Shin, Hwa Kyoung
    • Journal of Life Science
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    • v.32 no.7
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    • pp.550-566
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    • 2022
  • Stroke is among the leading causes of death and long-term physical and cognitive disabilities worldwide, affecting an estimated 15 million people annually. The pathophysiological process of stroke is complicated by multiple and coordinated events. The breakdown of the blood-brain barrier (BBB) in people with stroke can significantly contribute to the development of ischemic brain injury. Therefore, BBB disruption is recognized as a hallmark of stroke; thus, it is important to develop novel therapeutic strategies that can protect against BBB dysfunction in ischemic stroke. Traditional medicines are composed of natural products, which represent a promising source of new ingredients for the development of conventional medicines. Indeed, several studies have shown the effectiveness of Korean medicine on stroke, highlighting the value of Korean medicinal treatment for ischemic stroke. This review summarizes the current information and underlying mechanisms regarding the ameliorating effects of the formula, decoction, herbs, and active components of traditional Korean medicine on cerebral ischemia-induced BBB disruption. These traditional medicines were shown to have protective effects on the BBB in many cellular and animal ischemia models of stroke, and experiments in various animal species, such as mice and rats. In addition, they showed brain-protective effects by protecting the BBB through the regulation of tight junction proteins and matrix metalloproteinase-9, reducing edema, neuroinflammation, and neuronal cell death. We hope that this review will help promote further investigation into the neuroprotective effects of traditional Korean medicines and stimulate the performance of clinical trials on Korean herbal medicine-derived drugs in patients with stroke.

Smartphone Fundus Photography in an Infant with Abusive Head Trauma (학대뇌손상 영아에서 스마트폰으로 촬영한 안저소견)

  • Kim, Yong Hyun;Choi, Shin Young;Lee, Ji Sook;Yoon, Soo Han;Chung, Seung Ah
    • Journal of The Korean Ophthalmological Society
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    • v.58 no.11
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    • pp.1313-1316
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    • 2017
  • Purpose: To report fundus photography using a smartphone in an infant with abusive head trauma. Case summary: An 8-month-old male infant presented to the emergency room with decreased consciousness and epileptic seizures that the parents attributed to a fall from a chair. He had no external wounds or fractures to the skull or elsewhere. However, computerized tomography of the brain revealed an acute subdural hematoma in the right cranial convexity and diffuse cerebral edema, leading to a midline shift to the left and effacement of the right lateral ventricle and basal cistern. The attending neurosurgeon promptly administered a decompressive craniectomy. Immediately after the emergency surgery, a fundus examination revealed numerous multi-layered retinal hemorrhages in the posterior pole extending to the periphery in each eye. He also had white retinal ridges with cherry hemorrhages in both eyes. We acquired retinal photographs using the native camera of a smartphone in video mode. The photographer held the smartphone with one hand, facing the patient's eye at 15-20 cm, and held a 20 diopter condensing lens at 5 cm from the eye in the other hand. Our documentation using a smartphone led to a diagnosis of abusive head trauma and to obtain the criminal's confession, because the findings were specific for repetitive acceleration-deceleration forces to an infant's eye with a strong vitreoretinal attachment. Conclusions: This ophthalmic finding had a key role in the diagnosis of abusive head trauma. This case presented the diagnostic use of a smartphone for fundus photography in this important medicolegal case.

Steroid Effect on the Brain Protection During OPen Heart Surgery Using Hypothermic Circulatory Arrest in the Rabbit Cardiopulmonary bypass Model (저체온순환정지법을 이용한 개심술시 스테로이드의 뇌보호 효과 - 토끼를 이용한 심폐바이패스 실험모델에서 -)

  • Kim, Won-Gon;Lim, Cheong;Moon, Hyun-Jong;Chun, Eui-Kyung;Chi, Je-Geun;Won, Tae-Hee;Lee, Young-Tak;Chee, Hyun-Keun;Kim, Jun-Woo
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.471-478
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    • 1997
  • Introduction: The use of rabbits as a cardiopulmonary bypass(CPB) animal model is extremely dif%cult mainly due to technical problems. On the other hand, deep hypothermic circulatory arrest(CA) is used to facilitate surgical repair in a variety of cardiac diseases. Although steroids are generally known to be effective in the treatment of cerebral edema, the protective effects of steroids on the brain during CA are not conclusively established. Objectives of this study are twofold: the establishment of CPB technique in rabbits and the evaluation of preventive effect of steroid on the development of brain edema during CA. Material '||'&'||' Methods: Fifteen New Zealan white rabbits(average body weight 3.5kg) were divided into three experimental groups; control CA group(n=5), CA with Trendelenberg position group(n=5), and CA with Trendelenberg position + steroid(methylprednisolone 30 mglkg) administration group(n=5). After anesthetic induction and tracheostomy, a median sternotomy was performed. An aortic cannula(3.3mm) and a venous ncannula(14 Fr) were inserted, respectively in the ascending aorta and the right atrium. The CPB circuit consisted of a roller pump and a bubble oxygenator. Priming volume of the circuit was approximately 450m1 with 120" 150ml of blood. CPB was initiated at a flow rate of 80~85ml/kg/min, Ten min after the start of CPB, CA was established with duration of 40min at $20^{\circ}C$ of rectal temperature. After CA, CPB was restarted with 20min period of rewarming. Ten min after weaning, the animal was sacrif;cod. One-to-2g portions of the following tissues were rapidly d:ssected and water contents were examined and compared among gr ups: brain, cervical spinal cord, kidney, duodenum, lung, heart, liver, spleen, pancreas. stomach. Statistical significances were analyzed by Kruskal-Wallis nonparametric test. Results: CPB with CA was successfully performed in all cases. Flow rate of 60-100 mlfkgfmin was able to be maintained throughout CPB. During CPB, no significant metabolic acidosis was detected and aortic pressure ranged between 35-55 mmHg. After weaning from CPB, all hearts resumed normal beating spontaneously. There were no statistically significant differences in the water contents of tissues including brain among the three experimental groups. Conclusion: These results indicate (1) CPB can be reliably administered in rabbits if proper technique is used, (2) the effect of steroid on the protection of brain edema related to Trendelenburg position during CA is not established within the scope of this experiment.

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