• Journal of Korean Neurosurgical Society
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• 제65권3호
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• pp.415-421
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• 2022

Objective : Seizure recurrence after the first-ever seizure in patients with a supratentorial cerebral cavernous malformation (CCM) is almost certain, so the diagnosis and treatment of epilepsy is justified. The optimal method of management of these patients is still a matter of debate. The aim of our study was to identify factors associated with postoperative seizure control and assess the surgical morbidity rate. Methods : We retrospectively analysed 45 consecutive patients with a supratentorial CCM and symptomatic epilepsy in a single centre. Pre- and postoperative epidemiological data, seizure-related patient histories, neuroimaging results, surgery details and outcomes were obtained from hospital medical records. Seizure outcomes were assessed at least 12 months after surgery. Results : Thirty-five patients (77.8%) were seizure free at the long-term follow-up (Engel class I); six (13,3%) had rare, nocturnal seizures (Engel class II); and four (8.9%) showed meaningful improvement (Engel class III). In 15 patients (33%) in the Engel I group; it was possible to discontinue antiepileptic medication. Although there was not statistical significance, our results suggest that patients can benefit from early surgery. No deaths occurred in our study, and mild postoperative neurologic deficits were observed in two patients (4%) at the long-term follow-up. Conclusion : Surgical resection of CCMs should be considered in all patients with a supratentorial malformation and epilepsy due to the favourable surgical results in terms of the epileptic seizure control rate and low postoperative morbidity risk, despite the use of different predictors for the seizure outcome.

• Journal of Digestive Cancer Research
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• 제3권2호
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• pp.105-107
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• 2015

췌장암은 예후가 매우 불량한 암으로 수술적 절제술을 시행하여도 대부분의 경우 재발을 한다고 알려져 있다. 재발을 하는 경우 대개 항암화학요법을 시행하게 되나, 그 반응 또한 좋지 않은 것으로 알려져 있다. 간에 국소적으로 재발을 했을 경우 종양절제술을 시행하는 것에 대해서는 몇몇 보고가 있는 정도이며, 생존율을 향상시킬 수 있는지에 대해서는 연구가 거의 없는 상태이다. 본 증례는 유문보존 췌십이지장 절제술 시행 후 간에 국소적으로 재발한 췌장암에 대하여 gemcitabine 및 capecitabine과 oxaliplatin 병합 항암화학요법을 시행하였으나 크기가 증가하였고, 이에 종양절제술을 시행하였으며, 이후 장기생존을 보였던 경우로 매우 드문 증례를 경험하였기에 보고하는 바이다.

• Journal of Digestive Cancer Research
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• 제3권2호
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• pp.113-115
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• 2015

본 증례는 전이성 췌장암에서 연수막전이로 발현된 국내 첫 사례이다. 또한 급성뇌졸중 양상이 첫 증상으로 발현된 경우도 이전에 보고된 바가 없다. 향후 전이성 췌장암의 뇌전이 양상에 대해 좀 더 많은 증례를 통한 연구가 필요하며, 췌장암의 빈번한 연수막전이 기전에 대해서도 추가 연구가 필요하다.

• 한국방사선학회논문지
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• 제13권2호
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• pp.175-183
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• 2019

뇌신경계 인터벤션 시술은 장시간의 시술로 인해 피부의 수포, 탈모, 홍반 등의 방사선 피폭으로 인한 위해가 빈번히 보고되고 있다. 인체공학적으로 제작된 Bismuth (원자번호 83;Bi) 차폐체를 뇌혈관계 인터벤션 시술에 적용함으로써 의료방사선 피폭으로부터 두피 및 수정체의 방사선 피폭을 최소화하고자 하였다. 측정 부위는 4부위로 후두부(9 points), 양쪽 측두부(12 points), 양쪽 수정체부(6 points), 코 끝부(6 points)이며, 측정 소자는 광자극 형광 선량계(Optically Stimulated Luminescence Dosimeter: OSLD)를 각 지점(points)에 측정기를 부착 후 자체 제작된 Bismuth차폐 기구를 사용 전(A그룹)과 후(B그룹)를 측정한 후 피부표면선량(entrance surface dose)을 비교 분석하였다. A 그룹(Bismuth unshield)과 B 그룹(Bismuth shield)의 피부선량 평균은 A 그룹은 92.44 mGy였고, B 그룹은 67.55 mGy로 측정되었다. A 그룹에 비해 B 그룹에서 평균 26.92% 감소되었다. 후두부의 피부선량 평균은 A 그룹(9 point)은 146.08 mGy, B 그룹(9 point)은 103.23 mGy로 측정되었고 A 그룹에 비해 B 그룹에서 평균 29.32 % 감소하였다. 측두부의 피부선량 평균은 A 그룹(6 point)은 101.90 mGy, B 그룹(6 point)은 72.69 mGy로 측정되었고 A 그룹에 비해 B 그룹에서 평균 28.67% 감소하였다. 수정체부의 피부선량 평균은 A 그룹(3 point)은 27.51 mGy, B 그룹(3 point)은 21.39 mGy로 측정되었고 A 그룹에 비해 B 그룹에서 평균 22.26% 감소하였다. Bismuth 차폐체의 사용은 뇌혈관 중재적 시술 후 나타날 수 있는 일시적 탈모 및 기타 확률적 영향에 따른 방사선 장해를 감소시킬 수 있는 대안이 될 것으로 사료된다.

• Journal of Yeungnam Medical Science
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• 제2권1호
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• pp.95-102
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• 1985

대구 및 그 인접지역의 질병 발생 경향을 추정하고, 영남대학교 의과대학 부속병원의 약제수급 계획을 위한 참고자료를 얻기 위하여, 1985년 3월부터 동년 8월까지 당 병원 외래에 내원한 환자들을 위하여 내려진 약물 처방을 전산 집계하여 다음과 같은 결과를 얻었다. 가장 빈번히 처방된 약물로 부터 100종의 약물을 처방빈도 순으로 나열하였던 바, diazepam, aluminum compound, acetaminophen, isoniazid, metoclopramide, $polaranine^{(R)}$, carboxymethylcystein, ephedrine, codeine, caroverine (이하생략) 등의 순으로 나타났으며, 이와 같이 선정된 100종의 약물을 임상용도별로 분류하여 총 처방회수 521,855회에 대한 백분율을 조사한 결과는 다음과 같다. 중추신경계약물 (20.57%)이 가장 많았고, 다음은 위장관 및 평활근에 작용하는 약물 (18.64%), 호흡기계약물 (16.11%), 항균제 (15.12%), 심혈관 계약물 (5.64%)의 순으로 많았으며, 그 다음은 소염제 (4.33%), 단독비타민제 (3.76%), 호르몬 및 항호르몬제 (3.29%), 감기치료제 (3.12%), 이뇨제 (2.81%), 간기능이상치료제 (2.02%), 자율신경계약물 (1.89%), 항히스타민제 (1.02%) 및 소독약 (0.74%) 등의 순으로 나타났다.

• 대한의생명과학회지
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• 제12권2호
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• pp.81-89
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• 2006

The ischemia-responsive 94 gene (irp94) encoding a 94 kDa endoplasmic reticulum resident protein was investigated its molecular properties associated with unfoled protein responses. First, the expression of irp94 mRNA was tested after the reperfusion of the transient forebrain ischemia induction at the central nervous system in three Mongolian gerbils. Second, irp94 expression in PC12 cells, which are derived from transplantable rat pheochromocytoma cultured in the DMEM media, was tested at transcriptional and translational levels. The half life of irp94 mRNA was also determined In PC12 cells. Last, the changes of irp94 mRNA expression were investigated by the addition of various ER stress inducible chemicals (A23187, BFA, tunicamycin, DTT and $H_2O_2$) and proteasome inhibitors, and heat shock. High level expression of irp94 mRNA was detected after 3 hours reperfusion in the both sites of the cerebral cortex and hippocampus of the gerbil brain. The main regulation of irp94 mRNA expression in PC 12 cells was determined at the transcriptional level. The half life of irp94 mRNA in PC12 cells was approximately 5 hours after the initial translation. The remarkable expression of irp94 mRNA was detected by the treatment of tunicamycin, which blocks glycosylation of newly synthesized polypeptides, and $H_2O_2$, which induces apoptosis. When PC12 cells were treated with the cytosol proteasome inhibitors such as ALLN (N-acetyl-leucyl-norleucinal) and MG 132 (methylguanidine), irp94 mRNA expression was increased. These results indicate that expression of irp94 was induced by ER stress including oxidation condition and glycosylation blocking in proteins. Expression of irp94 was increased when the cells were chased after heat shock, suggesting that irp94 may be involved in recovery rather than protection against ER stresses. In addition, irp94 expression was remarkably increased when cytosol proteasomes were inhibited by ALLN and MG 132, suggesting that irp94 plays an important role for maintaining the ERAD (endoplasmic reticulum associated degradation) function.

• Journal of Korean Neurosurgical Society
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• 제61권3호
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• pp.363-375
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• 2018

Intraoperative monitoring (IOM) utilizes electrophysiological techniques as a surrogate test and evaluation of nervous function while a patient is under general anesthesia. They are increasingly used for procedures, both surgical and endovascular, to avoid injury during an operation, examine neurological tissue to guide the surgery, or to test electrophysiological function to allow for more complete resection or corrections. The application of IOM during pediatric brain tumor resections encompasses a unique set of technical issues. First, obtaining stable and reliable responses in children of different ages requires detailed understanding of normal age-adjusted brain-spine development. Neurophysiology, anatomy, and anthropometry of children are different from those of adults. Second, monitoring of the brain may include risk to eloquent functions and cranial nerve functions that are difficult with the usual neurophysiological techniques. Third, interpretation of signal change requires unique sets of normative values specific for children of that age. Fourth, tumor resection involves multiple considerations including defining tumor type, size, location, pathophysiology that might require maximal removal of lesion or minimal intervention. IOM techniques can be divided into monitoring and mapping. Mapping involves identification of specific neural structures to avoid or minimize injury. Monitoring is continuous acquisition of neural signals to determine the integrity of the full longitudinal path of the neural system of interest. Motor evoked potentials and somatosensory evoked potentials are representative methodologies for monitoring. Free-running electromyography is also used to monitor irritation or damage to the motor nerves in the lower motor neuron level : cranial nerves, roots, and peripheral nerves. For the surgery of infratentorial tumors, in addition to free-running electromyography of the bulbar muscles, brainstem auditory evoked potentials or corticobulbar motor evoked potentials could be combined to prevent injury of the cranial nerves or nucleus. IOM for cerebral tumors can adopt direct cortical stimulation or direct subcortical stimulation to map the corticospinal pathways in the vicinity of lesion. IOM is a diagnostic as well as interventional tool for neurosurgery. To prove clinical evidence of it is not simple. Randomized controlled prospective studies may not be possible due to ethical reasons. However, prospective longitudinal studies confirming prognostic value of IOM are available. Furthermore, oncological outcome has also been shown to be superior in some brain tumors, with IOM. New methodologies of IOM are being developed and clinically applied. This review establishes a composite view of techniques used today, noting differences between adult and pediatric monitoring.

• 대한한방내과학회지
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• 제19권2호
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• pp.28-36
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• 1998

Background : Yang-do-rack is frequently used in diagnosing syndromes in oriental medical hospital, but there has been few clinical report on Yang-do-rack. So we intended to find out the relationship among Yang-do-rack, general characteristics and the differentiaion of syndromes in acute stroke patients. Materials and Methods : In this study we selected the subjects who were hospitalized from March 1, 1998 to July 31. 1998 at the department of circulatory internal medicine at college of oriental medicine, in Kyung-Hee University, diagnosed acute cerebral infarction or hemorrhage within 7 days after onset time. We checked Yang-do-rack scores with Autonomic Nervous System YORAK (Sord Medicom co. Ltd, Korea) and calculated the scores of each diffentiation of syndroms. Resuts : 1. In left leg meridian, there was more numerical value male than female on LF1, LF2, LF4, LF6. The value of LF1, LF3, LF4, LF5 was getting lower as the score of heat-transformation syndrom(火熱證) increased. 2. In left arm meridian, there was more numerical value male than female on LH2, LH5. The value of LH1, LH3, LH5 was getting lower as the score of exuberance of Yang due to deficiency of Yin syndrom(陰虛陽亢證) increased. 3. In right leg meridian, there was more numerical value male than female on RF1, RF2, RF4, RF6. The value of RF3, RF5 was getting lower as the score of heat-transformation syndrom(火熱證) increased and RF4 as the score of exuberance of Yang due to deficiency of Yin syndrom(陰虛陽亢證) increased. 4. In right arm meridian, the value of RH1 was getting lower as the score of exuberance of Yang due to deficiency of Yin syndrom(陰虛陽亢證) increased. These results show that the Yang-do-rack diagnosis could offer supplemental help for diffrentiation of syndroms in acute stroke patient.

• 생명과학회지
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• 제30권11호
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• pp.939-946
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• 2020

뇌졸중은 전 세계적으로 신경계 장애를 일으키는 주요 원인 중 하나이며, 뇌졸중 환자는 다양한 운동, 인지 및 정신 장애를 나타낸다. GPR88은 orphan G protein coupled receptor이며 striatal medium spiny neurons에서 높게 발현이 되며, GPR88이 결손이 된 경우 motor coordination과 motor learning에 문제가 발생하게 된다. 본 연구에서는 Western blot 및 real-time PCR을 사용하여 허혈성 마우스 모델에서 GPR88 발현이 감소함을 발견 하였다. 또한, 뇌에서 유래한 세 가지 유형의 세포들, 뇌혈관내피세포(brain microvascular endothelial cells), 미세 아교세포(microglial cells) 및 신경 세포들에서 GPR88의 발현정도를 확인한 결과, HT22 신경 세포에서 GPR88의 발현이 가장 높음을 관찰하였고, 뇌졸중과 유사한 실험조건인 oxygen glucose deprivation (OGD) 조건에 배양한 HT22 신경세포에서 GPR88의 발현이 감소하였다. 또한 GPR88 효현제인 RTI-13951-33 (10 mg/kg)을 전처리후에 뇌허혈을 유발하였을 때, infarct volume의 감소, vestibular-motor function 및 neurological score의 개선효과를 관찰할 수 있었다. 이러한 결과는 GPR88이 허혈성 뇌졸중을 포함한 CNS 질환의 치료를 위한 잠재적인 약물표적이 될 수 있음을 제시한다.

• Journal of Acupuncture Research
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• 제19권1호
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• pp.159-174
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• 2002

Objective : The meridian theory in oriental medicine explains that each acu-point has a characteristic functional effect. It will be supposed that an acupuncture stimulation on different acu-point evokes different activation on different areas in the central nervous system(CNS) according to the meridian theory. On this supposition, our group tried the semi-quantitative [14C]2-deoxyglucose([14C]2-DG) autoradiography on the acupuncture stimulation to the hindlimb acu-points of Sprague-Dawley rats. Methods : A venous catheter for the intravenous administration of isotope was equipped in the right external jugular vein on 3 days prior to the [14C]2-DG study. On the day of the study, two acupuncture needles were inserted into the ST36(Zusanli) or LR3(Taichong) on the left hindlimb. Electro-acupuncture stimulation (2 Hz, 5 ms, 1~3 mA, 15 minutes) started just before the i.v. injection of [14C]2-DG ($25{\mu}Ci/rat$). The brain and the spinal cord were removed and processed for the [14C] 2-DG autoradiography. Results : The EA stimulation on ST36 reveals over 120% metaboilc activation in Arcuate nucleus, Anterior pretectal nucleus, Dorsal cochlear nucleus, Interposed cerebellar nucleus, and Nucleus of Darkschewitsch. The EA stimulation on LR3 reveals over 120% metaboilc activation in Lateral habenula nucleus, Medial vestibular nucleus, Ventromedial thalamic nucleus, Anteroventral thalamic nucleus, Anterior cingulate cortex, Dentate gyrus, Antero cortical amygdaloid nucleus, Anterior pretectal nucleus, and Dorsal tegmental nucleus compared with the non EA stimulation control group. Conclusion : These results demonstrate that the different acu-points evoke the different activations in brain areas. And with this functional brain mapping study, a new scientific elucidation for the basis of the acupuncture-meridian theory in oriental medicine through differences of activated area in CNS according to the each acupuncture point.