• 기본간호학회지
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• 제11권1호
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• pp.74-81
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• 2004

Purpose: This study investigated the need for information and social support in parents of children with epilepsy. Method: A total of 119 parents of children with epilepsy were recruited and asked to fill out questionnaires. Result: Of 119 parents, two-third reported that they received full and sufficient information about their child's disease and its management but one-third felt the information was insufficient and incomplete. Most parents (62.2%) felt at loss when their child had a seizure, either at home or at school. They wanted information on the causes of seizures, adequate steps deal with seizure and steps they should take to become adequate and supportive parents for their children. However, most parents were reluctant to disclose the disease or to receive support from outsiders. Conclusion: Regardless of the fact that most parents received sufficient information about the management of epilepsy, they felt at a loss when their child had a seizure attack. Therefore nurses should give specific instruction on seizure management and assess the needs of parents on a regular basis.

• Journal of Ginseng Research
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• 제18권3호
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• pp.165-174
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• 1994

To investigate the significant indicators Improving the undisturbed memory in animal behavior, we employed several behavioral methods (learning, relearning in radial maze, and active avoidance) with ginseng components. Results showed that the repeated intranasal administration of $Rb_1$ and total saponins from Korean red ginseng induced direct effects on the brain mechanisms in rats, and improved the spatial memory during the learning, relearning and retention in the 12-arm radial maze test. The intranasal treatment of the total saponins also effectively improved the disturbed memory (amnesia) by pentylentetrazole, and simultaneously protected the brain by decreasing the severity of motor epileptic seizures. The intraperitonial administration of polysaccharide fraction of Korean red ginseng could improve avoidance behavior (amount of the total ecapes) in the active-avoidance test. In addition, local changes of the temperature and resistance of skin observed after Rb, administration were suggested to reflect some action of sympathetic nerve Key words Memory, intranasal administration, pentylenetetrazole, Korea red ginseng.

• 대한소아신경학회지
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• 제26권4호
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• pp.276-279
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• 2018

클라인펠터 증후군은 다양한 임상양상을 나타내는 유전질환으로 알려져 있다. 그 중 드물게 경련과 같은 신경학적 증상을 동반하는 경우가 보고되고 있으며 보통 1세 이후의 연령에서 발병하며 항경련제에 반응이 좋은 것으로 알려져 있다. 5개월 남아가 얼굴 찡그림과 딸꾹질을 주소로 내원하였다. 환아는 출생 시 시행한 검사에서 클라인 펠터 증후군으로 진단된 병력이 있었으며 생후 26일에 안구편위로 입원치료의 병력이 있었다. 내원하여 시행한 혈액검사에서 특이소견 없었으나 혈중 테스토스테론 수치가 감소되어 있었고 항뮬러관 호르몬 수치가 증가되어 있었다. 시행한 영상검사에서 정상이었으나 경련이 재발하여 항경련제 복용하기 시작하였으나 간헐적인 경련이 반복되며 난치성 경과를 보이고 있다. 따라서 클라인펠터 증후군 환아에서 경련과 같은 신경학적 증상이 동반될 수 있음을 인지하고 면밀한 검사를 통해 조기에 진단하여 환아의 예후를 향상 시켜야 할 것이다. 이에 저자들은 클라인펠터 증후군으로 진단된 영아에서, 비발열성 난치성 경과를 보이는 1예를 경험하였기에 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제51권2호
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• pp.162-169
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• 2008

목 적 : Oxcarbazepine(OXC)은 대표적인 부분간질의 치료제로 2001년 미국 식약청으로 부터 승인을 받았으며 1970년대 말부터 임상 보고가 시작되었고 소아를 대상으로 OXC의 효용성 및 안전성에 대한 다수의 보고가 있다. 국내에는 1999년부터 임상적 적용이 시작되었으나 국내 소아 대상의 연구 보고가 제한적이다. 방 법 : 2001년 1월부터 2006년 12월까지 6년간 고려대학교 의료원 구로병원 소아과에 내원하여 OXC 투약을 시행하였던 환자 144명을 대상으로 후향적 자료 분석을 통해 효용성과 안전성을 연구하였다. 결 과 : OXC 투약 6개월 후 회복군은 77명(53.5%, n=144), 호전군은 48명(33.3%), 유지군은 14명(9.7%), 그리고 악화군은 5명(3.5%)이었고, 치료 12개월 후에는 회복군은 88명(61.1%, n=133), 호전군은 27명(18.8%), 유지군은 8명(5.6%), 그리고 악화군은 8명(5.6%)이었다. 단일요법 군의 회복군은 6개월 치료 후에 63명(66.3%, n=95), 12개월 치료 후에는 86명(90.5%, n=95)였으며 복합요법 군에서 6개월 투약 후에 회복군은 14명(28.6%, n=49), 치료 12개월 후에는 45명(91.8%, n=49)으로 유의한 차이를 보였다. OXC 투약 기간동안 부작용이 발생한 경우는 73명으로, 그 중 졸림(20.1%), 두통(12.5%), 어지러움(9.7%), 발진(8.3%), 피로함(4.2%) 등이 관찰되었으며 나이, 성별 및 약물 용량과는 유의한 인과관계가 없었다. 혈액 검사상 저나트륨혈증이 관찰된 경우는 총 24명(16.7%)이며 그 외 투약 후 검사 상 이상소견은 유의하게 관찰되지 않았다. 반면 투약 이후 빈혈의 빈도가 감소하였는데 혈색소와 체중 간에 유의한 상관관계는 없었다. 결 론 : 본 연구 결과 OXC 의 효용성은 국외 보고와 비교하여 우수하거나 큰 차이가 없었으며, 위중한 부작용 사례는 없었다. 소아 간질 환자의 OXC 치료 시 참고가 되는 자료가 될 수 있을 것이다.

• 생명과학회지
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• 제30권6호
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• pp.513-521
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• 2020

Bmi1은 PcG 단백의 일종으로 PRC를 구성하는 성분이다. Bmi1에 관한 초기의 연구는 주로 암세포에서의 역할에 집중되었고, 그 결과 Bmi1은 암세포의 증식과 생존에 중요한 역할을 하는 것으로 받아들여지고 있다. 그러나, 최근의 연구 결과 Bmi1은 퇴행성 신경계 질환이 있는 뇌에서 발현이 감소되어 있고 미토콘드리아의 기능과 활성 산소 수준을 조절하는 것으로 알려져 있다. 본 연구에서는 Bmi1 발현 저하 동물을 이용하여 간질에서 Bmi1의 약물 치료 표적 가능성을 밝히고자 하였다. Bmi1의 발현은 pilocarpine에 의한 경련중첩증 이후 해마의 CA1, CA3 그리고 치상회에서 뚜렷하게 증가하였다. 경련 양상을 볼 때 경련중첩증이 유도되는 비율은 Bmi1^+/+와 Bmi1^+/- 생쥐에서 각각 43.14%와 53.57%로 나타났다. 그러나, 치사율과 해마의 신경세포 손상에는 두 군 간에 통계적으로 유의한 차이를 보이지 않았다. 경련중첩증 유도 2개월 후에 나타난 간질 경련의 빈도수는 통계적 유의성은 없었으나 Bmi1^+/- 생쥐에서 약 50% 낮게 나타났다. 반면, 이끼섬유발아는 Bmi1^+/- 생쥐에서 통계적으로 유의하게 증가하였다. 이러한 결과를 종합하면, Bmi1의 발현이 감소할 때 pilocarpine에 의한 경련 유도와 이끼섬유발아가 증가함을 보여준다.

• The Korean Journal of Physiology and Pharmacology
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• 제21권2호
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• pp.169-177
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• 2017

Lamotrigine is an antiepileptic drug widely used to treat epileptic seizures. Using whole-cell voltage clamp recordings in combination with a fast drug application approach, we investigated the effects of lamotrigine on 5-hydroxytryptamine $(5-HT)_3$ receptors in NCB-20 neuroblastoma cells. Co-application of lamotrigine ($1{\sim}300{\mu}M$) resulted in a concentration-dependent reduction in peak amplitude of currents induced by $3{\mu}m$ of 5-HT for an $IC_{50}$ value of $28.2{\pm}3.6{\mu}M$ with a Hill coefficient of $1.2{\pm}0.1$. These peak amplitude decreases were accompanied by the rise slope reduction. In addition, $5-HT_3$-mediated currents evoked by 1 mM dopamine, a partial $5-HT_3$ receptor agonist, were inhibited by lamotrigine co-application. The $EC_{50}$ of 5-HT for $5-HT_3$ receptor currents were shifted to the right by co-application of lamotrigine without a significant change of maximal effect. Currents activated by 5-HT and lamotrigine co-application in the presence of 1 min pretreatment of lamotrigine were similar to those activated by 5-HT and lamotrigine co-application alone. Moreover, subsequent application of lamotrigine in the presence of 5-HT and 5-hydroxyindole, known to attenuate $5-HT_3$ receptor desensitization, inhibited $5-HT_3$ receptor currents in a concentration-dependent manner. The deactivation of $5-HT_3$ receptor was delayed by washing with an external solution containing lamotrigine. Lamotrigine accelerated the desensitization process of $5-HT_3$ receptors. There was no voltage-dependency in the inhibitory effects of lamotrigine on the $5-HT_3$ receptor currents. These results indicate that lamotrigine inhibits $5-HT_3$-activated currents in a competitive manner by binding to the open state of the channels and blocking channel activation or accelerating receptor desensitization.

• The Korean Journal of Physiology and Pharmacology
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• 제22권1호
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• pp.71-80
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• 2018

In patients with epilepsy, depression is a common comorbidity but difficult to be treated because many antidepressants cause pro-convulsive effects. Thus, it is important to identify the risk of seizures associated with antidepressants. To determine whether paroxetine, a very potent selective serotonin reuptake inhibitor (SSRI), interacts with ion channels that modulate neuronal excitability, we examined the effects of paroxetine on Kv3.1 potassium channels, which contribute to high-frequency firing of interneurons, using the whole-cell patch-clamp technique. Kv3.1 channels were cloned from rat neurons and expressed in Chinese hamster ovary cells. Paroxetine reversibly reduced the amplitude of Kv3.1 current, with an $IC_{50}$ value of $9.43{\mu}M$ and a Hill coefficient of 1.43, and also accelerated the decay of Kv3.1 current. The paroxetine-induced inhibition of Kv3.1 channels was voltage-dependent even when the channels were fully open. The binding ($k_{+1}$) and unbinding ($k_{-1}$) rate constants for the paroxetine effect were $4.5{\mu}M^{-1}s^{-1}$ and $35.8s^{-1}$, respectively, yielding a calculated $K_D$ value of $7.9{\mu}M$. The analyses of Kv3.1 tail current indicated that paroxetine did not affect ion selectivity and slowed its deactivation time course, resulting in a tail crossover phenomenon. Paroxetine inhibited Kv3.1 channels in a use-dependent manner. Taken together, these results suggest that paroxetine blocks the open state of Kv3.1 channels. Given the role of Kv3.1 in fast spiking of interneurons, our data imply that the blockade of Kv3.1 by paroxetine might elevate epileptic activity of neural networks by interfering with repetitive firing of inhibitory neurons.

• Molecular & Cellular Toxicology
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• 제2권2호
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• pp.120-125
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• 2006

Phenytoin is an anti-epileptic. It works by slowing down impulses in the brain that cause seizures. The recent microarray technology enables us to understand possible mechanisms of genes related to compounds which have toxicity in biological system. We have studied that the effect of a compound related to hepatotoxin in vitro system using a rat whole genome microarray. In this study, we have used a rat liver epithelial cell line WB-F344 and phenytoin as a hepatotoxin. WB-F344 was treated with phenytoin for 1 to 24 hours. Total RNA was isolated at times 1, 6 and 24h following treatment of phenytoin, and hybridized to the microarray containing about 22,000 rat genes. After analysis with clustering methods, we have identified a total of 1,455 differentially expressed genes during the time course. Interestingly, about 1,049 genes exhibited differential expression pattern in response to phenytoin in early time. Therefore, the identification of genes associated with phenytoin in early response may give important insights into various toxicogenomic studies in vitro system.

• Clinical and Experimental Pediatrics
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• 제55권5호
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• pp.171-176
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• 2012

Purpose: The aim of this study was to investigate the natural history of epilepsy and response to anti-epileptic drug treatment in patients with Angelman syndrome (AS) in Korea. Methods: We retrospectively reviewed the clinical records of 14 patients diagnosed with epilepsy out of a total of 17 patients with a genetic diagnosis of AS. These patients were seen at the Department of Pediatric Neurology at Severance Children's Hospital from March 2005 to March 2011. Results: Fourteen (9 males and 5 females) subjects (82.3%) were diagnosed with epilepsy in AS. The most common seizure types were generalized tonic-clonic (n=9, 27%) and myoclonic (n=9, 27%), followed by atonic (n=8, 24%), atypical absence (n=4, 12%) and complex partial seizure (n=3, 9%). The most commonly prescribed antiepileptic drug (AED) was valproic acid (VPA, n=12, 86%), followed by lamotrigine (LTG, n=9, 64%), and topiramate (n=8, 57%). According to questionnaires that determined whether each AED was efficacious or not, VPA had the highest response rate and LTG was associated with the highest rate of seizure exacerbation. Complete control of seizures was achieved in 6 patients. Partial control was achieved in 7 patients, while one patient was not controlled. Conclusion: Epilepsy is observed in the great majority of AS patients. It may have early onset and is often refractory to treatment. There are few reports about epilepsy in AS in Korea. This study will be helpful in understanding epilepsy in AS in Korea.

• 대한임상검사과학회지
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• 제38권2호
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• pp.141-146
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• 2006

Vagal nerve stimulation (VNS) has been proposed as a possible way to improve the control of refractory epilepsy. We report the effects following VNS treatment in patients with refractory epilepsy. Seventeen patients with a mean age of 12.8 years, ranging from 5 to 29 years, underwent the implantation of vagal nerve stimulation (Cyberonics, Houston, TX). We reviewed the clinical findings before and after VNS in seizure frequency, number of antiepileptic drugs (AED), and quality of life (QOL). All of the patients had intractable seizures, eleven of the patients had additional medical complications, three had hippocampus atrophy, one had encephalomalacia, five had encephalitis, one had pachygyria, and one had schizencephaly. Thirteen patients had symptomatic partial epilepsies, three patients had Lennox-Gastaut syndrome and one had cryptogenic partial epilepsy. The mean follow up duration was 35 months. The mean reduction of seizure frequency compared with baseline before VNS was 26.1% after 3 months (p<0.005), 41.9% after 6 months (p<0.001), 46.9% after 1 year (p<0.001), and 53% at the latest follow-up (p<0.001). Twelve patients showed an improvement of QOL such as mood, language, alertness, expression, and motor function. The most common side effects were transient hoarseness or voice change or cough, which was detected in six patients (35%) and wound infection in one patient (5%). This study has shown a good anti-seizure effect of VNS, decrease in seizure frequency and improvements in QOL. We concluded that VNS is a beneficial therapy in refractory epilepsy with a non-resectable epileptic focus. Further studies should be focused on the prediction of unresponsiveness and the adjustment of VNS parameters for maximum efficacy in patients with various medical histories.