• Journal of Korean Neurosurgical Society
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• 제29권10호
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• pp.1360-1364
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• 2000

This 26-year-old man gradually developed a disabling midbrain tremor involving both distal and proximal part of left upper arm. On neurologic examination, oculomotor palsy, and ataxia of the left arm were noted. Radiologic examination revealed a mass lesion on midbrain tegmentum. He was tentatively diagnosed as brain tumor (presumably germinoma) without stereotactic biopsy. Conventional radiation therapy was given for this lesion. Although there was improvement in the radiologic imaging, his midbrain tremor worsened and became untolerable. The authors performed MR-guided stereotactic Vim-thalamotomy. With macroelectrode stimulation and radiofequency lesioning, his resting, postural and action tremors were almost completely abolished in both distal and proximal part of left upper extremity. Authors consider that Vim thalamotomy is still an effective means of controlling midbrain tremor involving proximal upper limb.

• Annals of Clinical Neurophysiology
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• 제3권2호
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• pp.168-171
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• 2001

It has been said that variable anatomical structures and neural circuits are related to the generation of tremor. There are cerebral cortex, thalamus, basal ganglia, inferior olivary nucleus, midbrain tegmentum, stretch reflex, and musculoskeletal structures. The stretch reflex is related with the physiologic tremor and various peripherally originated tremors. We experienced a case with the post-stroke resting tremor which was induced and aggravated by mechanical stretching stimulation. In the present case, stretch reflex has a major role in the generation and exacerbation of tremor. It is presumed that the development of tremor is attributed to the increased rhythmicity of ventral intermedius nucleus of thalamus. The enhancement of thalamic rhythmicity may be due to the increasement of long latency reflex by post-stroke rigidity. This case suggests that stretch reflex may have a major role in the pathophysiologic mechanisms of a certain centrally originated tremor.

• 한국동물위생학회지
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• 제19권1호
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• pp.1-29
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• 1996

This study was conducted to elucidate the pathogenesis of Aujeszky's disease virus(ADV) by histopathologic examination. The first Korean ADV Isolate, which was isolated from piglets with clinical signs of Aujeszky's disease in Yangsan(YS) county, Kyungnam province, was inoculated into 32 days old piglets with a dose of $10^{5.9}$$TCID_{50}/ml$ through intranasal or intramuscular route. These piglets were sacrificed at intervals of every 24hrs for 8 days. The virulence of YS strain was determined by the observation of clinical signs, gross findings, and histopathologic changes in tissues. The virus recovery test was performed from brain, spleen, lung and tonsil in cell culture. The pathogenesis of YS strain was determined by the observation of histopathologlc lesions in CNS and neuronal tracts. The major clinical signs were fever, anorexia, dyspnea, constipation, tremor, ataxia, circling movement, hindleg paralysis and salivation. The clinical signs were more severe in piglets of the group inoculated intranasally than those of the intramuscularly inoculated gorup. Lymphocytopenia was detected on day 5 to day 6 postinoculation (PI). The ADV was recovered from the tissue homogenates of tonsil, lung, spleen and cerebrum in cell culture. The highest virus titer was detected from tonsil between day 6 and day 7 PI. Reddish sublobar consolidation foci were scattered in the apical and cardiac lobes of lung. Although yellowish necrotic foci were detected in tonsil and liver, hemorrhagic lesions were mainly observed in heart, kidney and lymph nodes. Histopathologically, degeneration and necrosis of nerve cells, nonsuppurative meningoe-ncephalitis, nodular gliosis and perivascular cuffings were observed in CNS. Multifocal fibronecrotic foci were observed in lung, liver, lymph nodes and spleen. The major pathologic changes were detected in the midbrain, pons and medulla oblongata. Eosinophilic intranuclear inclusion bodies were mainly observed in epithelia and /or macrophages of tonsil, liver, lung, spleen and submandibular lymph nodes, and neurons of brain, respectively. Observation of viral particles at various stages of replication were possible from the endothelial cells of the alveolar capillaries and tonsillar crypt epithelia by transmission electron microscope.

• 재활복지
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• 제18권4호
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• pp.237-255
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• 2014

특발성 파킨슨병(idiopathic Parkinson disease, IPD)은 알 수 없는 원인으로 인해 중뇌의 흑질신경세포가 손실되는 대표적인 퇴행성 신경계 질환이다. IPD 환자는 신체 운동 이상을 주로 호소하지만 이들 중 70~90%가 운동저하형 마비말장애(hypokinetic dysarthria)를 동반하는 것으로 알려져 있다. 진행된 심도의 IPD 환자의 운동 증상 호전에 가장 효과적인 치료 방법으로 알려진 시상밑부핵 심부뇌자극술(subthalamic nucleus deep brain stimulation, STN-DBS)은 말 산출에서는 그 효과가 일관되지 않게 보고된다. 이에 본 연구에서는 STN-DBS가 말 산출에 미치는 영향을 살펴보고, 연구에서 어떠한 말 평가 과제가 사용되었는지를 조사하기 위하여 medline을 통해 2012까지 이루어진 연구 논문을 수집하였다. 총 32편 중, 연구대상자들에서 술 후 말 상태의'호전'이 관찰된 논문은 42%,'악화'는 29%,'엇갈리는 결과'는 26%,'변화 없음'은 3%로 확인되었다. 말 효과 간에는 문맥발화(contextual speech)가 연구에 사용된 비중이 높을수록 술 후 말 상태는 부정적인 결과로 보고되었으며, 말 산출 단계 중 일부 단계(예: 호흡 및 발성만, 혹은 조음만)만이 반영된 평가 과제가 연구마다 선택적으로 사용되었음을 확인하였다. 이에 본 연구는 STN-DBS를 받은 IPD 환자의 말 평가는 말 산출 하부 단계를 모두 반영하는 문맥발화 과제를 통일적으로 사용할 것을 제안한다.