• 제목/요약/키워드: Neurosurgery

검색결과 4,372건 처리시간 0.032초

Single Centre Experience on Decision Making for Mechanical Thrombectomy Based on Single-Phase CT Angiography by Including NCCT and Maximum Intensity Projection Images - A Comparison with Magnetic Resonance Imaging after Non-Contrast CT

  • Kim, Myeong Soo;Kim, Gi Sung
    • Journal of Korean Neurosurgical Society
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    • 제63권2호
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    • pp.188-201
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    • 2020
  • Objective : The purpose of this study was to suggest that computed tomography angiography (CTA) is valuable as the only preliminary examination for mechanical thrombectomy (MT). MT after single examination of CTA including noncontrast computed tomography (NCCT) and maximum intensity projection (MIP) improves door-to-puncture time as well as results in favorable outcomes. Methods : A total of 157 patients who underwent MT at Dong Kang Medical Center from April 2015 to March 2019 were divided into two groups based on the examination performed prior to MT : CTA group who underwent CTA with NCCT and MIP, and NCCT+magnetic resonance image (MRi) group who underwent MRI including perfusion images after NCCT. In the two groups, time to CTA imaging or NCCT+MRi imaging after symptom onset, and time to arterial puncture and reperfusion were characterized as time-related outcomes. The evaluation of vascular recanalization after MT was defined as a modified thrombolysis in cerebral infarction (mTICI) scale. National Institutes of Health Stroke Scale (NIHSS) was assessed at the time of the visit to the emergency room and modified Rankin Scale (mRS) was assessed after 90 days. Results : Typically, there were 34 patients in the CTA group and 33 patients in the NCCT+MRi group. A significantly shorter delay for door-to-puncture time was observed (mean, 86±22.1 vs. 176±47.5 minutes; <0.01). Also, a significantly shorter door-to-imege time in the CTA group was observed (mean, 13±6.8 vs. 93±30.8 minutes; p<0.01). Moreover, a significantly shorter onset-to-puncture time was observed (mean, 195±128.0 vs. 314±157.6 minutes; p<0.01). Reperfusion result of mTICI ≥2b was 100% (34/34) in the CTA group and 94% (31/33) in the NCCT+MRi group, and mTICI 3 in 74% (25/34) in the CTA group and 73% (24/33) in the NCCT+MRi group. Favorable functional outcomes (mRS score ≤2 at 90 days) were 68% (23/34) in the CTA group and 60% (20/33) in the NCCT+MRi group. Conclusion : A single-phase CTA including NCCT and MIP images was performed as a single preliminary examination, which led to a reduction in the time of the procedure and resulted in good results of prognosis. Consequently, it is concluded that this method is of sufficient value as the only preliminary examination for decision making.

An Optimization of AAV-82Q-Delivered Rat Model of Huntington's Disease

  • So, Kyoung-Ha;Choi, Jai Ho;Islam, Jaisan;KC, Elina;Moon, Hyeong Cheol;Won, So Yoon;Kim, Hyong Kyu;Kim, Soochong;Hyun, Sang-Hwan;Park, Young Seok
    • Journal of Korean Neurosurgical Society
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    • 제63권5호
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    • pp.579-589
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    • 2020
  • Objective : No optimum genetic rat Huntington model both neuropathological using an adeno-associated virus (AAV-2) vector vector has been reported to date. We investigated whether direct infection of an AAV2 encoding a fragment of mutant huntingtin (AV2-82Q) into the rat striatum was useful for optimizing the Huntington rat model. Methods : We prepared ten unilateral models by injecting AAV2-82Q into the right striatum, as well as ten bilateral models. In each group, five rats were assigned to either the 2×1012 genome copies (GC)/mL of AAV2-82Q (×1, low dose) or 2×1013 GC/mL of AAV2-82Q (×10, high dose) injection model. Ten unilateral and ten bilateral models injected with AAV-empty were also prepared as control groups. We performed cylinder and stepping tests 2, 4, 6, and 8 weeks after injection, tested EM48 positive mutant huntingtin aggregates. Results : The high dose of unilateral and bilateral AAV2-82Q model showed a greater decrease in performance on the stepping and cylinder tests. We also observed more prominent EM48-positive mutant huntingtin aggregates in the medium spiny neurons of the high dose of AAV2-82Q injected group. Conclusion : Based on the results from the present study, high dose of AAV2-82Q is the optimum titer for establishing a Huntington rat model. Delivery of high dose of human AAV2-82Q resulted in the manifestation of Huntington behaviors and optimum expression of the huntingtin protein in vivo.

Effect of Lidocaine-HCl on Microviscosity of Phosphatidylcholine Model Membrane

  • Chung, In-Kyo;Kim, Inn-Se;Choi, Chang-Hwa;Cho, Goon-Jae;Kim, Jin-Bom;Son, Woo-Sung;Jang, Hye-Ock;Yun, Il
    • The Korean Journal of Physiology and Pharmacology
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    • 제4권3호
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    • pp.243-251
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    • 2000
  • In order to provide a basis for studying the molecular mechanism of pharmacological action of local anesthetics and to develop a fluorescence spectroscopic method which can detect the microviscosity of native and model membranes using intramolecular excimerization of 1,3-di(l-pyrenyl)propane (Py-3-Py), we examined the effect of lidocaine HCl on the microviscosity of model membranes of phosphatidylcholine fraction extracted from synaptosomal plasma membrane vesicles (SPMVPC). The excimer to monomer fluorescence intensity ratio (I'/I) of Py-3-Py in liquid paraffin was a simple linear function of $T/{\eta}.$ Based on this calibration curve, the microviscosity values of the direct probe environment in SPMVPC model membranes ranged from $234.97{\pm}48.85$ cP at $4^{\circ}C$ to %19.21{\pm}1.11$ cP at $45^{\circ}C.$ At $37^{\circ}C,$ a value of $27.25{\pm}0.44$ cP was obtained. The lidocaine HCl decreased the microviscosity of SPMVPC model membranes in a concentration-dependent manner, with a significant decrease in microviscosity value by injecting the local anesthetic even at the concentration of 0.5 mM. These results indicate that the direct environment of Py-3-Py in the SPMVPC model membranes is significantly fluidized by the lidocaine HCl. Also, the present study explicitly shows that an interaction between local anesthetics and membrane lipids is of importance in the molecular mechanism of pharmacological action of lidocaine HCl.

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신경외과 중환자실 환자의 경장영양 지침서 적용에 따른 영양적 중재 효과 (Effects of Nutritional Interventions based on Enteral Nutrition Guidelines for Neurosurgical Intensive Care Unit Patients)

  • 한정희;김영란;이영민;김애리;김호진;정영균;유정하
    • 한국의료질향상학회지
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    • 제17권1호
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    • pp.79-88
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    • 2011
  • Background : Evidence-based guidelines are now used for enteral nutrition(EN) in neurosurgical intensive care unit patients who mostly depend on EN. This study compared and analyzed the nutritive conditions of patients before and after they underwent guideline based nutritional interventions in order to determine whether using these guidelines improved their calorie supply. Methods : Data on the patients' nutritional requirements, maximum calorie supply through EN, serum albumin level, and total lymphocyte count were collected and analyzed using SAS version 9.1.3. All the statistical analyses were performed at a significance level of P<0.05. Result : The maximum calorie supply through EN was $923.1{\pm}359.7$ kcal before the intervention and $1254.4{\pm}196.3$ kcal after the intervention; this difference was statistically significant(P<0.05). The ratio of nutritional requirements to maximum calorie supply through EN was $55.5{\pm}22.4%$ and $74.2{\pm}13.9%$ before and after the intervention, respectively; this difference was statistically significant(P<0.05). This indicates a 19% increase in the ratio after the nutritional intervention. The serum albumin level also significantly increased from $2.7{\pm}0.6g/dL$ before the intervention to $3.2{\pm}0.4g/dL$ after the intervention(P<0.05). The total lymphocyte count slightly increased from $1267.7{\pm}728.2cells/mm^3$ before the intervention to $1801.9{\pm}1211.5cells/mm^3$ after the intervention; this difference was not statistically significant. Conclusion : The results showed that using the evidence-based feeding guidelines for interventions increased the calorie supply and improved the patients' nutritive conditions from moderate malnutrition to mild malnutrition.

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DBP 스폰지와 DBP/PLGA 지지체에서의 인간 디스크세포 거동분석 비교 (The Comparison of Sponges and PLGA Scaffolds Impregnated with DBP on Growth Behaviors of Human Intervertebral Disc Cells)

  • 이선경;홍희경;김수진;김용기;송이슬;하윤;이동원;강길선
    • 폴리머
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    • 제34권5호
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    • pp.398-404
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    • 2010
  • 본 연구팀은 DBP를 함침시킨 물성이 서로 다른 스폰지와 PLGA 지지체를 제작한 후 세포 부착, 증식 및 형태 유지를 알아보기 위한 실험을 수행하였다. WST 분석법과 SEM 관찰을 통하여 스폰지에 비해서 PLGA 지지체에서의 세포의 증식이 활발한 것을 확인하였고, RT-PCR을 통해 디스크세포에서 특이적으로 발현하는 제 2형 콜라겐과 어그리칸의 발현을 확인하였다. WST 결과, 세포 증식률은 DBP/PLGA 지지체가 DBP를 함침시킨 스폰지보다 세포 증식률이 높음을 확인하였다. 본 연구팀은 스폰지보다 PLGA 지지체가 인간디스크의 표현형 유지 및 증식에 있어서 긍정적인 영향을 미치는 것을 확인하였다.

Foramen Magnum Decompression with Duraplasty Using Lyoplant® for Caudal Occipital Malformation Syndrome in a Dog

  • Park, Wan-Sang;Kang, SungHun;Kim, Jun-Su;Park, Sung-Guon;Moon, Hee-Sup;Kim, Sang-yeon;Hong, Sung-Jin;Hwang, Tae-Sung;Lee, Hee-Chun;Hwang, Yong-Hyun;Park, Hyun;Lee, Jae-Hoon
    • 한국임상수의학회지
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    • 제34권6호
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    • pp.449-453
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    • 2017
  • A 3-year-old castrated male Maltese dog, weighing 4.8 kg was referred with hindlimb ataxia and right forelimb proprioceptive deficits were shown for 20 months. Chiari-like malformation and syringomyelia diagnosed through MRI at a local animal hospital and Knuckling of right forelimb and reluctance to walk were managed with steroid. The medical management was getting ineffective to manage for the symptoms one month before referred. Physical and neurological examinations, radiography, computed tomography, and magnetic resonance imaging were performed and diagnoses of caudal occipital malformation syndrome (COMS) and subsequent syringomyelia (SM) were made. Given that pharmacological treatment was previously ineffective, surgical intervention was recommended. Foramen magnum decompression with duraplasty using $Lyoplant^{(R)}$ was performed. Three days post-surgery, the dog showed improved gait and activity. After 2 months, the dog received no additional prescription medications. At the 12-month follow-up after surgery, the dog showed no clinical problems or recurrences, despite complete cessation of pharmacological treatment. In present report, we applied $Lyoplant^{(R)}$ as a dural graft has been carried out in a dog with COMS. Surgical decompression with $Lyoplant^{(R)}$ was an effective long-term (12-month) treatment for COMS without the need for any pharmacological treatment.

가잠 가수분해물에 의한 학습력 개선 및 두뇌의 혈류변화와 글루코스 사용정도의 긍정적 변화 (Association between Cerebral Blood Flow and Cognitive Improvement Effect by B. mori Extracted Component)

  • 이상형;김용식;김성수;강용구;이무열;이광길;여주홍;이원복;김대경
    • 한국잠사곤충학회지
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    • 제46권2호
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    • pp.77-79
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    • 2004
  • 최근 잠상산물 추출물인 BF-7이 기억력과 학습력 개선에 크게 유용하다는 연구결과들이 보고되고 있다. 이를 바탕으로 본 연구는 과연 이 BF-7이 일반적인 학생들의 학습력 및 인지력 개선을 유도하는지 여부를 재확인하고자 하였다. 본 연구결과 3주 동안의 BF-7 복용(매일 400mg)으로, 평균 IQ 10 이상의 증가를 보였다. 이의 의학적 검증을 위하여, SPECT를 이용하여 두뇌의 인지기능과 학습력 등을 담당하는 부위의 혈류량 개선을 살펴봄으로써 이런 개선효과를 확인하고자 하였다. 그 결과 parahippocampal gyrus 와 medial temporal area부위 즉 학습 관련한 두뇌부위의 혈류량과 글루코오스 사용량이 증가하는 것으로 나타났다. 따라서 BF-7의 복용은 효과적으로 두뇌의 활성을 유도하여, 인지기능과 기억력, 학습력 증진 효과를 갖는 것으로 나타났다.

악성 성상세포종에서 표피성장인자 수용체 과발현의 임상적 의의 (Clinical Implications of the Epidermal Growth Factor Receptor Overexpression in the High-grade Astrocytomas)

  • 홍성언;강진오;이혜경;양문호;임언;조경삼
    • Radiation Oncology Journal
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    • 제14권2호
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    • pp.87-93
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    • 1996
  • 목적 : 악성 성상세포종에서 표피 성장 인자 수용체의 과발현의 빈도와 예후 인자로서 가능성을 조사하기 위하여 본 연구를 시행하였다. 대상 및 방법 : 조직학적으로 악성 성상세포종으로 확진되고 방사선 치료를 받은 23명(역형성성상세포종 7예, 다형성 교아세포종 16예)의 파라핀 블록에 antihuman EGFR polyclonal antibody를 이용하여 면역염색을 시행하였다. 결과 : 표피 성장 인자 수용체는 역형성 성상세포종에서는 7예중 2예에서 양성이었고 다형성 교아세포종은 16예중 9예에서 양성으로 양군간의 발현 빈도의 차이는 통계적으로 유의하지 않았다 (p=0.44). 55세 미만의 환자는 11예중 3예에서 양성이었고 55세 이상은 12예중 8예에서 양성이었다(p=0.141). 표피 성장 인자 수용체 음성인 역형성 성상세포종 환자의 평균 생존기간(중앙값)은 37개월이었다. 다형성 교아세포종 환자의 평균 생존 기간은 표피 성장 인자 수용체 음성 군은 중앙값 11개월, 양성 군은 중앙값 7개월이었으나 두 군간의 통계적인 차이는 없었다(p=0.17). 결론 : 55세 이상 연령군에서 표피성장인자 수용체의 과발현의 빈도가 높았다. 다형성 교아세포종 환자의 생존율은 표피성장인자 수용체 과발현에 의하여 감소하였으나 유의한 영향을 받지 않았다.

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Isolation of human mesenchymal stem cells from the skin and their neurogenic differentiation in vitro

  • Byun, Jun-Ho;Kang, Eun-Ju;Park, Seong-Cheol;Kang, Dong-Ho;Choi, Mun-Jeong;Rho, Gyu-Jin;Park, Bong-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제38권6호
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    • pp.343-353
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    • 2012
  • Objectives: This aim of this study was to effectively isolate mesenchymal stem cells (hSMSCs) from human submandibular skin tissues (termed hSMSCs) and evaluate their characteristics. These hSMSCs were then chemically induced to the neuronal lineage and analyzed for their neurogenic characteristics in vitro. Materials and Methods: Submandibular skin tissues were harvested from four adult patients and cultured in stem cell media. Isolated hSMSCs were evaluated for their multipotency and other stem cell characteristics. These cells were differentiated into neuronal cells with a chemical induction protocol. During the neuronal induction of hSMSCs, morphological changes and the expression of neuron-specific proteins (by fluorescence-activated cell sorting [FACS]) were evaluated. Results: The hSMSCs showed plate-adherence, fibroblast-like growth, expression of the stem-cell transcription factors Oct 4 and Nanog, and positive staining for mesenchymal stem cell (MSC) marker proteins (CD29, CD44, CD90, CD105, and vimentin) and a neural precursor marker (nestin). Moreover, the hSMSCs in this study were successfully differentiated into multiple mesenchymal lineages, including osteocytes, adipocytes, and chondrocytes. Neuron-like cell morphology and various neural markers were highly visible six hours after the neuronal induction of hSMSCs, but their neuron-like characteristics disappeared over time (24-48 hrs). Interestingly, when the chemical induction medium was changed to Dulbecco's Modified Eagle Medium (DMEM) supplemented with fetal bovine serum (FBS), the differentiated cells returned to their hSMSC morphology, and their cell number increased. These results indicate that chemically induced neuron-like cells should not be considered true nerve cells. Conclusion: Isolated hSMSCs have MSC characteristics and express a neural precursor marker, suggesting that human skin is a source of stem cells. However, the in vitro chemical neuronal induction of hSMSC does not produce long-lasting nerve cells and more studies are required before their use in nerve-tissue transplants.

Flavonoids from Orostachys Japonicus A. Berger Induces Caspase-dependent Apoptosis at Least Partly through Activation of p38 MAPK Pathway in U937 Human Leukemic Cells

  • Lee, Won Sup;Yun, Jeong Won;Nagappan, Arulkumar;Jung, Ji Hyun;Yi, Sang Mi;Kim, Dong Hoon;Kim, Hye Jung;Kim, GonSup;Ryu, Chung Ho;Shin, Sung Chul;Hong, Soon Chan;Choi, Yung Hyun;Jung, Jin-Myung
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권2호
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    • pp.465-469
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    • 2015
  • Background: Orostachys japonicus A. Berger (A. Berger) is commonly used as a folk remedy for cancer therapy. However, the mechanisms of its anti-cancer activity are poorly investigated in human cancer cells. In this study, we investigated whether flavonoids extracted from Orostachys japonicus A. Berger (FEOJ) might have anticancer effects in human leukemia cells, focusing on cell death mechanisms. Materials and Methods: U937 human leukemic cancer cells were used. Results: FEOJ induced apoptosis in a dose-dependent manner in human U937 cancer cells. Flow cytometry revealed significant accumulation of cells with sub-G1 DNA content at the concentrations of $200{\mu}g/mL$ and $400{\mu}g/mL$. FEOJ-induced apoptosis was caspase-dependent through loss of mitochondrial membrane potential (MMP, ${\Delta}{\Psi}m$) in human U937 cancer cells, which might be associated with suppression of Bcl-2 and XIAP proteins. FEOJ induced the p38 MAPK signaling pathway, playing at least in part an important role in FEOJ-induced apoptosis. Conclusions: This study suggested that FEOJ may induce caspase-dependent apoptosis in human leukemic cells by regulating MMP (${\Delta}{\Psi}m$) through suppressing Bcl-2 and X-IAP. In addition, the results indicated that upstream p38 MAPK signaling regulates the apoptotic effect of FEOJ. This study provides evidence that FEOJ might have anti-cancer potential for human leukemic cells.