• Journal of Korean Neurosurgical Society
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• 제58권5호
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• pp.462-466
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• 2015

Objective : Post-craniotomy seizure (PCS) is reported only rarely. However, our department noted a 433% increase in PCS for a year beginning September 2010, especially after cerebrovascular surgery. Our goal was to identify the cause of our unusual outbreak of PCS. Methods : For almost one year after September 2010, cases of PCS increased significantly in our department. We analyzed 973 patients who had received a major craniotomy between January 2009 and November 2011. We included seizures that occurred only in the first 24 postoperative hours, which we defined as early PCS. After verifying the presence of PCS, we analyzed multiple seizure-provoking factors and their relation to the duration and character of seizure activity. Results : Overall PCS incidence was 7.2% (70/973). Cefazolin (2 g/L saline) was the antibiotic drug used for intraoperative irrigation in 88.4% of the operations, and no PCS occurred without intraoperative cefazolin irrigation. When analyzed by operation type, clipping surgery for unruptured aneurysms was the most frequently associated with PCS (80%). Using logistic regression, only 2 g cefazolin intraoperative irrigation (p=0.024) and unruptured aneurysm clipping surgery (p<0.001) were associated with early PCS. The seizure rate of unruptured aneurysm clipping surgery using 2 g cefazolin intraoperative irrigation was 32.9%. Conclusion : Intraoperative cefazolin irrigation must be avoided in patients undergoing craniotomy, especially for clipping of unruptured aneurysms, because of the increased risk of early PCS.

• Clinical and Experimental Pediatrics
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• 제45권4호
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• pp.540-544
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• 2002

저자들은 임상적으로 Rett 증후군이 의심된 2세 환아에서 MECP2 유전자의 직접 염기 서열 분석을 통해 P152R 돌연변이를 확인하였다. 이에 대한 문헌 고찰과 함께 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제46권4호
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• pp.404-408
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• 2003

저자들은 경련, 구토를 주소로 입원한 환아에서 만성 경막하출혈과 망막출혈을 보여 흔들린 아이 증후군으로 진단한 5례를 경험하였다. 현재까지 국내에서는 보고와 연구가 드물지만 의료인이 흔들린 아이 증후군에 대한 가능성을 염두에 두고 좀 더 적극적으로 방사선 검사나 안과 검사를 시행하면 올바른 진단과 함께 치명적인 합병증의 발생을 감소시킬 수 있다고 사료되는 바 문헌 고찰과 함께 보고하는 바이다.

• The Korean Journal of Physiology and Pharmacology
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• 제7권6호
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• pp.307-310
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• 2003

Kainic acid (KA) is a structural analogue of glutamate that interacts with specific presynaptic and postsynaptic receptors to potentiate the release and excitatory actions of glutamate. Systemic or intracerebroventricular (i.c.v.) administration of KA to experimental animals elicits multifocal seizures with a predominantly limbic localization, and results in neuronal death of cornu ammonia 1 (CA1), reactive gliosis and biochemical changes in the hippocampus and other limbic structures. Several lines of evidence suggest that reactive oxygen species (ROS) play a pivotal role in the pathogenesis of excitotoxic death by KA. Curcumin has been known to possess anti-oxidative and anti-inflammatory activities. In this study, the effects of curcumin on KA induced hippocampal cell death, reactive gliosis and biochemical changes in reactive glia were investigated by immunohistochemical methods. Our data demonstrated that curcumin attenuated KA-induced astroglial and microglial activation although it did not protect KA-induced hippocampal cell death.

• Journal of Korean Neurosurgical Society
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• 제40권5호
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• pp.323-329
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• 2006

Objective : This study was designed to analyze surgical strategies for patients with intractable supplementary sensorimotor area[SSMA] seizures. Methods : Seventeen patients who had surgical treatment were reviewed retrospectively. Preoperatively, phase I [non-invasive] and phase II [invasive] evaluation methods for epilepsy surgery were done. Seizure outcome was assessed with Engel's classification. The mean follow-up period was 27.2 months [from 12 months to 54 months]. Results : An MRI identified structural abnormality in eight patients and 3D-surface rendering revealed abnormal gyration in three. PET, SPECT, and surface EEG could not delineate the epileptogenic zone. Video-EEG monitoring with a subdural grid or depth electrodes verified the epileptogenic zone in all patients. Surgical procedures consisted of a resection of the SSMA and simultaneous callosotomy in two patients, a resection of the SSMA extending to the adjacent area in seven, a resection of a different area without a SSMA resection in seven, and a callosotomy in one. Seizure outcomes were class I in 11 [65%]. class II in five [29%], class III in one [6%]. Conclusion : In patients with intractable SSMA seizure, surgery was an excellent treatment modality. Precise delineation of the epileptogenic zone based on multimodal diagnostic methods can provide good surgical outcomes without neurological complications.

• Journal of Korean Neurosurgical Society
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• 제38권4호
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• pp.273-280
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• 2005

Objective : There is no acceptable indication and treatment of choice for infantile and child subdural hygroma and there are only a few reports about that in Korea. So the authors studied the clinical findings of infantile and child patients with subdural hygroma to improve the understanding and to suggest a standard treatment method. Methods : The authors retrospectively evaluated the causes, preoperative symptoms, radiological thicknesses, and postoperative results of 25patients with subdural hygroma who received surgical therapy. Results : There were 16boys and 9girls whose median age was 6months[range $2{\sim}120months$]. The main clinical manifestations were seizures, increased intracranial pressure, macrocrania and alteration of consciousness. Radiological thicknesses of the subdural hygroma varied from 7mm to 42mm and postoperative changes of thickness[y] could be expressed with the factor of month[x]: $y\;=\;-1.32\;{\times}\;+11.8$ in subdural drainage, and $y\;=\;-1.52\;{\times}\;+14.9$ in subduroperitoneal shunts. Of the 25patients, 2 [50%] were successfully treated by aspiration, 13 [59%] by subdural drainage, and 9 [69%] by subduroperitoneal shunt. Conclusion : It is suggested that the diagnosis and treatment of subdural hygroma in infants and children should be carefully addressed because of its high prevalence in children, and especially in infants. It is also suggested that the subdural drainage could be primary initial treatment method because it is simpler than a shunt, and since our data show that there is no statistical difference in postoperative recovery duration between the two operative methods.

• 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.

• Child Health Nursing Research
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• 제16권4호
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• pp.277-286
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• 2010

Purpose: The purpose of this study was to provide descriptive data about the characteristics of pediatric patients and nursing interventions in Regional Emergency Medical Centers (REMC). Methods: A retrospective design was used to examine the medical records of 4,310 children. The clinical data and nursing terminologies of REMC were analyzed using the Nursing Intervention Classification (NIC). Results: Male toddlers dominated the sample. The mean age of the children was 3.51 yr. In more than half of the visits, patients arrived between from 7 a.m. to 3 p.m., on a weekday. There were only 189 ambulance transports to REMC, (4.4% of visits). The most frequent injuries were due to falls (28.0%) and contusions (27.3%), but the most common reasons for visits were non-injury (73.4%): fever, cough/shortness of breath, seizures, and abdominal pain. Of the 4,310 visits, 27.8% spent 6-24 hours in the REMC, while 33% resulted in hospital admission and 2.1% in transfer to another hospital. Of the 17,929 nursing interventions, 17,909 elements (99.9%) were classified under NIC. All the listed NIC interventions, however, were not reflected in the level of practice demonstrated by REMC nurses. Conclusion: These results can enhance the understanding of pediatric emergency nursing interventions and can make NIC more applicable.

• Clinical and Experimental Pediatrics
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• 제51권5호
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• pp.538-541
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• 2008

멘케스병은 성염색체 열성으로 유전되는 질환으로 APT7A 유전자의 돌연변이에 의해 발생한다. 기전은 장에서의 구리 흡수와 운반에 결손이 있는 것으로 혈청 구리 및 ceruloplasmin 이 낮다. 특징적인 임상양상은 경련발작, 근육긴장저하, 저체온증을 나타내며 얼굴은 특징적으로 통통하며 저색소 피부색, 꼬이고 윤택이 없고 잘 부스러지는 머리카락을 보인다. 성장장애를 보이는 경우가 흔하며 심한 정신지체와 발달장애를 동반한다. 멘케스병에서 간비대가 간병증을 보이는 경우는 현재까지 보고되지 않았다. 저자들은 유전자 검사를 통해 멘케스병으로 확진된 4개월 소아가 영아연축, 발달장애, 머리카락 이상 외에도 이전에 잘 알려져 있지 않은 간비대를 보인 1례를 보고하는 바이다.

• 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.