• 대한임상독성학회지
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• 제7권2호
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• pp.77-82
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• 2009

Purpose: In highly doses, endosulfan lowers the seizure threshold and elicits central nervous system stimulation, which can result in seizures, respiratory failure, and death. Management of seizure control is essential for survival and prognosis of intoxicated patients. This study assessed whether seizure time was an independent predictor mortality in patients with endosulfan poisoning. Methods: This retrospective study enrolled patients with endosulfan poisoning presenting to Masan Samsung Hospital and Gyeongsang National University Hospital from January 2003 to December 2008. The data were collected from clinical records and laboratory files. Using a multivariate logistic analysis, data on the total population was retrospectively analyzed for association with mortality. Results: Of the 24 patients with endosulfan poisoning, nineteen (79.1%) experienced seizure. The patients in the seizure group showed significantly lower Glasgow coma scale score, base excess, bicarbonate, and significant existence of mechanical ventilation, as compared to the non seizure group (n=5). Seizure, Glasgow coma scale score, systolic blood pressure, bicarbonate level, need for respiratory support, pulse rate, respiratory rate, pH, base excess, and seizure time were associated with mortality. The fatality rate of endosulfan poisoning was 54.1% with higher mortality among patients experiencing. Longer seizure time was associated with higher mortality. Conclusion: Seizure time can be a significant independent predictor of mortality in patients with acute endosulfan poisoning. Physicians should aggressively treat for seizure control in patients with acute endosulfan poisoning.

• Clinical and Experimental Pediatrics
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• 제55권10호
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• pp.383-387
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• 2012

Purpose: Although benign rolandic epilepsy (BRE) is a benign condition, it may be associated with a spectrum of behavioral, psychiatric, and cognitive disorders. This study aimed to assess the cognitive and other neuropsychological profiles of children with BRE. Methods: In total, 23 children with BRE were consecutively recruited. All children underwent sleep electroencephalography (EEG) and were assessed on a battery of comprehensive neuropsychological tests including the Korean versions of the Wechsler intelligence scale for children III, frontal executive neuropsychological test, rey complex figure test, Wisconsin card sorting test, attention deficit diagnostic scale, and child behavior checklist scale. Results: The study subjects included 13 boys and 10 girls aged $9.0{\pm}1.6$ years. Our subjects showed an average monthly seizure frequency of $0.9{\pm}0.7$, and a majority of them had focal seizures (70%). The spike index (frequency/min) was $4.1{\pm}5.3$ (right) and $13.1{\pm}15.9$ (left). Of the 23 subjects, 9 showed frequent spikes (>10/min) on the EEG. The subjects had normal cognitive and frontal executive functions, memory, and other neuropsychological sub-domain scores, even though 8 children (35%) showed some evidence of learning difficulties, attention deficits, and aggressive behavior. Conclusion: Our data have limited predictive value; however, these data demonstrate that although BRE appears to be benign at the onset, children with BRE might develop cognitive, behavioral, and other psychiatric disorders during the active phase of epilepsy, and these problems may even outlast the BRE. Therefore, we recommend scrupulous follow-up for children with BRE.

• 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.

• 융합정보논문지
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• 제10권7호
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• pp.223-231
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• 2020

노인 운전자는 기능저하로 인해 사고 위험성이 증가하지만 스스로 변화를 점검하는 자가-조절 능력 또한 발달한다. 이에 실제 노인 운전자가 운전 능력과 위험성 변화에 대응하는 특성에 대한 정보는 노인의 운전 능력 평가 현장과 연구에 의미있는 근거를 제공할 수 있다. 따라서 본 연구의 목적은 한국 노인 운전자의 운전 위험성 자각 특성을 운전 중 행동과 운전관련 기능변화의 측면에서 분석하여 노인 운전자 평가를 위한 기초 자료를 제공하는 것이다. 지역사회에 거주하는 노인 운전자 500명을 대상으로 자가-보고식 평가를 실시하고 노인 운전자의 운전 위험성 자각 징후를 분석하였다. 그 결과 다수의 노인 운전자가 시각 및 청각이 저하되거나 운전 여건 변화에 적응하는데 어려움을 느낄 때 운전 위험성을 자각하는 특성이 있음을 확인하였다. 반면, 약물 복용이나 간질, 발작, 의식손실 등 의학적 건강 상태 변화에는 둔감하게 반응하는 특성이 확인되었다. 본 연구 결과가 고령화가 가속화되는 한국의 노인 운전자 안전 관리에 기여할 수 있기를 기대한다.

• 한국융합학회논문지
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• 제7권2호
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• pp.53-59
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• 2016

뇌전증은 뇌신경세포의 과흥분으로 인한 발작증상을 동반하는 질환이며, 최근 대단위 환자유전체 정보기술의 발달로 인해 뇌전증 발병의 원인으로서 유전자적 요인이 밝혀지고 있다. 본 연구에서는 지적장애 및 뇌전증 증상을 가지는 Miles-Carpenter syndrome (MCS)의 원인유전자에 대한 녹아웃동물을 활용하여 뇌전증 연구모델로 개발하고자 하였다. MCS 녹아웃 제브라피쉬는 억제성 GABA신경세포의 결손으로 인하여 비정상적으로 과다하게 움직이는 표현형을 나타내며, 이는 뇌전증 환자에서 보여지는 발작증상과 매우 유사한 것으로 판명되고 있다. 뇌전증 연구모델로 개발하기 위해, 기존에 알려진 뇌전증 치료제인 레티가빈을 MCS 녹아웃 제브라피쉬에 처리하여 약효를 평가하였으며 증상이 완화되는 것을 확인하였다. 이상의 결과들을 바탕으로 MCS 녹아웃동물이 향후 뇌전증 기전연구를 위한 동물모델로서의 융합적인 활용이 기대된다.

• Tuberculosis and Respiratory Diseases
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• 제64권5호
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• pp.369-373
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• 2008

결절성경화증은 유전성 신경피부 증후군으로 피부, 뇌, 신장 등의 여러 장기에 과오종을 형성하는 질환이다. 결절성경화증의 폐 침범은 드물지만 다발성 미세결절의 소견을 보이는 경우, 정확한 진단을 위해서는 고해상 흉부 전산화 단층 촬영 및 조직 검사가 필요하겠으며, 다발성 미세결절폐세포증식증을 감별 진단으로 고려해야 할 것이다. 이 질환의 임상적 의의 등 아직 알려진 것이 많지 않으나 현재까지의 보고로는 특별한 치료는 없으며 예후는 좋은 것으로 알려져 있다.

• BMB Reports
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• 제35권2호
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• pp.213-219
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• 2002

Malonyl-CoA decarboxylase (E.C.4.1.1.9) catalyzes the conversion of malonyl-CoA to acetyl-CoA. Although the metabolic role of this enzyme has not been fully defined, it has been reported that its deficiency is associated with mild mental retardation, seizures, hypotonia, cadiomyopathy, developmental delay, vomiting, hypoglycemia, metabolic acidosis, and malonic aciduria. Here, we isolated a cDNA clone for malonyl CoA decarboxylase from a rat brain cDNA library, expressed it in E. coli, and characterized its biochemical properties. The full-length cDNA contained a single open-reading frame that encoded 491 amino acid residues with a calculated molecular weight of 54, 762 Da. Its deduced amino acid sequence revealed a 65.6% identity to that from the goose uropigial gland. The sequence of the first 38 amino acids represents a putative mitochondrial targeting sequence, and the last 3 amino acid sequences (SKL) represent peroxisomal targeting ones. The expression of malonyl CoA decarboxylase was observed over a wide range of tissues as a single transcript of 2.0 kb in size. The recombinant protein that was expressed in E. coli was used to characterize the biochemical properties, which showed a typical Michaelis-Menten substrate saturation pattern. The $K_m$ and $V_{max}$ were calculated to be $68\;{\mu}M$ and $42.6\;{\mu}mol/min/mg$, respectively.

• International Journal of Oral Biology
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• 제31권2호
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• pp.33-43
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• 2006

Dysplasia-associated seizure disorders are markedly resistant to pharmacological intervention. Relatively little research has been conducted studying the effects of antiepileptic drugs(AEDs)on seizure activity in a rat model of dysplasia. We have used rats exposed to methylazoxymethanol acetate(MAM) in utero, an animal model featuring nodular heterotopia, to investigate the effects of AEDs in the dysplastic brain. Pilocarpine was used to induce acute seizure in MAM-exposed and age-matched vehicle-injected control animals. Field potential recordings were used to monitor amplitude and numbers of population spikes, and paired pulse inhibition in response to stimulation of commissural pathway. Two commonly used AEDs were tested: diazepam 5, 2.5 mg/kg; phenytoin 40, 60 mg/kg. Diazepam(DZP) and phenytoin(PHT) reduced the amplitude of population spike in control and MAM-exposed rats. However, the amplitude of population spike was nearly eliminated in control rats as compared to the MAM-exposed rats. Pharmaco-resistance was tested by measuring seizure latencies in awake rats after pilocarpine administration(320 mg/kg, i.p.) with and without pretreatment with AEDs. Pre-treatment with PHT 60 mg prolonged seizure latency in control rats, but not in MAM-exposed animals. The main findings of this study are that acute seizures initiated in MAM-exposed rats are relatively resistant to standard AEDs assessed in vivo. These data suggest that animal model with cortical dysplasia can be used to screen the effects of potential AEDs.

• Archives of Pharmacal Research
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• 제26권6호
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• pp.487-492
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• 2003

This study investigated the effects of extremely low frequency magnetic fields (ELF-MFs) on the sensitivity of seizure response to bicuculline, picrotoxin and NMDA in mice. The mice were exposed to either a sham or 20 G ELF-MFs for 24 hours. Convulsants were then administered i.p. at various doses. The seizure induction time and duration were measured and lethal dose ($LD_{50$}) and convulsant dose ($CD_{50}$) of the clonic and tonic convulsion were calculated. The analysis of glutamate, glycine, taurine and GABA of mouse brain was accomplished by HPLC. The mice exposed to ELF-MFs showed moderately higher $CD_{50}.{\;}LD_{50}$ and onset time on the bicuculline-induced seizure. However, the ELF-MFs did not influence them in the NMDA and picrotoxin-induced seizures. After the exposure to MFs exposure, the glutamate level was increased and GABA was decreased significantly in NMDA and picrotoxin-induced seizure. The level of glutamate and GABA were not changed by MFs in bicuculline-induced seizure. These results suggest that ELF-MFs may alter the convulsion susceptibility through GABAergic mechanism with the involvement of the level of glutamate and GABA.

• Childhood Kidney Diseases
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• 제17권2호
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• pp.132-136
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• 2013

Parainfluenza virus 감염은 횡문근융해증의 하나의 원인이 될 수 있다. 횡문근융해증은 지속된 금식기간동안 미토콘드리아 지방산 ${\beta}$-oxidation 장애에 의해 악화될 수 있다. 또한 후기 발생 isovaleric 산증을 가진 환아들에게서 고암모니아혈증이 이화작용을 일으키는 상태 후 발생할 수 있다. 본 케이스는 parainfluenza virus 감염과 후기 발생 isovaleric 산증을 가진 4세 남아가 혼수, 경련 및 심호흡 부전으로 빠르게 진행했던 경우이다. 초기 암모니아와 creatinine kinase는 각각 $385{\mu}Mol/L$과 23,707 IU/L 이었으나 지속적 신대체요법 시행 후 암모니아와 creatinine kinase 수치는 정상으로 돌아왔다. 그러므로 생명을 위협하는 횡문근융해증과 고암모니아혈증을 가진 환아들의 치료에 있어서 즉각적인 지속적 신대체요법의 사용을 권하는 바이다.