• Journal of Korean Neurosurgical Society
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• 제30권11호
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• pp.1300-1307
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• 2001

Purposes : This study reports the possible causes of seizure recurrence in patients underwent previous epilepsy surgery, and surgical strategy for resection of the additional epileptogenic zone locating at the distant area to the site of first resection. Methods : A total of 10 patients with previous surgery due to intractable epilepsy were studied. Five of these underwent standard temporal lobectomy, four extratemporal resection, and one corticoamygdalectomy. Seizure outcome of these were class III-IV. Evaluation methods for reoperation included MRI, 3D-surface rendering of MRI, PET, prologned video-EEG recording with surface electrodes and subdural grid electrodes. Additional resection was done in the frontal lobe in two, in the temporal lobe in three, in the parietal lobe in two, and in the supplementary sensori-motor area in two. Tumor in the superior frontal gyrus in the left hemisphere was removed in one patient. Extent of resection was decided based on the results of ictal subdural grid EEGs and MRI findings. Awake anesthesia and electrocortical stimulation were performed in the two patients for defining the eloquent area. Results : Histopathologic findings revealed extratemporal cortical dysplasia in six, hippocampal sclerosis and cortical dysplasia of the temporal neocortex in one, neuronal gliosis in two, and meningioma in one. Previous pathology of the five patients with cortical dysplasia in the second operation was hippocampal sclerosis plus cortical dysplasia of the temporal neocortex. After reoperation, seizure outcomes were class I in six, class II in three, class III in one at the mean follow-up period of 17.5 months. Characteristically, patients in class II-III after reoperation showed histopathologic findings of hippocampal sclerosis plus temporal neocortical cortical dysplasia plus extratemporal cortical dysplasia. Conclusions : Seizure recurrence after epilepsy surgery was related with the presence of an additional epileptogenic zone distant to the site of first operation, and the majority of the histopathology of the surgical specimens was cortical dysplasia. In particular, hippocampal sclerosis plus temporal neocortical cortical dysplasia was highly related with seizure recurrence in patients with previous operation. In these patients, multimodal evaluation methods were necessary in defining the additional epileptogenic zone.

• Journal of Korean Neurosurgical Society
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• 제29권2호
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• pp.222-230
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• 2000

Purpose : Resection of the epileptogenic zone in the parietal and occipital lobes may be relevant although only few studies have been reported. Methods : Eight patients with parietal epilepsy and nine patients with occipital epilepsy were included for this study. Preoperatively, all had video-EEG monitoring with extracranial electrodes, MRI, 3D-surface rendering of MRI using Allegro(ISG Technologies Inc., Toronto, Canada), and PET scans. Sixteen patients underwent invasive recording with subdural grid. Eight had parietal resection including the sensory cortex in two. Seven had partial occipital resection. Two underwent total unilateral occipital lobectomy. The extent of the resection was made based mainly on the data of invasive EEG recordings, MRI, and 3D-surface rendering of MRI, not on the intraoperative electrocorticographic findings as usually done. During resection, electrocortical stimulation was performed on the motor cortex and speech area. Results : Out of eight patients with parietal epilepsy, three had sensory aura, two had gustatory aura, and two had visual aura. Six of nine patients with occipital epilepsy had visual auras. All had complex partial seizures with lateralizing signs in 15 patients. Four had quadrantopsia. One had mild right hemiparesis. Abnormality in MRI was noticed in six out of eight parietal epilepsy and in eight out of nine occipital epilepsy. 3D-surface rendering of MRI visualized volumetric abnormality with geometric spatial relationships adjacent to the normal brain, in all of parietal and occipital epilepsy. Surface EEG recording was not reliable in localizing the epileptogenic zone in any patient. The subdural grid electrodes can be implanted on the core of the structural abnormality in 3D-reconstructed brain. Ictal onset zone was localized accurately by subdural grid EEGs in 16 patients. Motor cortex in nine and sensory speech area in two were identified by electrocortical stimulation. Histopathologic findings revealed cortical dysplasia in 10 patients ; tuberous sclerosis was combined in two, hamartoma and ganglioglioma in one each, and subpial gliosis in six. Eleven patients were seizure free at follow-up of 6 months to 37 months(mean 19.7 months) after surgery. Seizures recurred in two and were unchanged in one. Six produced transient sensory loss and one developed hemiparesis and tactile agnosia. One revealed transient apraxia. Two patients with preoperative quadrantopsia developed homonymous hemianopsia. Conclusion : This study suggests that surgical treatment was relevant in parietal and occipital epilepsies with good surgical outcome, without significant neurologic sequelae. Neuroimaging studies including conventional MRI, 3Dsurface rendering of MRI were necessary in identifying the epileptogenic zone. In particular, 3D-surface rendering of MRI was very helpful in presuming the epileptogenic zone in patients with unidentifiable lesion in the conventional MRI, in planning surgical approach to lesions, and also in making a decision of the extent of the epileptogenic zone in patients with identifiable lesion in conventional MRI. Invasive EEG recording with the subdural grid electrodes helped to confirm a core of the epileptogenic zone which was revealed in 3D-surface rendered brain.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2004년도 제29회 추계학술대회 발표논문집
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• pp.85-87
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• 2004

원격조정 아프터로딩 시스템에 사용하는 폴리에틸렌 삽입관에 금박을 입혀 라디오파(RF) 안테나로도 병행사용할수 있는 열 방사선 병용삽입관 을 제작하였다. 30W의 RF 전력으로 15분간 한천 판톰에 가열하였을 때 폴리에틸렌관은 약 5oC 상승하였으나 금박으로 코팅 된 폴리에틸렌관은 약 20${\circ}$C 상승하여 RF 안테나로 대용할 수가 있었다. 한천 팬텀 중앙부에 길이가 2 cm 인 4개의 전극을 1 cm 간격으로 정사각형이 되도록 삽입하여 가열하였을 때 90%등온곡선이 반경 1.25 cm 의 원형으로 균일하게 분포되었고 2 cm 간격으로 삽일 하였을 때 1.75 cm 반경으로 거의 4 각형의 균일한 분포를 얻었다. 개의 뇌 실질에 정방형의 중심을 43${\circ}$C로 50분간 온열 요법을 시행한 후 관찰한 조직병리학적 소견에서 의미있는 변화를 보였다.

• Toxicological Research
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• 제11권2호
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• pp.315-327
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• 1995

Diverse neurotoxic insults result in proliferation and hypertrophy of astrocytes, a subtype of glia in central nervous system. The hallmark of this response, often terms "reactive gliosis", is the enhanced expression of the major intermediate filament protein of castrocytes, glial fibrillary acidic protein (GFAP). These changes in the astrocytes suggest that GFAP may be a useful biochemical indicator of neurotoxicity. To investigate this possibility, we administered intra-peritoneally prototype nerotoxicants, metharnphetamine (MAP, 5 mg/kg), cocaine (30 mg/kg), N-buthyl benzenesulfonamide (NBBS, 300 mg/kg) and trimethytin (TMT, 8 mg/kg) to Wistar Rats and then assessed the effects of these agents on content of GFAP, which were determined by Sandwish ELISA and evaluated with neurotoxic symptoms, and quantitative changes of imrnunoreactivity of GFAP by light microscopic image analysis in specific regions. We found that assay of GFAP revealed time- and region-dependant patterns of neurotoxicity. The GFAP immunoreactivity of rat brain was increased in substantia nigra and hippocampus by MAP, NBBS and TMT; in roedial septal nucleus and nucleus accurnbens, it was also increased by RrBBS. Sandwich ELISA showed that GFAP levels of cerebrum in all groups on days 3 and 7 and that of brainstem(including cerebellum) in MAP, NBBS groups on day 1 and 3 were increased. A review of the background, design and results of these experiments are presented in this paper. Our findings indicate that GFAP is a sensitive and specific biomarker of neurotoxicity.otoxicity.

• Parasites, Hosts and Diseases
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• 제52권6호
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• pp.613-619
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• 2014

Neospora caninum (Apicomplexa; Sarcocystidae) is a protozoan that causes abortion in cattle, horses, sheep, and dogs as well as neurological and dermatological diseases in dogs. In the central nervous system of dogs infected with N. caninum, cysts were detected that exhibited gliosis and meningitis. Flavonoids are polyphenolic compounds that exhibit antibacterial, antiparasitic, antifungal, and antiviral properties. In this study, we investigated the effects of flavonoids in a well-established in vitro model of N. caninum infection in glial cell cultures. Glial cells were treated individually with 10 different flavonoids, and a subset of cultures was also infected with the NC-1 strain of N. caninum. All of the flavonoids tested induced an increase in the metabolism of glial cells and many of them increased nitrite levels in cultures infected with NC-1 compared to controls and uninfected cultures. Among the flavonoids tested, 3',4'-dihydroxyflavone, 3',4',5,7-tetrahydroxyflavone (luteolin), and 3,3',4',5,6-pentahydroxyflavone (quercetin), also inhibited parasitophorous vacuole formation. Taken together, our findings show that flavonoids modulate glial cell responses, increase NO secretion, and interfere with N. caninum infection and proliferation.

• Pediatric Infection and Vaccine
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• 제20권3호
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• pp.123-130
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• 2013

목적: 아급성경화범뇌염은 퇴행성 신경질환으로 홍역바이러스의 지속적 중추신경계 감염으로 나타난다. 저자들은 마우스 모델을 통해 아급성경화범뇌염 발병에서 만성 바이러스 감염에 관여하는 PD-1 유전자의 역할을 알아보고자 하였다. 방법: 3주령의 동형 PD-1 유전자 제거 마우스, 이형 PD-1 유전자 제거 마우스, 야생 BALB/c 마우스를 대상으로 측뇌실내 홍역바이러스를 주입하여 동물 모델로 하였다. 바이러스 주입 3개월 후, 마우스의 뇌 조직학적 소견을 관찰하고 혈청을 분리하여 IL-21의 혈청 농도를 ELISA kit을 통해 측정하였다. 결과: 야생 BALB/c 마우스에서 가장 많은 국소적 뇌백질의 괴사 및 성상세포의 증가가 관찰되었다. 이형 마우스에서 뇌실질의 병변은 적었으며 동형 마우스는 거의 보이지 않았다. 세 그룹에서 모두 혈청 IL-21의 증가는 보이지 않았다. 결론: 이 결과는 PD-1 유전자가 만성 바이러스 감염에 중요한 역할을 함을 시사한다.

• 대한한방내과학회지
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• 제29권3호
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• pp.629-640
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• 2008

Objective : The purpose of this study was to investigate the neuroprotective effect of Jukryuk on 4-vessel occlusion(4-VO) and middle cerebral artery (MCA) ischemia. Method : After administration of Jukryuk, we compared the Jukryuk-treated group, the control, and the sham groups, in view of several points as follows 1) We evaluated the damage characterized by coagulative cell change of pyramidal neurons and pronounced gliosis in each group 2) We counted the number of normal pyramidal shapes after ischemia in each group 3) Immunohistochemistry (cyclooxygenase-2) 4) In focal ischemic injury model, we measured the volume of ischemic area Results : In this experiment, the effect of Jukryuk was determined to be protecting neuron cell shape, reducing the number of neuron cells damaged by ischemia and the volume of the ischemic area. In immunohistochemistry, Jukryuk reduced cyclooxygenase-2 expression Conclusions : According to this study, Jukryuk can protect neuron cells from injury by cerebrovascular ischemia.

• 대한수의학회지
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• 제33권2호
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• pp.295-300
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• 1993

홍역이환개의 중추신경계에서 발생한 수초탈락을 수반하는 뇌척수염을 병리조직학적으로 관찰하고 조직반응과 수축탈락의 과정을 알아보기 위하여 중추신경계 조직을 파라핀 포매, 절편을 만들고 병소가 빈발하는 소뇌와 시신경로는 수초의 주요 구성단백인 MBP와 MAG 그리고 별아교세포의 Marker인 GFAP의 항혈청을 반응시켜 면역세포학적으로 관찰하였다. 조직학적으로는 대뇌에서 신경세포의 일부괴사, 신경아교세포의 결절형성, 소뇌에서는 4뇌실에 인접하여 백질부에서 수초의 공포변성, 수초탈락과 염증세포의 침윤이 현저하였고 피질부의 과립층에 인접한 부위와 시신경로에서도 수초탈락이 인정되었다. MBP와 MAG를 면역반응시킨 결과 수초의 공포화와 수초탈락이 현저한 부위에서는 MBP와 MAG가 동시에 소실되었고 부위에 따라서는 MBP또는 MAG가 먼저 소실되기도 하였다. 동시에 별아교세포의 반응은 수초탈락 초기에는 GFAP양성의 섬유와 세포가 크게 증가한 반면 수초탈락이 심하게 진행된 부위에서는 오히려 소실되는 경향이었다. 따라서 홍역이환 개에서 발생되는 수초탈락은 일차적으로 수초가 공격을 받아 파괴됨을 알 수 있었고 동시에 부위에 따라 다른 소견을 요인별로 비교하였다.

• Journal of Genetic Medicine
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• 제4권1호
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• pp.22-37
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• 2007

The autosomal dominant spinocerebellar ataxias (SCAs) are a group of neurodegenerative diseases, clinically and genetically heterogeneous, characterized by degeneration of spinocerebellar pathways with variable involvement of other neural systems. At present, 27 distinct genetic forms of SCAs are known: SCA1-8, SCA10-21, SCA23, SCA25-28, DRPLA (dentatorubral-pallidoluysian atrophy), and 16q-liked ADCA (autosomal dominant cerebellar ataxia). Epidemiological data about the prevalence of SCAs are restricted to a few studies of isolated geographical regions, and most do not reflect the real occurrence of the disease. In general a prevalence of about 0.3-2 cases per 100,000 people is assumed. As SCA are highly heterogeneous, the prevalence of specific subtypes varies between different ethnic and continental populations. Most recent data suggest that SCA3 is the commonest subtype worldwide; SCA1, SCA2, SCA6, SCA7, and SCA8 have a prevalence of over 2%, and the remaining SCAs are thought to be rare (prevalence <1%). In this review, we highlight and discuss the SCA7. The hallmark of SCA7 is the association of hereditary ataxia and visual loss caused by pigmentary macular degeneration. Visual failure is progressive, bilateral and symmetrical, and leads irreversibly to blindness. This association represents a distinct disease entity classified as autosomal dominant cerebellar ataxia (ADCA) type II by Harding. The disease affectsprimarily the cerebellum and the retina by the moderate to severe neuronal loss and gliosis, but also many other central nervous system structures as the disease progresses. SCA7 is caused by expansion of an unstable trinucleotide CAG repeat in the ATXN7 gene encoding a polyglutamine (polyQ) tract in the corresponding protein, ataxin-7. Normal ATXN7 alleles contain 4-35 CAG repeats, whereas pathological alleles contain from 36->450 CAG repeats. Immunoblott analysis demonstrated that ataxin-7 is widely expressed but that expression levels vary among tissues. Instability of expanded repeats is more pronounced in SCA7 than in other SCA subtypes and can cause substantial lowering of age at onset in successive generations termed ‘anticipation’ so that children may become diseased even before their parents develop symptoms. The strong anticipation in SCA7 and the rarity of contractions should have led to its extinction within a few generations. There is no specific drug therapy for this neurodegenerative disorder. Currently, therapy remains purely symptomatic. Cellular models and SCA7 transgenic mice have been generated which constitute valuable resources for studying the disease mechanism. Understanding the pathogenetic mechanisms of neurodegeneration in SCAs should lead to the identification of potential therapeutic targets and ultimately facilitate drug discovery. Here we summarize the clinical, pathological, and genetic aspects of SCA7, and review the current understanding of the pathogenesis of this disorder. Further, we also review the potential therapeutic strategies that are currently being explored in polyglutamine diseases.

• Radiation Oncology Journal
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• 제9권1호
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• pp.27-35
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• 1991

8MHz 라디오파를 이용한 자입식 온열치료를 위한 기초실험의 일환으로 조직등가물을 이용하여 다양한 needle electrode의 배열을 통한 적정 온도분포를 규명하고자 하였고, 직접 개의 뇌실질에 자입 온열요법을 시도하여 이에 따른 조직 병리학적 소견을 관찰하고자 하였다. 조직등가물 실침에서 저자들은 needle electrode 1 cm 간격의 정방형 배치에서 횡단면상 $90\%$ relative SAR 분포가 약 1.25 cm 반경의 균일한 원형으로 관찰됨을 알 수 있었고 종단면상 needle electrode의 길이에 따라 균일한 온도분포가 이루어짐을 관찰할 수 있었다. 정상 개의 뇌실질에 자입하여 직접 정방형의 중심을 $43^{\circ}C$로 유지하며 50분간 온열요법을 시행한 후 관찰한 조직 병리학적 소견은 liquefactive necrosis, pyknosis of neuronal element 및 Polymorphonuclear leukocytes들이 회백질에서 급성기에 관찰 되었고 liquefactive necrosis 주위에 lipid-laden macrophage들이 관찰됨이 공통적인 특징 이었으며 후기 변화로 괴사조직 주위로 신경교세포의 증식이 관찰되었다.