• 생명과학회지
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• 제23권12호
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• pp.1532-1540
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• 2013

Tbr2는 T-box family 전사인자의 하나로써 뇌의 발달, 전구세포의 증식, 그리고 CD8+ T 세포와 자연살상세포의 분화와 기능에 중요한 역할을 하는 것으로 알려져 있다. 본 연구는 마우스에서 pilocarpine을 이용하여 경련중첩증을 유도한 후 나타나는 병리기전에 Tbr2의 연관성을 확인하였다. 경련중첩증은 해마의 CA3, hilus 그리고 조롱박피질 등에서 뚜렷한 신경세포의 손상을 유발하였다. 흥미롭게도 Tbr2를 이용한 조직 염색에서 경련중첩증 2일 후에 CA3와 조롱박피질에서 면역반응성이 뚜렷하게 증가하는 것을 관찰하였다. 또한 CA3와 조롱박피질에서 Tbr2를 발현하는 세포는 미세아교세포와 단핵구, CD8+ T세포 또는 자연살상세포 등 백혈구의 표지물질인 CD11b 와 이중염색되는 것을 발견하였다. Tbr2와 CD11b에 동시에 염색된 세포는 아메바 모양의 형태를 갖추고 있는 것을 발견하였다. 게다가 혈관 내피세포에서 발혈되는 platelet endothelial cell adhesion molecule-1(PECAM-1)과 이중 염색한 결과 Tbr2를 발현하는 세포가 CA3 지역의 혈관내에 다량 존재하는 것을 확인하였다. 이상의 결과를 종합할 때 Tbr2를 발현하는 세포는 뇌 조직으로 이주하는 백혈구일 가능성이 높음을 보여준다. 이러한 결과는 경련중첩증에 따른 신경병리기전에 Tbr2가 관여할 가능성이 높음을 처음으로 제시하였다.

• BMB Reports
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• 제45권11호
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• pp.635-640
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• 2012

To understand the effects of HCN as potential mediators in the pathogenesis of epilepsy that evoke long-term impaired excitability; the present study was designed to elucidate whether the alterations of HCN expression induced by status epilepticus (SE) is responsible for epileptogenesis. Although HCN1 immunoreactivity was observed in the hippocampus, its immunoreactivities were enhanced at 12 hrs following SE. Although, HCN1 immunoreactivities were reduced in all the hippocampi at 2 weeks, a re-increase in the expression at 2-3 months following SE was observed. In contrast to HCN1, HCN 4 expressions were un-changed, although HCN2 immunoreactive neurons exhibited some changes following SE. Taken together, our findings suggest that altered expressions of HCN1 following SE may be mainly involved in the imbalances of neurotransmissions to hippocampal circuits; thus, it is proposed that HCN1 may play an important role in the epileptogenic period as a compensatory response.

• BMB Reports
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• 제48권9호
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• pp.507-512
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• 2015

In the present study, we addressed the question of whether treatment with mannitol, an osmotic diuretic, affects astrogliovascular responses to status epilepticus (SE). In saline-treated animals, astrocytes exhibited reactive astrogliosis in the CA1-3 regions 2-4 days after SE. In the mannitol-treated animals, a large astroglial empty zone was observed in the CA1 region 2 days after SE. This astroglial loss was unrelated to vasogenic edema formation. There was no difference in SE-induced neuronal loss between saline- and mannitol-treated animals. Furthermore, mannitol treatment did not affect astroglial loss and vasogenic edema formation in the dentate gyrus and the piriform cortex. These findings suggest that mannitol treatment induces selective astroglial loss in the CA1 region independent of vasogenic edema formation following SE. These findings support the hypothesis that the susceptibility of astrocytes to SE is most likely due to the distinctive heterogeneity of astrocytes independent of hemodynamics. [BMB Reports 2015; 48(9): 507-512]

• Investigative Magnetic Resonance Imaging
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• 제7권1호
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• pp.56-60
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• 2003

저자들은 2명의 경련 중첩증 환자들의 확산강조 자기공명영상을 보고하고자 한다. 확산강조 영상은 대뇌 반구에서 세포독성 부종을 시사하는 현성확산계수의 감소가 동반된 국소적 또는 미만성 고신호강도를 보였다. 이러한 고신호강도는 한 환자에서는 양측 측두두정후두엽과 도피질, 다른환자에서는 편측성 측두엽에서 나타났다.

• Clinical and Experimental Pediatrics
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• 제49권10호
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• pp.1086-1092
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• 2006

목 적 : RSE는 드물지 않으며 사망률이 높고 신경학적 후유증을 많이 남길 수 있는 중증 질환이다. 본 연구는 소아 난치성 간질 중첩증에서 뇌척수액 백혈구 증가증이 임상적으로 어떤 의미를 가지는지 알아보기 위해 시행하였다. 방 법 : 1999년 1월부터 2006년 1월까지 경북대학교 병원 소아과에 난치성 간질 중첩증을 주소로 입원한 37명의 환아 중에서 뇌척수액 검사를 시행한 25명의 환아를 대상으로 의무기록을 토대로 후향적 조사하였고 뇌척수액 백혈구 증가증이 있는 군과 없는 군을 나누어 비교하고, RSE가 간질의 첫 증상이었던 환아와 이전에 간질로 치료 받고 있던 환아 군을 나누어 비교하였다. 결 과 : 25명의 환아 중 6명에서 뇌척수액 백혈구 증가증이 있었고, 뇌척수액 백혈구 증가증이 없는 군에서 사망률과 필요약물 투여량에 유의한 차이가 없었다. 치료 후 경과는 뇌척수액 백혈구 증가증이 있는 군의 생존자가 더 심한 후유증이 남은 것으로 보이나 중추신경계 감염이 원인인 환아들을 제외하면 두군에서 치료 후 경과에 큰 차이가 없었다. 뇌척수액 백혈구 증가증이 있는 환아 들은 모두 처음 경련이 발생한 환아 들이었다. 결 론 : RSE로 진행한 경련 환아들 중에서 감염의 증거가 있을 경우는 뇌척수액 검사가 빠른 시간 안에 시행되어 중추신경계 감염 등의 원인 질환이 밝혀져야 하겠으나, 감염의 가능성이 적은 경우는 뇌척수액 검사 시기를 신중이 결정하는 것이 바람직하다고 생각된다. 그리고 경한 뇌척수액 백혈구 증가증은 예후에 특정한 영향을 주지 않으므로 감염이 의심되지 않는 경우에는 항생제, 항바이러스제 등의 사용에 신중을 기해야 한다고 생각한다.

• 대한중풍순환신경학회지
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• 제23권1호
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• pp.55-64
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• 2022

Nonconvulsive Status Epilepticus(NCSE) refers to continuous epileptic condition with altered mental status and behavioral symptoms, but without convulsive movement at least 10 minutes. In Salzburg criteria, well known as the diagnostic criteria of NCSE, it is diagnosed with clinical symptoms, electroencephalogram (EEG), and effects before and after the use of antiepileptic drugs (AEDs). Commonly being used to treat NCSE, AEDs are likely to have adverse effects. In the present case, a 85-year-old female NCSE patient complaining delirium underwent combined Korean medical treatment by acupuncture and herbal medicine for 13 days. The effect of treatment was assessed with delirium scales including Delirium Rating Scale-Revised-98(DRS-R-98) and Assessment Test for Delirium & Cognitive Impairment(4AT) per 2 days. After the treatment, both DRS-R-98 and 4AT scores decreased, and orientation and mental status of patient improved. This case report suggests that Korean medical treatment might be an effective option without side for those NCSE patients complaining delirium.

• Journal of Ginseng Research
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• 제31권3호
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• pp.159-174
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• 2007

Pharmacology of Korean Red ginseng gives us unique possibility to develop new class of antiepileptic drugs today and to improve one's biological activity. The chemical structures of ginsenosides (GS) have some principal differences from well-known antiepileptic new generation drugs. The antiepileptic effect of GS was also demonstrated in all models of epilepsy in rats (young and adult), which have studied, in all models of epilepsy including status epilepticus (SE), induced by lithium - pilocarpine. In our experiments in rats new evidences on protective effects were exerted as a result of premedication by GS. Pre-treatment of several GS could induce decrease of the seizures severity and brain structural damage (by MRI), neuronal degeneration in hippocampus. Wave nature of severity of motor seizures during convulsive SE was observed during lithium-pilocarpine model of SE in rats (the first increase of seizures was 30 min after the beginning of SE and the second - 90 min after. The efficacy of treatment on SE by ginsenoside as expected was observed after no less 3 weeks by daily GS i.p. administration. It is blocked SE or significantly decrease the severity of seizures during SE. The implication of presented data is that combination of ginsenosides from Korean Red ginseng and ginseng cell culture Dan25 that could be applied for prevention of epileptical status development. However, a development of optimal ratio of different ginsenosides $(Rb_1$ Rc, Rg, Rf,) should consummate in the new antiepileptic drug development.

• Annals of Clinical Neurophysiology
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• 제13권1호
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• pp.21-25
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• 2011

Periodic lateralized epileptiform discharges (PLEDs) had been debated whether it is ictal or non-ictal phenomenon. As most of PLEDs occur in patients with acute structural lesions, some epileptologists prefer PLEDS as a non-ictal phenomenon, rather an obscure epiphenomenon of etiological diseases. But, almost half of the patients with PLEDs do not have acute structural lesions in the brain and metabolic disorders or old CNS lesions may cause PLEDs and even more, no brain lesion was identified in some patients. There are many data supporting PLEDs as ictal phenomena. Occurrence of PLEDs usually accompanied by decreased mentality and is improved as PLEDs disappeared. Current SPECT study showed marked hyperperfusion in the lesion side of PLEDs, that is striking evidence of PLEDs as ictal phenomena. Also careful review of EEG with PLEDs revealed it is a dynamic process rather than a static state. Despite of these evidences, as PLEDs are an end-stage of animal status epilepticus models, it may be a transition of ictal to interictal state.

• 대한임상독성학회지
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• 제1권1호
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• pp.47-50
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• 2003

Endosulfan, one of organochlorine insecticides, is $\gamma$-aminobutyric acid (GABA) antagonist. In sufficient dose, this pesticide lower the seizure threshold and produce CNS stimulation, with resultant seizures, respiratory failure, and death. In patients with endosulfan intoxication, the first manifestation of toxicity is largely a generalized seizure without prodromal signs or symptoms. So the management of airway and seizure control are essential for survival and prognosis of intoxicated patients. We report two cases of acute endosulfan poisoning who manifest 'status epilepticus' similarly, but have different prognosis.

• Journal of Korean Neurosurgical Society
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• 제49권2호
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• pp.124-127
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• 2011

A 43-year-old male presenting with headache and dizziness underwent craniotomy and gross total resection of an extraaxial tumor was achieved via left occipital interhemispheric approach. The tumor was diagnosed as papillary meningioma arising from the left falcotentorium with such pathologic characteristics of bronchoalveolar adenocarcinoma. At postoperative day 40, he developed generalized tonic clonic seizure and then progressed to a status epilepticus pattern. Brain magnetic resonance imaging showed irregular leptomeningeal enhancement with a significant peritumoral area. Through a cerebrospinal fluid (CSF) study, we identified the meningioma cells of the papillary type from the CSF. At the postoperative day 60, he fell into semicomatose state, and the computed tomography imaging showed low density on both cerebral hemispheres, except the basal ganglia and cerebellum, with overall brain swelling and an increased intracranial pressure. He died on the following day. We experienced a rare case of a papillary meningioma with leptomeningeal seeding.