• Title/Summary/Keyword: 뇌 손상

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Smartphone Fundus Photography in an Infant with Abusive Head Trauma (학대뇌손상 영아에서 스마트폰으로 촬영한 안저소견)

  • Kim, Yong Hyun;Choi, Shin Young;Lee, Ji Sook;Yoon, Soo Han;Chung, Seung Ah
    • Journal of The Korean Ophthalmological Society
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    • v.58 no.11
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    • pp.1313-1316
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    • 2017
  • Purpose: To report fundus photography using a smartphone in an infant with abusive head trauma. Case summary: An 8-month-old male infant presented to the emergency room with decreased consciousness and epileptic seizures that the parents attributed to a fall from a chair. He had no external wounds or fractures to the skull or elsewhere. However, computerized tomography of the brain revealed an acute subdural hematoma in the right cranial convexity and diffuse cerebral edema, leading to a midline shift to the left and effacement of the right lateral ventricle and basal cistern. The attending neurosurgeon promptly administered a decompressive craniectomy. Immediately after the emergency surgery, a fundus examination revealed numerous multi-layered retinal hemorrhages in the posterior pole extending to the periphery in each eye. He also had white retinal ridges with cherry hemorrhages in both eyes. We acquired retinal photographs using the native camera of a smartphone in video mode. The photographer held the smartphone with one hand, facing the patient's eye at 15-20 cm, and held a 20 diopter condensing lens at 5 cm from the eye in the other hand. Our documentation using a smartphone led to a diagnosis of abusive head trauma and to obtain the criminal's confession, because the findings were specific for repetitive acceleration-deceleration forces to an infant's eye with a strong vitreoretinal attachment. Conclusions: This ophthalmic finding had a key role in the diagnosis of abusive head trauma. This case presented the diagnostic use of a smartphone for fundus photography in this important medicolegal case.

An Application of Constraint-Induced Therapy in Patients With Chronic Hemiparesis After Brain Injury (뇌 손상 후 편부전마비 환자에서의 억제-유도 치료의 적용)

  • Park, Ji-Won;Kim, Jong-Man;Kim, Yun-Hee
    • Physical Therapy Korea
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    • v.8 no.4
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    • pp.91-99
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    • 2001
  • 뇌 손상 후 급성기에 기능의 자발적인 회복이 일어나지만 환자들은 환측의 상지를 잘 사용하지 못하게 된다. 그 결과 원하는 움직임을 억제하는 상황을 발생시키는데 이것을 학습 무사용 증후군(learned nonu se syndrome)이라 한다. 이러한 학습 무사용 증후군을 치료하기 위해 억제-유도 치료(constraint-induced therapy)가 고안되었다. 억제-유도 치료는 연속되는 몇 주간에 걸쳐 매일 많은 시간 동안 건측의 상지를 묶어두고 환측 상지를 사용하게 하여 기능을 반복 학습하게 함으로써 기능을 증진시키는 방법이다. 이미 여러 연구자들이 경두개 자기자극(transcranial magnetic stimulation), 움직임 관련 피질전위(movement-related cortical potential), 기능적 자기공명 영상기법(functional magnetic resonance imaging) 등을 통하여 억제-유도 치료 후 운동피질영역에서의 재조직화를 보고함으로써 기능 증진과 관련된 회복 기전을 뒷받침하고 있다. 억제-유도 치료의 영역은 확대되어 뇌졸중, 척수손상, 고관절 치환술 후로 하지에서의 기능증진을 위하여 연구가 진행되고 있으며 특히 뇌졸중 후 실어증 환자에서 새로운 방법으로 제시되고 있다. 따라서, 억제-유도 치료는 신경학적인 손상 후 움직임의 재활에 있어서 치료-유도를 통한 중추신경계의 회복에 효과적으로 작용할 수 있다.

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Neuroprotective Effect of Dizocilpine (MK-801) via Anti-apoptosis on Hypoxic-ischemic Brain Injury in Neonatal Rats

  • Seo, Min-Ae;Lee, Hyun-Ju;Choi, Eun-Jin;Kim, Jin-Kyung;Chung, Hai-Lee;Kim, Woo-Taek
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.181-192
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    • 2010
  • Purpose: Current studies have demonstrated the neuroprotective effects of dizocilpine (MK-801) in many animal models of brain injury, including hypoxic-ischemic (HI) encephlopathy, trauma and excitotoxicity, but limited data are available for those during the neonatal periods. Here we investigated whether dizocilpine can protect the developing rat brain from HI injury via anti-apoptosis. Methods: In an in vitro model, embryonic cortical neuronal cell culture of Sprague-Dawley (SD) rats at 18-day gestation was done. The cultured cells were divided into three groups: normoxia (N), hypoxia (H), and hypoxia treated with dizocilpine (HD). The N group was prepared in 5% $CO_2$ incubators and the other groups were placed in 1% $O_2$ incubators (94% N2, 5% $CO_2$) for 16 hours. In an in vivo model, left carotid artery ligation was done in 7-day-old SD rat pups. The animals were divided into six groups; hypoxia (N), hypoxia (H), hypoxia with sham-operation (HS), hypoxia with operation (HO), HO treated with vehicle (HV), and HO treated with dizocilpine (HD). Hypoxia was made by exposure to a 2 hour period of hypoxic incubator (92% N2, 8% $O_2$). Results: In the in vitvo and in vivo models, the expressions of Bcl-2 in the hypoxia groups were reduced compared to the normoxia group. whereas those in the dizocilpine-treated group were increased compared to the hypoxia group. However. the expressions of Bax and caspase-3 and the ratio of Bax/Bcl-2 were revealed reversely. Conclusion: Dizocilpine has neuroprotective property over perinatal HI brain injury via anti-apoptosis.

A Case of Alpha Wave Asymmetric Neurofeedback Training of Adolescents having Left and Right Alpha Wave Asymmetry Caused by Traumatic Brain Injury Sequela (외상성 뇌손상 후유증으로 인한 좌 우 Alpha파 비대칭성이 유발된 청소년의 Alpha파 비대칭 뉴로피드백 훈련 1례)

  • Cheong, Moon Joo;Weon, Hee Wook;Chae, Eun Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.8
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    • pp.171-180
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    • 2017
  • The purpose of this study is to determine an effective training method to improve sequela, since traumatic brain injury sequela is a major factor in determining the quality of life. Neurofeedback training was conducted for an adolescent who had experienced traumatic brain injury during his childhood and who had difficulty in cognitive learning and emotional aspects. The assessment of an adolescent was conducted using K-WAIS-IV intelligence test and QEEG brain wave analysis. In the neurofeedback training, T3 alpha wave compensation and T4 alpha wave inhibition training were performed 36 times for 30 minutes three times a week. In addition to the neurofeedback training, respiratory meditation was also made available to the adolescent. As a result, the adolescent showed a stable condition as indicated by taking a good sleep, reducing test anxiety, and satisfaction with final exam results. This study revealed the possibility for hidden physical and psychological problems arising due to childhood brain trauma. It has also recently been discovered that a more diverse set of tools can be found. In addition, these childhood traumatic brain injuries can be improved through brain training and meditation. The study finding is meaningful for its suggestion of a fusion method for developing mind and body therapy in terms of brain science.

Protective Effects of Calcium Antagonists and Vitamine E on the Ischemia-induced Neuronal Damage in Rat Brain Slices (랫트 뇌절편에서의 허혈성 신경손상에 대한 칼슘길항제와 비타민의 보호효과)

  • Kim, Yong-Sik;Yoon, Young-Ran;Park, Chan-Woong
    • The Korean Journal of Pharmacology
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    • v.29 no.1
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    • pp.9-22
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    • 1993
  • To evaluate the protective effects of calcium antagonists, oxygen radical scavengers and excitatory amino acid (EAA) antagonist on the ischemic brain damage, we induced in vitro ischemic condition (namely, lack of oxygen and glucose) to rat hippocampal slices. And the degree of ischemic damage was determined by assaying changes in biochemical parameters such as ATP content and lactate ralease, MDA production in the presence or absence of the various drugs. During experimental ischemia for up to 60 min, ATP content was decreased and the amount of lactate release was markedly increased time-dependently. By changing the reaction medium which contained oxygen and glucose those biochemical parameters were recovered. But the recovery was not complete in this experimental condition. In the same ischemic conditions verapamil and vitamine E prevented the decrease of ATP content and the increase of lactate release from the slices. And verapamil and diltiazem decreased MDA release to the reaction medium. Superoxide dismutase (SOD) and MK-801 (as EAA receptor antagonist) protected the decrease of ATP content and reduced MDA release in 20 min ischemic condition, but glutathione affected ATP content and lactate release at the same condition. When oxygen and glucose were resupplied for 20 min after ischemic condition, verapamil showed the protective effect on the changes of ATP content and lactate release, and vitamine E decreased lactate release (at 20 min ischemia) and MDA release (at 60 min ischemia). These results showed that calcium antagonist and vitamine E protect the ischemic biochemical changes from rat hippocampal slices and calcium antagonist is more potent than vitamine E to protect the ischemical brain damege.

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A study of utilizing literature for healing human's brain and mind (뇌와 마음의 치유를 위한 문학의 활용에 대한 연구)

  • Ryu, Da-Young
    • Journal of Digital Convergence
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    • v.12 no.12
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    • pp.545-552
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    • 2014
  • Most people think that our brain and mind are separate, however, they are closely connected. With this idea, we can heal the sickness of our brain and mind. People understand their lives better through the process of 'Identification-Catharsis-Insight' by reading literatures. In addition, they can speak out from their suppressed heart and take comfort when they write. Therefore, they will enjoy the self-healing effects. In this regard, we can help the people who are suffering from their brain damages or people who have wounded heart using literatures, and heal their mind.

뇌혈류 자가조절과 내인성 $K^{+}$ channel 개방물질에 대한 연구

  • 홍기완
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1993.04a
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    • pp.85-85
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    • 1993
  • 뇌동맥계는 일과성 저혈압에 반응하여 혈관확장이 야기되고, 혈압 상승시에는 혈관수축이 일어남으로서 뇌혈류가 일정하게 조절된다. 이러한 자가조절은 뇌손상 등의 병적 상태에서 야기된다. 연구의 목적은 \circled1 Cromakalim, CGRP(calcitonin-gene related peptide), 및 substance P에 의하여 뇌연막동맥의 직경이 어떻게 변동하는가를 관찰하고 \circled2 이들 신경성 peptide의 작용에 대하여 $K^{+}$ 통로 개방 봉쇄제인 glibenclamide의 전처치 효과를 검색하고 \circled3 Capsaicin 전처치가 뇌혈류 자가조절에 어떻게 영향을 미치는가를 검색하였다. 그 결과는 다음과 같다. 1. 뇌혈류 자가조절은 대퇴동맥을 통한 사혈에 의하여 혈압하강을 일으킬 때 뇌연막 동맥은 이완하였고, reservoir내의 혈액을 체내로 주입함로서 혈압반전을 일으켰을 때는 혈관 수축이 일어났다. 2. 연막동맥은 glibenclamide (1~3$\mu$M)의 관류에 의하여는 영향을 받아니하였다. 3. 혈압변동에 따른 혈관직경의 변화를 회기직선으로 분석하였다. Glibenclamide 1과 3$\mu$M의 전처치 관류에 의하여 혈압하강에 따른 혈관 이완경사도와 혈압반전에 따른 혈관수축 경사도가 대조군에 비하여 현저히 약화되었다. 4. Cromakalim (0.1-30$\mu$M)의 각 농도를 대뇌표면에 관류시 연막동맥의 기초직경은 약물농도에 의존하여 증가되었고, 이는 glibenclamide (1$\mu$M) 전처치 관류에 의하여 억제되었다. 5. CGRP (0.1~100 nM)와 substance P (0.1~10nM)도 용량에 의존하여 혈관이완을 일으켰다. 전자는 glibenclamide (1$\mu$M) 전처치 관류에 의하여 억제되었으나 후자는 영향을 받지 아니하였다. 6. Capsaicin(50 nmol: intracisternally) 주사에 의하여 뇌혈류자가조절의 변동이 초래되었다. 이상의 결과들을 종합하면 CGRP가 혈압변동에 의하여 반사적으로 유리되고, 이는 glibenclamide-sensitive $K^{+}$ 통로에 작용하는 것으로 시사된다.

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The Neuroprotective Effects of 6-cyano-7-nitroquinoxalin-2,3-dione (CNQX) Via Mediation of Nitric Oxide Synthase on Hypoxic-ischemic Brain Injury in Neonatal Rats

  • Jung, Ji-Eun;Keum, Kyung-Hae;Choi, Eun-Jin;Kim, Jin-Kyung;Chung, Hai-Lee;Kim, Woo-Taek
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.59-69
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    • 2011
  • Purpose: Current studies have demonstrated the neuroprotective effects of 6-cyano-7-nitroquinoxalin-2,3-dione (CNQX) in many animal models of brain injury, including hypoxic-ischemic (HI) encephlopathy, trauma and excitotoxicity, but limited data are available for those during the neonatal periods. Here we investigated whether CNQX can protect the developing rat brain from HI injury via mediation of nitric oxide synthase. Methods: In an in vivo model, left carotid artery ligation was done in 7-day-old Sprague-Dawley (SD) rat pups. The animals were divided into six groups; normoxia (N), hypoxia (H), hypoxia with sham-operation (HS), hypoxia with operation (HO), HO treated with vehicle (HV), and HO treated with CNQX at a dose of 10 mg/kg (HC). Hypoxia was made by exposure to a 2 hr period in the hypoxic chamber (92% $N_2$, 8% $O_2$). In an in vitro model, embryonic cortical neuronal cell culture of SD rats at 18-day gestation was done. The cultured cells were divided into three groups: normoxia (N), hypoxia (H), and hypoxia treated with CNQX (HC). The N group was prepared in 5% $CO_2$ incubators and the other groups were placed in 1% $O_2$) incubators (94% $N_2$, 5% $CO_2$) for 16 hr. Results: In the in vitvo and in vivo models, the expressions of iNOS and eNOS were reduced in the hypoxia group when compared to the normoxia group, whereas they were increased in the CNQX-treated group compared to the hypoxia group. In contrast, the expression of nNOS was showed reversely. Conclusion: CNQX has neuroprotective property over perinatal HI brain injury via mediation of nitric oxide synthase.

Development of 3D Mutil-volume Visualization System for Stereotactic Surgery (뇌정위 수술계획을 위한 다원 3차원 영상가시화 시스템의 개발)

  • Choi, Jae-Jeong;Ge, Jin;Shin, Yeong-Gil
    • Proceedings of the Korean Information Science Society Conference
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    • 1998.10c
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    • pp.612-614
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    • 1998
  • 뇌정위 수술(Stereotactic Surgery)은 컴퓨터 단층영상과 자기공명 영상 같은 3차원 영상을 이용하여 뇌병변의 위치를 입체적으로 정확히 파악하여 정상 뇌에 대한 손상을 최소화하며 병변을 수술하는 기법이다. 본 논문에서는 수술 받을 환자의 컴퓨터 단층영상과 자기공명 영상 등 다양한 종류의 3차원 볼륨 데이터를 전처리한 다음 동일한 3차원 공간 내에서 정렬시켜 선택적 또는 동시적으로 3차원 영상을 가시화 하는 기법을 제안한다. 또한 3차원 영상에서 뇌정위 수술의 삽입점과 목표점을 지정할 수 있는 기능을 지원하며 수술 경로에 따른 가상 수술의 시뮬레이션을 통하여 수술 경로의 안전성을 검증할 수 있게 하였다.

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