• Journal of Yeungnam Medical Science
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• v.5 no.2
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• pp.87-93
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• 1988

The diagnosis of OPCA could be made clinically with important aid of brain CT scanning, although the definite and conclusive diagnosis only by postmortem pathological determination. We reviewed, clinically and with brain CT examination, 12 cases of patients with OPCA who were admitted to the Yeungnam University Hospital for a recent 5 years. The result were as following. : 1. The distribution of age is from 49 to 72, mainly 50 to 60. Man is more frequent than women at the 4.5 times. 2. The interval period from Sx. onset to diagnosis is 1 year to 6 years. 3. The usual initial Sxs. were dizziness(58%), ataxia(33%), and other less frequent Sxs. were weakness of low extremities, dysarthria, headache and urinary incontinence. The clinical manifestations at the initial diagnosis were cerebellar disturbance(100%), dysarthria(83%), and increased deep tendon reflexes(58%). 4. The results of brain CT finding are like this : ${\cdot}$ the width of cerebellar sulci is more than 1mm, other 4 cases more than 2mm. ${\cdot}$ the width of cerebellar pontine cistern of the patient if usually 3 to 4mm, other 2 cases extended to the 5mm. ${\cdot}$ the A. P and lateral lengths of 4th. ventricle is 4mm and 4 to 8mm respectively. ${\cdot}$ 6 cases of whole patients show coincidentally cerebral atrophy.

• Clinical and Experimental Pediatrics
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• v.50 no.6
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• pp.588-591
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• 2007

Left ventricular thrombus is mainly caused by anterior myocardial infarction or severe cardiac wall dysfunction of the apex, and is rarely caused by a complication of acute myocarditis. A 12-year-old female who developed symptoms of motor dysphasia and incomplete hemiparesis of the right side was admitted to the hospital. The brain MRI taken on the day of her admission showed acute cerebral infarction in the left basal ganglia and the frontoparietal lobe. The echocardiogram showed a movable thrombus, which was $19{\times}28mm$ sized and located in the apex of the left ventricle. So in order to prevent further thromboembolic event we performed open cardiac surgery via the atrium and removed the thrombus of the left ventricle. After the removal of the thrombus her symptoms improved and she was discharged from the hospital. Thrombus formation in acute viral myocarditis are considered to be related with endocardial injury and blood flow stasis. Treatment with anticoagulants in left ventricular thrombosis may not be effective and may even cause a major thromboembolism. When the thrombus is laminar and fixed, one should consider anticoagulant therapy. But if the thrombus is pedunculated and movable, which means that there are higher possibilities of major embolism or there may be already one, one should consider surgical removal. We report a 12-year-old girl who required surgical removal of a left ventricular thrombus caused by acute viral myocarditis.

• Toxicological Research
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• v.17
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• pp.47-57
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• 2001

Alzheimer's disease (AD) is the most common cause of dementia in the elderly, and its pathology is characterized by the presence of numerous numbers of senile plaques and neurofibrillary tangles. Several genetic and transgenic studies have indicated that excess amount of $\beta$-amyloid protein (A$\beta$) is produced by mutations of $\beta$TEX>$\beta$-amyloid precursor protein and causes learning impairment. Moreover, $A\beta$ has a toxic effect on cultured nerve cells. To prepare AD model animals, we have examined continuous (2 weeks) infusion of $A\beta$ into the cerebral ventricle of rats. Continuous infusion of $A\beta$ induces learning impairment in water maze and passive avoidance tasks, and decreases choline acetyltransferase activity in the frontal cortex and hippocampus. Immunohistochemical analysis revealed diffuse depositions of $A\beta$ in the cerebral cortex and hippocampus around the ventricle. Furthermore, the nicotine-evoked release of acetylcholine and dopamine in the frontal cortex/hippocampus and striatum, respectively, is decreased in the $A\beta$-infused group. Perfusion of nicotine (50 $\mu\textrm{M}$) reduced the amplitude of electrically evoked population spikes in the CA1 pyramidal cells of the control group, but not in those of the $A\beta$-infused group, suggesting the impairment of nicotinic signaling in the $A\beta$-infused group. In fact, Kd, but not Bmax, values for ［$^3H$］ cytisine binding in the hippocampus significantly increased in the $A\beta$-infused rats. suggesting the decrease in affinity of nicotinic acetylcholine receptors. Long-term potentiation (LTP) induced by tetanic stimulations in CA1 pyramidal cells, which is thought to be an essential mechanism underlying learning and memory, was readily observed in the control group, whereas it was impaired in the $A\beta$-infused group. Taken together, these results suggest that $A\beta$ infusion impairs the signal transduction mechanisms via nicotinic acetylcholine receptors. This dysfunction may be responsible, at least in part, for the impairment of LTP induction and may lead to learning and memory impairment. We also found the reduction of glutathione- and Mn-superoxide dismutase-like immunoreactivity in the brains of $A\beta$-infused rats. Administration of antioxidants or nootropics alleviated learning and memory impairment induced by $A\beta$ infusion. We believe that investigation of currently available transgenic and non-transgenic animal models for AD will help to clarify the pathogenic mechanisms and allow assessment of new therapeutic strategies.

• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.874-878
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• 2008

Purpose : This study was undertaken to develop an animal model of periventricular leukomalacia (PVL) induced by in utero clamping of pregnant rat aorta in fetal rats. Methods : A timed pregnanct Sprague-Dawley rat on embryonic day 21 just prior to delivery was sedated and anesthetized, and a Harvard ventilator for small animals was applied. Following laparotomy, the maternal aorta was clamped reversibly for 40 minutes using a surgical clip. The fetal rats were then delivered by Cesarean section, resuscitated if necessary, and reared by a surrogate mother rat until postnatal day 21 to obtain the brain specimen. After systemic perfusion and fixation, $10{\mu}m$ thick serial brain sections were obtained and stained for pathologic examination and assessment of ventriculomegaly. Ventriculomegaly was assessed by the measured ventricle to total brain volume ratio. Results : Eight out of eleven fetal rats (73%) survived in the ischemia group after induction of in utero ischemia by clamping maternal rat aorta, and all ten survived in the control group. Body and brain weights measured at postnatal day 21 were significantly lower in the ischemia group compared to the control group. In pathologic findings, significant ventriculomagaly ($3.67{\pm}1.21%$ vs. $0.23{\pm}0.06%$) was observed in the ischemia group compared to the control group; although cystic lesion was not observed, mild (n=6) and moderate (n=2) rerefaction of the brain tissue was observed. Conclusion : A fetal rat model of PVL induced by in utero clamping of pregnant rat aorta was developed.

• Investigative Magnetic Resonance Imaging
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• v.7 no.2
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• pp.116-123
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• 2003

Purpose : The present study was undertaken to evaluate the usefulness of cerebral diffusion (DWI) and perfusion MR imaging (PWI) in rabbit models with hyperacute cerebral ischemic infarction. Materials and Methods : Experimental cerebral infarction were induced by direct injection of mixture of Histoacryl glue, lipiodol, and tungsten powder into the internal cerebral artery of 6 New-Zealand white rabbits, and they underwent conventional T1 and T2 weighted MR imaging, DWI, and PWI within 1 hour after the occlusion of internal cerebral artery. The PWI scan for each rabbit was obtained at the level of lateral ventricle and 1cm cranial to the basal ganglia. By postprocessing using special imaging software, perfusion images including cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) maps were obtained. The detection of infarcted lesion were evaluated on both perfusion maps and DWI. MTT difference time were measured in the perfusion defect lesion and symmetric contralateral normal cerebral hemisphere. Results : In all rabbits, there was no abnormal signal intensity on T2WI. But on DWI, abnormal high signal intensity, suggesting cerebral infarction, were detected in all rabbits. PWI (rCBV, CBF and MTT map) also showed perfusion defect in all rabbits. In four rabbits, the calculated square of perfusion defect in MTT map is larger than that of CBF map and in two rabbits, the calculated size of perfusion defect in MTT map and CBF map is same. Any rabbits do not show larger perfusion defect on CBF map than MTT map. In comparison between CBF map and DWI, 3 rabbits show larger square of lesion on CBF map than on DWI. The others shows same square of lesion on both technique. The size of lesion shown in 6 MTT map were larger than DWI. In three cases, the size of lesion shown in CBF map is equal to DWI. But these were smaller than MTT map. The calculated square of lesion in CBF map, equal to that of DWI and smaller than MTT map was three. And in one case, the calculated square of perfusion defect in MTT map was largest, and that of DWI was smallest. Conclusion : DWI and PWI may be useful in diagnosing hyperacute cerebral ischemic infarction and in e-valuating the cerebral hemodynamics in the rabbits.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.418-421
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• 2003

Heart-lung transplantation is a widely accepted treatment for Eisenmenger'syndrome. The patient is a 41-years-old male diagnosed with Eisenmenger'syndrome due to patent ductus arteriosus. The pressures were checked as follows: aorta 130/80 mean 100 mmHg, pulmonary artery 130/80 mean 109 mmHg, and right ventricle 130/20 mmHg, right atrium mean 20 mmHg. The patient needed heart-lung transplantation due to enlarged right pulmonary artery (diameter 7.5 cm). The donor was a 24 years-old male diagnosed as brain death due to subdural hematoma. Ligation of patent ductus arteriosus was performed under the cardiopulmonary bypass followed by heart-lung transplantation. Patient was extubated on postoperative day one, transferred to the general ward on day 3, and was discharged on postoperative day 33. Cardiac and lung biopsy was performed on postoperative day 41 with no signs of rejection.

• Journal of Korean Neurosurgical Society
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• v.58 no.1
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• pp.1-8
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• 2015

Treatment of Leptomeningeal carcinomatosis (LMC) from solid cancers has not advanced noticeably since the introduction of intra-cerebrospinal fluid (CSF) chemotherapy in the 1970's. The marginal survival benefit and difficulty of intrathecal chemotherapy injection has hindered its wide spread use. Even after the introduction of intraventricular chemotherapy with Ommaya reservoir, frequent development of CSF flow disturbance, manifested as increased intracranial pressure (ICP), made injected drug to be distributed unevenly and thus, the therapy became ineffective. Systemic chemotherapy for LMC has been limited as effective CSF concentration can hardly be achieved except high dose methotrexate (MTX) intravenous administration. However, the introduction of small molecular weight target inhibitors for primary cancer treatment has changed the old concept of 'blood-brain barrier' as the ultimate barrier to systemically administered drugs. Conventional oral administration achieves an effective concentration at the nanomolar level. Furthermore, many studies report that a combined treatment of target inhibitor and intra-CSF chemotherapy significantly prolongs patient survival. Ventriculolumbar perfusion (VLP) chemotherapy has sought to increase drug delivery to the subarachnoid CSF space even in patients with disturbed CSF flow. Recently authors performed phase 1 and 2 clinical trial of VLP chemotherapy with MTX, and 3/4th of patients with increased ICP got controlled ICP and the survival was prolonged. Further trials are required with newly available drugs for CSF chemotherapy. Additionally, new LMC biologic/pharmacodynamic markers for early diagnosis and monitoring of the treatment response are to be identified with the help of advanced molecular biology techniques.

• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.766-770
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• 2008

Primary tumors of the heart are uncommon among pediatric patients. Rhabdomyoma is the most frequent cardiac tumor in infants and children, which is commonly associated with tuberous sclerosis. Tuberous sclerosis is a neurocutaneous syndrome affecting the brain, heart, skin, and other organs. Cardiac rhadomyomas are reported in 50-64% of infants with tuberous sclerosis. Tuberous sclerosis involves multiple locations in the atrium, ventricle and septum, and may induce mechanical obstruction of the outflow tract and heart failure depending on the location, number, size, and degree of invasion of tumors. Arrhythmias may also develop in infants with cardiac rhadomyomas, but only a few of these patients require prolonged anti-arrhythmic therapy because arrhythmia often disappears with spontaneous regression of the tumors, and the ultimate prognosis may be decided by the cerebral manifestations.

• The Korean Journal of Physiology and Pharmacology
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• v.2 no.5
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• pp.555-563
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• 1998

The renal function is under regulatory influence of central nervous system (CNS), in which various neurotransmitter and neuromodulator systems take part. However, a possible role of central GABA-benzodiazepine system on the central regulation of renal function has not been explored. This study was undertaken to delineate the renal effects of diazepam. Diazepam, a benzodiazepine agonist, administered into a lateral ventricle (icv) of the rabbit brain in doses ranging from 10 to 100 ${\mu}g/kg,$ elicited dose-related diuresis and natriuresis along with improved renal hemodynamics. However, when given intravenously, 100 ${\mu}g/kg$ diazepam did not produce any significant changes in all parameters of renal function and systemic blood pressure. Diazepam, 100 ${\mu}g/kg$ icv, transiently decreased the renal nerve activity (RNA), which recovered after 3 min. The plasma level of atrial natriuretic peptide (ANP) increased 7-fold, the peak coinciding with the natriuresis and diuresis. Muscimol, a GABAergic agonist, 1.0 ${\mu}g/kg$ given icv, elicited marked antidiuresis and antinatriuresis, accompanied by decreases in systemic blood pressure and renal hemodynamics. When icv 0.3 ${\mu}g/kg$ muscimol was given 3 min prior to 30 ${\mu}g/kg$ of diazepam icv, urinary flow and Na excretion rates did not change significantly, while systemic hypotension was produced. These results indicate that icv diazepam may bring about natriuresis and diuresis by influencing the central regulation of renal function, and that the renal effects are related to the increased plasma ANP levels, not to the decreased renal nerve activity, and suggest that the effects may not be mediated by the activation of central GABAergic system.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.2
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• pp.206-210
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• 2007

Turcot syndrome is characterized by the concurrence of a primary neuroepithelial brain tumor and multiple colorectal polyposis. We report a case of a 24-year-old woman diagnosed with Turcot syndrome. At first, the patient was diagnosed as having a medulloblastoma after a tumorectomy of the 4th ventricle mass. The patient underwent radiotherapy and chemotherapy. After high-dose chemotherapy, neutropenic fever and severe mucositis developed. For an evaluation of the persistent hematochezia and diarrhea, a colonoscopy was performed. It revealed pseudomembranous colitis and multiple polyps in the entire colon. According to the family history, her father had undergone a total colectomy due to colon cancer and polyposis of the entire colon. Her brother also was found to have multiple polyps in the colon by a colonoscopy. The patient was diagnosed with Turcot syndrome.