• Radiation Oncology Journal
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• 제11권1호
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• pp.79-82
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• 1993

본 연구는 1989년 10월부터 1992년 3월까지 아산재단 서울중앙병원에서 원발성 중추신경계 림프종으로 진단 받은 10명의 환자를 대상으로 하였다. 병리적 진단을 위한 조직은 5명에서 개두술에 의한 종양절제술로 얻어졌으며 나머지는 정위적 조직생검에 의해 얻어졌다. 성별분포는 남녀가 각 5명이었고 연령분포는 28세부터 72세로 평균연령은 45세로 나타났다. Working Formulation에 의한 세포아형은 7명에서 diffuse large cell type이었고 3명은 diffuse mixed cell type이었다. 전산화 단층촬영 결과 6명은 단일병소로 나타났으며 4명은 다발성병소로 나타났다. 치료는 전 환자가 전뇌방사선 조사를 4000 cGy/20 fx을 받은 후 원발병소에 2000 cGy/10 fx을 조사하여 총 6000 cGy를 시행하였다. 척수액 검사상 양성인 6명은 전뇌조사와 척수강내 항암제 투여를 받았으며 그중 1명은 척수강내 항암제 투여 3회 실시후 척수방사선 조사를 받았다. 척수액 검사상 음성인 4명중 3명은 전뇌조사만 실시했고 나머지 1명은 방사선 조사전 전신 항암제 투여를 받았다. 추적관찰기간은 7개월에서 26개월이었으며 평균 추적기간은 8개월 이었다. 1년 생존율은 86%이었고 2년 생존율은 69%로 나타났다. 현재까지 2명이 척수강내 재발 후 뇌실질내 재발로 사망했으며, 반면 7명의 환자는 방사선 치료후 병소가 완전히 없어졌다. 위의 결과로 볼때 원발성 중추신경계 림프종의 방사선 치료에 대한 월등한 초기반응과 원격 전이 가 적은 것을 고려하여 원발병소에 분할치료 방법들을 통한 전체 조사량을 증가시키는 것이 효과적이라고 생각되며 척수액 검사상 양성인 경우는 척수 방사선 조사와 척수강내 항암제를 함께 쓰는 좀더 적극적 치료가 필요하리라 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제55권6호
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• pp.623-630
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• 2003

저자들은 급성신부전과 미만성 폐포출혈이 있으면서 중추신경병증이 동반된 현미경적 다발성 혈관염 환자 l예와 특발성 괴사 사구체신염 진단 후 스테로이드 감량 도중 폐침윤이 동반된 전신적인 현미경적 다발성 혈관염의 형태로 재발한 환자 l예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Annals of Clinical Neurophysiology
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• 제15권1호
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• pp.13-18
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• 2013

It was sometimes difficult to differentiate between acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) and subacute inflammatory demyelinating polyneuropathy (SIDP). The CNS involvement of these polyneuropathies has rarely reported in the literature. We present the case of a 42-year-old man who developed rapidly developing inflammatory demyelinating polyneuropathy followed by right optic neuritis. This case showed progressive motor weakness and sensory dysfunction with time to nadir at 8 weeks, demyelination in nerve conduction study, no other etiology of neuropathy, no relapse during follow-up of 18 months, good response to steroid and complete recovery which favor SIDP more than A-CIDP. We experienced the case of SIDP associated with optic neuritis.

• Journal of Korean Neurosurgical Society
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• 제42권2호
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• pp.149-152
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• 2007

Authors report a very rare case of primary Hodgkin's lymphoma limited to the cerebellum. A 64-year-old female patient presented with headache, nausea, and vomiting. Magnetic resonance imaging of the brain revealed a nodular enhancing mass in the left cerebellar hemisphere. Tumor was removed totally with retromastoid suboccipital approach. Diagnosis was Hodgkin's lymphoma of mixed cellularity type, consisting of a dense mixed inflammatory infiltrate containing scattered large atypical mononuclear Hodgkin's cell and multinucleated Reed-Sternberg cells. Systemic work-up for the Hodgkin's lymphoma was followed with negative result. Postoperative radiation therapy was given and the patient is disease-free at 16 months after the operation.

• Tuberculosis and Respiratory Diseases
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• 제39권1호
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• pp.89-94
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• 1992

저자들은 전신성홍반성낭창에서 신장염에 이어 급성 폐렴이 발생하여 이의 악화로 사망한 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• 제50권1호
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• pp.68-71
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• 2011

We present a case of Neuro-Behçet's disease with an unpredictable clinical course. A 47-year-old man was admitted to the neurosurgery department of our hospital with a mild headache. Three days after admission, his consciousness suddenly decreased and respiratory distress progressed rapidly. A brain MRI revealed that the previously observed abnormal signal had extended markedly to both the thalamic areas and the entire brain stem, and the surrounding brain parenchyma were compressed by cerebral edema. Based on the patient's symptoms of recurrent oral and genital ulcers, skin lesions, and uveitis, a rheumatologist made a diagnosis of Behçet's disease with CNS involvement. The patient was treated with high-dose methylprednisolone with respiratory assistance in the intensive care unit for 9 days and his neurologic symptoms improved remarkably. Neuro-Behçet's disease must be considered in the differential diagnosis in rapidly deteriorated young neurological patients along with a stroke, low-grade glioma, multiple sclerosis, and occlusive venous disease.

• Pediatric Infection and Vaccine
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• 제4권2호
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• pp.298-302
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• 1997

Ramsay Hunt syndrome is a viral associated disease with severe otalgia, vertigo, fever, herpetic eruptions on either side of the external auditory meatus and cavum concha, ipsilateral facial nerve palsy and cochleovestibular dysfunction. This syndrome may be the most common cause of unilateral facial paralysis and involvement of both the vestibular and cochlear branch of 8th cranial nerve. And loss of taste sensation may be developed in same involement site. This syndrome affects adults in most cases, and a samll number of children with herpes zoster oticus have been reported. And concomittantly CNS invlovement of this snydrome is very rare. We experienced a 7 years old aged patient of Ramsay Hunt syndrome who had evidence of aseptic meningitis, and this patient showed well reponses with Acyclovir and symptomatic therapy. So, we report this case with brief review of related literatures.

• Korean Journal of Radiology
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• 제24권12호
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• pp.1260-1283
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• 2023

Magnetic resonance imaging (MRI) has been extensively applied in the study of multiple sclerosis (MS), substantially contributing to diagnosis, differential diagnosis, and disease monitoring. MRI studies have significantly contributed to the understanding of MS through the characterization of typical radiological features and their clinical or prognostic implications using conventional MRI pulse sequences and further with the application of advanced imaging techniques sensitive to microstructural damage. Interpretation of results has often been validated by MRI-pathology studies. However, the application of MRI techniques in the study of neuromyelitis optica spectrum disorders (NMOSD) remains an emerging field, and MRI studies have focused on radiological correlates of NMOSD and its pathophysiology to aid in diagnosis, improve monitoring, and identify relevant prognostic factors. In this review, we discuss the main contributions of MRI to the understanding of MS and NMOSD, focusing on the most novel discoveries to clarify differences in the pathophysiology of focal inflammation initiation and perpetuation, involvement of normal-appearing tissue, potential entry routes of pathogenic elements into the CNS, and existence of primary or secondary mechanisms of neurodegeneration.

• Annals of Clinical Neurophysiology
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• 제4권2호
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• pp.119-124
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• 2002

Background : Guillain-$Barr{\acute{e}}$ syndrome(GBS) is a neurologically emergent condition, leading to respiratory insufficiency without an early and appropriate treatment. Thus, the treatment of GBS requires early diagnosis but it is difficult due to the low sensitivity of laboratory tools in the initial stage. Hoffman reflex (H-reflex) and its facilitation by Jendrassik maneuver (JM) are sensitive tools evaluating the central circuit of motor system on the spinal cord level. The aim of this study is to test whether the change of H-reflex and F-wave under the JM is able to detect the early stage of GBS and whether GBS involves the central nervous system (CNS). Material and Methods : All 7 GBS patients who showed normal or nearly normal nerve conduction study were included. The facilitation of H-reflex and changes of F-wave were calculated by measuring the percent difference of H-reflex or F-wave amplitude under JM compared to basal H-reflex of F-wave amplitude. The changes of F-wave and H-reflex in the GBS patients were compared with them of 8 healthy controls. Results : The F-wave amplitudes of both healthy controls and GBS patients did not changed under the influence of JM ($102.4{\pm}24.9%$, $108.7{\pm}29.0%$ respectively). However, the facilitation of H-wave by JM in the GBS patients was absent ($98.8{\pm}5.8%$), even though the H-reflex amplitude I the healthy controls increased under the influence of JM ($124.8{\pm}12.1%$). Conclusions : The loss of H-reflex facilitation in GBS implies that this phenomenon might be the most early change detected in the electrophysiological study and support the early diagnosis, and that GBS might include lesion in the spinal motor CNS.

• 생명과학회지
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• 제30권11호
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• pp.939-946
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• 2020

뇌졸중은 전 세계적으로 신경계 장애를 일으키는 주요 원인 중 하나이며, 뇌졸중 환자는 다양한 운동, 인지 및 정신 장애를 나타낸다. GPR88은 orphan G protein coupled receptor이며 striatal medium spiny neurons에서 높게 발현이 되며, GPR88이 결손이 된 경우 motor coordination과 motor learning에 문제가 발생하게 된다. 본 연구에서는 Western blot 및 real-time PCR을 사용하여 허혈성 마우스 모델에서 GPR88 발현이 감소함을 발견 하였다. 또한, 뇌에서 유래한 세 가지 유형의 세포들, 뇌혈관내피세포(brain microvascular endothelial cells), 미세 아교세포(microglial cells) 및 신경 세포들에서 GPR88의 발현정도를 확인한 결과, HT22 신경 세포에서 GPR88의 발현이 가장 높음을 관찰하였고, 뇌졸중과 유사한 실험조건인 oxygen glucose deprivation (OGD) 조건에 배양한 HT22 신경세포에서 GPR88의 발현이 감소하였다. 또한 GPR88 효현제인 RTI-13951-33 (10 mg/kg)을 전처리후에 뇌허혈을 유발하였을 때, infarct volume의 감소, vestibular-motor function 및 neurological score의 개선효과를 관찰할 수 있었다. 이러한 결과는 GPR88이 허혈성 뇌졸중을 포함한 CNS 질환의 치료를 위한 잠재적인 약물표적이 될 수 있음을 제시한다.