• Title/Summary/Keyword: Clinical neurology

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Generation of $CD2^+CD8^+$ NK Cells from c-$Kit^+$ Bone Marrow Cells in Porcine

  • Lim, Kyu-Hee;Han, Ji-Hui;Roh, Yoon-Seok;Kim, Bum-Seok;Kwon, Jung-Kee;You, Myoung-Jo;Han, Ho-Jae;Ejaz, Sohail;Kang, Chang-Won;Kim, Jong-Hoon
    • The Korean Journal of Physiology and Pharmacology
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    • v.16 no.3
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    • pp.167-174
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    • 2012
  • Natural killer (NK) cells provide one of the initial barriers of cellular host defense against pathogens, in particular intracellular pathogens. Because bone marrow-derived hematopoietic stem cells (HSCs), lymphoid protenitors, can give rise to NK cells, NK ontogeny has been considered to be exclusively lymphoid. Here, we show that porcine c-$kit^+$ bone marrow cells (c-$kit^+$ BM cells) develop into NK cells in vitro in the presence of various cytokines [interleukin (IL)-2, IL-7, IL-15, IL-21, stem cell factor (SCF), and fms-like tyrosine kinase-3 ligand (FLT3L)]. Adding hydrocortisone (HDC) and stromal cells greatly increases the frequency of c-$kit^+$ BM cells that give rise to $CD2^+CD8^+$ NK cells. Also, intracellular levels of perforin, granzyme B, and NKG2D were determined by RT-PCR and western blotting analysis. It was found that of perforin, granzyme B, and NKG2D levels significantly were increased in cytokine-stimulated c-$kit^+$ BM cells than those of controls. And, we compared the ability of the cytotoxicity of $CD2^+CD8^+$ NK cells differentiated by cytokines from c-$kit^+$ BM cells against K562 target cells for 28 days. Cytokines-induced NK cells as effector cells were incubated with K562 cells as target in a ratio of 100 : 1 for 4 h once a week. In results, $CD2^+CD8^+$ NK cells induced by cytokines and stromal cells showed a significantly increased cytotoxicity 21 days later. Whereas, our results indicated that c-$kit^+$ BM cells not pretreated with cytokines have lower levels of cytotoxicity. Taken together, this study suggests that cytokines-induced NK cells from porcine c-$kit^+$ BM cells may be used as adoptive transfer therapy if the known obstacles to xenografting (e.g. immune and non-immune problems) were overcome in the future.

Usefulness of Korean Infant Developmental Screening Test in Premature Infants (미숙아에서 한국형 영유아 발달검사의 유용성)

  • Shin, Dong Han;Lee, Hee Sun;Lee, Jee Yeon;Choi, Byung Min;Eun, Baik-Lin;Hong, Young Sook;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1337-1341
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    • 2005
  • Purpose : This study aimed to evaluate the usefulness of Korean Infant Development Screening Test in predicting delayed development in premature infants. Methods : A total of 74 children with histories of prematurity, who visited the pediatric neurology clinic of Korean University Ansan Hospital from August, 2002 to July, 2004, were examined, using the Korean Infant Development Screening Test. They were divided into two groups; a normal group and a patient(neurologically compromised) group. Results : At 7 months of conceptional age, the normal and patient groups differed significantly in the fine motor, cognitive-adaptive sections. At 12 months of conceptional age both group, differed significantly in the gross motor, fine motor, personal-social, language and cognitive-adaptive sections. At 18-24 months, the group, differed significantly in gross motor, fine motor, personal-social, language and cognitive-adaptive sections. Conclusion : The Korean Developmental Screening Test was useful in predicting developmental delay in premature infants.

The Protective Effects of IGF-1 on Different Subpopulations of DRG Neurons with Neurotoxicity Induced by gp120 and Dideoxycytidine In Vitro

  • Lu, Lin;Dong, Haixia;Liu, Guixiang;Yuan, Bin;Li, Yizhao;Liu, Huaxiang
    • Biomolecules & Therapeutics
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    • v.22 no.6
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    • pp.532-539
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    • 2014
  • Peripheral neuropathy induced by human immunodeficiency virus (HIV) infection and antiretroviral therapy is not only difficult to distinguish in clinical practice, but also difficult to relieve the pain symptoms by analgesics because of the severity of the disease at the later stage. Hence, to explore the mechanisms of HIV-related neuropathy and find new therapeutic options are particularly important for relieving neuropathic pain symptoms of the patients. In the present study, primary cultured embryonic rat dorsal root ganglion (DRG) neurons were used to determine the neurotoxic effects of HIV-gp120 protein and/or antiretroviral drug dideoxycytidine (ddC) and the therapeutic actions of insulin-like growth factor-1 (IGF-1) on gp120- or ddC-induced neurotoxicity. DRG neurons were exposed to gp120 (500 pmol/L), ddC ($50{\mu}mol/L$), gp120 (500 pmol/L) plus ddC ($50{\mu}mol/L$), gp120 (500 pmol/L) plus IGF-1 (20 nmol/L), ddC ($50{\mu}mol/L$) plus IGF-1 (20 nmol/L), gp120 (500 pmol/L) plus ddC ($50{\mu}mol/L$) plus IGF-1 (20 nmol/L), respectively, for 72 hours. The results showed that gp120 and/or ddC caused neurotoxicity of primary cultured DRG neurons. Interestingly, the severity of neurotoxicity induced by gp120 and ddC was different in different subpopulation of DRG neurons. gp120 mainly affected large diameter DRG neurons (> $25{\mu}m$), whereas ddC mainly affected small diameter DRG neurons (${\leq}25{\mu}m$). IGF-1 could reverse the neurotoxicity induced by gp120 and/or ddC on small, but not large, DRG neurons. These data provide new insights in elucidating the pathogenesis of HIV infection- or antiretroviral therapy-related peripheral neuropathy and facilitating the development of novel treatment strategies.

Lateral Femoral Cutaneous Nerve Somatosensory Evoked Potential Study in Normal Adults (정상성인의 외측대퇴피부신경 체감각 유발전위 검사)

  • Moon, Seung-Sik;Park, Mee-Young
    • Journal of Yeungnam Medical Science
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    • v.18 no.1
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    • pp.67-74
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    • 2001
  • Background: Meralgia paresthetica(MP) which is characterized by paresthesias and sensory impairment without motor weakness in the anterolateral aspects of the thigh is produced by compression of the lateral femoral cutaneous nerve(LFCN). Even though the diagnosis of MP is mostly based on the clinical symptoms, electrophysiologic study is mandatory to confirm the disease objectively. It has been known that Somatosensory evoked potential(SSEP) study of LFCN is a simple and very useful method to evaluate MP, so we studied SSEP of LFCN in normal adults and offer normal values. Materials and Methods: Thirty six normal adults(23 males and 13 females) ages from 21 to 73 years old($mean{\pm}SD$:$42.06{\pm}15.74$) were studied SSEP of LFCN bilaterally. The stimulation site was anterolateral aspect of thighs and the recording site was Cz'. Results: The mean values($mean{\pm}SD$) of $LP_0$, $SP_0$, $LN_1$ and $SN_1$ of all subjects were 35.10(${\pm}2.42$), 33.80(${\pm}2.4$), 43.68(${\pm}1.88$) and 42.16(${\pm}2.12$) and the mean values($mean{\pm}SD$ of $DP_0$, $DN_1$ and DA(${\mu}V{\pm}SD$ were 1.30(${\pm}1.14$), 1.52(${\pm}1.38$) and 0.32(${\pm}0.33$). Conclusion: For the diagnosis of MP. comparison of latency difference between both sides is more reliable than simple value of latency itself because of individual differences of body types. According to our results. the latency difference should be less than 2 msec and the amplitude difference was less than 1.6 times in normal adults.

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Intravenous Fluid Selection for Unruptured Intracranial Aneurysm Clipping : Balanced Crystalloid versus Normal Saline

  • Kang, Jian;Song, Young Joo;Jeon, Sujeong;Lee, Junghwa;Lee, Eunsook;Lee, Ju-Yeun;Lee, Euni;Bang, Jae Seung;Lee, Si Un;Han, Moon-Ku;Oh, Chang Wan;Kim, Tackeun
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.534-542
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    • 2021
  • Objective : While balanced crystalloid (BC) could be a relevant fluid regimen with buffer system compared with normal saline (NS), there have been no studies on the optimal fluid for surgery of an unruptured intracranial aneurysm (UIA). This study aimed to compare the effects of fluid regimens between NS and BC on the metabolic and clinical outcomes of patients who underwent surgery for UIA. Methods : This study was designed as a propensity score matched retrospective comparative study and included adult patients who underwent UIA clipping. Patient groups were categorized as NS and BC groups based on the types of pre-operative fluid and the amount of fluid administered during surgery. The primary outcomes were defined as electrolyte imbalance and acidosis immediately after surgery. The secondary outcomes were the length of stay in the intensive care unit (ICU) and duration from the end of the operation to extubation. Results : A total of 586 patients were enrolled in this study, with each of 293 patients assigned to the NS and BC groups, respectively. Immediately after surgery, serum chloride levels were significantly higher in the NS group. Compared to the NS group, the BC group had lower incidence rates of acidemia (6.5% vs. 11.6%, p=0.043) and metabolic acidosis (0.7% vs. 4.4%, p=0.007). As compared to NS group, BC group had significantly shorter duration from the end of the operation to extubation (250±824 vs. 122±372 minutes, p=0.016) and length of stay in ICU (1.37±1.11 vs. 1.12±0.61 days, p=0.001). Throughout multivariable analysis, use of BC was found to be significant factor for favorable post-operative results. Conclusion : This study showed that the patients who received BC during UIA clipping had lower incidence of metabolic acidosis, earlier extubation and shorter ICU stay compared to those who received NS. Therefore, using BC as a peri-operative fluid can be recommended for patients who undergo surgery for UIA.

Herbal Medicine for Liver Cancer: A Protocol for Systematic Review and Meta-Analysis (간암에 대한 한약치료: 체계적 문헌고찰 및 메타분석의 프로토콜)

  • Kwon, Seungwon;Song, Ga Yeon;Yang, Seung-Bo
    • The Journal of Internal Korean Medicine
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    • v.43 no.4
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    • pp.559-566
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    • 2022
  • Introduction: The aim of this systematic review is to provide evidence confirming the efficacy and safety of herbal medicines used in the treatment of liver cancer. Methods: The review will include randomized clinical trials that compared herbal medicines used as treatments for liver cancer with other therapies, such as placebos and Western medicine. Only randomized controlled trials will be included in this review, and all types of herbal medicine will be evaluated. Eleven electronic databases will be searched from the inception date: the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, AMED, CINAHL, one Chinese database (CNKI), and five Korean databases (OASIS, DBpia, RISS, KISS, and NDSL). The selection of studies, data extraction, and management will be performed independently by four researchers. Methodological quality, including the risk of bias, will be assessed using the Cochrane risk-of-bias assessment tool. Results: The review of current evidence for the effectiveness of herbal medicine for liver cancer will be summarized and quantitatively analyzed. Conclusions: Our systematic review will provide evidence of the efficacy of herbal medicines as treatments for liver cancer. This evidence will provide useful information for practitioners and patients in the fields of oncology and complementary medicine.

Prediction of Prognosis in Glioblastoma Using Radiomics Features of Dynamic Contrast-Enhanced MRI

  • Elena Pak;Kyu Sung Choi;Seung Hong Choi;Chul-Kee Park;Tae Min Kim;Sung-Hye Park;Joo Ho Lee;Soon-Tae Lee;Inpyeong Hwang;Roh-Eul Yoo;Koung Mi Kang;Tae Jin Yun;Ji-Hoon Kim;Chul-Ho Sohn
    • Korean Journal of Radiology
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    • v.22 no.9
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    • pp.1514-1524
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    • 2021
  • Objective: To develop a radiomics risk score based on dynamic contrast-enhanced (DCE) MRI for prognosis prediction in patients with glioblastoma. Materials and Methods: One hundred and fifty patients (92 male [61.3%]; mean age ± standard deviation, 60.5 ± 13.5 years) with glioblastoma who underwent preoperative MRI were enrolled in the study. Six hundred and forty-two radiomic features were extracted from volume transfer constant (Ktrans), fractional volume of vascular plasma space (Vp), and fractional volume of extravascular extracellular space (Ve) maps of DCE MRI, wherein the regions of interest were based on both T1-weighted contrast-enhancing areas and non-enhancing T2 hyperintense areas. Using feature selection algorithms, salient radiomic features were selected from the 642 features. Next, a radiomics risk score was developed using a weighted combination of the selected features in the discovery set (n = 105); the risk score was validated in the validation set (n = 45) by investigating the difference in prognosis between the "radiomics risk score" groups. Finally, multivariable Cox regression analysis for progression-free survival was performed using the radiomics risk score and clinical variables as covariates. Results: 16 radiomic features obtained from non-enhancing T2 hyperintense areas were selected among the 642 features identified. The radiomics risk score was used to stratify high- and low-risk groups in both the discovery and validation sets (both p < 0.001 by the log-rank test). The radiomics risk score and presence of isocitrate dehydrogenase (IDH) mutation showed independent associations with progression-free survival in opposite directions (hazard ratio, 3.56; p = 0.004 and hazard ratio, 0.34; p = 0.022, respectively). Conclusion: We developed and validated the "radiomics risk score" from the features of DCE MRI based on non-enhancing T2 hyperintense areas for risk stratification of patients with glioblastoma. It was associated with progression-free survival independently of IDH mutation status.

MRI Findings in Parkinson's Disease: Radiologic Assessment of Nigrostriatal Degeneration (파킨슨병의 자기공명영상 소견: 흑질선조체 변성의 영상학적 평가)

  • Yun Jung Bae;Jong-Min Kim;Byung Se Choi;Yoo Sung Song;Yoonho Nam;Se Jin Cho;Jae Hyoung Kim;Sang Eun Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.508-526
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    • 2022
  • Parkinson's disease (PD) is a movement disorder that develops due to degenerative loss of dopaminergic cells in the substantia nigra of the midbrain. Recent advances in MRI techniques have demonstrated various imaging findings that can reflect the underlying pathophysiological processes occurring in Parkinson's disease. Many imaging studies have shown that such findings can assist in the diagnosis of Parkinson's disease and its differentiation from atypical parkinsonism. In this review, we present MRI techniques that can be used in clinical assessment, such as nigrosome imaging and neuromelanin imaging, and we provide the detailed imaging features of Parkinson's disease reflecting nigrostriatal degeneration.

Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging for Language Mapping in Brain Tumor Surgery: Validation With Direct Cortical Stimulation and Cortico-Cortical Evoked Potential

  • Koung Mi Kang;Kyung Min Kim;In Seong Kim;Joo Hyun Kim;Ho Kang;So Young Ji;Yun-Sik Dho;Hyongmin Oh;Hee-Pyoung Park;Han Gil Seo;Sung-Min Kim;Seung Hong Choi;Chul-Kee Park
    • Korean Journal of Radiology
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    • v.24 no.6
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    • pp.553-563
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    • 2023
  • Objective: Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging-derived tractography (DTI-t) contribute to the localization of language areas, but their accuracy remains controversial. This study aimed to investigate the diagnostic performance of preoperative fMRI and DTI-t obtained with a simultaneous multi-slice technique using intraoperative direct cortical stimulation (DCS) or corticocortical evoked potential (CCEP) as reference standards. Materials and Methods: This prospective study included 26 patients (23-74 years; male:female, 13:13) with tumors in the vicinity of Broca's area who underwent preoperative fMRI and DTI-t. A site-by-site comparison between preoperative (fMRI and DTI-t) and intraoperative language mapping (DCS or CCEP) was performed for 226 cortical sites to calculate the sensitivity and specificity of fMRI and DTI-t for mapping Broca's areas. For sites with positive signals on fMRI or DTI-t, the true-positive rate (TPR) was calculated based on the concordance and discordance between fMRI and DTI-t. Results: Among 226 cortical sites, DCS was performed in 100 sites and CCEP was performed in 166 sites. The specificities of fMRI and DTI-t ranged from 72.4% (63/87) to 96.8% (122/126), respectively. The sensitivities of fMRI (except for verb generation) and DTI-t were 69.2% (9/13) to 92.3% (12/13) with DCS as the reference standard, and 40.0% (16/40) or lower with CCEP as the reference standard. For sites with preoperative fMRI or DTI-t positivity (n = 82), the TPR was high when fMRI and DTI-t were concordant (81.2% and 100% using DCS and CCEP, respectively, as the reference standards) and low when fMRI and DTI-t were discordant (≤ 24.2%). Conclusion: fMRI and DTI-t are sensitive and specific for mapping Broca's area compared with DCS and specific but insensitive compared with CCEP. A site with a positive signal on both fMRI and DTI-t represents a high probability of being an essential language area.

Agreement and Reliability between Clinically Available Software Programs in Measuring Volumes and Normative Percentiles of Segmented Brain Regions

  • Huijin Song;Seun Ah Lee;Sang Won Jo;Suk-Ki Chang;Yunji Lim;Yeong Seo Yoo;Jae Ho Kim;Seung Hong Choi;Chul-Ho Sohn
    • Korean Journal of Radiology
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    • v.23 no.10
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    • pp.959-975
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    • 2022
  • Objective: To investigate the agreement and reliability of estimating the volumes and normative percentiles (N%) of segmented brain regions among NeuroQuant (NQ), DeepBrain (DB), and FreeSurfer (FS) software programs, focusing on the comparison between NQ and DB. Materials and Methods: Three-dimensional T1-weighted images of 145 participants (48 healthy participants, 50 patients with mild cognitive impairment, and 47 patients with Alzheimer's disease) from a single medical center (SMC) dataset and 130 participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset were included in this retrospective study. All images were analyzed with DB, NQ, and FS software to obtain volume estimates and N% of various segmented brain regions. We used Bland-Altman analysis, repeated measures ANOVA, reproducibility coefficient, effect size, and intraclass correlation coefficient (ICC) to evaluate inter-method agreement and reliability. Results: Among the three software programs, the Bland-Altman plot showed a substantial bias, the ICC showed a broad range of reliability (0.004-0.97), and repeated-measures ANOVA revealed significant mean volume differences in all brain regions. Similarly, the volume differences of the three software programs had large effect sizes in most regions (0.73-5.51). The effect size was largest in the pallidum in both datasets and smallest in the thalamus and cerebral white matter in the SMC and ADNI datasets, respectively. N% of NQ and DB showed an unacceptably broad Bland-Altman limit of agreement in all brain regions and a very wide range of ICC values (-0.142-0.844) in most brain regions. Conclusion: NQ and DB showed significant differences in the measured volume and N%, with limited agreement and reliability for most brain regions. Therefore, users should be aware of the lack of interchangeability between these software programs when they are applied in clinical practice.