• 한국산학기술학회논문지
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• 제19권6호
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• pp.275-279
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• 2018

뇌농양은 심각한 신경학적 후유증을 일으킬 수 있는 중추신경계 감염이다. 신경집중치료 발달에도 불구하고, 여전히 뇌농양은 특정 위험 환자에게 높은 사망률을 보이고 있다. 특히 세균성 뇌농양은 즉각 진단 및 적절한 항생제 치료가 필요한 응급 상황이다. 또한 드물게 뇌농양이 재발되는 경우도 있다. 본 연구에서는 두통으로 내원한 59세 남자환자를 대상으로 증례보고를 통해 동일 분야 연구에 활용하고자 자료분석을 하였다. 59세 남자가 두통을 주소로 내원하였고, 연속적으로 시행한 뇌자기공명영상과 뇌척수액 검사에서 우측 전두엽에 뇌농양을 확인하였고, 항생제 치료 및 수술적 치료 후 완치하였다. 퇴원 후 5개월 뒤 두통 및 경기 증상 있어 다시 촬영한 뇌자기공명영상에서 뇌농양의 재발이 확인되었다. 뇌농양 재발은 특정 조건, 즉, 농양 부위에 이물질이 남아 있거나 만성 부비동염, 동정맥루, 좌우션트 등이 있을 때 생길 수 있다.

• Journal of Korean Neurosurgical Society
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• 제53권5호
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• pp.281-287
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• 2013

Objective : Pleomorphic xanthoastrocytoma (PXA) is a rare primary low-grade astrocytic tumor classified as WHO II. It is generally benign, but disease progression and malignant transformation have been reported. Prognostic factors for PXA and optimal therapies are not well known. Methods : The study period was January 2000 to March 2012. Data on MR findings, histology, surgical extents and adjuvant therapies were reviewed in twenty-two patients diagnosed with PXA. Results : The frequent symptoms of PXA included seizures, headaches and neurologic deficits. Tumors were most common in the temporal lobe followed by frontal, parietal and occipital lobes. One patient who died from immediate post-operative complications was excluded from the statistical analysis. Of the remaining 21 patients, 3 (14%) died and 7 (33%) showed disease progression. Atypical tumor location (p<0.001), peritumoral edema (p=0.022) and large tumor size (p=0.048) were correlated with disease progression, however, Ki-67 index and necrosis were not statistically significant. Disease progression occurred in three (21%) of 14 patients who underwent GTR, compared with 4 (57%) of 7 patients who did not undergo GTR, however, it was not statistically significant. Ten patients received adjuvant radiotherapy and the tumors were controlled in 5 of these patients. Conclusion : The prognosis for PXA is good; in our patients overall survival was 84%, and event-free survival was 59% at 3 years. Atypical tumor location, peritumoral edema and large tumor size are significantly correlated with disease progression. GTR may provide prolonged disease control, and adjuvant radiotherapy may be beneficial, but further study is needed.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.689-697
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• 2020

Objective : Cerebral edema is the predominant mechanism of secondary inflammation after intracerebral hemorrhage (ICH). Pioglitazone, peroxisome proliferator-activated receptor gamma agonist has been shown to play a role in regulation of central nervous system inflammation. Here, we examined the pharmacological effects of pioglitazone in an ICH mouse model and investigated its regulation on NLRP3 inflammasome and glucose metabolism. Methods : The ICH model was established in C57 BL/6 mice by the stereotactical inoculation of blood (30 µL) into the right frontal lobe. The treatment group was administered i.p. pioglitazone (20 mg/kg) for 1, 3, and 6 days. The control group was administered i.p. phosphate-buffered saline for 1, 3, and 6 days. We investigated brain water contents, NLRP3 expression, and changes in the metabolites in the ICH model using liquid chromatography-tandem mass spectrometry. Results : On day 3, brain edema in the mice treated with pioglitazone was decreased more than that in the control group. Expression levels of NLRP3 in the ICH model treated with pioglitazone were decreased more than those of the control mice on days 3 and 7. The pioglitazone group showed higher levels of glycolytic metabolites than those in the ICH mice. Lactate production was increased in the ICH mice treated with pioglitazone. Conclusion : Our results demonstrated less brain swelling following ICH in mice treated with pioglitazone. Pioglitazone decreased NLRP3-related brain edema and increased anaerobic glycolysis, resulting in the production of lactate in the ICH mice model. NLRP3 might be a therapeutic target for ICH recovery.

• 생물정신의학
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• 제9권2호
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• pp.103-111
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• 2002

Neurocognitive research focusing on cognitive deficits in Depression has resulted in several important but yet potentially contradictory findings. Much literature documents the presence of significant neurocognitive impairments in depressive patients. Studies have shown that dysthymic disorder patients demonstrate a diffuse pattern of cognitive impairment which is frequently indistinguishable from that of focal braindamaged patients. Some reports have suggested that there is a focal pattern of deficit, such as anterior cingulate dysfunction, frontal lobe impairment, or dysfunction of the temporal-limbic cortex. The aim of this study is to evaluate the neurocognitive functions in dysthymic disorder patients, and to compare the functions with those of major depressive disorder patients. The subjects are 17 dysthymic disorder patients. And their neurocognitive functions are compared with those of 23 major depressive episode patients. Patients with a history of neurologic disease, alcohol dependence, substance abuse and mental retardation are excluded. They are assessed with a part of Vienna Test System which is computerized neurocognitive function tests and can evaluate attention, eductive ability, reproductive ability, visuoperceptual analysis, vigilance, visual immediate memory, the speed of information-processing, judgement, and fine motor coordinations. There are no other specific difference between two groups, except the result of cognitrone test. This study provides information about the neurocognitive functions and some difference between major depressive disorder patients and carefully diagnosed dysthymic disorder patients.

• The Journal of Korean Physical Therapy
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• 제25권3호
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• pp.126-131
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• 2013

This case report described a single case of adult stoke patient due to Moyamoya disease through long-term follow-up observation, which included his demographics, brain images, and change of motor function and functional activities. The subject was the 54-year-old male diagnosed with left hemiparesis from a stroke due to multifocal encephalomalacia in both hemispheres. At the time of the stroke attack, he took brain surgery intervention including external ventricular drain. Physical and occupational therapy for stroke rehabilitation were admitted including muscle strengthening exercises, functional activity/ADL training, neurofacilitative techniques with bobath or proprioceptive neuromuscular facilitation concepts, and compensatory strategy. Patient's MRI showed that right frontal lobe, right peri-ventricular area, left parietal, and left occipital lobes were damaged, and MRA showed that abnormal collateral vessel was richly developed in both hemispheres by occlusion of proximal internal carotid arteries in both sides. His motor strength was improved from poor to good grade in all of upper and lower limb motions, that MBC was improved from stage 1 to stage 5. In FAC and barthel index, at the initial evaluation, he could not perform any functional movement, but his FAC and barthel index were on 3 and 14 points at present, respectively. During long-term follow-up for approximately 4 years, the subject's functional motor ability was improved, as similar with recovery progression of usual stroke patient. We believe that this single case report will provide clinical information and concern regarding Moyamoya disease with physical therapist, in terms of such as epidemiology, pathogenesis, diagnostic procedures, clinical features, recovery process, and prognosis.

• 대한의용생체공학회:의공학회지
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• 제22권2호
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• pp.157-163
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• 2001

본 논문에서는 후취자극 제어장치를 이용하여 후각자극에 대한 인간의 뇌의 활성화 영역을 뇌기능자기공명영상(functional magnetic resonance imaging : fMRI)장치로 측정 또는 가시화하고 이의 임상적용에 대한 기초자료를 마련하고자 하였다. 우선 후각에 이상이 없고 코 수술 경험이 없는 오른손잡이 피험자 4명을 대상으로 5번에 걸쳐 Echo Plannar Imaging(EPI)에 의한 혈액산소농도의존(blood oxygen level dependent : BOLD)법을 이용하여 후각자극에 의한 뇌기능자기공명영상 실험을 수행하였다. 후각자극은 MRI 장치에서 사용할 수 있도록 제작된 후취제어장치를 사용하였으며, 제시된 향은 천연 향의 일종인 lavender-like fragrance를 사용하였다. 향의 제시는 후각의 피로도를 감안하여 3회의 휴식기관과 2회의 자극기간을 각 30초씩 번갈아 시행하였으며, 동시에 5초 간격으로 각 절편 당 30 영상을 연속적으로 획득하였다. Correlation법으로 0.4∼0.7의 문턱치(threshold)범위에서 통계 처리된 뇌의 활성화 영상은 EPI영상과 같은 부위의 T1 강조영상에 overlapping 시켰다. 호흡에 의한 artifact를 제거하기 위해 실험실에 만든 장치로 호흡을 측정하여 post-processing 할 때 반영하였다. 이렇게 얻어진 fMRI 영상의 신호변화를 관찰하여 활성 영역의 위치를 분석하였다. 그 결과 후각자극에 의해 뇌의 전두엽 피질(frontal cortex), 소뇌(cerebellum), 그리고 뇌교(pons)에서 활성화된 신호를 발견할 수 있었다. 또한, 측두엽(temporal lobe)과 뇌섬(insula)에서도 의미 있는 신호가 관찰되었다. 그러나, 일차 후각영역인 piriform cortex와 entorhinal cortex, amygdaloid complex, 그리고 이차후각영역인 orbitofrontal cotex에서는 그다지 많은 빈도로 신호가 발견되지 않았다. 결론적으로 BOLD법을 이용한 fMRI에 의하여 후각자극에 대한 뇌의 활성화영역을 관찰할 수 있었으며, 후각자극에 대한 뇌의 기능을 연구하는데 있어서 중요한 정량적 자료를 제공할 수 있다는 점을 확인할 수 있었다.

• 한국임상수의학회지
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• 제31권5호
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• pp.439-444
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• 2014

체중 2.7 kg의 5세령 암컷 말티즈 견이 양측 슬개골 탈구와 후지 파행으로 지역동물병원에 내원하였다. 도르레절제술과 슬개골의 외측 보강 봉합법을 이용하여 슬개골 탈구 정복술을 실시하였으나, 수술 3주 후 등을 굽힌 자세의 보행과 후지의 운동실조, 흉요추부의 압통, 간헐적인 경련증상으로 재 내원하였다. 자기공명영상 촬영 결과, 우측 전두엽의 종괴와 경수에서부터 3번 요수까지의 공동성 변화가 확인되었다. 병리조직학적 소견으로 뇌종양은 느슨한 망상구조 또는 레이스 모양의 수막세포들로 구성되었으며, 세포 외부에 다양한 크기와 형태의 많은 낭포성 공간이 관찰되었다. 면역조직화학염색 결과 종양세포들은 vimentin 양성, 신경원 특이 에놀라제 및 신경교 섬유질 산성 단백질에는 음성을 나타내었다. 경수와 흉수 부위에는 부정형의 확장된 중심관 유사 동공이 관찰되었다. 이 증례는 개에서 특이적인 두개강 내 소낭성 뇌수막종과 연관되어 2차적으로 발생한 척수공동증의 임상소견과 영상학적 및 병리조직학적 특징을 보여주고 있다.

• 대한불안의학회지
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• 제12권1호
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• pp.47-55
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• 2016

30% of patients with panic disorder (PD) show treatment-resistant and chronic waxing and waning course. Therefore, adequate treatment strategies for PD by evidence based pharmacotherapy and combined cognitive behavioral therapy (CBT) are recommended. Regarding how and why CBT for PD works, three hypotheses include the cognitive theory, anxiety control theory, and behavioral theory were discussed. The recent findings that the altered activation in frontal lobe is normalized after CBT, suggest a reduction of an altered top-down fear processing in the neural correlates of CBT in PD. In order to improve accessibility to CBT, brief CBT and internet based CBT for PD were suggested. Despite limitations of sample sizes and study design, most of studies suggest that brief CBT is more effective than control conditions, and even as equally effective as standard CBT. The evidences suggest that internet based CBT may not be significantly different from face-to-face CBT in reducing anxiety. Several advances within the field of third-wave CBT for PD have led to the development of new techniques based on mindfulness, such as mindfulness-based cognitive therapy and acceptance and commitment therapy. Based on Korean algorithm project for panic disorder, especially the psychological education and cognitive reconstruction components were recommended in CBT with PD.

• The Journal of Korean Physical Therapy
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• 제29권5호
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• pp.227-233
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• 2017

Purpose: The aim of this study was to determine if Pilates gymball exercise can change the electroencephalogram and cognitive function of mentally disabled people. Methods: Twenty-one mentally disabled people were enrolled in this study. They were assigned randomly to one of two groups: Pilates gymball exercise group (PGEG, n=11), and control group (CG, n=10). The subjects in the PGEG group performed the exercises for 50 minutes a day, three days per week for 6 weeks. The PGEG program consisted of warm up (10 minutes), main workout (30 minutes), and cool down (10 minutes). The main workout consisted of 10 exercise programs. The electroencephalogram (EEG) of Fp1, Fp2, F3, F4, C3, C4, O1, and O2 were measured using an PolyG-I system. The cognitive function was evaluated using a mini-mental state examination (MMSE). The measurements were performed before exercise, and 6 weeks after exercise. Covariance analysis (ANCOVA) was performed to determine the difference between the two groups Results: A significant difference in Fp1, Fp2, and F3 on the relative alpha power was observed between the PGEG and CG groups (p<0.05). A significant difference in Fp1 on the relative beta power was observed between the PGEG and CG groups (p<0.05). No significant difference in the MMSE score was observed between the PGEG and CG groups. Conclusion: Pilates gymball exercise did positively change the EEG in the frontal lobe. On the other hand, the effect related to cognitive was limited. Pilates gymball exercise appears to be more effective in facilitating brain stimulation related to cognition.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.197-202
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• 2001

Objective : The purpose of this study is to evaluate and compare surgical results of pterional(fronto-temporal) approach and interhemispheric approach for the high positioned anterior communicating artery aneurysm with our surgical experience. Methods : During the period between May 1990 and May 2001, 263 anterior communicating aneurysms were treated at the department of neurosurgery of Dong-A university hospital. Among them, 175 patients were operated by same operator. Thirty six out of the 175 cases were high positioned anterior communicating artery aneurysms located more than 15mm above the anterior clinoid process. Results : Pterional approaches were applied in 32 cases and interhemispheric approaches were applied in 4 cases of total 36 cases of the high positioned anterior communicating artery aneurysms. The 32 cases of pterional approach resulted in Good Recovery 20/32(63%), Moderate Disability 6/32(19%), Severe Disability 4/32(12%) and Dead 2/32(6%), and 4 cases of interhemispheric approach resulted in GR 3/4(75%) and MD 1/4(25%). Relatively, pterional approach showed poorer result on high positioned anterior communicating artery aneurysm located more than 19mm above the anterior clinoid process with GR 5/13(39%), MD 3/13(23%), SD 3/13(23%) and Dead 2/13(15%). Conclusion : Interhemispheric approach is preferable to pterional approach for certain cases of high positioned anterior communicating artery aneurysm located more than 19 mm above the anterior clinoid process because it provides adequate orientation to the regional anatomy, less retraction of frontal lobe and preservation of the olfactory tract and gyrus rectus without any surgical complications.