• Title/Summary/Keyword: cerebrospinal fluid

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Development of micro check valve with polymer MEMS process for medical cerebrospinal fluid (CSF) shunt system (Polymer MEMS 공정을 이용한 의료용 미세 부품 성형 기술 개발)

  • Chang, J.K.;Park, C.Y.;Chung, S.;Kim, J.K.;Park, H.J.;Na, K.H.;Cho, N.S.;Han, D.C.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2000.05a
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    • pp.1051-1054
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    • 2000
  • We developed the micro CSF (celebrospinal fluid) shunt valve with surface and bulk micromachining technology in polymer MEMS. This micro CSF shunt valve was formed with four micro check valves to have a membrane connected to the anchor with the four bridges. The up-down movement of the membrane made the CSF on & off and the valve characteristic such as open pressure was controlled by the thickness and shape of the bridge and the membrane. The membrane, anchor and bridge layer were made of the $O_2$ RIE (reactive ion etching) patterned Parylene thin film to be about 5~10 microns in thickness on the silicon wafer. The dimension of the rectangular nozzle is 0.2*0.2 $\textrm{mm}^2$ and the membrane 0.45 mm in diameter. The bridge width is designed variously from 0.04 mm to 0.12 mm to control the valve characteristics. To protect the membrane and bridge in the CSF flow, we developed the packaging system for the CSF micro shunt valve with the deep RIE of the silicon wafer. Using this package, we can control the gap size between the membrane and the nozzle, and protect the bridge not to be broken in the flow. The total dimension of the assembled system is 2.5*2.5 $\textrm{mm}^2$ in square, 0.8 mm in height. We could precisely control the burst pressure and low rate of the valve varing the design parameters, and develop the whole CSF shunt system using this polymer MEMS fabricated CSF shunt valve.

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Analysis of Signal Intensity in Choroid Plexuses by Diffusion Weighted Imaging (확산강조영상의 검사기법에 따른 맥락얼기의 신호강도 분석)

  • Oh, JongKap
    • Journal of the Korean Society of Radiology
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    • v.7 no.4
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    • pp.265-269
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    • 2013
  • This report aims at picturing out the clinical usefulness by analyzing the signal intensity in choroid plexuses which produce cerebrospinal fluids by diffusion weighted imaging. At first, subjects were chosen among the patients who showed high in signal intensity by diffusion weighted imaging. The subjects were taken another test by fluid attenuated inversion recovery diffusion weighted echo planer image(FLAIR-DW-EPI) the signals of fluid attenuation. And it was found that there are differences between the signal intensities of the two methods, which showed that the signal intensity in FLAIR-DW-EPI is equal to or low than, that in the Brain. By this, it is felt that it is helpful to diagnose the disease in choroid plexus by testing another more with FLAIR-DW-EPI methods the patients who showed high in signal intensity in choroid plexus by $T2^*$ diffusion weighted echo planer image($T2^*$-DW-EPI).

Enhancement Characteristics of Gadolinium Contrast Agent in the Rat Inner Ear Perilymph through CSF microcirculation (뇌척수액 미세순환을 통한 래트 내이 외림프의 가돌리늄 조영제 증강 특성)

  • Kim, Min Jung;Lee, Sang-Yeol;Lee, Hui Joong;Lee, Taekwan;Chang, Yongmin
    • Journal of Biomedical Engineering Research
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    • v.43 no.4
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    • pp.193-198
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    • 2022
  • Contrast enhanced magnetic resonance imaging using gadolinium-based contrast agent (GBCA) is a very useful in vivo technique to visualize the inner ear pathology including endolymphatic hydrops. Although systemic intravenous (IV) administration can visualize the perilymph space, the visualization was possible by indirect passage of contrast agent through blood-perilymph barrier. All animal experimental procedures were performed under anesthesia with 5% isoflurane. Lipopolysaccharide (LPS) was instilled into the left tympanic cavity through the tympanic membrane using a sterile 27gauge needle to induce hydrops model. Tucker-Davis Technologies system was used to measure Auditory Brainstem Responses (ABRs). For intracerebroven-tricular (ICV) administration, 25 µmol of GADOVIST (Bayer, Berlin, Germany) was used and diluted GADOVIST injection was 10 µl. MR imaging was acquired with a 9.4 Tesla MRI scanner. Transmit-receive volume coil with 40 mm inner diameter and 75 mm out diameter was used. ICV administration well demonstrated the strong enhancement along the cerebrospinal fluid (CSF) microcirculation pathway including CSF fluid in the subarachnoid space and CSF space of the inner ear structures. On the other hand, IV administration showed no contrast enhancement along the CSF microcirculation pathway and showed weak enhancement in the inner ear structures. In case of rat hydrops model, ICV administration showed that the reduced contrast enhancement in the perilymph space of the hydrops induced inner ear compared to the contrast enhancement in the perilymph space of the normal inner ear. New systemic ICV administration method provide contrast enhancement of GBCA in the inner ear through CSF microcirculation pathway.

Radiation Therapy of Intracranial Germinoma (두개강내 배아종의 방사선 치료)

  • Nho Young Ju;Chang Hyesook;Choi Eun Kyung;Kim Jong Hoon
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.207-213
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    • 1997
  • Purpose : Intracranial germinoma is the most radiocurable tumor of theprimary intracranial neoplasm. But, the optimum radiation dose and target volume remain controversial In this retrospective study, we analysed the spreading pattern at presentation and the pattern of the failure and survival of intracranial germinoma, Materials and Methods : From 1989 to 1996, 23 Patients were treated for intracranial germinoma at Department of Radiation Oncology, Twenty-one Patients were treated at their initial Presentation and 2 Patients were treated for recurrent disease. Six patients had multiple tumor masses on MRI and 7patients had ventricular seeding on MRI. The examination of cerebrospinal fluid cytology was done in 15 patients and 3 out of 15 patients had positive cerebrospinal cytology. In tumor marker study of $\alpha-FP\;and\;\beta-hCG$, 6 patients had mildly elevated $\beta-hCG$ in serum or cerebrospinal fluid. Twentyone Patients were treated with whole craniospinal axis irradiation and 2 Patients were given whole ventricular radiation therapy. The total dose was ranged between 4500cGy and 5600cGy to primary tumor site (median 5580cGy) Dose to the entire ventricular system ranged from 1980cGy to 3960 cGy (median 2700cGy) and dose to the spinal axis ranged from 2160cGy to 3900cGy (median 2700cGy) Results : Of 23 patients, 21 Patients are alive without evidence of diseasefor median 4 years follow-up. One Patient who had markedly elevated $\alpha-FP\;and\;\beta-hCG$, suffered from Persistent disease after radiation therapy and received 2 cycles of chemotherapy. She died 9 months after chemotherapy One patient who developed ventricular seeding after gamma-knife was treated with whole craniospinal irradiation, he died after 1 year due to probably brain necrosis. The hematologic toxicity of 3 or 4 grade were seen in 7 patients and patient's endocrinologic dysfunction was not deteriorated after radiation therapy. One patient had been treated with growth hormone replacement due to short stature. Conclusions : This retrospective study has confirmed the excellent result of radiation therapy in intracranial germinoma. The complication rate during or after radiation therapy is considered within acceptable range. ft is necessary to further investigate the optimal dose and treatment volume of radiation therapy. The role of chemotherapy in the treatment of intracranial germinoma should be further investigated.

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Reconstruction of Large Skull Defect Using Right-Angled Zigzag Osteotomy (직각 Z-절골술을 이용한 거대 두개골 결손의 재건)

  • Lee, Kiyoung;Paik, Hye Won;Byeon, Jun Hee
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.667-670
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    • 2007
  • Purpose: Among the materials for cranioplasty, autogenous bone is ideal because it is less susceptible to infection and has lower rates of subsequent exposure. However, the procedure is technically demanding to perform and requires a donor site. Disadvantages further exist when the defect is large and there are attendant limitations in donor site. The authors present their experience with reconstruction of large skull defect using right-angled zigzag osteotomized outer table of autogenous calvarial bone, overcoming the limitation in donor site. Methods: From 2000 to 2006, 9 patients were retrospectively reviewed, who had undergone reconstruction with right angled zigzag osteotomized outer table of autogenous calvarial bone. Results: Aesthetically satisfactory skull shape was achieved. Major complications of infection, hematoma, plate exposure, and donor site complications of dural tear with bleeding, cerebrospinal fluid leak, and meningitis were not seen. One patient had delayed wound healing and was successfully managed conservatively. Conclusion: Autogenous bone is the material of choice for cranioplasty, especially in complicated cases. Right angled zigzag osteotomy is a useful method in reconstruction of large skull defects with less donor site morbidity.

Ginsenoside Rb$_1$ Reduces Spontaneous Bursting Activity in Thalamocortical Slices of the Rat

  • Yang, Sung-Chil;Lee, Sang-Hun;Park, Jin-Kyu;Jung, Min-Whan;Lee, Chang-Joong
    • Journal of Ginseng Research
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    • v.24 no.3
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    • pp.134-137
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    • 2000
  • Spontaneous bursting activity was studied in rat thalamocortical slices using extracellular field potential recording to test the potential utilization of ginsenoside Rb$_1$ in controlling overactivated neural systems. In order to induce bursting activity, slices were perfused with Mg$\^$2+/-free artificial cerebrospinal fluid (ACSF). Two major types of spontaneous bursting activity, simple thalamocortical burst complexes (sTBCs) and complex thalamocortical burst complexes (cTBCs), were recorded in Mg$\^$2+/ -free ACSF. Ginsenoside Rb$_1$ selectively suppressed cTBCs. Duration and occurrence rate of cTBCs were reduced by 87.3${\pm}$10.2% and 85.3${\pm}$ 14.7% in the presence of 90 ${\mu}$M ginsenoside Rb$_1$ respectively, while amplitude and intraburst frequency were slightly changed by ginsenoside Rb$_1$. In contrast, ginsenoside Rb$_1$was much less effective in reducing duration and occurrence rate of sTBCs. We also tested effects of ginsenoside Rb$_1$ on bursting activity in the presence of a GABA$\sub$A/ receptor antagonist, bicuculline methiodide (BMI). Ginsenoside Rb$_1$ had no effect in suppressing BMI-induced bursting activities. These results suggest that ginsenoside Rbi may be useful in controlling seizure-like bursting activity under pathological conditions.

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Relationship between Sleep, Suicide, and Serotonin (수면, 자살, 세로토닌의 상호 관련성)

  • Park, Young-Min
    • Sleep Medicine and Psychophysiology
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    • v.20 no.1
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    • pp.5-9
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    • 2013
  • One of hypothesis is that sleep loss related to a decrease in serotonergic activity plays a significant role in attempted suicide. A growing evidence suggests that central serotonergic activity plays a key role in the etiology of suicide. It has been reported that the cerebrospinal fluid (CSF) levels of 5-hydroxyindoleacetic acid (5-HIAA), the main metabolite of serotonin, were reduced in suicide attempters. In addition, there is evidence that tryptophan hydroxylase is associated with suicide. The association between sleep and suicide was also suggested by some researchers. Several recent studies have showed the association between sleep disturbance and suicide rates in patients with mental disorders and in a general population. In addition, it has been suggested that serotonin plays a role in maintaining arousal and regulating muscle tone and in regulating some of the phasic events of REM sleep. Especially, it is well-known that 5-HT2 receptors are related to slow wave sleep. In conclusion, it is clear that sleep, serotonin activity, and suicide are linked, although the direction of causation needs clarification. In future, large population-based cohort studies are needed to demonstrate the direction of causation in the relationships between sleep, serotonin activity, and suicide.

Usefulness of Bipedicle Temporalis-pericranial Flap for Closure of Frontoethmoidal Encephalomeningoceles (전두사골 뇌수막류의 폐쇄를 위한 양경 측두근골막피판의 유용성)

  • Yun, Byung Min
    • Archives of Craniofacial Surgery
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    • v.10 no.2
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    • pp.97-102
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    • 2009
  • Purpose: To close anterior cranial base, various types of pedicle flaps have been developed previously. However, the results of those pedicle flaps were not constant. To solve such problem, the author designed bipedicle temporalis-pericranial (BTP) flap based on various types of existing flaps and this study intends to introduce this flap and present clinical application case. Methods: The pedicle of the proposed temporalis-pericranial flap is temporalis muscle. The point of this BTP flap is that because of both sides of the unilateral temporalis-pericranial flap are connected by midline pericranial tissue connected with dense vascular network communicate one another locally, that BTP flap can be safely elevated. The case is a 14 months old male patient of frontoethmoidal encephalomeningocele. Surgery was done in a way that after elevating BTP flap and removing encephalomeningocele, BTP flap was moved intracranially, and to prevent cerebrospinal fluid leakage, anterior cranial base was closed. Results: During 1 year and 6 month outpatient tracking observation, no particular finding like CSF leakage, meningitis or hydrocephalus was observed. Conclusion: The benchmarked BTP flap, effective in the treatment of frontoethmoidal encephalomeningocele, is one of the methods to close intracranium and extracranium.

Mandibular condyle and infratemporal fossa reconstruction using vascularized costochondral and calvarial bone grafts

  • Jang, Hyo Won;Kim, Nam-Kyoo;Lee, Won-Sang;Kim, Hyung Jun;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.2
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    • pp.83-86
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    • 2014
  • There are some difficulties in approaching and removing the lesion in infratemporal fossa because of its anatomical location. After wide excision of tumor lesion, it is also difficult for reconstruction of mandibular condyle and cranium base on infratemporal fossa. Besides, there are some possibilities of cerebrospinal fluid leakage, intracranial infection and bone resorption. It is also challenging for functional reconstruction that allows normal mandibular movement, preventing mandibular condyle from invaginating into the skull. In this report, we present 14-month follow-up results of a patient who had undergone posterior segmental mandibulectomy including condyle and infratemporal calvarial bone and mandible reconstruction with free vascularized costochondral rib and calvarial bone graft to restoration of the temporomandibular joint area.

Newly Developed Weakness of Lower Extremities Despite Improved Brain Metastasis of Lung Cancer after Radiotherapy

  • Yang, Jae Hyun;Jang, Young Joo;Ahn, Se Jin;Kim, Hye-Ryoun;Kim, Cheol Hyeon;Koh, Jae Soo;Choe, Du Hwan;Lee, Jae Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.6
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    • pp.574-576
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    • 2009
  • An intramedullary spinal cord metastasis (ISCM) rarely develops in systemic cancer but is indicative of a poor prognosis. A 56-year-old man was admitted due to weakness of the lower extremities. He had received radiotherapy 3 months prior for a brain metastasis that had developed 1 year after achieving a complete response from chemotherapy for extended stage small cell lung cancer. Although the brain lesion had improved partially, ISCM from the cervical to lumbar-sacral spinal cords, which was accompanied by a leptomeningeal dissemination, was diagnosed based on magnetic resonance imaging of the spine and cerebrospinal fluid cytology. Finally, he died of sudden cardiac arrest during treatment. This is the first case of ISCM involving the whole spinal segments. Physicians should be aware of the subsequent development of ISCM in lung cancer patients with a previously known brain metastasis who present with new neurological symptoms.