• Annals of Clinical Neurophysiology
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• 제6권1호
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• pp.52-56
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• 2004

Acute motor axonal neuropathy (AMAN) is a subtype of Guillain-Barre syndrome and characterized by selective involvement of motor fibers. Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of central nervous system. The coincidence of central and peripheral nervous system involvement has been reported rarely. We described a 37-year-old male patient presented with fever and altered consciousness. The examination of cerebrospinal fluid and brain magnetic resonance imaging was compatible with acute disseminated encephalomyelitis. Several days after admissionb his mentality was improved but quadriparesis, multiple cranial neuropathies, and areflexia were detected. Electrophysiologic studies suggested axonal form of motor dominant polyneuropathy. We report a case of acute motor axonal neuropathy combined with ADEM. We consider that this case is an example of simultaneous immunologic process to the common pathogenic epitope of central nervous system and peripheral nervous system.

• Annals of Clinical Neurophysiology
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• 제15권1호
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• pp.24-26
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• 2013

We encountered a case of pituitary apoplexy who presented with isolated headache and vomiting without visual disturbance or ophthalmoplegia. The cerebrospinal fluid examination was compatible with aseptic meningitis. A computed tomography revealed slightly high density in the pituitary fossa and suprasella area, but the signal change was very faint. Our case suggests that clinicians should take into account the possibility of pituitary apoplexy without visual disturbance or ophthalmoplegia, when aseptic meningitis is suspected.

• 대한수의학회지
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• 제48권1호
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• pp.93-98
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• 2008

A 6-year-old female Boston terrier dog was presented with seizure episode, forelimb paraparesis, excessive panting, and ataxia. On physical and neurological examination, episcleral vessel engorgement, delayed postural reaction, delayed pupillary light reflex (both direct and consensual), and crossed forelimb were noted. Serum biochemical profiles were not remarkable other than mildly elevated hepatic enzymes. On cerebrospinal fluid analysis, elevated protein concentration was observed. In magnetic resonance imaging scans, the left frontal brain lesion with ring enhancement strongly suggested the presence of intracranial tumor. Concurrently, secondary hydrocephalus and syringomyelia were also observed. The dog was euthanized at 4 months after initial presentation because of aggravated neurological signs. This case was definitely diagnosed as an intracranial anaplastic oligodendroglioma based on postmortem histopathologic examination.

• 대한수의학회지
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• 제48권4호
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• pp.463-467
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• 2008

Granulomatous meningoencephalomyelitis (GME) is a sporadic, idiopathic, non suppurative inflammatory disease of the canine central nervous system. GME appears to have a worldwide distribution and to occur mostly in young to middle-age dogs of small breeds. A 6-year-old female mixed dog with wry neck, ataxia and rolling was submitted to the Cheju National University for diagnosis. Grossly, in the brain, cerebrospinal fluid was mildly increased and dilatation of the subarachnoid blood vessels was observed. Histopathologically, the lesions were characterized by perivascular cuffs of lymphocytes, various numbers of macrophages and plasma cells in the brainstem and cerebral white matter. Numerous granuloma composed of lymphocytes and histiocytes were scattered throughout the brainstem. Two malacic foci characterized by axonal swelling and gitter cell infiltration with hemorrhage were noted in the medulla oblongata and cerebellum. Special stains failed to demonstrate any infectious agents. Immunohistochemically, the infiltrated cells demonstrated strong positive reactions for CD3, a marker for T lymphocytes origin. Based on the clinical signs, histopathology, and immunohistochemistry, this case was diagnosed as GME in a mixed dog.

• 한국환경보건학회지
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• 제30권1호
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• pp.15-21
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• 2004

In an attempt to analyze the characteristics of domestic pathogenic strains of S. pneumoniae, the basic epidemiological charactristics of pathogenic strains such as their serotypes and frequency of penicillin resistance, and pattern of chromosomal DNA from PFGE(pulsed-field gel electrophoresis) were observed. For this study,56 strains of S. pneumoniae isolated from inpatients and outpatients in the four domestic university hospitals were collected from January to December in 1998. Among those strains, a total of 56 pathogenic strains from blood(39 isolates), cerebrospinal fluid(8 isolates) and other specimen(9 isolates) were selected and isolated. The penicillin resistance frequency of those 56 strains was identified with disk diffusion method with 66.1％. From the invasive strains, predominant serotypes were isolated in the order of 19F(12.5％), 23F(10.7%), 14(10.7%) and 9V(10.7％), totalling 45 percent. This experiment also used PFGE patterns to compare the correlations among genetic subtypes in several serotypes. The DNA fragments digested with Sma I and Apa I were resolved by PFGE. The PFGE patterns digested with Sma I were better than Apa I for analysis. In the DNA fragments digested with Sma 1, PFGE analysis of 56 S. pneumoniae isolates showed 25 different patterns. As a result, serotype was on the whole correlated to PFGE pattern on the ground that each different PFGE pattern by serotype was observed. This study can be utilized not only fur the study of incidence trend of domestic pneumococcal diseases but also as a useful basic data for the development of identification tool and treatment.

• Journal of Korean Neurosurgical Society
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• 제30권1호
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• pp.81-84
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• 2001

Pneumocephalus is exceedingly rare in the absence of trauma or recent surgery. It is most commonly seen after severe head injury, with disruption of the dura and subsequent cerebrospinal fluid leakage. Intracranial air has also been reported as a complication of shunting. This may be secondary to intermittent shunt failure or a persistent communication between the extracranial and intracranial space that permits the entrance of air. In the present case, air appeared to enter the ventricular system through the fistula that connected the frontal sinus. This air replaced the CSF being drained into the peritoneal cavity by the shunt. The decrease of intracranial pressure after a shunt might play a role in causing pneumocephalus. We report a case of tension pneumocephalus after shunting for hydrocephalus as a life-threatning complication.

• Journal of Korean Neurosurgical Society
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• 제46권6호
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• pp.588-591
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• 2009

Radiologic findings of Bing-Neel syndrome, which is an extremely uncommon complication resulting from malignant lymphocyte infiltration into the central nervous system (CNS) in patients with Waldenstr$\ddot{o}$m's macroglobulinemia (WM), have been infrequently reported due to extreme rarity of the case. A 75-year-old man with WM presented at a neurology clinic with progressive gait and memory disturbances, and dysarthria of 2 months duration. Cerebrospinal fluid and serum protein electrophoresis and immunofixation electrophoresis showed IgM kappa-type monoclonal gammopathy. Brain magnetic resonance imaging revealed multifocal, hyperintense lesions on T2 weighted-images. Brain diffusion-weighted imaging (DWI) demonstrated hyperintensities in cerebral and cerebellar lesions that appeared isointense on apparent diffusion coefficient maps, which were compatible with vasogenic edema. Although histologic analysis is a confirmative study to prove direct cell infiltration into the brain, brain MRI with DWI may be a good supportive study to diagnose Bing-Neel syndrome.

• Journal of Korean Neurosurgical Society
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• 제46권6호
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• pp.581-583
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• 2009

Abducens nerve palsy associated with spinal surgery is extremely rare. We report an extremely rare case of abducens nerve palsy after lumbar spinal fusion surgery with inadvertent dural tearing, which resolved spontaneously and completely. A 61-year-old previous healthy man presented with chronic lower back pain of 6 weeks duration and 2 weeks history of bilateral leg pain. He was diagnosed as having isthmic spondylolisthesis at L4-5 and L5-S1, and posterior lumbar interbody fusion was conducted on L4-5 and L5-S1. During the operation, inadvertent dural tearing occurred, which was repaired with a watertight dural closure. The patient recovered uneventfully from general anesthesia and his visual analogue pain scores decreased from 9 pre-op to 3 immediately after his operation. However, on day 2 he developed headache and nausea, which were severe when he was upright, but alleviated when supine. This led us to consider the possibility of cerebrospinal fluid leakage, and thus, he was restricted to bed. After an interval of bed rest, the severe headache disappeared, but four days after surgery he experienced diplopia during right gaze, which was caused by right-side palsy of the abducens nerve. Under conservative treatment, the diplopia gradually disappeared and was completely resolved at 5 weeks post-op.

• 한국자기공명학회논문지
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• 제24권3호
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• pp.91-95
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• 2020

Transthyretin (TTR) is an abundant protein in blood plasma and cerebrospinal fluid (CSF), working as a homo-tetrameric complex to transport thyroxine (T₄) and a holo-retinol binding protein. TTR is well-known for its amyloidogenic property; several types of systemic amyloidosis diseases are caused by aggregation of either wild-type TTR or its variants, for which more than 100 mutations were reported to increase the amyloidogenicity of TTR. The rate-limiting step of TTR aggregation is the dissociation of a monomeric subunit from a tetrameric complex. A wide range of biochemical and biophysical techniques have been employed to elucidate the TTR aggregation processes, among which nuclear magnetic resonance (NMR) spectroscopy contributed much to characterize the structural and functional features of TTR during its aggregation processes. The present review focuses on discussing the recent advances of our understanding to the amyloidosis mechanism of TTR and to the structural features of its monomeric aggregation-prone state in solution. We expect that the present review provides novel insights to appreciate the molecular basis of TTR amyloidosis and to develop novel therapeutic strategies to treat diverse TTR-related diseases.

• Clinical and Experimental Pediatrics
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• 제52권6호
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• pp.705-709
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• 2009

대상포진은 흔한 질환으로 여러 가지 합병증을 동반 할 수 있으나 대상포진에 동반되어 수막염이 생긴 경우는 보고는 많지 않다. 저자들은 15개월에 수두 예방접종을 시행 받았고, 5세 때 수두를 앓은 과거력이 있던 건강한 14세 남자 환아에서 대상포진에 동반되어 급성 무균성 수막염이 발생한 증례에서 뇌척수액에서 중합효소연쇄반응을 통해 VZV DNA를 검출한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.