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알코올리즘 환자에서 뇌교외수초용해증과 연관된 주기교대눈떨림과 주기교대주시편위
강성원,이명제,정주리,김영진,양현덕 원광대학교 의과학연구소 2009 圓光醫科學 Vol.24 No.1
주기교대눈떨림와 주기교대주시편위는 이상안구 운동에서도 흔히 관찰되지 않는다. 이런 안구운동은 뇌교와 소뇌에 병변이 있을 때 나타난다고 보고되고 있다. 50세 남자 환자가 과음을 하고 난 이후 심하게 구토를 하여 입원하였다. 다음날 아침에 의식이 없었으며 주기교대눈떨림과 주기교대주시편위가 관찰되었다. 뇌자기공명영상에서는 뇌교나 소뇌에 병변없는 교뇌외수초용해증에 합당한 소견을 보였다. 저자는 아마도 교뇌외수초용해증이 소뇌와 전정신경핵의 경로중에 GABA 시스템에 이상이 발생하여 주기교대눈떨림과 주기교대 주시편위가 나타났을 것으로 추정한다. Background; Periodic alternating gaze deviation(PAGD) and periodic alternating nystagmus(PAN) are rare forms of abnormal eye movement. Multiple lesions in the cerebellum and brainstem have been reported with PAN and PAGD. Case Report; A 50-year-old man presented with severe vomiting after binge drinking. The next morning he. became vegetative state and showed PAGD and PAN. Brain MRI showed findings compatible with extrapontine myelinolysis(EPM) without any brainstem or cerebellar lesions. Conclusions; We postulate that the disturbed GABAnernic system in the pathway from the cerebellum to vestibular nuclei caused probably by EPM developed PAGD and PAN.
가역적 후외동맥 폐색으로 발현된 전조편두통 연관 뇌경색
김영진,이명제,정주리,강성원,양현덕 원광대학교 의과학연구소 2009 圓光醫科學 Vol.24 No.1
예전 인구에 근거하여 연구된 논문들은 편두통이 뇌졸중의 위험성을 높일 수 있다는 보고를 하였으며, 전조증상을 동반한 편두통은 중추신경계와 연관된 병인론적 과정을 통하여 뇌졸중과의 관련성이 있다는 보고가 있다. 그러나, 편두통성 뇌졸중의 병태생리는 아직 정확히 밝혀지지 않았다. 편두통의 발생 원인에서 혈관성 이론은 편두통을 혈관수축으로 발생하는 전조증상과 함께 대뇌 조절 장애로 발생한다는 이론으로 뇌허혈증상은 일으킬 수 있다. 전조증상을 동반한 편두통성 뇌경색은 허혈성 뇌졸중의 드문 원인이며, 또한 편두통과 허혈성 뇌졸중사이의 관련성은 아직 논란으로 남아 있다. 우리는 혈관경련 수축으로 나타날 수 있는 전조성 편두통과 관련된 뇌경색에서의 가역적 후뇌 동맥 폐색 1례를 보고한다. Several previous population-based studies reported an increase risk of stroke in association with migraine. Migraine with aura increased stroke risk with pathogenetic process in the central nervous system. However, the pathologic mechanism of migrainous infarction remains elusive. The vasogenic theory ascribes migraine to cerebral dysregulation with aura resulting from vasoconstriction. Migrainous infarction with aura is a rare cause of cerebral ischemic stroke. Also, the relationship between migraine and ischemic stroke remains controversial. We report a case of cerebral infarction associated with migraine with aura that shows reversible arterial narrowing which might be caused by vasospasm.
Yang, Dong-Yoon,Kim, Ju-Yong,Nahm, Wook-Hyun,Yi, Sang-Heon,Kim, Jin-Kwan,Kim, Jeong-Chan,Lee, Jin-Young Korea Association For Quaternary Research 2007 제사기학회지 Vol.21 No.2
Inorganic geochemical and mineralogical analyses from the trench sediments of the Hwayang wetland were carried out to verify the wet/dry conditions during 6000 - 5000 yr BP and abnormal event of 6300 yr BP of Korean west coast. Lithostratigraphy, mineralogy and major element concentrations of the sediments of the trench indicate that during 6000 - 5000 yr BP, a wet/dry conditions might be repeated at an interval of 200 years. Carbonate minerals precipitated with the decrease of water depth in the lake or wetland after about 6000 yr BP. On the other hand, the sediments coarser in mean grain size and larger in standard deviation were corresponded with periods of 6300 yr BP and 6230 yr BP. Especially, such a feature of grain size distribution of 6300 yr BP appears in other wetlands situated in the west coast, e.g., Hwangsan wetland and Cheollipo coastal wetland. During the period, the coarse sediments seem to have been delivered by a high energy like storming.
Yang, Deok-Hwan,Kim, Mi-Hyun,Lee, Youn-Kyung,Hong, Cheol Yi,Lee, Hyun Ju,Nguyen-Pham, Thanh-Nhan,Bae, Soo Young,Ahn, Jae-Sook,Kim, Yeo-Kyeoung,Chung, Ik-Joo,Kim, Hyeoung-Joon,Kalinski, Pawel,Lee, Je-J Springer International 2011 Annals of hematology Vol.90 No.12
<P>For wide application of a dendritic cell (DC) vaccination in myeloma patients, easily available tumor antigens should be developed. We investigated the feasibility of cellular immunotherapy using autologous alpha-type 1-polarized dendritic cells (관DC1s) loaded with apoptotic allogeneic myeloma cells, which could generate myeloma-specific cytotoxic T lymphocytes (CTLs) against autologous myeloma cells in myeloma patients. Monocyte-derived DCs were matured by adding the 관DC1-polarizing cocktail (TNF관/IL-1관/IFN-관/IFN-관/poly-I:C) and loaded with apoptotic allogeneic CD138(+) myeloma cells from other patients with matched monoclonal immunoglobulins as a tumor antigen. There were no differences in the phenotypic expression between 관DC1s loaded with apoptotic autologous and allogeneic myeloma cells. Autologous 관DC1s effectively took up apoptotic allogeneic myeloma cells from other patients with matched subtype. Myeloma-specific CTLs against autologous target cells were successfully induced by 관DC1s loaded with allogeneic tumor antigen. The cross-presentation of apoptotic allogeneic myeloma cells to 관DC1s could generate CTL responses between myeloma patients with individual matched monoclonal immunoglobulins. There was no difference in CTL responses between 관DC1s loaded with autologous tumor antigen and allogeneic tumor antigen against targeting patient's myeloma cells. Our data indicate that autologous DCs loaded with allogeneic myeloma cells with matched immunoglobulin can generate potent myeloma-specific CTL responses against autologous myeloma cells and can be a highly feasible and effective method for cellular immunotherapy in myeloma patients.</P>
Yang, Moon Sool,Yoon, Do Heum,Kim, Keung Nyun,Kim, Hoon,Yang, Joong Won,Yi, Seong,Lee, John Y. K.,Jung, Woo Ju,Rha, Koon Ho,Ha, Yoon Lippincott Williams Wilkins, Inc. 2011 1528-1159) Vol.36 No.2
STUDY DESIGN.: The use of the da Vinci Surgical System to perform an anterior lumbar interbody fusion in a swine model to identify the technical properties, processes, merits, demerits, and limitations of a video-assisted robotic surgical system. OBJECTIVE.: This study was designed to demonstrate the feasibility of using a robotic surgical system to perform spinal surgery. SUMMARY OF BACKGROUND DATA.: Video-assisted laparoscopic anterior fusion was first reported in 1995 and afterward was spotlighted for several years. However, this technique has not become popular because of technical difficulties and complications associated with video-assisted procedures on the spine. As such, there is a demand for investigations to improve this technology. The da Vinci Surgical System provides 3-dimensional visualization as well as uniquely dexterous instruments that are remarkably similar to human hands. Video-assisted surgery with the da Vinci Surgical System robot has already provided great value to the fields of urology, cardiology, gynecology, and general surgery over the last decade. Preclinical studies for application of this system in spinal surgery have recently been conducted. METHODS.: A pig underwent anterior lumbar interbody fusion using da Vinci Surgical System assistance, with Tyche expandable cages used for preparation of endplates and cage placement. The setup time, operation time, amount of bleeding, and the number of complications associated with robotic manipulation were recorded. Before euthanasia, the animal underwent radiologic examination to confirm proper placement of cages. RESULTS.: The total duration of the procedure took 6 hours, with some complications related to frozen armsand robotic arm collision. Even so, there was neither any significant nerve or vessel injury nor peritoneal organ damage. Furthermore, radiologic assessment confirmed proper position of the cage in the center of the disc space. CONCLUSION.: Use of the da Vinci Surgical System to perform an anterior spinal procedure was shown to be safe and effective in a swine animal model. The utilization of this advanced technology shows promise to reduce the incidence of complications compared with other approaches. It requires further testing in animal models and cadavers, along with serial comparisons to current procedures.