Astrocytes are major glial cells in central nervous system (CNS) and are known to express death receptors or ligands that can induce apoptosis of astrocytes or other brain cells. We have previously confirmed that cultured human astrocytes express fas and fas ligand and their expression may be regulated by various cytokines found in CNS. Because fas can rnediate cell death known as apoptosis, we investigated fas-mediated cell death in cultured human astrocytes and evaluated factors that may influence the fas-mediated apoptosis in astrocytes. Pretreatment of interferon-r and TNF-a increased cell death in astrocytes. Cell death induced by fas ligation was confirmed as apoptosis by phosphatidylserine translocation in cell membrane. Cycloheximide, protein synthesis inhibitor, potentiated fas-mediated cell death. However, buthionine sulfoxine did not potentiate fas-mediated apoptosis. Dexamethasone blocked cell death in dose-dependent and time-dependent manners. These findings collectively show that fas expressed on cultured human fetal astrocytes can induce apoptotic cell death after pretreatment of interferon-r and/or TNF-a. Therefore, the fas-fas ligand system in CNS may regulate the glial degeneration and may participate the neuronal loss in certain conditions. Furthermore, fas-mediated apoptosis of astrocytes can be potentiated by protein synthesis inhibitors and can be blocked by dexamethasone.
Apoptosis ; Astrocytes* ; Brain ; Cell Death ; Cell Membrane ; Central Nervous System ; Cycloheximide* ; Cytokines ; Dexamethasone* ; Fas Ligand Protein ; Humans* ; Ligands ; Ligation ; Neuroglia ; Neurons ; Protein Synthesis Inhibitors ; Receptors, Death Domain ; Signal Transduction

No abstract available.
Transplantation*

Cryptococcal meningitis is a relatively common central nervous system infection by Cryptococcus neoformans. Before the introduction of amphotericin B in 1956, cryptococcal infection of the central nervous system had been almost uniformly fatal. Although amphotericin B(alone or in combination with flucytosine) has been the standard therapeutic regimen, problems such as modest efficacy, nephrotoxcity, other clinically significant toxicities, and the inconvinience of intravenous dosing have led to search for a new antimycotic agents. Fluconazole is a new therapeutic agent which is effective as amphoterin B. Accumulating evidence suggests that the antifungal triazole fluconazole represent an advance in the treatment of cryptococcal meningitis, particulary in acquired immunodeficiency syndrom patients. Thus we report clinical experiences of fluconazole therapy for 5 cases of cryptococcal meningitis. Four of 5 patients are improved clinically and microbiologically, 1 of 5 patients is expired due to concomittent tuberculous infection.
Amphotericin B ; Central Nervous System ; Central Nervous System Infections ; Cryptococcus neoformans ; Fluconazole* ; HMGB1 Protein ; Humans ; Meningitis, Cryptococcal*

This is a case of a 10 year-old primary schoolgirl who showed two episodes of generalized convulsive epileptic seizure during the past one year. Physical and neurologic examination reveaIed no significant abnormality. There was no abnormal finding in Brain CT scan. Electroencephalographic study showed continuous bioccipital scotosensitive sharp-and-slow wvave discharges: appearing in 1) eye-closing state(either passive or active) in room light 2) either eye-closing or eye-opening state in darkness 3) seeing the vacant space 2 m beside a small light 3 m ahead of the patient, but disappearing in 1) eye-opening state in lighted room 2) seeing a small light either in darkness or in lighted room. Intermittent photic stimulation or hyperventilation revealed no unusual response.
Brain ; Child ; Darkness ; Epilepsy* ; Humans ; Hyperventilation ; Neurologic Examination ; Photic Stimulation ; Tomography, X-Ray Computed

Vesicoureteral reflux is closely associated with urinary tract infection and if persisted, will result in impairment of renal function. So, early detection and proper treatment are necessary. To looking for the reason of taking voiding cystourethrogram under the impression of vesicoureteral reflux among the patients who visit urologic out-patient department and to study the success rates of medical and surgical management, we reviewed 25 vesicoureteral reflux patients(36 ureters) from January, 1983 to August, 1986 in Ewha Woman`s University Hospital. The following results were obtained: 1. Among 25 patients, 18 were children. 2. Symptoms and signs on initial visit were fever, urinary frequency, flank pain, gross hematuria, abdominal mass in sequence and fever with urinary frequency was most common. 3. Normal findings on IVP in 15 among 25 patients and abnormal findings in 10 were noted. 4. 22 of 36 refluxing ureters were under grade IV. 5. Rates of disappearance of vesicoureteral reflux in medical and surgical management were 60%, 95%, receptively.
Child ; Fever ; Flank Pain ; Hematuria ; Humans ; Outpatients ; Ureter ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

Benign partial epilepsy of childhood is the most common type of epilepsy in school-aged children and is typically well controlled with antiepileptic drug, thus having an excellent prognosis. Recently, we have encountered one case of atypical benign partial epilepsy of childhood with the following atypical clinical and EEG features : predominant atypical absence seizure in addition to partial motor seizure, unusual awake EEG tracings of focal sharp waves in the frontocentrotemporal location, while the sleep tracings showed nearly continuous slow spike and wave activity. The administration of various antiepileptic drugs adversely provoked a drowsy mental state without seizure control. The patient dramatically improved after steroid therapy.
Anticonvulsants ; Child ; Electroencephalography ; Epilepsies, Partial* ; Epilepsy ; Epilepsy, Absence ; Humans ; Prognosis ; Seizures

The neuronal ceroid-lipofuscinosis (NCL) is a group of progressive,. Inherited neurodegenerative diseases characterized by the deposition of large numbers o autofluorescent cytosomes in most tissues. Based on the age at onset, clinical presentation, and morphological findings, NCL is divided into four subgroups: infantile, late inf antile, juvenile and adult types. Late inf antile NCL is characterized by age of onset 2.5-4 years, early seizure, frequent myoclonic jerk, late visual failure, whereas juvenile NCL by age of onset 4-7 years, early visual failure, late seizure, infrequent myoclonic jerks. We experienced unusual form of NCL as diagnosed by tissue biopsy. The patient is a 11 years old with a mixture form of juvenile and late infantile NCL, being called early juvenile NCL.
Adult ; Age of Onset ; Biopsy ; Child ; Humans ; Myoclonus ; Neurodegenerative Diseases ; Neuronal Ceroid-Lipofuscinoses* ; Seizures

Spontaneous Intracranial Hypotension(SIH) is a rare syndrome of spontaneous postural cephalalgia associated with low CSF pressure and usually without evidence of CSF leakage from meningeal defect due to dural puncture. The postural headache may appear suddenly or gradually and disappear within several weeks spontaneously. MRI findings maybe include diffuse symmetric pachymeningeal gadolinium-enhancement, also subdural effusion and downward brain displacement. We report two cases of SIH in which MRI of the brain reveals diffuse symmetric pachyme-ningeal enhancement.
Brain ; Headache ; Intracranial Hypotension* ; Magnetic Resonance Imaging* ; Punctures ; Subdural Effusion

The common causal lesions of pure dysarthria syndrome were known as anterior or posterior internal capsule, genu of internal capsule, adjacent corona radiata, or pons. And there are a few reports showed that bilateral small thalamic infarctions or paravermal cerebellar infarction also caused pure dysarthria. The rostral cerebellum, especially paravermal region is thought to have a major role in coordination of speech. The paravermal region is Intimately connected to caudal red nucleus. We report a patient with acute dysarthria and minlmal contralateral limb ataxia, in whom the causal lesion was in caudal red nucleus and superior part of decussation of brachium conjunctivum.
Ataxia ; Cerebellum ; Dysarthria* ; Humans ; Infarction* ; Internal Capsule ; Mesencephalon* ; Pons ; Red Nucleus

Ticlopidine, a widely used antiplatelet agent, has been rarely reported to cause thrombotic thrombocytopenic purpura (TTP). To the best of our knowledge, its occurrence has never before been reported in Korea. A 69 years old female patient suffered from an acute ischemic stroke. Ticlopidine 250mg bid was started and she followed an uneventful clin-ical course. The platelet count was normal on the 1st and the 12th day of ticlopidine administration. Around the 31st day, at home, she developed purpura, dyspnea and a stuporous mental status. Under the diagnosis of TTP, a plasma exchange was performed and her condition eventually returned to the baseline status. Ticlopidine induced TTP can developed abruptly despite close monitoring of platelet count, as illustrated by this case. Physicians prescribing ticlopi-dine should be aware of this potentially dangerous complication.
Aged ; Diagnosis ; Dyspnea ; Female ; Humans ; Korea ; Plasma Exchange ; Platelet Count ; Purpura ; Purpura, Thrombotic Thrombocytopenic* ; Stroke ; Stupor ; Ticlopidine*