BACKGROUND: The purpose of this study is to evaluate the synaptic reorganization and pattern of mossy fiber sprouting as a pathologic mechanism of chronic seizure in pilocarpine epilepsy model through histological alterations of hippocampus. METHOD: Sprague-Dawley, a sensitively damaged by pilocarpine stimulation, served as a experimental group(n=20). And the same dose of saline injected rats were served as a control group(n=10). They were implanted depth electrode in the hippocampus by a stereotaxic surgery, and injected pilocarpine 300mg/Kg intraperitoneally. They produced status epilepticus and the survival rats were monitored by a video-EEG monitoring system whether the spontaneous recurrent seizures occurring for more than 4 weeks. If more than 3 times spontaneous recurrent seizures were identified, then the rat hippocampus was examined by light microscope. RESULT: The pilocarpine injected group produced acute limbic seizure and developed to status epilepticus. The survival rats(n=10) became to chronic epilepsy state after silent period of everage 16.5 days. H&E staining demonstrated that loss of hilar polymorphic cell with ischemic changes and destruction of CA1 with damages of pyramidal cells in hippocampal subfields. Timm stains showed mossy fiber synatic reorganization in the supragranular and intragranular layer of dentate gyrus and infrapyramidal layer of CA3 hippocampal subfieid in pilocarpine induce seizure rats. CONCLUSION: These results suggest that chronic seizures in the pilocarpine epilepsy model is largely due to mossy fiber synatic reorganization, a consequence of supragranular mossy fiber sprouting. But intragranular and infrapyramidal axonal sprouting might have parts of role in synaptic reorganization. Additional research is required to determine the various patterns of axonal sprouting.
Animals ; Axons ; Coloring Agents ; Dentate Gyrus ; Electrodes ; Epilepsy* ; Hippocampus ; Pilocarpine* ; Pyramidal Cells ; Rats ; Rats, Sprague-Dawley ; Seizures ; Status Epilepticus

Asphyxia is the most important perinatal cause of neurologic morbidity in infants. Recently, elevated levels of CK-BB have been demonstrated in serum after asphyxic insult in infants. To evaluate the possibility of using serial measurements of CK-BB activity as a diagnostic method and a predictor of neurologic outcome in asphyxiatic infants. We studied CK-BB activity in serum of asphyxiated infants (16 preterm babies, 41 term babies) and healthy infants (11 preterm babies, 12 term babies) from birth (cord) to 5 days of serially. The results were as follows 1) Serum CK-BB activites (cord 76.0IU/L, 12 hours 34.1 IU/L, 1 day 22.4 IU/L, 2 days 8.2 IU/L) of asphyxiated preterm infants were much higher than those (cord 4.4IU/L, 12 hours 2.4IU/L, 1 day 1.6 IU/L, 2 days 1.1 IU/L) of healthy preterm infants, but there were no significant differences (P values>0.05). 2) Serum CK-BB activities (cord 59.0 IU/L, 12 hours 23.6 IU/L, day 17.6 IU/L) of asphyxiated term infants were significantly higher than those (cord 2.4 IU/L, 12 hours 2.7 IU/L, 1 day 0.4 IU/L) of healthy term infants (P values<0.05) 3) There were no significant differences in serum CK-BB activities between asphyxiated preterm infants who showed late neurologic deficits (P values>0.05) 4) Serum CK-BB activity (131.7 IU/L) at birth (cord) of asphyxiated term infants who showed late neurologic deficits was significantly higher than that (49.8 IU/L) of asphyxiated term infants who did not show late neurologic deficits (P value<0.05) In conclusion, it is suggested that serial measurement of CK-BB activity in serum of asphyxiated term infants from birth (cord) to 1 day of age is an available test for diagnosis of neonatal asphyxia and for a prediction of neurologic outcome of neonatal asphyxia.
Asphyxia ; Diagnosis ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature ; Neurologic Manifestations ; Parturition

With the aging process, the senile lids are manifested by the excessive skin, decreased height of palpebral fissures with interference of the vision. Sometimes these patients often complained the blepharitis on the lateral canthal area and phtophobia. But there are many diseases to differentiate from senile lids such as dermatochalasia, blepharochalasia, hypertrophy of orbicularis oculi, herniation of orbital fat, myasthenia gravis, and blepharoptosis. Blepharospasm must also be differentiated because of sysmptoms similar to the above described senile lids. Essential blepharospam is an idiopathic progressively debilitating desease which involve bilateral spasm of the orbicularis oculi. So just only an conventional blepharoplasty could not get an improvement of symptoms and some times it makes the symptoms worsen. This case report is about blepharospasm patients visiting for blepharoplasty. And the patients got relatively the satisfied results with the injection of botulinum A toxin, aided by neurologist, instead of blepharoplasty. In conslutions, The blepharospasm in required to detect in preoperative evaluation for blepharoplasty. Once the blepharospasm is diagnosed, it is better to cooperate with neurologist and to do the blepharoplasty.
Aging ; Blepharitis ; Blepharoplasty* ; Blepharoptosis ; Blepharospasm* ; Botulinum Toxins ; Botulinum Toxins, Type A ; Humans ; Hypertrophy ; Myasthenia Gravis ; Orbit ; Skin ; Spasm

The diagnosis of OPCA could be made clinically with important aid of brain CT scanning, although the definite and conclusive diagnosis only by postmortem pathological determination. We reviewed, clinically and with brain CT examination, 12 cases of patients with OPCA who were admitted to the Yeungnam University Hospital for a recent 5 years. The result were as following: 1. The distribution of age is from 49 to 72, mainly 50 to 60. Man is more frequent than women at the 4.5 times. 2. The interval period from Sx. Onset to diagnosis is 1 year to 6 years. 3. The usual initial Sxs. Were dizziness (58%), ataxia (33%), and other less frequent Sxs. Were weakness of low extremities, dysarthria, headache and urinary incontinence. The clinical manifestations at the initial diagnosis were cerebellar disturbance (100%), dysarthria (83%), and increased deep tendon reflexes (58%). 4. The results of brain CT finding are like this: the width of cerebellar sulci is more than 1mm, other 4 cases more than 2mm. the width of cerebellar pontine cistern of the patient if usually 3 to 4mm, other 2 cases extended to the 5 mm. the A. P and lateral lengths of 4th. ventricle is 4 mm and 4 to 8 mm respectively. 6 cases of whole patients show coincidentally cerebral atrophy.
Ataxia ; Atrophy ; Brain ; Clinical Study* ; Diagnosis ; Dizziness ; Dysarthria ; Extremities ; Female ; Headache ; Humans ; Olivopontocerebellar Atrophies* ; Reflex, Stretch ; Tomography, X-Ray Computed ; Urinary Incontinence

BACKGROUND: Meralgia paresthetica(MP) is clinically benign entrapment neuropathy which is characterized by paresthesias and sensory impairment in the cutaneous distribution of the lateral femoral cutaneous nerve(LFCN). The diagnosis of MP is mostly based on clinical symptoms. Sensory nerve conduction study of the LFCN have been of limited value because frequently they could not be recorded in able-bodied persons and also because lesions of the nerve may be localized proximally from the segment that is accessible to nerve conduction study. For these reasons, I studied simple bilateral somatosensory evoked potentials(SSEP) of LFCN to evaluate this clinical symptoms objectively. METHODS: 16 MP patients (mean age+/-SE : 50+/-3.21yrs) and 15 disease free adults(49+/-4.47yrs) were studied bilateral SSEP of LFCN. The stimulation site was anterolateral aspect of thigh and the recording site was Cz'. RESULTS: The mean latencies of P0 and N1 were prolonged on the affected side(P<0.05), The mean latency differences of P0 and N1 between two sides were increased in the patients with MP compare with those of controls.(P<0.001) The mean amplitude difference between two sides were increased in the patients with MP compare with that of controls(P<0.05). CONCLUSION: SSEP of LFCN can be used as a objective test to support the diagnosis of MP. I suggest more than 2.4msec difference for P0 latency between affected and unaffected side could be abnormal.
Diagnosis ; Evoked Potentials* ; Evoked Potentials, Somatosensory ; Humans ; Neural Conduction ; Paresthesia ; Thigh

Angiogenesis is essential for tumor growth and metastasis, however, the prognostic value of neovascularization is undetermined. The aim of this study is to evaluate the prognostic significance of microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression in breast carcinomas. An immunohistochemical stains for CD 31 (DAKO) to estimate MVD and VEGF (Santa Cruz) were done on 40 cases of invasive breast carcinoma. MVD was calculated as an average count of vessels per 200 power field in the most vascularized areas. VEGF expression was interpreted according to staining intensity and number of positive cells. Mean MVD was 35, and MVD was not correlated with lymph node metastasis or histologic grade, but high MVD (mean MVD>35) showed an increasing tendency in cases with larger size, negative ER/PR, and positive cathepsin D. All of the cases showed VEGF expression, but VEGF expression was not correlated with tumor size, histologic grade, lymph node metastasis, ER/PR status, and cathepsin D expression. These results suggest that MVD and VEGF expressions are not reliable prognostic factors.
Breast Neoplasms* ; Breast* ; Cathepsin D ; Coloring Agents ; Lymph Nodes ; Microvessels* ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A*

To evaluate the intractability of partial epileptic patients by variables, the author studied 113 patients (uncontrolled: 45, controlled: 68) who were admitted to the Department of Neurology, College of Medicine, Yeungnam University from January, 1991 to August, 1993. The results were as follows. The items related to complex partial seizures, multiple seizure types and a histories of status epilepticus or clusters of seizures were significantly associated with drug-refractoriness (p<0.01). A high frequency of seizures before evaluation was associated with a poor outcome(p<0.01). The presences of known etiology of seizures, neurologic abnormalities and psychiatric disturbance were associated with limited treatment responses(p<0.01, p<0.05, p<0.01). An abnormal EEG findings such as background slowing, focal slowing, epileptiform discharges or secondarily bilateral synchrony were statistically significant (p<0.01). Age at onset, sex, distribution of epileptic foci, duration of seizure before evaluation, family history and abnormal neuroradiologic findings were not statistically significant. By these results, it was suggested that having at least four factors of the above variables were associated with limited treatment response.
Electroencephalography ; Epilepsies, Partial* ; Humans ; Neurology ; Risk Factors ; Seizures ; Status Epilepticus

The author studied 20 healthy adults (20 hands) as a control and 30 patients (40 hands) with carpal tunnel syndrome to evaluate the clinical usefulness of measuring nerve conduction velocity after wrist flexion in diagnosis of carpal tunnel syndrome. The median nerve conduction velocity over wrist to finger segment was measured before and after wrist flexion for 1, 2 and 5 minutes, using belly-tendon method for motor nerve distal latency (MNDL) and antidromic method for sensory nerve conduction velocity (SNCV). The results were as follows: 1. In control group, MNDL increased in 1 hand and SNCV decreased in 2 hands after wrist flexion. In patient group, MNDL increased in 2 hands and SNCV decreased in 3 hands after wrist flexion. 2. In both control and patient group, there were no significant changes in mean values of SNCV and MNDL between before and after wrist flexion. 3. Phalen's wrist flexion test was positive in 5 percent of control and 60 percent of patient group. 4. Tinel's sign was present in 10 percent of control and 33 percent of patient group.
Adult ; Carpal Tunnel Syndrome* ; Diagnosis ; Fingers ; Hand ; Humans ; Median Nerve ; Methods ; Neural Conduction* ; Wrist*

Wilson's disease is a genetically transmitted autosomal recessive disorder of copper metabolism which affects the liver. Brain and other organs. The seizure in Wilson's disease is not infrequent but. It's report is very rare in Korea. The frequency of seizure is about 10 times more than that of general population The statistical proportions of types of seizure associated with Wilson's disease do not differ significantly from that seen in the general population. And the most common seizure type is focal motor form. The issue of the mechanisms producing seizure in Wilson's disease has attracted controversy, but the cause of seizure seems to be related with copper itself. Although the seizure is well controlled by anticonvulsants, the prognosis of seizure depends on the treatment of Wilson`s disease. We report a case of Wilson's disease associated with somatomotor status epilepticus.
Anticonvulsants ; Brain ; Copper ; Hepatolenticular Degeneration* ; Korea ; Liver ; Metabolism ; Prognosis ; Seizures ; Status Epilepticus

Endoscopic sinus surgery as a surgical technique for chronic sinusitis has become very popular. So, surgeons should be familiar with the structures and variation of the paranasal sinus to avoid the risks of endoscopic sinus surgery. Many investigations were performed to measure the sinus structure with CT and cadaver dissection. But, there were not to be performed precise measurements in paranasal sinus during operation. The authors measured the distance between anterior nares to intranasal structures such as uncinate process, bulla ethmoidalis, basal lamella, maxillary ostium, posterior wall of ethmoid sinus, anterior wall of sphenoid sinus and posterior wall of sphenoid sinus in 86 patients during endoscopic sinus surgery which were performed by one surgeon. The authors analyzed between measured distance in paranasal sinus and circumference and anteroposterior diameter of head using t-test. The results were as followed. 1) The distance from anterior nares to uncinate process was 45.3+/-2.8mm, to basal lamella 57.9+/-4.6mm, to maxillary ostium 48.3+/-4.7mm, to anterior wall of sphenoid sinus 69.9+/-3.6mm, and to posterior wall of sphenoid sinus 83.7+/-4.3mm. 2) There were no significant difference between sex, circumference and anteroposterior diameter of head.
Cadaver ; Endoscopes* ; Ethmoid Sinus ; Head ; Humans ; Nose* ; Paranasal Sinuses* ; Sinusitis ; Sphenoid Sinus