수기 액상세포검사 $Liqui-PREP^{TM}$의 세포보존력 평가 및 뇌척수액 세포검사에의 적용: 세포원심분리법과의 비교

박경신,이경지,정찬권,이대형,조빈,이연수,심상인,이교영,강창석,Park, Gyeong-Sin,Lee, Kyung-Ji,Jung, Chan-Kwon,Lee, Dae-Hyoung,Cho, Bin,Lee, Youn-Soo,Shim, Sang-In,Lee, Kyo-Young,Kang, Chang-Suk 대한세포병리학회 2007 대한세포병리학회지 Vol.18 No.1

Cerebrospinal fluid (CSF) cytology is an effective tool for evaluating diseases involving the central nervous system, but this technique is usually limited by its low cellularity and poor cellular preservation. Here we compared the manual liquid-base $Liqui-PREP^{TM}$ (LP) to the cytospin (CS) with using a mononuclear cell suspension and we applied both methods to the CSFs of pediatric leukemia patients. The cytopresevability, in terms of cell yield and cell size, and the clinical efficacy were evaluated. When 2000 and 4000 mononuclear cells were applied, LP was superior to CS for the cell yield, 16.8% vs 1.7% (P=0.001) and 26.2% vs 3.5% (P=0.002), respectively. The mean size of the smeared cells was 10.60 ${\mu}m$ in the CS, 5.01 ${\mu}m$ in the LP and 6.50 ${\mu}m$ in the direct smear (DS), and the size ratio was 1.7 (CS to DS), 0.8(LP to DS) and 2.1 (CS to LP), respectively. As compared to the cells in the DS, the cells in the CS were significantly enlarged, but those in the LP were slightly shrunken. Upon application to 109 CSF samples, 4 were diagnosed as positive for leukemia (positive), 4 had atypical cells and 101 were negative by CS; 6 were positive, one had atypical cells and 102 were negative by LP. For six cases, in which 4 were positive for leukemia and 2 of 4 had atypical cells by CS, they were positive by LP and they were also confirmed as positive according to the follow-up study. Three cases diagnosed as atypical cells (two by CS and one by LP), were confirmed as negative. In conclusion, these results suggest that LP is superior to CS for the cytopresevability and for rendering a definite diagnosis of cerebrospinal fluid.

뇌척수액의 세포병리

진소영,Jin, So-Young 대한세포병리학회 2008 대한세포병리학회지 Vol.19 No.2

Cerebrospinal fluid (CSF) cytology is based on the cytopathologic findings of other body fluids. However, CSF's cytologic features are less familiar to physicians than are those of the other body fluid's cytology because of the small number of cases. The low overall diagnostic accuracy and the presence of false positivity still remain as problems. The incidence of lymphoreticular malignancies and metastatic carcinomas are rather higher than that of primary brain tumors. In this review, the characteristic cytologic findings of conventional CSF cytology are reviewed along with a brief note on the technical preparation and diagnostic pitfalls.

Dehydroepiandrosterone and cortisol concentrations in the cerebrospinal fluid of dogs

Mongillo, Paolo,Bernardini, Marco,Prana, Elisa,Balducci, Federica,Gabai, Gianfranco,Marinelli, Lieta The Korean Society of Veterinary Science 2017 大韓獸醫學會誌 Vol.57 No.1

Concentrations of cortisol, dehydroepiandrosterone and dehydroepiandrosterone-sulfate were measured by performing radioimmunoassay of the cerebrospinal fluid of 68 dogs diagnosed with idiopathic epilepsy or inflammatory, degenerative, or non-neurological disease. No steroid concentration differences were found among diagnoses. Dehydroepiandrosterone and dehydroepiandrosterone-sulfate concentrations were higher in males than in females and dehydroepiandrosterone-sulfate decreased with increasing age. No sex or age effects were observed on cortisol or hormone ratios. Although limited to a relatively small sample, our results show sex- and age-dependent variations in these neurosteroid concentrations in cerebrospinal fluid. The role of such variations in the pathophysiology of the dog brain warrants further investigation.

Shunt Overdrainage Caused by Displacement of the Pressure Control Cam after Pressure Adjustment

김수호,이윤수,이민석,서상준,이정호,강동기 대한신경손상학회 2016 Korean Journal of Neurotrauma Vol.12 No.2

Although the Codman-Hakim programmable valve is one of most popular shunt systems used in the clinical practice for the treatment of hydrocephalus, malfunctions related with this system have been also reported which lead to underdrainage or overdrainage of the cerebrospinal fluid. While obstruction of the ventricular catheter by tissue materials or hematoma and catheter disconnection are relatively common, the malfunction of the valve itself is rare. Herein, we report on a rare case of shunt overdrainage caused by displacement of the pressure control cam after pressure adjustment. A 57-year-old female, who underwent a ventriculoperitoneal shunt eight years ago, experienced aggravating symptoms of shunt overdrainage after pressure adjustment. Displacement of the pressure control cam was revealed on the X-ray, and a shunt revision was performed. The purpose of this report is to provide a working knowledge of the valve structure and to enhance the ability to interpret the valve setting on an X-ray for diagnosis of valve malfunction.

뇌척수액에서 검출된 망막모세포종

지제근,김철우,서연림 대한병리학회 1988 Journal of Pathology and Translational Medicine Vol.22 No.2

Cytologic Diagnosis of Metastatic Alveolar Rhabdomyosarcoma in Cerebrospinal Fluid: A Case Report

심보배,고지원,문지혜,박인애,류한석 대한병리학회 2018 Journal of Pathology and Translational Medicine Vol.52 No.4

Rhabdomyosarcoma is a malignant soft tissue tumor which shows skeletal muscle differentiation. Leptomeningeal metastasis can occur as a late complication, but currently there are no reports that have documented the cytologic features in cerebrospinal fluid (CSF). We report a case of metastatic alveolar rhabdomyosarcoma diagnosed in the CSF of a 28-year-old male who was originally diagnosed with rhabdomyosarcoma on the neck, and that went through systemic therapy. The tumor was positive for anaplastic lymphoma kinase, but progressed despite additional therapy with crizotinib. The CSF specimen revealed small round cells, large atypical cells with abundant cytoplasm and eccentric nuclei, and cells with horseshoe-shaped nuclei. These cytologic findings were in agreement with previous literature and well-correlated with histopathology. This is the first report to document the cytologic feature of rhabdomyosarcoma in CSF. In many cases it is difficult to perform ancillary tests in a CSF specimen and cytopathologists should be aware of the cytomorphologic characteristics to avoid misdiagnosis.

Qualitative and Quantitative Comparison of Contrast-Enhanced Fluid-Attenuated Inversion Recovery, Magnetization Transfer Spin Echo, and Fat-Saturation T1-Weighted Sequences in Infectious Meningitis

Rajiv Azad,Mohit Tayal,Sheenam Azad,Garima Sharma,Rajendra Kumar Srivastava 대한영상의학회 2017 Korean Journal of Radiology Vol.18 No.6

Objective: To compare the contrast-enhanced fluid-attenuated inversion recovery (CE-FLAIR), the CE T1-weighted (CE-T1W) sequence with fat suppression (FS) and magnetization transfer (MT) for early detection and characterization of infectious meningitis. Materials and Methods: Fifty patients and 10 control subjects were evaluated with the CE-FLAIR and the CE-T1W sequences with FS and MT. Qualitative assessment was done by two observers for presence and grading of abnormal leptomeningeal enhancement. Quantitative assessment included computation of net meningeal enhancement, using single pixel signal intensity software. A newly devised FLAIR based scoring system, based on certain imaging features including ventricular dilatation, ependymal enhancement, infarcts and subdural effusions was used to indicate the etiology. Data were analysed using the Student’s t test, Cohen’s Kappa coefficient, Pearson’s correlation coefficient, the intraclass correlation coefficient, one way analysis of variance, and Fisher's exact test with Bonferroni correction as the post hoc test. Results: The CE-FLAIR sequence demonstrated a better sensitivity (100%), diagnostic accuracy (95%), and a stronger correlation with the cerebrospinal fluid, total leukocyte count (r = 0.75), protein (r = 0.77), adenosine deaminase (r = 0.81) and blood glucose (r = -0.6) values compared to the CE-T1W sequences. Qualitative grades and quantitative meningeal enhancement on the CE-FLAIR sequence were also significantly greater than those on the other sequences. The FLAIR based scoring system yielded a diagnostic accuracy of 91.6% and a sensitivity of 96%. A strong inverse Pearson’s correlation (r = -0.95) was found between the assigned score and patient’s Glasgow Coma Scale at the time of admission. Conclusion: The CE-FLAIR sequence is better suited for evaluating infectious meningitis and could be included as a part of the routine MR imaging protocol.

Fabrication of an Electromagnetic Micropump for Cerebrospinal Fluid Shunt

Kim, Myung-Sik,Lee, Sang-Wook,Yang, Sang-Sik The Korean Institute of Electrical Engineers 2002 전기학회논문지C Vol.51 No.12

This paper Presents the fabrication and test of a micropump that can be applied to an implantable cerebrospinal fluid shunt system for hydrocephalus patients The proposed micropump consists of a pair of corrugated parylene diaphragm chambers and a set of nozzle and diffuser. The electromagnetic force drives the diaphragms and pumps the fluid. The static or dynamic characteristics of the fabricated devices have been obtained experimentally. The site of the micropump is $14 \times 12 \times 8mm^3$. The flow rate increase by about $3 mell/h$ was observed in the operational pressure range the micropump.

Retention of Gadolinium in Cerebrospinal Fluid and Decreased Renal Function: A Case Report

박경식,허영진,정해웅,백진욱,추혜정,정천식 대한영상의학회 2017 대한영상의학회지 Vol.77 No.5

A gadolinium-based contrast is the preferred agent when differentiating acute neurological diseases. Since the renal route is the main pathway for excretion of gadolinium chelates, prolonged extracellular distribution of gadolinium has previously been reported in dialysis-dependent patients. Hence, gadolinium-based contrast agents are used cautiously in patients with known renal disease. Retention of gadolinium manifests as increased fluid-attenuated inversion recovery (FLAIR) signal intensity in the subarachnoid space, leading to diagnostic errors. Here, we describe a patient who presented to our emergency room with an acute cerebral infarction. Enhanced brain magnetic resonance imaging performed 2 days later revealed high signal intensity in the cerebrospinal fluid spaces on follow-up FLAIR images.

Nitric Oxide Metabolite Concentration in Cerebrospinal Fluid: Useful as a Prognostic Marker?

Saurabh Singh,Jyoti Prakash,Rakesh Singh,Ashish Verma,Hemant Bansal 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.5

Study Design: Prospective study. Purpose: To establish the significance of cerebrospinal fluid (CSF) nitric oxide metabolite (NOx) concentration in acute spinal cord injury (SCI) patients to assess the neurological severity and prognosis. Overview of Literature: Quantitative analysis of specific biomarkers in CSF will assess neurological severity more accurately and permit the formulation of a more precise management plan. Methods: Forty SCI patients represented the cases and 20 lower limb injury patients were the controls. NOx concentration in CSF was measured at week 1, 2, and 4 by Griess method. Magnetic resonance imaging (MRI, T2-weighted) done in each case to measure cord edema and neurological severity was assessed using the Frankel classification. Results: CSF NOx concentration peaked at week 2 and declined to normal by week 4. The concentration remained normal in controls. Mean NOx concentration was directly proportional to the severity of acute SCI as correlated with cord edema seen in MRI and neurological severity assessed. Conclusions: CSF NOx concentration can be considered a specific quantitative biomarker in acute stage of SCI to predict the severity and prognosis of SCI patients.