• Journal of the Korea Convergence Society
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• v.7 no.4
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• pp.1-7
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• 2016

Structural MRI(sMRI) imaging is used to extract morphometric features after Grey Matter (GM), White Matter (WM) for several univariate and multivariate method, and Cerebro-spinal Fluid (CSF) segmentation. A new approach is applied for the diagnosis of very mild to mild AD. We propose the classification method of Alzheimer disease patients from normal controls by combining morphometric features and Gaussian Mixture Models parameters along with MMSE (Mini Mental State Examination) score. The combined features are fed into Multi-kernel SVM classifier after getting rid of curse of dimensionality using principal component analysis. The experimenral results of the proposed diagnosis method yield up to 96% stratification accuracy with Multi-kernel SVM along with high sensitivity and specificity above 90%.

• Journal of Biomedical Engineering Research
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• v.22 no.5
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• pp.413-418
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• 2001

We developed shunt valves used to treat patients with hydrocephalus. The valves under development were constant Pressure type ventriculoperitoneal (VP) calves made of silicone elastomer. In vitro experiments showed that our valves had similar Pressure-flow control characteristics to the valved currently available in the market. Our valves also showed competent performance in the 28 days of continuous pumping tests acording to the IS07197 specifications. We artificially inducted hydrocephalus to a 10kg beagle do9. The size of the ventricles of the dog was substantially increased and the dog showed abnormal behavior. After our valve being implanted, the ventricles recovered regular size with the normal behavior observed in the dog. The flow orifice of the shunt valve diaphragm was in the older of 10$\mu$m during calve operation and hence the pressure-flow control characteristics tended to change by a small chance in the valve dimension. Therefore, precision design and manufacturing techniques were necessary for successful operations of the shunt valves .

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.95-98
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• 2010

Purpose: CSF (Cerebrospinal fluid) leakage is the most common complication of neurosurgery. Early management with conservative care or surgery must be followed appropriately due to the increased risk of lethal complications, such as meningitis. We report a case of intractable CSF leakage that occurred after a cerebellar tumor resection, which was treated successfully. Methods: A 53-year old male consulted our department for continuous CSF leakage for 3 months after having received conservative care and lumbar drainage. CSF collection was observed in the dead space of the posterior fossa after a cerebellar tumor resection and postoperative radiotherapy. Using a free latissimus dorsi muscle flap, the dead space within the skull was filled and the defects were covered successfully. Results: At 6 weeks after surgery, the follow-up MRI and CT revealed proper coverage and filling in the area where cerebellar tumor had been removed. No CSF leakage was observed at the postoperative 3 month follow-up. Conclusion: Recurrent CSF leakage was treated after cerebellar tumor resection with a relatively satisfactory result. In terms of the patient's treatment, much better results can be achieved by performing dead space filling using a flap with a sufficient size, in addition to coverage of the defects of the dura.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.50-50
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• 2003

World Wide Web (WWW)에서 Virtual Reality Modeling Language (VRML)를 이용하는 3 차원 (3D) 디스플레이는 사용자에게 직관적인 정보를 더 효과적으로 제공해 준다. 웹을 기반으로 하는 해부학적 영상과 융합되는 기능적 영상의 3D 가시화는 아직까지 체계적인 방식으로 연구가 활발히 진행되지 않았다. 이 연구의 목적은 2D 영상들과 함께 웹에서 VRML을 이용하여 구현되는 3D 해부학적 표면 영상들과 기능적 표면 영상들을 동시적으로 관찰할 수 있게 하고 VRML을 통해 만들어진 거리 측정 도구를 가지고 관심영역의 공간적인 위치 정보를 제공하는 것이다. 본 연구에서는 한 명의 간질 환자로부터 Magnetic Resonance (MR) 축면 영상과 발작기 및 발작간기 Single Photon Emission Computed Tomo graphy (SPECT) 축면 영상들을 각각 획득하였다. 발작 진원지의 확인을 향상시키기 위해서 subtraction ictal SPECT co registered to MRI (SISCOM) 을 수행하였다. SISCOM 결과로 나타난 각 2D 영상들은 모든 voxel 들의 평균 값 위로 1 표준편차와 2 표준편차에 해당하는 문턱 이상의 영상 값을 갖도록 하였다. SISCOM으로 나타나는 간질 발작 진원지들과 MRI 영상에서 회색질, 백색질 및 뇌척수액의 경계들을 각각 분할하고 marching cube 알고리즘에 의해 VRML 표면 영상들로 나타내었다. 축면 영상에서 실제 거리를 나타내는 x, y 축의 길이를 측정하고 z 축선의 길이를 계산하였다. VRML을 이용한 거리 측정 도구를 만들어 이전의 VRML 표면 영상들과 융합하였다. MRI 영상을 이용하여 3D 표면 영상들의 단면을 나타내고 3D 표면 영상들의 투명도를 설정하기 위해 Java Script 루틴을 사용자 인터페이스 도구로서 삽입하였다. 웹 페이지에서 구현되는 3D 표면 영상들의 투명도와 관찰 위치를 조절함에 따라 모델들 사이의 공간적인 정보를 직관적으로 알 수 있었다. 간질 발작 진원지에 대응하는 해부학적 구조를 3D 표면 영상들을 가로지르는 MRI 평면 영상들을 통해서 확인하였다. 결론적으로 본 연구에서 제시하는 웹에 근거한 3D 융합 영상의 가시화와 위치 측정은 진단 및 치료 방사선학과 외과학 등의 분야에서 온라인 방식의 연구와 교육에 있어 많은 도움을 줄 것이다.

• The Korean Journal of Cytopathology
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• v.9 no.1
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• pp.21-28
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• 1998

Cytologic evaluation of cerebrospinal fluid(CSF) is an effective tool in diagnosing many disorders involving the central nervous system(CNS). CSF examination has been found to be of particular value in the diagnosis of metastatic carcinoma, lymphomatous or leukemic involvement of CNS and certain primary CNS tumors. As a survey of metastatic tumors to CSF and an evaluation of the preparation techniques increasing cellular yield in our laboratory, 713 CSF specimens examined between July 1995 and April 1997(1 year 10 months), were reviewed. There were 75 positive and 5 suspicious cases, the latter have had no evidence of tumors clinically. Primary tumors of 75 positive cases were classified as follows; 4(5.3%) as primary brain tumors, 40(53.3%) as secondary carcinomas, 13(17.3%) as leukemias, and 18 (24.0%) as lymphomas. The most common primary site of metastatic carcinomas was the lung in 17 cases(42.5%) followed by the stomach in 13(32.5%), breast in 8 (20.0%), and unknown primary in 2(5.0%). Four primary brain tumors were 3 cerebellar medulloblastomas and a supratentorial primitive neuroectodermal tumor (PNET). All 40 metastatic carcinomas were adenocarcinoma presented as single cells or cell clusters. Although signet ring cells were frequent in the cases of gastric primary cancers, no significant cytologic differences according to the primary site were observed. The cytologic features of leukemia and lymphoma were characterized by hypercellular smears presenting as individual atypical cells with increased N/C ratio, presence of nucleoli, and nuclear protrusions. In medulloblastomas and PNET, the principal cytologic findings were small undifferentiated cells arranged singly or in loose clusters with occasional rosettoid features. This study suggests that the CSF cytology is useful in the diagnosis of malignancy, especially metastatic extracranial tumors and the diagnostic accuracy can be improved by increasing cellular yield using cytocentrifuge.

• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.234-240
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• 2001

Buccal cellulitis which presents with high fever and a swelling of the cheek with violaceous hue in young children is most often caused by H. influenzae. Bacteremia is common in buccal cellulitis caused by H. influenzae, and a culture of cerebrospinal fluid should be obtained because meningitis may be present despite the lack of meningeal irritation signs. Although buccal cellulitis is considered to be one of the important manifestations of H. influenzae infection, only two cases have been reported in Korea yet. We experienced a case of buccal cellulitis with H. influenzae bacteremia in an immunocompetent girl of 18-month-old. She was presented with high fever followed by rapidly progressive swelling and tenderness of both cheeks with violaceous hue in four hours. The blood culture revealed H. influenzae type b. There was no concurrent otitis media, sinusitis, or meningitis and no portal of entry was identified. Fever subsided two days after starting intravenous cefotaxime. Intravenous cefotaxime was subsequently changed to oral cefixime, and antibiotics were administered for a total of two weeks. We report this case with a review of related literature.

• Journal of Veterinary Clinics
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• v.27 no.6
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• pp.755-759
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• 2010

A 6-year-old, intact female Dachshund was presented with generalized seizure for 2 days. Based on the neurologic and physical examinations, intracranial diseases were suspected. 1.5T and 7.0T magnetic resonance imaging (MRI) of the brain were taken. The MRI results revealed diffuse hyperintense lesions in the area of the diencephalon to the medulla oblongata in the T2-weighted images. Canine distemper virus-induced meningoencephalitis was confirmed by the result of RT-PCR of the cerebrospinal fluid (CSF). The dog was euthanized 7 days after diagnosis due to poor prognosis and clinical deterioration. Postmortem histopathologic examination was consistent with the MRI findings. This is the first case report using 1.5T and 7.0T MRI to compare the virus-induced intracranial lesions in meningoencephalitis.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1994.04a
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• pp.233-233
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• 1994

인삼 성분이 학습 및 기억력 중진에 미치는 효과를 연구하기 위하여, 학습 및 기억력 저하를 유발하는 약물들에 대한 아답타겐 (상품명) 과 인삼 수 엑기스산의 효과를 관찰하였다. Ethylcholine aziridium ion(AF64A), scopolamine 및 morphine을 쥐 및 생쥐의 해마와 복강에 각 각 주입하여 학습 및 기억력 저하를 유발한 후 아답타겐을 경구 투여하여 학습 및 기억력에 미치는 효과를 수로시험을 통하여 측정하였다. 또한 인삼 수 엑기스산을 일주일 동안 복강 주사하여 각 효과를 수로시험을 통하여 측정하였다. 또한 인삼 수 엑기스산을 일주일동안 복강 주사하여 각종 신경계에 미치는 변화를 효소 활성도, 신경전달물질의 농도, 수용체 결합을 지표로 하여 살펴보았다. AF64A 투여군 중 플랫폼을 전혀 인지치 못한 군에 아답타겐을 투여시에는 투여 횟수에 따라 플랫폼을 인지하는 비율이 증가했다. 연습 후 일주일간 물을 투여한 대조군의 도달 시간에 큰 변화가 없음에 반해, 아답타겐을 투여시에는 3일 투여 후 최대 시간이 걸리고, 투여횟수가 증가할수록 점차 도달 시간이 단축되었다. 인공 뇌척수액 및 AF64A의 투여군에서 아답타겐을 5일간 투여한 경우 대조군보다 각각 3배 빠른 속도로 플랫폼을 기억하였다. 한편 scopola mine 투여시에는 아답타겐을 투여한 군이 투여하지 않은 군보다 약 3배 빨리 플랫폼에 도달하였으나 각 투여군의 매일의 도달 시간 차이에는 변화를 나타내지 않았다. 또한 4일 전에 아답타겐을 투여시에는 saline 및 merphine 투여시 약 1.4배 빨리 플랫폼을 인지하였다. 인삼 추출물을 7일 투여 했을 경우 선조체에서 도파민 합성 효소인 tyrosine hydroxylase 활성이 유의성 있게 증가했으며, 대사체인 DOPAC의 농도도 증가를 나타냈다. 그러나, 도파민, HVA및 대사율인 DOPAC/DA와 HVA/DA에는 변화를 보이지 않았다. 또한 선조체의 GABA농도는 약 66%로 낮아졌지만 AChE의 활성도는 변화가 없었다. 인삼 수 추출물을 2주일 투여시 선조체의 도파민 수용체의 특성변화는, D1 수용체의 친화력에는 변화가 없는 반면, 최대 결합 수용체 수는 약간 낮아졌고, D2 수용체의 경우 최대 결합 수용체수는 변화가 없었으나 친화력은 감소하였다. 또한 피질의 benzodiazipine수용체 결합 친화력에는 변화가 없는 반면 최대 결합 수용체 수는 약 15%의 증가를 나타내었고 연수의 benzodiazepine 및 피질의 GABA 수용체의 특성에는 에는 변화를 나타내지 않았다. 이상의 결과, AF64A, 아급성 scopolamine 및 급성 morphine꽈 투여로 학습능이 저하되고 아답타겐을 경구 투여시엔 저하된 학습능력 빛 기억력의 증가를 보였다. 또한 본 결과는 인삼성분 중에는 도파민 및 GABA신경계에 영향을 주는 성분이 있음을 제시하였다.

• Journal of Korean Neurosurgical Society
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• v.29 no.9
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• pp.1209-1214
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• 2000

Objectives : The measurement of resistance to cerebrospinal fluid outflow($R_o$) can clearly delineate cerebrospinal fluid dynamics in patients with ventricular dilatation and can help in selecting patients to undergo shunt placement. With regards to type of infusion method, bolus injection is known to be more practical and safer than continuous infusion. The purpose of this study was to obtain $R_o$ of normal adults using lumbar bolus injection method. Material and Methods : Twenty adults aged 25 to 52 years were studied using lumbar bolus injection method. Fifteen patients with hemifacial spasm and five with cerebral concussion underwent $R_o$ measurement under propofol general anesthesia and local anesthesia, respectively. Results : The mean values of $R_o$ determined 1 minute and 2 minutes after bolus injection were $4.8{\pm}1.7$ and $4.4{\pm}1.6mmHg/ml/min$, respectively. There was no significant difference of $R_o$ between propofol general anesthesia group and local anesthesia group. Two patients showed $R_o$ greater than 6mmHg/ml/min. One patient revealed unexpectedly high level of $R_o$ due to severe spinal stenosis. Conclusion : Mean Ro in this study was higher than that of Shapiro's study. Borderline Ro near 6mmHg/ml/min should be regarded with caution and compared with clinical symptoms and results of other studies. Patients with severe spinal stenosis should be evaluated with caution.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2000.05a
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• pp.1051-1054
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• 2000

We developed the micro CSF (celebrospinal fluid) shunt valve with surface and bulk micromachining technology in polymer MEMS. This micro CSF shunt valve was formed with four micro check valves to have a membrane connected to the anchor with the four bridges. The up-down movement of the membrane made the CSF on & off and the valve characteristic such as open pressure was controlled by the thickness and shape of the bridge and the membrane. The membrane, anchor and bridge layer were made of the $O_2$ RIE (reactive ion etching) patterned Parylene thin film to be about 5~10 microns in thickness on the silicon wafer. The dimension of the rectangular nozzle is 0.2＊0.2 $\textrm{mm}^2$ and the membrane 0.45 mm in diameter. The bridge width is designed variously from 0.04 mm to 0.12 mm to control the valve characteristics. To protect the membrane and bridge in the CSF flow, we developed the packaging system for the CSF micro shunt valve with the deep RIE of the silicon wafer. Using this package, we can control the gap size between the membrane and the nozzle, and protect the bridge not to be broken in the flow. The total dimension of the assembled system is 2.5＊2.5 $\textrm{mm}^2$ in square, 0.8 mm in height. We could precisely control the burst pressure and low rate of the valve varing the design parameters, and develop the whole CSF shunt system using this polymer MEMS fabricated CSF shunt valve.