• 인지과학
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• 제24권1호
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• pp.1-24
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• 2013

한국 사회에서 고령 인구가 지속적으로 증가하고 있는 추세에 발맞추어 본 논문은 노화과정에서 일어나는 뇌의 구조, 기능적 변화 및 인지 기능의 저하를 살펴보고, 고령화 대처의 한 방안으로 제안되고 있는 운동의 효과에 관하여 인지신경과학적 연구를 중심으로 개관하였다. 정상 노화 과정에서 일어나는 뇌의 변화는 전전두엽과 측두엽(해마 포함)의 부피변화와 함께 인지 과제 수행 시 과잉활성화와 같은 현상들이다. 이러한 뇌의 변화와 함께 인지 기능의 저하도 관찰되는데 주로 억제 및 기억 기능의 저하가 노화를 특징짓는 인지기능의 변화로 알려져 왔다. 이와 같은 노화 관련 뇌인지의 퇴행적 변화에 대응할 수 있는 보호적 요인 중 하나가 운동이다. 실제 노인을 대상으로 장기간 운동 프로그램을 실시한 연구 결과들은 참가 노인들의 전두엽과 측두엽, 특히 해마의 위축이 개선되고 억제와 기억 기능 역시 향상되었음을 보고하였다. 이러한 결과는 뇌세포 단위에서의 변화로부터 시작하여 노화하는 뇌 역시 변화할 수 있고, 운동이 이러한 긍정적인 변화를 유도할 수 있음을 보여준다.

• Radiation Oncology Journal
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• 제2권2호
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• pp.287-297
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• 1984

The normal intracranial structures are relatively resistant to therapeutic radiation, but may react adversely in a variety of ways, and the damage to nerve tissue may be slow in making its appearance, and once damage has occured the patient recovers slowly and incompletly. Therefore, it is important to consider the possibility of either recurrent tumor or late adverse effect in any patient who has had radiotherapy. The determination o( rnorphological/pathological correlation is very important to the therapeutic radiologist who uses CT scans to define a treatment volume, as well as to the clinician who wishes to explain the patient's clinical state in terms of regress, progression, persistence, or recurrence of tumor or radiation-induced edema or necrosis, The authors are obtained as following results ; 1. The field size(whole CNS, large, intermediate, small field) was variable according to the location and extension of tumor and histopathologic diagnosis, and the tatal tumor dose was 4,000 to 6,000 rads except one of recurred case of 9,100 rads. The duration of follow up CT scan was from 3 months to 5 year 10 months. 2, The histopathologic diagnosis of 9cases were glioblastoma multiforme(3 cases), pineal tumor (3), oligodendroglioma (1), cystic astrocytoma (1), pituitary adenoma (1) and their adverse effects after radiation therapy were brain atrophy (4 cases) , radiation necrosis(2), tumor recurrence with or without calcification (2), radiation·induced infarction (1). 3. The recurrent symptoms after radiation therapy of brain tumor were not always the results of regrowth of neoplasm, but may represent late change of irradiated brain. 4. It must be need that we always consider the accurate treatment planning and proper treatment method to reduce undesirable late adverse effects in treatment of brain tumors.

• Investigative Magnetic Resonance Imaging
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• 제19권3호
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• pp.168-177
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• 2015

Purpose: Brain surface intensity model (BSIM)-based cortical thickness analysis does not require complicated 3D segmentation of brain gray/white matters. Instead, this technique uses the local intensity profile to compute cortical thickness. The aim of the present study was to evaluate intra-rater and inter-rater reliability of BSIM-based cortical thickness analysis using images from elderly participants. Materials and Methods: Fifteen healthy elderly participants (ages, 55-84 years) were included in this study. High-resolution 3D T1-spoiled gradient recalled-echo (SPGR) images were obtained using 3T MRI. BSIM-based processing steps included an inhomogeneity correction, intensity normalization, skull stripping, atlas registration, extraction of intensity profiles, and calculation of cortical thickness. Processing steps were automatic, with the exception of semiautomatic skull stripping. Individual cortical thicknesses were compared to a database indicating mean cortical thickness of healthy adults, in order to produce Z-score thinning maps. Intra-class correlation coefficients (ICCs) were calculated in order to evaluate inter-rater and intra-rater reliabilities. Results: ICCs for intra-rater reliability were excellent, ranging from 0.751-0.940 in brain regions except the right occipital, left anterior cingulate, and left and right cerebellum (ICCs = 0.65-0.741). Although ICCs for inter-rater reliability were fair to excellent in most regions, poor inter-rater correlations were observed for the cingulate and occipital regions. Processing time, including manual skull stripping, was $17.07{\pm}3.43min$. Z-score maps for all participants indicated that cortical thicknesses were not significantly different from those in the comparison databases of healthy adults. Conclusion: BSIM-based cortical thickness measurements provide acceptable intra-rater and inter-rater reliability. We therefore suggest BSIM-based cortical thickness analysis as an adjunct clinical tool to detect cortical atrophy.

• 대한영상의학회지
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• 제81권4호
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• pp.979-984
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• 2020

묘성증후군은 드문 유전자 결손 증후군으로, 환아는 후두 및 후두개의 기형과 신경학적 구조적 이상으로 인해 특징적인 높은 톤의 단조로운 울음소리를 내고 반복적인 흡인성 폐렴을 앓는다. 이전 보고된 증례들의 뇌 자기공명영상 소견을 정리한 결과 교뇌 저형성이 가장 뚜렷하였고, 소뇌 저형성이 동반되기도 하여 주로 후두개와의 이상 소견을 보였다. 천막상부 구조물의 위축도 자주 관찰되었는데 이것은 교뇌 저형성에 의한 이차적인 변화로 생각되었다. 본원에서 확진된 3개월 환아 또한 교뇌 저형성이 두드러져 이전 보고된 증례들과 거의 유사하였으나 수초화 양상에서 내섬유막 전완의 수초화 감소가 아니라 전반적인 수초화의 지연이 관찰되었다는 점에서 타 증례와 차이가 있었다. 후두, 교뇌, 소뇌는 비슷한 척삭에서 유래하므로, 묘성증후군에서 생기는 후두 및 뇌의 구조적 이상은 발생 초기의 이상임을 시사한다.

• Korean Journal of Radiology
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• 제1권1호
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• pp.5-10
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• 2000

Objective: To describe the neuroradiologic findings of primary antiphospholipid antibody syndrome (PAPS). Materials and Methods: During a recent two-year period, abnormally elevated antiphospholipid antibodies were detected in a total of 751 patients. In any cases in which risk factors for stroke were detected - hypertension, diabetes mellitus, hyperlipidemia, smoking, and the presence of SLE or other connective tissue diseases - PAPS was not diagnosed. Neuroradiologic studies were performed in 11 of 32 patients with PAPS. We retrospectively reviewed brain CT (n = 7), MR (n = 8), and cerebral angiography (n = 8) in 11 patients with special attention to the presence of brain parenchymal lesions and cerebral arterial or venous abnormalities. Results: CT or MR findings of PAPS included nonspecific multiple hyper-intensity foci in deep white matter on T2-weighted images (5/11), a large infarct in the territory of the middle cerebral artery (4/11), diffuse cortical atrophy (2/11), focal hemorrhage (2/11), and dural sinus thrombosis (1/11). Angiographic findings were normal (5/8) or reflected either occlusion of a large cerebral artery (2/8) or dural sinus thrombosis (1/8). Conclusion: Neuroradiologic findings of PAPS are nonspecific but in young or middle- aged adults who show the above mentioned CT or MR findings, and in whom risk factors for stroke are not present, the condition should be suspected.

• Journal of Yeungnam Medical Science
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• 제5권2호
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• pp.87-93
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• 1988

저자등은 최근 5년동안 본원 신경과 외래와 입원 환자중 CT상 특징적인 뇌교소노위축을 보이고 그에 따른 임상적 증상을 보인 OPCA 환자 12예에서 다음과 같은 결과를 얻었다. 1. 연령분포는 49세에서 72세이며 주로 50대에서 60대에 많았다. 성별분포는 암자에서 약 4.5배 더 빈발하였다. 가족력이 있는 것으로 추정이 되는 1예에서는 발병연령이 보다 빨랐다. 2. 증상의 발현부터 진단까지의 기간은 대부분 1년에서 6년 사이였다. 3. 초기증상으로는 현기증(58%), 운동실조(33%) 등이 흔하였고 그 외에도 지전, 하지무력감, 구음장애, 두통, 뇨실금 등이었다. 또 진단당시 임상적 특징으로는 소뇌기능장애(100%), 구음장애(83%), 심부건반사항진(58%) 등이 주요 소견이었다. 4. CT소견으로 소뇌홈은 전례에서 1mm이상 확장되어 있었고 4예에서는 2mm이었다. 소뇌뇌교뇌조의 폭은 대부분이 3mm 내지 4mm이며 2예에서는 5mm였다. 제 4 뇌실은 전후 직경이 4mm, 좌우직경이 4mm 내지 8mm까지 확장된 소견을 보였으며 전례에서 전뇌교뇌조와 사구외조의 확장이 나타났다. 6예에서는 대뇌위축도 동반 되었음이 발견되었다.

• Journal of Korean Neurosurgical Society
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• 제50권5호
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• pp.403-408
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• 2011

Objective : Contrary to some clinical belief, there were quite a few studies regarding animal models of intracerebral hemorrhage (ICH) $in$ $vivo$ suggesting that prior use of statins may improve outcome after ICH. This study reports the effect of 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG CoA) reductase inhibitor, simvastatin given before experimental ICH. Methods : Fifty-one rats were subjected to collagenase-induced ICH, subdivided in 3 groups according to simvastatin treatment modality, and behavioral tests were done. Hematoma volume, brain water content and hemispheric atrophy were analyzed. Immunohistochemical staining for microglia (OX-42) and endothelial nitric oxide synthase (eNOS) was performed and caspase-3 activity was also measured. Results : Pre-simvastatin therapy decreased inflammatory reaction and perihematomal cell death, but resulted in no significant reduction of brain edema and no eNOS expression in the perihematomal region. Finally, prior use of simvastatin showed less significant improvement of neurological outcome after experimental ICH when compared to post-simvastatin therapy. Conclusion : The present study suggests that statins therapy after ICH improves neurological outcome, but prior use of statins before ICH might provide only histological improvement, providing no significant impact on neurological outcome against ICH.

• Investigative Magnetic Resonance Imaging
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• 제25권3호
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• pp.164-171
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• 2021

Purpose: Mild cognitive impairment (MCI) is a prodromal stage of Alzheimer's disease (AD). Brain atrophy in this disease spectrum begins in the medial temporal lobe structure, which can be recognized by magnetic resonance imaging. To overcome the unsatisfactory inter-observer reliability of visual evaluation, quantitative brain volumetry has been developed and widely investigated for the diagnosis of MCI and AD. The aim of this study was to assess the prediction accuracy of quantitative brain volumetry using a fully automated segmentation software package, NeuroQuant^®, for the diagnosis of MCI. Materials and Methods: A total of 418 subjects from the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer's Disease cohort were included in our study. Each participant was allocated to either a cognitively normal old group (n = 285) or an MCI group (n = 133). Brain volumetric data were obtained from T1-weighted images using the NeuroQuant software package. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to investigate relevant brain regions and their prediction accuracies. Results: Multivariate logistic regression analysis revealed that normative percentiles of the hippocampus (P < 0.001), amygdala (P = 0.003), frontal lobe (P = 0.049), medial parietal lobe (P = 0.023), and third ventricle (P = 0.012) were independent predictive factors for MCI. In ROC analysis, normative percentiles of the hippocampus and amygdala showed fair accuracies in the diagnosis of MCI (area under the curve: 0.739 and 0.727, respectively). Conclusion: Normative percentiles of the hippocampus and amygdala provided by the fully automated segmentation software could be used for screening MCI with a reasonable post-processing time. This information might help us interpret structural MRI in patients with cognitive impairment.

• 대한핵의학회지
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• 제30권1호
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• pp.56-64
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• 1996

목적 : 본 연구는 Sturge-Weber 증후군환자의 뇌관류 SPECT와 MRI를 비교해 봄으로써 이들 환자에 동반되는 특징적인 뇌관류 변화를 평가하고자 시행하였다. 방법 : 대상환자는 Sturge-Weber 증후군으로 진단된 3개월에서 12세에 이르는 5명의 환아로 모두 간질의 병력이 있었으며, MRI를 시행후 2주이내에 $^{99m}Tc$-HMPAO 또는 $^{99m}Tc$-ECD를 주사하고 삼중헤드 감마카메라에서 뇌관류 SPECT를 시행하였다. 결과 : 석회화를 동반되지 않은 3개월, 9개월, 3년 5개원의 3명의 환아에서는 MRI상 피질의 경미한 위축 소견과 함께 조영증강후 병변부위에 띠모양의 조영증강이 뇌피질을 따라서 관찰되었는데 뇌관류 SPECT상에는 이 부위에 경미한 관류감소 소견을 보였다. 3개월된 다른 1명의 환아에서는 MRI상 우측 대뇌 반구에 피질의 위축소견없이 대뇌피질을 따라 띠모양의 조영증강이 있고, T2강조 영상에서 나이에 비하여 수초화가 항진된 소견을 보였는데 뇌관류 SPECT상에서는 이 부위에 현저한 미만성 관류증가를 보였고, 6개월 뒤 추적 시행한 뇌관류 SPECT상에서는 다른 환아와 마찬가지로 병변부위의 관류저하가 관찰되었다. 또한 석회화가 동반된 12세 환아에서는 MRI상 심한 뇌위축과 함께 병변이 있는 우측 대뇌반구에 뇌관류 SPECT상 관류저하소견이 있었으나 일부 우측 측두엽에는 오히려 국소적으로 혈류가 증가된 부위가 있었다. 결론 : 이상에서 Sturge-Weber 증후군 환아의 뇌관류 SPECT 소견은 MRI상의 병변부위와 대체로 일치되는 관류저하를 보였다. 그러나 조기 병변의 환아에서 병변부위에 관류증가를 보이거나, 진행된 병변f에서도 오히려 국소적인 관류증가 부위를 관찰할 수 있었다. 이들 병변에서 관류가 증가되는 현상에 대해서는 설명하기 어려우나 Sturge-Weber 증후군의 병태생리를 이해하기 위한 향후 더 연구가 필요할 것으로 생각된다.

• Annals of Clinical Neurophysiology
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• 제13권1호
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• pp.48-50
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• 2011

Myotonic dystrophy type 1 (DM1) is an autosomal dominant multisystem disorder caused by the expansion of cytosine-thymine-guanine (CTG) repeats in the myotonic dystrophy protein kinase (DMPK) gene. Some literatures indicated that DM1 had incidental CNS lesions such as white matter lesions and diffuse gray matter atrophy. We report a patient with DM1 whose brain magnetic resonance image (MRI) showed multifocal hyperintense lesions and cystic lesion on both frontotemporoparietal lobes.