• 제목/요약/키워드: Brain shift

검색결과 80건 처리시간 0.021초

초발 정신병 환자에서 기저핵 구조물 부피의 패턴분석 (Pattern Analysis of Volume of Basal Ganglia Structures in Patients with First-Episode Psychosis)

  • 민세리;이태영;곽유빈;권준수
    • 생물정신의학
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    • 제25권2호
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    • pp.38-43
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    • 2018
  • Objectives Dopamine dysregulation has been regarded as one of the core pathologies in patients with schizophrenia. Since dopamine synthesis capacity has found to be inconsistent in patients with schizophrenia, current classification of patients based on clinical symptoms cannot reflect the neurochemical heterogeneity of the disease. Here we performed new subtyping of patients with first-episode psychosis (FEP) through biotype-based cluster analysis. We specifically suggested basal ganglia structural changes as a biotype, which deeply involves in the dopaminergic circuit. Methods Forty FEP and 40 demographically matched healthy participants underwent 3T T1 MRI. Whole brain parcellation was conducted, and volumes of total 6 regions of basal ganglia have been extracted as features for cluster analysis. We used K-means clustering, and external validation was conducted with Positive and Negative Syndrome Scale (PANSS). Results K-means clustering divided 40 FEP subjects into 2 clusters. Cluster 1 (n = 25) showed substantial volume decrease in 4 regions of basal ganglia compared to Cluster 2 (n = 15). Cluster 1 showed higher positive scales of PANSS compared with Cluster 2 (F = 2.333, p = 0.025). Compared to healthy controls, Cluster 1 showed smaller volumes in 4 regions, whereas Cluster 2 showed larger volumes in 3 regions. Conclusions Two subgroups have been found by cluster analysis, which showed a distinct difference in volume patterns of basal ganglia structures and positive symptom severity. The result possibly reflects the neurobiological heterogeneity of schizophrenia. Thus, the current study supports the importance of paradigm shift toward biotype-based diagnosis, instead of phenotype, for future precision psychiatry.

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Expression Patterns of Growth Related Genes in Juvenile Red Spotted Grouper (Epinephelus akaara) with Different Growth Performance after Size Grading

  • Mun, Seong Hee;You, Jin Ho;Oh, Hyeon Ji;Lee, Chi Hoon;Baek, Hea Ja;Lee, Young-Don;Kwon, Joon Yeong
    • 한국발생생물학회지:발생과생식
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    • 제23권1호
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    • pp.35-42
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    • 2019
  • Fish shows great difference in growth rate between individuals during larval development and early growth. This difference seriously reduces the production efficiency in fish culture. Growth hormone (GH)/Insulin-like growth factor 1 (IGF1) system is said to play some pivotal roles in fish growth. In this study, we investigated differences of GH, IGF1 and GHR gene expressions in juvenile red spotted grouper (Epinephelus akaara) with different growth performance. Red spotted groupers were reared under the same environmental condition (water temperature $24{\pm}1^{\circ}C$, natural light) for 96 days after hatching. They were divided into 3 groups by size (fast growing, middle growing and slow growing groups: FGG, MGG, and SGG, respectively). RNA was extracted from the brain, liver and muscle tissues from each group, and target gene expression was examined by real-time PCR. In the brain with pituitary gland, expression of GH gene in FGG was significantly higher than the expression in SGG, but the expression of IGF1 and GHR genes in the muscle was highest in SGG. Difference of GHR and IGF1 mRNA in the liver between groups with different growth performance was less clear than that in other tissues, although level of IGF1 mRNA was higher in SGG than in MGG. These results suggest that hormonal governing of growth is not the same in fast growing and slow growing fish, and size grading could cause a shift of hormonal state and growth pattern in this species.

소아 뇌에서의 혼성 이차원 양성자자기공명분광법의 임상적 응용 (Hybrid Two-Dimensional Proton Spectroscopic Imaging of Pediatric Brain: Clinical Application)

  • Sung Won Youn;Sang Kwon Lee;Yongmin Chang;No Hyuck Park;Jong Min Lee
    • Investigative Magnetic Resonance Imaging
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    • 제6권1호
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    • pp.64-72
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    • 2002
  • 목적 : 소아 뇌 질환에서의 자기공명분광법의 임상적 적용에 있어서 단일화적소 양성자 자기공명분광법과 고식적 이차원 양성자 자기공명분광법에 비해 혼성 이차원 양성자 자기공명분광법이 가지는 장점에 대하여 알아보고자 하였다. 대상 및 방법 : 생후 3일에서 15세까지의 79명의 소아 (정상소아 36명, 저산소성-허혈성 뇌 손상 10명, 대사성 질환 20명, 뇌막염-뇌염 3명, 뇌종양 7명, 신경섬유종증 1명, Sturge-Weber 증후군 1명, lissencephaly 1명)를 대상으로 81회의 혼성 이차원 양성자 자기공명분광검사를 시행하였다. 성인자원자(n=5)에서 단일화적소 양성자 자기공명분광법, 고식적 이차원 양성자 자기공명분광법, 그리고 혼성 이차원 양성자 자기공명분광법 모두를 실시하였고, 환아군 중 일부(n=12)에서 PRESS기법을 이용한 단일화적소 분광법과 혼성 이차원 양성자 자기공명 분광법을 함께 시행하였다. 1.5-T 초전도영상장치 하에서 standard head quatrature coil을 이용하여 양성자 자기공명분광을 얻었다. Phase encoding step은 16$\times$16으로 하였고, FOV는 환자 뇌의 크기에 따라 다양하게 하였으며, FOV내의 혼성 관심 체적 (hybrid VOI)은 $75{\times}75{\times}15{\;}\textrm{mm}^3$ 또는 그 이하로 함으로써 원하지 않는 지방에 의한 신호를 없애도록 하였다. PRESS기법 (TR/TE= 1,500 msec/135 또는 270 msec)을 적용하였고, 물에 의한 신호를 억제하기 위하여 chemical shift selective saturation pulse를 사용하였다. 혼성 이차원 양성자 자기공명분광검사의 획득시간(data acquistion time)과 분광의 질(spectral quality)을 단일화적소 양성자 자기공명분광법과 고식적이차원양성자 자기공명분광법의 그것과 비교하였다. 결과: 혼성 이차원 양성자 자기공명분광법은 79명의 소아 전 예에서 성공적으로 시행되었다. 단일화적소 양성자 자기공명분광법의 획득시간은 4.3분인 반면에, 혼성 이차원 양성자 자기공명분광법의 획득시간(data acquition time)은 6분 미만으로, 이는 소아의 뇌영상용으로 쓰기에 충분히 짧은 소요시간이었다. 혼성 이차원 양성자 자기공명분광법에 의한 분광은 단일화적소 자기공명분광법에 의한 분광과 거의 비슷한 민감도와 분광분해 능을 나타내었으며, 반면에 고식적인 이차원 양성자 자기공명분광법에 의한 분광보다는 훨씬 우수하였다.

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Risk Factors Associated with Subdural Hygroma after Decompressive Craniectomy in Patients with Traumatic Brain Injury : A Comparative Study

  • Jeon, Sei-Woong;Choi, Jong-Hun;Jang, Tae-Won;Moon, Seung-Myung;Hwang, Hyung-Sik;Jeong, Je-Hoon
    • Journal of Korean Neurosurgical Society
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    • 제49권6호
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    • pp.355-358
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    • 2011
  • Objective : Subdural hygroma (SDG) is a complication occurring after head trauma that may occur secondary to decompressive craniectomy (DC). However, the mechanism underlying SDG formation is not fully understood. Also, the relationship between the operative technique of DC or the decompressive effect and the occurrence and pathophysiology of SDG has not been clarified. Purpose of this study was to investigate the risk factors of SDG after DC in our series. Methods : From January 2004 to December 2008, DC was performed in 85 patients who suffered from traumatic brain injury. We retrospectively reviewed the clinical and radiological features. For comparative analysis, we divided the patients into 2 groups : one group with SDG after craniectomy (19 patients; 28.4% of the total sample), the other group without SDG (48 patients; 71.6%). The risk factors for developing SDG were then analyzed. Results : The mean Glasgow Outcome Scale (GOS) scores at discharge of the groups with and without SDG were 2.8 and 3.1, respectively (p<0.0001). Analysis of radiological factors showed that a midline shift in excess of 5 mm on CT scans was present in 19 patients (100%) in the group with SDG and in 32 patients (66.7%) in the group without SDG (p<0.05). An accompanying subarachnoid hemorrhage (SAH) was seen in 17 patients (89.5%) in the group with SDG and in 29 patients (60.4%) in the group without SDG (p<0.05). Delayed hydrocephalus accompanied these findings in 10 patients (52.6%) in the group with SDG, versus 5 patients (10.4%) in the group without SDG (p<0.05). On CT, compression of basal cisterns was observed in 14 members (73.7%) in the group with SDG and in 18 members of the group without SDG (37.5%) (p<0.007). Furthermore, tearing of the arachnoid membrane, as observed on CT, was more common in all patients in the group with SDG (100%) than in the group without SDG (31 patients; 64.6%) (p<0.05). Conclusion : GOS showed statistically significant difference in the clinical risk factors for SDG between the group with SDG and the group without SDG. Analysis of radiological factors indicated that a midline shifting exceeding 5 mm, SAH, delayed hydrocephalus, compression of basal cisterns, and tearing of the arachnoid membrane were significantly more common in patients with SDG.

Remote Cerebellar Hemorrhage after Supratentorial Aneurysmal Surgery : Report of Six Cases

  • Jang, Jae-Won;Joo, Sung-Pil;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • 제39권5호
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    • pp.370-373
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    • 2006
  • The case of postoperative hemorrhage occurring apart from the operative site as a complication of intracranial surgery is a rare malady, especially when it involves the cerebellum after supratentorial aneurysm surgery. In a review of the literature, the possible etiologies for cerebellar hemorrhage are: coagulopathy, intraoperative urokinase irrigation, excessive head rotation on positioning, brain shift due to excessive cerebrospinal fluid[CSF] and epidural hemovac drainage. We experienced six cases of cerebellar hemorrhage after supratentorial aneurysm surgery, and all of the patients were improved by instituting conservative medical treatment. The possible mechanism for the remote cerebellar hemorrhages seen in our series is probably a multifactorial effect, such as excessive epidural hemovac and CSF drainage, and jugular venous compression due to the operative position. The purpose of this report is to alert neurosurgeons to the existence of this syndrome and to suggest several ways of minimizing the possibility of their patients developing remote cerebellar hemorrhage.

Predictors for Functional Recovery and Mortality of Surgically Treated Traumatic Acute Subdural Hematomas in 256 Patients

  • Kim, Kyu-Hong
    • Journal of Korean Neurosurgical Society
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    • 제45권3호
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    • pp.143-150
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    • 2009
  • Objective : The purpose of this study was to investigate the reliable factors influencing the surgical outcome of the patients with traumatic acute subdural hematoma (ASDH) and to improve the functional outcome of these patients. Methods : A total of 256 consecutive patients who underwent surgical intervention for traumatic ASDH between March 1998 and March 2008 were reviewed. We evaluated the influence of perioperative variables on functional recovery and mortality using multivariate logistic regression analysis. Results : Functional recovery was achieved in 42.2% of patients and the overall mortality was 39.8%. Age (OR=4.91, p=0.002), mechanism of injury (OR=3.66, p=0.003), pupillary abnormality (OR=3.73, p=0.003), GCS score on admission (OR=5.64, p=0.000), and intraoperative acute brain swelling (ABS) (OR=3.71, p=0.009) were independent predictors for functional recovery. And preoperative pupillary abnormality (OR=2.60, p=0.023), GCS score (OR=4.66, p=0.000), and intraoperative ABS (OR=4.16, p=0.001) were independent predictors for mortality. Midline shift, thickness and volume of hematoma, type of surgery, and time to surgery showed no independent association with functional recovery, although these variables were correlated with functional recovery in univariate analyses. Conclusion : Functional recovery was more likely to be achieved in patients who were under 40 years of age, victims of motor vehicle collision and having preoperative reactive pupils, higher GCS score and the absence of ABS during surgery. These results would be helpful for neurosurgeon to improve outcomes from traumatic acute subdural hematomas.

Sedative Effect of Sophora flavescens and Matrine

  • Lee, Hyun-ju;Lee, Sun-young;Jang, Daehyuk;Chung, Sun-Yong;Shim, Insop
    • Biomolecules & Therapeutics
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    • 제25권4호
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    • pp.390-395
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    • 2017
  • The present study investigated the sedative effects of Sophora flavescens (SF) and its bioactive compound, matrine through performing locomotor activity test and the electroencephalography (EEG) analysis in the rat. The underlying neural mechanism of their beneficial effects was determined by assessing c-Fos immunoreactivity and serotonin (5-HT) in the brain utilizing immunohistochemical method and enzyme-linked immunosorbent assay. The results showed that SF and matrine administration had an effect on normalization of caffeine-induced hyperactivity and promoting a shift toward non-rapid eye movement (NREM) sleep. c-Fos-immunoreactivity and 5-HT level in the ventrolateral preoptic nucleus (VLPO), a sleep promoting region, were increased in the both SF and matrine-injected groups. In conclusion, SF and its bioactive compound, matrine alleviated caffeine-induced hyperactivity and promoted NREM sleep by activating VLPO neurons and modulating serotonergic transmission. It is suggested that SF might be a useful natural alternatives for hypnotic medicine.

Generalized Analysis on the Combined Effect of SPM and Fiber Chromatic Dispersion on Subcarrier Multiplexed Optical Transmission Systems for RoF Applications

  • Kim, Kyoung-Soo;Lee, Jae-Hoon;Jeong, Ji-Chai
    • Journal of the Optical Society of Korea
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    • 제15권2호
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    • pp.132-139
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    • 2011
  • We investigate theoretically the combined effect of fiber chromatic dispersion and self-phase modulation (SPM) on multi-channel subcarrier multiplexed (SCM) optical transmission systems in terms of the detected RF carrier power and SPM-induced power gain after transmission over single-mode fiber (SMF) links. According to the calculated power gain due to the SPM effect at the transmission distance of P3dB using the detected radio-frequency (RF) carrier power after photo-detection, the power gain is significantly degraded with large optical modulation index (OMI), small SCM channel spacing, and large fiber launching power because of the increased interaction between subcarrier channels. The nonlinear phase shift due to linear and nonlinear fiber characteristics is investigated to explain these results in detail. The numerical simulation results show that the OMI per SCM channel has to be smaller than 10 % for the fiber launching power of 10 dBm to guarantee prevention of SPM-induced power gain degradation below 0.5 dB for the SCM system with the channel spacing of 100 MHz. This result is expected to be utilized for the optical transmission systems using the SCM technology in future radio-over-fiber (RoF) networks.

미용적인 측면을 고려한 전두동 골절과 합병증의 치료 (Aesthetic treatment of frontal sinus fractures and their complications)

  • 김광석;황재하
    • 대한의사협회지
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    • 제61권12호
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    • pp.732-739
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    • 2018
  • The frontal sinus is a functionally important structure. It serves as a cushioning buffer to protect the brain in cases of facial trauma. Fractures of the frontal sinus can lead to aesthetic problems by causing a visible depression in the center of the forehead. The goals of frontal sinus fracture treatment have been to protect intracranial structures and to prevent early and late complications, even with invasive methods. Recently, however, the goals have shifted to preservation of nasofrontal outflow tract function through close observation and the utilization of endoscopic procedures. Excellent cosmetic results can be achieved through minimally invasive surgery. This shift in goals took place due to the ease of diagnosis and treatment of early and late complications. Therefore, patients with a frontal sinus fracture should be followed up continuously to ensure that complications are detected promptly. Herein, the authors describe the methods and current trends of frontal sinus fracture treatment.

퇴행성 뇌질환에서 PET의 발전과 임상적 적용 및 최신 동향 (Recent Updates on PET Imaging in Neurodegenerative Diseases)

  • 김유경
    • 대한영상의학회지
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    • 제83권3호
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    • pp.453-472
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    • 2022
  • 양전자방출단층촬영(PET)을 이용한 단백질병리의 생체영상기술은 퇴행성 치매의 질병 기전을 이해하는데 필요한 정보를 제공할 뿐 아니라, 질병의 조기 발견과 치료법 개발에서 중요한 역할을 수행하고 있다. 베타아밀로이드와 타우 PET 영상은 인체 뇌병리에 기반한 알츠하이머병 연속체에 대한 진단 바이오마커로 확립되어 조기진단과 감별진단을 용이하게 하고, 질병 예후를 예측하고 있다. 또한, 치매치료제 개발에서 예후 및 대리 바이오마커로의 역할이 커지고 있다. 이 종설에서는 치매를 유발하는 알츠하이머병 및 기타 퇴행성 뇌질환에서 베타아밀로이드와 타우 단백질의 뇌축적을 영상화하는 PET의 최근 임상적 적용과 최근 동향을 살펴보고, 잠재적 유용성을 소개하고자 한다.