• Korean Journal of Psychosomatic Medicine
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• v.5 no.2
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• pp.205-213
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• 1997

The aim of this study is to find the relationship between interictal psychiatric symptoms and seizure-related variables such as structural changes, regional interictal perfusion changes, the number of interictal epileptic discharges and the presence of accompanying generalized tonic clonic seizure(GTC). The subjects were 75 patients (47 males : mean age $28.3{\pm}7.7$) with intractable epilepsy, Interictal psychiatric symptoms were rated by Symptom Checklist-90-R(SCL-90-R). Each of 4 seizure variables was measured by MRI, $^{99m}TC-HMPAO$ SPECT and the prolonged EEG monitoring. The mean SCL-90-R subscale T-scores and the ratio of the patients with definite psychiatric symptoms(T-score > 65 at any one subscale of SCL-90-R) were compared among the groups with different seizure variables. Demographic variables and clinical variables were not statistically different among the groups with different seizure variables. The patients with right mesial temporal sclerosis had higher mean SCL-90-R scores for obsessive compulsive symptom, interpersonal sensitivity, depression, hostility and psychotic symptoms than the patients with left mesial temporal sclerosis, and they also showed higher ratio of definite psychiatric symptoms. The presence of interictal epileptic discharges was related with higher T-scores of paranoid subscale. The areas of hypoperfusion, the presence of the GTC, and other clinical seizure variables showed no significant influences on the mean SCL-90-R subscale T-scores. from these results, the authors speculated that interictal subictal epileptic dischrages may be related with psychiatric symptoms of the intractable epileptic patients, especially with right mesial temporal sclerosis.

• Journal of Korean Neurosurgical Society
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• v.45 no.1
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• pp.5-10
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• 2009

Objective : Direct surgical clipping of paraclinoid aneurysms poses technical challenges to even very experienced neurosurgeons, making endovascular treatment an alternative treatment modality in many centers. We have therefore retrospectively evaluated the safety and efficacy of endovascular detachable coil embolization of paraclinoid aneurysms. Methods : From June 1997 to June 2007, 65 patients underwent endovascular detachable coiling for 67 paraclinoid aneurysms (of which 9 were ruptured and 58 were unruptured) in our institute. Their medical records, radiological images and readings, and operation records were reviewed retrospectively. Results : After the initial embolization procedure, complete occlusion was achieved in 29 (43.3%) of the aneurysms treated by endovascular detachable coiling. Six aneurysms required retreatment, with two each requiring one, two, or three additional endovascular procedures. Fifty-five (82.1%) aneurysms were measured by three-dimensional time of flight (TOF) magnetic resonance images (MRI) or transfemoral cerebral angiography (TFCA) at a mean follow-up of 29.7 months (range from 4 to 94 months), with 39 aneurysms (70.9%) showing complete occlusion. Thromboembolic events (3.8%) were the most frequent complication. Rupture did not occur during or after any of the procedures. According to the Glasgow Outcome Scale (GOS), 98.4% of the patients treated by coil embolization had a score of 4 or 5. Conclusion : Our results indicate that endovascular detachable coiling is a safe and effective treatment modality in paraclinoid aneurysms.

• The Journal of Internal Korean Medicine
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• v.25 no.3
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• pp.388-397
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• 2004

Object: This study was designed to investigate the clinical and practical characteristics of stroke patients treated with the age-old herbal medicines, Bojungikki-tang and Bojungikki-tang-gamibang. Methods: The 80 patients studied were all diagnosed with stroke by neurological examination, B-CT and B-MRI scan. They were treated with Bojungikki-tang and Bojungikki-tang-gamibang over 5 days and symptoms were observed. There were inpatients and outpatients at the Oriental Medical hospital of Dong-eui University from January in 2000 to June in 2003. All patients were interviewed and medical charts examined. Result and Conclusion: The results were found: 1.Many were in their sixties. Average age was 64.54. 2.Cerebral infarction was diagnosed in 86.25% of all cases. 3.30% of stroke cases occurred in spring. 4.Average blood pressure was 129/84mmHg on the fifth day of treatment with Bojungikki-tang and Bojungikki-tang-gamibang and 135/86mmHg on the first day. 5.The white color were best in facial color about 85.29%. 6.There were many who returned for treatment within 6 to 10 days. 7.Bojungikki-tang and Bojungikki-tang-gamibang were used Rt. hemiplegia more than for Lt. hemiplegia.

• Journal of Physiology & Pathology in Korean Medicine
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• v.16 no.6
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• pp.1291-1296
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• 2002

Blood circulation of brain is divided into two major categories; anterior one from carotid artery and posterior one from vertebrobasilar artery. In stroke patients, it is important to diagnose which is involved, because there is many difference in the aspects of clinical menifestations and prognosis, especially in the acute stage. In some cases of vertebrobasilar infarction, such as Wallenberg's syndrome, charicteristic cranial nerve signs, eye movement disorders and cerebellar signs are appeared. And in Dejerine's syndrome, only pure motor or sensory defecits can be appeared without any brainstem signs. So It shoud be differenciated by Brain MRI from those of the cerebral hemisphere lesions. And in the cases that nausea, vomitting and dysphagia are the first menifestations, it is frequently misdiagnosed as internal medical disease, causing appropriate treatment delayed. In this case report, we are to describe the clinical menifestations and progresses of two cases of brainstem infarctions, review previously published case reports about them and compare them to our cases. The first is Dejerine's syndrome i.e. medial medullary infarction, the second is Wallenberg's syndrome i.e. lateral medullary infarction. Simultaneously we are to investigate the oriental medical approach in the bran stem infarctions.

• Journal of the Institute of Electronics Engineers of Korea TC
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• v.46 no.12
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• pp.102-107
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• 2009

As technology gets developed, medical equipments are also modernized and leading-edge systems, such as PACS become popular. Many scientists noticed importance of medical image processing technology. Technique of region segmentation is the first step of digital medical image processing. Segmentation technique helps doctors to find out abnormal symptoms early, such as tumors, edema, and necrotic tissue, and helps to diagnoses correctly. Segmentation of white matter, gray matter and CSF of a brain image is very crucial part. However, the segmentation is not easy due to ambiguous boundaries and inhomogeneous physical characteristics. The rate of incorrect segmentation is high because of these difficulties. Fuzzy-based segmentation algorithms are robust to even ambiguous boundaries. In this paper a modified Fuzzy-based segmentation algorithm is proposed to handle the noise of MR scanners. A proposed algorithm requires minimal computations of mean and variance of neighbor pixels to adjust a new neighbor list. With the addition of minimal compuation, the modified FCM(mFCM) lowers the rate of incorrect clustering below 30% approximately compared the traditional FCM.

• Journal of the Korean Society of Radiology
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• v.8 no.1
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• pp.35-42
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• 2014

The purpose of this study is to know the differences of metabolism in abnormal brain disease using a single-voxel proton MR spectroscopy(1H MRS) Together with five normal volunteers and each five patients with brain diseases, pathologically proved, underwent MRI and 1H MRS. The quantitative results of 1H MRS in adrenoleukodystrophy(ALD), hepatic encephalopathy(HE), and infarction gave unique information on the metabolite changes related with the white matter: the concentration of NAA decreased in all diseases; Cho, mI and Lac increased in ALD; Cho decreased in HE; and ${\beta}{\cdot}{\gamma}$-Glx and Lac increased in infarction. It is concluded that 1H MRS is capable of diagnosing brain diseases by monitoring metabolite changes in vivo that subsequently develope into abnormalities. 1H MRS may be a useful clinical tool for in both diagnosis and prognosis of brain diseases.

• The Journal of Korean Physical Therapy
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• v.25 no.3
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• pp.126-131
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• 2013

This case report described a single case of adult stoke patient due to Moyamoya disease through long-term follow-up observation, which included his demographics, brain images, and change of motor function and functional activities. The subject was the 54-year-old male diagnosed with left hemiparesis from a stroke due to multifocal encephalomalacia in both hemispheres. At the time of the stroke attack, he took brain surgery intervention including external ventricular drain. Physical and occupational therapy for stroke rehabilitation were admitted including muscle strengthening exercises, functional activity/ADL training, neurofacilitative techniques with bobath or proprioceptive neuromuscular facilitation concepts, and compensatory strategy. Patient's MRI showed that right frontal lobe, right peri-ventricular area, left parietal, and left occipital lobes were damaged, and MRA showed that abnormal collateral vessel was richly developed in both hemispheres by occlusion of proximal internal carotid arteries in both sides. His motor strength was improved from poor to good grade in all of upper and lower limb motions, that MBC was improved from stage 1 to stage 5. In FAC and barthel index, at the initial evaluation, he could not perform any functional movement, but his FAC and barthel index were on 3 and 14 points at present, respectively. During long-term follow-up for approximately 4 years, the subject's functional motor ability was improved, as similar with recovery progression of usual stroke patient. We believe that this single case report will provide clinical information and concern regarding Moyamoya disease with physical therapist, in terms of such as epidemiology, pathogenesis, diagnostic procedures, clinical features, recovery process, and prognosis.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.528-530
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• 2007

Purpose: Holoprosencephaly(HPE) is a rare developmental defect due to incomplete cleavages of the prosencephalon during the third week of fetal development. Chromosomal anomalies, genetic syndrome, teratogen, or genetic disorder of non-syndromic HPE are usually accepted as etiology. The consequences of prechordal mesoderm defect are varying degrees of deficit of midline facial development, especially the median nasal process(premaxilla), and incomplete morphogenesis of the forebrain. We experienced a case of lobar HPE with complete cleft lip and palate. Methods: A female newborn infant was born at $38^{+6}$ weeks' gestational age via NSVD. The infant's birth weight was 3.6 kg, height 52 cm, and head circumference 32.5 cm, showing microcephaly, flat nose, median complete cleft lip & palate, and hypotelorism, along with defects of midfacial development including losses of premaxilla, philtrum, nasal septum, and columella. Results: There were no specific findings noted from the head and neck X-ray and tests for endocrine and metabolic disorders, but clinical characteristics of midface and dysgenesis corpus callosum on brain MRI were seen, so that this case was diagnosed with HPE. Conclusion: HPE is divided into three categories of alobar, semilobar, and lobar prosencephaly according to the degree of cerebral hemisphere separation. Assesment of patient's brain abnormality and malformation is essential in determining the extent and benefit of surgical intervention. This case was included in the lobar type HPE which shows relatively good prognosis compared with other types and reconstruction of median complete cleft lip & palate and midfacial defects will be performed.

• Journal of Korean Neurosurgical Society
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• v.29 no.4
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• pp.564-568
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• 2000

The authors present a rare case of subependymal giant cell astrocytoma which successfully treated with endoscopic tumor resection. A 15-year-old boy was presented with multiple episode of generalized seizure and intermittent headache for 5 years. The patient had facial adenoma sebaceum, multiple nevi on his back, and mental retardation. Cerebral MRI scans showed a round tumor located at the frontal horn of right ventricle near the foramen monro. The tumor was totally removed with endoscopic procedure and histologically confirmed as a subependymal giant cell astrocytoma. Subependymal giant cell astrocytomas can cause all the clinical problems that are associated with other types of intracranial tumor. However, surgical indication is not well standardized, because of the lack of basic knowledge about the tumor and the likelihood of surgical morbidity. We believe that endoscopic surgery, a minimally invasive technique, can circumvent the surgical disadvantage while achieving the surgical goal.

• Current Optics and Photonics
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• v.2 no.6
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• pp.499-507
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• 2018

For the spatiotemporally aligned observation of photothrombosis induction and transient variations of in vivo brain stroke, we developed a novel photothrombosis inducing system compatible to a magnetic resonance imaging (MRI) system using nonmagnetic stereotaxic equipment. From the spatial point of view, the system provides a more reliable level of reproducibility of the photothrombosis in each brain. From the temporal point of view, from T1- and T2-weighted in vivo MR (magnetic resonance) images, the transient variations such as incidence, location, and size of the thrombosis are measured quantitatively. In addition, the final variation is observed in the ex vivo brain by TTC (Triphenyltetrazolium chloride) staining based on histological assay and utilized for the verification of the MR images. From the experimental result of the rat brain, the proposed system shows more reliable characteristics for transient variations of brain strokes.