• 한국방사선학회논문지
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• 제16권5호
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• pp.575-583
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• 2022

AUDIT(Alcohol Use Disorders Identification Test)에서 정상 음주자, 위험 음주자 및 알코올 사용 장애자로 분류하여 뇌 백질 영역의 ROI(Region Of Interest)에 대한 FA 측정값을 분석하였다. TBSS(Tract-Based Spatial Statics) 도구를 사용하여 ROI의 FA 값을 추출하였다. TBSS라는 도구는 뇌 회백질보다는 백질에 대한 FA값과 MD 값의 민감도가 더 높고 뇌 신경섬유의 비등방도를 정량적으로 도출해 낼 수 있는 장점이 있고 백질에 더 특화된 프로그램이라 할 수 있다. 특히 양쪽 맥락총 평균 차이가 높았고 정상 음주자에서는 FA의 평균값이 0.2831과 0.2872로 나타났으며, 알코올 사용 장애자의 경우 0.1972와 0.1936로 나타났다. 즉, AUDIT 척도에서 점수가 높을수록 뇌 백질의 계측한 모든 ROI 영역에서 FA 값이 더 낮게 측정되는 것을 알 수 있었으며 뇌 백질에 신경 섬유로의 손상에 대한 미세구조 변화를 확인할 수 있었다. AUDIT 척도를 사용하여 DTI의 FA 값에 대한 지침을 제시할 수 있으며 혈액학적 인자의 가이드인 처럼 FA 값을 산정한다면 알코올 사용 장애자의 선별 및 진단에 유용한 검사법이라 사료 된다.

• Journal of Korean Neurosurgical Society
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• 제66권2호
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• pp.144-154
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• 2023

Objective : Stroke caused from large vessel occlusion (LVO) has emerged as the most common stroke subtype worldwide. Intravenous tissue plasminogen activator administration (IV-tPA) and additional intraarterial thrombectomy (IA-Tx) is regarded as standard treatment. In this study, the authors try to find the early recanalization rate of IV-tPA in LVO stroke patients. Methods : Total 300 patients undertook IA-Tx with confirmed anterior circulation LVO, were analyzed retrospectively. Brain computed tomography angiography (CTA) was the initial imaging study and acute stroke magnetic resonance angiography (MRA) followed after finished IV-tPA. Early recanalization rate was evaluated by acute stroke MRA within 2 hours after the IV-tPA. In 167 patients undertook IV-tPA only and 133 non-recanalized patients by IV-tPA, additional IA-Tx tried (IV-tPA + IA-Tx group). And 131 patients, non-recanalized by IV-tPA (IV-tPA group) additional IA-Tx recommend and tried according to the patient condition and compliance. Results : Early recanalization rate of LVO after IV-tPA was 12.0% (36/300). In recanalized patients, favorable outcome (modified Rankin Scale, 0-2) was 69.4% (25/36) while it was 32.1% (42/131, p<0.001) in non-recanalized patients. Among 133 patients, non-recanalized after intravenous recombinant tissue plasminogen activator and undertook additional IA-Tx, the clinical outcome was better than not undertaken additional IA-Tx (favorable outcome was 42.9% vs. 32.1%, p=0.046). Analysis according to the perfusion/diffusion (P/D)-mismatching or not, in patient with IV-tPA with IA-Tx (133 patients), favorable outcome was higher in P/D-mismatching patient (52/104; 50.0%) than P/D-matching patients (5/29; 17.2%; p=0.001). Which treatment tired, P/D-mismatching was favored in clinical outcome (iv-tPA only, p=0.008 and IV-tPA with IA-Tx, p=0.001). Conclusion : The P/D-mismatching influences on the recanalization and clinical outcomes of IV-tPA and IA-Tx. The authors would like to propose that we had better prepare IA-Tx when LVO is diagnosed on initial diagnostic imaging. Furthermore, if the patient shows P/D-mismatching on MRA after IV-tPA, additional IA-Tx improves treatment results and lessen the futile recanalization.

• Investigative Magnetic Resonance Imaging
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• 제11권1호
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• pp.10-19
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• 2007

기존 MRI, 즉 T1 강조-, T2 강조-, 확산-, 관류-, 기능적-, 등의 영상법은 조직의 물리적 파라미터 그리고 기능적 특성을 알려주는 역할을 한다. 본 종설에서는 최근 관심이 높아지고 있는 영상기법의 하나로 MRE (Magnetic Resonance Elastography, 자기공명탄성법)를 소개하고자 한다. MRE는 기존의 물리적, 기능적 측정을 벗어나 조직의 기계적 특성에 관한 정보를 제공해준다는 면에서 MRI를 이용한 새로운 modality로서의 가능성을 시사해 준다. 예로부터 진단의 가장 기초적인 방법중 하나로서 촉진을 이용하여 조직의 경도를 가늠하여 왔다. MRE는 조직의 경도를 MRI를 이용하여 객관적으로 수치화해준다. MRE 임상실험을 성공적으로 수행하기 위해서는 몇 가지 하드웨어와 소프트웨어(트랜스듀서, 펄스대열, 영상처리 알고리즘)가 구비되어야 한다. 트랜스듀서는 인체에 진동을 전달해주는 부분으로서 MRE 응용을 가능하게 하는 핵심적인 역할을 한다. 따라서 MRI 시스템의 자기장과 인체의 골격, 피부와 트랜스듀서 접촉면의 압력, 마찰을 고려하여 제작하여야 한다. 트랜스듀서를 통해서 인체 내부에 진동이 전달되고 있으면 최적의 영상을 얻기 위하여 고려되어야 할 사항이 펄스대열을 조정하는 것이다. 마지막으로 여러 가지 물질에 대한 가정(등방성, 균질성, 비압축성)하에서 영상처리 알고리즘은 파동방정식(Helmholtz equation)으로 표현되며 이로부터 탄성도(Elasticity or Modulus)를 구할 수 있다. 본 종설에서는 이에 대한 리뷰 및 MRE를 이용한 응용분야에 대하여 살펴본다.

• 대한영상의학회지
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• 제82권5호
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• pp.1218-1230
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• 2021

목적 고위험 환자에서 초기 간암 선별 검사로써 단축 자기공명영상 검사의 환자별 진단능을 기존의 고식적 간 자기공명영상검사와 비교하고자 한다. 대상과 방법 간암 고위험군에서 간 자기공명영상 검사를 시행 받은 총 201명의 환자에 대해 연구를 시행하였다. 단축 자기공명영상 검사 군의 프로토콜은 T2 강조영상, 담도기 T1 강조영상, 확산강조영상 등으로 구성되며, 두 명의 영상의학과 의사가 각각의 환자에 대해 후향적으로 단축 자기공명영상검사 군 및 고식적 자기공명영상검사 군, 두 군의 영상을 독립적으로 평가하였다. 두 연구자 간 일관성은 Cohen's kappa 값을 이용하여 비교하였다. 복합적인 참조표준을 이용하여 두 군에서 각각 진단능을 평가하여 비교하였다. 결과 79 명의 환자에서 총 93개의 간암이 발견되었다. 두 연구자 간 일관성은 두 군에서 모두 매우 양호하였다(κ = 0.839, 0.948). 단축 자기공명영상검사 군에서 민감도 및 음성예측도는 각각 94.9% 및 96.4%였으며, 이는 고식적 자기공명영상검사 군과 큰 차이를 보이지 않았다(96.2%, 97.5%). 결론 단축 자기공명영상검사는 고식적 자기공명영상검사에 비교하여 임상적으로 허용 가능한 민감도와 음성예측도를 갖는다. 따라서 간암 고위험군 환자에서 간암 선별검사로써 새로운 대안이 될 수 있을 것이다.

• 한국진공학회:학술대회논문집
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• 한국진공학회 2012년도 제43회 하계 정기 학술대회 초록집
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• pp.343-344
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• 2012

It has been known since the mid 1960s that Ag can be photodissolved in chalcogenide glasses to form materials with interesting technological properties. In the 40 years since, this effect has been used in diverse applications such as the fabrication of relief images in optical elements, micro photolithographic schemes, and for direct imaging by photoinduced Ag surface deposition. ReRAM, also known as conductive bridging RAM (CBRAM), is a resistive switching memory based on non-volatile formation and dissolution of a conductive filament in a solid electrolyte. Especially, Ag-doped chalcogenide glasses and thin films have become attractive materials for fundamental research of their structure, properties, and preparation. Ag-doped chalcogenide glasses have been used in the formation of solid electrolyte which is the active medium in ReRAM devices. In this paper, we investigated the nature of thin films formed by the photo-dissolution of Ag into Ge-Se glasses for use in ReRAM devices. These devices rely on ion transport in the film so produced to create electrically programmable resistance states. [1-3] We have demonstrated functionalities of Ag doped chalcogenide glasses based on their capabilities as solid electrolytes. Formation of such amorphous systems by the introduction of Ag+ ions photo-induced diffusion in thin chalcogenide films is considered. The influence of Ag+ ions is regarded in terms of diffusion kinetics and Ag saturation is related to the composition of the hosting material. Saturated Ag+ ions have been used in the formation of conductive filaments at the solid electrolyte which is the active medium in ReRAM devices. Following fabrication, the cell displays a metal-insulator-metal structure. We measured the I-V characteristics of a cell, similar results were obtained with different via sizes, due to the filamentary nature of resistance switching in ReRAM cell. As the voltage is swept from 0 V to a positive top electrode voltage, the device switches from a high resistive to a low resistive, or set. The low conducting, or reset, state can be restored by means of a negative voltage sweep where the switch-off of the device usually occurs.

• 대한의용생체공학회:의공학회지
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• 제28권6호
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• pp.817-824
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• 2007

Tractography using Diffusion Tensor Magnetic Resonance Imaging (DT-MRI) is a method to determine the architecture of axonal fibers in the central nervous system by computing the direction of the principal eigenvector in the white matter of the brain. However, the fiber tracking methods suffer from the noise included in the diffusion tensor images that affects the determination of the principal eigenvector. As the fiber tracking progresses, the accumulated error creates a large deviation between the calculated fiber and the real fiber. This problem of the DT-MRI tractography is known mathematically as the ill-posed problem which means that tractography is very sensitive to perturbations by noise. To reduce the noise in DT-MRI measurements, a tensor-valued median filter which is reported to be denoising and structure-preserving in fiber tracking, is applied in the tractography. In this paper, we proposed the modified gradient descent method which converges fast and accurately to the optimal tensor-valued median filter by changing the step size. In addition, the performance of the modified gradient descent method is compared with others. We used the synthetic image which consists of 45 degree principal eigenvectors and the corticospinal tract. For the synthetic image, the proposed method achieved 4.66%, 16.66% and 15.08% less error than the conventional gradient descent method for error measures AE, AAE, AFA respectively. For the corticospinal tract, at iteration number ten the proposed method achieved 3.78%, 25.71 % and 11.54% less error than the conventional gradient descent method for error measures AE, AAE, AFA respectively.

• Journal of Korean Neurosurgical Society
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• 제58권4호
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• pp.316-320
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• 2015

Objective : The main concern during transfemoral carotid artery stenting (CAS) is preventing cerebral embolus dislodgement. We compared clinical outcomes and intraprocedural embolization rates of CAS using a distal filter protection device or proximal balloon occlusion device. Methods : From January 2011 to March 2015, a series of 58 patients with symptomatic or asymptomatic internal carotid artery stenosis ${\geq}70%$ were treated with CAS with embolic protection device in single center. All patients underwent post-CAS diffusion-weighted magnetic resonance imaging (DW-MRI) to detect new ischemic lesions. We compared clinical outcomes and postprocedural embolization rates. Results : CAS was performed in all 61 patients. Distal filter protection success rate was 96.6% (28/29), whose mean age was 70.9 years, and mean stenosis was 81%. Their preprocedural infarction rate was 39% (11/28). Subsequent DW-MRI revealed 96 new ischemic lesions in 71% (20/28) patients. In contrast, the proximal balloon occlusion device success rate was 93.8% (30/32), whose mean age was 68.8 years and mean stenosis was 86%. Preprocedure infarction rate was 47% (14/30). DW-MRI revealed 45 new ischemic lesions in 57% (17/30) patients. Compared with distal filter protection device, proximal balloon occlusion device resulted in fewer ischemic lesions per patient (p=0.028). In each group, type of stent during CAS had no significant effect on number of periprocedural embolisms. Only 2 neurologic events occurred in the successfully treated patients (one from each group). Conclusion : Transfemoral CAS with proximal balloon occlusion device achieves good results. Compared with distal filter protection, proximal balloon occlusion might be more effective in reducing cerebral embolism during CAS.

• 대한불안의학회지
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• 제16권2호
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• pp.106-112
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• 2020

Objective : Social anxiety disorder (SAD) is characterized by fear of social threat and exhibits limbic hyper-reactivity toward social stimuli such as emotional faces. A previous study identified the uncinate fasciculus (UF) sub-tract as particularly related to facial memory. To explore the white matter tract relating to face-specific brain regions, we investigated the UF sub-tract in SAD. Methods : The diffusion tensor images of 22 patients with SAD and 20 healthy controls were analyzed with tractography. The UF sub-tract was delineated using the regions of interest of face patches in the anterior temporal lobe and the orbitofrontal cortex, and fractional anisotrophy (FA) and total number of streamlines (ST) were analyzed. We examined the group comparison of FA and ST of the UF sub-tract and correlations of FA and ST with the social anxiety symptoms such as the Liebowitz Social Anxiety Scale (LSAS), the Social Interaction Anxiety Scale (SIAS), the Social Phobia Scale (SPS) and the Fear of Negative Evaluation scale (FNE) in SAD. Results : There were no group differences in FA and ST of the UF sub-tract. However, negative correlations were observed between ST of the right UF sub-tract and severity of social anxiety symptoms (LSAS, r_s=-0.480, p=0.024; SIAS, r_s=-0.580, p=0.005; SPS, r_s=-0.590, p=0.004; FNE, r_s=-0.675, p=0.001) in patients with SAD. Conclusion : Although patients with SAD did not show quantitative abnormalities in the UF sub-tact connecting face-specific brain regions, this structure seems to play a role in the symptom severity of SAD.

• 한국진공학회:학술대회논문집
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• 한국진공학회 2014년도 제46회 동계 정기학술대회 초록집
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• pp.326-326
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• 2014

It has been known since the mid 1960s that Ag can be photodissolved in chalcogenide glasses to form materials with interesting technological properties. In the 40 years since, this effect has been used in diverse applications such as the fabrication of relief images in optical elements, micro photolithographic schemes, and for direct imaging by photoinduced Ag surface deposition. ReRAM, also known as conductive bridging RAM (CBRAM), is a resistive switching memory based on non-volatile formation and dissolution of a conductive filament in a solid electrolyte. Especially, Ag-doped chalcogenide glasses and thin films have become attractive materials for fundamental research of their structure, properties, and preparation. Ag-doped chalcogenide glasses have been used in the formation of solid electrolyte which is the active medium in ReRAM devices. In this paper, we investigated the nature of thin films formed by the photo-dissolution of Ag into Ge-Se glasses for use in ReRAM devices. These devices rely on ion transport in the film so produced to create electrically programmable resistance states [1-3]. We have demonstrated functionalities of Ag doped chalcogenide glasses based on their capabilities as solid electrolytes. Formation of such amorphous systems by the introduction of Ag+ ions photo-induced diffusion in thin chalcogenide films is considered. The influence of Ag+ ions is regarded in terms of diffusion kinetics and Ag saturation is related to the composition of the hosting material. Saturated Ag+ ions have been used in the formation of conductive filaments at the solid electrolyte which is the active medium in ReRAM devices. Following fabrication, the cell displays a metal-insulator-metal structure. We measured the I-V characteristics of a cell, similar results were obtained with different via sizes, due to the filamentary nature of resistance switching in ReRAM cell. As the voltage is swept from 0 V to a positive top electrode voltage, the device switches from a high resistive to a low resistive, or set. The low conducting, or reset, state can be restored by means of a negative voltage sweep where the switch-off of the device usually occurs.

• The Journal of Korean Physical Therapy
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• 제31권6호
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• pp.358-362
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• 2019

Purpose: We investigated the difference in injury of the corticospinal tract (CST) and the spinothalamic tract (STT) in patients with putaminal hemorrhage, using diffusion tensor tractography (DTT). Methods: Thirty one consecutive patients with PH and 34 control subjects were recruited for this study. DTT scanning was performed at early stage of PH (7-63 days), and the CST and STT were reconstructed using the Functional Magnetic Resonance Imaging of Brain (FMRIB) Software Library program. Injury of the CST and STT was defined in terms of the configuration or abnormal DTT parameters was more than 2 standard deviations lower than that of normal control subjects. Results: Among 31 patients, all 31 patients (100%) had injury of the CTS, whereas 25 patients (80.6%) had injury of the STT: the incidence of CST injury was significantly higher than that of STT (p<0.05). In detail, 20 (64.5%) of 31 patients showed a discontinuation of the CST in the affected hemisphere; in contrast, 14 patients (45.2%) of 31 patients showed a discontinuation of the STT in the affected hemisphere. Regarding the FA value, 6 (19.4%) of 31 patients and 2 (6.4%) of 31 patients were found to have injury in the CST and STT, respectively. In terms of the fiber number, the same injury incidence was observed in 11 patients (35.5%) in both the CST and STT. Conclusion: The greater vulnerability of the CST appears to be ascribed to the anatomical characteristics; the CST is located anteriorly to the center of the putamen compared with the STT.