• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.665-675
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• 2020

Purpose This study aimed to identify independent predictors of favorable outcomes associated with emergent carotid artery stenting (CAS) in patients with acute anterior circulation stroke. Materials and Methods This study included 93 patients with acute stroke who underwent emergent CAS to treat stenoocclusive lesions in the cervical internal carotid artery (ICA) within 6 hours of the onset of the associated symptoms. Data were compared between patients with and without favorable outcomes. The independent predictors of a favorable outcome were determined via logistic regression analysis (modified Rankin Scale 0-2 at 90 days). Results Intracranial tandem occlusion was noted in 81.7% of patients (76/93) among which (76/93), 55 of whom underwent intracranial recanalization therapy. Intracranial reperfusion was successful in 74.2% (69/93) and favorable outcomes were noted in 51.6% of patients (48/93). The mortality rate was 6.5% (6/93). In logistic regression analysis, diffusion-weighted imaging-Alberta Stroke Program Early CT Score [odds ratio (OR), 1.487; 95% confidence interval (CI), 1.018-2.173, p = 0.04], successful reperfusion (OR, 5.199; 95% CI, 1.566-17.265, p = 0.007), and parenchymal hemorrhage (OR, 0.042; 95% CI, 0.003-0.522, p = 0.014) were independently associated with a favorable outcome. Conclusion Baseline infarct size, reperfusion status, and parenchymal hemorrhage were independent predictors of favorable outcomes after emergent CAS to treat stenoocclusive lesions in the cervical ICA in patients with acute anterior circulation stroke.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.153-165
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• 2017

Objectives : Recent neuroimaging studies focus on dysfunctions in connectivity between cognitive circuits and emotional circuits: anterior cingulate cortex that connects dorsolateral orbitofrontal cortex and prefrontal cortex to limbic system. Previous studies on pediatric depression using DTI have reported decreased neural connectivity in several brain regions, including the amygdala, anterior cingulate cortex, superior longitudinal fasciculus. We compared the neural connectivity of psychotropic drug naïve adolescent patients with a first onset of major depressive episode with healthy controls using DTI. Methods : Adolescent psychotropic drug naïve patients(n=26, 10 men, 16 women; age range, 13-18 years) who visited the Korea University Guro Hospital and were diagnosed with first onset major depressive disorder were registered. Healthy controls(n=27, 5 males, 22 females; age range, 12-17 years) were recruited. Psychiatric interviews, complete psychometrics including IQ and HAM-D, MRI including diffusion weighted image acquisition were conducted prior to antidepressant administration to the patients. Fractional anisotropy(FA), radial, mean, and axial diffusivity were estimated using DTI. FMRIB Software Library-Tract Based Spatial Statistics was used for statistical analysis. Results : We did not observe any significant difference in whole brain analysis. However, ROI analysis on right superior longitudinal fasciculus resulted in 3 clusters with significant decrease of FA in patients group. Conclusions : The patients with adolescent major depressive disorder showed statistically significant FA decrease in the DTI-based structure compared with healthy control. Therefore we suppose DTI can be used as a bio-marker in psychotropic drug-naïve adolescent patients with first onset major depressive disorder.

• Journal of Korean Neurosurgical Society
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• v.50 no.2
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• pp.75-80
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• 2011

Objective : Leukoaraiosis (LA) has been suggested to be related to the poor outcome or the occurrence of symptomatic intracerebral hemorrhage (sICH) after acute ischemic stroke. We retrospectively investigated the influences of LA on long-term outcome and the occurrence of sICH after thrombolysis in acute ischemic stroke (AIS). Methods : In this study, we recruited 164 patients with AIS and magnetic resonance image (MRI)-detected thrombolysis. The presence and extent of LA were assessed using the Fazekas grading system. The National Institutes of Health Stroke Scale score was used to assess the baseline measure of neurologic severity, and the modified Rankin Scale score assessment was used up to 1 year after thrombolysis. Results : Of 164 subjects, 56 (34.2%) showed LA on MRI. Compared to the 108 patients without LA, the patients with LA were of much older age (p<0.01), had a higher prevalence of hypertension (p<0.01), and had a much poorer outcome at 90 days (p=0.05) and 1 yr (p=0.01) after thrombolysis. There were no significant differences in sICH between patients with and without LA on MRI. In univariate analysis for the occurrence of poor outcome at 90 days after thrombolysis, the size of ischemic lesion on diffusion weighted images (DWI), [odds ratio (OR), 1.03; 95% confidence interval (95% CI), 1.01-1.04; p<0.01], recanalization (OR, 0.03; 95% CI, 0.01-0.10; p<0.01), sICH (OR, 12.2; 95% CI, 1.54-95.8), neurologic severity (OR, 1.17; 95% CI, 1.09-1.25; p<0.01), blood glucose level (OR, 1.01; 95% CI, 1.00-1.02; p=0.03), and the presence of LA on MRI (OR, 2.01; 95% CI, 1.04-3.01; p=0.04) were statistically significant. In multivariate analysis, neurologic severity (OR, 1.14; 95% CI, 1.04-1.24; p<0.01), recanalization (OR, 0.03; 95% CI, 0.01-0.11; p<0.01), lesion size on DWI (OR, 1.02; 95% CI, 1.01-1.03; p=0.02), serum glucose level (OR, 1.01; 95% CI; 1.01-1.02; p=0.03), and the presence of LA on MRI (OR, 3.2; 95% CI, 1.22-8.48; p<0.01) showed statistically significant differences. These trends persisted up to 1 yr after thrombolysis. Conclusion : In this study, we demonstrated that the presence of LA on MRI might be related to poor outcome after use of intravenous tissue plasminogen activator in AIS.

• Journal of Korean Neurosurgical Society
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• v.54 no.6
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• pp.467-476
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• 2013

Objective : This study aimed to evaluate the hypotheses that administration routes [intra-arterial (IA) vs. intravenous (IV)] affect the early stage migration of transplanted human bone marrow-derived mesenchymal stem cells (hBM-MSCs) in acute brain infarction. Methods : Male Sprague-Dawley rats (n=40) were subjected to photothrombotic infarction. Three days after photothrombotic infarction, rats were randomly allocated to one of four experimental groups [IA group : n=12, IV group : n=12, superparamagnetic iron oxide (SPIO) group : n=8, control group : n=8]. All groups were subdivided into 1, 6, 24, and 48 hours groups according to time point of sacrifice. Magnetic resonance imaging (MRI) consisting of T2 weighted image (T2WI), $T2^*$ weighted image ($T2^*WI$), susceptibility weighted image (SWI), and diffusion weighted image of rat brain were obtained prior to and at 1, 6, 24, and 48 hours post-implantation. After final MRI, rats were sacrificed and grafted cells were analyzed in brain and lung specimen using Prussian blue and immunohistochemical staining. Results : Grafted cells appeared as dark signal intensity regions at the peri-lesional zone. In IA group, dark signals in peri-lesional zone were more prominent compared with IV group. SWI showed largest dark signal followed by $T2^*WI$ and T2WI in both IA and IV groups. On Prussian blue staining, IA administration showed substantially increased migration and a large number of transplanted hBM-MSCs in the target brain than IV administration. The Prussian blue-positive cells were not detected in SPIO and control groups. Conclusion : In a rat photothrombotic model of ischemic stroke, selective IA administration of human mesenchymal stem cells is more effective than IV administration. MRI and histological analyses revealed the time course of cell migration, and the numbers and distribution of hBM-MSCs delivered into the brain.

• Investigative Magnetic Resonance Imaging
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• v.15 no.2
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• pp.110-122
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• 2011

Purpose : The purpose of this study is to establish the method generating human brain anatomical connectivity from Korean children and evaluating the network topological properties using small-world network analysis. Materials and Methods : Using diffusion tensor images (DTI) and parcellation maps of structural MRIs acquired from twelve healthy Korean children, we generated a brain structural connectivity matrix for individual. We applied one sample t-test to the connectivity maps to derive a representative anatomical connectivity for the group. By spatially normalizing the white matter bundles of participants into a template standard space, we obtained the anatomical brain network model. Network properties including clustering coefficient, characteristic path length, and global/local efficiency were also calculated. Results : We found that the structural connectivity of Korean children group preserves the small-world properties. The anatomical connectivity map obtained in this study showed that children group had higher intra-hemispheric connectivity than inter-hemispheric connectivity. We also observed that the neural connectivity of the group is high between brain stem and motorsensory areas. Conclusion : We suggested a method to examine the anatomical brain network of Korean children group. The proposed method can be used to evaluate the efficiency of anatomical brain networks in people with disease.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.598-606
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• 2020

Objective : The purpose of this study was to evaluate the impact of time interval between index event and stenting on the periprocedural risk of stenting for symptomatic carotid stenosis and to determine the optimal timing of stenting. Methods : This retrospective study included 491 (322 symptomatic [65.6%] and 169 asymptomatic [34.4%]) patients undergoing carotid stenting. The symptomatic patients were categorized into Day 0-3, 4-7, 8-10, 11-14, 15-21, and >21 groups according to the time interval between index event and stenting. Periprocedural (≤30 days) risk for clinical (any neurological deterioration) and radiological (new infarction on postprocedural diffusion-weighted imaging) events of stenting in each time interval versus asymptomatic stenosis was calculated with logistic regression analysis adjusted for confounders, and provided as odds ratio (OR) and 95% confidence interval (CI). Results : Overall clinical event rate (4.3%) of stenting for symptomatic carotid stenosis was higher than that for asymptomatic stenosis (1.2%; OR, 3.979 [95% CI, 1.093-14.489]; p=0.036). Stenting in Day 0-3 (13.2%; OR, 10.997 [95% CI, 2.333-51.826]; p=0.002) and Day 4-7 (8.3%; OR, 6.775 [95% CI, 1.382-33.227]; p=0.018) was associated with high risk for clinical events. However, the clinical event rates in stenting after 7 days from index event (Day 8-10, 1.8%; Day 11-14, 2.5%; Day 15-21, 0%; Day >21, 2.9%) were not different from that in stenting for asymptomatic stenosis. Overall radiological event rate (55.6%) in symptomatic stenosis was also higher than that in asymptomatic stenosis (35.5%; OR, 2.274 [95% CI, 1.553-3.352]; p<0.001). The high risk for radiological events was maintained in all time intervals (Day 0-3 : 55.3%; OR, 2.224 [95% CI, 1.103-4.627]; p=0.026; Day 4-7 : 58.3%; OR, 2.543 [95% CI, 1.329-4.949]; p=0.005; Day 8-10 : 53.6%; OR, 2.096 [95% CI, 1.138-3.889]; p=0.018; Day 11-14 : 57.5%; OR, 2.458 [95% CI, 1.225-5.021]; p=0.012; Day 15-21 : 55.6%; OR, 2.271 [95% CI, 1.099-4.764]; p=0.028; Day >21 : 54.8%; OR, 2.203 [95% CI, 1.342-3.641]; p=0.002). Conclusion : This study showed that as stenting was delayed, the periprocedural risk for clinical events decreased. The clinical event risk was high only in stenting within 7 days and comparable with that for asymptomatic stenosis in stenting after 7 days from index event, although the radiological event risk was not affected by stenting timing. Therefore, our results suggest that delayed stenting after 7 days from symptom onset is a safe strategy for symptomatic stenosis.

• Proceedings of the KIEE Conference
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• 2007.04a
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• pp.58-60
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• 2007

Magnetic Resonance Imaging(MRI) has become a very widely used medical procedur e. Clo.sed and open systems are typically used with static magnetic fields at or below 2 Tesla. BWhole body SAR(specific absorbsion rate) is the value of SAR averaged over the entire body of the patient over any period of 15 minutes. Head SAR is the value of SAR averaged over the head of the patient for any period of 10 minutes. SAR is a measure of the absorption of electromagnetic energy in the body' (typically in watts per kilogram (W/kg)). The normal operating mode comprises values of head SAR not higher than 3 W/kg. The second level controlled operating mode comprises values higher than 3 W/kg. Current FDA guidance limits the SAR in the whole body. including the head to a range of 1.5 to 4.0 W/kg, depending on the patient's clinical condition. SAR, limit restrictions are incorporated in all MRI systems. and domestic' s guidance limits the SAR in a part body. including the head to 3.2w/kg and less. The purpose of this study is to evaluate on change of head SAR in using MRI pulse sequence and to check if exceed 3.2(w/kg) level in domestic a part exposure through measured head SAR. 23 patient's the average head SAR of pulse sequence is that T2WI sagittal is 0.5375. T2WI axial(FSE) is 0.4817, T1WI axial(SE) is, 0.8179. FLAIR axial is 0.4580. GRE axial is 0.0077, Diffusion is 0.0824w/kg. The head SAR exposed per patient was proved 2.3845w/kg less than the international standard. Coefficient of correlation for the relations body weight and SAR or for the relations ETL(echo train length) and SAR is 1 value. Coefficient of correlation for the relations between TR(time to repeat) and SAR is -0.602 value. so SAR increased relative to weight body and ETL. But the relations between TR and SAR is negative definite.

• Journal of Biomedical Engineering Research
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• v.32 no.3
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• pp.245-250
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• 2011

Parallel imaging technique can provide several advantages for a multitude of MRI applications. Especially, in SENSE technique, sensitivity maps were always required in order to determine the reconstruction matrix, therefore, a number of difference approaches using sensitivity information from coils have been demonstrated to improve of image quality. Moreover, many filtering methods were proposed such as adaptive matched filter and nonlinear diffusion technique to optimize the suppression of background noise and to improve of image quality. In this study, we performed SENSE reconstruction using computer simulations to confirm the most suitable method for the feasibility of filtering effect and according to changing order of polynomial fit that were applied on variation of spatial resolution of sensitivity map. The image was obtained at 0.32T(Magfinder II, Genpia, Korea) MRI system using spin-echo pulse sequence(TR/TE = 500/20 ms, FOV = 300 mm, matrix = $128{\times}128$, thickness = 8 mm). For the simulation, obtained image was multiplied with four linear-array coil sensitivities which were formed of 2D-gaussian distribution and the image was complex white gaussian noise was added. Image processing was separated to apply two methods which were polynomial fitting and filtering according to spatial resolution of sensitivity map and each coil image was subsampled corresponding to reduction factor(r-factor) of 2 and 4. The results were compared to mean value of geomety factor(g-factor) and artifact power(AP) according to r-factor 2 and 4. Our results were represented while changing of spatial resolution of sensitivity map and r-factor, polynomial fit methods were represented the better results compared with general filtering methods. Although our result had limitation of computer simulation study instead of applying to experiment and coil geometric array such as linear, our method may be useful for determination of optimal sensitivity map in a linear coil array.

• Journal of the Korean Chemical Society
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• v.48 no.6
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• pp.553-560
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• 2004

In this experiment, a three dimensional structure analysis was carried out to examine the surface defects of semiconductor made artificially on known scale. It was investigated the three dimensional imaging according to the sample depth and the thermal diffusivity as well as the carrier transport properties. The thermal diffusivity measurement of the intrinsic GaAs semiconductor was also analyzed by the difference of frequency-dependence photoacoustic signals from the sample surface of different conditions. Thermal properties such as thermal diffusion length or thermal diffusivity of the Si wafer with and without defects on the surface were obtained by interpreting the frequency dependence of the PA signals. As a result, the photoacoustic signal is found to have the dependency on the shape and depth of the defects so that their structure of the defects can be analyzed. This method demonstrates the possibility of the application to the detection of the defects, cracks, and shortage of circuits on surface or sub-surface of the semiconductors and ceramic materials as a nondestructive testing(NDT) and a nondestructive evaluation(NDE) technique.

• Korean Journal of Biological Psychiatry
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• v.26 no.1
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• pp.8-13
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• 2019

Objectives Disrupted integrities of the fornix and stria terminalis have been suggested in schizophrenia. However, very few studies have focused on the fornix and stria terminalis comparing first-episode schizophrenia (FESZ), chronic schizophrenia (CS), and healthy controls (HCs) with the application of diffusion-tensor imaging (DTI) technique. The objective of this study is to compare the connectivity of the fornix and stria terminalis among FESZ, CS, and HCs. Methods We included the 44 FESZ patients, 39 CS patients and 20 HCs in this study. Voxel-wise statistical analysis of the fractional anisotropy (FA) data was performed using Tract-Based Spatial Statistics to analyze the connectivity of fornix and stria terminalis. In addition, the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) were used to evaluate clinical symptom severities. Results There were no significant differences between the FESZ, CS, and HCs in age, sex, education years. The SAPS and SANS scores of the schizophrenia groups showed no significant differences. FA values of the right fornix cres/stria terminalis in the CS group were significantly lower than those in FESZ and HCs. There were no significant differences of FA values of the right fornix cres/stria terminalis between the FESZ and the HCs. Pearson correlation analyses revealed that significant correlation between FA values of the right fornix cres/stria terminalies of the the FESZ group and positive, negative symptom scales, and FA values of the right fornix cres/stria terminalis of the CS group and negative symptom scales. Conclusions This study shows that FA values of the fornix and stria terminalis in the CS were lower than in the FESZ and the HCs. These results suggest that the fornix and stria terminalis can play a role in pathophysiology of schizophrenia. Thus current study can broaden our understanding of the pathophysiology of schizophrenia.