Hur, Yun Jung;Lee, Joon Soo;Lee, Jong Doo;Kim, Heung Dong
Clinical and Experimental Pediatrics
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v.51
no.3
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pp.286-292
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2008
Purpose : We performed EEG and PET on children with epilepsy concomitantly in order to evaluate the effects of epileptiform and non-epileptiform discharge of EEG on glucose metabolism. Methods : Seventy three children with epilepsy who had PET and EEG simultaneously were included in our study. The subjects were classified in two ways: (1) based on the frequency of epileptiform discharge and (2) the severity of non-epileptiform discharge. We evaluated the clinical aspects of their seizures, the severity of focal slow waves during the interictal period with the frequency of spikes or sharp waves in order to compare with the PET results. Results : The subjects were divided by the frequency of epileptiform discharge, with 13 in the no/rare group, 7 in the occasional group, and 53 children in the frequent group. The concordant rates with PET in each group were 0%, 42.9%, and 67.9%, respectively, showing high correlations with the frequency of epileptiform discharge (P<0.05, r=0.491). The subjects as divided by the severity of non-epileptiform discharge were 15 in the no group, 25 in the infrequent group, 17 in the intermediate group, and 16 in the continuous group. The concurrence rates with PET for each group were 13.3%, 52.0%, 64.7%, and 68.8%, respectively, also showing a high correlation with the severity of non-epileptiform discharge (P<0.05, r= 0.365). Conclusion : Epileptiform discharge and non-epileptiform discharge in EEG showed a certain association with hypometabolism in PET. We recommend EEG to reduce false lateralization and to localize lesions in cases of high frequency and severity.
Purpose: We developed a computer-aided classifier using artificial neural network (ANN) to discriminate the cerebral metabolic pattern of medial and lateral temporal lobe epilepsy (TLE). Materials and Methods: We studied brain F-18-FDG PET images of 113 epilepsy patients sugically and pathologically proven as medial TLE (left 41, right 42) or lateral TLE (left 14, right 16). PET images were spatially transformed onto a standard template and normalized to the mean counts of cortical regions. Asymmetry indices for predefined 17 mirrored regions to hemispheric midline and those for medial and lateral temporal lobes were used as input features for ANN. ANN classifier was composed of 3 independent multi-layered perceptrons (1 for left/right lateralization and 2 for medial/lateral discrimination) and trained to interpret metabolic patterns and produce one of 4 diagnoses (L/R medial TLE or L/R lateral TLE). Randomly selected 8 images from each group were used to train the ANN classifier and remaining 51 images were used as test sets. The accuracy of the diagnosis with ANN was estimated by averaging the agreement rates of independent 50 trials and compared to that of nuclear medicine experts. Results: The accuracy in lateralization was 89% by the human experts and 90% by the ANN classifier Overall accuracy in localization of epileptogenic zones by the ANN classifier was 69%, which was comparable to that by the human experts (72%). Conclusion: We conclude that ANN classifier performed as well as human experts and could be potentially useful supporting tool for the differential diagnosis of TLE.
Objective : The Mini-Mental State Examination(MMSE) and Brief Cognitive Rating Scale(BCRS) are frequently using screening tests fur evaluating the cognitive function in clinical practice and research. The authors tried to evaluate the clinical usefulness of these tests for the patients with non-traumatic subcortical cerebrovascular disease. Method : We administered the MMSE and BCRS to 85 patients and 195 normal control group. In order to compare the test results according to the lesion site, we divided patients into left sided lesion group(21 patients), right sided lesion group(31 patients) and both sided lesion group(13 patients). Their cognitive function was evaluated by the BNA and daily living functional activity was examined by the IADLs(Instrumental Activities of Daily Living Scale)and GERRI(Geriatric Evaluation by Relative's Rating Instrument). Results : The results are as follows : 1) In the BNA, the patients scored significantly lower than control group at all items(except Right-Left Orientation and Motor Impersistence), but there were no difference in the MMSE(total score and all 5 items), and only 2 items(recent memory and self-care) were significantly different between two groups in the BCRS. 2) In the comparison by lateralization, there were significant differences among three groups at 3 items(Left Tactile Form Perception, Left Finger Localization and Right Finger Localization) in the BNA. But, there were no difference in the MMSE and BCRS. 3) In the correlation between daily living functioning and the MMSE/BCRS, control group showed no relation(except item of cognitive functioning), but patient group was significantly correlated with 3 items(social functioning, instrumental activities of daily living and cognitive functioning). Conclusions : These findings suggest that MMSE and BCRS are not useful as the test for cognitive function and discrimination of lateralization in patients with non-traumatic subcortical cerebrovascular disease. However, scores of these tests may be related with the functional level(such as daily living function) of patients.
Objectives: Brain maturation involves brain lateralization and asymmetry to achieve efficient information processing and cognitive controls. This study elucidates normal brain maturation change during the gap between ages 6-9 and age 14-17 using resting EEG. Methods: An EEG dataset was acquired from open source MIPDB (Multimodal Resource for Studying Information Processing in the Developing Brain). Ages 6-9 (n = 24) and ages 14-17 (n = 26) were selected for analysis, and subjects with psychiatric illness or EEG with severe noise were excluded. Finally, ages 6-9 (n = 14) and ages 14-17 (n = 11) were subjected to EEG analysis using EEGlab. A 120-sec length of resting EEG when eyes were closed was secured for analysis. Brain topography was compartmentalized into nine regions, best fitted with brain anatomical structure. Results: Absolute power of the delta band and theta band in ages 6-9 was greater than that of ages 14-17 in the whole brain, and, also is relative power of delta band in frontal compartment, which is same line with previous studies. The relative power of the beta band of ages 14-17 was greater than that of ages 6-9 in the whole brain. In asymmetry evaluation, relative power of the theta band in ages 14-17 showed greater power in the left than right frontal compartment; the opposite finding was noted in the parietal compartment. For the alpha band, a strong relative power distribution in the left parietal compartment was observed in ages 14-17. Absolute and relative power of the alpha band is distributed with hemispheric left lateralization in ages 14-17. Conclusion: During the gap period between ages 6-9 and ages 14-17, brain work becomes more complicated and sophisticated, and alpha band and beta band plays important roles in brain maturation in typically developing children.
Background: The intermittent delta activity in electroencephalographies (EEGs) of patients with focal brain lesions has been reported to be a marker of an epileptogenic focus. This study investigated the concordance between the current source distribution (CSD) of the interictal epileptiform discharges (IEDs) and that of the background delta frequency bands (DFBs) of the scalp EEG. Methods: We collected scalp EEGs of 13 patients with focal epilepsy that contained uniregional IEDs and unilateral delta to theta slow waves. We applied a distributed source model using LORETA$^{(R)}$ to determine the CSD of the peak points of the IEDs and the DFBs of the background activity. Results: The CSDs of the DFBs were ipsilateral to the CSDs of the peak point of the averaged IEDs in ten patients, and bilateral with ipsilateral predominance in three patients. In the cases with an ipsilateral CSD of the DFB, 8 of 10 patients had concordance of the CSD localization between the averaged IED and the DFB. In the cases with bilateral CSD of the DFB, 2 of 3 patients had concordance of the CSD localization between the averaged IED and the DFB. Conclusions: The CSD localization and lateralization appear to be concordant between the IEDs and the DFB of background activity in epileptic patients. Therefore, the CSD of the DFB in EEGs with visually observable slow activities may predict those of IEDs.
Objective: This study aims to discover how tongue self-resistance exercise affects the swallowing function of patients with stroke. Method: The subjects of this study were two patients who were treated at the Y hospital in Gyeonggido. Data were gathered by VFSS regarding the degree of swallowing disability and oral intake before and after intervention. This study analyzed case studies of two patients. One patient's intervention was applied in September 2012 for three weeks. The other's intervention was applied in February 2014 for three weeks. At the first session, the VFSS examination was administered. Then, intervention began after the patients gave their consent for participation. Each session was practiced 10 times per set, but one session had 3 sets. Intervention frequency consisted of five sessions per week, and it was conducted for three weeks. Tongue self-resistance exercise included tongue protrusion, tongue lateralization, and tongue elevation on the hard palate. Results: The first tongue self-resistance exercise had a positive effect on swallowing function because of the decrease in VFS score. The second tongue self-resistance exercise showed improved oral intake based on FOIS scores. Conclusion: This study's results suggest that there are many benefits of tongue self-resistance exercise on the swallowing function when it is applied to patients with stroke.
Park, Chul-Kee;Hwang, Sung Kyun;Gwak, Ho-Shin;Yoo, Heon;Chung, Young Seob;Paek, Sun Ha;Kim, Dong Gyu;Jung, Hee-Won;Kim, Seong Yeon;Hong, Seung Kuan
Journal of Korean Neurosurgical Society
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v.29
no.10
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pp.1316-1321
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2000
Objectives : The authors analyzed the surgical series of Cushing's disease to evaluate the proper treatment policy and to verify the possible prognostic factors. Material and Methods : Of 50 patients diagnosed as Cushing's disease and operated at Department of Neurosurgery of our institute between 1988 and 1999, 48 patients with available medical records were analyzed retrospectively. Mean follow-up period was 48 months(3 to 109 months). Preoperative diagnosis was made after evaluating the patients with multiple-stage endocrinological studies and 31 selective patients were evaluated with inferior petrosal sinus sampling(IPSS). Magnetic resonance imaging(MRI) and/or high resolution computerized tomography(CT) was done in all patients. A total of 51 transsphenoidal adenomectomy(TSA) were performed including 3 revision for initial surgical failure cases. Remission was decided on the basis of both endocrinological criteria and clinical status. Radiation and/or ketoconazole therapy were applied to failed cases. For the verification of prognostic factors, the authors evaluated the statistical significance of multiple variables over remission rate by chi-square test. Result : Sensitivity of IPSS for central localization was 93.5% which was better than that of MRI(87.5%). But for lateralization, it was 72.4% for IPSS versus MRI 90.5%. Success rate of TSA was 82%(42/51) and recurrence rate was 9%(4/48). When including adjuvant treatments for surgically failed cases, overall success rate was 89.6% and all of 3 reoperated cases(TSA) due to recurrence were successful. Significant complication occurred in 7.8%(4/51) after TSA including hypopituitarism, diabetes insipidus, and visual loss. Non-existence of tumor in MRI and prolonged symptom duration(>3 years) were significant prognostic factors. Conclusion : TSA can be considered as initial treatment for Cushing's disease. In surgically failed cases, multiple treatment modality may improve the overall outcome and repeated TSA for recurrent cases seem to provide similar success.
Objectives Alteration of epigenetic effects of testosterone during early development was suggested as an ancillary mechanism for the genesis of schizophrenia. EEG coherence was thought to be a marker for cerebral laterality of which important determinant was testosterone during early development. We studied sex-related differences of EEG coherences between patients with schizophrenia and controls to examine the sex effects in the genesis of schizophrenia. Methods EEG was recorded in 35 patients with schizophrenia and 46 healthy controls in the eyes closed resting state. Pair-wise EEG coherences were calculated over delta, theta, alpha, beta and gamma frequency bands. To examine the differences of EEG coherence according to sex in each group, ANCOVA was performed using Statistical Analysis system (SAS, Ver 9.3) and R (Ver 2.15.2). Results Healthy control males showed more increased right intrahemispheric coherences than healthy control females in delta, theta, alpha and beta frequency bands. In patients with schizophrenia, this male dominant pattern in right intrahemispheric coherences was attenuated especially in alpha and beta bands. Healthy control females showed more increased interhemispheric coherences than healthy control males in delta, theta, beta and gamma frequency bands. In patients with schizophrenia, these female dominant patterns in interhemispheric coherences were attenuated especially in delta, theta, and beta bands, which were commonly observed in frontal to central areas. Conclusion Sex differences in resting EEG coherences were attenuated in schizophrenia patients. These results imply that sex-related aberrant cerebral lateralization might exist in patients with schizophrenia, which are partly due to sex hormones via epigenetic mechanisms.
Journal of Elementary Mathematics Education in Korea
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v.17
no.1
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pp.67-86
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2013
The purpose of this study is to analyze selection of factors of Schoenfeld's problem solving behavior shown in problem solving process of mathematically gifted students based on brain preference of the students and to present suggestions related to hemispheric lateralization that should be considered in teaching such students. The conclusions based on the research questions are as follows. First, as for problem solving methods of the students in the Gifted Education Center based on brain preference, the students of left brain preference showed more characteristics of the left brain such as preferring general, logical decision, while the students of right brain preference showed more characteristics of the right brain such as preferring subjective, intuitive decision, indicating that there were differences based on brain preference. Second, in the factors of Schoenfeld's problem solving behavior, the students of left brain preference mainly showed factors including standardized procedures such as algorithm, logical and systematical process, and deliberation, while the students of right brain preference mainly showed factors including informal and intuitive knowledge, drawing for understanding problem situation, and overall examination of problem-solving process. Thus, the two types of students were different in selecting the factors of Schoenfeld's problem solving behavior based on the characteristics of their brain preference. Finally, based on the results showing that the factors of Schoenfeld's problem solving behavior were differently selected by brain preference, it may be suggested that teaching problem solving and feedback can be improved when presenting the factors of Schoenfeld's problem solving behavior selected more by students of left brain preference to students of right brain preference and vice versa.
Journal of The Korean Association For Science Education
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v.24
no.5
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pp.805-813
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2004
Our educational system clearly places much greater value on left hemisphere learning. Students who process information in other ways are at a serious disadvantage and may not be learning efficiently. Since mind mapping emphasizing visual and spatial language, it helps students to use the whole brain and promotes more effective comprehension. The purpose of this research was to determine the effects of the instruction using mind map on the science achievement of students. A pretest-posttest control group design was employed. Subjects were 153 male and female, first grade students in a middle school. A control group of 83 was instructed with a traditional teaching method, and an experimental group of 70 was instructed by using a mind mapping strategy. Two groups were treated for 50 hours during 17 weeks. Tolerance's 'Style Of Learning And Thinking(SOLAT)' was used to assess students' lateralization preferences. A 30-item multiple choice posttest was used to assess students' achievement. To analyze the data, we used an analysis of covariance(ANCOVA) and i-tests. It was found that 21.6% of students was left brain dominant, 31.4%, right brain dominant and 47.1 % was integrated style. There was no gender difference in hemispheric dominance. Significant differences existed between the test scores when they were taught by using a mind map. Mind mapping turned out to be a valuable learning technique for the right brain students, helping them to achieve the same level of subject mastery as left brain students. There was a significant difference between males and females in relation to mind map application. Female scored significantly higher than males.
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