• Title/Summary/Keyword: Magnetic Resonance

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Microscopic Decompression of Digital Nerve Surrounded by Hemangioma: A Case Report (미세수술을 통하여 수지신경을 압박하는 혈관종을 성공적으로 제거한 증례 보고)

  • Ko, Jun Gul;Kim, Jun Hyeok;Rha, Eun Young;Lee, Jun Yong;Yoo, Gyeol;Baek, Sang Oon
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.301-305
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    • 2018
  • Hemangiomas are benign neoplasms of endothelial cells origin, rarely found in hand region. Authors report a 62-year-old female with capillary hemangioma of right index finger causing a neuropathic symptom via nerve compression. A space-occupying vascular lesion surrounding the radial digital nerve was revealed in magnetic resonance imaging (MRI), which was removed under microscopic assist. The digital nerve was decompressed consequently. The mass was firmly attached to both the digital nerve and digital artery, requiring a meticulous microscopic dissection to preserve the nerve and artery. Compression neuropathy caused by space-occupying lesions is rare and its diagnosis is often difficult. A microscopic surgical approach can be used to successfully relieve neuropathic pain after proper diagnosis established by diagnostic tools such as MRI as in this case.

Fistula Formation Between the Disc and Dura after Percutaneous Endoscopic Lumbar Discectomy - A Case Report - (경피적 내시경 요추 추간판 절제술 후 발생한 추간판과 경막 사이의 누공 형성 - 증례 보고 -)

  • Kim, Hak Sun;Kim, Hyoung Bok;Chung, Hoon-Jae;Yang, Jea Ho
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.180-184
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    • 2018
  • Study Design: Case report Objectives: To document fistula formation between the disc and dura by an unrecognized dural tear after percutaneous endoscopic lumbar discectomy (PELD). Summary of Literature Review: The risk of durotomy is relatively low with PELD, but cases of unrecognized durotomies have been reported. An effective diagnostic tool for such situations has not yet been identified. Materials and Methods: A patient twice underwent transforaminal PELD under the diagnosis of a herniated lumbar disc at L4-5. She still complained of intractable pain and motor weakness around the left lower extremity at 6 months postoperatively. Magnetic resonance imaging showed no specific findings suggestive of violation of the nerve root. However, L5 and S1 nerve root injury was noted on electromyography. An exploratory operation was planned to characterize damage to the neural structures. Results: In the exploration, a dural tear was found at the previous operative site, along with a fistula between the disc and dura was also found at the dural tear site. The durotomy site was located on the ventrolateral side of the dura and measured approximately 5 mm. The durotomy site was repaired with Nylon 5-0 and adhesive sealants. The patient's preoperative symptoms diminished considerably. Conclusions: Fistula formation between the disc and dura can be caused by an unrecognized dural tear after PELD. Discography is a reliable diagnostic tool for fistulas formed by an unrecognized durotomy.

A Thoracolumbar Pure Spinal Epidural Cavernous Hemangioma - A Case Report - (흉요추부에서 발견된 경막외 해면상 혈관종 - 증례 보고 -)

  • Choi, Byeong Sam;Kim, Ju Yeon;Lee, Sungjoon
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.169-174
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    • 2018
  • Study Design: Case report. Objectives: We report a case of pure epidural cavernous hemangioma located at the thoracolumbar spine in a 53-year-old woman that mimicked a neurogenic tumor on magnetic resonance imaging (MRI). Summary of Literature Review: A pure spinal epidural cavernous hemangioma without bony involvement is a very rare lesion about which limited information is available in the literature. Materials and Methods: A 53-year-old woman visited our clinic for hypoesthesia with a tingling sensation in the left anterolateral thigh that had begun a month ago. No other neurologic symptoms or signs were present upon a neurologic examination. MRI from an outside hospital showed a $2.0{\times}0.5cm$ elongated mass at the T11-12 left neural foramen. The tumor was completely removed in piecemeal fashion. Results: The histopathologic examination revealed a cavernous hemangioma, which was the final diagnosis. The outcome was favorable in that only operation-related mild back pain remained, without any neurologic deficits, after a postoperative follow-up of 2 years and 3 months. No recurrence was observed on MRI at 2 years postoperatively. Conclusion: Pure epidural spinal cavernous hemangioma is very rare, and it is very difficult to differentiate from other epidural lesions. However, we believe that it should be included in the differential diagnosis of spinal epidural tumors due to its favorable prognosis.

Isolation of 20(S)-Ginsenoside Rg3 and Rg5 from the Puffed Red Ginseng (팽화 홍삼으로부터 20(S)-Ginsenoside Rg3와 Rg5의 분리 및 구조동정)

  • An, Young-Eun;Cho, Jin-Gyeong;Baik, Nam-In;Choi, Sung-Won;Hur, Nam-Yoon;Park, Seok-Jun;Kim, Byung-Yong;Baik, Moo-Yeol
    • Food Engineering Progress
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    • v.14 no.2
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    • pp.159-165
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    • 2010
  • Red ginseng tail roots (9.8 g water/100 g sample) were puffed at 7, 8, 9, and 10 $kg_{f}/cm^{2}$ using a rotational puffing gun. Puffed red ginseng was extracted with 70% ethanol, and the concentrated extract was successively partitioned with diethyl ether, n-butanol and $H_{2}O$. Two unknown ginsenosides from puffed red ginseng were found at 63 and 65 min of retention time in HPLC chromatogram suggesting that chemical structure of some ginsenosides might be altered during the puffing process. Identification of two unknown compounds was carried out using TLC, HPLC and NMR. Two major compounds were isolated from TLC. According to TLC result, compound I was expected to be the mixture of ginsenosides Rk1 and Rg5, and compound II was expected to be a 20(S)-ginsenoside $Rg_{3}$. Three compounds were isolated from n-butanol fraction through repeated silica gel and octadecyl silica gel column chromatographies. From the result of $^{1}H$- and $^{13}C$-NMR data, the chemical structures of unknown compounds were determined as ginsenoside $Rg_{5}$ and 20(S)-ginsenoside $Rg_{3}$. Unfortunately, ginsenoside $Rk_{1}$ could not be separated from ginsenoside-$Rg_{5}$ in the compound I. It was carefully reexamined using HPLC and confirmed that the last unknown compound was ginsenoside-$Rk_{1}$.

Synthesis and Characterization of Polymers with Azobenzene and Hexamethylene Groups in Main Chain (주사슬에 아조벤젠기와 헥사메틸렌기를 갖는 고분자의 합성 및 특성)

  • Gu, Su-Jin;Lee, Eung-Jae;Bang, Moon-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.4
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    • pp.86-92
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    • 2019
  • Polymers with various compositions of azobenzene and hexamethylene groups in the main chain were synthesized by a Schotten-Baumann reaction and their properties were investigated. The chemical structures and physical properties of the synthesized polymers were investigated by Fourier transform infrared spectroscopy, proton nuclear magnetic resonance spectroscopy, differential scanning calorimetry, thermogravimetric analysis, polarized optical microscopy, and x-ray diffraction. The polymers showed an inherent viscosity of 1.28-1.36 dl/g and were relatively insoluble in most organic solvents. The melt transition temperature increased rapidly with increasing number of azobenzene groups in the polymer. When the azobenzene monomer content was more than 50 mol%, no melting transition occurred below the decomposition temperature. Among the polymers with a melt transition temperature, the MP-A3C7 and MP-A5C5 polymers were liquid crystalline materials and exhibited a nematic phase with weak liquid crystallinity over a wide liquid crystal temperature range. This difference in the properties of the synthesized polymers is likely due to the changes in intermolecular forces resulting from the linearity and polarity of the trans-form of azobenzene.

The First Report on Clinical Manifestation of Cryopyrin-Associated Periodic Syndrome in Korean Children

  • Kim, Kwang Yeon;Kim, Sae Yun;Park, Su Eun;Lee, Jina;Lee, Hyunju;Lee, Soyoung;Kim, Joong Gon
    • Pediatric Infection and Vaccine
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    • v.25 no.3
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    • pp.113-122
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    • 2018
  • Purpose: The aim of this study was to evaluate the clinical characteristics of children diagnosed as cryopyrin-associated periodic syndrome (CAPS) in Korea. Methods: Diagnosis was made based on clinical features and confirmed by a mutation in the cold-induced autoinflammatory syndrome 1 (CIAS1) gene. Especially, osteocartilaginous overgrowth in the patella or distal femur was so characteristic that its presence warranted a diagnosis of chronic infantile neurologic cutaneous and articular/NOMID. Results: We observed the clinical features of 9 Korean CAPS patients. All the patients suffered from an urticarial rash with recurrent fever. Among the 9 patients, 6 presented with rash and 4 with fever on the 1st or 2nd days of birth. Eight patients showed myalgia, and 7 patients showed arthralgia in the joints, and 6 patients showed radiologic findings of arthropathy including cupping of the metaphysis, excessive growth of the epiphysis, osteopenia or overgrowth of the cartilage. Four patients showed brain atrophy, enlarged ventricles or leptomeningeal enhancement on magnetic resonance imaging. Intellectual disability was observed in 1 patient. Five patients had eye involvement as conjunctivitis, uveitis, chorioretinitis, avascular area or papillary edema, and 3 patients showed progressive hearing loss. All 9 patients showed increased C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Conclusions: All the patients carried a mutation on exon 3 of the CIAS1 gene. After the anakinra (interleukin-1 receptor antagonist) therapy, the fever and rash immediately disappeared, and CRP and ESR were improved.

Obtaining Informed Consent Using Patient Specific 3D Printing Cerebral Aneurysm Model

  • Kim, Pil Soo;Choi, Chang Hwa;Han, In Ho;Lee, Jung Hwan;Choi, Hyuk Jin;Lee, Jae Il
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.398-404
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    • 2019
  • Objective : Recently, three-dimensional (3D) printed models of the intracranial vascular have served as useful tools in simulation and training for cerebral aneurysm clipping surgery. Precise and realistic 3D printed aneurysm models may improve patients' understanding of the 3D cerebral aneurysm structure. Therefore, we created patient-specific 3D printed aneurysm models as an educational and clinical tool for patients undergoing aneurysm clipping surgery. Herein, we describe how these 3D models can be created and the effects of applying them for patient education purpose. Methods : Twenty patients with unruptured intracranial aneurysm were randomly divided into two groups. We explained and received informed consent from patients in whom 3D printed models-(group I) or computed tomography angiography-(group II) was used to explain aneurysm clipping surgery. The 3D printed intracranial aneurysm models were created based on time-of-flight magnetic resonance angiography using a 3D printer with acrylonitrile-butadiene-styrene resin as the model material. After describing the model to the patients, they completed a questionnaire about their understanding and satisfaction with aneurysm clipping surgery. Results : The 3D printed models were successfully made, and they precisely replicated the actual intracranial aneurysm structure of the corresponding patients. The use of the 3D model was associated with a higher understanding and satisfaction of preoperative patient education and consultation. On a 5-point Likert scale, the average level of understanding was scored as 4.7 (range, 3.0-5.0) in group I. In group II, the average response was 2.5 (range, 2.0-3.0). Conclusion : The 3D printed models were accurate and useful for understanding the intracranial aneurysm structure. In this study, 3D printed intracranial aneurysm models were proven to be helpful in preoperative patient consultation.

Layered Double Hydroxide Nanoparticles for Bio-Imaging Applications (LDH 나노입자 기반의 바이오 이미징 소재)

  • Jin, Wenji;Ha, Seongjin;Lee, Dongki;Park, Dae-Hwan
    • Korean Chemical Engineering Research
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    • v.57 no.4
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    • pp.445-454
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    • 2019
  • Layered double hydroxides (LDHs) nanoparticles have emerged as novel nanomaterials for bio-imaging applications due to its unique layered structure, physicochemical properties, and good biocompatibility. Bio-imaging is one of the most important fields for medical applications in clinical diagnostics and therapeutics of various diseases. Enhanced diagnostic techniques are needed to realize new paradigm for next-generation personalized medicine through nanoscale materials. When nanotechnology is introduced into bio-imaging system, nanoparticle probes can endow imaging techniques with enhanced ability to obtain information about biological system at the molecular level. In this review, we summarize structural features of LDH nanoparticles with current issues of bio-imaging system. LDH nanoparticle probes are also discussed through in vitro as well as in vivo studies in various bio-imaging techniques including fluorescence imaging, magnetic resonance imaging (MRI), positron emission tomography (PET), and computed X-ray tomography (CT), which will have the potential in the development of the advanced nanoparticles with high sensitivity and selectivity.

The Feasibility for Whole-Night Sleep Brain Network Research Using Synchronous EEG-fMRI (수면 뇌파-기능자기공명영상 동기화 측정과 신호처리 기법을 통한 수면 단계별 뇌연결망 연구)

  • Kim, Joong Il;Park, Bumhee;Youn, Tak;Park, Hae-Jeong
    • Sleep Medicine and Psychophysiology
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    • v.25 no.2
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    • pp.82-91
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    • 2018
  • Objectives: Synchronous electroencephalogram (EEG) and functional magnetic resonance imaging (fMRI) has been used to explore sleep stage dependent functional brain networks. Despite a growing number of sleep studies using EEG-fMRI, few studies have conducted network analysis on whole night sleep due to difficulty in data acquisition, artifacts, and sleep management within the MRI scanner. Methods: In order to perform network analysis for whole night sleep, we proposed experimental procedures and data processing techniques for EEG-fMRI. We acquired 6-7 hours of EEG-fMRI data per participant and conducted signal processing to reduce artifacts in both EEG and fMRI. We then generated a functional brain atlas with 68 brain regions using independent component analysis of sleep fMRI data. Using this functional atlas, we constructed sleep level dependent functional brain networks. Results: When we evaluated functional connectivity distribution, sleep showed significantly reduced functional connectivity for the whole brain compared to that during wakefulness. REM sleep showed statistically different connectivity patterns compared to non-REM sleep in sleep-related subcortical brain circuits. Conclusion: This study suggests the feasibility of exploring functional brain networks using sleep EEG-fMRI for whole night sleep via appropriate experimental procedures and signal processing techniques for fMRI and EEG.

Diffusion Tensor-Derived Properties of Benign Oligemia, True "at Risk" Penumbra, and Infarct Core during the First Three Hours of Stroke Onset: A Rat Model

  • Chiu, Fang-Ying;Kuo, Duen-Pang;Chen, Yung-Chieh;Kao, Yu-Chieh;Chung, Hsiao-Wen;Chen, Cheng-Yu
    • Korean Journal of Radiology
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    • v.19 no.6
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    • pp.1161-1171
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    • 2018
  • Objective: The aim of this study was to investigate diffusion tensor (DT) imaging-derived properties of benign oligemia, true "at risk" penumbra (TP), and the infarct core (IC) during the first 3 hours of stroke onset. Materials and Methods: The study was approved by the local animal care and use committee. DT imaging data were obtained from 14 rats after permanent middle cerebral artery occlusion (pMCAO) using a 7T magnetic resonance scanner (Bruker) in room air. Relative cerebral blood flow and apparent diffusion coefficient (ADC) maps were generated to define oligemia, TP, IC, and normal tissue (NT) every 30 minutes up to 3 hours. Relative fractional anisotropy (rFA), pure anisotropy (rq), diffusion magnitude (rL), ADC (rADC), axial diffusivity (rAD), and radial diffusivity (rRD) values were derived by comparison with the contralateral normal brain. Results: The mean volume of oligemia was $24.7{\pm}14.1mm^3$, that of TP was $81.3{\pm}62.6mm^3$, and that of IC was $123.0{\pm}85.2mm^3$ at 30 minutes after pMCAO. rFA showed an initial paradoxical 10% increase in IC and TP, and declined afterward. The rq, rL, rADC, rAD, and rRD showed an initial discrepant decrease in IC (from -24% to -36%) as compared with TP (from -7% to -13%). Significant differences (p < 0.05) in metrics, except rFA, were found between tissue subtypes in the first 2.5 hours. The rq demonstrated the best overall performance in discriminating TP from IC (accuracy = 92.6%, area under curve = 0.93) and the optimal cutoff value was -33.90%. The metric values for oligemia and NT remained similar at all time points. Conclusion: Benign oligemia is small and remains microstructurally normal under pMCAO. TP and IC show a distinct evolution of DT-derived properties within the first 3 hours of stroke onset, and are thus potentially useful in predicting the fate of ischemic brain.