• The Journal of the Korea Contents Association
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• v.17 no.7
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• pp.437-442
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• 2017

Previously, studies on compensation material to increase the signal intensity have been conducted which does not affect the reading of images. However, the compensation material has a concern on patient infection as it is attached directly on the skin. Therefore, in this study, we tested an indirect attachment of the compensation material as an alternative method of the direct attachment. The silicon compensation material was fabricated in the form of a cylindrical bar and attached to each element of the 8 channel head coil. Then the signal intensities of the water phantom pre and post application of the silicon were measured. T1 and T2-weighted images were acquired using an 8-channel head coil and a 3.0T superconducting MRI. Signal intensities were measured by using an image measuring program. Paired t-test was used to verify if there were significant differences. The signal intensity before application of the silicon was significantly increased by 3.39% and 2.62% in T1 and T2 weighted images, respectively. Although the indirect attachment method had a limitation to completely replace the existing method, it was considered to be useful in patients with infectious diseases such as diabetic complications since it had a meaningful improvement in signal intensity based on the filling factor increase.

• Journal of Yeungnam Medical Science
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• v.30 no.2
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• pp.116-119
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• 2013

A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.623-630
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• 2020

Objective : A primary degenerative sagittal imbalance has been considered because of unique lifestyles such as the prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Previous papers have reported that sagittal imbalance disease is often seen distinctly in the farming districts of "oriental" countries such as Korea and Japan. However, this finding was only evaluated with the use of X-ray, and other factors such as magnetic resonance imaging (MRI), muscle volume, compression fracture, and laboratory results were not considered. Thus, using these, we evaluate the agricultural work-associated factors for Korean elderly spinal sagittal imbalance. Methods : We recruited 103 Korean participants who had a sagittal vertical axis (SVA) of >5 cm in this Korean Elderly Sagittal Imbalance Cohort Study. The following were evaluated : radiological parameters, MRI, compression fracture, vitamin D, parathyroid hormone, C-terminal telopeptide, osteocalcin, bone mineral density and muscle fatty change, muscle volume, and health-related quality of life from patients' survey. Moreover, in this survey, the farmers' annual working hours were investigated. Subsequently, we analyzed the associated factors for spinal sagittal imbalance depending on occupation. Results : A total of 46 participants were farmers, and the others were housewives, sellers, and office workers. The farmer group had more SVA (141 vs. 99 mm, p=0.001) and pelvic tilt (31° vs. 24°, p=0.004) and lesser lumbar lordosis (20° vs. 30°, p=0.009) and thoracic kyphosis (24° vs. 33°, p=0.03) than non-farmer group. A significantly positive correlation was noted between the working hour and SVA in the farmer group (p=0.014). The visual analogue scale score for back pain (8.26 vs. 6.96, p=0.008) and Oswestry Disability Index (23.5 vs. 19.1, p=0.003) in the farmer group were higher than that in the non-farmer group, but the Short Form-36 score was not significantly different between the two groups. The Mini-Mental State Exam score was significantly lower in the farmer group than in the non-farmer group (24.85 vs. 26.98, p=0.002). Conclusion : The farmer group had more sagittal imbalance and back pain in proportion to the working hours even though the muscle and bone factors and general laboratory condition were not significantly different between the two groups. These results supported that the long hours spent in the crouched posture while performing agricultural work were a risk factor for severe sagittal imbalance.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.281-287
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• 2011

Objective : Pituitary apoplexy is life-threatening clinical syndrome caused by the rapid enlargement of a pituitary tumor due to hemorrhage and/or infarction. The pathogenesis of pituitary apoplexy is not completely understood. We analyzed the magnetic resonance imaging (MRI) of pituitary tumors and subsequently correlated the radiological findings with the clinical presentation. Additionally, immunohistochemistry was also performed to determine whether certain biomarkers are related to radiological apoplexy. Methods : Thirty-four cases of pituitary adenoma were enrolled for retrospective analysis. In this study, the radiological apoplexy was defined as cases where hemorrhage, infarction or cysts were identified on MRI. Acute clinical presentation was defined as the presence of any of the following symptoms: severe sudden onset headache, decreased visual acuity and/or visual field deficit, and acute mental status changes. Angiogenesis was quantified by immunohistochemical expression of fetal liver kinase 1 (Flk-1), neuropilin (NRP) and vascular endothelial growth factor (VEGF) expression, while microvascular density (MVD) was assessed using Endoglin and CD31. Results : Clinically, fourteen patients presented with acute symptoms and 20 for mild or none clinical symptoms. Radiologically, fifteen patients met the criteria for radiological apoplexy. Of the fifteen patients with radiologic apoplexy, 9 patients presented acute symptoms whereas of the 19 patient without radiologic apoplexy, 5 patients presented acute symptoms. Of the five biomarkers tracked, only VEGF was found to be positively correlated with both radiological and nonradiological apoplexy. Conclusion : While pituitary apoplexy is currently defined in cases where clinical symptoms can be histologically confirmed, we contend that cases of radiologically identified pituitary hemorrhages that present with mild or no symptoms should be designated subacute or subclinical apoplexy. VEGF is believed to have a positive correlation with pituitary hemorrhage. Considering the high rate of symptomatic or asymptomatic pituitary tumor hemorrhage, additional studies are needed to detect predictors of the pituitary hemorrhage.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.6
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• pp.427-431
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• 2018

We report a case of a patient with necrotizing fasciitis followed by liver abscess. A 51-year-old man was admitted to our hospital with a 5-day history of fever and chills with painful swelling of the right thigh. A magnetic resonance imaging (MRI) scan showed fluid collection with numerous dark signal intensities considered as air-bubbles between the posteromedial and posterolateral groups of the right thigh, resulting in presumptive diagnosis of necrotizing fasciitis. At the time of admission, an ultrasonograph of the abdomen showed increased parenchymal echogenicity of both kidneys and no liver abscess. Ten days after fasciotomy, an abdominal computed tomography (CT) scan showed intrahepatic abscess. Sonography-guided percutaneous drainage was performed. Both cultures of pus specimens from the liver abscess and right thigh yielded Klebsiella pneumoniae (K. pneumoniae). The patient was treated with fasciotomy several times and parenteral antibiotics, after which he began to improve. After 5 weeks, liver abscess size was reduced, and after 10 weeks, liver abscess disappeared. To the best of our knowledge, this is the first case of K. pneumoniae-necrotizing fasciitis followed by liver abscess.

• Journal of Korean Neurosurgical Society
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• v.51 no.4
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• pp.215-218
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• 2012

Objective: Traumatic epidural hematomas (EDHs) in children are a relatively unusual occurrence. The cause and outcome vary depending on period and reg ion of study. The aims of this analysis were to review the cause and outcome of pediatric EDHs nowadays and to discuss outcome-related variables in a large consecutive series of surgically treated EDH in children. Methods: This is a retrospective review of 29 patients with surgically treated EDHs between Jan 2000 and February 2010. Patients' medical records, computed tomographic (Cl) scans, and, if performed, magnetic resonance imaging (MRI) were reviewed to define variables associated with outcome. Variables included in the analysis were age, associated severe intracranial injury, abnormal pupillary response, hematoma thickness, severity of head injury (Glasgow Coma Scale score), parenchymal brain injury, and diffuse axonal injury. Results: The mean (SO) age of the patients was 109 months (0-185 months). Most of the injuries with EDHs occurred in traffic accident (14 cases, 48.2%) and followed by slip down in 6 cases and falls in 6 cases. There were one birth injury and one unknown cause. EDHs in traffic accidents occurred in pedestrians hit by a motor vehicle, 9 cases; motorbike and car accidents, 5 cases and bicycle accidents, 1 case. The locations of hematoma were almost same in both sides (left side in 15 cases). Temporal lobe is the most common site of hematomas (13 cases, 44%). The mean size of the EDHs was 18 mm (range, 5-40 mm). Heterogeneous hematomas in CT scans were 20 cases (67%). Two patients were referred with unilateral or bilateral dilated pupil(s). There was enlargement of EDH in 5 patients (17%). All of them were heterogeneous hematomas in CT scans. Except for 4 patients, all EDHs were associated with skull fracture(s) (87%). There was no case of patient with major organ injury. CT or MRI revealed brain contusion in 5 patients, and diffuse axonal injury in one patient The mortality was zero, and the outcomes were excellent in 26 and good in 2 patients. None of the tested variables were found to have a prognostic relevance. Conclusion: Regardless of the EDH size, the clinical status of the patients, the abnormal pupillary findings, or the cause of injury, the outcome and prognosis of the patients with EDH were excellent.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.140-146
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• 2012

Purpose: The objective of this study was to assess the clinical outcome of arthroscopic release of the extensor carpi radialis brevis (ECRB) tendon in chronic recalcitrant lateral epicondylitis and tried to determine any prognostic factors. Materials and Methods: A retrospective review of 24 patients with lateral epicondylitis treated by arthroscopic ECRB release was performed. Outcome measures included a patient self rating and visual analog scale (VAS). Functional evaluation was made with Quick-disabilities of the arm, shoulder and hand (DASH) score system to identify preoperative factors that might be associated with the outcomes. Results: Twenty one (88%) elbows received benefit from the procedure. A mean preoperative VAS pain score and the mean Quick-DASH were significantly improved at final follow up. Age, sex, dominant arm and duration of symptom, presence of capsular tear or calcification did not correlate significantly with the clinical outcome. Three of four patients without T2-weighted high signal focus of the ECRB origin on preoperative magnetic resonance imaging (MRI) showed higher Quick-DASH score. Conclusion: Arthroscopic release of the ECRB is an effective option for chronic recalcitrant lateral epicondylitis. Lack of high signal focus on preoperative MRI is significantly associated with a poor surgical outcome and a considerable factor for the proper surgical indication.

• Progress in Medical Physics
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• v.16 no.1
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• pp.32-38
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• 2005

Impaired processing of facial information is one of the broad ranges of cognitive deficits seen in patients with schizophrenia. The purpose of this study was to elucidate the differences in brain activities involved in the process of facial working memory between schizophrenic patients and healthy comparison subjects. Ten patients with schizophrenia were recruited along with matched healthy volunteers as a comparison group. Functional magnetic resonance imaging (fMRI) was used to assess cortical activities during the performance of a 1-back working memory paradigm using images of neutral faces as mnemonic content. The patient group performed the tasks with reduced accuracy. Group analysis revealed that left fusiform gyrus, right superior frontal gyrus, bilateral middle frontal gyri/insula, left middle temporal gyrus, precuneus and vermis of cerebellum and showed decreased cortical activities in the patient group. On the other hand, an increased level of activation in lateral prefrontal cortex and parietal lobule was observed from the patient group, all in the right hemisphere. A decreased level of activity in the left fusiform gyrus among the patient group implicates inefficient processing of facial information. An increased level of activation in prefrontal and parietal neural networks from the patient group confirms earlier findings on the impaired working memory of patients with schizophrenia.

• Journal of Veterinary Clinics
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• v.26 no.5
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• pp.490-494
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• 2009

A 2-year-old Maltese and a 5-month-old Yorkshire terrier were presented with ataxia. Tetraparesis was observed in a 9-year -old Yorkshire terrier. The localizations of the lesions suggested brain or cervical spinal cord by the neurological examination, and the following images was achieved: radiography, axial images of computed tomography (CT), reconstruction image of CT such as multi-planar reformation(MPR) and 3-dimensional(3D) reconstruction and magnetic resonance imaging (MRI). On radiography, the misalignment between atlas (C1) and axis (C2), absent dens of axis, and increased space between the dorsal arch of C1 and spinous process of C2 were found. The discontinuation between dens and body of C2 was identified through axial CT images, and the fragmentation of dens separated from axis was observed through MPR and 3D image in all case. The hyperintense lesions and the spinal cord compression on T2-weighted MR images were represented in a dog with tetraparesis, the others represented only spinal cord compression. Three dogs were diagnosed as atlantoaxial instability (AAI) by dens fracture of C2. The dog with tetraparesis was euthanized due to guarded prognosis. The others were recovered completely. It is difficult to differentiate dens fracture of C2 from abnormal dens such as agenesis and hypoplasia. We thought that CT is very useful to evaluate the dens of C2 and differentiate the causes of AAI, and the reconstruction images of CT such as MPR and 3D make the translation of the fragmented dens or axis of AAI more precisely evaluate.

• The Journal of the Korean bone and joint tumor society
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• v.8 no.3
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• pp.83-89
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• 2002

Purpose: To analyze the postoperative functional and radiographic follow-up results in patients who underwent percutaneous radiofrequency ablation therapy after the diagnosis of osteoid osteoma. Materials and Methods: Seven patients, who were clinically and radiographically diagnosed with osteoid osteoma from July 1999 to January 2001, and received percutaneous radiofrequency ablation therapy. The average follow-up period was 15.5 months(range, 8~25 months). For the diagnosis and accurate localization of the lesion, simple radiography, computed tomography and magnetic resonance imaging(MRI) were performed preoperatively. Simple radiographs and MRI were taken periodically for the follow-up studies. Results: In all 7 patients, symptoms completely disappeared within 3 days after the operation. The average period of hospitalization was 2.4 days, excluding 1 patient who needed an additional burn treatment. The average postoperative night and day pain scores were 1.8 and 1.3, respectively. The average vocational and recreational activity scores were 1 and 0.6, respectively. Conclusions: Satisfactory functional results were obtained with percutaneous radiofrequency ablation therapy for the elimination of osteoid osteoma. Compared to conventional treatment, the advantages of this therapy were short hospitalization period, no internal fixation and bone graft for preventing fracture, and no limitation of joint motion by long fixation period.