• Investigative Magnetic Resonance Imaging
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• 제18권2호
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• pp.167-170
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• 2014

내측세로다발은 조화로운 눈운동의 핵심적인 역할을 하는 유수 합성로이며 수도관주위회색질의 배쪽의 중간선 근처에 놓여있다. 내측세로다발의 병변은 신경핵사이 눈근육마비로 불리는 동측의 내전 결손과 반대측 외전 안진을 야기한다. 중뇌와 교뇌에서 인접한 백질과 섞여있는 신경로는 전산화단층촬영술과 자기공명영상과 같은 뇌영상에서 구별하기 어렵다. 지금까지 우리가 알기로는 내측세로다발은 실제 자기공명영상에서 구체적으로 묘사되지 않았다. 우리는 염증성 탈수초성 질환에서 자기공명영상에 내측세로다발의 전체 연결 과정을 보이는 증례를 보고한다.

• Journal of Korean Neurosurgical Society
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• 제47권5호
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• pp.365-369
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• 2010

Objective : There has been inconsistency about definition of the temporal stem despite of several descriptions demonstrating its microanatomy using fiber dissection and/or diffusion tensor tractography. This study was designed to clarify three dimensional configurations of the temporal stem. Methods : The fronto-temporal regions of several formalin-fixed human cerebral hemispheres were dissected under an operating microscope using the fiber dissection technique. The consecutive coronal cuts of the dissected specimens were made to define the relationships of white matter tracts comprising the temporal stem and the subcortical gray matters (thalamus, caudate nucleus, amygdala) with inferior limiting (circular) sulcus of insula. Results : The inferior limiting sulcus of insula, limen insulae, medial sylvian groove, and caudate nucleus/amygdala were more appropriate anatomical structures than the roof/dorso-lateral wall of the temporal horn and lateral geniculate body which were used to describe previously for delineating the temporal stem. The particular space located inside the line connecting the inferior limiting sulcus of insula, limen insulae, medial sylvian groove/amygdala, and tail of caudate nucleus could be documented. This space included the extreme capsule, uncinate fasciculus, inferior occipito-frontal fasciculus, anterior commissure, ansa peduncularis, and inferior thalamic peduncle including optic radiations, whereas the stria terminalis, cingulum, fimbria, and inferior longitudinal fiber of the temporal lobe were not passing through this space. Also, this continued posteriorly along the caudate nucleus and limiting sulcus of the insula. Conclusion : The temporal stem is white matter fibers passing through a particular space of the temporal lobe located inside the line connecting the inferior limiting sulcus of insula, limen insulae, medial sylvian groove/amygdala, and tail of caudate nucleus. The three dimensional configurations of the temporal stem are expected to give the very useful anatomical and surgical insights in the temporal lobe.

• Animal cells and systems
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• 제6권2호
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• pp.159-165
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• 2002

Projections from the prefrontal cortex to subdivisions of the dorsal raphe nucleus were investigated in the rat using retrograde and anterograde tracing methods. A retrograde tracer, gold-conjugated horseradish peroxidase (WGA-apo-HRP-gold), was injected into each subdivision of the dorsal raphe including lateral wing, dorsomedial, and ventromedial areas. The majority of retrogradely labeled cells were located in the prelimbic, infralim-bic, and dorsal peduncular areas of the medial prefrontal cortex. A few cells were also identified in the cingulate, various regions of the orbital, and agranular insular cortices. Secondly, an anterograde tracer, Phaseolus vulgaris leucoagglutinin (PHA-L), was injected into the medial prefrontal cortex involving the prelimbic or infralimbic areas. Axonal fibers with varicosities were identified in all subdivisions of the DR including the lateral wing, dorsomedial, and ventromedial areas. Projections were bilateral, with ipsilateral predominance. Axonal fibers were observed at the lateral border of medial longitudinal fasciculus or in the interfascicular region at the midline. The present findings demonstrate that both the midline and lateral wing regions of the dorsal raphe nucleus receive excitatory input from cognitive and emotional centers of the cerebral cortex.

• Journal of Korean Neurosurgical Society
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• 제39권6호
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• pp.438-442
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• 2006

The sylvian aqueduct syndrome is a global rostral midbrain dysfunction induced by a transtentorial pressure gradient through the aquaeductus. Several months after ventriculoperitoneal shunt, a patient with hydrocephalus began experiencing a constellation of midbrain dysfunction symptoms, including bradykinesia, medial longitudinal fasciculus syndrome, third nerve palsy, and mutism. These were indicative of cerebral aqueduct syndrome. In addition, the patient showed posture-dependent underdrainage or overdrainage. All symptoms were resolved after distal catheter elongation and floating cranioplasty. We present a case of reversible parkinsonism, which developed in a patient with shunted hydrocephalus and aqueductal stenosis, and discuss the diagnosis and treatment of the sylvian aqueduct syndrome. We also review the literature to address problems of drainage and potential treatment modalities.

• 한방안이비인후피부과학회지
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• 제29권3호
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• pp.177-185
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• 2016

양안성 핵간안근마비의 전형적인 임상적 특징을 보이면서 뇌 자기공명영상검사(Brain Brain magnetic resonance imaging, Brain MRI)상 뇌간병변을 확인할 수 없었던 환자에 대하여 침치료, 약침치료, 전침치료, 한약치료 등의 한방치료를 통해 증상의 호전을 경험하였기에 이를 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제8권1호
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• pp.220-230
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• 1991

Internuclear ophthalmoplegia is a conjugated gaze disorder characterized by impaired adduction on the side of a lesion involving the medial longitudinal fasciculus with dissociated nystagmus of the other abducting eye. Six patients with INO(who had clinical cerebrovascular diseases) underwent MR imaging and the results were as follows : 1. The MLF lesions were identified by MR imaging in 5 cases 2. The ratio of unilateral INO to bilateral INO was 5:1 3. The nature of lesions was infarction in 4 cases and hemorrhage in 1 case 4. The sites of MLF lesion were in the midbrain in 4 cases and in the pons in 1 case 5. All 5 cases of INO identified by MR imaging had other lesion sites in addition to MLF lesion.

• 대한한방내과학회지
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• 제33권4호
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• pp.599-608
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• 2012

Objectives : To report three cases of eye movement impairment: internuclear ophthalmoplegia (INO) due to pontine infarction, traumatic abducens nerve palsy, and abducens nerve involvement in Miller-Fisher syndrome. Cases Summary : There were three cases. First, a 64-year-old woman, who was given a diagnosis of INO due to pontine infarction, had left gaze palsy of her right eye while the convergence was intact. Second, a 34-year-old man had abduction impairment of his right eye after a traffic accident. Third, a 66-year-old man, who was diagnosed with Miller-Fisher syndrome, had left gaze palsy of his left eye. Their symptoms improved substantially and their anxieties were relieved after treatment with herbal medicine and acupuncture. Conclusions : There has been no certain cure for eye movement impairment yet. In this report, we present three successful cases of patients with eye movement impairment and show that Korean medical treatment could be a solution for this incurable disease.

• Investigative Magnetic Resonance Imaging
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• 제21권4호
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• pp.223-232
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• 2017

Purpose: To report the use of multiband accelerated echo-planar imaging (EPI) for resting-state functional MRI (rs-fMRI) to achieve rapid high temporal resolution at 3T compared to conventional EPI. Materials and Methods: rs-fMRI data were acquired from 20 healthy right-handed volunteers by using three methods: conventional single-band gradient-echo EPI acquisition (Data 1), multiband gradient-echo EPI acquisition with 240 volumes (Data 2) and 480 volumes (Data 3). Temporal signal-to-noise ratio (tSNR) maps were obtained by dividing the mean of the time course of each voxel by its temporal standard deviation. The resting-state sensorimotor network (SMN) and default mode network (DMN) were estimated using independent component analysis (ICA) and a seed-based method. One-way analysis of variance (ANOVA) was performed between the tSNR map, SMN, and DMN from the three data sets for between-group analysis. P < 0.05 with a family-wise error (FWE) correction for multiple comparisons was considered statistically significant. Results: One-way ANOVA and post-hoc two-sample t-tests showed that the tSNR was higher in Data 1 than Data 2 and 3 in white matter structures such as the striatum and medial and superior longitudinal fasciculus. One-way ANOVA revealed no differences in SMN or DMN across the three data sets. Conclusion: Within the adapted metrics estimated under specific imaging conditions employed in this study, multiband accelerated EPI, which substantially reduced scan times, provides the same quality image of functional connectivity as rs-fMRI by using conventional EPI at 3T. Under employed imaging conditions, this technique shows strong potential for clinical acceptance and translation of rs-fMRI protocols with potential advantages in spatial and/or temporal resolution. However, further study is warranted to evaluate whether the current findings can be generalized in diverse settings.

• 대한한방내과학회지
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• 제40권2호
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• pp.254-261
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• 2019

Internuclear Ophthalmoplegia (INO) is characterized by lesion side eye's adduction limitation in lateral horizontal gaze and nystagmus in the abducting eye due to lesions in the Medial Longitudinal Fasciculus (MLF). Brainstem infarction is one of the causes of INO, but related issues have seldom been reported in the Korean medical literature. The present case was a pontine infarction patient with INO who complained of diplopia and eye movement disorder. The patient was treated with Korean medicine treatment, including herbal medicine, acupuncture, cupping, and moxibustion for 30 days. Her changes in clinical symptoms were measured with a Numeric Rating Scale (NRS) and a length of External Ocular Movement (EOM), in which the patient's right eyeball moved to the left from the midline in the left gaze. After treatment, her clinical symptoms were improved. Diplopia decreased from NRS 10 to NRS 2, and eye movement disorder was improved such that EOM increased from 1mm to 5 mm. Therefore, integrative Korean medicine treatment may be effective in the treatment of INO patients caused by pontine infarction.

• Investigative Magnetic Resonance Imaging
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• 제16권2호
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• pp.115-123
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• 2012

목적: Tract-based spatial statistics와 화소기반 형태분석 방법을 이용하여 경도의 알츠하이머병 환자와 경도인 지장애 환자에서 확산텐서영상을 이용하여 뇌 백질의 이상을 평가하고자 하였다. 대상과 방법: 21명의 경도의 알츠하이머병 환자와 13명의 경도인지장애 환자, 그리고 16명의 건강한 노인군을 대상으로 확산텐서영상을 시행하였다. 각 참가자마다 분할 비등방도를 구하여 Tract-based spatial statistics를 이용하여 세 그룹간의 비교를 하였다. Tract-based spatial statistics 방법과의 비교를 위하여, 화소기반 형태분석 방법을 이용한 분석도 함께 시행하였다. 결과: Tract-based spatial statistics 분석결과, 경도의 알츠하이머 환자에서 건강한 노인군보다 방사관의 양측 전각과 우측 후각, 후시상방사, 우측 상세로다발, 뇌량체부, 우측 쐐기전소엽이랑에서 분할 비등방도가 유의하게 감소하였다. 화소기반 형태분석에서는 양측 갈고리다발, 좌측 부해마회의 백질, 우측 대상다발에서 추가적으로 분할 비등 방도가 감소되어 있었다. 경도의 알츠하이머 환자군과 경도인지장애 환자군의 비교, 경도인지장애 환자군과 건강한 노인군의 비교연구에서는 분할 비등방도의 유의한 차이는 없었다. 결론: Tract-based spatial statistics 분석결과, 경도의 알츠하이머 환자군에서 건강한 노인군에 비해 뇌 백질의 분할 비등방도가 여러 곳에서 감소되어 있었다. 화소기반 형태분석방법은 tract-based spatial statistics보다 더 많은 곳에서 뇌 백질의 이상을 보였다. 그러나, 인공물 또한 더 많이 관찰되었다.