• Journal of Korean Neurosurgical Society
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• v.62 no.4
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• pp.476-486
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• 2019

Objective : The functional information of $^{11}C$-methionine positron emission tomography (MET-PET) images can be applied for Gamma knife radiosurgery (GKR) and its image quality may affect defining the tumor. This study conducted the phantom-based evaluation for geometric accuracy and functional characteristic of diagnostic MET-PET image co-registered with stereotactic image in Leksell $GammaPlan^{(R)}$ (LGP) and also investigated clinical application of these images in metastatic brain tumors. Methods : Two types of cylindrical acrylic phantoms fabricated in-house were used for this study : the phantom with an array-shaped axial rod insert and the phantom with different sized tube indicators. The phantoms were mounted on the stereotactic frame and scanned using computed tomography (CT), magnetic resonance imaging (MRI), and PET system. Three-dimensional coordinate values on co-registered MET-PET images were compared with those on stereotactic CT image in LGP. MET uptake values of different sized indicators inside phantom were evaluated. We also evaluated the CT and MRI co-registered stereotactic MET-PET images with MR-enhancing volume and PET-metabolic tumor volume (MTV) in 14 metastatic brain tumors. Results : Imaging distortion of MET-PET was maintained stable at less than approximately 3% on mean value. There was no statistical difference in the geometric accuracy according to co-registered reference stereotactic images. In functional characteristic study for MET-PET image, the indicator on the lateral side of the phantom exhibited higher uptake than that on the medial side. This effect decreased as the size of the object increased. In 14 metastatic tumors, the median matching percentage between MR-enhancing volume and PET-MTV was 36.8% on PET/MR fusion images and 39.9% on PET/CT fusion images. Conclusion : The geometric accuracy of the diagnostic MET-PET co-registered with stereotactic MR in LGP is acceptable on phantom-based study. However, the MET-PET images could the limitations in providing exact stereotactic information in clinical study.

• Korean Journal of Radiology
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• v.24 no.4
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• pp.349-361
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• 2023

Objective: To quantitatively assess the pulmonary vasculature using non-contrast computed tomography (CT) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) pre- and post-treatment and correlate CT-based parameters with right heart catheterization (RHC) hemodynamic and clinical parameters. Materials and Methods: A total of 30 patients with CTEPH (mean age, 57.9 years; 53% female) who received multimodal treatment, including riociguat for ≥ 16 weeks with or without balloon pulmonary angioplasty and underwent both non-contrast CT for pulmonary vasculature analysis and RHC pre- and post-treatment were included. The radiographic analysis included subpleural perfusion parameters, including blood volume in small vessels with a cross-sectional area ≤ 5 mm² (BV5) and total blood vessel volume (TBV) in the lungs. The RHC parameters included mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), and cardiac index (CI). Clinical parameters included the World Health Organization (WHO) functional class and 6-minute walking distance (6MWD). Results: The number, area, and density of the subpleural small vessels increased after treatment by 35.7% (P < 0.001), 13.3% (P = 0.028), and 39.3% (P < 0.001), respectively. The blood volume shifted from larger to smaller vessels, as indicated by an 11.3% increase in the BV5/TBV ratio (P = 0.042). The BV5/TBV ratio was negatively correlated with PVR (r = -0.26; P = 0.035) and positively correlated with CI (r = 0.33; P = 0.009). The percent change across treatment in the BV5/TBV ratio correlated with the percent change in mPAP (r = -0.56; P = 0.001), PVR (r = -0.64; P < 0.001), and CI (r = 0.28; P = 0.049). Furthermore, the BV5/TBV ratio was inversely associated with the WHO functional classes I-IV (P = 0.004) and positively associated with 6MWD (P = 0.013). Conclusion: Non-contrast CT measures could quantitatively assess changes in the pulmonary vasculature in response to treatment and were correlated with hemodynamic and clinical parameters.

• Korean Journal of Biological Psychiatry
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• v.19 no.3
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• pp.121-127
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• 2012

Objectives : The multimodal telepresence systems have been adopted in a variety of applications, such as telemedicine, space or underwater teleoperation and videoconference. Multimedia, one of the telepresence systems, has been used in various fields including entertainment, education and communication. The degree of subjective telepresence is defined as the probability that a person perceives to be physically in the remote place when he/she experiences a multisensory feedback from the multimedia. The current study aimed to explore the neural mechanism of telepresence related to multisensory feedback in patients with schizophrenia. Methods : Brain activity was measured using functional magnetic resonance imaging while fifteen healthy controls and fifteen patients with schizophrenia were experiencing filmed referential conversation at various distances (1 m, 5 m and 10 m). Correlations between the image contrast values and the telepresence scores were analyzed. Results : Subjective telepresence was not significantly different between the two groups. Some significant correlations of brain activities with the telepresence scores were found in the left postcentral gyrus, bilateral inferior frontal gyri, right fusiform gyrus, and left superior temporal sulcus. There were no main effects of group and distance. Conclusion : These results suggest that patients with schizophrenia experience telepresence as appropriately as healthy people do when exposed to multimedia. Therefore, patients with schizophrenia would have no difficulty in immersing themselves in multimedia which may be used in clinical training therapies.

• BMB Reports
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• v.51 no.9
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• pp.427-428
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• 2018

Based on the piling reports of disruptions in the thalamus of patients with schizophrenia, the alteration in the thalamo-cortical system has been regarded as the core pathophysiology. As the thalamus is composed of distinctive nuclei with different cytoarchitecture and cortical connections, nuclei specific investigations have been actively conducted in post-mortem studies. In addition, the importance of early changes has been highlighted, which in turn has led to investigations of the thalamo-cortical system using non-invasive neuroimaging methods. From this perspective, the early structural changes in the thalamo-cortical system, such as the thalamo-cortical connection and nuclei specific microstructural changes (which are coherent with findings from post-mortem methods) will be briefly discussed. The main findings, which are the reduced thalamo-prefrontal connection and reduced microstructural complexity in the higher-order nuclei detected in first-episode psychosis patients, suggest the occurrence of early alterations within and between the communication hub of the brain and cortex. These findings suggest not only directions for further studies for unveiling the thalamo-cortical system related pathophysiology, but also the possibility of using the reduced microstructural complexity in the higher order nucleus as a biomarker for schizophrenia.

• Journal of Internet Computing and Services
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• v.10 no.5
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• pp.165-181
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• 2009

This paper presents an effective representation scheme for the shape analysis of the hippocampal structure and a stereoscopic-haptic environment to enhance sense of realism. The parametric model and the 3D skeleton represent various types of hippocampal shapes and they are stored in the Octree data structure. So they can be used for the interactive shape analysis. And the 3D skeleton-based pose normalization allows us to align a position and an orientation of the 3D hippocampal models constructed from multimodal medical imaging data. We also have trained Support Vector Machine (SVM) for classifying between the normal controls and epileptic patients. Results suggest that the presented representation scheme provides various level of shape representation and the SVM can be a useful classifier in analyzing the shape differences between two groups. A stereoscopic-haptic virtual environment combining an auto-stereoscopic display with a force-feedback (or haptic) device takes an advantage of 3D applications for medicine because it improves space and depth perception.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.4
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• pp.490-493
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• 2000

Mesiodens are supernumerary teeth in the region of the maxillary central incisors, a condition which can lead to disorders of the dentition. Their presence may lead to disorders, such as delay in eruption of permanent teeth, development of dentigerous cysts, resorption of adjacent roots and eruption of a supernumerary tooth into nasal cavity. The optimal time for surgical intervention is controversial. Early diagnosis is important so as to enable good prognosis. Diagnosis primarily depends on x-ray films. Panorama film, occlusal film, periapical film have been used for detection of mesiodens. But, all of them have disadvantages. $SCANORA^{(R)}$ is a multimodal radiology system which utilizes the principles of narrow beam radiology and spiral tomography. Pre-programmed imaging procedure are provided for many dental situations An optional personal computer can be connected into the unit to help design the examination. We report two cases diagnosed by $SCANORA^{(R)}$. When compared with tube shift technique, it is simple and exact method of detecting mesiodens.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.28 no.1
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• pp.7-16
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• 1998

The Scanora/sup (R)/ X-ray unit uses the principles of narrow beam radiography and spiral tomography. Starting with a panoramic overview as a scout image. multiple tomographic projections could be selected. This study evaluated the accuracy of spiral tomography in comparison to routine panoramic radiography for dental implant treatment planning. An experimental study was performed on a cadaver mandible to assess the accuracy of panoramic radiography and spiral tomography film images for measurement of metallic spheres. After radiographic images of the metallic spheres on the surgical stent were measured and corrected for a fixed magnification of radiographic images. following results were obtained. 1. In the optimal position of the mandible. the minimal horizontal and vertical distortion was evident in the panoramic radiography images. The mean horizontal and vertical magnification error in anterior sites was 5.25％ and 0.75％. respectively. The mean horizontal and vertical magnification error in posterior sites was 0.50％ and 1.50％. respectively. 2. In the displaced forward or in an eccentric position of the mandible. the magnification error of the panoramic radiography images increased significantly over the optimal position. Overall, the mean horizontal magnification error of the anterior site in the different positions changed dramatically within a range of -17.25％ to 39.00％, compared to the posterior range of -5.25％ to 8.50％. However, the mean vertical magnification error stayed with the range of 0.5％ to 3.75％ for all the mandibular positions. 3. The magnification effects in the tomographic scans were nearly identical for the anterior and posterior with a range of 2.00％ to 5.75％ in the horizontal and 4.50％ to 5.50％ in the vertical dimension, respectively. 4. A statistically significant difference between the anterior and posterior measurements was found in the horizontal measurements of the panoramic radiography images of the displaced forward and backward position of the mandible(P<0.05). Also a significant difference between the optimal panoramic and tomographic projections was found only in the vertical measurement(P<0.05).

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.540-546
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• 2018

Purpose: The purpose of this study was to suggest a multimodal diagnostic approach to determine the cause of the disease in patients diagnosed with synovitis of the wrist and who underwent synovectomy. Materials and Methods: Twenty-nine patients, who underwent contrast magnetic resonance imaging (MRI) preoperatively and synovectomy from January 2000 to December 2013, were reviewed retrospectively. Among them, 17 patients underwent a $Tc^{99m}$ white blood cell (WBC) scan preoperatively. In patients who met the diagnostic criteria of rheumatoid arthritis (RA), the diagnosis was confirmed as RA if the MRI finding or histology was compatible with RA. If the MRI finding and histology were disparate, the final diagnosis was made based on the histologic finding. Results: Of the nine patients who met the diagnostic criteria of RA, seven patients were finally diagnosed as RA and two patients as tuberculous arthritis. Of the 20 patients who did not meet the diagnostic criteria of RA, the MRI findings and histology were consistent with the same disease in 12 patients. In the remaining eight patients, five were diagnosed with nonspecific chronic synovitis, one with RA, and two with tuberculous arthritis based on the clinical findings, MRI, and histology findings. Conclusion: MRI and a WBC scan are very useful imaging modalities for diagnosing the causative condition of the wrist synovitis. A histology evaluation after synovectomy can also be useful in cases with a difficult diagnosis or are refractory to medications.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.2
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• pp.99-107
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• 2020

Fibromyalgia is a disorder characterized by the core symptom of chronic widespread pain, along with fatigue, sleep disturbances, mood changes, and cognitive difficulties. The etiology of fibromyalgia involves a combination of biological factors, such as genetic vulnerability, alterations in pain processing and stress response system ; psychological factors, such as anxiety, depression, anger, and perceived stress ; environmental factors, such as infections, febrile diseases, and trauma. Central sensitization, which is amplified in the process of sensory stimulation, has been emphasized as a key etiological factor, as supported by enhanced wind-up, delayed aftersensation, decreased nociceptive flexion reflex threshold and functional imaging studies. Several guidelines recommend that a multimodal approach be used to treat fibromyalgia, including both pharmacological and non-pharmacological treatments, tailored to each individual, and that clinicians should provide an intellectual framework through sufficient education and emphasis on the importance of self-management. The prevalence of mood disorders, anxiety disorders, and other psychiatric problems is 7-9 times higher in patients with fibromyalgia than in the general population ; moreover, the association between fibromyalgia and certain psychopathologies or sleep problems has also been suggested. Since psychiatric problems, with shared vulnerabilities and risk factors, interact with fibromyalgia bidirectionally and also affect the disease course, an integrated management approach is needed to determine the risk of comorbidities.

• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.281-293
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• 2020

An anterior cruciate ligament (ACL) reconstruction is one of the most frequent surgical procedures in the knee joint, but despite the better understanding of anatomy and biomechanics, surgical reconstruction procedures still fail to restore rotational stability in 7%-16% of patients. Hence, many studies have attempted to identify the factors for rotational laxity, including the anterolateral ligament (ALL), but still showed controversies. Descriptions of the ALL anatomy are also confused by overlapping nomenclature, but it is usually known as a distinctive fiber running in an anteroinferior and oblique direction from the lateral epicondyle of the femur to the proximal anterolateral tibia, between the fibular head and Gerdy's tubercle. The importance of the ALL as a secondary restraint in the knee has been emphasized for successful ACL reconstructions that can restore rotational stability, but there is still some controversy. Some studies reported that the ALL could be a restraint to the tibial rotation, but not to anterior tibial translation. On the other hand, some studies reported that the role of ALL in rotational stability would be limited as a secondary structure because it bears loads only beyond normal biomechanical motion. The diagnosis of an ALL injury can be performed by a physical examination, radiology examination, and magnetic resonance imaging, but it should be assessed using a multimodal approach. Recently, ALL was considered one of the anterolateral complex structures, as well as the Kaplan fiber in the iliotibial band. Many studies have introduced many indications and treatment options, but there is still some debate. The treatment methods are introduced mainly as ALL reconstructions or lateral extra-articular tenodesis, which can achieve additional benefit to the knee stability. Further studies will be needed on the indications and proper surgical methods of ALL treatment.