• Journal of Korean Neurosurgical Society
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• 제56권2호
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• pp.108-113
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• 2014

Objective : Ankylosing spondylitis is an inflammatory rheumatic disease mainly affecting the axial skeleton. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. In this study, we reviewed fractures in patients with ankylosing spondylitis that had been clinically diagnosed to better define the mechanism of injury, associated neurological deficit, predisposing factors, and management strategies. Methods : Between January 2003 and December 2013, 12 patients with 13 fractures with neurological complications were treated. Neuroimaging evaluation was obtained in all patients by using plain radiography, CT scan, and MR imaging. The ASIA Impairment Scale was used in order to evaluate the neurologic status of the patients. Management was based on the presence or absence of spinal instability. Results : A total of 9 cervical and 4 thoracolumbar fractures were identified in a review of patients in whom ankylosing spondylitis had been diagnosed. Of these, 7 fractures were associated with a hyperextension mechanism. 10 cases resulted in a fracture by minor trauma. Posttraumatic neurological deficits were demonstrated in 11 cases and neurological improvement after surgery was observed in 5 of these cases. Conclusions : Patients with ankylosing spondylitis are highly susceptible to spinal fracture and spinal cord injury even after only mild trauma. Initial CT or MR imaging of the whole spine is recommended even if the patient's symptoms are mild. The patient should also have early surgical stabilization to correct spinal deformity and avoid worsening of the patient's neurological status.

• Journal of Korean Neurosurgical Society
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• 제61권1호
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• pp.35-41
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• 2018

Objective : Rehemorrhage is the most severe complication of postoperative patients with spontaneous intracerebral hemorrhage. The aim of the present study was to assess independent predictors of rehemorrhage and find the possibility of preventing rehemorrhage in postoperative patients with spontaneous intracerebral hemorrhage (sICH). Methods : Medical records of 263 postoperative patients with sICH from our Hospital were reviewed. The relationships between rehemorrhage and parameters were examined by univariate and multivariate analyses. The parameters include time from onset to surgery, hematologic paremeters, neuroimaging characteristics, level and variability of systolic blood pressure, medical histories, operation duration, and blood loss. In addition, relationship between rehemorrhage and clinical outcome were analyzed by using multivariate analyses. Results : Thirty-five (13.31%) patients experienced rehemorrhage after operation. Multivariate analyses indicated that the following factors were independently associated with rehemorrhage : history of diabetes mellitus (odds ratio [OR], 2.717; 95% confidence interval [CI], 1.005-7.346; p=0.049), and midline shift (for every 1 mm increase, OR, 1.117; 95% CI, 1.029-1.214; p=0.009). Rehemorrhage was an independent risk factor of poor functional outcome (OR, 3.334; 95% CI, 1.094-10.155; p=0.034). Conclusion : Our finding revealed that history of diabetes mellitus and admission midline shift were possibly associated with rehemorrhage in postoperative patients with sICH.

• 감성과학
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• 제21권3호
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• pp.29-48
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• 2018

Although the concept of "common sense" is often taken for granted, judging whether behavior or knowledge is common sense requires a complex series of mental processes. Additionally, different perceptions of common sense can lead to social conflicts. Thus, it is important to understand how we perceive common sense and make relevant judgments. The present study investigated the dynamics of neural representations underlying judgments of what common sense is. During functional magnetic resonance imaging, participants indicated the extent to which they thought that a given sentence corresponded to common sense under the given perspective. We incorporated two different decision contexts involving different cultural perspectives to account for social variability of the judgments, an important feature of common sense judgments apart from logical true/false judgments. Our findings demonstrated that common sense versus non-common sense perceptions involve the amygdala and a brain network for episodic memory recollection, including the hippocampus, angular gyrus, posterior cingulate cortex, and ventromedial prefrontal cortex, suggesting integrated affective, mnemonic, and social functioning in common sense processing. Furthermore, functional connectivity multivariate pattern analysis revealed that interactivity among the amygdala, angular gyrus, and parahippocampal cortex reflected representational features of common sense perception and not those of non-common sense perception. Our study demonstrated that the social memory network is exclusively involved in processing common sense and not non-common sense. These results suggest that intergroup exclusion and misunderstanding can be reduced by experiencing and encoding long-term social memories about behavioral norms and knowledge that act as common sense of the outgroup.

• 감성과학
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• 제21권3호
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• pp.83-102
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• 2018

The process model of emotion regulation suggests that cognitive reappraisal and expressive suppression engage at different time points in the regulation process. Although multiple brain regions and networks have been identified for each strategy, no articles have explored changes in network characteristics or network connectivity over time. The present study examined (a) the whole-brain network and six other resting-state networks, (b) their modularity and global efficiency, which is an index of the efficiency of information exchange across the network, (c) the degree and betweenness centrality for 160 brain regions to identify the hub nodes with the most control over the entire network, and (d) the intra-network and inter-network functional connectivity (FC). Such investigations were performed using a traditional large-scale FC analysis and a relatively recent sliding window correlation analysis. The results showed that the right inferior orbitofrontal cortex was the hub region of the whole-brain network for both strategies. The present findings of temporally altering functional activity of the networks revealed that the default mode network (DMN) activated at the early stage of reappraisal, followed by the task-positive networks (cingulo-opercular network and fronto-parietal network), emotion-processing networks (the cerebellar network and DMN), and sensorimotor network (SMN) that activated at the early stage of suppression, followed by the greater recruitment of task-positive networks and their functional connection with the emotional response-related networks (SMN and occipital network). This is the first study that provides neuroimaging evidence supporting the process model of emotion regulation by revealing the temporally varying network efficiency and intra- and inter-network functional connections of reappraisal and suppression.

• 대한의용생체공학회:의공학회지
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• 제32권1호
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• pp.55-60
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• 2011

Although sound intensity is considered as one of important factors in auditory processing, its neural mechanism in auditory neurons with limited dynamic range of firing rates is still unclear. In this study, we examined the effect of sound intensity adaptation on the change of glucose metabolism in a rat brain using [F-18] micro positron emission tomography (PET) neuroimaging technique. In the experiment, broadband white noise sound was given for 30 minutes after the [F-18]FDG injection in order to explore the functional adaptation of rat brain into the sound intensity levels. Nine rats were scanned with four different sound intensity levels: 40 dB, 60 dB, 80 dB, 100 dB sound pressure level (SPL) for four weeks. When glucose uptake during the adaptation of a high intensity sound level (100 dB SPL) was compared with that during adaptation to a low intensity level (40 dB SPL) in the experiment, the former induced a greater uptake at bilateral cochlear nucleus, superior olivary complexes and inferior colliculi in the auditory pathway. Expectedly, the metabolic activity in those areas linearly increased as the sound intensity level increased. In contrast, significant decrease interestingly occurred in the bilateral auditory cortices: The activities of auditory cortex proportionally decreased with higher sound intensities. It may reflect that the auditory cortex actively down-regulates neural activities when the sound gets louder.

• Journal of Korean Neurosurgical Society
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• 제40권5호
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• pp.330-335
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• 2006

Objective : The aim of the study was to review the clinical and radiological findings of those non-functioning adenomas[NFAs] with positive immnoreactivity for anterior pituitary hormones. Methods : Sixty patients with pituitary adenoma were treated at the author's institution between January 2000 and July 2005. All consecutive patients were underwent transsphenoidal surgery by same operator. In addition to the routine histopathological examination, surgical specimen was examined by immunohistochemical staining against adenohypophyseal cells. And clinical analysis was performed by retrospective review of medical records, neuroimaging examinations and immunohistochemical technique. We classified these pituitary adenomas into functioning adenomas [group F], immuno-positive NFAs [group S, so-called silent adenoma] and immuno-negative NFAs [group N], and compared clinical and radiological differences between group F, N, and S. Results : Of the 60 cases, group F was 25, group S was 25, and group N was 10. Among the group S, 5 cases showed reactivity against PRL, 1 against GH, 1 against both PRL and GH, 1 against TSH and GH, 2 against ACTH, 11 against FSH and 4 against both LH and FSH. Radiologically, invasiveness was noted in 8 in group S, compared to 3 in group N and 1 in group F [p = 0.02]. Intratumoral bleeding was noted in 7 of group S, 2 of group N and 2 of group F [p >0.05]. Conclusion : Silent adenomas were thought to behave more aggressive than other subgroups of pituitary adenomas. And so we suggest the immunohistochemical study against adenohypophyseal cells may be helpful for evaluating clinical course of pituitary adenoma, expecially for, NFAs.

• Journal of Korean Neurosurgical Society
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• 제48권3호
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• pp.230-235
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• 2010

Objective : The aim of this study is to compare the surgical outcome of the initial and recent surgical cases, during our 15-years experience, in terms of the surgical strategies and the prognostic factors for surgically remediable epilepsy. Methods : We retrospectively reviewed and compared the surgical outcomes between the initial 256 (Group I) and recent 139 (Group II) patients according to the time period of operation for a total of 518 consecutive epilepsy surgeries at our institution since 1992. The patients of the middle intermediate period, which were subjected to changed surgical strategies, were excluded. Results : The surgical outcome data from the initial and recent groups showed a much improved outcome for patients who underwent temporal lobe epilepsy (TLE) surgery over time. The number of patients with a good outcome (Engel class I-II) was much increased from 87.7% (178 TLE cases of Group I) to 94.8% (79 TLE cases of Group II) and this was statistically significant (p = 0.0324) on univariate analysis. Other remarkable changes were the decreased performance of intracranial invasive studies from 43.5% in Group I to 30.9% in Group II due to the advanced neuroimaging tools. The strip/grid ratio was reduced from 131/32 in Group I to 17/25 in Group II, because of a markedly reduced mesial TLE surgery and an increased extratemporal epilepsy surgery. Conclusion : Our results show that surgical outcome of epilepsy surgery has improved over time and it has shown to be efficient to control medically intractable epilepsy. Appropriate patient selection, comprehensive preoperative assessments and more extensive resection are associated with good postoperative outcomes.

• 인지과학
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• 제24권1호
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• pp.1-24
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• 2013

한국 사회에서 고령 인구가 지속적으로 증가하고 있는 추세에 발맞추어 본 논문은 노화과정에서 일어나는 뇌의 구조, 기능적 변화 및 인지 기능의 저하를 살펴보고, 고령화 대처의 한 방안으로 제안되고 있는 운동의 효과에 관하여 인지신경과학적 연구를 중심으로 개관하였다. 정상 노화 과정에서 일어나는 뇌의 변화는 전전두엽과 측두엽(해마 포함)의 부피변화와 함께 인지 과제 수행 시 과잉활성화와 같은 현상들이다. 이러한 뇌의 변화와 함께 인지 기능의 저하도 관찰되는데 주로 억제 및 기억 기능의 저하가 노화를 특징짓는 인지기능의 변화로 알려져 왔다. 이와 같은 노화 관련 뇌인지의 퇴행적 변화에 대응할 수 있는 보호적 요인 중 하나가 운동이다. 실제 노인을 대상으로 장기간 운동 프로그램을 실시한 연구 결과들은 참가 노인들의 전두엽과 측두엽, 특히 해마의 위축이 개선되고 억제와 기억 기능 역시 향상되었음을 보고하였다. 이러한 결과는 뇌세포 단위에서의 변화로부터 시작하여 노화하는 뇌 역시 변화할 수 있고, 운동이 이러한 긍정적인 변화를 유도할 수 있음을 보여준다.

• Imaging Science in Dentistry
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• 제45권1호
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• pp.1-5
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• 2015

Purpose: Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Materials and Methods: Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Results: Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. Conclusion: In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

• 생물정신의학
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• 제19권1호
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• pp.1-8
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• 2012

The mechanism of psychotherapy is explained by the recent developments in neuroscience and neuroimaging. The purpose of this study is to understand the nature of psychotherapy and to discuss the future of psychotherapy improvement with the help of advances of the neurobiological findings in psychotherapy. For this study, we investigated a wide range of materials. We searched for various researches on psychotherapy, brain, and neurobiology. In addition to the conventional psychodynamic psychotherapy, we investigated research findings on cognitive behavioral therapy, interpersonal psychotherapy and eye movement desensitization and reprocessing (EMDR). Moreover, based on the actual experiences of treating patients, we speculated the neurobiological mechanisms of the process and results of psychotherapy. With the development of neuroscience, we are now able to understand the personal consciousness, unconsciousness and developmental process. Also subdividing the disease is made possible. Personalized treatment has become available, and we are able to predict the prognosis of patients. Our memories are composed by implicit memory and explicit memory. By psychotherapy, we can consciously remember explicit memory, and it becomes easier to explore implicit memory through free association. Through psychotherapy, we will also be able to learn the effect of acquired environment and experience. Psychotherapy is able to correct human behaviors by modifying the memories. Through the regulation of emotions, it becomes possible to modify the memories and correct the behaviors. In this process, doctor-patient relationship is the main factor which cause positive treatment effects. Furthermore imagination therapy or unconscious, non-verbal stimuli could bring about positive treatment effects. Now psychotherapy could be explained and studied by neuroscientific researches. In this sense, we could provide the direction of future advances in neuroscience by the neurobiological understanding of psychotherapy.