• Clinical and Experimental Pediatrics
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• 제53권7호
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• pp.759-765
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• 2010

Purpose: This study evaluated the clinical manifestations of and risk factors for pituitary insufficiency in children and adolescents with Rathke's cleft cysts. Methods: Forty-four patients with Rathke's cleft cysts younger than 19 years who visited Seoul National University Children's Hospital between January 1995 and September 2009 were enrolled. Rathke's cleft cysts were confirmed histologically through an operation in 15 patients and by brain magnetic resonance imaging (MRI) in 29 patients. The clinical, hormonal, and imaging features were reviewed retrospectively. Results: The clinical presentation of symptomatic patients was as follows: headache (65%), endocrinopathy (61%), and visual disturbance (19%). Endocrinopathy included central precocious puberty (18%), diabetes insipidus (14%), general weakness (11%), and decreased growth velocity (7%). After surgery, hyperprolactinemia resolved in all patients, but growth hormone insufficiency, hypothyroidism, and diabetes insipidus did not improve. Pituitary insufficiency except gonadotropin abnormality correlated significantly with severe headache, visual disturbance, general weakness, and cystic size. Suprasellar extension of cysts and high signals in the T2-weighted image on brain MRI were related to hypothyroidism, hypocortisolism, and diabetes insipidus. Multivariable linear regression analysis showed that only general weakness was a risk factor for pituitary insufficiency ($R^2$=0.549). Conclusion: General weakness is a risk factor for pituitary insufficiency in patients with Rathke's cleft cysts. When a patient with a Rathke's cleft cyst complains of general weakness, the clinician should evaluate pituitary function and consider surgical treatment.

• The Korean Journal of Pain
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• 제34권4호
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• pp.447-453
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• 2021

Background: Provocative discography (PD) is a test that is useful in diagnosing discogenic pain (DP). In this study, to diagnose DP, we used a posterolateral approach of needle placement and followed pressure criteria laid down by the Spine Intervention Society. The aim was to identify the correlation between magnetic resonance imaging (MRI) findings (desiccation, high intensity zone and change in shape and size of the disc) and the results of PD. Methods: Records of 50 patients who underwent PD for DP were analyzed. A total of 109 PDs were performed, with 54 suspect and 55 control discs. Alternate pain generators were ruled out. Results: A total of 35 suspect discs were positive on PD. The mean disc pressure in the suspect disc was 31.9 ± 7.9 psi (range, 15-44). Of the 50 patients who underwent PD, 35 had positive MRI findings. A significant positive correlation was found only between disc desiccation and discography result (r = 0.6, P < 0.001). Logistic regression analysis revealed that only desiccation successfully predicted the result of discography (OR = 26.5, P < 0.001); a high intensity zone and a disc protrusion/extrusion had an OR 2.3 and 1.24, respectively. Disc desiccation of Pfirmann grade 3 or more had a sensitivity and specificity of 0.93 and 0.64 respectively in identifying painful discs; the positive likelihood ratio was 2.58 while the negative likelihood ratio was 0.11. Conclusions: In patients with DP, disc desiccation is the most useful MRI feature that predicts a painful disc on PD.

• 한국콘텐츠학회논문지
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• 제12권12호
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• pp.63-70
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• 2012

의료 영상처리 분야에서의 일반적인 객체 인식 방법은 영역 분할 알고리즘을 기반으로 처리되어진다. 컴퓨팅 분야에서의 이러한 영역 분할 알고리즘은 대부분 밝기 정보, 형태 정보, 패턴 분석 등 다양한 입력정보의 컴퓨팅 처리를 통해 처리된다. 그러나 이러한 컴퓨팅 방법으로는 앞서 언급된 입력 정보들이 의미가 없을 경우, 영역 분할에 많은 제약이 따르게 된다. 따라서 본 논문은 이러한 컴퓨팅 처리의 근본적인 제약사항을 해결하고자, MR 이론의 R2-map 정보 기반의 효과적인 영역 분할 방법은 제안하였다. 본 방법은 간 영역이 포함된 영상에서 실험하였으며, R2-map의 특징점들을 2차원 영역성장법의 씨앗점으로 설정한 후, 검출된 영역의 최종 경계선 보정작업을 통해 경계가 모호하더라도 영역 분할이 가능하게끔 하였다. 해당 영상의 실험 결과, 평균 7.5%의 평균 영역 차이로 기존의 대표 영역 분할 알고리즘에 비해 높은 정확도가 산출되었다.

• Pediatric Infection and Vaccine
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• 제30권3호
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• pp.159-164
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• 2023

뇌농양은 생명을 위협할 수 있는 심각한 중추신경계 감염으로 특히 소아에서는 증상이 모호하여 시의적절한 진단이 이루어지지 않는 경우가 종종 발생한다. 저자들은 면역력이 정상인 소아에서 드문 병원체에 의한 중추신경계 감염을 진단 및 치료하여 보고하는 바이다. 7년 전 심방중격결손을 진단받았고, 1달 전부터 충치 치료를 받은 과거력이 있는 10세 여아가 10일 전 발생한 두통을 주소로 입원하였다. 뇌자기공명영상에서 4.2 cm 크기의 뇌농양이 오른쪽 두정엽에서 발견되어 두개골절개술과 농양 흡인을 시행하였다. 흡인된 농과 조직에서 Aggregatibacter aphrophilus가 배양되었고, 16S rRNA sequencing에서 Actinomyces georgiae가 확인되어 ampicillin-sulbactam을 8주간 투여하였다. 수술 및 항균요법으로 환자의 증상이 호전되었고, 추적한 뇌자기공명영상에서 농양과 부종도 호전되어 치료를 종료하였다.

• 대한관절경학회지
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• 제16권2호
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• pp.128-133
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• 2012

목적: 이중 다발 전방십자인대 재건술 후 이식건의 자기공명영상(magnetic resonance imaging, MRI) 추시 소견과 안정성과의 관계를 알아보고자 하였다. 대상 및 방법: 1.5 테슬라 자기공명영상을 이용하였으며, 이식건의 신호 강도는 Sonoda 등의 분류를 이용하여 1, 2, 3 등급으로 분류하였고, 주행은 직선과 곡선으로 분류하였다. 전방 안정성은 Lachman, KT 관절계, $30^{\circ}$ 전방 전위 방사선 검사로, 회전 안정성은 pivot shift 검사로 평가하였다. 이식건의 자기공명영상 소견과 안정성의 상관 관계를 평가하였다. 결과: 신호 강도는 전내측 다발이 1 등급 66.7%, 2 등급 26.7%, 3 등급 6.7%였고, 후외측 다발이 1 등급 63.3%, 2 등급 33.3%, 3 등급 3.3%였다. 주행은 전내측 다발이 직선 83.3%, 곡선 16.7%였고, 후외측 다발이 직선 86.7%, 곡선 13.3%였다. 전내측 다발의 주행은 전방 안정성과 관련이 있었고, 후외측 다발의 주행은 회전 안정성과 관련이 있었다. 신호 강도는 안정성과 관련이 없었다. 결론: 이중 다발 전방 십자 인대 재건술 후 이식건의 자기공명영상 추시 소견과 안정성과의 관계에서 전방 안정성 면에서는 전내측 다발의 주행이, 회전 안정성 면에서는 후외측 다발의 주행이 관련이 있었다.

• 대한약침학회지
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• 제17권1호
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• pp.70-73
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• 2014

Objectives: Yamen is the fifteenth acupoint of the Governor Vessel Meridian (GV15). It is anatomically close to the medulla oblongata, so finding the safety depth of the acupoint is very important. However, few studies on the safety depth of GV15 have been done. Methods: This study tried to measure the safety depth of GV15 by using magnetic resonance imaging (MRI) scans and to analyze the factors affecting the safety depth through multiple regression analyses. This study was carried out for patients who had a brain MRI scan while visiting Jeonju Wonkwang Hospital, Korea. The shortest distance between the glabella and the occipital protuberance (DGO), the horizontal distance between the glabella and the back of the head (DGB) and the dangerous depth (DD) were measured from the sagittal views of the MRI images. The DD is the horizontal distance from the skin's surface at GV15 to the spinal dura mater. Results: The model suggested that the safety depth (SD) was significantly associated with gender (${\beta}$ = 0.474, P < 0.0001), DGO (${\beta}$ = 0.272, P = 0.027), and BMI (${\beta}$ = 0.249, P = 0.005) and the combination of three variables can explain the SD, with $R^2$ = 0.571 (Table 3). A longer SD was associated with males and with greater BMI and DGO. Conclusion: This study suggests that gender, BMI and DGO may be important factors when the SD of GV15 is considered clinically through a multiple regression analysis of GV15.

• 대한의용생체공학회:의공학회지
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• 제31권4호
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• pp.285-291
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• 2010

Recently, advance on various modalities of diagnosing, prostate volume estimation became possible not only by the existing two-dimension medical images data but also by the three-dimensional medical images data. In this study, magnetic resonance image (MRI), computer tomography (CT) and ultrasound (US) were employed to evaluate prostate phantom volume measurements for estimation, comparison and analysis. For the prostate phantoms aimed at estimating the volume, total of 17 models were developed by using devils-tongue jelly and changing each of the 5ml of capacity from 20ml to 100ml. For the volume estimation through 2D US, the calculation of the diameter with C9-5Mhz transducer was conducted by ellipsoid formula. For the volume estimation through 3D US, the Qlab software (Philips Medical) was used to calculate the volume data estimated by 3D9-3Mhz transducer. Moreover, the images by 16 channels CT and 1.5 Tesla MRI were added by the method of continuous cross-section addition and each of imaginary prostate model's volume was yielded. In the statistical analysis for comparing the availability of volume estimation, the correlation coefficient (r) was more than 0.9 for all indicating that there were highly correlated, and there were not statistically significant difference between each of the correlation coefficient (p=0.001). Therefore, the estimation of prostate phantom volume using three-dimensional modalities of diagnosing was quite closed to the actual estimation.

• Investigative Magnetic Resonance Imaging
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• 제9권2호
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• pp.134-139
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• 2005

목적 : 청각의 뇌기능 영상 검사 시 소음 감쇠기의 유용성을 알아보고자 하였다. 대상 및 방법 : 소음 감쇠기는 실리콘 이어폰, 귀마개 그리고 마스크로 구성하였다. 마스크와 귀마개는 방음효과가 크다고 알려져 있는 부드러운 재질의 폴리우레탄 시트와 폴리우레탄 폼을 사용하여 제작하였다. 500 Hz의 순음 자극에 대한 청각의 뇌기능 자기공명영상 실험은 4명의 지원자를 대상으로 다음의 세가지 경우로 구별하여 시행하였다: 첫째, 마스크와 귀마개, 이어폰을 모두 착용한 경우, 둘째, 귀마개와 이어폰만을 착용한 경우 그리고 마지막으로 소음 감쇠기를 착용하지 않은 경우 이다. 데이터 획득을 위하여 고성능 경사자계 시스템이 갖추어진 1.5 T 자기공명영상장치에서 BOLD 자기공명 영상기법을 사용하였다. 영상 데이터는 SPM 99 분석프로그램을 이용하여 분석하여 활성화 지도를 획득하였다. 결과 : 소음감쇠기의 모든 구성요소를 사용한 경우 활성화는 주로 일차 청각중추에서만 집중되어 나타나는 결과를 얻었다. 귀마개와 이어폰만을 착용했을 때는 청각의 뇌 활성화 영역이 일차 청각중추와 이차 청각 영역에 분산되어 나타는 결과를 얻었으며 마지막으로 소음감쇠기를 사용하지 않은 경우 청각영역이 오른쪽의 일부만이 활성화 되었다. 결론 : 마스크, 귀마개, 이어폰으로 구성된 소음 감쇠기는 청각의 뇌기능 영상 검사 시 매우 유용할 것으로 기대된다.

• Investigative Magnetic Resonance Imaging
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• 제24권3호
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• pp.123-131
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• 2020

Purpose: Joint label fusion (JLF) is a popular multi-atlas-based segmentation algorithm, which compensates for dependent errors that may exist between atlases. However, in order to get good segmentation results, it is very important to set the several free parameters of the algorithm to optimal values. In this study, we first investigate the feasibility of a JLF algorithm for prostate segmentation in MR images, and then suggest the optimal set of parameters for the automatic prostate segmentation by validating the results of each parameter combination. Materials and Methods: We acquired T2-weighted prostate MR images from 20 normal heathy volunteers and did a series of cross validations for every set of parameters of JLF. In each case, the atlases were rigidly registered for the target image. Then, we calculated their voting weights for label fusion from each combination of JLF's parameters (r_pxy, r_pz, r_sxy, r_sz, β). We evaluated the segmentation performances by five validation metrics of the Prostate MR Image Segmentation challenge. Results: As the number of voxels participating in the voting weight calculation and the number of referenced atlases is increased, the overall segmentation performance is gradually improved. The JLF algorithm showed the best results for dice similarity coefficient, 0.8495 ± 0.0392; relative volume difference, 15.2353 ± 17.2350; absolute relative volume difference, 18.8710 ± 13.1546; 95% Hausdorff distance, 7.2366 ± 1.8502; and average boundary distance, 2.2107 ± 0.4972; in parameters of r_pxy = 10, r_pz = 1, r_sxy = 3, r_sz = 1, and β = 3. Conclusion: The evaluated results showed the feasibility of the JLF algorithm for automatic segmentation of prostate MRI. This empirical analysis of segmentation results by label fusion allows for the appropriate setting of parameters.

• Journal of Ginseng Research
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• 제31권3호
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• pp.159-174
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• 2007

Pharmacology of Korean Red ginseng gives us unique possibility to develop new class of antiepileptic drugs today and to improve one's biological activity. The chemical structures of ginsenosides (GS) have some principal differences from well-known antiepileptic new generation drugs. The antiepileptic effect of GS was also demonstrated in all models of epilepsy in rats (young and adult), which have studied, in all models of epilepsy including status epilepticus (SE), induced by lithium - pilocarpine. In our experiments in rats new evidences on protective effects were exerted as a result of premedication by GS. Pre-treatment of several GS could induce decrease of the seizures severity and brain structural damage (by MRI), neuronal degeneration in hippocampus. Wave nature of severity of motor seizures during convulsive SE was observed during lithium-pilocarpine model of SE in rats (the first increase of seizures was 30 min after the beginning of SE and the second - 90 min after. The efficacy of treatment on SE by ginsenoside as expected was observed after no less 3 weeks by daily GS i.p. administration. It is blocked SE or significantly decrease the severity of seizures during SE. The implication of presented data is that combination of ginsenosides from Korean Red ginseng and ginseng cell culture Dan25 that could be applied for prevention of epileptical status development. However, a development of optimal ratio of different ginsenosides $(Rb_1$ Rc, Rg, Rf,) should consummate in the new antiepileptic drug development.