• Journal of the Korean Society of Radiology
• /
• v.84 no.3
• /
• pp.736-744
• /
• 2023

Adult-onset Alexander Disease (AOAD) is a rare genetically determined leukoencephalopathy that presents with ataxia, spastic paraparesis, or brain stem signs including speech abnormalities, swallowing difficulties, and frequent vomiting. The diagnosis of AOAD is frequently proposed based on the findings on MRI. We demonstrate two cases (37-year-old female and 61-year-old female) with characteristic imaging findings and changes in follow-up MRI in patients with AOAD, which were confirmed via glial fibrillary acidic protein (GFAP) mutation analysis. On MRI, the typical tadpole-like brainstem atrophy and periventricular white matter abnormalities were noted. The presumptive diagnoses were made based on the typical MRI appearances and, subsequently, confirmed via GFAP mutation analysis. Follow-up MRI demonstrated the progression of atrophy in the medulla and upper cervical spinal cord. Our report could help raise awareness of characteristic MRI findings of AOAD, thus helping clinicians use GFAP analysis for AOAD diagnosis confirmation.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.2
• /
• pp.222-230
• /
• 2000

Purpose : Resection of the epileptogenic zone in the parietal and occipital lobes may be relevant although only few studies have been reported. Methods : Eight patients with parietal epilepsy and nine patients with occipital epilepsy were included for this study. Preoperatively, all had video-EEG monitoring with extracranial electrodes, MRI, 3D-surface rendering of MRI using Allegro(ISG Technologies Inc., Toronto, Canada), and PET scans. Sixteen patients underwent invasive recording with subdural grid. Eight had parietal resection including the sensory cortex in two. Seven had partial occipital resection. Two underwent total unilateral occipital lobectomy. The extent of the resection was made based mainly on the data of invasive EEG recordings, MRI, and 3D-surface rendering of MRI, not on the intraoperative electrocorticographic findings as usually done. During resection, electrocortical stimulation was performed on the motor cortex and speech area. Results : Out of eight patients with parietal epilepsy, three had sensory aura, two had gustatory aura, and two had visual aura. Six of nine patients with occipital epilepsy had visual auras. All had complex partial seizures with lateralizing signs in 15 patients. Four had quadrantopsia. One had mild right hemiparesis. Abnormality in MRI was noticed in six out of eight parietal epilepsy and in eight out of nine occipital epilepsy. 3D-surface rendering of MRI visualized volumetric abnormality with geometric spatial relationships adjacent to the normal brain, in all of parietal and occipital epilepsy. Surface EEG recording was not reliable in localizing the epileptogenic zone in any patient. The subdural grid electrodes can be implanted on the core of the structural abnormality in 3D-reconstructed brain. Ictal onset zone was localized accurately by subdural grid EEGs in 16 patients. Motor cortex in nine and sensory speech area in two were identified by electrocortical stimulation. Histopathologic findings revealed cortical dysplasia in 10 patients ; tuberous sclerosis was combined in two, hamartoma and ganglioglioma in one each, and subpial gliosis in six. Eleven patients were seizure free at follow-up of 6 months to 37 months(mean 19.7 months) after surgery. Seizures recurred in two and were unchanged in one. Six produced transient sensory loss and one developed hemiparesis and tactile agnosia. One revealed transient apraxia. Two patients with preoperative quadrantopsia developed homonymous hemianopsia. Conclusion : This study suggests that surgical treatment was relevant in parietal and occipital epilepsies with good surgical outcome, without significant neurologic sequelae. Neuroimaging studies including conventional MRI, 3Dsurface rendering of MRI were necessary in identifying the epileptogenic zone. In particular, 3D-surface rendering of MRI was very helpful in presuming the epileptogenic zone in patients with unidentifiable lesion in the conventional MRI, in planning surgical approach to lesions, and also in making a decision of the extent of the epileptogenic zone in patients with identifiable lesion in conventional MRI. Invasive EEG recording with the subdural grid electrodes helped to confirm a core of the epileptogenic zone which was revealed in 3D-surface rendered brain.

• The Journal of the Acoustical Society of Korea
• /
• v.22 no.8
• /
• pp.717-726
• /
• 2003

This paper presents the methods that design the Wavelet-based pitch detector for 2,4 kbps Harmonic-CELP Coder, and that achieve the effective waveform interpolation by decision window shape of the transition region, Waveform interpolation coder operates by encoding one pitch-period-sized segment, a prototype segment, of speech for each frame, generate the smooth waveform interpolation between the prototype segments for voiced frame, But, harmonic synthesis of the prototype waveforms between previous frame and current frame occur not only waveform errors but also discontinuity at frame boundary on that case of pitch halving or doubling, In addtion, in transition region since waveform interpolation coder synthesizes the excitation waveform by using overlap-add with triangularity window, therefore, Harmonic-CELP fail to model the instantaneous increasing speech and synthesis waveform linearly increases, First of all, in order to detect the precise pitch period, we use the hybrid 1st pitch detector, and increse the precision by using 2nd ACF-pitch detector, Next, in order to modify excitation window, we detect the onset, offset of frame by GCI, As the result, pitch doubling is removed and pitch error rate is decreased 5.4% in comparison with ACF, and is decreased 2,66% in comparison with wavelet detector, MOS test improve 0.13 at transition region.

• Phonetics and Speech Sciences
• /
• v.13 no.3
• /
• pp.53-64
• /
• 2021

It is known that the voicing contrast for Japanese word-initial stops is primarily realized as differences in the voice onset time (VOT). However, recent studies have reported that voiced stops are more often produced with a positive VOT than with a negative VOT among the younger generation nationwide. It is also known that post-stop F0 is associated with the stop contrast, but the degree of F0 use differs from region to region. This study explores whether the difference in post-stop F0 functions as a perceptual cue to the stop contrast along with VOT. Fifty-five college students who are native listeners from four different regions participated in two or three perception tests. The results show that VOT is a primary cue to the voiced-voiceless distinction of word-initial stops, but that the effect of post-stop F0 on the stop contrast is marginal. The post-stop F0 is involved in perception only when VOT is ambiguous, such that a sound with high F0 is more often perceived as a voiceless stop, but not vice versa. The results of this study indicate that the acoustic parameters associated with the stop contrast are not the same in production and perception, and suggest that other factors such as context, which is not an acoustic characteristic, may also be involved in the stop contrast.

• The Journal of the Korea Contents Association
• /
• v.15 no.8
• /
• pp.424-433
• /
• 2015

This study tried to investigate the differences between auditory preferences for a discrimination study of minimal pairs with the different onset and the same nucleus of a syllable on the basis of articulator-distance in case of Korean infants and toddlers. As a result we found a main effect for articulator-distance and age but not an effect according to the types of phonation especially in terms of tense. Former results are line with the previous studies having reported the order of consonants acquisition based on the places of articulation suggesting that more sensitive responses for the contiguous and different phonemes may lead earlier acquisition for the same place of articulation of the speech sounds. Specifically, bilabial soudns are followed by alveolar and palatal sounds in order. The latter results also showed that tense consonants got a high rate of recognition beside lax consonants according to the age and sex.

• Journal of The Korean Society of Emergency Medicine
• /
• v.29 no.5
• /
• pp.437-448
• /
• 2018

Objective: Acute ischemic stroke (AIS) requires time-dependent reperfusion therapy, and early recognition of AIS is important to patient outcomes. This study was conducted to identify the clinical features and risk factors of AIS patients that are missed during the early stages of diagnosis. Methods: We retrospectively reviewed AIS patients admitted to a hospital through the emergency department. AIS patients were defined as ischemic stroke patients who visited the emergency department within 6 hours of symptom onset. Patients were classified into two groups: an activation group (A group), in which patients were identified as AIS and the stroke team was activated, and a non-activation group (NA group), for whom the stroke team was not activated. Results: The stroke team was activated for 213 of a total of 262 AIS patients (81.3%), while it was not activated for the remaining 49 (18.7%). The NA group was found to be younger, have lower initial National Institutes of Health Stroke Scale scores, lower incidence of previous hypertension, and a greater incidence of cerebellum and cardio-embolic infarcts than the A group. The chief complaints in the A group were traditional stroke symptoms, side weakness (61.0%), and speech disturbance (17.8%), whereas the NA group had non-traditional symptoms, dizziness (32.7%), and decreased levels of consciousness (22.4%). Independent factors associated with missed stroke team activation were nystagmus, nausea/vomiting, dizziness, gait disturbance, and general weakness. Conclusion: A high index of AIS suspicion is required to identify such patients with these findings. Education on focused neurological examinations and the development of clinical decision tools that could differentiate non-stroke and stroke are needed.

• The Journal of the Society of Stroke on Korean Medicine
• /
• v.6 no.1
• /
• pp.33-43
• /
• 2005

Objectives : This study was prepared for investigating the clinical features of stroke patients. Methods : We retrospectively reviewed the medical records of 169 patients who were admitted to Dept. of Internal Medicine, College of Oriental Medicine, Kyung-Won University with a diagnosis of stroke from Jan. 1, 2003 to Dec. 31, 2003. Results : Ischemic stroke(include TIA, 85.2%) was more common than hemorrhagic stroke(14.8%). The incidence in male was 46.7%, in female was 53.3% and the most prevalent age group is over-sixties. Cerebral infarction was most frequently noticed in MCA territory and lacunar-inf., hemorrhage in putamen. Hypertention, the most preceding diseases, followed by diabetes mellitus. The rate of recurrence was 30.18%. Cerebral infarction and cerebral hemorrhage was much occurred in acting. The most patients visited the hospital after 5 days. The most common symptoms in admission time were motor weakness and speech disorder. The complication was mostly urinary tract infection. Physical treatment from onset, in cerebral infarction was 9.14 days and in cerebral hemorrhage was 18.33 days. Conclusions : Our study on CVA patients was similar to previous studies from 1994 to 2002. In most cases, western and oriental treatment and medicine were given synthetically.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.7
• /
• pp.269-274
• /
• 2017

This study aimed to investigate the acoustic differences that occur in diverse sections of sustained vowel phonation, which is often used in an objective speech analysis of voice disorder patients. The subjects included 17 voice disorder patients (vocal nodules) and 12 normal individuals without any voice disorder. The participants' sustained vowel phonation of /a/ was divided into onset, middle, and offset, and the jitter, shimmer, and NHR in each section were analyzed using the MDVP(Multi-Dimensional Voice Program). The Friedman test and post hoc analysis were used. In the vocal nodules group, the jitter, shimmer and NHR were significantly higher in the off section of sustained vowel phonation than in the middle section, and there were no significant differences between the beginning and middle sections. In contrast, in the group of normal individuals, there were no significant differences between any of the sections. The values of the acoustic parameters according to the section of analysis in the sustained vowel phonation are different and the vocal in the end section is significantly more unstable than that in the middle section. The results of this study will be useful for selecting the sections to be analyzed in sustained vowel phonation and interpreting the results of the analysis.

• Journal of Pharmacopuncture
• /
• v.18 no.4
• /
• pp.26-31
• /
• 2015

Objectives: This study used semiology based on traditional Chinese medicine (TCM) to investigate vital energy (Qi) behavior in women with abdominal myofascial pain syndrome (AMPS). Methods: Fifty women diagnosed with chronic pelvic pain (CPP) secondary to AMPS were evaluated by using a questionnaire based on the theories of "yin-yang," "zang-fu", and "five elements". We assessed the following aspects of the illness: symptomatology; specific location of myofascial trigger points (MTrPs); onset, cause, duration and frequency of symptoms; and patient and family history. The patients tongues, lips, skin colors, and tones of speech were examined. Patients were questioned on various aspects related to breathing, sweating, sleep quality, emotions, and preferences related to color, food, flavors, and weather or seasons. Thirst, gastrointestinal dysfunction, excreta (feces and urine), menstrual cycle, the five senses, and characteristic pain symptoms related to headache, musculoskeletal pain, abdomen, and chest were also investigated. Results: Patients were between 22 and 56 years old, and most were married (78%), possessed a elementary school (66%), and had one or two children (76%). The mean body mass index and body fat were 26.86 kg/cm2 (range: 17.7 - 39.0) and 32.4% (range: 10.7 - 45.7), respectively. A large majority of women (96%) exhibited alterations in the kidney meridian, and 98% had an altered gallbladder meridian. We observed major changes in the kidney and the gallbladder Qi meridians in 76% and 62% of patients, respectively. Five of the twelve meridians analyzed exhibited Qi patterns similar to pelvic innervation Qi and meridians, indicating that the paths of some of these meridians were directly related to innervation of the pelvic floor and abdominal region. Conclusion: The women in this study showed changes in the behavior of the energy meridians, and the paths of some of the meridians were directly related to innervation of the pelvic floor and abdominal region.

• Journal of East-West Nursing Research
• /
• v.2 no.1
• /
• pp.22-36
• /
• 1997

Functional recovery of cerebrovascular accident (CVA) patients were studied by examining functional independence measure (FIM) to evaluate the functional state of the patients at admission to and at discharge from the hospital and its relationship with the family support. Study subjects consisted of 129 CVA patients, who were admitted and received rehabilitation treatment at K Medical Center of Oriental Medicine from August 3 to December 18, 1997. The results were as follows: 1) Total FIM score was $72.37{\pm}25.16$ at admission and $101.67{\pm}22.13$ at discharge. The difference of average score was 29.30, which was statistically significant by paired t-test. 2) The largest difference between FIM scores at admission and at clischarge was observed in items of walking and wheel-chair riding, and the smallest clifference in items of social interaction. 3) The recovery was faster with motor function than with cognitive function, because the difference of FIM scores at admission and at discharge was much larger with motor function. 4) Recovery was better in groups under age 49 than in groups above age 70. Functional recorvery was prominent especially in groups with normal sensory state and speech functions, and groups without urinary incontinence. Recovery was less significantly in patients with paraplegic patients hospitalized longer than 2 months, patients with family all the time, and patients with CVA over 11 days. 5) We could not find any relationship between functional recovery and family support. FIM scores were lower in groups of old age(r=-0.325), long stayed in hospital (r=-0.426), and long period of time after the onset of disease(r= -0.339) with a reciprocal correlation between FIM scores and these parameters. 6) Stepwise multiple regression analysis was done to evaluate factors to affect the recovery from CVA. FIM score at admission could explain 51.2 % of the functional recovery. Important factors were periods of hospitalization, state of sensory function, age, and education (listed in decreasing order of importance). In total, they could explain 64.89% of the functional recovery. These results indicate that functional recovery of CVA patients, who were admitted to oriental medicine hospital for rehabilitation treatment, could be estimated by measuring FIM scores. Recovery was significantly better at discharge from the hospital than at admission and motor function recovery rate was much faster than that of cognitive function. 2. Recommendation Based on these results, we recommend following further studies. 1) Comparative study of recovery of motor function and of sensory function would be necessary by measuring FIM scores once a week to evaluate the recovery of CVA patients. 2) It would be interesting to see whether there is any difference of functional recovery between patients treated with either western medicine or oriental medicine. 3) Psychological factors affecting the recovery of CVA patients need to be studied.