• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1001-1007
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• 2000

Objective : We analysed diverse clinical features of the cavernous angioma. Also, we report the experience in differ-ent methods of the management and their results. Method : Data from 80 patients who were confirmed pathologically or diagnosed radiologically between Jan. 1990 and Sept. 1998 at our hospital were analysed. Variable factors that were examined were : clinical features, effects of treatment, and complications. Results : There were 47 male and 33 female patients. The age at the first presentation was from 3 to 57(mean 34.1) years old. Clinical features were seizure in 28 cases(38%), bleeding in 24 cases(32%), neurologic deficits in 12 cases(16%), headache in 10 cases(14%), and six incidental cases. The locations of lesion were cerebral and cerebellar hemisphere in 45 cases(56.2%), brainstem, basal ganglia, and thalamus in 32 cases(40%), multiple in 3 cases (3.8%). Seizure was common at the third decade and occurred frequently with the cavernous angioma in temporal (43%) or frontal lobe(39%). Bleeding was frequent after the third decade with peak at the fourth decade and had high incidence in brainstem or thalamus. The gamma-knife radiosurgery was done in 47 cases. Rebleeding occurred in 3 cases, but it was within postradiosurgery 1 year. Symptomatic radiation change occurred in 2 cases of 8 radiation change on MRI. On follow-up MRI, no evidence of rebleeding was found in 30 cases. Also, The lesion size was decreased in 3 cases. Resection was performed in 23 cases ; total 20, subtotal 2, partial 1. Postoperative complication occurred in 6 cases(26.1%). After surgery, 7(63.6%) of 11 seizure patients had outcome of seizure-free. Subclinical rebleeding occurred in one of two subtotal resected cases. In 11 patients, conservative management was done. There was neither rebleeding nor symptom aggravation during follow-up period of mean 17.2 months. Conclusion : The solution for prevention of rebleeding is complete removal of the lesion located at noneloquent area or accessible region, especially for the patients who presented symptoms or intractable seizure. However, the Gamma knife radiosurgery is considered when the lesions are located at eloquent area or when severe postoperative morbidity is expected.

• Science of Emotion and Sensibility
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• v.22 no.3
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• pp.3-20
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• 2019

With advancements in technology of virtual reality, it is used for various purposes in many fields such as medical care and healthcare, but as the same time there are also increasing reports of nausea, eye fatigue, dizziness, and headache from users. These symptoms of motion sickness are referred to as cybersickness, and various researches are under way to solve the cybersickness problem because it can cause inconvenience to the user and cause adverse effects such as discomfort or stress. However, there is no official standard for the causes and solutions of cybersickness at present. This is also related to the absence of tools to quantitatively measure the cybersickness. In order to overcome these limitations, this study proposed quantitative and objective cybersickness evaluation method. We measured 128-channel EEG waves from ten participants experiencing visually stimulated virtual reality. We calculated the relative power of delta and alpha in 11 regions (left, middle, right frontal, parietal, occipital and left, right temporal lobe). Multiple regression models were obtained in a stepwise manner with the motion sickness susceptibility questionnaire (MSSQ) scores indicating the susceptibility of the subject to the motion sickness. A multiple regression model with the highest under the area ROC curve (AUC) was derived. In the multiple regression model derived from this study, it was possible to distinguish cybersickness by accuracy of 95.1% with 11 explanatory variables (P_D.MF, P_D.LP, P_D.MP, P_D.RP, P_D.MO, P_A.LF, P_A.MF, P_A.RF, P_A.LP, P_A.RP, P_A.MO). In summary, in this study, objective response to cybersickness was confirmed through 128 channels of EEG. The analysis results showed that there was a clearly distinguished reaction at a specific part of the brain. Using the results and analytical methods of this study, it is expected that it will be useful for the future studies related to the cybersickness.

• The Korean Journal of Nuclear Medicine
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• v.32 no.1
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• pp.20-31
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• 1998

A robust algorithm to disclose and display the difference of ictal and interictal perfusion may facilitate the detection of ictal hyperfusion foci. Diagnostic performance of localizing epileptogenic zones with subtracted SPECT images was compared with the visual diagnosis using ictal and interictal SPECT, MR, or PET. Ietal and interictal Tc-99m-HMPAO cerebral perfusion SPECT images of 48 patients(pts) were processed to get parametric subtracted images. Epileptogenic foci of all pts were diagnosed by seizure free state after resection of epileptogenic zones. In subtraction SPECT, we used normalized difference ratio of pixel counts(ictal-interictal)/interictal ${\times}100%$) after correcting coordinates of ictal and interictal SPECT in semi-automatized 3-dimensional fashion. We found epileptogenic zones in subtraction SPECT and compared the performance with visual diagnosis of ictal and interictal SPECT, MR and PET using post-surgical diagnosis as gold standard. The concordance of subtraction SPECT and ictal-interictal SPECT was moderately good(kappa=0.49). The sensitivity of ictal-interictal SPECT was 73% and that of subtraction SPECT 58%. Positive predictive value of ictal-interictal SPECT was 76% and that of subtraction SPECT was 64%. There was no statistical difference between sensitivity or positive predictive values of subtraction SPECT and ictal-interictal SPECT, MR or PET. Such was also the case when we divided patients into temporal lobe epilepsy and neocortical epilepsy. We conclude that subtraction SPECT we produced had equivalent diagnostic performance compared with ictal-interictal SPECT in localizing epileptogenic zones. Additional value of these subtraction SPECT in clinical interpretation of ictal and interictal SPECT should be further evaluated.

• Pediatric Infection and Vaccine
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• v.15 no.1
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• pp.30-35
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• 2008

Purpose : We evaluated clinical presentations of brain abscesses, including predisposing factors, causative organisms, and mortality rate in neonates and children. Methods : We retrospectively reviewed the medical charts of neonates and children with brain abscesses treated at Severance Hospital from January 1997 through December 2006. Results : Among 27 neonates and children with brain abscesses, overall mortality was 22 % and 38% of survivors developed neurologic sequelae. The mortality rate was 38% in 8 infants with brain abscesses. The most common location of brain abscesses were frontal and parietal lobes, followed by temporal lobe. There were 7 cases with multiple brain abscesses. Streptococci (33%), Staphylococci (27%), and Gram-negative enterics (20%) were commonly isolated. The common predisposing conditions were neurosurgical procedure (30 %), cyanotic congenital heart disease (15%), and sinusitis/otitis (7%). Fever (74%), headache (37%), nausea/vomiting (33%), and altered mental status (33%) occurred commonly. Compared with children older than 1 year of age, infants were associated with multiple brain abscesses (63%, P=0.011) and high rates of death or neurologic sequelae (88%, P= 0.033). Conclusion : We should have a high index of suspicion in order to recognize the condition as early as possible, especially in infancy with brain abscesses who presents vague or nonspecific symptoms and signs.

• Journal of Korean Neurosurgical Society
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• v.51 no.4
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• pp.215-218
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• 2012

Objective: Traumatic epidural hematomas (EDHs) in children are a relatively unusual occurrence. The cause and outcome vary depending on period and reg ion of study. The aims of this analysis were to review the cause and outcome of pediatric EDHs nowadays and to discuss outcome-related variables in a large consecutive series of surgically treated EDH in children. Methods: This is a retrospective review of 29 patients with surgically treated EDHs between Jan 2000 and February 2010. Patients' medical records, computed tomographic (Cl) scans, and, if performed, magnetic resonance imaging (MRI) were reviewed to define variables associated with outcome. Variables included in the analysis were age, associated severe intracranial injury, abnormal pupillary response, hematoma thickness, severity of head injury (Glasgow Coma Scale score), parenchymal brain injury, and diffuse axonal injury. Results: The mean (SO) age of the patients was 109 months (0-185 months). Most of the injuries with EDHs occurred in traffic accident (14 cases, 48.2%) and followed by slip down in 6 cases and falls in 6 cases. There were one birth injury and one unknown cause. EDHs in traffic accidents occurred in pedestrians hit by a motor vehicle, 9 cases; motorbike and car accidents, 5 cases and bicycle accidents, 1 case. The locations of hematoma were almost same in both sides (left side in 15 cases). Temporal lobe is the most common site of hematomas (13 cases, 44%). The mean size of the EDHs was 18 mm (range, 5-40 mm). Heterogeneous hematomas in CT scans were 20 cases (67%). Two patients were referred with unilateral or bilateral dilated pupil(s). There was enlargement of EDH in 5 patients (17%). All of them were heterogeneous hematomas in CT scans. Except for 4 patients, all EDHs were associated with skull fracture(s) (87%). There was no case of patient with major organ injury. CT or MRI revealed brain contusion in 5 patients, and diffuse axonal injury in one patient The mortality was zero, and the outcomes were excellent in 26 and good in 2 patients. None of the tested variables were found to have a prognostic relevance. Conclusion: Regardless of the EDH size, the clinical status of the patients, the abnormal pupillary findings, or the cause of injury, the outcome and prognosis of the patients with EDH were excellent.

• Progress in Medical Physics
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• v.18 no.2
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• pp.65-72
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• 2007

An echo planar imaging (EPI)-based spin-echo sequence Is often used to obtain diffusion tensor imaging (DTI) data on most of the clinical MRI systems, However, this sequence is confounded with the susceptibility artifacts, especially on the temporal lobe in the human brain. Therefore, the objective of this study was to design a pulse sequence that relatively immunizes the susceptibility artifacts, but can map diffusion tensor components in a single-shot mode. A multi-slice multi-echo pulsed-gradient spin-echo (MePGSE) sequence with eight echoes wasdeveloped with selective refocusing pulses for all slices to map the full tensor. The first seven echoes in the train were diffusion-weighted allowing for the observation of diffusion in several different directions in a single experiment and the last echo was for crusher of the residual magnetization. All components of diffusion tensor were measured by a single shot experiment. The sequence was applied in diffusive phantoms. The preliminary experimental verification of the sequence was illustrated by measuring the apparent diffusion coefficient (ADC) for tap water and by measuring diffusion tensor components for watermelon. The ADC values in the series of the water phantom were reliable. The MePGSE sequence, therefore, may be useful in human brain studies.

• The Korean Journal of Nuclear Medicine
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• v.25 no.1
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• pp.17-26
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• 1991

뇌 혈류의 기능적 영상화는 간질병소의 국소화에 이용되고 있으며 측두엽성간질의 편측화에 여러가지 진단 방법이 이용되고 있으나 만족할만한 결과를 보이지 못하고 있다. 최근 PET또는 SPECT를 이용하여 측두엽성간질에서 발작 간에 측두엽 병소의 대사율 및 혈류의 감소가 나타나며, 이러한 소견은 발작 유발 병소의 편측화에 매우 유용할것이라는 보고들이 있다. 저자들은 측두엽성간질에서 간질 병소를 편측화 하는데에 $^{99m}Tc-HMPAO$ SPECT의 유용성을 평가 하고자 측두엽성간질 31예에서 발작 간의 $^{99m}Tc-HMPAO$ SPECT 소견, 뇌파, 자기 공명 영상 및 전산화 단층 소견을 비교하였다. SPECT 소견에 따른 나이, 병력 기간과 병발시 나이 등의 임상 지수 간에는 유의한 차이가 없었다. 31예의 환자중 23예에서(74.2%) 국소 뇌 혈류 감소를 보였으며 17예(54.8%)에서 측두엽에 관류 감소가 관찰 되었다. 비인두 뇌파 표준 뇌파는 24예(77.4%)에서 측두엽에 편측화를 보였으며 SPECT와 뇌파 양자가 모두 편측화된 경우 일치도는 8/12예 (66.7%) 였다. 16예에서 시행된 전산화 단층 영상은 모두 편측화를 보이지 못했으며 27예에서 시행된 자기 공명 영상에서는 단지 1예에서 편측화를 보였다. 이상의 결과로서 발작 간의 $^{99m}Tc-HMPAO$ SPECT는 측두엽성간질 병소의 편측화에 유용한 보조 검사로 생각된다.

• Journal of Veterinary Clinics
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• v.26 no.6
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• pp.650-654
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• 2009

A 1-week-old, male Korean native calf with acute clinical signs of depression, mild diarrhea, ataxia, recumbency and tremor was referred to Chonbuk Veterinary Medical Center of Chonbuk National University. Vision loss and cornea edema were also observed on physical examination. The patient had been deteriorated with nystagumus, strabisumus and opisthtonus. Blood cell count test and blood biochemistry test revealed remarkable leukocytosis, and hypoalbuminemia and increased blood urea nitrogen. No remarkable findings were observed on radiography. On magnetic resonance imaging study, there were enlarge lateral, third, and forth ventricles. The cortical grey and subcortical white matter of left temporal lobe showed hypointense on T1-weighted images and hyperintense on T2-weighted images, and slightly enhanced on contrast-enhanced T1-weighted images. Escherichia coli strain was identified from cerebrospinal fluid sample. Palliative treatment was attempted but the neonatal calve was expired three days after admission. Severe multifocal fibrino-suppurative meningitis with Escherichia coli infection was confirmed histopathologically.

• Journal of Sasang Constitutional Medicine
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• v.11 no.2
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• pp.283-299
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• 1999

1. Purpose : Systemic injection of kainic acid in experimental animals induces the limbic seizure and structural damages in hippocampus and amygdala which resembles the changes in human temporal lobe epilepsy. The author performed this study to investigate the neuroprotective effects of Yuldahansotang, on the neurotoxicity induced by kainic acid in the hippocampus in rats. 2. Method : Kainic acid was administered intraperitoneally. And feeding with Yuldahansotang for 3 weeks after kainic acid administration. Seizure were induced in male mice (kainate 10-40 mg/kg i.p) and animals were sacrified at various time-points after injection. The experimental animals were sacrificed at 1, 2, 3day and 1, 3weeks while Yuldahansotang administrations. Seizure were graded using a behavioral scale developed in our laboratory. c-fos belong to immediate early genes(IEGs) known to have rapid and brief responses. And neuronal injury was assayed by examining DNA fragmentation using in situ nick translation histochemistry. 3. Results & Conclusion : Seizure severity paralled kainate dosage. At higher doses DNA fragmentation is seen mainly in hippocampus in area CA3, and variable in CA1, thalamus, amygdala within 24 h, is maximal within 72 h, and is large gene by 7 days after administration of kainate. And we can't see the expression of DNA fragmentation and c-fos in the mice what feeded by Yuldahansotang after 7 days from kainic acid administration. It is consequently suggested that Yuldahansotang may attenuate the kainic acid-induced neuronal degeneration and increase the immunoreactivity of hippocampus in mouse.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.399-408
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• 1998

Purpose : This study was designed to demonstrate the potential therapeutic advantage of 3-dimensional (3-D) treatment planning over the conventional 2-dimensional (2-D) approach in patients with carcinoma of the nasopharynx. Materials and Methods : The two techniques were compared both qualitatively and quantitatively for the boost portion of the treatment (19.8 Gy of a total 70.2 Gy treatment schedule) in patient with T4. The comparisons between 2-D and 3-D plans were made using dose statistics, dose-volume histogram, tumor control probabilities, and normal tissue complication probabilities. Results : The 3-D treatment planning improved the dose homogeneity in the planning target volume. In addition, it caused the mean dose of the planning target volume to increase by 15.2$\%$ over 2-D planning. The mean dose to normal structures such as the temporal lobe, brain stem, parotid gland, and temporomandibular joint was reduced with the 3-D plan. The probability of tumor control was increased by 6$\%$ with 3-D treatment planning compared to the 2-D planning, while the probability of normal tissue complication was reduced. Conclusion : This study demonstrated the potential advantage of increasing the tumor control by using 3-D planning. but prospective studies are required to define the true clinical benefit.