• Journal of Korean Neurosurgical Society
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• 제57권3호
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• pp.192-196
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• 2015

Objective : Tremor is a common movement disorder that interferes with daily living. Since the medication for tremor has some limitations, surgical intervention is needed in many patients. In certain patients who cannot undergo aggressive surgical intervention, Gamma Knife thalamotomy (GKT) is a safe and effective alternative. Methods : From June 2012 to August 2013, 7 patients with an intractable tremor underwent GKT. Four of these 7 patients had medical comorbidities, and 3 patients refused to undergo traditional surgery. Each patient was evaluated with the modified Fahn-Tolosa-Marin tremor rating scale (TRS) along with analysis of handwriting samples. All of the patients underwent GKT with a maximal dose of 130 Gy to the left ventralis intermedius (VIM) nucleus of the thalamus. Follow-up brain MRI was performed after 3 to 8 months of GKT, and evaluation with the TRS was also performed. Results : Six patients showed objective improvement in the TRS score. Excluding one patient who demonstrated tremor progression, there was 28.9% improvement in the TRS score. However, five patients showed subjective improvement in their symptoms. On comparing the TRS scores between follow-up periods of more and less than 4 months, the follow-up TRS score at more than 4 months of GKT was significantly improved compared to that at less than 4 months of GKT. Follow-up MRI showed radiosurgical changes in 5 patients. Conclusion : GKT with a maximal dose of 130 Gy to the VIM is a safe procedure that can replace other surgical procedures.

• Journal of Korean Neurosurgical Society
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• 제46권2호
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• pp.109-115
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• 2009

Objective: The decision to adopt a conservative or surgical modality for a relatively small volume of spontaneous intracerebral hemorrhage (SICH) is difficult and often controversial, especially when consciousness is tolerable. The authors examined the results of stereotactic-guided evacuation of SICH for relatively small volumes with respect to functional outcome. Methods: This prospective study was performed on 387 patients with SICH who underwent stereotactic-guided evacuation (n = 204, group A) or conservative treatment (n = 183, group B) during the past 8 years. The primary end-point was recovery of functional status, which was estimated using the Modified Barthel Index (MBI) and the modified Rankin Scale (mRS). Results: All patients had a Glasgow coma scale (GCS) score of $\geq$ 13 and unilateral hemiparesis of less than motor power grade 3. Group demographic characteristics and initial neurological statuses were similar. In all cases, the volume of SICH involved was < 30 cm$^3$ and location was limited to basal ganglia and thalamus. At 6-month follow-ups, MBI was 90.9 in group A and 62.4 in group B (p < 005), and MRS was 1.2 in group A and 3.0 in group B (p < 0.05). Better motor function and stereotactic-guided evacuation had a significant effect on a functional recovery in regression analyses. Conclusion: Even in patients with a small volume of SICH, stereotactic-guided evacuation improved functional recovery in activities in daily life than conservative treatment did.

• Journal of Korean Neurosurgical Society
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• 제47권6호
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• pp.415-419
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• 2010

Objective : It is usually difficult to perform the neuroendoscopic procedure in patients without hydrocephalus due to difficulties with ventricular cannulation. The purpose of this study was to find out the value of navigation guided neuroendoscopic biopsy in patients with peri- or intraventricular tumors without hydrocephalus. Methods : Six patients with brain tumors without hydrocephalus underwent navigation-guided neuroendoscopic biopsy. The procedure was indicated for verification of the histological diagnosis of the neoplasm, which was planned to be treated by chemotherapy and/or radiotherapy as the first line treatment, or establishment of the pathological diagnosis for further choice of the most appropriate treatment strategy. Results : Under the guidance of navigation, targeted lesion was successfully approached in all patients. Navigational tracking was especially helpful in entering small ventricles and in approaching the third ventricle through narrow foramen Monro. The histopathologic diagnosis was established in all of 6 patients : 2 germinomas, 2 astrocytomas, 1 dysembryoplastic neuroepithelial tumor and 1 pineocytoma. The tumor biopsy sites were pineal gland (n = 2), suprasellar area (n = 2), subcallosal area (n = 1) and thalamus (n = 1). There were no operative complications related to the endoscopic procedure. Conclusion : Endoscopic biopsy or resection of peri- or intraventricular tumors in patients without hydrocephalus is feasible. Image-guided neuroendoscopic procedure improved the accuracy of the endoscopic approach and minimized brain trauma. The absence of ventriculomegaly in patients with brain tumor may not be served as a contraindication to endoscopic tumor biopsy.

• 한국한의학연구원논문집
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• 제2권1호
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• pp.514-550
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• 1996

There are many theory in acupuncture mechanism, so we must know the detail contents. and then we can use the acupuncture as we know. the follow article will be helpful in this part. 1. Spinal cord are role in intermediate part in somatosensorypathway also in acupuncture stumulating tract 2. Acute pain pathway started in laminae I, V of gray colmn, next are the spinothalamic tract(trigeminal spinothalamic tract in above neck part) and then go to the specific thalamic nucleus. but chronic pain in laminae II, III, VI, VII, next are spinoreticular tract(trigeminal spinoreticular tract in the neck part) and finally to the nonspecific thalamic nucleus. 3. Thalamus is very important area in somatosensory stimuation including acupuncture stumulating sensory also as a pain control center. but except this, there are Hypothalamus, Limbic system Cerebral cortex and Cerebellum as intermediator. as we Know hypothalamus is related to the emotional analgesic system with a limbic system. 4. A ${\delta$ fiber has relationship in Acute, sharp and initial pain, contrary this C fiber is related with Chronic, dull and last pain. 5. In Acupuncture mechanism of pain analgesia, there are two theory, one is gate control theory as large fiber another is stimuation produced analgesia as small diameter fier. 6. In DNIC, the stimulation sources are mechanical, thermal, heating, pain and acupuncture stimulation etc. we call these as a Heterotopic Noxious Stimulation. 7. In DNIC, SRD(Subnucleus reticularis dorsalis)is core nucleus in pain imtermediated analgesic mechanism. 8. Takeshige insisted nonacupuncture point dependent analgesic mechanism and acupuncture point dependent analgesic mechanism. and protested that Stimulation acupuncture piing evoke blocking nomacupuncture point analgesic pathway.

• 대한한방내과학회지
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• 제27권2호
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• pp.533-537
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• 2006

The purpose of this study is to present a case of gaze palsy due to thalamic infarction improved by acupuncture and herb medicine. Monocular gaze palsies which result from a supranuclear cerebral lesion are rare clinical manifestations. The pre-frontal cortico-oculomotor pathways travel across the thalamus and mesodienphalic junction terminating directly in oculomotor complexes. The acute disinhibition of these neurons by a posterior thalamic lesion results in a sustained but transient discharge of the medial rectus and tonic activation. Results of this study suggest a role for conservative therapy with herb medicine and acupuncture to treat gaze palsy due to thalamic infarction. Further research into oriental medical treatment for such disorders will be forthcoming.

• 한국임상수의학회지
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• 제33권1호
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• pp.10-15
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• 2016

The purpose of this study was to establish reproducible ischemic infarction model using allogenic blood clot in beagle dogs and identify induced ischemic lesion after middle cerebral artery occlusion using magnetic resonance imaging (MRI) and histopathologic findings. Twenty eight male beagle dogs with no evidence of neurologic disease were experimented. Allogenic embolus was made using a healthy beagle dog. After internal carotid artery (ICA) was exposure, 16G catheter was introduced through the ICA. The dog was administered 0.3 ml blood clot for 15 seconds followed by 3 ml of saline for 15 seconds. MRI scans were performed with 1.5T to evaluate ischemic lesion at 7 days after middle cerebral artery occlusion procedure. Evaluation parameters of MRI include location, distribution, infarction type, margin, shape, mass effect and intensity of T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), fluid attenuated inversion recovery (FLAIR) sequence, diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC). On MRI, all dogs (28/28) showed focal or multifocal lesion including telencephalon and thalamus lesions, especially caudate nucleus (24/28). These lesions had well-defined margin from adjacent brain parenchyma, none or mild mass effect and various shape. Most of dogs appeared hyperintensity on T1WI, T2WI, FLAIR, and DWI/ADC, corresponding to chronic infarction. These lesions were histopathologically confirmed atrophic changes and unstained lesion. In conclusion, MRI is the useful method to provide information about ischemic infarction in dogs and the best reproducible ischemic infarction model was developed by using allogenic blood clot.

• 대한핵의학회지
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• 제27권1호
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• pp.22-27
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• 1993

Drug abuse is widespread in worldwide and has been associated with neurologic complication. Zipeprol is one of the drugs which been abused for psychological satisfaction in some adolescents. This agent is non-opioid antitussive agent, which is not legally considered as being capable of creating dependence or abuse liability at therapeutic serum levels. But it has been reported that acute or chronic overdose create neurologic complication such as convulsion as well as dependence. Recently we experienced six zipeprol abusers who admitted due to convulsion and variable neurologic symptoms. The aim of our study was to determine the role of $^{99m}Tc$-HMPAO brain SPECT in those patients. EEG and brain CT showed no abnormal finding, but brain SPECT showed focal or multiple perfusion abnormalities in frontal, parietal, occipital cortex, basal ganglia, thalamus and especially at temporal cortex. These results suggest that brain SPECT may be a useful diagnostic tool to evaluate the cerebral dysfunction infused by zipeprol abuse.

• 한국감성과학회:학술대회논문집
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• 한국감성과학회 2009년도 춘계학술대회
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• pp.109-112
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• 2009

The purpose of this study was to examine the differences in the brain activation evoked by music arranged in major and minor key used with an identical motion film during the fMRI testing. A part of the audio-visual combinations composed by Iwamiya and Sano were used for the study stimuli. This audio- visual clip was originally developed by combining a small motion segment of the animation "The Snowman" and music arranged in both major and minor key from the original jazz music "Avalon" rewritten in a classical style. Twenty-seven Japanese male graduate and undergraduate students participated in the study. Brain regions more activated by the major key than the minor key when presented with the identical motion film were the left cerebellum, the right fusiform gyrus, the right superior occipital, the left superior orbito frontal, the right pallidum, the left precuneus, and the bilateral thalamus. On the other hand, brain regions more activated by the minor key than the major key when presented with the identical motion film were the right medial frontal, the left inferior orbito frontal, the bilateral superior parietal, the left postcentral, and the right precuneus. The study showed a difference in brain regions activated between the two different stimulus (i.e., major key and minor key) controlling for the visual aspect of the experiment. These findings imply that our brain systematically generates differently in the way it processes music written in major and minor key(Supported by the User Science Institute of Kyushu University, Japan and the Korea Science and Engineering Foundation).

• 한국임상수의학회지
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• 제31권5호
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• pp.457-460
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• 2014

뇌경색으로 진단한 소형견 3 마리의 자기공명영상 (MRI)을 평가하였다. 뇌경색은 소뇌, 시상, 혹은 다발성으로 발생하였다. 뇌경색은 병변의 경계가 비교적 뚜렷하고, 균질하게 T1강조영상에서 저신호, T2강조영상에서 고신호를 나타내었다. 조영증강효과는 없거나, 병변의 주변부로 미약하게 조영증강효과가 나타나기도 했다. 확산강조영상 (DWI)에서는 고신호로 나타나며 이 부위의 겉보기확산계수 (ADC)는 감소되었다.

• 감성과학
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• 제20권4호
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• pp.113-126
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• 2017

The purpose of the study was to find grey matter (GM) and white matter (WM) volume reduction in the brain reward system among patients with alcohol dependency. This study investigated regional GM and WM in chronic alcoholic patients, focusing primarily on the reward system, including principal components of the mesocorticolimbic reward circuit as well as cortical areas with modulating and oversight functions. Sixteen abstinent long-term chronic alcoholic men and demographically matched 16 healthy control men participated in the study. Morphometric analysis was performed on magnetic resonance brain scans using voxel-based morphometry (VBM)-diffeomorphic Anatomical Registration through Exponentiated Liealgebra (DARTEL). We derived GM and WM volumes from total brain and cortical and subcortical reward-related structures. Morphometric analyses that revealed the total volume of GM and WM was reduced and cerebrospinal fluid (CSF) was increased in the alcohol group compared to control group. The pronounced volume reduction in the reward system was observed in the GM and WM of the nucleus accumbens (NAc), GM of the amygdala, GM and WM of the hippocampus, WM of the thalamus, GM and WM of the insula, GM of the dorsolateral prefrontal cortex (DLPFC), GM of the orbitofrontal cortex (OFC), GM of the cingulate cortex (CC), GM and WM of the parahippocampal gyrus in the alcohol group. We identified volume reductions in WM as well as GM of reward system in the patients with alcohol dependency. These structural deficits in the reward system elucidate underlying impairment in the emotional and cognitive processing in alcoholism.