• 대한중풍순환신경학회지
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• 제14권1호
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• pp.115-121
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• 2013

2013년 2월 19일부터 2013년 3월 16일까지 대전대학교 둔산한방병원에서 입원치료를 받은 시상통증증후군 환자 1례를 태음인(太陰人) 간조열증(肝燥熱證)으로 인한 중풍(中風)으로 판단하고 열다한소탕(熱多寒少湯) 가감방(加減方)을 투여하고 침구(鍼灸)치료, 부항요법(附缸療法), 물리치료, 재활 및 운동치료 등을 병행하면서 환자의 시상통증증후군 증상을 면밀히 관찰한 결과 유의한 효과를 얻었는바 이에 보고하는 바이나 향후 더 많은 증례를 통한 지속적인 연구가 필요할 것으로 사료된다.

• 운동영양학회지
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• 제13권2호
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• pp.115-122
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• 2009

Intracerebral hemorrhage (ICH) is a common cause of stroke, and it occurs mainly in the striatum, thalamus, cerebellum, and pons. Physical exercise is known to ameliorate neurologic impairment induced by various brain insults. In the present study, the influence of pre-and post-conditioning of treadmill exercise on spatial learning ability, the lesion volume, and apoptotic neuronal cell death in the striatum following ICH in rats was investigated. ICH in the striatum was induced by injection of collagenase using strereotaxic instrument. The rats in the pre-exercise group were scheduled to run on a treadmill before ICH induction for 2 consecutive weeks. The rats in the post-exercise group were scheduled to run on a treadmill after ICH induction for 2 weeks. The rats in the pre-exercise and post-exercise group were scheduled to run on a preconditioning treadmill exercise 2 weeks before ICH induction until postconditioning treadmill exercise 2 weeks after ICH induction, except the day of surgery. For this study, radial arm maze task, Nissl staining, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay, and immunohistochemistry for caspase-3 were performed. Our date showed that treadmill exercise suppressed the ICH-induced apoptotic neuronal cell death and decreased lesion volume in the stratum. Treadmill exercise also alleviated the ICH-induced impairment of spatial learning ability. Preconditioning treadmill exercise before the ICH insult and postconditioning treadmill exercise after the ICH insult showed similar effectiveness on the recovery of ICH. In this study, however, preconditioning exercise before the ICH insult and postconditioning exercise after the ICH insult showed the most potent effectiveness on the recovery of ICH.

• Annals of Clinical Neurophysiology
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• 제25권2호
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• pp.93-102
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• 2023

Background: We aimed to identify any differences in the structural covariance network based on structural volume and those in the functional network based on cerebral blood flow between the ipsilateral and contralateral hemispheres of pain in patients with episodic migraine without aura. Methods: We prospectively enrolled 27 patients with migraine without aura, all of whom had unilateral migraine pain. We defined the ipsilateral hemisphere as the side of migraine pain. We measured structural volumes on three-dimensional T1-weighted images and cerebral blood flow using arterial spin labeling magnetic resonance imaging. We then analyzed the structural covariance network based on structural volume and the functional network based on cerebral blood flow using graph theory. Results: There were no significant differences in structural volume or cerebral blood flow between the ipsilateral and contralateral hemispheres. However, there were significant differences between the hemispheres in the structural covariance network and the functional network. In the structural covariance network, the betweenness centrality of the thalamus was lower in the ipsilateral hemisphere than in the contralateral hemisphere. In the functional network, the betweenness centrality of the anterior cingulate and paracingulate gyrus was lower in the ipsilateral hemisphere than in the contralateral hemisphere, while that of the opercular part of the inferior frontal gyrus was higher in the former hemisphere. Conclusions: The present findings indicate that there are significant differences in the structural covariance network and the functional network between the ipsilateral and contralateral hemispheres of pain in patients with episodic migraine without aura.

• 대한한방내과학회지
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• 제44권5호
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• pp.823-829
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• 2023

Objectives: This study reports the case of a patient with right hemiparesis after a left thalamic infarction, in which the patient experienced improved clinical symptoms (hemiparesis, constipation) after treatment with a complex Korean medicine treatment. Methods: A 81-year-old male patient diagnosed with acute left thalamic infarction was treated with daily acupuncture and herbal medicine (Boyanghwanoh-tang-gagam) three times a day. Jowiseunggi-tang extract granules were administered to treat constipation by adjusting the dosage according to the reported symptoms. The patient's clinical course was assessed using changes in Modified Barthel Index (MBI) score, Manual Muscle Testing (MMT) grade, and defecation frequency . Results: The patient's MBI score improved from 35 to 69 and was discharged with the ability to walk under supervision. The MMT grade also improved from 3/4 to 5/5 in the upper/lower extremities. Other clinical symptoms, including constipation, also improved, leading to the discontinuation of magnesium medication. Conclusion: These findings suggest that complex Korean medicine treatments, including herbal medicine and acupuncture, may be an effective treatment for post-stroke hemiplegic patients.

• Korean Journal of Radiology
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• 제22권7호
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• pp.1142-1151
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• 2021

Objective: To evaluate microstructural damage in high myopia (HM) patients using 3T diffusion kurtosis imaging (DKI). Materials and Methods: This prospective study included 30 HM patients and 33 age- and sex-matched healthy controls (HCs) with DKI. Kurtosis parameters including kurtosis fractional anisotropy (FA), mean kurtosis (MK), axial kurtosis (AK), and radial kurtosis (RK) as well as diffusion metrics including FA, mean diffusivity, axial diffusivity (AD), and radial diffusivity derived from DKI were obtained. Group differences in these metrics were compared using tract-based spatial statistics. Partial correlation analysis was used to evaluate correlations between microstructural changes and disease duration. Results: Compared to HCs, HM patients showed significantly reduced AK, RK, MK, and FA and significantly increased AD, predominately in the bilateral corticospinal tract, right inferior longitudinal fasciculus, superior longitudinal fasciculus, inferior fronto-occipital fasciculus, and left thalamus (all p < 0.05, threshold-free cluster enhancement corrected). In addition, DKI-derived kurtosis parameters (AK, RK, and MK) had negative correlations (r = -0.448 to -0.376, all p < 0.05) and diffusion parameter (AD) had positive correlations (r = 0.372 to 0.409, all p < 0.05) with disease duration. Conclusion: HM patients showed microstructural alterations in the brain regions responsible for motor conduction and vision-related functions. DKI is useful for detecting white matter abnormalities in HM patients, which might be helpful for exploring and monitoring the pathogenesis of the disease.

• 대한치매학회지
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• 제21권2호
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• pp.71-78
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• 2022

Background and Purpose: The expression of the 18-kDA mitochondrial translocator protein (TSPO) in the brain is an attractive target to study neuroinflammation. However, the binding properties of TSPO ligands are reportedly dependent on genetic polymorphism of the TSPO gene (rs6971). The objective of this study is to investigate the rs6971 gene polymorphism in the Korean population. Methods: We performed genetic testing on 109 subjects including patients with mild cognitive impairment, Alzheimer's disease (AD) dementia, non-AD dementia, and cognitively unimpaired participants. Magnetic resonance imaging scans and detailed neuropsychological tests were also performed, and 29 participants underwent ¹⁸F-DPA714 PET scans. Exon 4 of the TSPO gene containing the polymorphism rs6971 (Ala or Thr at position 147) was polymerase chain reaction amplified and sequenced using the Sanger method. The identified rs6971 genotype codes (C/C, C/T, or T/T) of the TSPO protein generated high-, mixed-, or low-affinity binding phenotypes (HABs, MABs, and LABs), respectively. Results: We found that 96.3% of the study subjects were HAB (105 out of 109 subjects), and 3.7% of the subjects were MAB (4 out of 109 subjects). ¹⁸F-DPA-714 PET scans showed nonspecific binding to the thalamus and brainstem, and increased tracer uptake throughout the cortex in cognitively impaired patients. The participant with the MAB polymorphism had a higher DPA714 signal throughout the cortex. Conclusions: The majority of Koreans are HAB (aprox. 96%). Therefore, the polymorphism of the rs6971 gene would have a smaller impact on the availability of second-generation TSPO PET tracers.

• 대한핵의학회지
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• 제32권5호
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• pp.397-402
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• 1998

목적: 대뇌피질의 구조적 병변이 없는 기저핵 혈종환자에 있어서, 대뇌와 소뇌의 해리 현상에 관해 알아보고자하였다. 대상 및 방법 : CT와 MRI상 혈종이 기저핵에 국한되고, 대뇌 피질의 구조적 병변이 없는 12명의 환자를 대상으로 하였다. Tc-99m ECD PECT검사가 전 예에서 시행되었고, 대조군으로 MRI상 구조적 병변이 없고 SPECT 검사상 육안적으로 정상 소견을 보인 20명의 정신과 환자가 선택되었다. 해리 현상에 의한 rCBF의 변화를 육안적으로 확인하였고, 반정량적 분석을 위해 asymmetric index (AI)를 이용하였다. AI가 기저핵, 시상, 소뇌와 대뇌 피질 (전두엽, 측두엽, 두정엽)에서 측정되었고, 대조군 AI의 (평균+2X표준편차)보다 큰 AI를 가지는 경우를 저혈류로 정의하였다. 결과: 환자군에서 측정된 소뇌와 대뇌 피질의 평균 AI는 대조군과 비교하여 통계학적으로 의미 있게 큰 수치를 보였다 (p<0.05): 소뇌 ($18.68{\pm}8.94$ vs $4.35{\pm}0.94$, 평균 표준표차), 시상 ($31.91{\pm}10.61$ vs $2.51{\pm}1.45$), 기저핵 ($35.94{\pm}16.15$ vs $4.34{\pm}2.08$), 두정엽 ($18.94{\pm}10.69$ vs $3.24{\pm}0.87$), 전두엽 ($13.60{\pm}10.8$ vs $4.02{\pm}2.04$), 측두엽 ($18.92{\pm}11.95$ vs $5.13{\pm}1.69$). 12명의 환자 중 혈종의 반대측 소뇌(10명), 동측 시상 (12명) 동측 두정엽 (12명), 전두엽 (6명), 측두엽 (10명)에서 육안적으로 또한 AI를 이용한 반정량적 분석상 의미 있는 저혈류를 보였다. 결론: 교차소뇌해리 현상과 피질 해리 현상은 기저핵 혈종 환자에서 빈번하게 관찰되었다. 이는 교차 소뇌해리 현상이 기존에 알려진 피질 뇌교 소뇌로 (corticopontocerebellar tract)의 장애가 없이도 발생할 수 있다는 것을 시사한다.

• 한국의학물리학회지:의학물리
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• 제19권4호
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• pp.256-262
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• 2008

자기공명분광법(magnetic resonance spectroscopy: MRS)은 인체내 대사물질을 정량분석하여 병변의 조기진단 및 정밀진단에 도움을 주고 있으며, 최근 임상에 이용되고 있는 자기공명분광법은 single voxel spectroscopy (SVS) 기법과 multi voxel spectroscopy (MVS) 기법이 있다. 본 연구에서는 SENSE와 NEX를 변화시킨 multi voxel spectroscopy (MVS)의 데이터와 기존 single voxel spectroscopy (SVS)의 데이터를 비교 분석하여, 각각의 데이터의 유의성 차이를 평가하고자 하였다. 정상 성인 지원자 13명(남자: 5명, 여자: 8명, 평균 41세, 표준편차 11.65세)을 대상으로 chemical shift image (CSI)를 이용한 MVS검사를 시행하였다. 장비는 3.0T Achieva Release Version 2.1 (Philips Medical System, Netherland)을 이용하였고, 8 channel head coil을 사용하여 brain thalamus 부위에서 CSI spectrum을 1 slice 획득하였다. Scan parameter로는 FOV (field of view): $230{\times}184mm^2$, TR (time to repetition): 2000 msec, TE (time to echo): 288 msec, matrix: $15{\times}12$, VOI(view of interest): $110{\times}110mm^2$, voxel size: $15{\times}15{\times}15mm^3$로 하였다. SENSE factor (S)와 NEX (N)는 S1*N1, S2*N1, S2*N2, S3*N2로 변화하여 스펙트럼을 획득하였고, 각 scan time은 5분 54초, 3분 32초, 6분 20초, 4분 20초였다. 얻은 모든 MRS 데이터는 jMRUI 3.0 Version 프로그램에서 분석하였고, SENSE factor와 NEX를 변화시켜 얻은 MVS data 그룹들이 정상 성인 뇌 대사물질의 변화에 영향을 주는지 검증하기 위해 그룹 간에 ANOVA분석을 실행하여 P 값이 0.05보다 크게 나오면 그룹들 사이에 유의한 차이가 없다고 분석하였다. NAA/Cr과 Cho/Cr의 상대적 비율은 MV와 SVS사이에서는 유의한 차이가 없었다. 즉, SENSE factor와 NEX를 변화시켜 얻은 MVS data에서 정상 성인 뇌조직의 대사물질의 변화를 관찰한 결과, S1*N1의 NAA/Cr은 $1.45{\pm}0.03$, Cho/Cr은 $0.88{\pm}0.03$이고, S2*N1의 NAA/Cr은 $1.44{\pm}0.03$, Cho/Cr은 $0.87{\pm}0.05$, S2*N2의 NAA/Cr은 $1.43{\pm}0.02$, Cho/Cr은 $0.87{\pm}0.04$이며, S3*N2의 NAA/Cr은 $1.45{\pm}0.03$, Cho/Cr은 $0.87{\pm}0.03$으로 나타났다(F-value : 1.37, D.F : 3, P-value : 0.262). 그러나 데이터의 질을 측정하기 위한 MVS 데이터의 NAA Peak line-width는 SVS 데이터의 NAA Peak line-width 보다 약 3배 정도 넓었다. 본 연구에서는 MVS에서 SENSE factor와 NEX 값을 다양하게 변화시킨 MVS의 데이터와 SVS의 데이터가 큰 차이가 없음을 확인하였다. 즉, 어는 특정 부위의 뇌 조직의 대사물질은 MVS와 SVS 기법 모두 큰 차이가 없음을 확인할 수 있었다. 그러므로 MVS는 SVS보다 광범한 부위를 짧은 시간 안에 검사할 수 있으므로 매우 유용한 방법이라고 사료된다.

• Applied Microscopy
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• 제24권4호
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• pp.61-77
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• 1994

The calcium-binding proteins (CaBP), parvalbumin (PV) and calbindin-D 28K (calbindin) are particularly abundant and specific in their distribution, and present in different subsets of neurons in many brain regions. Although their physiological roles in the neurons have not been elucidated, they are valuable markers of neuronal subpopulations for anatomical and developmental studies. This study is designed to characterize dorsal lateral geniculate nucleus (dLGN) neurons and axon terminals in terms of differential expression of immunoreactivity (IR) for two well-known CaBPs, PV and calbindin. The experiments were carried out on 6 adult monkeys. Monkeys were perfused under deep Nembutal anesthesia with 2% paraformaldehyde and 0.2% glutaraldehyde in 0.1M phosphate buffer. After removal, the brains were postfixed for 6-8 hr in 2% paraformaldehyde at $4^{\circ}C$ and infiltrated with 30% sucrose at $4^{\circ}C$. Thereafter, they were frozen in dry ice. Serial sections of the thalamus, at $20{\mu}m$, were made in the frontal plane with a sliding microtome. The sections were stained for PV and calbindin with indirect immunocytochemical methods. For electron microscopy, after infiltration with 30% sucrose the blocks of thalamus were serially sectioned at $50{\mu}m$ with a Vibratome in the coronal plane and stained immediately by indirect ABC methods without Triton X-100 in incubation medium. Stained sections were postfixed in 0.2% osmium tetroxide, dehydrated and flat-embedded in Spurr resin. The block was then trimmed to contain only a selected lamina or interlaminar space. The dLGN proper showed strong PV IR in fibers in all laminae and interlaminar zones. Particularly dense staining was noted in layers 1 and 2 that contain many stained fibers from optic tract. Neuronal cell body stained with PV was concentrated only in the laminae. In these laminae staining was moderate in cell bodies of all large and medium-sized neurons, and was strong in cell bodies of some small neurons together with their processes. Calbindin IR was marked in the neuronal cell body and neuropil in the S layers and interlaminar zones whereas moderate in the neuropil throughout the nucleus. Regional difference in distribution of PV and calbindin IR cell is distinct; the former is only in the laminae and the latter in both the S layer and interlaminar space. The CaBP-IR elements were confined to about $10{\mu}m$ in depth of Vibratome section. The IR product for CaBP was mainly associated with synaptic vesicle, pre- and post-synaptic membrane, and outer mitochondrial membrane and along microtubule. PV-IR was noted in various neuronal elements such as neuronal soma, dendrite, RLP, F, PSD and some myelinated or unmyelinated axons, and was not seen in the RSD and glial cells. Only a few neuronal components in dLGN was IR for calbindin and its reaction product was less dense than that of PV, and scattered throughout cytoplasm of soma of some relay neurons, and was also persent in some dendrite, myelinated axons and RLP. The RSD, F, PSD and glial elements were always non-IR for calbindin. Calbindin labelled RLP were presynaptic to unlabeled dendrite or dendritic spine and PSD. Calbindin-labeled dendrite of various sizes were always postsynaptic to unlabeled RSD, RLP or F. From this study it is suggested that dLGN cells of different functional systems and their differential projection to the visual cortex can be distinguished by differential expression of PV and calbindin.

• 한국의학물리학회지:의학물리
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• 제14권2호
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• pp.108-123
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• 2003

IPD와 MSA, PSP환자를 SPM2를 이용하여 정상인과 환자그룹간 비교를 시행하여 국소 뇌 당대사의 분포에 대한 통계적 뇌 지도를 구현하고, 이 통계적 뇌 지도를 기본 패턴으로 하여 IPD와 APD를 분류하는데 유용하게 활용하고, SPM 방법으로 진단하였을 때의 민감도와 특이도를 알아보고자 한다 $^{18}$ F-FDG PET 영상에서 24명의 Parkinsonism 환자를 신경과 분류에 의해 IPD, MSA, PSP 환자로 구분하여 뇌 신경계질환에 대한 병력이 없는 같은 연령 대 22명의 정상인과 비교하고 환자 그룹 간 비교를 시행하여 SPM 방법과 육안 판독으로 분석하고 대사저하 부위를 통계적 뇌 지도로 구현하여 국소화하였다. 18F-FDG PET에서 IPD로 진단된 8명의 환자를 동일한 PET 표준공간으로 이동하여 정상인과 비교한 결과 전두엽에서 75% (8명중 6명), 두정엽에서 38% (8명중 3명), 측두엽에서 50% (8명중 4명)가 감소한 패턴을 보였고, MSA로 진단된 9명의 환자는 미상핵 보다 조가비핵에서 44% (9명중 4명), 뇌교(pons)에서 56% (9명중 5명)가 감소한 패턴을 보였고 전두엽에서 56% (9명중 5명), 두정엽과 측두엽에서 33% (9명중 3명), 소뇌에서 44% (9명중 4명)가 감소한 패턴을 보였다. PSP에서는 선조체와 전두엽에서 57% (7명중 4명), 측두엽에서 29% (7명중 2명), 두정엽에서 14% (7명중 1명)가 SPM으로 분석한 결과 뇌 당대사가 줄어든 패턴을 보였다. 조가비핵(Z=3.5), 뇌교(Z=3.3) 그리고 소뇌(Z=3.2)에서 IPD보다 MSA에서 감소된 뇌 패턴을 보여 MSA와 IPD를 구별할 수 있는 요인으로 결정할 수 있었고 대상회(Z=2.7), 조가비핵(Z=3.3), 시상(Z=3.9) 그리고 중뇌(Z=2,6)가 IPD 보다 PSP에서 감소된 패턴을 보여 PSP와 IPD를 구별할 수 있는 요인으로 결정할 수 있었다. SPM2를 이용하여 분석한 결과 IPD에서는 민감도 75%, 특이도 100%, MSA에서는 민감도 100%, 특이도 75%, PSP에서 민감도 86%, 특이도 94%로 $^{18}$ F-FDG PET에서 통계적 뇌 지도를 기본 패턴으로 IPD와 APD를 분류하는데 SPM 방법이 유용한 결과를 보였다.