• Title/Summary/Keyword: White Matter

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DENTAL TREATMENT IN A PATIENT WITH METACHROMATIC LEUKODYSTROPHY UNDER GENERAL ANESTHESIA : A CASE REPORT (이염성 백질 이영양증 환아의 치아우식 치료 증례 보고)

  • Ryu, Jiyeon;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Young Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Kim, Chong-Chul;Lee, Sang-Hoon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.2
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    • pp.96-100
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    • 2016
  • Metachromatic leukodystrophy (MLD) is a progressive and degenerative neurological disease caused by a deficiency of the catabolic enzyme arylsulfatase A. Deficiency of arylsulfatase A results in accumulation of sulfatide in the white matter of the peripheral and central nervous system and it occurs demyelination as a result. The patient gradually goes through mental and motor failure. General symptoms of MLD include gait disturbance, mental deterioration, muscle rigidity and impaired swallowing. Inheritance of the disease is autosomal recessive. We report a dental caries treatment of a 3-year old boy with MLD. The patient underwent hematopoietic stem cell transplantation (HSCT) to slow the progression of the disease. He was suffered from difficulties of mastication and swallowing from the degenerative neurological symptom. He was ingesting food by both oral feeding and tubal feeding after he took percutaneous endoscopic gastrostomy (PEG). The cause of multiple caries was mainly presumed as patient's prolonged time of meal. The treatment was performed under general anesthesia considering patient's incompliance. Severely affected lower primary molars were treated with pulp treatment and restored with stainless steel crown. Others were restored with composite resin. There were no postoperative complications. MLD is life threatening progressive disease and also has an impact on unfavorable condition for oral health. Routine home oral care and periodic professional dental care should be emphasized to the caregiver of patient considering the susceptibility of dental caries. Not only the medical care, but periodic dental office visit would benefit the quality of life of the patient.

The Noise Performance of Diffusion Tensor Image with Different Gradient Schemes (확산 텐서 영상에서 확산 경사자장의 방향수에 따른 잡음 분석)

  • Lee Young-Joo;Chang Yongmin;Kim Yong-Sun
    • Journal of Biomedical Engineering Research
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    • v.25 no.6
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    • pp.439-445
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    • 2004
  • Diffusion tensor image(DTI) exploits the random diffusional motion of water molecules. This method is useful for the characterization of the architecture of tissues. In some tissues, such as muscle or cerebral white matter, cellular arrangement shows a strongly preferred direction of water diffusion, i.e., the diffusion is anisotropic. The degree of anisotropy is often represented using diffusion anisotropy indices (relative anisotropy(RA), fractional anisotropy(FA), volume ratio(VR)). In this study, FA images were obtained using different gradient schemes(N=6, 11, 23, 35. 47). Mean values and the standard deviations of FA were then measured at several anatomic locations for each scheme. The results showed that both mean values and the standard deviations of FA were decreased as the number of gradient directions were increased. Also, the standard error of ADC measurement decreased as the number of diffusion gradient directions increased. In conclusion, different gradient schemes showed a significantly different noise performance and the schem with more gradient directions clearly improved the quality of the FA images. But considering acquisition time of image and standard deviation of FA, 23 gradient directions is clinically optimal.

The Clinical Usefulness of Tc-99m ECD Brain SPECT in Acute Measles Encephalitis (홍역 후 발생된 급성 뇌염 진단시 Tc-99m ECD 뇌혈류 SPECT의 임상적 유용성)

  • Lim, Seok-Tae;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.229-234
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    • 2003
  • Purpose: Since the prognosis of measles encephalitis is poor, early diagnosis and proper management are very important to improve clinical outcomes. We compared Tc-99m ECD brain SPECT (SPECT) with MR imaging (MRI) for the detection of acute measles encephalitis. Materials and Methods: Eleven patients(M : F=4 : 7, age range 18 months-14 yrs) with acute measles encephalitis were enrolled in this studies. All of them underwent both MRI and SPECT. The results of SPECT were scored from 0 (normal) to 3 (most severe defect) according to perfusion state. We compared two image modalities for the detection of brain abnormality in acute measles encephalitis. Results: Seven of 11 patients (63.6%) revealed high signal intensity in the white matter on T2WI of MRI, on the other hand all patients (100%) showed hypoperfusion on SPECT. Severe perfusion deficits above score 2 were located with decreasing frequencies in the frontal lobe (81.8%), temporal lobe (72.7%), occipital lobe (27.3%), basal ganglia (27.3%), and parietal lobe (9.1%). Conclusion: We conclude that SPECT is more useful than MRI for the detection of brain involvement in patients with acute measles encephalitis.

Toxic Optic Neuropathy Caused by Chlorfenapyr Poisoning (클로르페나피르 음독 후 발생한 독성 시신경병증 1예)

  • Park, Su Jin;Jung, Jae Uk;Kang, Yong Koo;Chun, Bo Young;Son, Byeong Jae
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1097-1102
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    • 2018
  • Purpose: To report a case of toxic optic neuropathy caused by chlorfenapyr ingestion accompanied by central nervous system involvement. Case summary: A 44-year-old female visited our clinic complaining of reduced visual acuity in both eyes for 7 days. She had ingested a mouthful of chlorfenapyr for a suicide attempt 2 weeks prior to the visit. Gastric lavage was performed immediately after ingestion at the other hospital. Her best-corrected visual acuity was finger count 30 cm in the right eye and hand motion in the left eye. Both pupils were dilated by 5.0 mm and the response to light was sluggish in both eyes. A relative afferent pupillary defect was detected in her left eye. Funduscopy revealed optic disc swelling in both eyes. Magnetic resonance imaging of the brain showed a symmetric hyper-intense signal in the white matter tract including the internal capsule, corpus callosum, middle cerebellar peduncle, and brainstem. The patient was diagnosed with toxic optic neuropathy induced by chlorfenapyr ingestion, and underwent high-dose intravenous corticosteroid pulse therapy. Three days later, the best-corrected visual acuity was no light perception in both eyes. Three months later, optic atrophy was observed in both eyes. Optical coherence tomography revealed a reduction in the thicknesses of the retinal nerve fiber layer and ganglion cell and inner plexiform layer in the macular area. Conclusions: Ingestion of even a small amount of chlorfenapyr can cause severe optic nerve damage through the latent period, despite prompt lavage and high-dose steroid treatment.

Comparison of Fornix and Stria Terminalis Connectivity among First-Episode Schizophrenia, Chronic Schizophrenia and Healthy Controls (초발 조현병, 만성 조현병과 건강 대조군의 뇌활과 분계섬유줄 연결성 비교)

  • Lee, Arira;Yun, Mirim;Yook, Ki Hwan;Choi, Tai Kiu;Lee, Kang Soo;Bang, Minji;Lee, Sang-Hyuk
    • Korean Journal of Biological Psychiatry
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    • v.26 no.1
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    • pp.8-13
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    • 2019
  • Objectives Disrupted integrities of the fornix and stria terminalis have been suggested in schizophrenia. However, very few studies have focused on the fornix and stria terminalis comparing first-episode schizophrenia (FESZ), chronic schizophrenia (CS), and healthy controls (HCs) with the application of diffusion-tensor imaging (DTI) technique. The objective of this study is to compare the connectivity of the fornix and stria terminalis among FESZ, CS, and HCs. Methods We included the 44 FESZ patients, 39 CS patients and 20 HCs in this study. Voxel-wise statistical analysis of the fractional anisotropy (FA) data was performed using Tract-Based Spatial Statistics to analyze the connectivity of fornix and stria terminalis. In addition, the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) were used to evaluate clinical symptom severities. Results There were no significant differences between the FESZ, CS, and HCs in age, sex, education years. The SAPS and SANS scores of the schizophrenia groups showed no significant differences. FA values of the right fornix cres/stria terminalis in the CS group were significantly lower than those in FESZ and HCs. There were no significant differences of FA values of the right fornix cres/stria terminalis between the FESZ and the HCs. Pearson correlation analyses revealed that significant correlation between FA values of the right fornix cres/stria terminalies of the the FESZ group and positive, negative symptom scales, and FA values of the right fornix cres/stria terminalis of the CS group and negative symptom scales. Conclusions This study shows that FA values of the fornix and stria terminalis in the CS were lower than in the FESZ and the HCs. These results suggest that the fornix and stria terminalis can play a role in pathophysiology of schizophrenia. Thus current study can broaden our understanding of the pathophysiology of schizophrenia.

The co-injection of antioxidants with foot-and-mouth disease vaccination altered growth performance and blood parameters of finishing Holstein steers

  • Seo, Jakyeom;Song, Minho;Jo, Namchul;Kim, Woonsu;Jeong, Sinyong;Kim, Jongnam;Lee, Seyoung;Seo, Seongwon
    • Asian-Australasian Journal of Animal Sciences
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    • v.32 no.6
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    • pp.792-799
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    • 2019
  • Objective: This study was conducted to evaluate whether the co-injection of antioxidants together with foot-and-mouth disease (FMD) vaccination has the potential to attenuate the negative effects caused by vaccination in Holstein finishing steers. Methods: A total of 36 finishing Holstein steers (body weight [BW]: $608{\pm}45.6kg$, 17 months old) were randomly allocated to one of three treatments: i) control (CON, only FMD vaccination without any co-injection), ii) co-injection of commercial non-steroidal anti-inflammatory drugs (NSAID) with FMD vaccination at a ratio of 10:1 (NSAID vol/FMD vaccine vol) as a positive control (PCON), iii) co-injection of commercial mixture of vitamin E and selenium with FMD vaccination (VITESEL) (1 mL of FMD vaccine+1 mL of antioxidants per 90 kg of BW). Changes in growth performance and blood parameters because of treatments were determined. Results: No significant difference in BW, average daily gain, and dry matter intake of the steers was observed among the treatments. The FMD vaccination significantly increased white blood cells (WBC), neutrophils, platelets, and mean platelet volume (p<0.01) in blood analysis. The count of lymphocyte tended to increase after vaccination (p = 0.08). In blood analysis, steers in VITESEL tended to have higher numbers of WBC, neutrophils, and platelets compared to that of other treatments (p = 0.09, 0.06, and 0.09, respectively). Eosinophils in VITESEL were higher than those in PCON (p<0.01). Among blood metabolites, blood urea nitrogen and aspartate transaminase were significantly increased, but cholesterol, alanine transferase, inorganic phosphorus, Mg, and albumin were decreased after FMD vaccination (p<0.01). Conclusion: The use of antioxidants in FMD vaccination did not attenuate growth disturbance because of FMD vaccination. The metabolic changes induced by vaccination were not controlled by the administration of antioxidants. The protective function of antioxidants was effective mainly on the cell counts of leukocytes.

Localization of Bilateral Hemisphere Lesion Using Combined Transcranial Magnetic Stimulation and Diffusion Tensor Imaging: Report of Two Cases (경두개 자기자극과 확산텐서 신경섬유로 검사를 통한 대뇌 병변의 국소화: 증례보고)

  • Lee, Hyung Nam;Oh, Young-Bin;Kim, Gi-Wook;Won, Yu Hui;Ko, Myoung-Hwan;Seo, Jeong-Hwan;Park, Sung-Hee
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.106-111
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    • 2018
  • Transcranial magnetic stimulation (TMS) has been a gold standard for investigating central motor pathways in humans. Diffusion tensor imaging with fiber tractography (DTI FT) is known for its usefulness in detecting white matter lesion in vivo. We investigated the clinical usefulness of elucidating the integrity and continuity of corticospinal tract (CST) by combined use of TMS and DTI FT in this study. We report two cases who have presented with left hemiparesis and evaluated by both TMS and DTI FT; 10-year-old boy with Mitochondrial Encephalomyopathy with Lactic Acidosis and Stroke-like episode syndrome and 20-year-old woman with traumatic brain injury. Combined use of TMS and DTI FT successfully led to localize the brain lesion that might cause motor impairment in patients with abnormal signal intensities in MRI. The results of this study suggest that TMS and DTI FT might provide the detailed information between function and anatomy of the CST, complementarily.

Effects of dietary L-glutamine and glutamic acid combination, and whey powder on the performance and nutrient digestion in weaned piglets fed grain-based diets

  • Almeida, Jonathan Madson dos Santos;Pascoal, Leonardo Augusto Fonseca;de Almeida, Jorge Luiz Santos;Guerra, Ricardo Romao;da Silva, Jose Humberto Vilar;da Silva, David Rwbystanne Pereira;Neto, Manoel Rosa Silva;Martins, Terezinha Domiciano Dantas
    • Animal Bioscience
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    • v.34 no.12
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    • pp.1963-1973
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    • 2021
  • Objective: The present study aimed to evaluate the influence of including L-glutamine along with glutamic acid as a supplement in weaned piglets' diets with and without whey powder. Methods: Two assays were carried out. A total of 40 piglets ([Landrace×Large White]×Pietrain) weaned at 24 days of age with an initial body weight of 6.6±0.6 kg were used in the first assay, and the following parameters were evaluated: growth performance, the incidence of diarrhea, morphometry, intestinal integrity, and hepatic glycogen index. The animals were then blocked into four groups according to different diets: diet all-grain feeding (G); diet all-grain feeding with whey powder (GW); and with vs without 1% supplementation of the commercial product containing L-glutamine and glutamic acid (A or NA). Whey powder was added according to the stage of life, corresponding to 17%, 10%, and 5%, respectively, in order to meet the need for lactose. The animals were evaluated at 24 to 42 days and at 24 to 55 days of age. The nutrient digestibility for the second assay was carried out by using 24 animals with an average weight of 11.49±1.6 kg, and the same diets were tested. Results: The supplementation of L-glutamine + glutamic acid or the addition of whey powder in diets for weaned piglets provided (p<0.05) greater feed intake, greater weight gain and improved feed conversion in the initial period (24 to 42 days age). However, in the whole period (24 to 55 days age) only amino acid supplementation affected (p<0.05) growth performance. There was a positive interaction (p<0.05) between the type of diet and L-glutamine + glutamic acid supplementation on villus height, crypt depth and the villus:crypt ratio in the duodenum. In addition, L-glutamine + glutamic acid supplementation reduced (p<0.05) the crypt depth and improved the villus:crypt ratio in the jejunum. The inclusion of whey powder affected (p<0.05) positively the digestibility coefficients analyzed except mineral matter digestibility coeficients. The supplementation of 1% the commercial product composed of L-glutamine and glutamic acid improved (p<0.05) only the digestibility coefficient of crude protein. Conclusion: These results indicate that supplementation of 1% commercial product containing L-glutamine + glutamic acid in diets for piglets from 24 to 55 days of age, dispenses with the use of whey powder when evaluating growth performance. Amino acid supplementation alone or associated with whey powder affects (p<0.05) positively the indicators of the intestinal integrity.

Reduced Volume of a Brainstem Substructure in Adolescents with Problematic Smartphone Use

  • Cho, In Hee;Yoo, Jae Hyun;Chun, Ji-Won;Cho, Hyun;Kim, Jin-Young;Choi, Jihye;Kim, Dai-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.32 no.4
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    • pp.137-143
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    • 2021
  • Objectives: Despite the growing concern regarding the adverse effects related to problematic smartphone use (PSU), little is known about underlying morphologic changes in the brain. The brainstem is a deep brain structure that consists of several important nuclei associated with emotions, sensations, and motor functions. In this study, we sought to examine the difference in the volume of brainstem substructures among adolescents with and without PSU. Methods: A total of 87 Korean adolescents participated in this study. The PSU group (n=20, age=16.2±1.1, female:male=12:8) was designated if participants reported a total Smartphone Addiction Proneness Scale (SAPS) score of ≥42, whereas the remaining participants were assigned to the control group (n=67, age=15.3±1.7, female:male=19:48). High-resolution T1 magnetic resonance imaging was performed, and the volume of each of the four brainstem substructures [midbrain, pons, medulla, and superior cerebellar peduncle (SCP)] was measured. Analysis of covariance was conducted to reveal group differences after adjusting for effects of age, gender, whole brainstem volume, depressive symptoms, and impulsivity. Results: The PSU group showed a significantly smaller volume of the SCP than the control group (F=8.273, p=0.005). The volume of the SCP and the SAPS score were negatively correlated (Pearson's r=-0.218, p=0.047). Conclusion: The present study is the first to reveal an altered volume of the brainstem substructure among adolescents with PSU. This finding suggests that the altered white matter structure in the brainstem could be one of the neurobiological mechanisms underlying behavioral changes in PSU.

Changes in Physical Properties and Wood Chemical Components of sawdust medium during Oak Mushroom (Lentinula edodes) Cultivation (표고 재배 중 톱밥 배지의 물리적 성질과 목재 화학성분 변화)

  • Jong-Shin Lee;Seog-Goo Kang;Seung-Min Yang;Jin-Kyoung Kim
    • The Korean Journal of Mycology
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    • v.50 no.4
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    • pp.291-300
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    • 2022
  • In this study, the physical properties of the medium and changes in the wood chemical composition of the sawdust were investigated during the cultivation of oak mushroom sawdust bags, and the following results were obtained. After inoculation, the weight of the medium decreased during the incubation period. It is determined that this is not due to evaporation of moisture containing the medium or decomposition of sawdust, but to decomposition of rice bran, a low molecular substance added to the medium. It was confirmed that the moisture content of the medium was steadily increased during incubation, and it was estimated that the organic substrates such as rice brane in the medium was decomposed by mycelium, and water, one of the decomposition products of organic substrates, caused an increase in the moisture content of the medium. Along with the increase in the harvest of oak mushrooms, the proportion of organic substances such as holocellulose and lignin, the main components of the wood cell wall of sawdust, steadily decreased. In particular, the degradation characteristics of the wood cell wall component of shiitake, which is a white rot fungi, were confirmed by higher lignin reduction rate than that of holocellulose. On the other hand, ash, which is an inorganic material, increased with an increase in the number of mushroom harvests. The increase in the amount of ash in the medium may have been due to the decrease in the organic matter content such as holocellulose and lignin.