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Tc-99m ECD Brain SPECT in MELAS Syndrome and Mitochondrial Myopathy: Comparison with MR findings (MELAS 증후군과 미토콘드리아 근육병에서의 Tc-99m ECD 뇌단일 광전자방출 전산화단층촬영 소견: 자기공명영상과의 비교)

  • Park, Sang-Joon;Ryu, Young-Hoon;Jeon, Tae-Joo;Kim, Jai-Keun;Nam, Ji-Eun;Yoon, Pyeong-Ho;Yoon, Choon-Sik;Lee, Jong-Doo
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.6
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    • pp.490-496
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    • 1998
  • Purpose: We evaluated brain perfusion SPECT findings of MELAS syndrome and mitochondrial myopathy in correlation with MR imaging in search of specific imaging features. Materials and Methods: Subjects were five patients (four females and one male; age range, 1 to 25 year) who presented with repeated stroke-like episodes, seizures or developmental delay or asymptomatic but had elevated lactic acid in CSF and serum. Conventional non-contrast MR imaging and Tc-99m-ethyl cysteinate dimer (ECD) brain perfusion SPECT were Performed and imaging features were analyzed. Results: MRI demonstrated increased T2 signal intensities in the affected areas of gray and white matters mainly in the parietal (4/5) and occipital lobes (4/5) and in the basal ganglia (1/5), which were not restricted to a specific vascular territory. SPECT demonstrated decreased perfusion in the corresponding regions of MRI lesions. In addition, there were perfusion defects in parietal (1 patient), temporal (2), and frontal (1) lobes and basal ganglia (1) and thalami (2). In a patient with mitochondrial myopathy who had normal MRI, decreased perfusion was noted in left parietal area and bilateral thalami. Conclusion: Tc-99m ECD SPECT imaging in patients with MELAS syndrome and mitochondrial myopathy showed hypoperfusion of parieto-occipital cortex, basal ganglia, thalamus and temporal cortex, which were not restricted to a specific vascular territory. There were no specific imaging features on SPECT. The significance of abnormal perfusion on SPECT without corresponding MR abnormalities needs to be evaluated further in larger number of patients.

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A Study on Jeong Su-yeong's Handscroll of a Sightseeing Trip to the Hangang and Imjingang Rivers through the Lens of Boating and Mountain Outings (선유(船遊)와 유산(遊山)으로 본 정수영(鄭遂榮)의 《한임강유람도권》 고찰)

  • Hahn, Sangyun
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.96
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    • pp.89-122
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    • 2019
  • In this paper, I argue that the Handscroll of a Sightseeing Trip to the Hangang and Imjingang Rivers by Jeong Su-yeong (1743~1831, pseudonym: Jiwujae) is a record of his private journeys to several places on the outskirts of Hanyang (present-day Seoul) and that it successfully embodies the painter's subjective perspective while boating on these rivers and going on outings to nearby mountains. Around 1796, Jeong Su-yeong traveled to different places and documented his travels in this 16-meter-long handscroll. Several leaves of paper, each of which depicts a separate landscape, are pieced together to create this long handscroll. This indicates that the Handscroll of a Sightseeing Trip to the Hangang and Imjingang Rivers reflected the painter's personal subjective experiences as he went along his journey rather than simply depicts travel destinations. The Handscroll of a Sightseeing Trip to the Hangang and Imjingang Rivers features two types of travel: boating and mountain outings on foot. Traveling by boat takes up a large portion of the handscroll, which illustrates the channels of the Hangang and Imjingang Rivers. Mountain outings correspond to the sections describing the regions around Bukhansan, Gwanaksan, and Dobongsan Mountains. Jeong Su-yeong traveled to this wide span of places not just once, but several times. The fact that the Hangang River system are not presented in accordance with their actual locations shows that they were illustrated at different points. After visiting the riversides of the Hangang and Namhangang Rivers twice, Jeong Su-yeong delineated them in fourteen scenes. Among them, the first eight illustrate Jeong's initial trip by boat, while the other six scenes are vistas from his second trip. These fourteen scenes occupy half of this handscroll, indicating that the regions near the Hangang River are painted most frequently. The scenes of Jeong Su-yeong's first boating trip to the system of the Hangang River portray the landscapes that he personally witnessed rather than famous scenes. Some of the eight scenic views of Yeoju, including Yongmunsan Mountain, Cheongsimru Pavilion, and Silleuksa Temple, are included in this handscroll. However, Jeong noted spots that were not often painted and depicted them using an eye-level perspective uncommon for illustrating famous scenic locations. The scenes of Jeong's second boating trip include his friend's villa and a meeting with companions. Moreover, Cheongsimru Pavilion and Silleuksa Temple, which are depicted in the first boating trip, are illustrated again from different perspectives and in unique compositions. Jeong Su-yeong examined the same locations several times from different angles. A sense of realism is demonstrated in the scenes of Jeong's first and second boating trips to the channels of the Hangang River, which depict actual roads. Furthermore, viewers can easily follow the level gaze of Jeong from the boat. The scenes depicting the Imjingang River begin from spots near the Yeongpyeongcheon and Hantangang Rivers and end with places along the waterways of the Imjingang River. Here, diverse perspectives were applied, which is characteristic of Imjingang River scenes. Jeong Su-yeong employed a bird's-eye perspective to illustrate the flow of a waterway starting from the Yeongpyeongcheon River. He also used an eye-level perspective to highlight the rocks of Baegundam Pool. Thus, depending on what he wished to emphasize, Jeong applied different perspectives. Hwajeogyeon Pond located by the Hantangang River is illustrated from a bird's-eye perspective to present a panoramic view of the surroundings and rocks. Similarly, the scenery around Uhwajeong Pavilion by the Imjingang River are depicted from the same perspective. A worm's-eye view was selected for Samseongdae Cliff in Tosangun in the upper regions of the Imjingang River and for Nakhwaam Rock. The scenes of Jeong Su-yeong's mountain outings include pavilions and small temple mainly. In the case of Jaeganjeong Pavilion on Bukhansan Mountain, its actual location remains unidentified since the pavilion did not lead to the route of the boating trip to the system of the Hangang River and was separately depicted from other trips to the mountains. I speculate that Jaeganjeong Pavilion refers to a pavilion either in one of the nine valleys in Wooyi-dong at the foot of Bukhansan Mountain or in Songajang Villa. Since these two pavilions are situated in the valleys of Bukhansan Mountain, their descriptions in written texts are similar. As for Gwanaksan Mountain, Chwihyangjeong and Ilganjeong Pavilions as well as Geomjisan Mountain in the Bukhansan Mountain range are depicted. Ilganjeong Pavilion was a well-known site on Gwanaksan that belonged to Shin Wi. In this handscroll, however, Jeong Su-yeong recorded objective geographic information on the pavilion rather than relating it to Shin Wi. "Chwihyangjeong Pavilion" is presented within the walls, while "Geomjisan Mountain" is illustrated outside the walls. Handscroll of a Sightseeing Trip to the Hangang and Imjingang Rivers also includes two small temples, Mangwolam and Okcheonam, on Dobongsan Mountain. The actual locations of these are unknown today. Nevertheless, Gungojip (Anthology of Gungo) by Yim Cheonsang relates that they were sited on Dobongsan Mountain. Compared to other painters who stressed Dobong Seowon (a private Confucian academy) and Manjangbong Peak when depicting Dobongsan Mountain, Jeong Su-yeong highlighted these two small temples. Jeong placed Yeongsanjeon Hall and Cheonbong Stele in "Mangwolam small temple" and Daeungjeon Hall in front of "Okcheonam small temple." In addition to the buildings of the small temple, Jeong drew the peaks of Dobongsan Mountain without inscribing their names, which indicates that he intended the Dobongsan peaks as a background for the scenery. The Handscroll of a Sightseeing Trip to the Hangang and Imjingang Rivers is of great significance in that it embodies Jeong Su-yeong's personal perceptions of scenic spots on the outskirts of Hanyang and records his trips to these places.