• 대한핵의학회지
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• 제36권2호
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• pp.91-101
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• 2002

목적: 본 연구의 목적은 첫째, 알쯔하이머형 치매의 국소뇌혈류량이 일정 시간이 지난 후 감소되는 양상을 voxel based 분석을 통해 확인하고자 하였다. 둘째, 이들 환자에 있어서 두뇌 특정부위가 임상에서 흔하게 쓰이는 간이정신상태검사인 MMSE-K(Mini-Mental State Examination, Korean version)의 수행과 상관을 보이는 영역이 있는지 살펴보고자 하였다. 대상 및 방법: Tc-99m HMPAO SPECT를 이용해서 9명의 probable 알쯔하이머형 치매 환자군에게 평균 1.8년의 기간을 두고 각각 두 번의 영상(기저영상과 추적검사 영상)을 얻었고, 이를 각각 9명의 정상노인으로부터 얻은 영상과 비교 분석하였다. 각 영상은 공간정규화 이후 소뇌의 활성화에 따라 계수 정규화되었고, SPM99를 사용하여 voxel based 분석을 하였다. 결과: 대조군에 비하여 환자군에서 뇌혈류량의 감소를 보이는 영역이, 기저검사에서 주로 두정측두영역인데 비하여 추적검사시에는 전두엽 영역으로 확대되었다. MMSE-K 점수와 가장 높은 상관관계를 보이며 뇌혈류가 감소하는 영역은 기억의 부호화와 관련된다고 알려진 좌측 중/하전두엽과 중측두엽, 그리고 후대상회와 전설소엽이었다. 결론: probable 알쯔하이머형 치매 환자군에게 있어서 질병이 진전됨에 따라 변하는 뇌혈류 감소가 두정엽에서 전두엽을 포함하였다. 특히 좌측전두엽의 혈류량 감소는 MMSE-K로 측정된 인지기능 수행 저하와 유의미한 상관을 보임이 확인되었다. 본 연구는 SPM을 이용한 이러한 분석방법을 통하여 핵의학 영상을 알쯔하이머형 치매의 경과추적과 진단의 유용한 도구로 사용할 수 있음을 보인다.

• Journal of Chest Surgery
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• 제26권7호
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• pp.526-531
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• 1993

Sixty-one consecutive patients with coronary artery bypass graft for myocardial revascularization were retrospectively reviewed to analyze various pattern of postoperative complication and death during hospital stay from Nov. 1988 to Oct. 1992. Fortytwo of the patients were male and nineteen female. The mean age was 56 and 51 years in male and female. Preoperative diagnosises were unstable angina in 14 of patients, stable angina in 28, postmyocardial infarction state in 15, and state of failed percutaneous transluminal coronary angioplasty in 4. 141 stenosed coronary arteries were bypassed with use of 20 pedicled internal mammary artery and 124 reversed saphenous vein grafts. Postoperative complications and perioperative death were as follows: 1. Of 61 patients undergoing operation, peri and postoperative over all complication occured in 15 patients [ 25% ]; newly developed myocardial infarction in 4, intractable cardiac arrhythmia including atrial fibrillation and frequent ventricular premature contraction in 3, bleeding from gastrointestinal tract in 2, persistent vegetative state as a sequele of brain hypoxia in 1, wound necrosis in 1, left hemidiaphragmatic palsy in 3 and poor blood flow through graft in 2. 2. Operative mortality was 8%[5 patients]. 3 out of these died in operating room; 1 patient by bleeding from rupture of calcified aortic wall, 1 by air embolism through left atrial vent catheter, 1 by low cardiac output syndrome. 2 patients died during hospital stay; 1 by acute respiratory distress syndrome with multiuple organ failure, 1 by brain death after delayed diagnosis of pericardial tamponade.

• Journal of Korean Neurosurgical Society
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• 제62권2호
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• pp.136-143
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• 2019

Moyamoya disease (MMD) is a progressive cerebrovascular disease with unknown etiology, characterized by bilateral steno-occlusive changes at the terminal portion of the internal carotid artery and an abnormal vascular network formation at the base of the brain. MMD has an intrinsic nature to convert the vascular supply for the brain from internal carotid (IC) system to the external carotid (EC) system, as indicated by Suzuki's angiographic staging. Insufficiency of this 'IC-EC conversion system' could result not only in cerebral ischemia, but also in intracranial hemorrhage from inadequate collateral anastomosis, both of which represent the clinical manifestation of MMD. Surgical revascularization prevents cerebral ischemic attack by improving cerebral blood flow, and recent evidence further suggests that extracranial-intracranial bypass could powerfully reduce the risk of re-bleeding in MMD patients with posterior hemorrhage, who were known to have extremely high re-bleeding risk. Although the exact mechanism underlying the hemorrhagic presentation in MMD is undetermined, most recent angiographic analysis revealed the characteristic angio-architecture related to high re-bleeding risk, such as the extension and dilatation of choroidal collaterals and posterior cerebral artery involvement. We sought to update the current management strategy for hemorrhagic MMD, including the outcome of surgical revascularization for hemorrhagic MMD in our institute. Further investigations will clarify the optimal surgical strategy to prevent hemorrhagic manifestation in patients with MMD.

• The Korean Journal of Physiology and Pharmacology
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• 제21권6호
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• pp.643-650
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• 2017

Vascular dementia (VaD) is a group of heterogeneous diseases with the common feature of cerebral hypoperfusion. To identify key factors contributing to VaD pathophysiology, we performed a detailed comparison of Wistar and Sprague-Dawley (SD) rats subjected to permanent bilateral common carotid artery occlusion (BCCAo). Eight-week old male Wistar and SD rats underwent BCCAo, followed by a reference memory test using a five-radial arm maze with tactile cues. Continuous monitoring of cerebral blood flow (CBF) was performed with a laser Doppler perfusion imaging (LDPI) system. A separate cohort of animals was sacrificed for evaluation of the brain vasculature and white matter damage after BCCAo. We found reference memory impairment in Wistar rats, but not in SD rats. Moreover, our LDPI system revealed that Wistar rats had significant hypoperfusion in the brain region supplied by the posterior cerebral artery (PCA). Furthermore, Wistar rats showed more profound CBF reduction in the forebrain region than did SD rats. Post-mortem analysis of brain vasculature demonstrated greater PCA plasticity at all time points after BCCAo in Wistar rats. Finally, we confirmed white matter rarefaction that was only observed in Wistar rats. Our studies show a comprehensive and dynamic CBF status after BCCAo in Wistar rats in addition to severe PCA dolichoectasia, which correlated well with white matter lesion and memory decline.

• 한국산학기술학회논문지
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• 제10권10호
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• pp.2985-2989
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• 2009

본 논문에서는 학습집중력을 향상시킬 수 있는 시트를 제작하였다. 학습집중력의 향상을 입증하기위하여 인체 내에 존재하고 있는 조영제를 이용하여 공간적 시간적 해상도가 뛰어나고 비침습적으로 뇌기능을 측정할 수 있는 기능적 자기공명영상을 획득하여 분석을 한 결과 기억작용과 관련 있는 전두엽 부근의 뇌혈류량의 활성화를 확인할 수 있었고 뇌파 측정 분석 결과 절대알파파와 절대베타파의 비율에서 유의할 만한 변화를 확인하였다. 기능적 자기공명영상은 뇌의 생리기능적 역할을 규명, 의학적으로 수술 전후 장애를 방지하고 예방하는데 활용되고 있으며 뇌신경망의 가시화로 학습집중력 향상 시트등과 같이 뇌와 관련된 제품을 개발하는데 많은 연구가 이루어질 것이다.

• Korean Journal of Radiology
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• 제22권2호
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• pp.233-242
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• 2021

Objective: To evaluate the association of MRI features with the major genomic profiles and prognosis of World Health Organization grade III (G3) gliomas compared with those of glioblastomas (GBMs). Materials and Methods: We enrolled 76 G3 glioma and 155 GBM patients with pathologically confirmed disease who had pretreatment brain MRI and major genetic information of tumors. Qualitative and quantitative imaging features, including volumetrics and histogram parameters, such as normalized cerebral blood volume (nCBV), cerebral blood flow (nCBF), and apparent diffusion coefficient (nADC) were evaluated. The G3 gliomas were divided into three groups for the analysis: with this isocitrate dehydrogenase (IDH)-mutation, IDH mutation and a chromosome arm 1p/19q-codeleted (IDHmut1p/19qdel), IDH mutation, 1p/19q-nondeleted (IDHmut1p/19qnondel), and IDH wildtype (IDHwt). A prediction model for the genetic profiles of G3 gliomas was developed and validated on a separate cohort. Both the quantitative and qualitative imaging parameters and progression-free survival (PFS) of G3 gliomas were compared and survival analysis was performed. Moreover, the imaging parameters and PFS between IDHwt G3 gliomas and GBMs were compared. Results: IDHmut G3 gliomas showed a larger volume (p = 0.017), lower nCBF (p = 0.048), and higher nADC (p = 0.007) than IDHwt. Between the IDHmut tumors, IDHmut1p/19qdel G3 gliomas had higher nCBV (p = 0.024) and lower nADC (p = 0.002) than IDHmut1p/19qnondel G3 gliomas. Moreover, IDHmut1p/19qdel tumors had the best prognosis and IDHwt tumors had the worst prognosis among G3 gliomas (p < 0.001). PFS was significantly associated with the 95th percentile values of nCBV and nCBF in G3 gliomas. There was no significant difference in neither PFS nor imaging features between IDHwt G3 gliomas and IDHwt GBMs. Conclusion: We found significant differences in MRI features, including volumetrics, CBV, and ADC, in G3 gliomas, according to IDH mutation and 1p/19q codeletion status, which can be utilized for the prediction of genomic profiles and the prognosis of G3 glioma patients. The MRI signatures and prognosis of IDHwt G3 gliomas tend to follow those of IDHwt GBMs.

• 한국의학물리학회지:의학물리
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• 제15권1호
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• pp.45-53
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• 2004

통계적 파라미터를 이용한 뇌지도작성(SPM)은 어른에서부터 어린이에게까지 환자그룹간 또는 개개의 서로 다른 상태의 그룹간의 기능 영상을 비교하는데 널리 사용되고 있다. 그러나 SPM을 이용하여 어린이 뇌 영상을 분석할 경우 성인의 표준틀영상에 정규화되어 분석되고, 이로 인해 오차가 발생할 수 있다. 따라서 본 연구는 국내 어린이 2세에서 6세 사이 36명(평균 나이: 4.36세, 표준편차: 1.41세, 남자: 17명, 여자: 19명)의 MRI 영상을 이용하여 평균 MRI 영상을 만들고, 2세에서 6세 사이 13명의 어린이(평균나이: 4.80세, 표준편차: 1.17세, 남: 10명, 여: 3명)의 SPECT 뇌영상을 이용하여 평균 SPECT 영상을 만들었다. 이들 평균영상으로 국내어린이의 뇌 표준틀영상을 만들고, 어린이 ADHD의 뇌영상을 국내 어린이 표준틀영상과 SPM의 표준틀영상에 정규화 시켜 뇌혈류량에 따라 발생하는 화소덩어리의 위치를 비교하였다. 분석결과는 각 표준틀영상에 따라 최대 25 mm의 편차가 생겼다. 따라서 SPM을 이용한 어린이의 뇌영상을 분석할 경우 표준틀영상 또는 p값을 고려해야할 필요가 있다.

• 한국자기공명학회논문지
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• 제6권1호
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• pp.45-53
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• 2002

Objectives: This study investigated alterations in regional cerebral blood flow (rCBF) in patients with transient global amnesia (TGA) using statistical parametric mapping 99 (SPM99). Methods: Noninvasive rCBF measurements using 99mTc-ethyl cysteinate dimer (ECD) SPECT were performed on 8 patients with TGA who have ongoing symptoms and 17 age matched controls. The relative rCBF maps in patients with TGA and controls were compared. Results: In patients with TGA, significant decreased rCBF was found along the L superior temporal extending to L parietal region of the brain and L thalamus. There were areas of increased rCBF in the R temporal, R frontal region and R thalamus. Conclusion: We could demonstrate decreased perfusion in left cerebral hemisphere and increased perfusion in right cerebral hemisphere in patients with TGA using SPM99. The imbalanced change of rCBF between bilateral cerebral hemisphere in patients with TGA might suggest that imbalanced neuronal activity between the bilateral hemispheres may have strong relationship to the pathogenesis of the TGA. For quantitative SPECT analysis in TGA patients, we recommend SPM99 rather than the ROI method because of its definitive advantages.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 춘계학술대회
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• pp.92-94
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• 1997

By measuring the increase of regional cerebral blood flow (rCBF) during the activation tasks, we can describe the brain regions that participate in certain specific functions. In this study, we composed the functional maps of verbal and nonverbal memory by performing the rCBF positron emission tomography (PET) activation studies and analyzing the differences between control and each activation state. Successive four tasks, which consist of one control state and three different activation tasks, were performed on 6 normal volunteers. All images were spatially normalized on standard atlas and the differences between control and activation states were statistically analyzed. The verbal memory activated predominantly left-sided structures, especially left superior temporal cortex, and the nonverbal short-term memory activated the right frontal cortex. Also, some regions ,where is thought to be related with short-term memory system, such as cingulate gyrus and hippocampus were activated. We conclude that biological validity of the brain regions for verbal and nonverbal memory could be tested using rCBF PET imaging technique and statistical analysis.

• 한국임상수의학회지
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• 제36권2호
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• pp.116-118
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• 2019

A 2-year-old female Persian cat weighing 2.95 kg was admitted for dystocia. The levels of white blood cells and thrombocytes were decreased in blood analysis. In radiography and ultrasonography, there were four fetuses with no remarkable signs of blood flow and heartbeat. In particular, one of them showed symptom of Spalding's sign, which is a rare symptom that indicated overriding of the fetal cranial bones and shrinkage of the head with a decreased volume. It was reported that Spalding's sign is one of the strong indication of fetal death in human uterus and it occurs rarely with normal fetus without apparent reason prior to labor in human. This is the first report to provide the Spalding's sign in domestic cats and this will be applied in a strong presumptive evidence that fetal death has occurred with brain disruption sequence while pregnancy in domestic animals.