• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1555-1562
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• 2000

Objects : Surgical management of the distal anterior cerebral artery(DACA) aneurysms presents several unique problems to surgeons, such as difficulty in early identification of parent arteries, high incidence of rebleeding and premature rupture, and requirement of unfamiliar approach other than conventional frontotemporal craniotomy. Therefore, preoperative anatomical knowledge of anterior interhemispheric fissure and entry point of dissection is prerequisite. Authors utilized a frontobasal approach for DACA aneurysms by using consistent external landmark for guidance to the deep structure. Materials and Methods : From Nov. 1995 to Jun. 1999, a surgical clipping of DACA aneurysms was carried out in 9 patients among a total 131 patients with intracranial aneurysms. In each case, the clinical and aneurysmal features were carefully reviewed through the angiograms, medical records, and intraoperative findings. Results : The incidence of DACA aneurysms was 6.9% from our series. All cases were arisen from juxtacallosal por-tion ; 6 cases from pericallosal-callosomarginal(PC-CM) junction and 3 from pericallosal-frontopolar(PC-FP) junction. Associated vascular anomalies were noted in 3 cases and multiple aneurysms in 3 cases, respectively. The preoperative clinical grades were generally poor. An early surgery was performed in 7 cases and frontobasal interhemispheric approaches in 7 cases. Postoperatively, two patients died of complications ; one delayed ischemic vasospasm and one aspiration pneumonia but remaining patients recovered well. Conclusion : The frontobasal interhemispheric approach was useful for DACA aneurysms in early surgery. Division of superior sagittal sinus(SSS) enabled a minimal retraction of brain on both sides, and prevention of intraoperative rupture was possible. Authors suggest the frontopolar(first frontal bridging) vein as a constant external landmark for approaching the genu of the corpus callosum and juxtacallosal DACA aneurysms.

• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.370-377
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• 2009

Objective : There is no definite adjustment protocol for patients shunted with programmable valves. Therefore, we attempted to find an appropriate method to adjust the valve, initial valve-opening pressure, adjustment scale, adjustment time interval, and final valve-opening pressure of a programmable valve. Methods : Seventy patients with hydrocephalus of various etiologies were shunted with programmable shunting devices (Micro Valve with $RICKHAM^{(R)}$ Reservoir). The most common initial diseases were subarachnoid hemorrhage (SAH) and head trauma. Sixty-six patients had a communicating type of hydrocephalus, and 4 had an obstructive type of hydrocephalus. Fifty-one patients had normal pressure-type hydrocephalus and 19 patients had high pressure-type hydrocephalus. We set the initial valve pressure to $10-30\;mmH_2O$, which is lower than the preoperative lumbar tapping pressure or the intraoperative ventricular tapping pressure, conducted brain computerized tomographic (CT) scans every 2 to 3 weeks, correlated results with clinical symptoms, and reset valve-opening pressures. Results : Initial valve-opening pressures varied from 30 to $180\;mmH_2O$ (mean, $102{\pm}27.5\;mmH_2O$). In high pressure-type hydrocephalus patients, we have set the initial valve-opening pressure from 100 to $180\;mmH_2O$. We decreased the valve-opening pressure $20-30\;mmH_2O$ at every 2- or 3-week interval, until hydrocephalus-related symptoms improved and the size of the ventricle was normalized. There were 154 adjustments in 81 operations (mean, 1.9 times). In 19 high pressure-type patients, final valve-opening pressures were $30-160\;mmH_2O$, and 16 (84%) patients' symptoms had nearly improved completely. However, in 51 normal pressure-type patients, only 31 (61%) had improved. Surprisingly, in 22 of the 31 normal pressure-type improved patients, final valve-opening pressures were $30\;mmH_2O$ (16 patients) and $40\;mmH_2O$ (6 patients). Furthermore, when final valve-opening pressures were adjusted to $30\;mmH_2O$, 14 patients symptom was improved just at the point. There were 18 (22%) major complications : 7 subdural hygroma, 6 shunt obstructions, and 5 shunt infections. Conclusion : In normal pressure-type hydrocephalus, most patients improved when the final valve-opening pressure was $30\;mmH_2O$. We suggest that all normal pressure-type hydrocephalus patients be shunted with programmable valves, and their initial valve-opening pressures set to $10-30\;mmH_2O$ below their preoperative cerebrospinal fluid (CSF) pressures. If final valve-opening pressures are lowered in 20 or $30\;mmH_2O$ scale at 2- or 3-week intervals, reaching a final pressure of $30\;mmH_2O$, we believe that there is a low risk of overdrainage syndromes.

• Progress in Medical Physics
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• v.16 no.1
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• pp.24-31
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• 2005

The stereotactic radiosurgery (SRS) describes a method of delivering a high dose of radiation to a small tar-get volume in the brain, generally in a single fraction, while the dose delivered to the surrounding normal tissue should be minimized. To perform automatic plan of the SRS, a new method of multi-isocenter/shot linear accelerator (linac) and gamma knife (GK) radiosurgery treatment plan was developed, based on a physical lattice structure in target. The optimal radiosurgical plan had been constructed by many beam parameters in a linear accelerator or gamma knife-based radiation therapy. In this work, an isocenter/shot was modeled as a sphere, which is equal to the circular collimator/helmet hole size because the dimension of the 50% isodose level in the dose profile is similar to its size. In a computer-aided system, it accomplished first an automatic arrangement of multi-isocenter/shot considering two parameters such as positions and collimator/helmet sizes for each isocenter/shot. Simultaneously, an irregularly shaped target was approximated by cubic structures through computation of voxel units. The treatment planning method by the technique was evaluated as a dose distribution by dose volume histograms, dose conformity, and dose homogeneity to targets. For irregularly shaped targets, the new method performed optimal multi-isocenter packing, and it only took a few seconds in a computer-aided system. The targets were included in a more than 50% isodose curve. The dose conformity was ordinarily acceptable levels and the dose homogeneity was always less than 2.0, satisfying for various targets referred to Radiation Therapy Oncology Group (RTOG) SRS criteria. In conclusion, this approach by physical lattice structure could be a useful radiosurgical plan without restrictions in the various tumor shapes and the different modality techniques such as linac and GK for SRS.

• Progress in Medical Physics
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• v.10 no.1
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• pp.33-40
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• 1999

Purpose: To simulate and measure the signal intensity of various tissues near bone interface in 2D and 3D neurological MR images. Materials and Methods: In neurological proton density (PD) weighted images, every component in the head including cerebrospinal fluid (CSF), muscle and scalp, with the exception of bone, are visualised. It is possible to acquire images in 2D or 3D. A 2D fast spin-echo (FSE) sequence is chosen for the 2D acquisition and a 3D gradient-echo (GE) sequence is chosen for the 3D acquisition. To find out the signal intensities of CSF, muscle and fat (or scalp) for the 2D spin-echo(SE) and 3D gradient-echo (GE) imaging sequences, the theoretical signal intensities for 2D SE and 3D GE were calculated. For the 2D fast spin-echo (FSE) sequence, to produce the PD weighted image, long TR (4000 ms) and short TE$_{eff}$ (22 ms) were employed. For the 3D GE sequence, low flip angle (8$^{\circ}$) with short TR (35 ms) and short TE (3 ms) was used to produce the PD weighted contrast. Results: The 2D FSE sequence has CSF, muscle and scalp with superior image contrast and SNR of 39 - 57 while the 3D GE sequence has CSF, muscle and scalp with broadly similar image contrast and SNR of 26 - 33. SNR in the FSE image were better than those in the GE image and the skull edges appeared very clearly in the FSE image due to the edge enhancement effect in the FSE sequence. Furthermore, the contrast between CSF, muscle and scalp in the 2D FSE image was significantly better than in the 3D GE image, due to the strong signal intensities (or SNR) from CSF, muscle and scalp and enhanced edges of CSF. Conclusion: The signal intensity of various tissues near bone interface in neurological MR images has been simulated and measured. Both the simulation and imaging of the 2D SE and 3D GE sequences have CSF, fat and muscle with broadly similar image intensity and SNR's and have succeeded in getting all tissues about the same signal. However, in the 2D FSE sequence, image contrast between CSF, muscle and scalp was good and SNR was relatively high, imaging time was relatively short.

• Investigative Magnetic Resonance Imaging
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• v.18 no.3
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• pp.200-207
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• 2014

Purpose : We evaluated the diagnostic value of susceptibility-weighted imaging (SWI) for the detection of developmental venous anomaly (DVA). Materials and Methods: Retrospective review of 1068 brain MR examinations found 28 DVAs in 28 patients (2.6%) on contrast-enhanced T1-weighted images. SWI, T2, and FLAIR images of 28 patients with DVA and 28 sex- and age-matched control patients without DVA were analyzed by blinded readers on each type of sequences. All images were independently reviewed by two radiologists who were blinded to other MR imaging finding. In cases of discrepancy, two reviewers reached a consensus later. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each MR sequence for the detection of DVA were determined. Statistical analysis was performed by using the Mcnemar test. The significance level was p < 0.05. Results: The sensitivity, specificity, PPV, and NPV of SWI for the detection of DVA were 85.7%, 92.9%, 92.3%, and 86.7%, respectively. T2 and FLAIR images showed sensitivity of 35.7% and 35.7%, specificity of 92.9% and 96.4%, PPV of 83.3% and 90.9%, and NPV of 59.1% and 60.0%, respectively. On SWI, the sensitivity and NPV for the detection of DVAs were significantly higher than those of T2 and FLAIR images (p < 0.05). Conclusion: SWI was sensitive and specific for the detection of DVA.

• Investigative Magnetic Resonance Imaging
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• v.18 no.1
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• pp.17-24
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• 2014

Purpose : To determine whether high-resolution contrast-enhanced three dimensional imaging with spoiled gradient-recalled sequence (HR-CE 3D-SPGR) plays a meaningful role in the assessment of intracranial vertebral artery (ICVA) and posterior inferior cerebellar artery (PICA) in lateral medullary infarction (LMI). Materials and Methods: Twenty-five patients confirmed with LMI were retrospectively enrolled with approval by the IRB of our institute, and 3T MRI with HR-CE 3D-SPGR and contrast-enhanced magnetic resonance angiography (CE-MRA) were performed. Two radiologists who were blinded to clinical information and other brain MR images including diffusion weighted image independently evaluated arterial lesions in ICVA and PICA. The demographic characteristics, the area of LMI and cerebellar involvement were analyzed and compared between patients with arterial lesion in ICVA only and patients with arterial lesions in both ICVA and PICA on HR-CE 3D-SPGR. Results: Twenty-two of twenty-five LMI patients had arterial lesions in ICVA or PICA on HR-CE 3D SPGR. However twelve arterial lesions in PICA were not shown on CE-MRA. Concurrent cerebellar involvement appeared more in LMI patients with arterial lesion in ICVA and PICA than those with arterial lesion in ICVA alone (p = 0.069). Conclusion: HR-CE 3D-SPGR can help evaluate arterial lesions in ICVA and PICA for LMI patients.

• Investigative Magnetic Resonance Imaging
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• v.12 no.1
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• pp.33-39
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• 2008

Purpose : There is debate concerning the observation of metabolite changes on MRS at the designated cortex during some tasks. The purpose of this study is to assess the change of the lactate content at the motor cortex during hand-grasping tasks with performing real-time fMRI-guided fMRS. Materials and Methods : Seven healthy volunteers (23-28 years old) underwent realtime fMRI during right hand grasping tasks with using a 1.5 T system. After confirming the activating area, single voxel MRS was preformed at 1) the baseline, 2) during the task and 3) after the task on the activating cortex. The three consecutive spectra were compared for observing the changes of the lactate content by the tasks. The Cho/Cr, NAA/Cr and Lac/Cr ratios were calculated manually from those spectra. Results : MRS during the tasks revealed the lactate peaks at the 1.33 ppm resonance frequency with great conspicuity at the activated area, which was identified on the real-time fMRI. After the task scan, the lactate peaks completely disappeared and the spectra recovered to the values of the baseline scan in all volunteers. At baseline, during the task and after the task, the Cho/Cr ratios were 0.81, 0.76 and 0.77, respectively, and the NAA/Cr ratios were 1.68, 1.65 and 1.72, respectively, and the Lac/Cr ratios were 0.28, 0.41 and 0.30, respectively. During the task, Lac was significantly increased by 46%. Conclusion : We observed prominent lactate peaks on MRS during hand-grasping tasks at the activated area, as was shown on the real-time fMRI. We suggest that fMRS can be used as a sensitive tool for observing the metabolite changes of the functioning brain.

• Journal of Wetlands Research
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• v.22 no.3
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• pp.194-199
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• 2020

Unlike in the past, the world is facing water shortages due to climate change and difficulties in simultaneously managing the risks of flooding. The Four Major Rivers project was carried out with the aim of realizing a powerful nation of water by managing water resources and fostering the water industry, and the construction period was relatively short compared to the unprecedented scale. Therefore, the prediction and analysis of how the river environment changes after the Four Major Rivers Project is insufficient. Currently, part of the construction section of the Four Major Rivers Project is caused by repeated erosion and sedimentation due to the effects of sandification caused by large dredging and flood-time reservoirs, and the head erosion of the tributaries occurs. In order to solve these problems, the riverbed maintenance work was installed, but it resulted in erosion of both sides of the river and the development of new approaches and techniques to keep the river bed stable, such as erosion and excessive sedimentation, is required. The water agent plays a role of securing a certain depth of water for the main stream by concentrating the flow so much in the center and preventing levee erosion by controlling the flow direction and flow velocity. In addition, Groyne products provide various ecological environments by forming a natural form of riverbeds by inducing local erosion and deposition in addition to the protection functions of the river bank and embankment. Therefore, after reviewing the method of determining the shape of the Groyne structure currently in use by utilizing the mobile limit flow rate and marginal reflux force, a new Critical Movement Velocity(${\bar{U}}_d$) and a new resistance coefficient formula considering the mathematical factors applicable to the actual domestic stream were developed and the measures applicable to Groyne installation were proposed.

• Korean Journal of Cognitive Science
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• v.28 no.1
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• pp.1-26
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• 2017

This study investigated the cortical generators of P300 in college students with schizotypal traits by using an auditory oddball paradigm, event-related potentials (ERPs) and standardized low resolution brain electromagnetic tomography (sLORETA) model. We also investigated the relationship between the current density of P300 and the clinical symptoms of schizophrenia. Based on the scores of Schizotypal Personality Questionnaire(SPQ), schizotypal trait (n=37) and control (n=42) groups were selected. For the measurement of P300, an auditory oddball paradigm, in which frequent standard tones (1000Hz) and rare target tones (1500Hz) were presented randomly, was used. Participants were required to count the number of the target tones during the task and report this at the end of the experiment. The two groups did not differ significantly in the accuracy of the oddball task. The schizotypal trait group showed significantly smaller P300 amplitudes than control group. In terms of source localization, both groups showed the P300 current density over bilateral frontal, parietal, temporal and occipital lobes. However, the schizotypal trait group showed significantly reduced activations in the left superior temporal gyrus and the right middle temporal gyrus, but increased activations in both left inferior frontal gyrus and right superior frontal gyrus compared to the control group. Furthermore, a negative correlation between the current density of the right superior frontal gyrus and SPQ disorganization score was found in the schizotypal trait group. These findings indicate that the individuals with schizotypal traits have dysfunctions of frontal and temporal areas, which are known to be the source of P300, as observed in patients with schizophrenia. In addition, the present results indicate that the disorganization score, rather than total score, of the SPQ is useful in predicting the risk of future schizophrenia.

• Journal of Distribution Science
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• v.14 no.3
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• pp.55-62
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• 2016

Purpose - Average using time of smart-phone for Korean people is 3 hours 39 minutes and most people who are using a computer at home and their workplace can be affected over force to neck and shoulder due to unstable body posture. musculoskeletal disorders which caused by unstable body posture can affect strongly to decrease work efficiency. So this research is designed to measure the effect of using computer & smart-phone on decreased work efficiency due to musculoskeletal disorders and mediating effect between decreased work efficiency and musculoskeletal disorders. Research Design, Data, and Methodology - The author has developed a questionnaire with 6 hypothesis on the basis of previous research result with 5 constructs. The questionnaires were also made by interview and E-mail. 300 copies of questionnaires were distributed and 282 questionnaire were used for the analysis as valid data responses. SPSS ver.21.0 were used and made Cronbach's α and reliability test, correlation, Baron & Kenny 3 step mediated regression analysis. Result - Cronbach's α shows 0.770~0.954 and C.R. is 0.963~0.997 which is higher than 0.7. and AVE was 0.867~0.933. So the data are all acceptable condition. Using for a long time of a computer & smart-phone has a positive effect on musculoskeletal disorders. This means, it can cause musculoskeletal disorders if people use a computer & smart-phone for a long time due to unstable body posture. And musculoskeletal disorders can effect strongly decrease work efficiency. This study also found out that a long time of using computer can cause musculoskeletal disorders rather than using smart-phone a long time. To check mediate effect of musculoskeletal disorders between using a computer & smart-phone and Decreased Work Efficiency, author used 3-step mediated regression analysis of Baron & Kenny (1986). Using a computer for a long time mediate partially and using a smart-phone for a long time mediate completely. This means that using a smart-phone a long time is not the actual reason to decrease work efficiency. But using level of smart-phone is increasing rapidly day by day. So we need to make additional research about this matter seriously. Conclusion - Nowadays, people can not live on without a computer & smart-phone even a moment. But, using a computer for a long time will affect to cause musculoskeletal disorders and it will effect strongly to decrease work efficiency. Before, we thought over that musculoskeletal disorders were diseases of elder people. But, we found out from this study that musculoskeletal disorders can be happen to any people, even children, or workers in heavy industry or engaged in brain work. So we need to be careful when we use a computer for a long time. People also need to be careful to keep correct body posture when using both a computer and smart-phone since a smart-phone became more popular and using time level became longer. Due to increased income and living standard of people, physical growth of young people is so rapid. But the physical environment of society is not suitable for them since it can not follow up the speed of growth. Suitable work table is very important to prevent musculoskeletal disorder which can affect decrease work efficiency. For a person, a society or country, increased productivity is very important since it can directly connected to the job satisfaction. Education and reeducation for the people is also important, but to teach them how to keep good condition of health will be more important since it can increase the quality of work efficiency and quality of life. Computer and Smart-phone is one the best invention of modern society, but it can cause mental and physical disease which can affect decrease work efficiency and productivity. So it is necessary to observe attentively for the situation continually.