• 동의생리병리학회지
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• 제21권6호
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• pp.1569-1575
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• 2007

In oriental medicine, Sukjihwang (SJH, Rehmanniae radix preparat) has been used as one of the key ingredients for the prescription of several herbal decoctions and applied clinically for the treatment of several diseases including nervous system and cardiovascular disease. Here, possible growth-promoting effects of SJH on injured spinal cord axons were investigated in the rats. SJH administration increased levels of active form of ERK1/2 protein and Cdc2 proteins in the injured spinal cord tissue. Anterograde DiI-tracing of corticospinal tract axons showed that SJH-treatment enhanced axonal arborization in the injury area and extensive axonal extension into the caudal area. In SJH-treated group, glial scar formed after spinal cord injury was confined in a smaller area compared to the control group, and the trabecula structure was well observed within the injury cavity. Furthermore, increased proliferation and migration of astrocytes in the injury cavity were observed by SJH treatment. Thus, these present data provide a biological evidence on potential importance of SJH therapy for the treatment of injured spinal cord.

• Annals of Clinical Neurophysiology
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• 제3권2호
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• pp.160-163
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• 2001

Mirror movements in adult is usually accompanied with various clinical syndromes. But the pathogenesis of mirror movement is not clearly understood. A 20-year-old man visited with complaining of mirror movements in both hands, ophthalmoplegia and sensorineural hearing loss. He underwent through electromyography, transcranial magnetic stimulation, and functional magnetic resonance image. And we concluded that the mechanisms of his mirror movements were both ipsilateral innervated corticospinal tract and simultaneous activation of both motor cortex.

• Journal of Yeungnam Medical Science
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• 제22권2호
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• pp.119-130
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• 2005

Stroke is a leading cause of chronic physical disability. The recent randomized controlled trials have that motor function of chronic stroke survivors could be improved through physical or pharmacologic intervention in the stroke rehabilitation setting. In addition, several functional neuroimaging techniques have recently developed, it is available to study the functional topography of sensorimotor area of the brain. However, the mechanisms involved in motor recovery after stroke, are still poorly understood. Four motor recovery mechanisms have been suggested, such as reorganization into areas adjacent to the injured primary motor cortex (M1), unmasking of the motor pathway from the unaffected motor cortex to the affected hand, attribution of secondary motor areas, and recovery of the damaged contralateral corticospinal tract. Understanding the motor recovery mechanisms would provide neurorehabilitation specialists with more information to allow for precise prognosis and therapeutic strategies based on the scientific evidence; this may help promote recovery of motor function. This review introduces several methodologies for neuroimaging techniques and discusses theoretical issues that impact interpretation of functional imaging studies of motor recovery after stroke. Perspectives, for future research are presented.

• 대한근전도전기진단의학회지
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• 제20권2호
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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.

• 대한의용생체공학회:의공학회지
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• 제25권1호
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• pp.43-47
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• 2004

뇌의 기능성과 분산 영역간의 연결성에 대한 관심이 매우 증대되고 있는 추세다. 그 중에서 DTI (확산 텐서 영상)는 비침습적으로 뇌에서의 물분자의 확산과 뇌의 회백질 신경 다발 구조에 대한 정보를 제공할 수 있는 자기공명영상 기법이다. 따라서 우리는 이 기법을 통해 다른 해부학적 혹은 기능적 자기공명영상 기법으로는 얼을 수 없는 뇌의 신경 섬유 다발과 대뇌 피질 영역의 연결성 정보를 얻을 수 있다. 본 연구에서는 컬러 코딩 방식에 의하여 뇌의 주된 신경 다발의 방향성을 가시화 하고자 한다. 인간 뇌의 방향성 지도는 연합섬유, 방사섬유. 교련섬유. 운동 및 감각회로 섬유의 다발들을 구별하기 쉽게 하여준다. 우리는 이 목적 하에 24비트 칼라코딩 방법을 윈도우 PC 환경에서 IDL을 이용하여 구현하였다. 덧붙여 방향성의 각각의 성분 및 이방성에 대한 컬러 코딩과 이들을 표현하기 위한 다양한 색상표를 구현하였다. 결론적으로 우리의 24 비트 킬러 코딩을 이용한 뇌 회백질의 신경 다발의 방향성 가시화에 성공하였다. 우리가 구현한 방법에 의해 뇌의 주요 신경 다발들이 잘 가시화됨을 확인하였다.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2005년도 제30회 춘계학술대회
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• pp.32-34
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• 2005

Purpose: To investigate the metabolic changes in the motor and motor association cortices following axonal injury in the internal capsule that was caused by deep intracerebral hematoma. Materials and Methods: Using proton magnetic resonance spectroscopy (1H MRS), the authors studied the primary motor cortices (M-1) and supplementary motor areas (SMA) of 9 hemiparetic patients with documentable hemiparesis of varying severity, and we studied 10 normal volunteers as controls. To measure the M-1 and SMA biochemical changes, 4 separate single volumes of interest (VOIs) were located bilaterally in the affected and unaffected hemisphere (AH and UH). Results: 1H MRS provided a neuronal and axonal viability index by measuring levels of N-acetylaspartate (NAA) and creatine/phosphocreatine (Cr). The M-1/SMA NAA/Cr ratios of the AH and UH in patients, and the AH and normal volunteers were compared. The NAA/Cr ratios of the M-1 and SMA in AH, and the SMA in UH were significantly lower than those of normal volunteers. Conclusion: These 1H MRS findings indicate that axonal injury in the descending motor pathway at the level of internal capsule could induce metabolic changes in the higher centers of the motor pathway.

• 한국의학물리학회지:의학물리
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• 제18권4호
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• pp.214-220
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• 2007

Line propagation과 Brute force approach를 기반으로 한 확산텐서 트랙토그래피에서 신경다발추적을 위한 시작점을 선택하기 위한 조건으로 기존에 사용하는 Fractional anisotropy (FA)값 이외에 vector correlation function (VCF)를 제안하여 트랙토그래피를 구현하였다. 뇌전체의 트랙토그래피에 대하여, 본 연구에서 제안한 VCF를 사용할 경우 FA가 0.3 이상인 경우에 백질 외 영역에서 41% 적은 시작점을 사용하여 백질 외의 신경섬유가 아닌 부분들이 제거된 결과를 얻었다. 또한 관심영역에 대한 피질척수로의 영상에서는 백질 내에서는 50% 적은 시작점을 사용하였으나 기존기법과 매우 유사한 결과를 얻었다.

• Annals of Clinical Neurophysiology
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• 제14권2호
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• pp.64-71
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• 2012

Background: It is generally accepted that upper motor neuron (UMN) lesion can alter lower motor neuron (LMN) function by the plasticity of neural circuit. However there have been only few researches regarding the axonal excitability of LMN after UMN injury especially during the acute stage. The aim of this study was to investigate the nerve excitability properties of the LMNs following an acute to subacute supratentorial corticospinal tract lesion. Methods: An automated nerve excitability test (NET) using the threshold tracking technique was utilized to measure multiple excitability indices in median motor axons of 15 stroke patients and 20 controls. Testing of both paretic and non-paretic side was repeated twice, during the acute stage and subacute stage. The protocols calculated the strength-duration time constant from the duration-charge curve, parameters of threshold electrotonus (TE), the current-threshold relationship from sequential sub-threshold current, and the recovery cycle from sequential supra-threshold stimulation. Results: On the paretic side, compared with the control group, significant decline of superexcitablity and increase in the relative refractory period were observed during the subacute stage of stroke. Additionally, despite the absence of statistical significance, a mildly collapsing in ('fanning in') of the TE was found. Conclusions: Our results suggest that supratentorial brain lesions can affect peripheral axonal excitability even during the early stage. The NET pattern probably suggests background membrane depolarization of LMNs. These features could be associated with trans-synaptic regulation of UMNs to LMNs as one of the "neural plasticity" mechanisms in acute brain injury.

• Journal of Yeungnam Medical Science
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• 제40권2호
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• pp.136-145
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• 2023

Hepatic encephalopathy (HE) is a severe neuropsychiatric abnormality in patients with either acute or chronic liver failure. Typical brain magnetic resonance imaging findings of HE are bilateral basal ganglia high signal intensities due to manganese deposition in chronic liver disease and hyperintensity in T2, fluid-attenuated inversion recovery, or diffusion-weighted imaging (DWI) with hemispheric white matter changes including the corticospinal tract. Low values on apparent diffusion coefficient mapping of the affected area on DWI, indicating cytotoxic edema, can be observed in acute HE. However, neuropsychological impairment in HE ranges from mild deficits in psychomotor abilities affecting quality of life to stupor or coma with higher grades of hepatic dysfunction. In particular, the long-lasting compensatory mechanisms for the altered metabolism in chronic liver disease make HE imaging results variable. Therefore, the clinical relevance of imaging findings is uncertain and differentiating HE from other metabolic diseases can be difficult. The recent introduction of concepts such as "acute-on-chronic liver failure (ACLF)," a new clinical entity, has led to a change in the clinical view of HE. Accordingly, there is a need to establish a corresponding concept in the field of neuroimaging diagnosis. Herein, we review HE from a historical and etiological perspective to increase understanding of brain imaging and help establish an imaging approach for advanced new concepts such as ACLF. The purpose of this manuscript is to provide an understanding of HE by reviewing neuroimaging findings based on pathological and clinical concepts of HE, thereby assisting in neuroimaging interpretation.

• 전자공학회논문지SC
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• 제47권4호
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• pp.30-39
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• 2010

자기공명확산텐서영상(diffusion tensor magnetic resonance image, DT-MRI)으로부터 얻어진 확산텐서는 잡음에 민감하므로 주 고유벡터(principle eigenvector, PEV)의 필드에도 잡음이 포함되기 쉽다. 신경다발영상은 잡음에 매우 민감한 PEV로부터 얻어지기 때문에 실제 신경다발의 방향과 다를 수 있다. 따라서 잡음을 제거하기 위한 정규화(regularization) 과정이 필요하다. 본 연구에서는 고유값과 고유벡터를 정규화 하기 위한 방법으로 Dyadic Sorting(DS) 방법을 사용하였고 이를 구현하기 위한 알고리듬을 제시하였다. DS 방법은 $3\times3$ 화소에서의 고유값-고유벡터 쌍의 오버랩 정도를 측정할 수 있는 Intervoxel overlap function을 이용하여 고유값, 고유벡터를 재배열하는 방법이다. 본 연구에서는 이 방법을 3차원으로 적용하여 주 고유 벡터가 $45^{\circ}$인 합성영상과 임상데이터에 적용하였고, 그 결과 임상데이터의 피질척수로에 적용한 경우 제안한 DS 방법이 중간값 필터 방법에 비하여 AAE, AFA가 각각 79.97%~83.64%, 85.62%~87.76% 우수함을 보였다.