• Journal of Korean Neurosurgical Society
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• v.29 no.1
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• pp.101-107
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• 2000

Objectives : The evaluation of peripheral nerve injuries has traditionally relied on a clinical history, physical examination, and electrodiagnostic studies. The purpose of the present study was to examine serial magnetic resonance image(MRI) changes following acute muscle denervation under experimental conditions and to identify potential advantages and disadvantages of this use of MRI. Methods : An experimental transection of right sciatic nerve on Spargue-Dawley rats was performed. MRI was performed with T1-weighted spin-echo and STIR sequences. The imaging findings were compared with EMG in order to determine its sensitivity relative to this standard procedure. A simultaneous histopathological study provided information about the morphological basis of the imaging findings. Signal intensities were expressed as a ratio of abnormal to normal. Results : The signal intensity ratio of muscles with the STIR sequence was increased significantly at 2 weeks after sciatic nerve transection(p<0.05), although definite signal change was seen as early as 4 days postdenervation in one. EMG revealed significant denervation potential from 3 days after nerve transection. Diffuse cell atrophy was revealed hostologically at 2 weeks after transection, which was at the same time of significant signal change in MRI. Conclusion : MRI signal changes in denervated muscles secondary to nerve injury correlate with the degree of muscle atrophy on histologic examination. In addition to EMG, MRI can document the course of muscle atrophy and mesenchymal abnormalities in denervation. These results indicate that MRI can play a complementary role in the evaluation of patients with denervation.

• Journal of Korean Neurosurgical Society
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• v.58 no.2
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• pp.112-118
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• 2015

Objective : Thoracic ossification of the ligamentum flavum (OLF) is a relatively rare disease. Because of ambiguous clinical symptom, it is difficult for early diagnosis of OLF and subsequent treatment can be delayed or missed. Therefore, the purpose of this study is to comprehensively assess the prevalence and distribution of thoracic OLF by magnetic resonance imaging (MRI) and coexisting spinal disease in Korean patients with back pain or leg pain. Methods : The sample included 2134 Korean patients who underwent MRI evaluation for back pain. The prevalence and distribution of thoracic OLF were assessed using lumbar MRI with whole spine sagittal images. Additionally, we examined the presence of coexisting lumbar and cervical diseases. The presence of thoracic OLF as well as clinical parameters such as age, sex, and surgery were retrospectively reviewed. Results : The prevalence of thoracic OLF in total patients was 16.9% (360/2134). The prevalence tended to increase with aging and was higher in women than in men. The lower thoracic segment of T10-11 was the most frequently affected segment. Of the 360 patients with OLF, 31.9% had coexisting herniated thoracic discs at the same level. Approximately 74% of the patients with OLF had coexisting lumbar and cervical disease. Nine (2.5%) of 360 OLF patients underwent surgery for thoracic lesion. Conclusion : The prevalenceof thoracic OLF was relatively higher than those of previous reports. And coexisting lumbar and cervical disease were very frequent. Therefore, we should check coexisting spinal diseases and the exact diagnostic localization of ossification besides lumbar disease.

• Journal of Korean Neurosurgical Society
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• v.37 no.4
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• pp.275-281
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• 2005

Objective: The prolactinoma is the most common pituitary tumor and sometimes shows severe invasiveness to the adjacent cavernous sinus, especially in the male patient. The dopamine agonist can be used as an alternative treatment modality to surgery. But, the transsphenoidal or transcranial approach for tumor removal has been more preferred treatment option of neurosurgeons in invasive prolactinoma. Especially rapid decompression of mass effect and resolution of the neurologic deficit is demanded. The prospective study is done in order to identify the therapeutic efficacy of bromocriptine as an initial treatment option for the invasive prolactionomas. Methods: Twenty patients with invasive prolactinoma were studied. Preoperative neurological and endocrinological evaluations were done, and size and invasiveness of the tumor was estimated on MRI. Bromocriptine was administrated by increasing dose planning reaching maximum dose at 1 month of treatment, with close neurological and endocrinological monitoring. At 3months after treatment, MRI was taken and decision was made whether to continue bromocriptine or to have surgical intervention. Results: Thirteen patients showed excellent result with only bromocriptine treatment. These patients showed not only marked reduction of tumor volume and prolactin level, but also, improving clinical symptoms and other hormonal deficits. 13patients who had visual field defect and decreased visual acuity had all improved visual symptoms. But, the remaining 4patients required surgical treatment due to insufficient reduction of tumor size inspite of normalized prolactin level within 3months. Remaining 2patients had $20{\sim}30%$ of tumor size reduction, but prolactin level was not normalized. One patient required radiation therapy. Conclusion: Bromociptine can be used as initial treatment for the invasive prolactinomas with careful monitoring of the neurological and endocrinological status. It should be carefully followed up for tumor size reduction within 3 months after initiation of treatment.

• Journal of radiological science and technology
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• v.22 no.2
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• pp.41-46
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• 1999

Osteoporosis, which causes mainly fracture of the spine, proximal femur and distal radius by minimal trauma, is a major public health problem and its prevalence is steadily increasing in Korea according to the development of public health care. There are reliable methods for diagnosis based on bone densitometry. Early detection and intervention are important for reducing the incidence of fractures. A consensus definition of osteoporosis, based on bone density measurement, has been developed by the World Health Organization(WHO). In this study, bone mineral density(RMD) was measured by dual energy x-ray absorptiometry(DEXA) at the proximal femur and lumbar spine in 132 post-menopausal women. The purpose of this study is to find influential factors on the BMD of the proximal femur and the lumbar spine and to analyze correlation between BMD and the problematic factors. We obtained the following results : 1. Mean BMD score, T-score and Z-score of the proximal femur were $0.81(g/cm^2)$, -2.45(S.D.) and -2.09(S.D.) respectively and in the lumbar spine were $0.83(g/cm^2)$, -2.02(S.D.), -2.43(S.D.) respectively. 2. In correlation analysis between BMD and many factors, correlation coefficients were -0.467, 0.212, -0.321 and 0.241 in age, height, duration after menopause respectively. BMI and the residuals were comparatively small. 3. Correlation coefficients to age matched BMD, in height and body weight were 0.222 and 0.241, in age and duration after menopause were -0.268, -0.282. 4. The fracture threshold of proximal femur BMD to the 90th percentile was $0.845(g/cm^2)$. 5. At the result of multiple regression analysis, age, body weight, $BMI(kg/m^2)$ and duration after menopause described as significant variables.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.322-326
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• 2011

Objective : Stenting of symptomatic intracranial stenosis has recently become an alternative treatment modality. However, urgent intracranial stenting in patients with intracranial stenosis following a transient ischemic attack (TIA) or minor stroke is open to dispute. We sought to assess the feasibility, safety, and effectiveness of urgent intracranial stenting for severe stenosis (>70%) in TIA or minor stroke patients. Methods : Between June 2009 and October 2010, stent-assisted angioplasty by using a balloon-expandable coronary stent for intracranial severe stenosis (>70%) was performed in 7 patients after TIA and 5 patients after minor stroke (14 stenotic lesions). Technical success rates, complications, angiographic findings, and clinical outcomes were retrospectively analyzed. Results : Stenting was successful in all 12 patients. The mean time from symptom onset to stenting was 2.1 days (1-8 days). Post-procedural angiography showed restoration to a normal luminal diameter in all patients. In-stent thrombosis occurred in one patient (n=1, 8.3%), and was lysed with abciximab. No device-related complications, such as perforations or dissections at the target arteries or intracranial hemorrhaging, occurred in any patient. The mortality rate was 0%. No patient had an ischemic event over the mean follow-up period of 12.5 months (range, 7-21 months), and follow-up angiography (n=7) revealed no significant in-stent restenosis (>50%). Conclusion : Urgent recanalization with stenting is feasible, safe, and effective in patients with TIA or acute minor stroke with intracranial stenosis of ${\geq}$ 70%.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.377-380
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• 2011

Objective : The purpose of this study was to determine the anatomic relationships between neurovascular structures and the transverse carpal ligament so as to avoid complications during endoscopic carpal tunnel surgery. Methods : Twenty-eight patients (age range, 35-69 years) with carpal tunnel syndrome were entered into the study. We examined through wrist magnetic resonance imaging in three different positions (neutral, radial flexion, and ulnar flexion) and determined several anatomic landmark (distance from the hamate hook to the median nerve, ulnar nerve, and ulnar vessel) based on the lateral margin of the hook of the hamate. The median nerve and ulnar neurovascular structure were studied with the wrist in the neutral, ulnar, and radial flexion positions. Results : The ulnar neurovascular structures usually passed just over or ulnar to the hook of the hamate. However, in 12 hands, a looped ulnar artery coursed 0.6-3.3 mm radial to the hook of the hamate and continued to the superficial palmar arch. The looped ulnar artery migrates on the ulnar side of Guyon's canal (-5.2-1.8 mm radial to the hook of the hamate) with the wrist in radial flexion. During ulnar flexion of the wrist, the ulnar artery shifts more radially beyond the hook of the hamate (-2.5-5.7 mm). Conclusion : It is appropriate to transect the ligament greater than 4 mm apart from the lateral margin of the hook of the hamate without placing the edge of the scalpel toward the ulnar side. We would also recommend not transecting the transverse carpal ligament in the ulnar flexed wrist position to protect the ulnar neurovascular structure.

• Journal of Acupuncture Research
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• v.20 no.4
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• pp.114-133
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• 2003

Objective : The meridian theory in oriental medicine explains that Sp9(Yinlingquan) has been considered very important for gynecological disorders, spleen and stomach disorders, and water metabolic disorders. Functional MRI is the best method of showing the evidences of the effect of the Electro-acupuncture treatment through scientific methods. On this supposition, Electro-acupuncture stimulation on Sp9(Yinlingquan) was carried out on six healthy volunteers, using the gradient echo sequence with the 3.0T whole-body MRI system(ISOL). Methods : Electro-acupuncture stimulation on Sp9(Yinlingquan), the experiment was carried out on six healthy volunteers, using the gradient echo sequence with the 3.0T whole-body MRI system(ISOL). After the needle insertion on right Sp9(Yinlingquan), 2Hz of electric stimulation was given for 30 seconds, repeated five times, with 30 seconds' intervals. The Image analysis including motion correction, talairach transformation, and smoothing was done using SPM99. Results : The electro-acupuncture stimulation on Sp9(Yinlingquan) activates Brodmann Area 13, 19, 22, 39, 40, 47 which may be the central pathways of the electro-acupuncture stimulation on Sp9(Yinlingquan). We also hypothesize that those brain areas may be directly or indirectly related with the mechanism of the effect of electro-acupuncture stimulation on Sp9(Yinlingquan).

• The korean journal of orthodontics
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• v.42 no.2
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• pp.56-63
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• 2012

Objective: To identify the right and left difference of the facial soft tissue landmarks three-dimensionally from the subjects of normal occlusion individuals. Materials and Methods: Cone-beam computed tomography (CT) scans were obtained in 48 normal occlusion adults (24 men, 24 women), and reconstructed into 3-dimensional (3D) models by using a 3D image soft ware. 3D position of 27 soft tissue landmarks, 9 midline and 9 pairs of bilateral landmarks, were identified in 3D coordination system, and their right and left differences were calculated and analyzed. Results: The right and left difference values derived from the study ranged from 0.6 to 4.6 mm indicating a high variability according to the landmarks. In general, the values showed a tendency to increase according to the lower and lateral positioning of the landmarks in the face. Overall differences were determined not only by transverse differences but also by sagittal and vertical differences, indicating that 3D evaluation would be essential in the facial soft tissue analysis. Conclusions: Means and standard deviations of the right and left difference of facial soft tissue landmarks derived from this study can be used as the diagnostic standard values for the evaluation of facial asymmetry.

• Tuberculosis and Respiratory Diseases
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• v.39 no.1
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• pp.95-101
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• 1992

A 27 years old male developed right-sided massive, recurrent, pleural transudate. EKG and echocardiogram showed right ventricular hypertropy. Chest X-ray and concurrent perfusion lung scan, performed after enough expansion of the right lung by drainage of the effusion through small cathter, showed that perfusion defect mismatched with the roentgenographic defect, which was likely to be a high probability of pulmonary thromboembolism. By cardiac catherization and pulmonary angiography the occlusion of pulmonary veins drained from the upper and middle lobe of the right lung could be revealed. More precise cause of occlusion couldn't be clear up because thoracotomy had to have been dangerous due to severe pulmonary hypertension. So the massive reurrent effusion was treated by repeated tetracycline instilations through chest tube and he was discharged. After following up 14 months at out-patient clinic, he expired because of sudden massive hemoptysis.

• Tuberculosis and Respiratory Diseases
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• v.47 no.2
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• pp.259-264
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• 1999

The scimitar syndrome, a rare complex anomaly, is defined as an anomalous right pulmonary venous drainage, partial or complete, to the inferior vena cava. The shape of the Turkish curved sword (scimitar) has provided the name of this syndrome. Additional characteristics of this syndrome such as hypoplasia of the right lung and of the right pulmonary arterial tree, anomalous arterial supply of the right lung from the aorta, dextrocardia and bronchial anomalies are common. Recently we experienced a case of scimitar syndrome (adult form) in a 19-year-old woman patient, so we report the case with a brief review of the literature.