• Title/Summary/Keyword: f-MRI

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Serial $^{99m}Tc$-HMPAO Brain SPECT for Assessing Perfusion Improvement after EDAS in Moyamoya Patients (모야모야병에서 EDAS 수술효과의 평가를 위한 수술전후 $^{99m}Tc$-HMPAO SPECT의 유용성)

  • Lee, Kyung-Han;Lee, Sang-Hyung;Yeo, Jeong-Seok;Kwark, Chul-Eun;Chung, June-Key;Lee, Myoung-Chul;Cho, Byoung-Kyu;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.22-30
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    • 1994
  • Encephalo-duro-arterio-synangiosis (EDAS) is a relatively new surgical procedure for treatment of childhood moyamoya disease. We assessed regional cerebral perfusion in moyamoya patients before (1.3 mo) and after (6.8 mo) EDAS with $^{99m}Tc$-HMPAO brain SPECT. A total of 21 EDAS operations in 17 moyamoya patients was included. Preoperative CT or MRI showed cerebral infarction in 14 patients and carotid angiography showed Suzuki grade I to V stenosis in 6%, 9%, 62%, 12% and 12% of the hemispheres respectively. Preoperative SPECT showed regional hypoperfusion in all patients, bilateral frontal and temporal lobes being the most frequently involved site. $4{\times}4$ pixel sized ROIs were applied on the frontotemporal cortex in 3 slice averaged transverse tomographic images. An index of regional perfusion was measured as: PI (%)=average F-T activity/average cerebellar activity${\times}100$ Pre-EDAS ipsilateral PI ranged from 23.7 to 98.4% (mean: $74.3{\pm}17%$) and increased significantly after operation ($81.4{\pm}17%$, p<0.001). Individual post-EDAS PI improved in 15/21 cases, showed no significant change in 5 and was slightly aggravated in 1. The amount of clinical improvement (${\Delta}CI$) was graded with a scale of 0 to 4 based on frequency and severity of TIA attacks. When patients were grouped according to pre-EDAS PI, group II (PI 70-89) showed a significantly higher ${\Delta}CI$ (3.3) compared to group I (PI< 70, 1.57) or group III (PI >90, 0.5) (P< 0.001). The amount of perfusion improvement (${\Delta}PI$) showed significant correlation with ${\Delta}CI$ (r=0.42, p=0.04). ${\Delta}PI$ did not, however, correlate with the amount of neovascularization assessed angiographically in 8 patients. Serial HMPAO SPECT is an useful noninvasive study for assessing perfusion improvement after EDAS in childhood moyamoya patients.

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Usefulness of FDG-PET/CT as a Diagnostic Tool for Routine Post Therapy Evaluation in Endometrial Cancer (자궁내막암의 치료 후 루틴 추적검사 방법으로서 FDG-PET/CT의 유용성)

  • Lee, Shin-Jae;Jeon, Tae-Joo;Kim, Seung-Jo;Kim, Hee-Jin;An, Hee-Jung
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.4
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    • pp.301-308
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    • 2009
  • Purpose: The aim of this study was to evaluate the usefulness of FDG-PET/CT as follow up imaging tool in patients with endometrial cancer after therapy. Material and Methods: One hundred one patients with endometrial cancer who underwent FDG PET/CT after the treatment of this disease were included in this study population (25-79 yr old, Mean age 50.6 yr old) and all these patients also performed various laboratory and imaging studies such as serum tumor marker, CT or MRI. The lesions having increased focal FDG uptake were classified into benign, equivocal, and malignant one according to their pattern and activity. Tumor recurrence was confirmed by histopathological results and other clinical and imaging data. Results: Among the 19 patients with 30 malignant or equivocal hot uptakes, 11 of 14 patients supposed to be malignant finding in PET/CT were proved to be tumor recurrence, while one of 5 patients with equivocal lesions were recurred malignancy, Two false negative cases were turned out to be peritoneal carcinomatosis, Estimated sensitivity, specificity and accuracy of PET/CT for diagnosis of recurrence in endometrial carcinoma after treatment were 86 %, 92 % and 91 %, respectively. Positive and negative predictive values in the same issue were 63% and 98%, respectively. Conclusion: FDG-PET/CT is useful for regular work up of endometrial carcinoma after the treatment because of its high negative predictive value as well as high sensitivity and specificity.

Synthesis and Reaction of 1,5,3,7-Diazadiphosphocine-1,5-Dicarboxylic Acids (1,5,3,7-Diazadiphosphocine-1,5-Dicarboxylic Acids의 합성과 반응)

  • Cho, Seung-Hwan;Song, Ju-Hyun;Lee, Do-Hun;Lee, Yong-Gyun;Park, Yu-Mi;Choi, Soon-Kyu;Hahn, Jung-Tai;Jung, Dai-Il
    • Journal of Life Science
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    • v.17 no.7 s.87
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    • pp.910-914
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    • 2007
  • In order to synthesize new bioactive compounds and contrasting agents, reactions of glycine and glutamic acid as an animo acid with paraformaldehyde and hypophosphorous acid were executed. Products are 3,7-dihydroxy-3,7-dioxoperhydro-1,5,3,7-diazadiphosphocine-1,5-diacetic acid 1 and 3,7-dihydroxy-3,7- dioxoperhydre-1,5,3,7-diazadiphosphocine-1,5-di-(2-glu taric acid) 3. 2-[5-(1,2-Dicarboxyethyl)-3,7-dihydroxy-3,7-dioxo-315.715-[1,5,3,7] diazadiphosphocan-1-yl]-succinic acid 2 by using aspartic acid was not obtained. Esterification of 3,7- dihydroxy-3,7-dioxoperkydro-1,5,3,7-diaza-diphosphocine-1,5-diacetic acid 1 by treatment of methanol, ethanol, and propanol were executed. 3,7-Dihydroxy-3,7-dioxoperhydro-1,5,3,7-diazadiphosphocine-1,5-diacetic acid methyl ester 4, 3.7-dihydroxy-3,7-dioxoperhydro-1,5,3,f-diazadiphosphocine-1.5-diacetic acid ethyl ester 5, and 3,7-dihydroxy-3,7-dioxoperhydro-1,5,3,7-diazadiphosphocine-1,5-diacetic acid propyl ester 6 were respectively synthesized in good yields. Continuously, we will try synthesis of novel compounds and evaluation of biological activity.

Brain Activity of Science High School Students and Foreign Language High School Students during the Intelligence Task (과학고학생과 외국어고학생의 지능과제 수행 시 뇌활동성 분석)

  • Cho, Sun-Hee;Choi, Yu-Yong;Lee, Kun-Ho
    • Journal of Gifted/Talented Education
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    • v.22 no.2
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    • pp.317-332
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    • 2012
  • We investigated brain activity during the performance of the intelligence task by a science high school student group (n=8) and a foreign language high school student group (n=5). Both groups scored in the top 1% on intelligence tests (science high school group: RAPM mean score=34.0, WAIS mean IQ=139.6; foreign language high school group: RAPM mean score=33.8, WAIS mean IQ=147.2). Analysis of brain activity during the performance of the intelligence task showed that both groups had brain activity in certain areas, including the left and right prefrontal cortex, parietal cortex, and anterior cingulate. The science high school group showed the highest activity in the right parietal cortex, which is related to visuo-spatial working memory, whereas the foreign language high school group showed the highest activity in the left prefrontal cortex, which is related to verbal working memory. The foreign language high school group showed higher brain activity than the science high school group in the left precentral gyrus which is related to the motion of the tongue and lips. These results show that the science high school group utilized the visuo-spatial area, whereas the foreign language high school group utilized the verbal area during the performance of the intelligence task. This suggests that the major thinking process differs depending on the gifted students' primary field of study, although they are doing the same task.

Reduced Volume of a Brainstem Substructure in Adolescents with Problematic Smartphone Use

  • Cho, In Hee;Yoo, Jae Hyun;Chun, Ji-Won;Cho, Hyun;Kim, Jin-Young;Choi, Jihye;Kim, Dai-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.32 no.4
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    • pp.137-143
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    • 2021
  • Objectives: Despite the growing concern regarding the adverse effects related to problematic smartphone use (PSU), little is known about underlying morphologic changes in the brain. The brainstem is a deep brain structure that consists of several important nuclei associated with emotions, sensations, and motor functions. In this study, we sought to examine the difference in the volume of brainstem substructures among adolescents with and without PSU. Methods: A total of 87 Korean adolescents participated in this study. The PSU group (n=20, age=16.2±1.1, female:male=12:8) was designated if participants reported a total Smartphone Addiction Proneness Scale (SAPS) score of ≥42, whereas the remaining participants were assigned to the control group (n=67, age=15.3±1.7, female:male=19:48). High-resolution T1 magnetic resonance imaging was performed, and the volume of each of the four brainstem substructures [midbrain, pons, medulla, and superior cerebellar peduncle (SCP)] was measured. Analysis of covariance was conducted to reveal group differences after adjusting for effects of age, gender, whole brainstem volume, depressive symptoms, and impulsivity. Results: The PSU group showed a significantly smaller volume of the SCP than the control group (F=8.273, p=0.005). The volume of the SCP and the SAPS score were negatively correlated (Pearson's r=-0.218, p=0.047). Conclusion: The present study is the first to reveal an altered volume of the brainstem substructure among adolescents with PSU. This finding suggests that the altered white matter structure in the brainstem could be one of the neurobiological mechanisms underlying behavioral changes in PSU.

Craniopharyngioma : Comparison of Tumor Characteristics Relevant with Initial Symptomatology between Children and Adults (두개인두종 : 소아와 성인에서 초기 증상과 연관된 종양의 특징 비교)

  • Park, Dong Hyuk;Park, Jung Yul;Kim, Joo Han;Jung, Yong Gu;Lee, Hoon Kap;Lee, Ki Chan;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.985-991
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    • 2001
  • Objectives : The craniopharyngioma is a benign tumor located at least in part in the suprasellar cistern. However, the symptoms and signs from this tumor may be determined not only by the location of the tumor but also by its size and the age of the patient. The objective of our study is to analyze retrospectively the clinical manifestations of craniopharyngiomas with regards to tumor characteristics in children and adults. Material and Methods: Twenty-three patients(16 adults, 7 children) treated for craniopharyngioma between 1990 and 1999 were studied to demonstrate the relationship of tumor size, growth pattern, and its invasiveness with clinical symptoms. As part of the assessment, 16 adults(M : F=8 : 8, mean age : 43.7 years) and 7 children(M : F=5 : 2, mean age : 10.1 years) underwent magnetic resonance(MR) imaging and computerized tomography(CT) scanning with a three-dimensional volume acquisition sequence. Results : The three major cardinal signs were defined to increased intracranial pressure, endocrine dysfunction, and visual problems. The tumor size in child group was larger than that in adult group. Also, visual problems, symptoms of increased intracranial pressure and hydrocephalus were more frequently observed in child group. However, endocrine dysfunction and neuropsychological symptoms related with hypothalamic connections to the thalamus, pituitary, frontal lobe, and other cortical areas were more frequent in adult group. Conclusions: In our series, the tumor size and invasiveness of craniopharyngioma revealed to be relevent with initial symptoms of increased intracranial pressure and visual symptoms which were more frequent in child group. As for the growth pattern, we did not find major difference between adults and children.

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Somatotopic Mapping of the Supplementary Motor Area (부운동영역의 뇌지도화)

  • Han Young Min;Jeong Su-Hyun;Lee Heon;Jin Gong Yong;Lee Sang Yong;Chung Gyung Ho
    • Investigative Magnetic Resonance Imaging
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    • v.8 no.1
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    • pp.9-16
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    • 2004
  • Purpose : The purpose of this study was to assess supplementary motor area (SMA) activation during motor, sensory, word generation, listening comprehension, and working memory tasks using functional magnetic resonance imaging (fMRI). Materials and Methods : Sixteen healthy right-handed subjects (9M, 7F) were imaged on a Siemens 1.5T scanner. Whole brain functional maps were acquired using BOLD EPI sequences in the axial plane. Each paradigm consisted of five epochs of activation vs. the control condition. The activation tasks consisted of left finger complex movement, hot sensory stimulation of the left hand, word generation, listening comprehension, and working memory. The reference function was a boxcar waveform. Activation maps were thresholded at an uncorrected p=0.0001. The thresholded activation maps were placed into MNI space and the anatomic localization of activation within the SMA was compared across tasks. Results : SMA activation was observed in 16 volunteers for the motor task, 11 for the sensory task, 15 for the word generation task, 5 for the listening comprehension task, and 15 for the working memory task. The rostral aspects of the SMA showed activity during the word generation and working memory tasks, and the caudal aspects of the SMA showed activity during the motor and sensory tasks. Right (contralateral) SMA activation was observed during the motor and sensory tasks, and left SMA activation during the word generation and memory tasks. Conclusion : Our results suggest that SMA is involved in a variety of functional tasks including motor, sensory, word generation, and working memory. The results obtained also support the notion that functionally specific subregions exist within the region classically defined as the SMA.

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Detection of Multidrug Resistance Using Molecular Nuclear Technique (분자핵의학 기법을 이용한 다약제내성 진단)

  • Lee, Jae-Tae;Ahn, Byeong-Cheol
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.2
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    • pp.180-189
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    • 2004
  • Although the outcome of cancer patients after cytotoxic chemotherapy is related diverse mechanisms, multidrug resistance (MDR) for chemotherapeutic drugs due to cellular P-glycoprotein (Pgp) or multidrug-resistance associated protein (MRP) is most important factor in the chemotherapy failure to cancer. A large number of pharmacologic compounds, including verapamil, quinidine, tamoxifen, cyclosporin A and quinolone derivatives have been reported to overcome MDR. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) are available for the detection of Pgp and MRP-mediated transporter. $^{99m}Tc$-MIBI and other $^{99m}Tc$-radiopharmaceuticals are substrates for Pgp and MRP, and have been used in clinical studies for tumor imaging, and to visualize blockade of PgP-mediated transport after modulation of Pgp pump. Colchicine, verapamil and daunorubicin labeled with $^{11}C$ have been evaluated for the quantification of Pgp-mediated transport with PET in vivo and reported to be feasible substrates with which to image Pgp function in tumors. Leukotrienes are specific substrates for MRP and $N-[^{11}C]acetyl-leukotriene$ E4 provides an opportunity to study MRP function non-invasively in vivo. SPECT and PET pharmaceuticals have successfully used to evaluate pharmacologic effects of MDR modulators. Imaging of MDR and reversal of MDR with bioluminescence in a living animal is also evaluated for future clinical trial. We have described recent advances in molecular imaging of MDR and reviewed recent publications regarding feasibility of SPECT and PET imaging to study the functionality of MDR transporters in vivo.

Shoulder Uptake in the Bone Scintigraphy in Patients with Hemiplegic Reflex Sympathetic Dystrophy Syndrome (반신마비성 반사성교감신경 이영양증후군 환자의 골스캔상 견관절 섭취)

  • Lee, Jong-Jin;Chung, June-Key;Lee, Dong-Soo;Hong, Joon-Beom;Han, Tai-Ryoon;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.4
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    • pp.288-293
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    • 2004
  • Purpose: increased uptake of wrist and hand joints in three phase bone scintigraphy (TPBS) have been used in the detection of reflex sympathetic dystrophy syndrome (RSDS). TPBS frequently shows increased shoulder uptake in the hemiplegic RSDS patients. We investigated the significance of the shoulder uptake in the detection of these patients. Materials and Methods: Twenty three patients who had hemiplegia due to brain stroke and diagnosed as RSD were enrolled in this study (M:F=16:7, R:L=11:12). The mean age was $63{\pm}10$ yrs. Ter normal volunteer (mean age: $60{\pm}5$, M:F=1:9) data was used as control group. TPBS was performed $59{\pm}32$ days after stoke (acute stage). We obtained the count ratios of bilateral hands by drawing a region of interest (ROI) in three phase images and compared to the count ratios of shoulders in the delayed image. Hand ROI included an ipsilateral wrist. Sensitivity of detecting the affected limb was defined using the right/left count ratio of normal control. Results: Sensitivities using count ratios of hand blood flow, blood pool and delayed image were 45%, 76% and 78%, respectively. Sensitivity of shoulder count ratio was 74%. Log of right/left counts of hand delayed image and that of shoulder delayed image were correlated well with statistical significance (Spearman's R=0.824, p<0.001). Conclusion: Shoulder uptake showed good correlation with hand uptake in the delayed image of TPBS. Shoulder uptake maybe helpful in the diagnosis of reflex sympathetic dystrophy syndrome in patients with hemiplegia.

Association between Medial Temporal Atrophy, White Matter Hyperintensities, Neurocognitive Functions and Activities of Daily Living in Patients with Alzheimer's Disease and Mild Cognitive Impairment (알츠하이머병 및 경도인지장애 환자에서 내측두엽 위축, 대뇌백질병변, 신경인지기능과 일상생활 수행능력과의 연관성)

  • An, Min hyuk;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.67-76
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    • 2021
  • Objectives : The aim of this study was to compare activities of daily living (ADLs) according to degenerative changes in brain [i.e., medial temporal lobe atrophy (MTA), white matter hyperintensities] and to examine the association between neurocognitive functions and ADLs in Korean patients with dementia due to Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods : Participants were 111 elderly subjects diagnosed with AD or MCI in this cross-sectional study. MTA in brain MRI was rated with standardized visual rating scales (Scheltens scale) and the subjects were divided into two groups according to Scheltens scale. ADLs was evaluated with the Korean version of Blessed Dementia Scale-Activity of daily living (BDS-ADL). Neurocognitive function was evaluated with the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet (CERAD-K). Independent t-test was performed to compare ADLs with the degree of MTA. Pearson correlation and hierarchical multiple regression analyses were performed to analyze the relationship between ADLs and neurocognitive functions. Results : The group with high severity of the MTA showed significantly higher BDS-ADL scores (p<0.05). The BDS-ADL score showed the strongest correlation with the word list recognition test among sub-items of the CERAD-K test (r=-0.568). Findings from the hierarchical multiple regression analysis revealed that the scores of MMSE-K and word list recognition test were factors that predict ADLs (F=44.611, p<0.001). Conclusions : ADLs of AD and MCI patients had significant association with MTA. Our study, which identifies factors correlated with ADLs can provide useful information in clinical settings. Further evaluation is needed to confirm the association between certain brain structures and ADLs.