Lee, Kyung Jin;Son, Hyung Sun;Park, Sung Chan;Cho, Kyung Keun;Park, Hae Kwan;Choi, Chang Rak
Journal of Korean Neurosurgical Society
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v.30
no.1
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pp.41-46
/
2001
Objective : The exact position of the lesion during the pallidotomy is critical to obtain the clinical improvement of parkinson's disease without damage to surrounding structure. Ventriculogrphy, CT(computed tomograpy) or MRI(magnetic resonance imaging) have been used to determine the initial coordinates of stereotactic target for pallidotomy. The goal of this study was to determine whether microelectrode recording significantly improves the neurophysiologic localization of the target obtained from MRI. Methods : Twenty patients were studied. They underwent a unilateral pallidotomy. Leksell frame was applied and T1 axial images parallel to the AC-PC(anterior commissure-posterior commissure) plane using a 1.5 Tesla MRI with 3mm slice thickness were obtained. Anteroposterior coordinate of target was chosen at 2mm in front of the midcommissural point and lateral coordinate between 19 and 22mm from the midline. The vertical coordinate was calculated on coronal slice using a fast spin echo inversion recovery sequence(FSEIR) related to the position of the choroidal fissure and ranged over 4-5mm below the AC-PC plane. Confirmation of the anatomical target was done on axial slices using the same FSEIR sequence . Microrecording was done at the pallidum contralateral to the symptomatic side using an electrode with a tip diameter of $1{{\mu}m}$ diameter tip and 1.1-1.4 mOhm impedance at 1000Hz. Electrophysiologic localization of the target was also confirmed intraoperatively by macrostimulation. Results : Microrecording techniques were reliable to define the transition from the base of the pallidum which was characterized by the disappearance of spike activity and by the change of the audible background activity. Signals from high amplitude neurons firing at 200-400Hz were recorded in the pallidal base. X, Y and Z coordinates of target obtained from the MRI were within 1mm from the X, Y, Z coordinates obtained with microrecording in 16 patients (80%), 15 patients(75%), 10 patients(50%) respectively. The difference of Y coordinate between on MRI and on microrecording was 4mm in only one patient. Conclusion : The MRI was accurate to localize the target within 1mm of the error from microrecording target in 70% of the patients. 4mm discrepancy was observed only once. We conclude that MRI alone can be used to determine the target for pallidotomy in most patients. However, microrecording technique can still be extremely valuable in patents with aberrant anatomy or unusual MRI coordinates. We also consider physiologic confirmation of the target using macrostimulation to be mandatory in all cases.
Park, Myung-Hwan;Lee, Jin-Wan;Lee, Kang-Won;Ryu, Chang-Woo;Jahng, Geon-Ho
Investigative Magnetic Resonance Imaging
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v.13
no.2
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pp.161-170
/
2009
Purpose : A parallel imaging method provides us to improve temporal resolution to obtain three-dimensional (3D) MR images. The objective of this study was to optimize three 3D MRI techniques by adjusting 2D SESNE factors of the parallel imaging method in phantom and human brain. Materials and Methods : With a 3 Tesla MRI system and an 8-channel phase-array sensitivity-encoding (SENSE) coil, three 3D MRI techniques of 3D T1-weighted imaging (3D T1WI), 3D T2-weighted imaging (3D T2WI) and 3D fluid attenuated inversion recovery (3D FLAIR) imaging were optimized with adjusting SESNE factors in a water phantom and three human brains. The 2D SENSE factor was applied on the phase-encoding and the slice-encoding directions. Signal-to-noise ratio(SNR), percent signal reduction rate(%R), and contrast-to-noise ratio(CNR) were calculated by using signal intensities obtained in specific regions-of-interest (ROI). Results : In the phantom study, SENSE factor = 3 was provided in 0.2% reduction of signals against without using SENSE with imaging within 5 minutes for 3D T1WI. SENSE factor = 2 was provided in 0.98% signal reduction against without using SENSE with imaging within 5 minutes for 3D T2WI. SENSE factor = 4 was provided in 0.2% signal reduction against without using SENSE with imaging around 6 minutes for 3D FLAIR. In the human brain study, SNR and CNR were higher with SENSE factors = 3 than 4 for all three imaging techniques. Conclusion : This study was performed to optimize 2D SENSE factors in the three 3D MRI techniques that can be scanned in clinical time limitations with minimizing SNR reductions. Without compromising SNR and CNR, the optimum 2D SENSE factors were 3 and 4, yielding the scan time of about 5 to 6 minutes. Further studies are necessary to optimize 3D MRI techniques in other areas in human body.
Purpose : To compare the enhancement pattern of normal facial nerves on 3D-FLAIR and 3D-T1-FFE-F) sequences at 3.0 T MR units. Materials and Methods: We assessed 20 consecutive subjects without a history of facial nerve abnormalities who underwent temporal bone MRI with contrast enhancement between January 2008 and March 2009. Two neuroradiologists independently reviewed pre-/post-enhanced 3D-T1-FFE-FS and 3D-FLAIR images respectively with 2-week interval to assess the enhancement of normal facial nerves divided into five anatomical segments. The degree of enhancement in each segment was graded as none, mild or strong, and the results of 3D-FLAIR and 3D-T1-FFE-FS image sets were compared. Results: On 3D-FLAIR images, one of the two reviewers observed mild enhancement of the genu segment in two (10%) subjects. On 3D-T1-FFE-FS images, at least one segment of the facial nerve was enhanced in 13 (65%) subjects. At least one reviewer found that 17 of the 100 segments showed enhancement on 3D-T1-FFE-FS images, with the mastoid segment being the most commonly enhanced. Interobserver agreement on 3D-T1-FFE-FS images was good for enhancement of the normal facial nerve (${\kappa}$= 0.589). Conclusion: In contrast to 3D-T1-FFE-FS, normal facial nerve segments rarely showed enhancement on 3D-FLAIR images.
Purpose: This study evaluated the clinical results of surgical treatment with minimally invasive plate osteosynthesis for treating displaced intra-articular fractures of the calcaneus in comparison with conventional lateral extensile approach plate osteosynthesis. Materials and Methods: Of 79 cases of Sanders type II or III calcaneus fractures, 15 cases treated with the minimally invasive calcaneal plate (group M) and 64 cases treated with lateral extensile approach calcaneal plate (group E) were identified. After successful propensity score matching considering age, sex, diabetes mellitus history, and Sanders type (1:3 ratio), 15 cases (group M) and 45 cases (group E) were matched and the demographic, radiologic, and clinical outcomes were compared between the two groups. Results: The median time of surgery from injury was 2.0 days in group M and 6.0 days in group E (p=0.014). At the six months follow-up, group M showed results comparable with those of group E in radiographic outcomes. In the clinical outcomes, group M showed better postoperative American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) scores than did group E (p=0.001, p=0.008). A greater range of subtalar motion was achieved at the six months follow-up in group M (inversion 20.0° vs. 10.0°, p=0.002; eversion 10.0° vs. 5.0°, p=0.025). Although there were no significant differences in complications between the two groups (1 [6.7%] vs. 7 [15.6%], group M vs. group E; p=0.661), there was only one sural nerve injury and no wound dehiscence and deep infection in group M. Conclusion: Minimally invasive plate osteosynthesis showed superior clinical outcomes compared with that of the conventional lateral extensile approach plate osteosynthesis in Sanders type II or III calcaneus fractures. We suggest applying minimally invasive plate osteosynthesis in Sanders type II or III calcaneus fractures.
Lee, Sangmin;Cho, Soo Bueum;Choi, Dae Seob;Park, Sung Eun;Shin, Hwa Seon;Baek, Hye Jin;Choi, Ho Cheol;Kim, Ji-Eun;Choi, Hye Young;Park, Mi Jung
Investigative Magnetic Resonance Imaging
/
v.20
no.2
/
pp.105-113
/
2016
Purpose: Susceptibility vessel sign (SVS) on gradient echo image, which is caused by MR signal loss due to arterial thrombosis, has been reported in acute middle cerebral artery (MCA) infarction. However, the reported sensitivity and diagnostic accuracy of SVS have been variable. Susceptibility-weighted imaging (SWI) is a newly developed MR sequence. Recent studies have found that SWI may be useful in the field of cerebrovascular diseases, especially for detecting the presence of prominent veins, microbleeds and the SVS. The purpose of this study was to evaluate the diagnostic values of SWI for the detection of hyperacute MCA occlusion. Materials and Methods: Sixty-nine patients (37 males, 32 females; 46-89 years old [mean, 69.1]) with acute stroke involving the MCA territory underwent MR imaging within 6 hours after the symptom onset. MR examination included T2, FLAIR (fluid-attenuated inversion recovery), DWI, SWI, PWI (perfusion-weighted imaging), contrast-enhanced MR angiography (MRA) and contrast-enhanced T1. Of these patients, 28 patients also underwent digital subtraction angiography (DSA) within 2 hours after MR examination. Presence or absence of SVS on SWI was assessed without knowledge of clinical, DSA and other MR imaging findings. Results: On MRA or DSA, 34 patients (49.3%) showed MCA occlusion. Of these patients, SVS was detected in 30 (88.2%) on SWI. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of SWI were 88.2%, 97.1%, 96.8%, 89.5% and 92.8%, respectively. Conclusion: SWI was sensitive, specific and accurate for the detection of hyperacute MCA occlusion.
Data analysis of groundwater monitoring wells and geostatistical methods are used to identify the local characteristics of sea water intrusion and the range of sea water intrusion at the southeastern coastal area of Busan, Korea. Rainfall and groundwater level of two monitoring wells show a linear correlation because of the direct groundwater recharge by the precipitation. However, rainfall and electric conductivity have the inverse relationship because of the increase of groundwater. Electric conductivity rapidly increased at 24m depth and exceeded 20,000$\mu\textrm{s}$/cm near 26m depth in the monitoring wells. The variations of groundwater level and electric conductivity show that the interface between sea water and fresh water tends to move upward when groundwater level goes down. In the cross correlation analysis, groundwater level versus rainfall represents the largest cross correlation coefficient in 0 time lag but the cross correlation coefficient of electric conductivity versus rainfall is the largest when the time lag is 9 days. This suggests that the fluctuations of groundwater level respond to rainfall in a short time, but the interface between sea water and fresh water respond very slow to rainfall. Horizontal extents of sea water intrusion are estimated to 14 m from the east of Line 1, and 25 m from the southeast end of Line 2 in the inversion of dipole-dipole profiling data of two survey lines. The data of VES by the Schulumberger array in May and July show lognormal distributions. In the kriged apparent resistivity and earth resistivity distributions, the resistivities of July are increased comparing to those of May. This reflects that the concentration of sea water in aquifer is reduced due to the increased groundwater recharge from the rainfall in June and July. In analyzing the vertical and horizontal apparent resistivities and earth resistivity distributions, the geostatistical methods are very useful to identify the variations of earth resistivity distributions at the coastal area.
Seo, Hye-Eun;Lee, Ji Hye;Kim, Ji Yoon;Lee, Dong Ha;Lee, Heung Kyo;Lee, Kun Soo
Clinical and Experimental Pediatrics
/
v.50
no.9
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pp.875-881
/
2007
Purpose : Chromosome analysis is important in genetic study and genetic counseling. This study was performed to evaluate the type and incidence of chromosome abnormalities in a single hospital for 25 years. Methods : Chromosome analyses were performed on peripheral blood lymphocytes, obtained from 4,856 patients with suspected chromosomal aberrations, referred to cytogenetic laboratory in Department of Pediatrics, Kyungpook National University Hospital from May 1981 to October 2005. Results : We analyzed 4,567 cases. Children were 3,014 cases (66.0%) and adult were 1,553 cases (34.0 %). The most common purpose of the chromosomal analysis was growth and developmental abnormality in children and infertility in adults. Total chromosomal aberration rate was 16.9% (770/4,567). Among those cases, the numerical abnormalities were 12.2% (558 cases), the structural abnormalities were 4.1% (187 cases), and others were 0.5% (25 cases). The relative frequencies of autosomal abnormalities were 6.4% (294 cases) in Down syndrome; 0.2% (7 cases) in Edwards syndrome; 0.1% (4 cases) in Patau syndrome; 0.2% (10 cases) in other abnormalities, of sex chromosome, 2.9% (131 cases) in Klinefelter syndrome; 2.2% (99 cases) in Turner syndrome; 0.2% (8 cases) in 47, XXX; 0.1% (3 cases) in 47, XYY. Among the structural abnormalities, translocation was 1.8% (84 cases), inversion was 0.8% (37 cases), deletion was 0.4% (17 cases), and insertion was 0.3% (13 cases), in order of frequency. Conclusion : In this study, the type, incidence and distribution of cytogenetic abnormalities by karyotype were reviewed. We hope that our study could be used as a basic information on the diagnosis, treatment and genetic counseling for chromosome abnormalities in Korea.
Cho, Kyung Eun;Yoon, Choon-Sik;Song, Ho-Taek;Lee, Young Han;Lim, Daekeon;Suh, Jin-Suck;Kim, Sungjun
Investigative Magnetic Resonance Imaging
/
v.17
no.2
/
pp.110-122
/
2013
Purpose : To compare the image quality and ligament traceability in ankle images obtained using Volume Isotropic Turbo Spin Echo Acquisition (VISTA) MRI with and without fat suppression. Materials and Methods: The signal-to-noise ratios (SNRs) in images from a phantom and from the ankle of a volunteer were compared. Ten ankles from 10 non-symptomatic volunteers were imaged for comparisons of contrast ratio (CR) and ligament traceability. All examinations were performed using VISTA sequences with and without fat suppression on a 3T MRI scanner. The SNRs were obtained from images with subjects and without subjects (noise-only). Contrast ratios from images of the 10 ankles were acquired between fluid and tendon (F-T), F-cartilage (C), F-ligament (L), fat (f)-T, f-C and f-L. Two musculoskeletal radiologists independently scored the traceability of 7 ligaments, in sagittal, axial and coronal images respectively, based on a 4-point scale (1 as not traceable through 4 as clearly traceable). The Wilcoxon signed-rank test was used to compare the CR. Fisher's exact test and Pearson's chi-squared test were used to compare the ligament traceability. Results: The SNRs did not differ significantly between the two sequences except in bone marrow. VISTA SPAIR showed the higher CR only in F-T (p = 0.04), whereas VISTA showed higher CR in f-T (p = 0.005), f-C (p = 0.005) and f-L (p = 0.005). The calcaneofibular ligament traceability with VISTA was superior to that obtained with VISTA SPAIR (p < 0.05) in all planes. Conclusion: VISTA showed significant superiority to VISTA SPAIR in tracing CFL due to the superior CR between fat and ligament.
The 1 $km^2$ area studied is located in Sukchun-ri, Hwasung-koon, the southern part of Kyeonggi-do. Even though this site has been known as a contaminated area caused by seawater intrusions, geophysical and geochemical surveys have never been carried out at the site to determine the extent of the seawater contamination and to investigate whether the seawater intrusion is in progress. The purpose of this study is to determine the extent of seawater contamination and a preferred channel of the seawater intrusion using geophysical methods such as DC resistivity surveys with Schlumberger array and a dipole-dipole array. In order to determine whether the seawater intrusion is in progress in the area, DC resistivity monitoring with Schlumberger array was performed. According to the resistivity map obtained from the inversion of the resistivity data measured with Schlumberger array, the study area is divided into two districts as relatively lowly resistive (less than 30 ohm-m) and highly resistive (more than 30 ohm-m) areas. The distribution of the lowly resistive area is consistent with the distribution of the layer composed of clay minerals, and the resistivity of this layer decreases slowly as approaching to the old seashore. Hydrogeological analysis shows that the clay layer within a distance of about 200 m from the seashore has been already contaminated by sea-water and its electric conductivity is 8 times higher than that of the sand layer covered by the clay layer. According to the results of the 2-dimensional DC resistivity surveys with a dipole-dipole array, there are two preferred channels of the seawater intrusion in the site, and both the channels are in the NW-SE direction from the old seashore. The lowly resistive zone in the southern channel extends to a depth of 80 m. The DC resistivity monitoring with Schlumberger array was carried out along the preferred channel which has the low resistivity Bone (fracture zone) that extended to a depth of 80 m. The time series of apparent resistivity, measured at a distance of 260 m from the old coast line, fluctuates with a period of 12 hours. From these observations, it can be concluded that the seawater intrusion caused by tidal action is still in progress along the fractured zone interpreted by the DC resistivity surveys with a dipole-dipole array.
Even after the Gyeongju earthquake and the Pohang earthquake, hundreds of aftershocks and micro-earthquakes are still occurring in the southeastern part of the Korean Peninsula. These phenomena mean that the stress is constantly working, implying that another huge earthquake may occur in the future. Therefore, the gravity field interpretation method was used to analyze the deep geological structure of the Pohang-Ulsan region in the southeastern Korean Peninsula. First, a gravity survey was performed to collect the insufficient data and to calculate the detailed Bouguer gravity anomaly in the study area. Based on the gravity anomaly data, the location, direction, and maximum depth of deep fault lines were analyzed using the inversion methods "Curvature analysis" and "Euler deconvolution method". As a result, it is interpreted that at least six fault lines(C1~C6) exist in deep depth. The deep fault line C1 is well correlated to the Yeonil Tectonic Line(YTL), suggesting that YTL is extended up to about 4000m deep. The deep fault line C2 consists of several segment faults and well correlated to the fault lines on the surface. Inferred fault lines C3, C4, and C5 have an NW-SE direction, which is parallel to the Ulsan fault. The deep fault line C6 has the direction of NE-SW, and it is interpreted that the eastern boundary fault of Eoil Basin is extended to the deep. Comparing the inferred fault lines with the distribution of micro-earthquakes, the location of the deep fault line C1 is well correlated to the hypocenter of micro-earthquakes. This implies that faults in deep depth are related to the recent earthquakes in the southeastern Korean Peninsula.
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