• Title/Summary/Keyword: 좌우뇌

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Change of Cerebral Blood Flow Distribution and Vascular Reserve according to Age in Koreans Measured by Tc-99m HMPAO Brain SPECT (한국 정상인에서 연령에 따른 뇌혈류분포와 혈류예비능의 변화: Tc-99m HMPAO SPECT에 의한 연구)

  • Song, Ho-Cheon;Bom, Hee-Seung;Sohn, Hye-Kyung;Jeong, Hwan-Jeong;Min, Jung-Jun;Kim, Ji-Yeul;Lee, Jae-Tae;Moon, Dae-Hyuk;Lee, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.3
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    • pp.247-261
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    • 1999
  • Purpose: The aim of this study was to evaluate the normal values of regional cerebral blood flow (rCBF) and cerebrovascular reserve (CVR) in normal children to aged volunteers using Tc-99m HMPAO, Materials and Methods: Thirty four right-handed normal volunteers (20 males, 14 females, mean age $40.3{\pm}24.9$ years, range 4 to 82 years) were underwent rost/acetazolamide (ACZ) brain SPECT using Tc-99m HMPAO and the sequential injection and subtraction method. rCBF was estimated on the basis of a semiquantitative approach by means of right/left ratio, region/cerebellum and region to whole brain ratios in (rental, parietal, temporal, and occipital lobes, basal ganglia, thalami, and cerebellum. CVR was measured by means of % perfusion increase calculated as % mean count change compared to rest rCBF in each regions. Results: Mean values of right to left ratios range from 1.004 to 1.018, rCBF was highest in cerebellum and lowest in basal ganglia and thalami. Frontal and temporal rCBF decreased while occipital and thalamic rCBF increased according to age. No sexual difference of rCBF was noted. Mean CVR was $29.9{\pm}12.9%$. Mean CVR significantly increased to late teens, and declined thereafter. After 6th decade, CVR in both frontal lobes, left parietal lobe and right basal ganglia decreased significantly with advancing age. There was no sexual difference of CVR. Conclusion: Quantitative assessment of CVR was possible by ACZ Tc-99m HMPAO brain SPECT. It revealed that rCBF and CVR changed according to age in normal Korean volunteers. There was no sexual difference.

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General Activity and Stress Response of Rats Following Removal of the Mamillary Bodies (유두체를 떼어버린 흰쥐의 일반활동 및 스트레스에 대한 반응)

  • Kim, Chul;Choi, Hyun;Kim, Chung-Chin;Kim, Jong-Kyu;Kim, Myung-Suk
    • The Korean Journal of Physiology
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    • v.2 no.1
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    • pp.79-88
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    • 1968
  • For the purpose of assessing the influence of the mamillary bodies on the general activity and stress response, mamillary body·damaged rats(mamillary body group), operated control rats, and normal control animals were prepared and 2 experiments were carried out. The mamillary bodies. were damaged electrolytically by passing 0.3 ma d.c. current through stereotaxically implanted electrodes. The operated control group received the same treatment except passage of current. In the 1st experiment, each subject belonging to the mamillary body group .(9 rats) or the operated control group (13 animals) was put individually into an activity cage across which an infrared beam traversed. The number of beam interruptions by the movement of the subject in the cage was. recorded hourly for 48 hours and was regarded as an index of general activity. In the 2nd experiment, each of the mamillary body group (52 animals), the operated control group (45 rats), and the normal control group (37 animals) was further divided into 4 subgroups and the adrenal ascorbic acid content of one of the 4 subgroups was measured before, another subgroup immediately after, a third subgroup 2 hours after, and the remaining subgroup 4 hours after termination of a cold stress ($-10^{\circ}C$ for 1 hour). Following results were obtained: 1. Though the total activities in 48 hours of the mamillary body group and the operated control group were not significantly different, the activities of the malnillary body group for a few hours. at the beginning of the measurement and also in the evenings of both the 1st and the 2nd experimental days were significantly greater than those of the operated control group. 2. Judged by the significant reduction in adrenal ascorbic acid content, the stress response of the mamillary body group was as marked as that of the operated control or the normal control group-immediately after termination of cold exposure. Recovery from the stress was accelerated significantly in the mamillary body group and insignificantly in the operated control group compared with that of the normal control group, the intergroup difference of the former two groups being insignificant. It was inferred from the above results that the mamillary bodies may exert an inconspicuous inhibitory influence upon the central mechanism of general activity, and that the mamillaryies bodies may not be the main seat of the stress mechanism, although more works are desirable to confirm the results.

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Differentiation of Parkinson's Disease and Essential Tremor on I-123 IPT(I-123-N-(3-iodopropen-2-yl)-$2{\beta}$-carbomethoxy- $3{\beta}$-(4-cholorophenyl) tropane) Brain SPECT (파킨슨병과 본태성 진전의 감별진단에서 I-123 IPT(I-123-N-(3-iodopropen-2-yl)-$2{\beta}$-carbomethoxy-$3{\beta}$-(4-cholorophenyl) tropane) 뇌 단일광전자방출 전산화단층촬영의 역할)

  • Pai, Moon-Sun;Choi, Tae-Hyun;Ahn, Sung-Min;Choi, Jai-Yong;Ryu, Won-Gee;Lee, Jae-Hoon;Ryu, Young-Hoon
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.100-106
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    • 2009
  • Purpose: The study was to assess I-123-N-(3-iodopropen-2-yl)-2[beta]-carbomethoxy-3[beta]-(4-cholorophenyl) tropane(IPT) SPECT in differential diagnosis among early stage of Parkinson's disease(PD) and essential tremor(ET) and normal control(NL) groups quantitatively. Materials and Methods: I-123 IPT brain SPECT of 50 NL, 20 early PD, 30 advanced PD, and 20 ET were performed at 20 minutes and 2 hours. Specific/nonspecific binding of striatum was calculated by using right and left striatal specific to occipital non-specific uptake ratio(striatum-OCC/OCC). Results: Mean value of specific/nonspecific binding ratio was significantly different between advanced PD group and NL group. However, significant overlap of striatal specific/nonspecific binding ratio was observed between PD group and ET group. Bilateral striatal specific/nonspecific binding ratios were decreased in advanced PD. Lateralized differences in the striatal uptake of I-123 IPT correlated with asymmetry in clinical findings in PD group. Conclusion: I-123 IPT SPECT may be a useful method for the diagnosis of PD and objective evaluation of progress of clinical stages. Care should be made in the differential diagnosis of early stage of PD and other motor disturbances mimicking PD such as ET in view of significant overlap in striatal I-123 specific/nonspecific binding ratio.

Clinical Experiences of Cardiac Surgery Using Minimal Incision (소절개선을 이용한 심장수술의 임상고찰)

  • Kim, Kwang-Ho;Kim, Joung-Taek;Lee, Seo-Won;Kim, Hae-Sook;Lim, Hyun-Kung;Lee, Choon-Soo;Sun, Kyung
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.373-378
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    • 1999
  • Background: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. Material and Method: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. Result: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. Conclusion: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.

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Analysis of source localization of P300 in college students with schizotypal traits (조현형 인격 성향을 가진 대학생의 P300 국소화 분석)

  • Jang, Kyoung-Mi;Kim, Bo-Mi;Na, Eun-Chan;An, Eun-Ji;Kim, Myung-Sun
    • 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.

The Discriminating Nature of Dopamine Transporter Image in Parkinsonism: The Competency of Dopaminergic Transporter Imaging in Differential Diagnosis of Parkinsonism: $^{123}I-FP-CIT$ SPECT Study (도파민운반체 영상의 파킨슨증 감별진단 성능: $^{123}I-FP-CIT$ SPECT 연구)

  • Kim, Bom-Sahn;Jang, Sung-June;Eo, Jae-Seon;Park, Eun-Kyung;Kim, Yu-Kyeong;Kim, Jong-Min;Lee, Won-Woo;Kim, Sang-Eun
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.4
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    • pp.272-279
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    • 2007
  • Purpose: The aim of this study was to evaluate the discriminating nature of $^{123}I-FP-CIT$ SPECT in patients with parkinsonism. Methods: $^{123}I-FP-CIT$ SPECT images acquired from the 18 normal controls; NC ($60.4{\pm}10.0$ yr) and 237 patients with parkinsonism ($65.9{\pm}9.2$ yr) were analyzed. From spatialIy normalized images, regional counts of the caudate, putamen, and occipital lobe were obtained using region of interest method. Binding potential (BP) was calculated with the ratio of specific to nonspecific binding activity at equilibrium. Additionally, the BP ratio of putamen to caudate (PCR) and asymmetric Index (ASI) were measured. Results: BPs of NC $3.37{\pm}0.57,\; 3.10{\pm}0.41,\; 3.23{\pm}0.48$ for caudate, putamen, whole striatum, respectively) had no significant difference with those of essential tremor; ET ($3.31{\pm}0.64,\; 3.06{\pm}0.61,\; 3.14{\pm}0.63$) and Alzheimer's disease; AD (3.33 $\pm$0.60, 3.29$\pm$0.79, 3.31$\pm$0.70), but were higher than those of Parkinson's disease; PD (1.92$\pm$0.74, 1.39$\pm$0.68, 1.64$\pm$0.68), multiple system atrophy; MSA (2.36$\pm$1.07, 2.16$\pm$0.91, 2.26$\pm$0.96), and dementia with Lewy body; DLB (1.95$\pm$0.72, 1.64$\pm$0.65, 1.79$\pm$0.66)(p<0.005). PD had statisticalIy lower values of PER and higher values of ASI than those of NC (p<0.005). And PD had significantIy lower value of PCR, higher ASI and lower BP in the putamen and whole striatum than MSA (p<0.05). Conclusion: Dopamine transporter image of $^{123}I-FP-CIT$ SPECT was a good value in differential diagnosis of parkinsonism.

A Study on the Clinical Usefulness of MMSE and BCRS for Cognitive Function Test in Patients with Non-Traumatic Subcortical Cerebrovascular Disease (비외상성 피질하 뇌혈관질환 환자에서 인지평가도구로서 정신상태소검사(MMSE)와 간이인지평가척도(BCRS)의 임상적 유용성에 대한 연구)

  • Choi, Hong;Lee, Young-Ho;Choi, Young-Hee;Ko, Dae-Kwan;Chung, Young-Cho;Park, Byoung-Kwan;Kim, Soo-Ji;Chung, Sook-Haui;Ko, Byoung-Hee;Song, Il-Byoung;Park, Kun-Woo;Lee, Dae-Hie
    • Sleep Medicine and Psychophysiology
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    • v.3 no.1
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    • pp.68-78
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    • 1996
  • Objective : The Mini-Mental State Examination(MMSE) and Brief Cognitive Rating Scale(BCRS) are frequently using screening tests fur evaluating the cognitive function in clinical practice and research. The authors tried to evaluate the clinical usefulness of these tests for the patients with non-traumatic subcortical cerebrovascular disease. Method : We administered the MMSE and BCRS to 85 patients and 195 normal control group. In order to compare the test results according to the lesion site, we divided patients into left sided lesion group(21 patients), right sided lesion group(31 patients) and both sided lesion group(13 patients). Their cognitive function was evaluated by the BNA and daily living functional activity was examined by the IADLs(Instrumental Activities of Daily Living Scale)and GERRI(Geriatric Evaluation by Relative's Rating Instrument). Results : The results are as follows : 1) In the BNA, the patients scored significantly lower than control group at all items(except Right-Left Orientation and Motor Impersistence), but there were no difference in the MMSE(total score and all 5 items), and only 2 items(recent memory and self-care) were significantly different between two groups in the BCRS. 2) In the comparison by lateralization, there were significant differences among three groups at 3 items(Left Tactile Form Perception, Left Finger Localization and Right Finger Localization) in the BNA. But, there were no difference in the MMSE and BCRS. 3) In the correlation between daily living functioning and the MMSE/BCRS, control group showed no relation(except item of cognitive functioning), but patient group was significantly correlated with 3 items(social functioning, instrumental activities of daily living and cognitive functioning). Conclusions : These findings suggest that MMSE and BCRS are not useful as the test for cognitive function and discrimination of lateralization in patients with non-traumatic subcortical cerebrovascular disease. However, scores of these tests may be related with the functional level(such as daily living function) of patients.

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Smoking-Induced Dopamine Release Studied with $[^{11}C]Raclopride$ PET ($[^{11}C]Raclopride$ PET을 이용한 흡연에 의한 도파민 유리 영상 연구)

  • Kim, Yu-Kyeong;Cho, Sang-Soo;Lee, Do-Hoon;Ryu, Hye-Jung;Lee, Eun-Ju;Ryu, Chang-Hung;Jeong, In-Soon;Hong, Soo-Kyung;Lee, Jae-Sung;Seo, Hong-Gwan;Jeong, Jae-Min;Lee, Won-Woo;Kim, Sang-Eun
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.6
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    • pp.421-429
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    • 2005
  • Purpose: It has been postulated that dopamine release in the striatum underlies the reinforcing properties of nicotine. Substantial evidence in the animal studies demonstrates that nicotine interacts with dopaminergic neuron and regulates the activation of the dopaminergic system. The aim of this study was to visualize the dopamine release by smoking in human brain using PET scan with $[^{11}C]raclopride$. Materials and Methods: Five male non-smokers or ex-smokers with an abstinence period longer than 1 year (mean age of $24.4{\pm}1.7$ years) were enrolled in this study $[^{11}C]raclopride$, a dopamine D2 receptor radioligand, was administrated with bolus-plus-constant infusion. Dynamic PET was performed during 120 minutes ($3{\times}20s,\;2{\times}60s,\;2{\times}120s,\;1{\times}180s\;and\;22{\times}300s$). following the 50 minute-scanning, subjects smoked a cigarette containing 1 mg of nicotine while in the scanner. Blood samples for the measurement of plasma nicotine level were collected at 0, 5, 10, 15, 20, 25, 30, 45, 60, and 90 minute after smoking. Regions for striatal structures were drawn on the coronal summed PET images guided with co-registered MRI. Binding potential, calculated as (striatal-cerebellar)/cerebellar activity, was measured under equilibrium condition at baseline and smoking session. Results: The mean decrease in binding potential of $[^{11}C]raclopride$ between the baseline and smoking in caudate head, anterior putamen and ventral striatum was 4.7%, 4.0% and 7.8%, respectively. This indicated the striatal dopamine release by smoking. Of these, the reduction in binding potential in the ventral striatum was significantly correlated with the cumulated plasma level of the nicotine (Spearman's rho=0.9, p=0.04). Conclusion: These data demonstrate that in vivo imaging with $[^{11}C]raclopride$ PET could measure nicotine-induced dopamine release in the human brain, which has a significant positive correlation with the amount or nicotine administered bt smoking.

Tetralogy of Fallot Associated with Pulmonary Atresia and Major Aortopulmonary Collateral Arteries -Comparison between the different surgical approaches- (폐동맥폐쇄와 주대동맥폐동맥혈관부행지를 동반한 활로씨사징증 -다양한 외과적 치료접근의 비교-)

  • 이정렬;양지혁;김용진;노준량
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.471-479
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    • 1999
  • Background: Patients with tetralogy of Fallot(TOF), pulmonary atresia(PA) and major aortopulmonary collateral arteries(MAPCAs) have been managed by heterogenous surgical strategies. We have taken 5 different surgical approaches to this lesion. In this study, relative advantages and disadvantages of each strategy were discussed by analyzing our surgical results. Material and Method: Between January 1986 and June 1998, 50 patients aged 1 to 177(39${\pm}$31) months at a various morphologic spectrum of this lesion were treated at our institution. The groups, which were classified according to the initial approaches, consisted of one-stage unifocalization(A-1, n=9), staged unifocalization(A-2, n=11), right ventricle to pulmonary artery connection(RV-PA)(B-1, n=11), one-stage RV-PA plus unifocalization (B-2, n=11), and one-stage definitive repair(C, n=8). Morphologic charateristics, operative mortalities, and probabilities of definitive repair were compared between the groups and the causes of death, complications and the follow-up results were described. Result: Mean ages at the first operation were 57${\pm}$18(A-1), 42${\pm}$48(A-2), 18${\pm}$14(B-1), 52${\pm}$55(B-2), and 32${\pm}$34(C) months (p<0.05). Mean numbers of MAPCAs were least in group C (A-1=4.3${\pm}$1.0, A-2=4.5${\pm}$1.3, B-1=4.1${\pm}$1.9, B-2=4.1${\pm}$1.6, C=3.4${\pm}$1.8 : p<0.05). The ratios of the direct and the indirect MAPCAs in each group were not different between the grousps (A-1=91%/9%, A-2=78%/22%, B-1=80%/20%, B-2=80%/20%, C=81%/19% : p>0.05). Nineteen patients had more than 1 dependent MAPCAs. True pulmonary arteries were not present 13 patients and they were confluent in 29. A total of 101 operations were performed. Operative mortalities of initial procedures were 33%(3/9, A-1), 18%(2/11, A-2), 0%(0/11, B-1), 36%(5/11, B-2) and 13%(1/8, C) (p<0.05). Percentages of the definitive repair among the patients of each group were 22%(2/9, A-1), 18%(2/11, A-2). 45%(5/11, B-1), 27%(4/11, B-2), and 100%(8/8, C)(p<0.05). Hypoxic respiratory and cardiac failure(6), hypoxic encephalopathy(2) and sepsis(4) were the major causes of death. Phrenic nerve palsy occured in 5 patients. Thirty-one patients among the survivals have been followed up for a mean duration of 74${\pm}$42(3-145) months. One and five year actuarial survival rates were 73% and 73 %. Conclusion: In conclusion, Right ventricle to pulmonary artery connection used in patients with TOF/PA/MAPCA as an inital procedure appeared to be highly successful in enhancing the chance of satisfactory definitive repair without the significant surgical risks. One-stage total repair at an ealier age group could be performed safely with the resonable outcomes. Unifocalization approach, whether it was performed in a single stage or in the multiple stages, resulted in the high operative mortality and the lowest chance of definitive repair, however more tailored selection of the patients and the long follow-up is mandatory to prove the usefulness of this approach.

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A Survey on Breakfast of Commuting Local College Students and Suggestions for Desirable Breakfast Menu (통학 지방대학생의 아침식사 섭취실태와 바람직한 아침식단에 대한 제안)

  • 이혜양
    • The Korean Journal of Food And Nutrition
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    • v.11 no.3
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    • pp.323-328
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    • 1998
  • This study was to investigate regularity of breakfast and food habits of commuting local college students. The regularly breakfast eating rate was found to be 32.9% in man and 26.5% in woman. The mean score of food habits was pretty low, 36.7 out of minimum possible score 12 and maximum 60. The mean score of nutrition attitude was 58.1 out of minimum possible score 18 and maximum 90. This survey showed that skipping breakfast or irregularity of breakfast led to overeating, high fat diet, lot of alcohol and imbalanced diet. It was known that breakfast was the most important among three meals. But having balanced breakfast daily was very difficult according to loss of appetite and busy schedule early in the morning. I suggested carbohydrate food, protein food, and vitamin & mineral food items desirable for nutritionally balanced, easily digestible, tasteful, quick and easily cooking breakfast menu. It was recommended to choose on item out of each of three food categories considering calory(1/3 of daily recommended calory intake for breakfast).

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