• The Korean Journal of Nuclear Medicine
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• v.36 no.2
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• pp.91-101
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• 2002

Purpose : The aim of this study was to identify the brain areas in which reductions of regional cerebral blood flow (rCBF) were correlated with decline of general mental function, measured by Mini-Mental State Examination (MMSE). Materials and Methods : Tc-99m HMPAO brain SPECT was peformed in 9 probable AD patients at the initial and follow-up periods of 1.8 years (average) after the first study. MMSE scores were also measured in both occasions. The mean MMSE score of the initial study 16.4 (range: 5 - 24) and the mean MMSE score of the follow-up was 8.1 (range: 0 - 17). Each SPECT image was normalized to the cerebellar activity and a correlation analysis was peformed between the level of rCBF in AD patients and the MMSE scores by voxel-based analysis using SPM99 software. Results : Significant correlation was found between the blood-flow decrease in left inferior prefrontal region (BA 47) and left middle temporal legion (BA 21) and the MMSE score changes. Additional areas such as anterior and posterior cingulate cortices, precuneus, and bilateral superior and middle prefrontal regions showed the similar trends. Conclusions : A relationship was found between reduction of regional cerebral blood flow in left prefrontal and temporal areas and decline of cognitive function in Alzheimer's disease(AD) patients. This voxel-based analysis is useful in evaluating the progress of cognitive function in Alzheimer's disease.

• Investigative Magnetic Resonance Imaging
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• v.21 no.2
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• pp.91-96
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• 2017

Purpose: To describe technical methods for functional magnetic resonance imaging (fMRI) study with arterial spin labeling (ASL) compared to blood oxygenation level-dependent (BOLD) technique and discuss the potential of ASL for research and clinical practice. Materials and Methods: Task-based (n = 1) and resting-state fMRI (rs-fMRI) (n = 20) were performed using ASL and BOLD techniques. Results of both techniques were compared. Results: For task-based fMRI with finger-tapping, the primary motor cortex of the contralateral frontal lobe and the ipsilateral cerebellum were activated by both BOLD and ASL fMRI. For rs-fMRI of sensorimotor network, functional connectivity showed similar results between BOLD and ASL. Conclusion: ASL technique has potential application in clinical and research fields because all brain perfusion imaging, CBF measurement, and rs-fMRI study can be performed in a single acquisition.

• Journal of Korean Neurosurgical Society
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• v.42 no.5
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• pp.413-415
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• 2007

A 26-year-old man was admitted to our department due to intermittent left hemiparesis for 3 months. Magnetic resonance Image showed subacute infarction in the right precentral gyrus. Digital subtraction angiography and magnetic resonance angiography revealed an aneurysmal protrusion at the right middle cerebral artery (MCA) bifurcation. It was difficult to differentiate the aneurysm from the occlusion of the middle trunk of the MCA trifurcation. Brain single photon emission computerized tomography showed a decrease in perfusion in the right posterior frontal lobe without vascular reserve. Therefore, we planned a superficial temporal artery MCA anastomosis with an exploration of the right MCA bifurcation. Intraoperatively, the aneurysmal opacification on preoperative angiography proved to be the proximal stump of the occluded middle trunk of the MCA trifurcation. An aneurysmal protrusion at the MCA bifurcation does not always indicate an aneurysm. In diagnosing protruding vascular lesions at the MCA bifurcation, the possibility of a vascular stump should be considered according to their angioanatomical appearance and the history of the patient.

• Biomedical Science Letters
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• v.11 no.2
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• pp.129-134
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• 2005

Three different deconvolution techniques for quantifying cerebral blood flow (CBF) from whole brain $T2^{\ast}-weighted$ bolus tracking images were implemented (parametric Fourier transform P-FT, parametric single value decomposition P-SVD and nonparametric single value decomposition NP-SVD). The techniques were tested on 206 regions from 38 hyperacute stroke patients. In the P-FT and P-SVD techniques, the tissue and arterial concentration time curves were fit to a gamma variate function and the resulting CBF values correlated very well $(CBF_{P-FT}\;=\;1.02{\cdot}CBF_{p-SVD},\;r^2\;=\;0.96)$. The NP-SVD CBF values correlated well with the P-FT CBF values only when a sufficient number of time series volumes were acquired to minimize tracer time curve truncation $(CBF_{P-FT}\;=\;0.92{\cdot}CBF_{NP-SVD},\;r^2\;=\;0.88)$. The correlation between the fitted CBV and the unfitted CBV values was also maximized in regions with minimal tracer time curve truncation $(CBV_{fit}\;=\;1.00{\cdot}CBV_{ Unfit},\;^r^2\;=\;0.89)$. When a sufficient number of time series volumes could not be acquired (due to scanner limitations) to avoid tracer time curve truncation, the P-FT and P-SVD techniques gave more reliable estimates of CBF than the NP-SVD technique.

• Journal of Korean Critical Care Nursing
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• v.2 no.1
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• pp.26-35
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• 2009

Purpose: This paper reviews current diagnostic evaluation, treatment, nursing considerations, and the nurse practitioner’s (NP) role in acute ischemic stroke care. Methods: National guidelines and extensive literature on acute stroke care were reviewed and a relevant clinical case was introduced. Results: Computerized tomography (CT) of the head without contrast is the initial brain imaging procedure for patients with an acute stroke. Magnetic resonance imaging (MRI) can be an alternative test. Restoration of cerebral perfusion to the affected area is a key therapeutic strategy for ischemic stroke. A number of treatment strategies such as thrombolysis, anticoagulation, antiplatelet, and surgical treatment can be selected to improve blood flow to the ischemic region. The NP on the stroke team is involved with immediate stroke management including neurological assessment, ensuring adequate oxygenation, blood pressure management, activity, and diet. Discharge planning with the patient, family teaching and coordination of follow up care should also be implemented early in the hospitalization. Conclusion: The nurse practitioner is one of the cardinal members on the stroke team, and must be updated with current treatment and management guidelines.

• Restorative Dentistry and Endodontics
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• v.19 no.2
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• pp.621-632
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• 1994

This experiment was performed to study the effect of capsaicin on the excitatory amino acids (EAAs) neurotransmitter in medullary dorsal horn and to clarify the relationship between substance P and excitatory amino acids. Horizontal slice of rat medullary dorsal horn was prepared and perfused with modified Krebs-Ringer solution in brain slice chamber. Release of EAAs was induced by veratrine and capsaicin were added to perfusion solution to observe the changes in EAA release. Capsaicin and ruthenium red, capsaicin antagonist, were also systemically injected with 50mg/kg in first day and 100mg/kg in second day for 2 days. Medulla oblongata containing the medullary dorsal horn was isolated, homogenized and centrifused. Spernatant was freeze-dried and EAA was determined by HPLC. Release of glutamate and aspartate was significantly increased by veratrine or capsaicin, but veratrine evoked release of EAAs was blocked by capsaicin in vitro, and injected ruthenium red did not have effect on the contents of EMs in vivo. Systemically injected capsaicin evoked the slight decrease in content of glutamate and aspartate in medullary dorsal horn and this effect of capsaicin was unaffected by ruthenium red.

• The Korean Journal of Physiology and Pharmacology
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• v.25 no.1
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• pp.79-85
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• 2021

α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors are differentially regulated in the nucleus accumbens (NAcc) of the brain after cocaine exposure. However, these results are supported only by biochemical and electrophysiological methods, but have not been validated with immunohistochemistry. To overcome the restriction of antigen loss on the postsynaptic target molecules that occurs during perfusion-fixation, we adopted an immersion-fixation method that enabled us to immunohistochemically quantify the expression levels of the AMPA receptor GluA1 subunit in the NAcc. Interestingly, compared to saline exposure, cocaine significantly increased the immunofluorescence intensity of GluA1 in two sub-regions, the core and the shell, of the NAcc on withdrawal day 21 following cocaine exposure, which led to locomotor sensitization. Increases in GluA1 intensity were observed in both the extra-post synaptic density (PSD) and PSD areas in the two sub-regions of the NAcc. These results clearly indicate that AMPA receptor plasticity, as exemplified by GluA1, in the NAcc can be visually detected by immunohistochemistry and confocal imaging. These results expand our understanding of the molecular changes occurring in neuronal synapses by adding a new form of analysis to conventional biochemical and electrophysiological methods.

• Nuclear Engineering and Technology
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• v.55 no.1
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• pp.248-253
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• 2023

Directly, it is not possible to measure the absorbed dose of radiopharmaceuticals in the organs of the human body. Therefore, simulation methods are utilized to estimate the dose in distinct organs. In this study, individual organs were separately considered as the source organ or target organ to calculate the mean absorption dose, which SAF and S factors were then calculated according to the target uptake via MIRD method. Here, ^99mTc activity distribution within the target was analyzed using the definition and simulation of ideal organs by summing the fraction of cumulative activities of the heart as source organ. Thus, GATE code was utilized to simulate the Zubal humanoid phantom. To validate the outcomes in comparison to the similar results reported, the accumulation of activity in the main organs of the body was calculated at the moment of injection and cardiac rest condition after 60 min of injection. The results showed the highest dose absorbed into pancreas was about 21%, then gallbladder 18%, kidney 16%, spleen 15%, heart 8%, liver 8%, thyroid 7%, lungs 5% and brain 2%, respectively, after 1 h of injection. This distinct simulation model may also be used for different periods after injection and modifying the prescribed dose.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.752-759
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• 1997

Profound hypothermia protects . cerebral function during total circulatory arrest(TCA) in the surgical treatment of a variety of cardiac and aortic diseases. Despite its importance, there is no ideal technique to monitor the brain injury from ischemia. Since 1994, we have developed compressed spectral array(CSA) of electroencephalography(EEG) and monitored cerebral activity to reduce ischemic injury. The purposes of this study are to analyse the efficacy of CSA and to establish objective criteria to consistently identify the safe level of temperature and arrest time. We studied 6 patients with aortic dissection(AD, n=3) or aortic arch aneurysm(n=3, ruptured in 2). Body temperatures from rectum and esophagus and the EEG were monitored continuously during cooling and rewarming period. TCA with cerebral ischemia was performed in 3 patients and TCA with selective cerebral perfusion was performed in 3 patients. Total ischemic time was 30, 36 and 56 minutes respectively for TCA group and selective perfusion time was 41, 56 and 92 minutes respectively for selective perfusion group. The rectal temperatures for flat EEG were between 16.1 and 22. $1^{\circ}C$ (mean: 18.4 $\pm$ 2.0): the esophageal temperatures between 12.7 and $16.4^{\circ}C$ (mean $14.7\pm1.6).$ The temperatures at which EEG reappeared $5~15.4^{\circ}C$ for esophagus. There was no neurological defic t and no surgical mortality in this series. In summary, the electrical cerebral activity Teappeared within 23 minutes at the temperature less than $16^{\circ}C$ for rectum. It seemed that $15^{\circ}C$ of esophageal temperature was not safe for 20 minutes of TCA and continuous monitoring the EEG with CSA to identify the electrocerebral silence was useful.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1126-1135
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• 2000

Objectives : The goal of surgical management of cerebral arteriovenous malformation(AVM) is elimination of the lesion without development of new neurological deficits. To improve the management results of cerebral AVMs in the future, this article discusses about surgical complications of the AVM and their management. Material and Methods : During the past 18 years, 116 patients with cerebral AVMs were managed by surgery. Among these cases, 7 cases died, 7 cases developed new neurological deficits, 11 cases residual AVM and 5 cases intracerebral hematoma(ICH) after surgery. The author analyzes the causes of those complications and investigates the methods to minimized those complications based on the review of the literatures. Results : One stage removal of AVM and ICH in the poor neurological state were performed in 5 of 7 death cases. Subtotal removal of ICH followed by delayed AVM surgery after recovery is regard as one method to improve the outcome of patient with large ICH. Postoperative new neurological deficits developed owing to normal perfusion pressure breakthrough(NPPB) in 3, judgement error in 2, preoperative embolization in 1 and cortical injury in 1 case(s). Proper management of NPPB, accurate anatomical knowledge and physiological monitoring during operation, and well trained skill for embolization are regard as methods to minimize those complications. Residual AVMs after surgery were noticed in 11 cases, in which unintended 6 cases due to inaccurate dissection of peripheral margin of AVM, and intended 3 cases due to massive brain swelling during operation, 1 cases due to diffuse type and 1 case due to multiple type of AVM. Accurate dissection of peripheral margin of AVM and mild hypotension during operation may help to avoid this complication. Postoperative hemorrhage occurred in 3 cases due to rupture of the residual AVM and in 2 cases due to oozing from the AVM bed. Complete resection of AVM, complete control of bleeding points at AVM bed and mild hypotension during early postoperative period are the methods to avoid this complication. Conclusion : A precise but flexible therapeutic strategy and refined skill for endovascular, radiosurgical and microsurgical techniques are required to successful treatment of cerebral AVM. Adequate timing of AVM resection, accurate anatomical knowledge, proper management of NPPB and accurate dissection of peripheral margin of AVM are the key points for avoiding complications of the AVM surgery.