• Title/Summary/Keyword: Brain shift

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Alteration Analysis of Normal Human Brain Metabolites with Variation of SENSE and NEX in 3T Multi Voxel Spectroscopy (3T Multi Voxel Spectroscopy에서 SENSE와 NEX 변화에 따른 정상인 뇌 대사물질 변화 분석)

  • Seong, Yeol-Hun;Rhim, Jae-Dong;Lee, Jae-Hyun;Cho, Sung-Bong;Woo, Dong-Chul;Choe, Bo-Young
    • Progress in Medical Physics
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    • v.19 no.4
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    • pp.256-262
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    • 2008
  • To evaluate the metabolic changes in normal adult brains due to alterations SENSE and NEX (number of excitation) by multi voxel MR Spectroscopy at 3.0 Tesla. The study group was composed of normal volunteers (5 men and 8 women) with a mean ($\pm$ standard deviation) age of 41 (${\pm}11.65$). Their ages ranged from 28 to 61 years. MR Spectroscopy was performed with a 3.0T Achieva Release Version 2.0 (Philips Medical System-Netherlands). The 8 channel head coil was employed for MRS acquisition. The 13 volunteers underwent multi voxel spectroscopy (MVS) and single voxel spectroscopy (SVS) on the thalamus area with normally gray matter. Spectral parameters were as follows: 15 mm of thickness; 230 mm of FOV (field of view); 2000 msecs of repetition time (TR); 288 msecs of echo time (TE); $110{\times}110$ mm of VOI (view of interest); $15{\times}15{\times}15$ mm of voxel size. Multi voxel spectral parameters were made using specially in alteration of SENSE factor (1~3) and 1~2 of NEX. All MRS data were processed by the jMRUI 3.0 Version. There was no significant difference in NAA/Cr and Cho/Cr ratio between MVS and SVS likewise the previous results by Ross and coworkers in 1994. In addition, despite the alterations of SENSE factor and NEX in MVS, the metabolite ratios were not changed (F-value : 1.37, D.F : 3, P-value : 0.262). However, line-width of NAA peak in MVS was 3 times bigger than that in SVS. In the present study, we demonstrated that the alterations of SENSE factor and NEX were not critically affective to the result of metabolic ratios in the normal brain tissue.

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Compare the Intracranial Pressure Trend after the Decompressive Craniectomy between Massive Intracerebral Hemorrhagic and Major Ischemic Stroke Patients

  • Huh, Joon;Yang, Seo-Yeon;Huh, Han-Yong;Ahn, Jae-Kun;Cho, Kwang-Wook;Kim, Young-Woo;Kim, Sung-Lim;Kim, Jong-Tae;Yoo, Do-Sung;Park, Hae-Kwan;Ji, Cheol
    • Journal of Korean Neurosurgical Society
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    • v.61 no.1
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    • pp.42-50
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    • 2018
  • Objective : Massive intracerebral hemorrhage (ICH) and major infarction (MI) are devastating cerebral vascular diseases. Decompression craniectomy (DC) is a common treatment approach for these diseases and acceptable clinical results have been reported. Author experienced the postoperative intracranaial pressure (ICP) trend is somewhat different between the ICH and MI patients. In this study, we compare the ICP trend following DC and evaluate the clinical significance. Methods : One hundred forty-three patients who underwent DC following massive ICH (81 cases) or MI (62 cases) were analyzed retrospectively. The mean age was $56.3{\pm}14.3$ (median=57, male : female=89 : 54). DC was applied using consistent criteria in both diseases patients; Glasgow coma scale (GCS) score less than 8 and a midline shift more than 6 mm on brain computed tomography. In all patients, ventricular puncture was done before the DC and ICP trends were monitored during and after the surgery. Outcome comparisons included the ictus to operation time (OP-time), postoperative ICP trend, favorable outcomes and mortality. Results : Initial GCS (p=0.364) and initial ventricular ICP (p=0.783) were similar among the ICH and MI patients. The postoperative ICP of ICH patients were drop rapidly and maintained within physiological range if greater than 80% of the hematoma was removed. While in MI patients, the postoperative ICP were not drop rapidly and maintained above the physiologic range (MI=18.8 vs. ICH=13.6 mmHg, p=0.000). The OP-times were faster in ICH patients (ICH=7.3 vs. MI=40.9 hours, p=0.000) and the mortality rate was higher in MI patients (MI=37.1% vs. ICH=17.3%, p=0.007). Conclusion : The results of this study suggest that if greater than 80% of the hematoma was removed in ICH patients, the postoperative ICP rarely over the physiologic range. But in MI patients, the postoperative ICP was above the physiologic range for several days after the DC. Authors propose that DC is no need for the massive ICH patient if a significant portion of their hematoma is removed. But DC might be essential to improve the MI patients' outcome and timely treatment decision.

The Level of Fatigue and Motor Performance During Drum Playing Depending on Co-Presence of Singing Tasks in Patients With Chronic Stroke (전자 드럼 연주 시 노래부르기 유무에 따른 만성 뇌졸중 환자의 피로도 및 운동 수행력 비교)

  • Kim, Hyun Ji
    • Journal of Music and Human Behavior
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    • v.14 no.2
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    • pp.71-90
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    • 2017
  • The purpose of this study was to compare immediate differences in fatigue and motor performance during instrumental playing in patients with chronic stroke depending on whether singing task was concurrently presented. A total of 12 patients with chronic stroke were recruited from community and daycare centers for older adults in Seoul. Six subjects were randomly assigned to the experimental group and six to the comparison group. The experimental group was asked to sing while playing the electronic drum, and the comparison group only played the drum. The results of this study showed that statistically significant differences in perceived fatigue and exertion were found between the two groups, while no significant group differences were found in level of engagement in playing or force of tapping during drum playing. This study supports the inclusion of a singing task in instrument playing rehabilitation to effectively decrease perceived fatigue and level of intensity of exercises, although this may not lead to immediate changes in motor function or level of target exercises. The results indicate that singing while instrument playing may help stroke patients shift their attention from the executed motor movements to singing and alleviate the attentional and emotional load from intense movements. This study presents implications for how to select and pattern target movements in music therapy intervention for better motor outcomes.

Glioblastoma in a Pekingese (페키니즈견의 아교모세포종 증례)

  • Cho, Hyun-kee;Yoo, Dae-Young;Kang, Joo-yeon;Lee, Kwon-Young;Hwang, In-Koo;Choi, Jung-Hoon;Chung, Jin-Young
    • Journal of Veterinary Clinics
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    • v.32 no.6
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    • pp.544-547
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    • 2015
  • An 11-year-old, intact male Pekingese was brought to the Veterinary Teaching Hospital of Kangwon National University with a 10-day history of seizures. Fifteen days before coming to Kangwon National University, the dog had visited a local animal hospital for lameness, and non-steroidal anti-inflammatory drugs were prescribed to treat this symptom. However, 10 days before coming to our hospital, the dog experienced generalized seizures. Two days before his arrival, generalized ataxia and mental dullness also occurred. Our examinations revealed no remarkable findings on a routine blood test or X-ray. However, the neurological examinations confirmed mental dullness, generalized ataxia, and a lack of menace response and pupillary light reflexes. Nine hours later, dyspnea occurred, and 12 hours after that, the patient was euthanized per the client's request. A necropsy of transverse sections confirmed the presence of a prominent midline shift due to extended tumor growth. On histopathological analyses, pseudopalisading necrosis of the glial cells and microvascular proliferation were observed. In immunohistochemical analysis, glial fibrillary acidic protein, proliferating cell nuclear antigens, and ionized calcium binding adaptor molecule 1 immunoreactive cells were observed in the tumor area. Based on the results, the tumor was confirmed to be a glioblastoma. Primary intracranial tumors are rare in the veterinary field. This case report describes the clinical and histopathological findings of glioblastoma in a Pekingese.

Pattern classification of the synchronized EEG records by an auditory stimulus for human-computer interface (인간-컴퓨터 인터페이스를 위한 청각 동기방식 뇌파신호의 패턴 분류)

  • Lee, Yong-Hee;Choi, Chun-Ho
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.12 no.12
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    • pp.2349-2356
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    • 2008
  • In this paper, we present the method to effectively extract and classify the EEG caused by only brain activity when a normal subject is in a state of mental activity. We measure the synchronous EEG on the auditory event when a subject who is in a normal state thinks of a specific task, and then shift the baseline and reduce the effect of biological artifacts on the measured EEG. Finally we extract only the mental task signal by averaging method, and then perform the recognition of the extracted mental task signal by computing the AR coefficients. In the experiment, the auditory stimulus is used as an event and the EEG was recorded from the three channel $C_3-A_1$, $C_4-A_2$ and $P_Z-A_1$. After averaging 16 times for each channel output, we extracted the features of specific mental tasks by modeling the output as 12th order AR coefficients. We used total 36th order coefficient as an input parameter of the neural network and measured the training data 50 times per each task. With data not used for training, the rate of task recognition is 34-92 percent on the two tasks, and 38-54 percent on the four tasks.

Study of 4 Cases with Changes of Unified Parkinson's Disease Rating Scale, Heart Rate Variability and Quality of Life in Parkinson's Disease Patients through Whole Body Gi-Hyeol Therapy (전신기혈요법 치료를 통해 Unified Parkinson's Disease Rating Scale, Heart Rate Variability 및 삶의 질이 변화된 파킨슨 환자 4례에 대한 증례보고)

  • Mok, Seo-Hee;Lee, Ji-Won;Lee, Tae-Jong;Seo, Jung-Bok;Kim, Kyoung-Ah;Kim, Joe-Young;Park, Byung-Jun;Kim, Dong-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.2
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    • pp.71-80
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    • 2021
  • Parkinson's disease is one of the typical neurodegenerative disease and it is caused by the destruction of substantia nigra in brain leading to lack of dopamine secretion, and it presents 4 major motor symptoms such as tremor, bradykinesia, stiffness, postural instability. Furthermore, it causes many non-motor symptoms such as anosmia, REM sleep conduct disorder, orthostatic hypotension, dementia and autonomic ataxia such as lack of adjusting blood pressure, hyperhydrosis, constipation. Dopaminergic therapy is the most commonly used strategy, but long term treatment of levodopa induce various adverse effects. Thus, many people are focusing on new therapies other than established therapies, and there are many tries and approaches with paradigm shift. Our medical team was able to get 4 cases of PD patients who are hospitalized in our hospital, treated by Whole Body Gi-Hyeol Therapy consisting of acupuncture therapy, herbal therapy, and mental therapy, and their conditions improved in perspective of Unified Parkinson's Disease Rating Scale(UPDRS), Heart Rate Variability(HRV), and Quality of life. Among all 4 cases, UPDRS score and quality of life score is gotton better, and among 2 cases SDNN, RMS-SD, TP, LF, HF scores are finely increased. And PDQ-39 score which shows quality of life is also improved. However, in spite of these improvements and positive results, there were no meaningful improvement in a hurt from a fall which is important to the aged, muscular atrophy which causes bone fracture and SMI(Skeletal Muscle Mass Index) which is indicator of osteoporosis. Thus, supplementary treatment about Whole Body Gi-Hyeol Therapy such as more active nutrition intervention, safe and effective kinesitherapy is needed, and from now on continuous case reports and systematic clinical research which has control group must be carried out.

Smartphone Fundus Photography in an Infant with Abusive Head Trauma (학대뇌손상 영아에서 스마트폰으로 촬영한 안저소견)

  • Kim, Yong Hyun;Choi, Shin Young;Lee, Ji Sook;Yoon, Soo Han;Chung, Seung Ah
    • Journal of The Korean Ophthalmological Society
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    • v.58 no.11
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    • pp.1313-1316
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    • 2017
  • Purpose: To report fundus photography using a smartphone in an infant with abusive head trauma. Case summary: An 8-month-old male infant presented to the emergency room with decreased consciousness and epileptic seizures that the parents attributed to a fall from a chair. He had no external wounds or fractures to the skull or elsewhere. However, computerized tomography of the brain revealed an acute subdural hematoma in the right cranial convexity and diffuse cerebral edema, leading to a midline shift to the left and effacement of the right lateral ventricle and basal cistern. The attending neurosurgeon promptly administered a decompressive craniectomy. Immediately after the emergency surgery, a fundus examination revealed numerous multi-layered retinal hemorrhages in the posterior pole extending to the periphery in each eye. He also had white retinal ridges with cherry hemorrhages in both eyes. We acquired retinal photographs using the native camera of a smartphone in video mode. The photographer held the smartphone with one hand, facing the patient's eye at 15-20 cm, and held a 20 diopter condensing lens at 5 cm from the eye in the other hand. Our documentation using a smartphone led to a diagnosis of abusive head trauma and to obtain the criminal's confession, because the findings were specific for repetitive acceleration-deceleration forces to an infant's eye with a strong vitreoretinal attachment. Conclusions: This ophthalmic finding had a key role in the diagnosis of abusive head trauma. This case presented the diagnostic use of a smartphone for fundus photography in this important medicolegal case.

Increased Expression of Phospholipase C-$\gamma1$ Activator Protein, AHNAK in Human Lung Cancer Tissues (인체 폐암조직에서 Phospholipase C-$\gamma1$의 활성화 단백, AHNAK의 발현양상)

  • Oh, Yoon-Jung;Park, Chun-Seong;Choi, So-Yeon;Cheong, Seong-Cheoll;Lee, Sun-Min;Hwang, Sung-Chul;Lee, Yi-Hyeong;Hahn, Myung-Ho;Lee, Kyi-Beom;Ryu, Han-Young;Ha, Mahn-Joon;Bae, Yoon-Su;Rhee, Seo-Goo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.347-355
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    • 1999
  • Background: Phospholipase C(PLC) plays a central role in cellular signal transduction and is important in cellular growth, differentiation and transformation. There are currently ten known mammalian isozymes of PLC reported to this date. Hydrolysis of phosphatidylinositol 4,5-bisphosphate($PIP_2$) by PLC produces two important second messengers, inositol 1,4,5-trisphosphate($IP_3$) and diacylglycerol. PLC-${\gamma}1$, previously, was known to be activated mainly through growth factor receptor tyrosine kinase. Other mechanisms of activating PLC-yl have been reported such as activation through tau protein in the presence of arachidonic acid in bovine brain and activation by $IP_3$, phosphatidic acid, etc. Very recently, another PLC-${\gamma}1$ activator protein such as tau has been found in bovine lung tissue, which now is considered to be AHNAK protein. But there has been no report concerning AHNAK and its associated disease to this date. In this study, we examined the expression of the PLC-${\gamma}1$ activator, AHNAK, in lung cancer specimens and their paired normal. Methods: From surgically resected human lung cancer tissues taken from twenty-eight patients and their paired normal counterparts, we evaluated expression level of AHNAK protein using immunoblot analysis of total tissue extract Immunohistochemical stain was performed with primary antibody against AHNAK protein. Results: Twenty-two among twenty-eight lung cancer tissues showed overexpression of AHNAK protein (eight of fourteen squamous cell lung cancers, all of fourteen adenocarcinomas). The resulting bands were multiple ranging from 70 to 200 kDa in molecular weight and each band was indistinct and formed a smear, reflecting mobility shift mainly due to proteolysis during extraction process. On immunohistochemistry, lung cancer tissues showed a very heavy, dense staining with anti-AHNAK protein antibody as compared to the surrounding normal lung tissue, coresponding well with the results of the western blot Conclusion: The overexpression of PLC-${\gamma}1$ activator protein, AHNAK in lung cancer may provide evidence that the AHNAK protein and PLC-${\gamma}1$ act in concerted manner in carcinogenesis.

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Identification of novel mutations of the ATP7A gene and prenatal diagnosis of Menkes disease by mutation analysis (DNA 분석을 이용한 ATP7A 유전자의 새로운 돌연변이 발견과 멘케스병의 산전 진단)

  • Choi, Jin-Ho;Kim, Gu-Hwan;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.4 no.1
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    • pp.38-44
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    • 2007
  • Purpose : Menkes disease is an X-linked recessively inherited disorder caused by the mutation of the ATP7A gene encoding copper-transporting P-type AT Pase. The phenotypic features are progressive neurological degeneration, mental retardation, loose skin, and vascular complications. Early diagnosis and treatment are very important for the prognosis of Menkes disease. Here, we describe nov el mutations of the ATP7A gene and prenatal diagnosis by mutation analysis. Methods : Five unrelated Korean Menkes patients were included in this study. They presented with depigmented wool-like hair, progressive neurologic deterioration, and hypotonia in infancy. Serum copper and ceruloplasmin levels w ere decreased. Brain magnetic resonance imaging revealed tortuous intracranial vessels. Mutation analysis has been carried out using cDNA from cultured skin fibroblasts or genomic DNA from peripheral leukocytes. Prenatal diagnosis was performed in two cases using chorionic villi samples or amniocytes. Results : Four novel mutations have been identified from four different families; c.3511+1G>A (p.E1099_N1171delinsMfsX 18), c.4005+5 G>A (p.V1268_R1335del), c.1870_2172del (p.S624_Q724del), and c.3352 G>A (p.G1118S). T he remaining one was previously reported (c.1933 C>T (p.V 1268_R1335del)). On prenatal DNA analysis, one w as diagnosed as normal, while the other turned out to be a female heterozygote with p.S624_Q724del mutation of the ATP7A gene. Conclusion : We identified 4 novel mutations of the ATP7A gene. Prenatal diagnosis in families at risk is critical in order to choose preventiv e options including an early treatment with copper-histidine therapy or therapeutic termination. Most mutations of the ATP7A gene were frame-shift mutations and prenatal diagnosis has been successfully carried out.

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Autopoietic Machinery and the Emergence of Third-Order Cybernetics (자기생산 기계 시스템과 3차 사이버네틱스의 등장)

  • Lee, Sungbum
    • Cross-Cultural Studies
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    • v.52
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    • pp.277-312
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    • 2018
  • First-order cybernetics during the 1940s and 1950s aimed for control of an observed system, while second-order cybernetics during the mid-1970s aspired to address the mechanism of an observing system. The former pursues an objective, subjectless, approach to a system, whereas the latter prefers a subjective, personal approach to a system. Second-order observation must be noted since a human observer is a living system that has its unique cognition. Maturana and Varela place the autopoiesis of this biological system at the core of second-order cybernetics. They contend that an autpoietic system maintains, transforms and produces itself. Technoscientific recreation of biological autopoiesis opens up to a new step in cybernetics: what I describe as third-order cybernetics. The formation of technoscientific autopoiesis overlaps with the Fourth Industrial Revolution or what Erik Brynjolfsson and Andrew McAfee call the Second Machine Age. It leads to a radical shift from human centrism to posthumanity whereby humanity is mechanized, and machinery is biologized. In two versions of the novel Demon Seed, American novelist Dean Koontz explores the significance of technoscientific autopoiesis. The 1973 version dramatizes two kinds of observers: the technophobic human observer and the technology-friendly machine observer Proteus. As the story concludes, the former dominates the latter with the result that an anthropocentric position still works. The 1997 version, however, reveals the victory of the techno-friendly narrator Proteus over the anthropocentric narrator. Losing his narrational position, the technophobic human narrator of the story disappears. In the 1997 version, Proteus becomes the subject of desire in luring divorcee Susan. He longs to flaunt his male egomaniac. His achievement of male identity is a sign of technological autopoiesis characteristic of third-order cybernetics. To display self-producing capabilities integral to the autonomy of machinery, Koontz's novel demonstrates that Proteus manipulates Susan's egg to produce a human-machine mixture. Koontz's demon child, problematically enough, implicates the future of eugenics in an era of technological autopoiesis. Proteus creates a crossbreed of humanity and machinery to engineer a perfect body and mind. He fixes incurable or intractable diseases through genetic modifications. Proteus transfers a vast amount of digital information to his offspring's brain, which enables the demon child to achieve state-of-the-art intelligence. His technological editing of human genes and consciousness leads to digital standardization through unanimous spread of the best qualities of humanity. He gathers distinguished human genes and mental status much like collecting luxury brands. Accordingly, Proteus's child-making project ultimately moves towards technologically-controlled eugenics. Pointedly, it disturbs the classical ideal of liberal humanism celebrating a human being as the master of his or her nature.