• Title/Summary/Keyword: Cerebral atrophy

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Interictal rCBF SPECT, MRI and Surgical Outcome of Intractable Temporal Lobe Epilepsy (난치성 측두엽간질의 발작간 뇌혈류 SPECT, MRI와 수술성과 비교)

  • Zeon, Seok-Kil;Joo, Yang-Goo;Lee, Sang-Doe;Son, Eun-Ik;Lee, Young-Hwan
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.307-312
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    • 1994
  • Interictal single photon emission computed tomography of regional cerebral blood flow (rCBF SPECT) in 18 intractable temporal lobe epilepsy patients(8 male and 10 female patients: average 23.5 years old) were compared with 2.0 T magnetic resonance imaging (MRI). And surgical outcome was analysed with the findings, symptom duration and lateralization of temporal lobe. Preoperatively rCBF SPECT was done in all 18 patients with intravenous injection of 740 MBq 99mTc-HMPAO. MRI was also done preoperatively in 13 patients. Surgical outcome was classified by Engel's outcome classification(four-part classification recommended at the first Palm Desert conference). rCBF SPECT detected correctly lateralising abnormality of temporal lobe hypoperfusion in 13/18(72.2%), contralateral temporal lobe hypoperfusion in 2/18(11.1%) and showed no def-inite abnormality in 3/18(16.7%). The positive predictive value of unilateral temporal lobe hypoperfusion was 87%. MRI detected correct localising abnormality in 8/13(61.5%), such as hippocampal atrophy(7/13), asymmetric temporal horn(6/13), anterior temporal lobe atrophy(1/13), increased signal intensity from hippocampus(1/13) and calcific density(1/13), and no abnormal finding was noted in 5/13(38.5%). There was no false positive findings and the positive predictive value of MRI was 100%. Only 2 cases showed same lateralization findings in rCBF SPECT and MRI. There was no significant correlation between symptom duration and no abnormal findings on SPECT or MRI. Surgical outcome showed class I in 15/18(83.3%), and class II in 2/18(11.1%). One case of no abnormal finding in both SPECT and MRI showed class III surgical outcome. No class IV surgical outcome was noted. Surgical outcome, lateralization of epileptic focus in temporal lobe and abnormal findings in rCBR SPECT or MRI were not significantly correlated.

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The Clinical Analysis on 32 Cases of Dementia (치매환자(患者) 32례(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Lee, Y.W.;Kang, H.J.;Cho, M.R.;Jin, C.S.;Hong, S.;Kim, J.S.
    • The Journal of Internal Korean Medicine
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    • v.19 no.1
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    • pp.301-317
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    • 1998
  • A clinical analysis was carried out for 32 patients who were treated in Dept. of Dong-shin Oriental Medicine Hospital from 10st January to 16st May in 1998 and ruled out as dememtia. The results were summarized as follows. 1. In the distribution of sex, female was more than male. And the age of seventies(17 cases, 53.125%) was highest in the frequency of age. 2. In the distribution of having history of drinking and smoking were each 4 cases(12.5%) and 7 cases(21.875%). 3. In the distribution of seasons, the ratio of spring and winter were each 16 cases(50.0%), 15 cases(46.875%), that of summer and fall were comparatively low. 4. In the period from onset to admission, the period within a week had 20 cases(62.5%) as top, and the most period of treatment was 2 and 3 weeks(28.125%). 5. The number of cases that had preceding disease was 35 cases(71.875%), a major portion of preceding diseases were hypertension, diabetes mellitus, stroke. 6. The most common symptom was disorientation(78.125%), and the next common symptom was motor desability(71.875%), and memory disturbance, verbal disturbance was each 59.375 and 47.1%. 7. In the distribution of the CT scan films, 15 cases(46.875%) showed cerebral infarction and that of another 5cases (15.625%) showed cerebral hemorrhage, that of another 2 cases(6.25%) showed brain atrophy. 8. In the lipid density of blood, T-Cholesterol, TG, HDL-Cholesterol, LDL- Cholesterol was within normal limit. 9. In the MMSE-K, the most score was from 16 point to 20 point, and second only was from 11 point to 15 point, and the next was from 6 point to 10 point. 10. In the Ischemic score, 20 cases(62.5%) was diagnosed as brain vascular type dementia, and mixed type dementia was 9 cases(28.125%), Alzheimer type dementia was 3 cases(9.375%). 11. The most used recipes were a sort of recipes to activate of flow the vital energy and the blood, to remove the phlegm(41 cases 33.9%), especially DODAMHOALHEL TANG (12 cases, 9.9%), ANSINCHUNGNOITANG (8 case, 6.6%) was the most used recipe. 12. In the judgement of efficacy, 17 cases(53.125%) showed excellent efficacy, 10 cases(31.25%) showed good efficacy, 5 cases(15.625%) showed no change and that according to MMSE-K, 4 case(18.18%) showed excellent efficacy, 15 cases(68.18%) showed good efficacy, 15 cases(68.18%) showed no change.

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The Neuroprotective Effects of InSamYangYoung-tang(Renshenyangrongtang) on Aβ-induced Damages in Mice (인삼양영탕(人蔘養榮湯)이 Aβ를 처리한 PC12 세포와 생쥐의 손상 뇌신경조직에 미치는 영향)

  • Jang, Young-Joo;Jung, In-Chul;Lee, Sang-Ryong
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.1
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    • pp.109-124
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    • 2010
  • Objectives: This experiment was designed to investigate the effect of the InSamYangYoung-tang(Renshenyangrongtang) extract on $A{\beta}$-induced AD model. Methods: The effects of the InSamYangYoung-tang(Renshenyangrongtang) extract on neural damages of cultured PC12 cells induced by $A{\beta}$ were investigated. The effects of the InSamYangYoung-tang(Renshenyangrongtang) extract on neural damages of hippocampal and cortical neurons in the mouse induced by $\beta$-amyloid were investigated. Results: 1. $A{\beta}$ treatment into neuronal cells activated cell death pathway when analyzed by MTT assay and by histological analysis. Then InSamYangYoung-tang(Renshenyangrongtang) treatment improved cell survival to a similar level as in normal group. 2. $A{\beta}$ treatment increased caspase 3 protein levels but decreased phospho-Erk1/2 in neuronal cells. InSamYangYoung-tang(Renshenyangrongtang) treatment reversed the production levels of two proteins close to those in normal group. 3. $A{\beta}$ treatment induced the atrophy of neuronal cells in terms of neuronal processes and cell body shrinkage, but InSamYangYoung-tang(Renshenyangrongtang) greatly improved their morphology. 4. Neuroprotective activity, as observed in InSamYangYoung-tang(Renshenyangrongtang)-treated groups, was similarly observed in cells treated with galantamine which was used as a positive control. Moreover, overall recovery pattern by InSamYangYoung-tang(Renshenyangrongtang) was similar between cultured PC12 cells and in vivo hippocampal and cerebral cortical neurons in the mouse brain. Conclusions: This experiment shows that the InSamYangYoung-tang(Renshenyangrongtang) may play a protective role in neural tissues damaged by cytotoxic substances. Since neuronal damage seen in degenerative brains such as AD are largely unknown, the current data may provide possible insight into therapeutic strategies for AD treatments. InSamYangYoung-tang(Renshenyangrongtang) might be effective for the treatment of AD. Investigation into the clinical use of the InSamYangYoung-tang(Renshenyangrongtang) for AD is suggested for future research.

Development of Korean Tissue Probability Map from 3D Magnetic Resonance Images (3차원 MR 영상으로부터의 한국인 뇌조직확률지도 개발)

  • Jung Hyun, Kim;Jong-Min, Lee;Uicheul, Yoon;Hyun-Pil, Kim;Bang Bon, Koo;In Young, Kim;Dong Soo, Lee;Jun Soo, Kwon;Sun I., Kim
    • Journal of Biomedical Engineering Research
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    • v.25 no.5
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    • pp.323-328
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    • 2004
  • The development of group-specific tissue probability maps (TPM) provides a priori knowledge for better result of cerebral tissue classification with regard to the inter-ethnic differences of inter-subject variability. We present sequential procedures of group-specific TPM and evaluate the age effects in the structural differences of TPM. We investigated 100 healthy volunteers with high resolution MRI scalming. The subjects were classified into young (60, 25.92+4.58) and old groups (40, 58.83${\pm}$8.10) according to the age. To avoid any bias from random selected single subject and improve registration robustness, average atlas as target for TPM was constructed from skull-stripped whole data using linear and nonlinear registration of AIR. Each subject was segmented into binary images of gray matter, white matter, and cerebrospinal fluid using fuzzy clustering and normalized into the space of average atlas. The probability images were the means of these binary images, and contained values in the range of zero to one. A TPM of a given tissue is a spatial probability distribution representing a certain subject population. In the spatial distribution of tissue probability according to the threshold of probability, the old group exhibited enlarged ventricles and overall GM atrophy as age-specific changes, compared to the young group. Our results are generally consistent with the few published studies on age differences in the brain morphology. The more similar the morphology of the subject is to the average of the population represented by the TPM, the better the entire classification procedure should work. Therefore, we suggest that group-specific TPM should be used as a priori information for the cerebral tissue classification.

Natural Course of Initially Non-Operated Cases of Acute Subdural Hematoma : The Risk Factors of Hematoma Progression

  • Son, Seong;Yoo, Chan Jong;Lee, Sang Gu;Kim, Eun Young;Park, Chan Woo;Kim, Woo Kyung
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.211-219
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    • 2013
  • Objective : The objectives of the present study were to characterize the natural course of initially non-operated traumatic acute subdural hematoma (ASDH) and to identify the risk factors of hematoma progression. Methods : Retrospective analysis was performed using sequential computed tomography (CT) images maintained in a prospective observational database containing 177 ASDH cases treated from 2005 to 2011. Patients were allocated to four groups as followings; 136 (76.8%) patients to the spontaneous resolution group, 12 (6.8%) who underwent operation between 4 hours and 7 days to the rapid worsening group (RWG), 24 (13.6%) who experienced an increase of hematoma and that underwent operation between 7 and 28 days to the subacute worsening group (SWG), and 5 (2.8%) who developed delayed aggravation requiring surgery from one month after onset to the delayed worsening group (DWG). Groups were compared with respect to various factors. Results : No significant intergroup difference was found with respect to age, mechanism of injury, or initial Glasgow Coma Scale. The presence of combined cerebral contusion or subarachnoid hemorrhage was found to be a significant prognostic factor. Regarding CT findings, mixed density was common in the RWG and the SWG. Midline shifting, hematoma thickness, and numbers of CT slices containing hematoma were significant prognostic factors of the RWG and the SWG. Brain atrophy was more severe in the SWG and the DWG. Conclusion : A large proportion of initially non-operated ASDHs worsen in the acute or subacute phase. Patients with risk factors should be monitored carefully for progression by repeat CT imaging.

A Case of Klippel-Trenaunay Syndrome Combinded with Sturge-Weber Syndrome (Klippel-Trenaunay 증후군과 Sturge-Weber 증후군이 동반된 1례)

  • Kim, Mi Young;Lee, So Young;Kim, Na Yeon;Lee, Sun Ju;Kim, Won Duck;Cho, Sung Min;Lee, Dong Seok;Kim, Doo Kwun;Choi, Sung Min
    • Clinical and Experimental Pediatrics
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    • v.46 no.9
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    • pp.909-912
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    • 2003
  • Klippel-Trenaunay syndrome is a rare mesodermal phakomatosis characterized by cutaneous haemangiomata( usually unilateral and involving an extremity), venous varicosities and osseous and soft tissue hypertrophy, of the affected limb. Sturge-Weber syndrome, also a mesodermal pharkomatosis, is characterized by a port-wine nevus, which is present from birth and covers the face and cranium in the territory of the first division of the trigeminal nerve. Homolateral to the skin lesion, there is atrophy and calcification of the cerebral hemisphere. We experienced an unusual 26-months-old female, who had features of both Klippel-Trenaunay syndrome and Sturge-Weber syndrome. She had an extensive nevus flammeus which extended primarily over both sides of her face and the right side of the trunk and extremities, hypertrophy of the right extremity without evidence of arterovenous fistula, right glaucoma, choroidal hemangioma and leptomeningeal hemangioma, which combined Klippel-Trenaunay syndrome and Sturge-Weber syndrome. We reported this rare case with a brief review of some related literatures.

Risk factors of ocular involvement in children with mitochondrial respiratory chain complex defect

  • Chae, Jung-Hyun;Lee, Jung-Hun;Kim, Kyo-Ryung;Byeon, Suk-Ho;Lee, Young-Mock;Kang, Hoon-Chul;Lee, Joon-Soo;Kim, Heung-Dong
    • Clinical and Experimental Pediatrics
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    • v.53 no.12
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    • pp.994-999
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    • 2010
  • Purpose: Mitochondrial dysfunction can present with various symptoms depending on the organ it has affected. This research tried to analyze the ophthalmologic symptoms and ophthalmologic examination (OE) results in patients with mitochondrial disease (MD). Methods: Seventy-four patients diagnosed with mitochondrial respiratory chain complex defect with biochemical enzyme assay were included in the study. They were divided into 2 groups based on the OE results by funduscopy and were analyzed on the basis of their clinical features, biochemical test results, morphological analysis, and neuroimaging findings. Results: Thirty-seven (50%) of the 74 MD patients developed ophthalmologic symptoms. Abnormal findings were observed in 36 (48.6%) patients during an OE, and 16 (21.6%) of them had no ocular symptoms. Significantly higher rates of prematurity, clinical history of epilepsy or frequent apnea events, abnormal light microscopic findings in muscle pathology, diffuse cerebral atrophy in magnetic resonance imaging, and brainstem hyperintensity and lactate peaks in magnetic resonance spectroscopy were noted in the group with abnormal OE results. Conclusion: Although the ophthalmologic symptoms are not very remarkable in MD patients, an OE is required. When the risk factors mentioned above are observed, a more active approach should be taken in the OE because a higher frequency of ocular involvement can be expected.

Three-Phase Bone Scintigraphy in Reflex Sympathetic Dystrophy Syndrome of the Hand (반사성 교감신경계 기능장애 증후군(RSDS)의 손 3상 골스캔 소견)

  • Ahn, Myeong-Im;Park, Jeong-Mi;Park, Young-Ha;Kim, Sung-Hoon;Chung, Soo-Kyo;Shinn, Kyung-Sub;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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    • pp.81-86
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    • 1991
  • Reflex sympathetic dystrophy syndrome (RSDS), known also as Sudeck's atrophy, is an uncommon disorder recognized by its distinctive symptom complex consisting of pain and tenderness, vasomotor instability, swelling, and dystrophic skin changes and radiologic changes. The present study has been carried out to prospectively establish scintigraphic diagnostic criteria for RSDS using three-phase radionuclide bone scintigraphy (TPBS). In addition, the usefulness in the evaluation of treatment of RSDS was assessed. Patients included were 6 men and 7 women with the age ranging from 25 to 63 years (average 47 years). Diagnosis was based on typical clinical symptoms and signs as described above. Associated clinical conditions in these patients were cerebral infarction (4 patients), lung cancer (2 patients), trauma (1 patient), lymphoma (1 patient), and unknown cause (5 patients). All patients showed diffuse radionuclide accumulation in juxtaarticular region on the delayed static image and 11 patients showed diffusely increased activities also on scintiangiogram and blood-pool image. Fillow-up TPBS after corticosteroid therapy in 4 patients revealed near normal return of abnormal radionuclide accumulations in the affected hand. TPBS is an useful test for the diagnosis of as well as the evaluation of the therapeutic effects of RSDS.

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Region Segmentation and Volumetry of Brain MR Image represented as Blurred Gray Value by the Partial Volume Artifact (부분체적에 의해 번진 명암 값으로 표현된 뇌의 자기공명영상에 대한 영역분할 및 체적계산)

  • 성윤창;송창준;노승무;박종원
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.25 no.7A
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    • pp.1006-1016
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    • 2000
  • This study is to segment white matter, gray matter, and cerebrospinal fluid(CSF) on a brain MR image and to calculate the volume of each. First, after removing the background on a brain MR image, we segmented the whole region of a brain from a skull and a fat layer. Then, we calculated the partial volume of each component, which was present in scanning finite thickness, with the arithmetical analysis of gray value from the internal region of a brain showing the blurring effects on the basis of the MR image forming principle. Calculated partial volumes of white matter, gray matter and CSF were used to determine the threshold for the segmentation of each component on a brain MR image showing the blurring effects. Finally, the volumes of segmented white matter, gray matter, and CSF were calculated. The result of this study can be used as the objective diagnostic method to determine the degree of brain atrophy of patients who have neurodegenerative diseases such as Alzheimer's disease and cerebral palsy.

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Effect of Ghrelin on Memory Impairment in a Rat Model of Vascular Dementia (그렐린이 혈관성 치매 쥐의 기억 손상에 미치는 효과)

  • Park, Jong-Min;Kim, Youn-Jung
    • Journal of Korean Academy of Nursing
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    • v.49 no.3
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    • pp.317-328
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    • 2019
  • Purpose: The purpose of this study was to identify the effect of ghrelin on memory impairment in a rat model of vascular dementia induced by chronic cerebral hypoperfusion. Methods: Randomized controlled groups and the posttest design were used. We established the representative animal model of vascular dementia caused by bilateral common carotid artery occlusion and administered $80{\mu}g/kg$ ghrelin intraperitoneally for 4 weeks. First, behavioral studies were performed to evaluate spatial memory. Second, we used molecular biology techniques to determine whether ghrelin ameliorates the damage to the structure and function of the white matter and hippocampus, which are crucial to learning and memory. Results: Ghrelin improved the spatial memory impairment in the Y-maze and Morris water maze test. In the white matter, demyelination and atrophy of the corpus callosum were significantly decreased in the ghrelin-treated group. In the hippocampus, ghrelin increased the length of hippocampal microvessels and reduced the microvessels pathology. Further, we confirmed angiogenesis enhancement through the fact that ghrelin treatment increased vascular endothelial growth factor (VEGF)-related protein levels, which are the most powerful mediators of angiogenesis in the hippocampus. Conclusion: We found that ghrelin affected the damaged myelin sheaths and microvessels by increasing angiogenesis, which then led to neuroprotection and improved memory function. We suggest that further studies continue to accumulate evidence of the effect of ghrelin. Further, we believe that the development of therapeutic interventions that increase ghrelin may contribute to memory improvement in patients with vascular dementia.