• Title/Summary/Keyword: Magnetic Resonance Imaging/methods

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fMRI Study on the Brain Activity Induced by Manual Acpuncture at BL62 (신맥(申脈) 혈위자극이 fMRI상 뇌활성화 변화에 미치는 영향 연구)

  • Rheu, Kyoung-Hwan;Choi, Il-Hwan;Park, Hi-Joon;Lim, Sa-Bi-Na
    • Korean Journal of Acupuncture
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    • v.23 no.2
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    • pp.89-103
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    • 2006
  • Objectives: Recently, the effect of acupuncture has been approved not only in the East but also in the West, so the interest on acupuncture was greatly improved. Especially, functional magnetic resonance imaging(fMRI) was embossed as the study tool for the mechanism of acupuncture noninvasively and many studies on the mechanism of acupuncture using fMRI were carried out. We archived the fMRI study on the brain activity induced by manual acupuncture at BL62(申脈). Methods: The study was the acupuncture at BL62(申脈) and we acquired 9 fMRI results from 6 persons$(age\;20{\sim}30,\;4\;male\;and\;2\;female)$. These studies employed The block design for mapping brain activity and acupuncture was perfomed at BL62(申脈) on the left foot. Results: The brain related motor function was cerebellum, basal ganglia and cerebral cortex and thalamus connected these elements. In the result of this study, the regions of significant activation in the cerebellum was centered on the spinocerebellum in the anterior lobe, so we presumed that this result showed the input of stimulation by the acupuncture on BL62(申脈). But basal ganglia and cerebral cortex showed the regions of significant activation in the left larger than the right and regions of the cerebral cortex was the motor and sensory cortex. Such a result explained that acupuncture at BL62(申脈) could have influence the motor function and acupuncture at left BL62(申脈) could affect the right side through the activation of the left basal ganglia and cerebral cortex. Conclusions: In the theory of crossing needling at collaterals(繆刺論), it the pathogenic factor invaded in the Yang Heel channel(陽?脈) that was one of the eight Extra meridians(奇經八脈), we recognized the disease of the collateral channel and used contralateral BL62(申脈) for treatment of the Yang Heel channel(陽?脈). Moreover the result of this study could bear the construction that acupuncture at the left BL62(申脈) treats the contralateral lesion and this construction is related to the theory of crossing needling at collaterals(繆刺論).

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Percutaneous Radiofrequency ablation for the Treatment of Osteoid osteoma (유골골종의 경피적 고주파 열 치료)

  • Seo, Jai-Gon;Jung, Kwang-Hoon;Yang, Il-Soon
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.3
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    • pp.83-89
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    • 2002
  • Purpose: To analyze the postoperative functional and radiographic follow-up results in patients who underwent percutaneous radiofrequency ablation therapy after the diagnosis of osteoid osteoma. Materials and Methods: Seven patients, who were clinically and radiographically diagnosed with osteoid osteoma from July 1999 to January 2001, and received percutaneous radiofrequency ablation therapy. The average follow-up period was 15.5 months(range, 8~25 months). For the diagnosis and accurate localization of the lesion, simple radiography, computed tomography and magnetic resonance imaging(MRI) were performed preoperatively. Simple radiographs and MRI were taken periodically for the follow-up studies. Results: In all 7 patients, symptoms completely disappeared within 3 days after the operation. The average period of hospitalization was 2.4 days, excluding 1 patient who needed an additional burn treatment. The average postoperative night and day pain scores were 1.8 and 1.3, respectively. The average vocational and recreational activity scores were 1 and 0.6, respectively. Conclusions: Satisfactory functional results were obtained with percutaneous radiofrequency ablation therapy for the elimination of osteoid osteoma. Compared to conventional treatment, the advantages of this therapy were short hospitalization period, no internal fixation and bone graft for preventing fracture, and no limitation of joint motion by long fixation period.

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Comparison of New AJCC Staging System with OId AJCC Staging System in Nasopharyngeal Carcinoma (비인강암에서의 AJCC의 새로운 병기 분류법과 기존 병기 분류법의 비교)

  • Hong Semie;Wu Hong-Gyun;Park Charn I1
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.221-225
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    • 2000
  • Purpose : This study was designed to examine the reliability of the new version of the AJCC staging system (1997) of nasopharyngeal carcinoma in comparison with the AJCC staging system of 1992. Materials and Methods :Between 1983 and 1996, 185 patients with histologically proven nasopnaryngeal carcinoma were treated with radiation therapy at the Department of Therapeutic Radiology Seoul National University Hospital. For these patients, AJCC staging system of 1992 was compared with the 1997 version by reviewing hospital records, computed tomography (CT) and/or magnetic resonance imaging (MRI). Results :5-year overall suwival rates according to the 1992 and 1997 AJCC staging systems were 100$\%$, and 100$\%$ at stage 1: 100$\%$, and 68.8$\%$ at stage 11; 61.4$\%$, and 63.8$\%$ at stage 111; 61.1$\%$, and 63.2$\%$ at stage IV. S-year overall survival rates of each classification showed significant differences between stages (p=0.0049 for the old version, p=0.01 for the new), but no significant difference was found between the staging systems except at stage 11. Conclusion : The new AJCC staging system allows staging as reliably as the 1992 version, but the adequacy of the newly modified staging classification should be confirmed by further clinical examination.

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The Correlation between Caudal Epidurogram and Low Back Pain

  • Jo, Dae-Hyun;Jang, Sul
    • The Korean Journal of Pain
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    • v.25 no.1
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    • pp.22-27
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    • 2012
  • Background: The common causes of lower back pain with or without leg pain includes disk disease and spinal stenosis. A definitive diagnosis is usually made by means of magnetic resonance imaging (MRI), but treatment is often difficult because the MRI findings are not consistent with the symptoms of the patient in many cases. The objective of this study was to observe the correlation between the patterns of epidurography performed in patients having lower back pain with or without leg pain and the position or severity of the pain as subjectively described by the patients. Methods: The subjects of this study were 69 outpatients with lower back pain with or without leg pain who visited our clinic and complained of predominant pain on one side. We performed caudal epidural block using an image intensifier. A mixture of the therapeutic drug and the contrast agent (10 ml) was injected to observe the contrast flow pattern. The patients who complained of predominant pain on one side were divided into the left side group and the right side group. A judgment of inconsistency was made if the contrast agent flowed to the side of the pain, while a judgment of consistency was made if the contrast agent flowed to the opposite side of the pain. The degree of the drug distribution was evaluated by counting the number of cells to which the contrast agent's flowed for evaluating the correlation between the contrasted cell and the severity of pain (one group ${\leq}$ VAS 7, the other group ${\geq}$ VAS 8) the degree of the contrast agent's contrast was evaluated by dividing and counting an image into 15 cells (the left, right, and middle sections at each level of L4, L5, S1, S2, and S3). Results: Thirty out of the 69 patients who had laterality in pain, that is, those who complained of predominant pain on one side, showed that the laterality of the pain and the contrast agent flow was consistent, while 39 patients showed that the laterality was inconsistent (P: 0.137). The evaluation of the correlation between the pain and the contrast agent flow showed that the mean number of contrasted cells was $9.0{\pm}2.2$ for the 46 patients in the group with a VAS of 7 or lower and $6.5{\pm}2.0$ for the 23 patients in the group with a VAS of 8 or higher, indicating that the former group showed a significantly greater number of contrasted cells (P < 0.001). Conclusions: This study, conducted with patients having lower back pain with or without leg pain, showed that the contrast flow pattern of caudal epidurography had a significant correlation with the severity of the pain but not with the laterality of the pain.

The Abnormality of Posterior Default Mode Network in Medication-Naïve Attention-Deficit Hyperactivity Disorder Children : Resting State fMRI Study (약물 복용력이 없는 주의력결핍 과잉행동장애 아동에서의 뒤쪽 내정상태회로 이상 : 휴식상태 기능적 뇌자기공명영상 연구)

  • Choi, Jee-Wook;Go, Hyo-Jin;Woo, Young-Sup;Song, Seung-Hoon;Yang, Po-Song;Jeong, Bum-Seok
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.23 no.2
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    • pp.57-62
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    • 2012
  • Objectives : Characteristic symptoms, including hyperactivity and easy distractibility, in children with attention-deficit hyperactivity disorder (ADHD) suggest that their brain status, even at rest, might differ from that of healthy children. This study was conducted in order to determine whether resting state brain activity is compromised in medication-naive children with ADHD. Methods : Twenty medication-naive children with ADHD (mean age $10.3{\pm}2.5$) and 28 age- and gender-matched healthy volunteers (mean age $10.3{\pm}2.0$) underwent measurements for resting state brain activity using functional magnetic resonance imaging (fMRI). Among resting state related-independent components (RSICs) extracted from fMRI data using independent component analysis, a significant difference in RSICs was observed between groups, using a mixed Gaussian/gamma model. Results : Except for IQ, which was higher in the healthy control group, no demographic difference was observed between the two groups (p<.001). Significantly less activation of one RSIC, which includes the bilateral precuneus/posterior cingulate cortex, occipito-temporal junction, and anterior cingulate cortex, was observed in the ADHD group, compared with the control group (p<.05). Conclusion : An abnormal RSIC, posterior default mode network (DMN), was observed in the medication-naive ADHD group. Results of our study suggest that abnormality of posterior DMN is one of the main pathophysiologies of ADHD.

Case Report of 6 Patients Not Improved after Conservative Treatment of Herniated Lumbar Intervertebral Disc (요추간판탈출증으로 보존적 치료후 호전되지 않는 환자 6 례 보고)

  • Lee, Sam-Ro;Kim, Hyun-Jung;Byun, Jae-Young;Ahn, Soo-Gi;Lee, Jong-Deok
    • Journal of Acupuncture Research
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    • v.17 no.3
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    • pp.265-276
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    • 2000
  • Objectives : The purpose of this study is to observe the clinical characteristics of 6 patients who were not improved after admitted conservative treatment in this 311 patients. Methods : We retrospectivety reviewed 311 patients of Herniated Lumbar Intervertebral Disc which undenvent admitted conservative treatment from November 1997 to June 2000. 311 patients were diagnosed by computed tomography or magnetic resonance imaging in addition to physical examination. Other complications were not detected in 311 patients with Hemiated Lumbar Intervertebral Disc. In case that the scoliosis appeared to caused by severe pain, we included this scoliosis patient with the object of survey. Results : 1. In 6 patients who were not improved, 4 patients were large herniation and 2 patients were medium herniation. 2. In all of 6 patients, the angle of straight leg raising test was low and was not imporved unril discharge. 3. X-ray findings showed straightening in all of 6 patients, disc space narrowing in 3 of 6 patients. 4. X-ray findings showed scoliosis in 3 of 4 patients who were severe pain. 5. The onset was relarively long from 30 days to 7 years. 6. The age was relatively young from 10's to 30's. 7. The adimission date was ralatively long from 32 days to 105 days. Conclusions : In 6 patients, there were observed much volume of disc herniation, low angle of straight leg raising test, young people in an age group, straightening of x-ray finding.

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The Effects of Treatment of Korean Medicine for Superior Labrum Anterior to Posterior Lesions: A Retrospective Chart Review

  • Park, Ju-Hun;Cho, Hyun-Woo;Park, Han-Bin;Yoo, Dong-Hwi;Kim, Sang-Gyun;Kwon, Oh-Hoon;Choi, Kang-Eah;Choi, Seong-Hun;Chu, Hong-Min;Jang, Jong-Won
    • Journal of Acupuncture Research
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    • v.37 no.1
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    • pp.49-58
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    • 2020
  • Background: This study aimed to investigate the clinical effectiveness of treatment of Korean medicine on superior labrum anterior to posterior (SLAP) lesions. Methods: A total of 55 inpatients diagnosed with SLAP lesions by magnetic resonance imaging, were investigated from May 1st, 2014 to May 31st, 2019 at Haeundae Jaseng Hospital of Korean Medicine. The patients were sorted by gender, age, causing factor, illness duration, period of hospitalization, SLAP lesion type, complications, and treatments. Treatments included acupuncture, pharmacopuncture, Chuna therapy, herbal treatment, and physiotherapy. After treatment, the Numeric Rating Scale, Shoulder Pain and Disability Index, and European Quality of Life 5-Dimension questionnaire were used to evaluate treatment effect. Results: There were more males than females in this study (1:0.83). Patients were more likely to be in their 50s (38.18%), have an unknown etiology (70.91%), and be in the subacute disease stage (41.82%). According to the SLAP lesion type, most of the inpatients had Type 2 lesions (69.09%). For inpatients diagnosed with SLAP lesions, the mean shoulder numeric rating scale score decreased from 5.55 ± 0.90, to 4.07 ± 1.18 (p < 0.001), the mean Shoulder Pain and Disability Index score decreased from 50.35 ± 18.36, to 39.90 ± 19.34 (p < 0.001), and the mean European quality of life 5-dimension index increased from 0.70 ± 0.16, to 0.75 ± 0.13 (p < 0.01) after treatment. Conclusion: Treatment of Korean medicine effectively decreased pain and increased the quality of life of the patients with SLAP lesions in this study.

Software development for the visualization of brain fiber tract by using 24-bit color coding in diffusion tensor image

  • Oh, Jung-Su;Song, In-Chan;Ik hwan Cho;Kim, Jong-Hyo;Chang, Kee-Hyun;Park, Kwang-Suk
    • Proceedings of the KSMRM Conference
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    • 2002.11a
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    • pp.133-133
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    • 2002
  • Purpose: The purpose of paper is to implement software to visualize brain fiber tract using a 24-bit color coding scheme and to test its feasibility. Materials and Methods: MR imaging was performed on GE 1.5 T Signa scanner. For diffusion tensor image, we used a single shot spin-echo EPI sequence with 7 non-colinear pulsed-field gradient directions: (x, y, z):(1,1,0),(-1,1,0),(1,0,1),(-1,0,1),(0,1,1),(0,1,-1) and without diffusion gradient. B-factor was 500 sec/$\textrm{mm}^2$. Acquisition parameters are as follows: TUTE=10000ms/99ms, FOV=240mm, matrix=128${\times}$128, slice thickness/gap=6mm/0mm, total slice number=30. Subjects consisted of 10 normal young volunteers (age:21∼26 yrs, 5 men, 5 women). All DTI images were smoothed with Gaussian kernel with the FWHM of 2 pixels. Color coding schemes for visualization of directional information was as follows. HSV(Hue, Saturation, Value) color system is appropriate for assigning RGB(Red, Green, and Blue) value for every different directions because of its volumetric directional expression. Each of HSV are assigned due to (r,$\theta$,${\Phi}$) in spherical coordinate. HSV calculated by this way can be transformed into RGB color system by general HSV to RGB conversion formula. Symmetry schemes: It is natural to code the antipodal direction to be same color(antipodal symmetry). So even with no symmetry scheme, the antipodal symmetry must be included. With no symmetry scheme, we can assign every different colors for every different orientation.(H =${\Phi}$, S=2$\theta$/$\pi$, V=λw, where λw is anisotropy). But that may assign very discontinuous color even between adjacent yokels. On the other hand, Full symmetry or absolute value scheme includes symmetry for 180$^{\circ}$ rotation about xy-plane of color coordinate (rotational symmetry) and for both hemisphere (mirror symmetry). In absolute value scheme, each of RGB value can be expressed as follows. R=λw|Vx|, G=λw|Vy|, B=λw|Vz|, where (Vx, Vy, Vz) is eigenvector corresponding to the largest eigenvalue of diffusion tensor. With applying full symmetry or absolute value scheme, we can get more continuous color coding at the expense of coding same color for symmetric direction. For better visualization of fiber tract directions, Gamma and brightness correction had done. All of these implementations were done on the IDL 5.4 platform.

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The Relationship between Temporomandibular joint Pain and the Relative Signal Intensity of Retrodiscal Tissue on T1-, and T2-Weighted MRI Images (원판후조직의 T1, T2 강조영상상의 상대적 신호강도와 관절통증의 상관관계)

  • Jung, Jae-Kwang;Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.36 no.3
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    • pp.177-185
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    • 2011
  • Aims: The purpose of this study was to evaluate the relationship between temporomandibular joint pain and the relative signal intensity (RSI) of retrodiscal tissue on T1-, and T2-weighted MRI images. Materials and Methods: This study was based on 122 TMJs of 61 patients who complain of TMJ pain in only one side but were revealed to have disc displacement in both TMJs according to MRI findings. The signal intensities of regions of interest (ROIs) in retrodiscal tissues were measured using T1-, and T2-weighted MRI images. The RSIs of retrodiscal tissues were referenced to the signal intensities of the ROIs of brain gray matter. The relationships between the RSI of retrodiscal tissue and joint pain, joint effusion, condylar degenerative change, and degree of disc displacement were examined. In addition, the relationships between joint pain and joint effusion, condylar degenerative change, and degree of disc displacement were examined. Results: On T1-weighted MR images, the painful TMJs showed significantly higher retrodiscal tissue RSI than non-painful TMJs. In addition, there is an association between joint pain and the degree of disc displacement. However, on T2-weighted MR images, the RSIs of retrodiscal tissues didn't show any significant differences with regard to joint pain, joint effusion, condylar degenerative change, and degree of disc displacement. Conclusions: The signal intensity of retrodiscal tissue can be used as a diagnostic marker for painful TMJ. However, the overall results suggest the signal intensity of retrodiscal tissue has a limited diagnostic significance in determining the pathologic status of TMJ.

The Predictable Factors of the Postoperative Kyphotic Change of Sagittal Alignment of the Cervical Spine after the Laminoplasty

  • Lee, Jun Seok;Son, Dong Wuk;Lee, Su Hun;Kim, Dong Ha;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.577-583
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    • 2017
  • Objective : Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty. Methods : We retrospectively reviewed the medical records of 49 patients who underwent open door laminoplasty for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL) at Pusan National University Yangsan Hospital between January 2011 and December 2015. Inclusion criteria were as follows : 1) preoperative diagnosis of OPLL or CSM, 2) no previous history of cervical spinal surgery, cervical trauma, tumor, or infection, 3) minimum of one-year follow-up post laminoplasty with proper radiologic examinations performed in outpatient clinics, and 4) cases showing C7 and T1 vertebral body in the preoperative cervical sagittal plane. The radiologic parameters examined included C2-C7 Cobb angles, T1 slope, C2-C7 sagittal vertical axis (SVA), range of motion (ROM) from C2-C7, segmental instability, and T2 signal change observed on magnetic resonance imaging (MRI). Clinical factors examined included preoperative modified Japanese Orthopedic Association scores, disease classification, duration of symptoms, and the range of operation levels. Results : Mean preoperative sagittal alignment was $13.01^{\circ}$ lordotic; $6.94^{\circ}$ lordotic postoperatively. Percentage of postoperative kyphosis was 80%. Patients were subdivided into two groups according to postoperative Cobb angle change; a control group (n=22) and kyphotic group (n=27). The kyphotic group consisted of patients with more than $5^{\circ}$ kyphotic angle change postoperatively. There were no differences in age, sex, C2-C7 Cobb angle, T1 slope, C2-C7 SVA, ROM from C2-C7, segmental instability, or T2 signal change. Multiple regression analysis revealed T1 slope had a strong relationship with postoperative cervical kyphosis. Likewise, correlation analysis revealed there was a statistical significance between T1 slope and postoperative Cobb angle change (p=0.035), and that there was a statistically significant relationship between T1 slope and C2-C7 SVA (p=0.001). Patients with higher preoperative T1 slope demonstrated loss of lordotic curvature postoperatively. Conclusion : Laminoplasty has a high probability of aggravating sagittal balance of the cervical spine. T1 slope is a good predictor of postoperative kyphotic changes of the cervical spine. Similarly, T1 slope is strongly correlated with C2-C7 SVA.