The Journal of the Society of Stroke on Korean Medicine
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v.7
no.1
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pp.23-33
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2006
Objectives : This study was prepared for investigating the clinical features of stroke patients. Methods : We retrospectively reviewed the medical records of 102 patients who were admitted to Department of Internal Medicine, College of Oriental Medicine, Kyung-Won University with a diagnosis of stroke from Jan. 1, 2004 to Dec. 31, 2004. Results : Ischemic stroke(include TIA, 82.4%) was more common than hemorrhagic stroke(17.6%). The incidence in male was 41.2%, in female was 17.6% and the most prevalent age group is over-sixties. Cerebral infarction was most frequently noticed in lacunar-infarction and hemorrhage in putamen. Hypertention, the most preceding diseases, followed by diabetes mellitus and CVA. The rate of recurrence was 27.45%. Cerebral infarction and cerebral hemorrhage was much occurred after rising. The most patients visited the hospital within 24 Hours. The most common symptoms in admission time were motor weakness and speech disorder. The complication was mostly mental disorder. Conclusion : Our study on CVA patients was similar to previous studies from 1994 to 2003. In most cases, western and oriental treatment and medicine were given synthetically.
Dong Jae Shin;Seung Hong Choi;Roh-Eul Yoo;Koung Mi Kang;Tae Jin Yun;Ji-Hoon Kim;Chul-Ho Sohn;Sang Won Jo;Eun Jung Lee
Korean Journal of Radiology
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v.22
no.8
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pp.1352-1368
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2021
Objective: For an accurate dynamic contrast-enhanced (DCE) MRI analysis, exact baseline T1 mapping is critical. The purpose of this study was to compare the pharmacokinetic parameters of DCE MRI using synthetic MRI with those using fixed baseline T1 values. Materials and Methods: This retrospective study included 102 patients who underwent both DCE and synthetic brain MRI. Two methods were set for the baseline T1: one using the fixed value and the other using the T1 map from synthetic MRI. The volume transfer constant (Ktrans), volume of the vascular plasma space (vp), and the volume of the extravascular extracellular space (ve) were compared between the two methods. The interclass correlation coefficients and the Bland-Altman method were used to assess the reliability. Results: In normal-appearing frontal white matter (WM), the mean values of Ktrans, ve, and vp were significantly higher in the fixed value method than in the T1 map method. In the normal-appearing occipital WM, the mean values of ve and vp were significantly higher in the fixed value method. In the putamen and head of the caudate nucleus, the mean values of Ktrans, ve, and vp were significantly lower in the fixed value method. In addition, the T1 map method showed comparable interobserver agreements with the fixed baseline T1 value method. Conclusion: The T1 map method using synthetic MRI may be useful for reflecting individual differences and reliable measurements in clinical applications of DCE MRI.
This fMRI study is aim to investigate effects of competitive environment in cognitive empathic process in human brain. Empathy is known as a crucial factor for human's adaptive behavior in aspects of social cognition and it is almost automatic process, on the other hand competitive situation is psychologically devastated environment to win someone for getting rewards. We hypnotized that reading and understanding of other person's mind are a specific characteristic related to survival evolutionarily, however competition would have an effect on the empathic cognitive process because of mechanisms of competition. To manipulate the competitive atmosphere, one researcher took a role of competitor against participants and they were instructed to get monetary rewards when their performance was better than a competitor. 21 participants(9 males and 12 females) performed to judge the emotional valence of the empathic task consisted of illustrated images with various situation could be experienced in real world as on $1^{st}$ person perspective in both competitive and non-competitive condition, and did same performance with objects stimulus in control condition. In order to examine the competition effects on empathic process,, hemodynamic response were obtained during fMRI session and the imaging data were analyzed to identify brain regions where responses to each condition across the two consecutive runs. Participants' reaction time in competitive condition was faster statistically significant than non-competitive one. Activation for competitive condition increased in the following areas: ACC, mPFC, SMG, thalamus extended caudate and Nacc, parahippocampal gyrus, and for non-competitive condition increased paracingulate gyrus, temporal pole, vmPFC, superior occipital gyrus. As a result of regression analysis using empathic scores as covariance, the rSMG, IFG, fusiform gyrus, thalamus, putamen were correlated with higher empathic levels, and TPJ were correlated with lower empathic scores. We suggest that these observations could mean competitive environment have an effect on neural base of cognitive empathic process.
Purpose: Neuroreceptor PET studies require 60-120 minutes to complete and head motion of the subject during the PET scan increases the uncertainty in measured activity. In this study, we investigated the effects of the data-driven head mutton correction on the evaluation of endogenous dopamine release (DAR) in the striatum during the motor task which might have caused significant head motion artifact. Materials and Methods: $[^{11}C]raclopride$ PET scans on 4 normal volunteers acquired with bolus plus constant infusion protocol were retrospectively analyzed. Following the 50 min resting period, the participants played a video game with a monetary reward for 40 min. Dynamic frames acquired during the equilibrium condition (pre-task: 30-50 min, task: 70-90 min, post-task: 110-120 min) were realigned to the first frame in pre-task condition. Intra-condition registrations between the frames were performed, and average image for each condition was created and registered to the pre-task image (inter-condition registration). Pre-task PET image was then co-registered to own MRI of each participant and transformation parameters were reapplied to the others. Volumes of interest (VOI) for dorsal putamen (PU) and caudate (CA), ventral striatum (VS), and cerebellum were defined on the MRI. Binding potential (BP) was measured and DAR was calculated as the percent change of BP during and after the task. SPM analyses on the BP parametric images were also performed to explore the regional difference in the effects of head motion on BP and DAR estimation. Results: Changes in position and orientation of the striatum during the PET scans were observed before the head motion correction. BP values at pre-task condition were not changed significantly after the intra-condition registration. However, the BP values during and after the task and DAR were significantly changed after the correction. SPM analysis also showed that the extent and significance of the BP differences were significantly changed by the head motion correction and such changes were prominent in periphery of the striatum. Conclusion: The results suggest that misalignment of MRI-based VOI and the striatum in PET images and incorrect DAR estimation due to the head motion during the PET activation study were significant, but could be remedied by the data-driven head motion correction.
Purpose: We investigated quantification of dopaminergic transporter (DAT) and serotonergic transporter (SERT) on $^{123}I$-FP-CIT SPECT for differentiating between multiple systemic atrophy (MSA) and idiopathic Parkinson's disease (IPD). Materials and Methods: N-fluoropropyl-$2{\beta}$-carbomethoxy-$3{\beta}$-4-[$^{123}I$]-iodophenylnortropane SPECT ($^{123}I$-FP-CIT SPECT) was performed in 8 patients with MSA (mean age: $64.0{\pm}4.5yrs$, m:f=6:2), 13 with early IPD (mean age: $65.5{\pm}5.3yrs$, m:f=9:4), and 12 healthy controls (mean age: $63.3{\pm}5.7yrs$, m:f=8:4). Standard regions of interests (ROls) of striatum to evaluate DAT, and hypothalamus and midbrain for SERT were drawn on standard template images and applied to each image taken 4 hours after radiotracer injection. Striatal specific binding for DAT and hypothalamic and midbrain specific binding for SERT were calculated using region/reference ratio based on the transient equilibrium method. Group differences were tested using ANOVA with the postHoc analysis. Results: DAT in the whole striatum and striatal subregions were significantly decreased in both patient groups with MSA and early IPD, compared with healthy control (p<0.05 in all). In early IPD, a significant increase in the uptake ratio in anterior and posterior putamen and a trend of increase in caudate to putamen ratio was observed. In MSA, the decrease of DAT was accompanied with no difference in the striatal uptake pattern compared with healthy controls. Regarding the brain regions where $^{123}I$-FP-CIT binding was predominant by SERT, MSA patients showed a decrease in the binding of $^{123}I$-FP-CIT in the pons compared with controls as well as early IPD patients (MSA: $0.22{\pm}0.1$ healthy controls: $0.33{\pm}0.19$, IPD: $0.29{\pm}0.19$), however, it did not reach the statistical significance. Conclusion: In this study, the differential patterns in the reduction of DAT in the striatum and the reduction of pontine $^{123}I$-FP-CIT binding predominant by SERT could be observed in MSA patients on $^{123}I$-FP-CIT SPECT. We suggest that the quantification of SERT as well as DAT using $^{123}I$-FP-CIT SPECT is helpful to differentiate parkinsonian disorders in early stage.
Objectives : This study was built to investigate the effect of Trachelospermi Caulis herbal-acupuncture on the Collagen-induced arthritis(CIA) in rats. Methods : Arthritis was induced by intradermal injection of Bovine type II collagen solution into base of tail. Experimental group were divided into 5 groups ; Normal(N) group, Control(C) group, Trachelospermi Caulis high(TH) group, Trachelospermi Caulis low(TL) group, Saline(S) group(n=7 for each group). Normal group was had no management. Control group was injected with Bovine type II collagen solution and taken no treatment. Trachelospermi Caulis high group was injected with Bovine type II collagen solution and taken high-intensity(10mg/kg) herbal-acupuncture treatment on $ST_{36}$. Trachelospermi Caulis low group was injected with Bovine type II collagen solution and taken low-intensity(5mg/kg) herbal-acupuncture treatment on $ST_{36}$. Saline group was injected with Bovine type II collagen solution and taken saline injection on $ST_{36}$. Body weight, paw edema volume and ankle joint thickness were measured during experimental day. On the last experimental day, we analyzed WBC count, TNF-$\alpha$ & IL-$1{\beta}$ concentration, c-fos immunohistochemistry and NADPH-d histochemistry for evaluating the effect of Trachelospermi Caulis herbal-acupuncture. Results : The results were as follows ; 1. In the change of paw edema volume, TH group only has significant difference compared with C group. 2. In the change of ankle joint thickness, TH group only has significant difference compared with C group. 3. In WBC count of serum, TH, TL groups have significant decrease compared with C group. 4. In TNF-$\alpha$ concentration of effusion, TH, TL groups have significant decrease compared with C group. and TH group has significant decrease compared with TL group. 5. In IL-$1{\beta}$ concentration of effusion, TH, TL groups have significant decrease compared with C group. and TH group has significant decrease compared with TL group. 6. In c-fos positive neurons of S1S2(cortex) region, TH, TL, S groups have significant decrease compared with C group. 7. In NADPH-d positive neurons of CPu(caudate putamen) region, TH, TL groups have significant decrease compared with C group. 8. In NADPH-d positive neurons of Tfp(transverse fibers of pons) region, TH, TL, S groups have significant decrease compared with C group. and TH group has significant decrease compared with S group. Conclusions : According to above results, we hope that Trachelospermi Caulis herbal-acupuncture may have the effect that decreases progression and development of CIA. And it can be suggested that Trachelospermi Caulis herbal-acupuncture may reduce the expression of c-fos and NOS.
Welders working in a confined space, like in the shipbuilding industry, are at risk of being exposed to high concentrations of welding fumes and developing pneumoconiosis or other welding-fume exposure related diseases. Among such diseases, manganism resulting from welding-fume exposure remains a controversial issue, as the movement of manganese into specific brain regions has not been clearly established. Accordingly, to investigate the distribution of manganese in the brain after welding-fume exposure, male Sprague Dawley rats were exposed to welding fumes generated from manual metal arc stainless steel (MMA-SS) at concentrations of $63.6{\pm}4.1$$mg/m^3$ (low dose, containing 1.6 $mg/m^3$ Mn) and $107.1{\pm}6.3$$mg/m^3$ (high dose, containing 3.5 $mg/m^3$ Mn) total suspended particulates for 2 hrs per day, in an inhalation chamber over a 60-day period. Blood, brain, lungs and liver samples were collected after 2 hr, 15, 30, and 60 days of exposure and the tissues analyzed for their manganese concentrations using an atomic absorption spectrophotometer. Although dose- and time-dependent increases in the manganese concentrations were found in the lungs and livers of the rats exposed for 60 days, only slight manganese increases were observed in the blood during this period. Major statistically significant increases in the brain manganese concentrations were detected in the cerebellum after 15 days of exposure and up until 60 days. Slight increases in the manganese concentrations were also found in the substantia nigra, basal ganglia (caudate nucleus, putamen, and globus pallidus), temporal cortex, and frontal cortex, thereby indicating that the pharmacokinetics and distribution of manganese inhaled from welding fumes would appear to be different from those resulting from manganese-only exposure.
Shin, Woo Jong;Moon, Yeo Ok;Yoon, Hye Ran;Dong, Eun Sil;Ahn, Young Min
Clinical and Experimental Pediatrics
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v.46
no.3
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pp.295-301
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2003
Glutaric aciduria type 1(GA1) is an autosomal recessive disorder of the lysine, hydroxylysine and tryptophan metabolism caused by the deficiency of mitochondrial glutaryl-CoA dehydrogenase. This disease is characterized by macrocephaly at birth or shortly after birth and various neurologic symptoms. Between the first weeks and the 4-5th year of life, intercurrent illness such as viral infections, gastroenteritis, or even routine immunizations can trigger acute encephalopathy, causing injury to caudate nucleus and putamen. But intellectual functions are well preserved until late in the disease course. We report a one-month-old male infant with macrocephaly and hypotonia. In brain MRI, there was frontotemporal atrophy(widening of sylvian cistern). In metabolic investigation, there were high glutarylcarnitine level in tandem mass spectrometry and high glutarate in urine organic acid analysis, GA1 was confirmed by absent glutaryl-CoA dehydrogenase activity in fibroblast culture. He was managed with lysine free milk and carnitine and riboflavin. He developed well without a metabolic crisis. If there is macrocephaly in an infant with neuroradiologic sign of frontotemporal atrophy, GA1 should have a high priority in the differential diagnosis. Because current therapy can prevent brain degeneration in more than 90% of affected infants who are treated prospectively, recognition of this disorder before the brain has been injured is essential for treatment.
Purpose: Normal aging results in detectable changes in the brain structure and function. We evaluated the changes of regional cerebral glucose metabolism in the normal aging process with FDG PET. Materials and Methods: Brain PET images were obtained in 44 healthy volunteers (age range 20-69 'y'; M:F = 29:15) who had no history of neuropsychiatric disorders. On 6 representative transaxial images, ROIs were drawn in the cortical and subcortical areas. Regional FDG uptake was normalized using whole brain uptake to adjust for the injection dose and correct for nonspecific declines of glucose metabolism affecting all brain areas equally. Results: In the prefrontal, temporoparietal and primary sensorimotor cortex, the normalized FDG uptake (NFU) reached a peak in subjects in their 30s. The NFU in the prefrontal and primary sensorimotor cortex declined with age after 30s at a rate of 3.15%/decade and 1.93%/decade, respectively. However, the NFU in the temporoparietal cortex did not change significantly with age after 30s. The anterior (prefrontal) posterior (temporoparietal) gradient peaked in subjects in their 30s and declined with age thereafter at a rate of 2.35%/decade. The NFU in the caudate nucleus was decreased with age after 20s at a rate of 2.39%/decade. On the primary visual cortex, putamen, and thalamus, the NFU values did not change significantly throughout the ages covered. These patterns were not significantly different between right and left cerebral hemispheres. Of interest was that the NFU in the left cerebellar cortex was increased with age after 20s at a rate of 2.86%/decade. Conclusion: These data demonstrate regional variation of the age-related changes in the cerebral glucose metabolism, with the most prominent age-related decline of metabolism in the prefrontal cortex. The increase in the cerebellar metabolism with age might reflect a process of neuronal plasticity associated with aging.
Objective : This study investigated the alteration of neural activity and effect of Yanggyuksanhwa-tang (Lianggesanhuo-tang) on cerebral ischemia of rats. Methods : Considering age-related impact on cerebral ischemia, aged rats (18 months old) were used for this study. Ischemic damage was induced by the transient occlusion of bilateral common carotid arteries (BCAO) with hypotension. Yanggyuksanhwa-tang (Lianggesanhuo-tang) was administered twice a day orally. Then alterations of neural activities in the brain of aged BCAO rats were measured by the [$^{14}C$]2-deoxyglucose autoradiography method. Results : The BCAO in aged rats led to significant decrease of neural activity in the whole brain. Treatment with Yanggyuksanhwa-tang (Lianggesanhuo-tang) significantly attenuated the decrease of neural activity in the whole brain following BCAO ischemia. Treatment significantly attenuated the decrease of neural activity in the CA1, CA2, CA3, dentate gyrus of the hippocampus, activated barrel, barrel cortex, somatosensory cortex, cingulate cortex, caudate putamen, and medial septal nucleus following BCAO in aged rats. Treatment with Yanggyuksanhwa-tang (Lianggesanhuo-tang) also significantly attenuated the decrease of neural activity in the anteroventral thalamic nucleus, ventral anterior thalamic nucleus, arcuate nucleus, posterior hypothalamic area, medial mammillary nucleus, lateral periaqueductal gray, dorsal raphe nucleus, interpeduncular nucleus, median raphe nucleus, and medial pontine nucleus. Conclusion : It can be suggested that Yanggyuksanhwa-tang (Lianggesanhuo-tang) has a neuroprotecuve effect on cerebral ischemia through the control of glucose metabolic rate and cerebral blood flow.
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