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Viscoelastic Property of the Brain Assessed With Magnetic Resonance Elastography and Its Association With Glymphatic System in Neurologically Normal Individuals

  • Bio Joo;So Yeon Won;Ralph Sinkus;Seung-Koo Lee
    • Korean Journal of Radiology
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    • v.24 no.6
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    • pp.564-573
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    • 2023
  • Objective: To investigate the feasibility of assessing the viscoelastic properties of the brain using magnetic resonance elastography (MRE) and a novel MRE transducer to determine the relationship between the viscoelastic properties and glymphatic function in neurologically normal individuals. Materials and Methods: This prospective study included 47 neurologically normal individuals aged 23-74 years (male-to-female ratio, 21:26). The MRE was acquired using a gravitational transducer based on a rotational eccentric mass as the driving system. The magnitude of the complex shear modulus |G*| and the phase angle 𝛗 were measured in the centrum semiovale area. To evaluate glymphatic function, the Diffusion Tensor Image Analysis Along the Perivascular Space (DTI-ALPS) method was utilized and the ALPS index was calculated. Univariable and multivariable (variables with P < 0.2 from the univariable analysis) linear regression analyses were performed for |G*| and 𝛗 and included sex, age, normalized white matter hyperintensity (WMH) volume, brain parenchymal volume, and ALPS index as covariates. Results: In the univariable analysis for |G*|, age (P = 0.005), brain parenchymal volume (P = 0.152), normalized WMH volume (P = 0.011), and ALPS index (P = 0.005) were identified as candidates with P < 0.2. In the multivariable analysis, only the ALPS index was independently associated with |G*|, showing a positive relationship (β = 0.300, P = 0.029). For 𝛗, normalized WMH volume (P = 0.128) and ALPS index (P = 0.015) were identified as candidates for multivariable analysis, and only the ALPS index was independently associated with 𝛗 (β = 0.057, P = 0.039). Conclusion: Brain MRE using a gravitational transducer is feasible in neurologically normal individuals over a wide age range. The significant correlation between the viscoelastic properties of the brain and glymphatic function suggests that a more organized or preserved microenvironment of the brain parenchyma is associated with a more unimpeded glymphatic fluid flow.

Effects of Limited Dorsiflexion Range of Motion on Movement Strategies during Landing (발등굽힘 관절가동범위 제한이 착지 시 움직임 전략에 미치는 영향)

  • Inje Lee;Donggun Kim;Hyeondeukje Kim;Hyunsol Shin;Jiwon Lee;Yujin Jang;Myeongwoo Pi
    • Korean Journal of Applied Biomechanics
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    • v.33 no.4
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    • pp.147-154
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    • 2023
  • Objective: This study aimed 1) to compare the Landing Error Scoring System (LESS) score and movement patterns during landing of the lesser dorsiflexion range of motion (LDFROM) group to that with the greater dorsiflexion range of motion group, and 2) to identify the correlation between the weight-bearing dorsiflexion range of motion (WBDF ROM), LESS score, and movement patterns during landing. Method: Fifty health adults participated in this study. WBDF ROM was measured using the weight bearing lunge test while movement patterns during landing was assessed using the LESS. The joint angles of the ankle, knee and hip joints during landing were analyzed using the 2D video analysis. After mean value of WBDF ROM was calculated, participants were divided into two groups (GDFROM and LDFROM) based on the mean value. The Mann-Whiteny 𝒰 test was used to identify differences in movement strategies during landing between two groups and the Pearson's correlation analysis was performed to determine relationships between WBDF ROM and movement strategies. Results: The LDFROM group showed the poorer LESS score and stiffer landing kinematics during landing compared to the GDFROM group (p<0.05). In addition, DFROM was significantly related to the LESS score and landing kinematics (p<0.05) except for total hip excursion (p=0.228). Conclusion: Our main findings showed that the LDFROM group had poorer landing quality and stiffer landing movements compared to the GDFROM group. In addition, increase of WBDF ROM significantly improved landing quality and soft-landing movements. To reduce shock during landing such as ground reaction forces, individuals need to better utilize WBDF ROM and lower extremity movements based on our findings. Therefore, intervention programs for safer landings should include exercises that increase WBDF ROM and utilize eccentric contraction.

Esophageal Leiomyoma: Radiologic Findings in 12 Patients

  • Po Song Yang;Kyung Soo Lee;Soon Jin Lee;Tae Sung Kim;In-Wook Choo;Young Mog Shim;Kwhanmien Kim;Yookyung Kim
    • Korean Journal of Radiology
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    • v.2 no.3
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    • pp.132-137
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    • 2001
  • Objective: The aim of our study was to describe and compare the radiologic findings of esophageal leiomyomas. Materials and Methods: The chest radiographic (n = 12), esophagographic (n = 12), CT (n = 12), and MR (n = 1) findings of surgically proven esophageal leiomyomas in 12 consecutive patients [ten men and two women aged 34 - 47 (mean, 39) years] were retrospectively reviewed. Results: The tumors, surgical specimens of which ranged from 9 to 90 mm in diameter, were located in the upper (n = 1), middle (n = 5), or lower esophagus (n = 6). In ten of the 12 patients, chest radiography revealed the tumors as mediastinal masses. Esophagography showed them as eccentric, smoothly elevated filling defects in 11 patients and a multilobulated encircling filling defect in one. In 11 of the 12 patients, enhanced CT scans revealed a smooth (n = 9) or lobulated (n = 2) tumor margin, and attenuation was homogeneously low (n = 7) or iso (n = 4). In one patient, the tumor signal seen on T2-weighted MR images was slightly high. Conclusion: Esophageal leiomyomas, located mainly in the middle or distal esophagus, are consistently shown by esophagography to be mainly eccentrically elevated filling defects and at CT, lesions showing homogeneous low or isoattenuation are demonstrated.

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A Newly Designed Nitinol Stent: Early Clinical Experience in the Treatment of Iliac Artery Stenoses and Occlusions

  • Chang Jin Yoon;Jin Wook Chung;Jae Hyung Park;Soon Hyung Hong;Soon Young Song;Hyung Gehn Lim;Yoon Sin Lee
    • Korean Journal of Radiology
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    • v.2 no.3
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    • pp.145-150
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    • 2001
  • Objective: To investigate the effectiveness of the newly designed Niti-S stent in the management of iliac arterial stenoses and occlusions. Materials and Methods: Stenoses (n=25) or occlusions (n=5) in the iliac arteries of 25 patients (30 limbs) were treated. The site of the lesions was the common (n=15) or external (n=11) iliac artery, or both (n=4). Eight limbs were treated for diffuse disease, six for highly eccentric lesion, five for occlusive lesion, and 11 for failed angioplasty. Results: In all patients, technical success was achieved without major complications. One death, not procedure-related, occurred within 30 days. Ankle-brachial indexes improved from 0.63 0.30 to 0.99 0.21, and ischemic symptoms showed improvement in 22 patients (88%). Fontaine classifications before stenting, namely IIa(n=3), IIb(n=16), III(n=2), and IV(n=4) improved to I(n=17), IIa(n=5), and IV(n=3). Follow-up over a 27 (mean, 19.8 8)-month period showed that cumulative patency rates were 95.8% at 1 year and 86.2% at 2 and 3 years. No significant decrease in the mean ankle-brachial index was observed. Conclusion: The Niti-S stent appears to be a safe and effective device for the treatment of iliac stenoses and occlusions. These preliminary results require confirmation with a larger series.

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Effects of Shoulder Muscle Strength on Terminal Range by Humeral Head Retroversion (상완골 후경각이 가동역에 따른 견관절 근력에 미치는 영향)

  • Park, Si-Young;Lee, Dong-Jun
    • Journal of Life Science
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    • v.20 no.4
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    • pp.549-554
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    • 2010
  • Increased external rotation and decreased internal rotation have been noted to occur progressively in the throwing shoulders of baseball pitchers. The purpose of this study was to provide descriptive data for terminal range eccentric antagonist/concentric agonist shoulder muscle strength in collegiate baseball pitchers with humeral head retroversion diagnosed through MRI. The dominant and non-dominant shoulders of 9 asymptomatic baseball pitchers were tested through a range of 20 degrees of external rotation to 90 degrees of internal rotation using the Biodex system 3 isokinetic dynamometer at speeds of $90^{\circ}/s$ and $180^{\circ}/s$. Differences between the dominant and non-dominant shoulders were assessed using the paired samples t-test. Total range of motion, measured at $90^{\circ}$ of glenohumeral abduction, was $180.1^{\circ}$ for dominant shoulders and $183.7^{\circ}$ for non-dominant shoulders. Humeral head retroversion measured $47.6{\pm}6.1^{\circ}$ in dominant and $37.8{\pm}5.3^{\circ}$ in non-dominant extremities. The mean internal rotator concentric contraction (IR-Con) showed a significant difference compared to $31.5{\pm}5.1$ (Nm) in dominant and $38.7{\pm}5.2$ (Nm) in non-dominant shoulders at $180^{\circ}/s$ (p<0.05). The mean external rotator eccentric contraction (ER-Ecc) showed a significant difference compared to $20.3{\pm}4.7$ (Nm) in dominant and $25.1{\pm}3.7$ (Nm) in non-dominant shoulders at $90^{\circ}/s$ (p<0.05). There is a pattern of increased external rotation and decreased internal rotation in the dominant extremity that significantly correlates with an increase in humeral retroversion.

Minimally Invasive Repair of Pectus Excavatum Based on the Nuss Principle: An Evolution of Techniques and Early Results on 322 Patients (Nuss 술식에 기초한 누두흉의 최소 침습 수술: 수술 수기의 개발 및 322예의 조기 성적)

  • Park, Hyun-Joo;Song, Cheol-Min;Her, Keun;Jeon, Cheol-Woo;Chang, Won-Ho;Park, Han-Gyu;Lee, Seock-Yeol;Lee, Cheol-Sae;Youm, Wook;Lee, Kihl-Roh
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.164-174
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    • 2003
  • Background: The Nuss procedure is a recently developed technique for minimally invasive repair of pectus excavatum using a metal bar. Although its technical simplicity and cosmetic advantages are remarkable, applications have been limited to children with standard pectus excavatum. We report a single center experience of the technique that has been evolving in order to correct asymmetric pectus configurations and adult patients. Material and Method: Between August 1999 and June 2002, 322 consecutive patients un-derwent repair by the Nuss technique and its modifications. Among them, 71 (22%) were adults. For the precise correction, morphology of the pectus was classified as symmetric and asymmetric types. Asymmetric type was subdivided into eccentric and unbalanced types. In repair, differently shaped bars were applied to individual types of pectus to achieve symmetric correction. Result: Symmetric type was 57.5% (185/322) and asymmetric type was 42.5% (137/322). Eccentric, unbalanced, and combined types were 71, 47 and 19, respectively, Major modifications were bar shaping and fixation. In asymmetric group, different shapes of asymmetric bars were applied (n=125, 38.8%). For adult patients, double bar or compound bar technique was used (n=51, 15.8%). To prevent bar rotation, multipoint wire fixations to ribs were used. Major postoperative complications were pneumothorax (n=24, 7.5%) and bar displacement (n=11, 3.4%). 42 patients had bar removal 2 years after the initial procedure. Conclusion: The Nuss procedure is safe and effective. Modifications of the techniques in accordance with precise morphological classification enabled the correction of all variety of pectus excavatum including asymmetric types and adult patients.

Analysis of Complications Associated with the Nuss Procedure: Risk Factors and Preventive Measures (너스수술의 합병증에 대한 고찰: 위험인자 분석과 예방책의 제시)

  • Park, Hyung-Joo;Chang, Won-Ho;Jeon, Cheol-Woo;Park, Han-Gyu;Lee, Seock-Yeol;Lee, Cheol-Sae;Youm, Wook;Lee, Kihl-Roh
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.524-529
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    • 2004
  • Background: Since the Nuss procedure for the correction of pectus excavatum is in its early stage, there have been problems that need to be solved. We examined complications in a single-institute experience of the Nuss technique in order to develop possible solutions to prevent them. Material and Method: 335 consecutive patients, who underwent the modified Nuss procedure between August 1999 and October 2002, were studied retrospectively. Median age was 8 years (range 1 to 46). 264 patients (78.8%) were in pediatric group (age$\leq$15) and 71 patients (21.2%) were in adult group (age> 15). 193 patients (57.6%) had symmetric and 142 patients (42.4%) had asymmetric pectus configurations. Risk factors predicting postoperative complications were analyzed using multi-variate logistic regression. Result: Postoperative complication rates were 18.9% (61/335) in total patients. Frequent complications were pneumothorax 24 (7.5%), bar displacement 11 (3.4%), and wound seroma 10 (3.1%) in order. Early complications (within a month, 49 cases, 15.2%) were pneumothorax (n=23, 6.9%), wound seroma (n=12, 3.6%), and bar displacement (n=8, 2.4%). Late complications (after a month, 12 cases, 3.7%) were pericarditis and pericardial effusion (n=5, 1.5%), bar displacement (n=4, 1.2%), and hemothorax (n=3, 0.9%). Techniques were modified to prevent complications especially in bar shaping and fixation, which led to decrease complication rate in later experience (Operation Date 1: 15/51 (29.4%) vs Operation Date 2: 34/284 (12.0%), p=0.004). Grand Canyon type (eccentric long canal type) showed higher complication rate than other types (GC type: 12/30(40%) vs Others: 37/305 (12.1%), p<0.001). Major risk factors are severity of pectus (OR=2.88, p=0.038), Grand Canyon type (OR=2.82, p=0.044), and Op. Date 1 (OR=4.05, p=0.001). Conclusion: Major complications were related to severe eccentric type of pectus configuration (Grand Canyon type) and lack of surgeon's experience (Op. Date 1). Com-plication rate was reduced with accumulation of experience and advancement of surgical techniques. The Nuss procedure can be performed at a low risk of complications with our current technique.

Influence of Column Aspect Ratio on the Hysteretic Behavior of Slab-Column Connection (슬래브-기둥 접합부의 이력거동에 대한 기둥 형상비의 영향)

  • Choi, Myung-Shin;Cho, In-Jung;Ahn, Jong-Mun;Shin, Sung-Woo
    • Journal of the Korea Concrete Institute
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    • v.19 no.4
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    • pp.515-525
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    • 2007
  • In this investigation, results of laboratory tests on four reinforced concrete flat plate interior connections with elongated rectangular column support which has been used widely in tall residential buildings are presented. The purpose of this study is to evaluate an effect of column aspect ratio (${\beta}_c={c_1}/{c_2}$=side length ratio of column section in the direction of lateral loading $(c_1)$ to the direction of perpendicular to $c_1$) on the hysteretic behavior under earthquake type loading. The aspect ratio of column section was taken as $0.5{\sim}3\;(c_1/c_2=1/2,\;1/1,\;2/1,\;3/1)$ and the column perimeter was held constant at 1200mm in order to achieve nominal vertical shear strength $(V_c)$ uniformly. Other design parameters such as flexural reinforcement ratio $(\rho)$ of the slab and concrete strength$(f_{ck})$ was kept constant as ${\rho}=1.0%$ and $f_{ck}=40MPa$, respectively. Gravity shear load $(V_g)$ was applied by 30 percent of nominal vertical shear strength $(0.3V_o)$ of the specimen. Experimental observations on punching failure pattern, peak lateral-load and story drift ratio at punching failure, stiffness degradation and energy dissipation in the hysteresis loop, and steel and concrete strain distributions near the column support were examined and discussed in accordance with different column aspect ratio. Eccentric shear stress model of ACI 318-05 was evaluated with experimental results. A fraction of transferring moment by shear and flexure in the design code was analyzed based on the test results.

Effects of Low Intensity Resistance Training Speed on Body Composition, Muscle Activity and Muscle Strength in Obese Middle-aged Women (저강도 저항운동의 속도 차이가 비만중년여성의 신체조성, 근활성도 및 근력에 미치는 영향)

  • Lee, Woo-Jung;Seo, Sang-Won;Lee, Ho-Seong
    • 한국체육학회지인문사회과학편
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    • v.56 no.4
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    • pp.575-584
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    • 2017
  • The purpose of this study was to examine the effects of low intensity resistance training speed on body composition, muscle activity and muscle strength in obese middle-aged women. The subjects (n = 12) were randomly assigned to normal resistance training speed group (NSG, n = 6) and slow resistance training speed group (SSG, n = 6). NSG was performed the for 3 sets ${\times}$ 35 times and total 3-s per repetition (eccentric: 1-s, isometric: 1-s, concentric: 1-s), and SSG performed for 3 sets ${\times}$ 15 times and total 7-s per repetition (eccentric: 3-s, isometric: 1-s, concentric: 3-s). Both groups performed the low intensity resistance training at 30% of 1-RM for 105-s per set, rest for 1 min between sets, rest for 3 min between exercises, and 2~3 times per week, for 4 weeks. The body composition, muscle activity and muscle strength were measured before and 4 week after resistance training. WHR at NSG and body fat at SSG were significantly decreased after resistance training compared with before (P<.05). Muscle activity of biceps brachii, vastus medialis and vastus lateralis at both groups were significantly decreased after resistance training compared with before (P<.05, P<.01). Muscle strength of biceps curl and leg extension at both groups were significantly increased after resistance training compared with before (P<.01). However, body composition, muscle activity and muscle strength did not show statistically significant differences between the groups. Our results suggest that body composition, muscle activity and muscle strength should closely related to the performance time of resistance training (development time of muscle contraction), rather than resistance training speed (repetition frequency).

Correlation of isokinetic strength and angular velocity of knee during Fente motion in elite fencer (엘리트 펜싱 선수들의 팡트 동작에 따른 무릎 신전근 근력과 각가속도의 상관)

  • Kim, Kee Hyun;Kim, Tea Gyu
    • Journal of Digital Convergence
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    • v.12 no.9
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    • pp.407-415
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    • 2014
  • The purpose of this study is to identify the relation between isokinetic strength of knee extensors and angular velocity of knee joint during fente motion in elite fencers by three disciplines and gender, and to provide the preliminary data for developing the training program and rehabilitation program to enhance sports-performance by three disciplines and gender. Total 31 elite fencers who trained at the national training center of the Korean Olympic Committee (KOC) participated in this study.; 10 fleuret (4 males), 10 epee (6 males) and 11 sabre (5 males). Subjects were measured eccentric and concentric isokinetic strength (PT/BW, WK/BW) of the knee extensors at angular velocity of $60^{\circ}/s$, $180^{\circ}/s$ and $300^{\circ}/s$, and flexion (P1) and extension (P2) angular velocity of knee joint during fente motion. To examine the relationship between isokinetic strength of knee extensor and angular velocity of knee motion, Pearson's correlation coefficient (r). ${\alpha}=.05$ was considered significant. In conclusion, the relationship of isokinetic strength of knee extensors and angular velocity of knee was different depending on three disciplines and gender.