• Title/Summary/Keyword: motor-function

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Effect of bronchial artery embolization in the management of massive hemoptysis : factors influencing rebleeding (대량객혈 환자에서 기관지 동맥색전술의 효과 : 색전술후 재발의 원인과 예측인자)

  • Kim, Byeong Cheol;Kim, Jeong Mee;Kim, Yeon Soo;Kim, Seong Min;Choi, Wan Young;Lee, Kyeong Sang;Yang, Suck Cheol;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Lee, Jung Hee;Kim, Chang Soo;Seo, Heung Suk
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.590-599
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    • 1996
  • Background : Bronchial artery embolization has been established as an effective means to control hemoptysis, especially in patients with decreased pulmonary function and those with advanced chronic obstructive pulmonary disease. We evaluated the effect of arterial embolization in immediate control of massive hemoptysis and investigated the clinical and angiographic characteristics and the course of patients with reccurrent hemoptysis after initial succeseful embolization. Another purpose of this study was to find predictive that cause rebleeding after bronchial artery embolization. Method : We reviewed 47 cases that underwent bronchial artery embolization for the management of massive hemoptysis, retrospectively. We analyzed angiographic findings in all cases before bronchial artery embolization and also reviewed the angiographic findings of patients that underwent additional bronchial artery embolization for the control of reccurrent hemoptysis to find the clauses of rebleeding. Results : 1) Underlying causes of hemoptysis were pulmonary tuberculosis(n=35), bronchiectasis(n=5), aspergilloma(n=2), lung cancer(n=2), pulmonary A-V malformation(n=1), and unknown cases(n=2). 2) Overal immediate success rate was 94%(n=44), an6 recurrence rate was 40%(n=19). 3) The prognostic factors such as bilaterality, systemic-pulmonary artery shunt, multiple feeding arteries and degree of neovascularity were not statistically correlated with rebleeding tendency (p value>0.05). 4) At additional bronchial artery embolization, Revealed recannalization of previous embolized arteries were 14/18cases(78%) and the presence of new deeding arteries was 8/18cases(44%). 5) The complications(31cases, 66%) such as fever, chest pain, cough, voiding difficulty, paralytic ileus, motor and sensory change of lower extremity, atelectasis and splenic infarction were occured. Conclusion : Recannalization of previous embolized arteries is the major cause of recurrence after bronchial artery embolization. Despite high recurrence rate of hemoptysis, bronchial artery embolization for management of massive hemoptysis is a effective and saute procedure in immediate bleeding control.

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Functional MRI of Visual Cortex: Correlation between Photic Stimulator Size and Cortex Activation (시각피질의 기능적 MR 연구: 광자극 크기와 피질 활성화와의 관계)

  • 김경숙;이호규;최충곤;서대철
    • Investigative Magnetic Resonance Imaging
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    • v.1 no.1
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    • pp.114-118
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    • 1997
  • Purpose: Functional MR imaging is the method of demonstrating changes in regional cerebral blood flow produced by sensory, motor, and any other tasks. Functional MR of visual cortex is performed as a patient stares a photic stimulation, so adaptable photic stimulation is necessary. The purpose of this study is to evaluate whether the size of photic stimulator can affect the degree of visual cortex activation. Materials and Methods: Functional MR imaging was performed in 5 volunteers with normal visual acuity. Photic stimulator was made by 39 light-emitting diodes on a plate, operating at 8Hz. The sizes of photic stimulator were full field, half field and focal central field. The MR imager was Siemens 1.5-T Magnetom Vision system, using standard head coil. Functional MRI utilized EPI sequence (TR/TE= 1.0/51. Omsec, matrix $No.=98{\times}128$, slice thickness=8mm) with 3sets of 6 imaging during stimulation and 6 imaging during rest, all 36 scannings were obtained. Activation images were obtained using postprocessing software(statistical analysis by Z-score), and these images were combined with T-1 weighted anatomical images. The activated signals were quantified by numbering the activated pixels, and activation a index was obtained by dividing the pixel number of each stimulator size with the sum of the pixel number of 3 study using 3 kinds of stimulators. The correlation between the activation index and the stimulator size was analysed. Results: Mean increase of signal intensities on the activation area using full field photic stimulator was about 9.6%. The activation index was greatest on full field, second on half field and smallest on focal central field in 4. The index of half field was greater than that of full field in 1. The ranges of activation index were full field 43-73%(mean 55%), half field 22-40 %(mean 32%), and focal central field 5-24%(mean 13%). Conclusion: The degree of visual cortex activation increases with the size of photic stimulator.

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Neural pathway innervating ductus Deferens of rats by pseudorabies virus and WGA-HRP (흰쥐에서 WGA-HRP와 pseudorabies virus를 이용한 정관의 신경로에 대한 연구)

  • Lee, Chang-Hyun;Chung, Ok-Bong;Ko, Byung-Moon;Lee, Bong-Hee;Kim, Soo-Myung;Kim, In-Shik;Yang, Hong-Hyun
    • Korean Journal of Veterinary Research
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    • v.43 no.1
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    • pp.11-24
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    • 2003
  • This experimental studies was to investigate the location of PNS and CNS labeled neurons following injection of 2% WGA-HRP and pseudorabies virus (PRY), Bartha strain, into the ductus deferens of rats. After survival times 4-5 days following injection of 2% WGA-HRP and PRV, the rats were perfused, and their brain, spinal cord, sympathetic ganglia and spinal ganglia were frozen sectioned ($30{\mu}m$). These sections were stained by HRP histochemical and PRY inummohistochemical staining methods, and observed with light microscope. The results were as follows ; 1. The location of sympathetic ganglia projecting to the ductus deferens were observed in pelvic ganglion, inferior mesenteric ganglion and L1-6 lwnbar sympathetic ganglia. 2. The location of spinal ganglia projecting to the ductus deferens were observed in T13-L6 spinal ganglia. 3. The PRY labeled neurons projecting to the ductus deferens were observed in lateral spinal nucleus, lamina I, II and X of cervical segments. In thoracic segments, PRY labeled neurons were observed in dorsomedial part of lamina I, II and III, and dorsolateral part of lamina IV and V. Densely labeled neurons were observed in intermediolateral nucleus. In first lumbar segment, labeled neurons were observed in intermediolateral nucleus and dorsal commisural nucleus. In sixth lumbar segment and sacral segments, dense labeled neurons were observed in sacral parasympathetic nuc., lamina IX and X. 4. In the medulla oblongata, PRV labeled neurons projecting to the ductus deferens were observed in the trigeminal spinal nuc., A1 noradrenalin cells/C1 adrenalin cells/caudoventrolateral reticular nuc., rostroventrolateral reticular nuc., area postrema, nuc. tractus solitarius, raphe obscurus nuc., raphe pallidus nuc., raphe magnus nuc., parapyramidal nuc., lateral reticular nuc., gigantocellular reticular nuc.. 5. In the pons, PRV labeled neurons projecting to the ductus deferens were ohserved in parabrachial nuc., Kolliker-Fuse nuc., locus cooruleus, subcooruleus nuc. and AS noradrenalin cells. 6. In midbrain, PRV labeled neurons projecting to the ductus deferens were observed in periaqueductal gray substance, substantia nigra and dorsal raphe nuc.. 7. In the diencephalon, PRV labeled neurons projecting to the ductus deferens were observed in paraventricular hypahalamic nuc., lateral hypothalamic nuc., retrochiasmatic nuc. and ventromedial hypothalamic nuc.. 8. In cerebrum, PRV labeled neurons projecting to the ductus deferens were observed in area 1 of parietal cortex. These results suggest that WGA-HRP labeled neurons of the spinal cord projecting to the rat ductus deferens might be the first-order neurons related to the viscero-somatic sensory and sympathetic postganglionic neurons, and PRV labeled neurons of the brain and spinal cord may be the second and third-order neurons response to the movement of smooth muscles in ductus deferens. These PRV labeled neurons may be central autonomic center related to the integration and modulation of reflex control linked to the sensory and motor system monitaing the internal environment. These observations provide evidence for previously unknown projections from ductus deferens to spinal cord and brain which may be play an important neuroanatornical basic evidence in the regulation of ductus deferens function.

Neuroprotective Effect of Phenytoin and Hypothermia on a Spinal Cord Ischemic Injury Model in Rabbits (토끼의 척수 허혈 손상 모델에서 페니토인과 저체온의 신경 보호 효과의 비교)

  • Oh, Sam-Sae;Choe, Ghee-Young;Kim, Won-Gon
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.405-416
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    • 2008
  • Background: Spinal cord ischemic injury during thoracic and thoracoabdominal aortic surgeries remains a potentially devastating outcome despite using various methods of protection. Neuronal voltage-dependent sodium channel antagonists are known to provide neuroprotection in cerebral ischemic models. This study was designed to compare the neuroprotective effects of phenytoin with those of hypothermia in a rabbit model of spinal cord ischemia. Material and Method: Spinal cord ischemia was induced in New Zealand white rabbits by means of infrarenal aortic cross clamping for 25 minutes. Four groups of 8 animals each were studied. The control group and the hypothermia group received retrograde infusion of saline only ($22^{\circ}C$, 2 mL/min); the normothermic phenytoin group and the hypothermicphenytoin group received retrograde infusion of 100 mg of phenytoin at different rectal temperatures ($39^{\circ}C$ and $37^{\circ}C$, respectively) during the ischemic period. The neurologic function was assessed at 24 and 72 hours after the operation with using the modified Tarlov criteria. The spinal cords were harvested after the final neurologic examination for histopathological examination to objectively quantify the amount of neuronal damage. Result: No major adverse effects were observed with the retrograde phenytoin infusion during the aortic ischemic period. All the control rabbits became severely paraplegic, Both the phenytoin group and the hypothermia group had a better neurological status than did the control group (p < 0.05). The typical morphological changes that are characteristic of neuronal necrosis in the gray matter of the control animals were demonstrated by means of the histopathological examination, whereas phenytoin or hypothermia prevented or attenuated these necrotic phenomena (p < 0.05). The number of motor neuron cells positive for TUNEL staining was significantly reduced, to a similar extent, in the rabbits treated with phenytoin or hypothermia. Phenytoin and hypothermia had some additive neuroprotective effect, but there was no statistical significance between the two on the neurological and histopathological analysis. Conclusion: The neurological and histopathological analysis consistently demonstrated that both phenytoin and hypothermia may afford significant spinal cord protection to a similar extent during spinal cord ischemia in rabbits, although no significant additive effects were noticed.

Decreased Attention in Narcolepsy Patients is not Related with Excessive Daytime Sleepiness (기면병 환자의 주의집중 저하와 주간졸음증 간의 상관관계 부재)

  • Kim, Seog-Ju;Lyoo, In-Kyoon;Lee, Yu-Jin;Lee, Ju-Young;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.2
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    • pp.122-132
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    • 2005
  • Objectives: The objective of this study is to assess cognitive functions and their relationship with sleep symptoms in young narcoleptic patients. Methods: Eighteen young narcolepsy patients and 18 normal controls (age: 17-35 years old) were recruited. All narcolepsy patients had HLA $DQB_1$ *0602 allele and cataplexy. Several important areas of cognition were assessed by a battery of neuropsychological tests consisting of 13 tests: executive functions (e.g. cognitive set shifting, inhibition, and selective attention) through Wisconsin card sorting test, Trail Making A/B, Stroop test, Ruff test, Digit Symbol, Controlled Oral Word Association and Boston Naming Test; alertness and sustained attention through paced auditory serial addition test; verbal/nonverbal short-term memory and working memory through Digit Span and Spatial Span; visuospatial memory through Rey-Osterrieth complex figure test; verbal learning and memory through California verbal learning test; and fine motor activity through grooved pegboard test. Sleep symptoms in narcolepsy patients were assessed with Epworth sleepiness scale, Ullanlinna narcolepsy scale, multiple sleep latency test, and nocturnal polysomnography. Relationship between cognitive functions and sleep symptoms in narcolepsy patients was also explored. Results: Compared with normal controls, narcolepsy patients showed poor performance in paced auditory serial addition (2.0 s and 2.4 s), digit symbol tests, and spatial span (forward)(t=3.86, p<0.01; t=-2.47, p=0.02; t=-3.95, p<0.01; t=-2.22, p=0.03, respectively). There were no significant between-group differences in other neuropsychological tests. In addition, results of neuropsychological test in narcolepsy patients were not correlated with Epworth sleepiness scale score, Ullanlinna narcolepsy scale score and sleep variables in multiple sleep latency test or nocturnal polysomnography. Conclusion: The current findings suggest that young narcolepsy patients have impaired attention. In addition, impairment of attention in narcolepsy might not be solely due to sleep symptoms such as excessive daytime sleepiness.

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A Functional MRI Study on the Brain Activation Associated with Mental Calculation (기능적 자기공명영상을 이용한 수리연산의 대뇌 활성화에 관한 연구)

  • Choi Dae Seob;Na Dong Gyu;Kim Sam Soo;Cho Jae Min;Park Eui Dong;Chung Sung Hoon;Ryoo Jae Wook
    • Investigative Magnetic Resonance Imaging
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    • v.9 no.1
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    • pp.16-23
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    • 2005
  • Purpose : In order to investigate the functional brain anatomy associated with mental calculation, functional magnetic resonance imaging was performed. Materials and Methods : In six normal right handed subjects, functional MR images were obtained using a 1.57 MR scanner and the EPI BOLD technique. The study included experiment I and experiment II. Each experiment consisted of five resting and four activation periods with each period of 30 seconds. During the activation period of both experiment I and II, calculation equations[an example: $(4+5)\times8=72$] were presented and the subjects were instructed to decide true or false of them. During the resting period of experiment I, the subjects were instructed to visually fixate on a crosshair. During the resting period of experiment II, two diagrams (an example: $(\bullet,\;\blacksquare)$)were presented and the subjects were instructed to decide they are same or not. For the post-processing of images, the SPM program was used, with the threshold of significance set at p<0.00001. The activated areas during the tasks were assessed. Results : In experiment 1, the inferior frontal gyrus, prefrontal cortex, promoter area, supplementary motor area, and intraparietal sulcus including superior parietal cortex were activated bilaterally. Although these areas were also activated in experiment II, the activated signals in the right frontal and parietal lobes were lessened. Conclusion : The left inferior frontal gyrus and prefrontal cortex and bilateral intraparietal sulci were activated during mental calculation. The right frontal and parietal lobes might be related to attention and decision making.

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The Radiation Therapy for Spinal Cord Compression in Hematologic Malignancy (혈암에서 발생한 척추압박증상의 방사선 치료)

  • Kim In Ah;Choi Ihl Bohng;Chung Su Mi;Kang Ki Mun;Kay Chul Seong;Choi Byung Ok;Jang Ji Young;Shinn Kyung Sub;Kim Chun Choo
    • Radiation Oncology Journal
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    • v.12 no.3
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    • pp.393-399
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    • 1994
  • Spinal cord compression, an oncologic emergency, is a rare complication of hematologic malignancy Our experience was obtained with a series 32 Patients following retrospective analysis for assessing the role of radiation therapy and identifying the prognostic factors affecting on treatment outcome. Diagnosis was usually made by means of radiologic study such as myelography or computerized tomography (CT) or magnetic resonance imaging (MRI) and neurologic examination. Five cases were diagnosed by subjective symptom only with high index of suspicion. In 31 cases, the treatment consisted in radiation therapy alone and the remained one patient had laminectomy before radiation therapy because of diagnostic doubts. Total treatment doses ranged from 800 cGy to 4000 cGy with median of 2000 cGy. Initially large fraction size more than 250 cGy were used in 13 patients with rapidly progressed neurologic deficit. The clinical parameters considered in evaluating the response to treatment were backache, motor-sensory performance and sphincter function. Half of all patients showed good response. Partial response and no response were noted in $37.5\%$ and $12.5\%$, respectively. Our results showed higher response rate than those of other solid tumor series. The degree of neurologic deficit at that time of diagnosis was the most important predictor of treatment outcome. The elapsed time from development of symptoms to start of treatment was significantly affected on the outcome. But histology of primary tumor total dose and use of initial large fraction size were not significantly affect on the outcome. These results confirmed the value of early diagnosis and treatment especially in radiosensitive hematologic malignancy.

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BOLD Responses to Acupuncture on Each Side of ST36 (족삼리 좌우측 자침에 대한 BOLD 반응)

  • Yeo, Sujung;Bae, Seong-In;Choe, Ilwhan;Jahng, Geon-Ho;Lim, Sabina
    • Korean Journal of Acupuncture
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    • v.31 no.1
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    • pp.20-32
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    • 2014
  • Objectives : There has been some controversy about the modulatory effects on brain function during acupuncture on each side of the same acupoint. This study was designed to investigate and compare the blood oxygen level-dependent(BOLD) responses of acupuncture on each side of ST36. Methods : Fourteen healthy subjects were recruited for imaging and received acupuncture or placebo stimulations either on the left or on the right acupoint of ST36 in each scan. For the voxel-wise statistical analysis, one sample T-test and the within-subject analysis of variance(ANOVA) test were performed using SPM8 software. Results : This study showed that acupuncture on each side of ST36 showed different BOLD signal patterns. Higher BOLD responses after acupuncture stimulations at the left ST36 compared to the right were observed mainly in the parahippocampal gyrus(BA 28), dorsolateral prefrontal cortex(DLPFC, BA 44), thalamus, culmen and claustrum. We investigated the different neural responses between rest and activation periods of placebo and acupuncture stimulations on each side of ST36. Acupuncture at the right ST36 elicited activation mainly in the insula, supplementary motor area(SMA) and anterior cingulate cortex(ACC), while acupuncture at the left ST36 elicited activation mainly in the insula, primary somatosensory cortex(SI, BA 2) and DLPFC(BA 44). Conclusions : To our knowledge, this is the first reported functional MRI study directly comparing when needling at the right and at the left side of ST36. This study's preliminary results proved to be evidence of acupuncture's different effects when performed on opposite sides of an acupoint.

A Research on Ball-Balancing Robot (볼 벨런싱 로봇에 관한 연구)

  • Kim, Ji-Tae;Kim, Dae-young;Lee, Won-Joon;Jin, Tae-Seok
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2017.05a
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    • pp.463-466
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    • 2017
  • The purpose of this paper is to develop a module capable of all-directional driving different from conventional wheeled robots, and to solve the problems of the conventional mobile robot with side driving performance degradation, It is possible to overcome the disadvantages such as an increase in the time required for the unnecessary driving. The all - direction spherical wheel drive module for driving a ball - balancing robot is required to develop a power transfer mechanism and a driving algorithm for driving the robot in all directions using three rotor casters. 3DoF (Axis) A driver with built-in forward motion algorithm is embedded in the module and a driving motor module with 3DoF (axis) for driving direction and speed is installed. The movement mechanism depends on the sum of the rotation vectors of the respective driving wheels. It is possible to create various movement directions depending on the rotation and the vector sum of two or three drive wheels. It is possible to move in different directions according to the rotation vector field of each driving wheel. When a more innovative all-round spherical wheel drive module for forward movement is developed, it can be used in the driving part of the mobile robot to improve the performance of the robot more technically, and through the forward-direction robot platform with the drive module Conventional wheeled robots can overcome the disadvantage that the continuous straightening performance is lowered due to resistance to various environments. Therefore, it is necessary to use a full-direction driving function as well as a cleaning robot and a mobile robot applicable in the Americas and Europe It will be an essential technology for guide robots, boarding robots, mobile means, etc., and will contribute to the expansion of the intelligent service robot market and future automobile market.

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The Clinical Utility of Korean Bayley Scales of Infant and Toddler Development-III - Focusing on using of the US norm - (베일리영유아발달검사 제3판(Bayley-III)의 미국 규준 적용의 문제: 미숙아 집단을 대상으로)

  • Lim, Yoo Jin;Bang, Hee Jeong;Lee, Soonhang
    • Korean journal of psychology:General
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    • v.36 no.1
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    • pp.81-107
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    • 2017
  • The study aims to investigate the clinical utility of Bayley-III using US norm in Korea. A total of 98 preterm infants and 93 term infants were assessed with the K-Bayley-III. The performance pattern of preterm infants was analyzed with mixed design ANOVA which examined the differences of scaled scores and composite scores of Bayley-III between full term- and preterm- infant group and within preterm infants group. Then, We have investigated agreement between classifications of delay made using the BSID-II and Bayley-III. In addition, ROC plots were constructed to identify a Bayley-III cut-off score with optimum diagnostic utility in this sample. The results were as follows. (1) Preterm infants have significantly lower function levels in areas of 5 scaled scores and 3 developmental indexes compared with infants born at term. Significant differences among scores within preterm infant group were also found. (2) Bayley-III had the higher scores of the Mental Development Index and Psychomotor Developmental Index comparing to the scores of K-BSID-II, and had the lower rates of developmental delay. (3) All scales of Bayley-III, Cognitive, Language and Motor scale had the appropriate level of discrimination, but the cut-off composite scores of Bayley-III were adjusted 13~28 points higher than 69 for prediction of delay, as defined by the K-BSID-II. It explains the lower rates of developmental delay using the standard of two standard deviation. This study has provided empirical data to inform that we must careful when interpreting the score for clinical applications, identified the discriminating power, and proposed more appropriate cut-off scores. In addition, discussion about the sampling for making the Korean norm of Bayley-III was provided. It is preferable that infants in Korea should use our own validated norms. The standardization process to get Korean normative data must be performed carefully.