Journal of Yeungnam Medical Science

Communications

The applicability of noncontact sensors in the field of rehabilitation medicine: Yoo Jin Choo, Jun Sung Moon, Gun Woo Lee, Wook-Tae Park, Min Cheol Chang; J Yeungnam Med Sci. 2024;41(1):53-55. Published online December 26, 2023; DOI: https://doi.org/10.12701/jyms.2023.01144

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Abstract PDF: A noncontact sensor field is an innovative device that can detect, measure, or monitor physical properties or conditions without direct physical contact with the subject or object under examination. These sensors use a variety of methods, including electromagnetic, optical, and acoustic technique, to collect information about the target without physical interaction. Noncontact sensors find wide-ranging applications in various fields such as manufacturing, robotics, automobiles, security, environmental monitoring, space industry, agriculture, and entertainment. In particular, they are used in the medical field, where they provide continuous monitoring of patient conditions and offer opportunities in rehabilitation medicine. This article introduces the potential of noncontact sensors in the field of rehabilitation medicine.

Case report

Cerebral fat embolism syndrome: diagnostic challenges and catastrophic outcomes: a case series: Hussein A. Algahtani, Bader H. Shirah, Nawal Abdelghaffar, Fawziah Alahmari, Wajd Alhadi, Saeed A. Alqahtani; J Yeungnam Med Sci. 2023;40(2):207-211. Published online September 7, 2022; DOI: https://doi.org/10.12701/jyms.2022.00360

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Fat embolism syndrome is a rare but alarming, life-threatening clinical condition attributed to fat emboli entering the circulation. It usually occurs as a complication of long-bone fractures and joint reconstruction surgery. Neurological manifestations usually occur 12 to 72 hours after the initial insult. These neurological complications include cerebral infarction, spinal cord ischemia, hemorrhagic stroke, seizures, and coma. Other features include an acute confusional state, autonomic dysfunction, and retinal ischemia. In this case series, we describe three patients with fat embolism syndrome who presented with atypical symptoms and signs and with unusual neuroimaging findings. Cerebral fat embolism may occur without any respiratory or dermatological signs. In these cases, diagnosis is established after excluding other differential diagnoses. Neuroimaging using brain magnetic resonance imaging is of paramount importance in establishing a diagnosis. Aggressive hemodynamic and respiratory support from the beginning and consideration of orthopedic surgical intervention within the first 24 hours after trauma are critical to decreased morbidity and mortality.

Citations

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Embolia grasa cerebral de presentación inusual: reporte de caso
Lizeth Acosta Tascón, Tomás Acosta Pérez, Jaime Andrés Gómez Jiménez, José Mauricio Cárdenas Prieto
Neurología Argentina.2024; 16(2): 87. CrossRef
Cerebral fat embolism with turbid urine as the initial sign
Xiaowen Qiu, Baohui Zhou, Xiaoyu Qiu
Brain Injury.2024; 38(11): 938. CrossRef
Occurrence of Numerous Cerebral White Matter Hyperintensities in Trauma Patients With Cerebral Fat Embolism: A Systematic Review and Report of Two Cases
Gregory S Huang, C. Michael Dunham, Elisha A Chance
Cureus.2023;[Epub] CrossRef

Original article

Non–coplanar whole brain radiotherapy is an effective modality for parotid sparing: Jaehyeon Park, Jae Won Park, Ji Woon Yea; Yeungnam Univ J Med. 2019;36(1):36-42. Published online January 3, 2019; DOI: https://doi.org/10.12701/yujm.2019.00087

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Abstract PDF

Background
The purpose of this study was to evaluate the efficacy and feasibility of non–coplanar whole brain radiotherapy (NC–WBRT) for parotid sparing.
Methods
Fifteen cases, previously treated with WBRT were selected. NC–WBRT plans were generated. The beam arrangement for the non–coplanar plans consisted of superior anterior, right, and left beams. After generation of the non–coplanar plans a field–in–field technique was applied to the bilateral parallel opposed beams in order to reduce maximum dose and increase dose homogeneity. The NC–WBRT plans were subsequently compared with the previously generated bilateral WBRT (B–WBRT) plans. A field–in–field technique was also used with the B–WBRT plans according to our departmental protocol. As per our institutional practice a total dose of 30 Gy in 10 fractions of WBRT was administered 5 days a week.
Results
The mean dose to the parotid gland for the two different plans were 16.2 Gy with B–WBRT and 13.7 Gy with NC–WBRT (p<0.05). In the NC–WBRT plan, the V5Gy, V10Gy, V15Gy, V20Gy, and V25Gy of the parotid were significantly lower (p<0.05) than those of the B–WBRT plan. The Dmax of the lens was also lower by 10% with NC–WBRT.
Conclusion
The use of NC–WBRT plans could be a simple and effective method to reduce irradiated volumes and improve the dose–volume parameters of the parotid gland.

Citations

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DiffRecon: Diffusion-based CT reconstruction with cross-modal deformable fusion for DR-guided non-coplanar radiotherapy
Jiawei Sun, Nannan Cao, Hui Bi, Liugang Gao, Kai Xie, Tao Lin, Jianfeng Sui, Xinye Ni
Computers in Biology and Medicine.2024; 179: 108868. CrossRef
Technical note: Feasibility of gating for dynamic trajectory radiotherapy – Mechanical accuracy and dosimetric performance
Hannes A. Loebner, Daniel Frauchiger, Silvan Mueller, Gian Guyer, Paul‐Henry Mackeprang, Marco F. M. Stampanoni, Michael K. Fix, Peter Manser, Jenny Bertholet
Medical Physics.2023; 50(10): 6535. CrossRef
Impact of the gradient in gantry‐table rotation on dynamic trajectory radiotherapy plan quality
Hannes A. Loebner, Silvan Mueller, Werner Volken, Philipp Wallimann, Daniel M. Aebersold, Marco F. M. Stampanoni, Michael K. Fix, Peter Manser
Medical Physics.2023; 50(11): 7104. CrossRef
Retrospective analysis of portal dosimetry pre-treatment quality assurance of intracranial SRS/SRT VMAT treatment plans
Ernest Osei, Sarah Graves, Johnson Darko
Journal of Radiotherapy in Practice.2022; 21(4): 540. CrossRef
Application of piecewise VMAT technique to whole-brain radiotherapy with simultaneous integrated boost for multiple metastases
Yuan Xu, Yingjie Xu, Kuo Men, Jianping Xiao, Jianrong Dai
Radiation Oncology.2022;[Epub] CrossRef
Setup uncertainties and appropriate setup margins in the head-tilted supine position of whole-brain radiotherapy (WBRT)
Jae Won Park, Ji Woon Yea, Jaehyeon Park, Se An Oh, Ngie Min Ung
PLOS ONE.2022; 17(8): e0271077. CrossRef
Examination of the best head tilt angle to reduce the parotid gland dose maintaining a safe level of lens dose in whole‐brain radiotherapy using the four‐field box technique
Hidetoshi Shimizu, Koji Sasaki, Takahiro Aoyama, Hiroyuki Tachibana, Hiroshi Tanaka, Yutaro Koide, Tohru Iwata, Tomoki Kitagawa, Takeshi Kodaira
Journal of Applied Clinical Medical Physics.2021; 22(2): 49. CrossRef
Noncoplanar Versus Coplanar Intensity-Modulated Radiation Therapy (IMRT) for Protection of the Lip and Buccal Mucosa
Zheng Lao, Fan Bi, Wenhui Fan, Xuanli Xu, Wenyong Tu, Huifeng Shi
Technology in Cancer Research & Treatment.2021; 20: 153303382110195. CrossRef
Whole brain radiotherapy using four-field box technique with tilting baseplate for parotid gland sparing
Jaehyeon Park, Ji Woon Yea
Radiation Oncology Journal.2019; 37(1): 22. CrossRef

Case Reports

Visual recovery demonstrated by functional MRI and diffusion tensor tractography in bilateral occipital lobe infarction.: Jeong Pyo Seo, Sung Ho Jang; Yeungnam Univ J Med. 2014;31(2):152-156. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.152

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Abstract PDF

We report on a patient who showed visual recovery following bilateral occipital lobe infarct, as evaluated by follow up functional magnetic resonance imaging (fMRI) and diffusion tensor tractography (DTT). A 56-year-old female patient exhibited severe visual impairment since onset of the cerebral infarct in the bilateral occipital lobes. The patient complained that she could not see anything, although the central part of the visual field remained dimly at 1 week after onset. However, her visual function has shown improvement with time. As a result, at 5 weeks after onset, she notified that her visual field and visual acuity had improved. fMRI and DTT were acquired at 1 week and 4 weeks after onset, using a 1.5-T Philips Gyroscan Intera. The fiber number of left optic radiation (OR) increased from 257 (1-week) to 353 (4-week), although the fiber numbers for right OR were similar. No activation in the occipital lobe was observed on 1-week fMRI. By contrast, activation of the visual cortex, including the bilateral primary visual cortex, was observed on 4-week fMRI. We demonstrated visual recovery in this patient in terms of the changes observed on DTT and fMRI. It appears that the recovery of the left OR was attributed more to resolution of local factors, such as peri-infarct edema, than brain plasticity.

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Diffusion Tensor Imaging Studies on Recovery of Injured Optic Radiation: A Minireview
Eun Bi Choi, Sung Ho Jang
Neural Plasticity.2020; 2020: 1. CrossRef

A Case of Severe Hypoglycemic Encephalopathy with Extensive Brain Lesions in Non-diabetics and Alcoholism.: Chang Hun Bin, Min Su Park, Se Jin Lee; Yeungnam Univ J Med. 2010;27(1):37-41. Published online June 30, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.1.37

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Abstract PDF

Hypoglycemic encephalopathy is a rare problem among diabetic patients who are receiving treatment with insulin or other glucose-lowering drugs. The MRIs of patients with hypoglycemic encephalopathy commonly show scattered lesions in the cerebral cortex, hippocampus and basal ganglia, but lesions in the cerebellum or brain stem are extremely rare. A 44-year-old alcoholic woman without diabetes was admitted with a semicomatose mentality and seizure with severe hypoglycemic encephalopathy with extensive brain lesions seen on MRI at the middle cerebellar peduncle and midbrain, as well as in the other brain areas.

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Consideration of Prognostic Factors in Hypoglycemic Encephalopathy
Ik-Kwon Seo, Woo-Ik Choi, Sang-Chan Jin, Hyuk-Won Chang
Korean Journal of Critical Care Medicine.2012; 27(4): 209. CrossRef

Bilateral Medial Medullary Infarction Demonstrated by Diffusion-Weighted Imaging: Case Report.: Han Won Jang, Woo Mok Byun; Yeungnam Univ J Med. 2009;26(1):70-73. Published online June 30, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.1.70

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Abstract PDF

A 78-year-old woman presented with weakness of the extremities, dysarthria, dizziness, and sensory impairment. Magnetic resonance imaging showed acute bilateral medial medullary infarction. Contrast enhanced magnetic resonance angiography demonstrated stenosis or occlusion of both intracranial vertebral arteries. We present a rare case of bilateral medullary infarction seen on diffusion-weighted imaging.

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Bilateral Medial Medullary Infarction (Dejerene Syndrome) Patient Suffering from Quadriplegia Treated by Korean Traditional Medicine: a Case Report
Yoo-na Lee, Yu-min An, Kyungmin Baek, Woo-seok Jang
The Journal of Internal Korean Medicine.2020; 41(5): 902. CrossRef

Supratentorial Leptomeningeal Hemangioblstoma －Case Report－: Han Won Jang, Woo Mok Byun, Jae Kyo Lee, Jae Ho Cho, Kil Ho Cho, Mi Soo Hwang, Bok Hwan Park, Joon Hyuk Choi; Yeungnam Univ J Med. 2007;24(2 Suppl):S770-774. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S770

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Abstract PDF

Hemangioblastoma is a benign tumor that most commonly occurs in the cerebellum and associated with von Hippel-Lindau (VHL) disease. Supratentorial hemanigoblastomas are exceptionally rare. We describe the magnetic resonance imaging (MRI) and histopathologic findings of a supratentorial leptomeningeal hemangioblastoma.

Citations

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Sporadic supratentorial hemangioblastoma with meningeal affection: A case report and literature review
Juan Francisco Sánchez-Ortega, Marta Claramonte, Mónica Martín, Juan Calatayud-Pérez
Surgical Neurology International.2021; 12: 394. CrossRef
Supratentorial hemangioblastomas in von Hippel–Lindau wild-type patients – case series and literature review
Luís Rocha, Carolina Noronha, Ricardo Taipa, Joaquim Reis, Mário Gomes, Ernesto Carvalho
International Journal of Neuroscience.2018; 128(3): 295. CrossRef
Meningeal Supratentorial Hemangioblastoma in a Patient with Von Hippel-Lindau Disease Mimicking Angioblastic Menigioma
Hoon Kim, Ik-Seong Park, Kwang Wook Jo
Journal of Korean Neurosurgical Society.2013; 54(5): 415. CrossRef
Supratentorial hemangioblastoma: clinical features, prognosis, and predictive value of location for von Hippel-Lindau disease
S. A. Mills, M. C. Oh, M. J. Rutkowski, M. E. Sughrue, I. J. Barani, A. T. Parsa
Neuro-Oncology.2012; 14(8): 1097. CrossRef

Original Articles

Cone-Beam CT Image-Guided Radiosurgery of Brain Metastasis : Technical Note and Clinical Application: Sei-One Shin, Sang Mo Yun; Yeungnam Univ J Med. 2007;24(2 Suppl):S591-597. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S591

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Abstract PDF: Background
：This study was performed to test feasibility of CBCT(cone-beam computerized tomography) guided radiosurgery. Materials and Methods：We used CBCT which was mounted on a retractable arm at 90° to the treatment source. CBCT images were overlapped on the digitally reconstructed images from simulation CT scan. Then, 3 dimensional volumetric CT image matching was performed. If there were any positioning errors, automated patient re-positioning was done.
Results
：A radiosurgery treatment plan was carried out with a set of specially designed multiple non-coplanar arcs. The goal of plan was to deliver single session 18 Gy at periphery of the target. We treated a patient with a solitary brain metastasis from left upper lung cancer. Serial imaging study for treatment response revealed a satisfactory result with no remarkable treatment related side effects.
Conclusion
：CBCT image guided radiosurgery system is very simple and could be a convenient image guiding modality for stereotactic radiosurgery or fractionated radiotherapy with an acceptable geometric accuracy and radiation exposure.

Transcallosal Fibers from the Corticospinal Tract in Adults with Brain Injury: Sung Ho Jang, Sang Ho Ahn, Yun Woo Cho; Yeungnam Univ J Med. 2007;24(2 Suppl):S424-429. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S424

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Abstract PDF

Background
：Diffusion tensor image tractography (DTT) can visualize white matter tracts and provide us with a powerful vehicle for investigating the neuralpathway at the subcortical level. Using DTT, we attempted to demonstrate abnormal transcallosal fibers from the corticospinal tract in patients with brain injury. Materials and Methods：Four adults with brain injury (2 patients: stroke, 1 patient: brain tumor with hemorrhage, 1 patient: diffuse axonal injury) and 14 normal control subjects were enrolled in this study. DTT was performed using 1.5-T with a Synergy-L Sensitivity Encoding head coil. Three-dimensional reconstructions of the fiber tracts were obtained with FA<3.0, and an angle change >45o as termination criteria.
Results
：Transcallosal fibers were observed in two of 14 normal controls, and ascended to the cortex leaving the corpus callosum. All four patients showed transcallosal fibers which stemmed from the corticospinal tract of the unaffected hemisphere, and descended to or around the lesion at the subcortical area.
Conclusion
：It seems that transcallosal fibers which arise from the corticospinal tract of the unaffected hemisphere may act as pathological fibers for motor deficit compensation.

Citations

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Usefulness of DTI-based three dimensional corticospinal tractography in children with hemiplegic cerebral palsy
Ji Hyun Yeo, Su Min Son, Eun Sil Lee, Han Ku Moon
Korean Journal of Pediatrics.2009; 52(1): 99. CrossRef

MRI Findings of Neuro-Behcet' Disease.: Han Won Jang, Woo Mok Byun, Kil Ho Cho, Mi Soo Hwang; Yeungnam Univ J Med. 1998;15(2):306-315. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.306

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Abstract PDF: MR findings in nine patients(three female, six male) with neuroBehcet's disease were retrospectively analyzed. NeuroBehcet's disease was diagnosed on the basis of typical clinical symptoms. Involved site, pattern, signal intensity, and contrast enhancement pattern on MRI were evaluated. In addition, follow up MR imaging was performed in four patients. The midbrain(7/9), internal capsule(7/9), pons(6/9), thalamus(6/9), basal ganglia(5/9), middle cerebella peduncle(4/9), medulla oblongata(2/9), and subcortical white matter(2/9) are involved on MRI. The size of lesions were 1cm to 3cm and their margin was ill-defined and patchy. Inhomogeneous high signal intensity on the T2-weighted images and low signal intensity on T1-weighted images was seen respectvely. In four of nine cases, there was focal enhancement. On follow up MR imaging, improvement or recurrance of the lesions was found. Also in two cases of follow up cases there was artophy in brainstem and/or middle cerebellar peduncles. In conclusion, MR imaging with systemic clinical symptoms is useful for diagnosing neuro-Behcet's disease.

The Measurement of Blood Flow of Anterior Cerebral Artery in Premature Newborns Using Duplex Dopple Ultrasonography.: Mi Soo Hwang, Kyeung Kug Bae, Jae Kyo Lee; Yeungnam Univ J Med. 1997;14(1):77-84. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.77

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Abstract PDF: We measured the blood flow velocity of the anterior cerebral artery via anterior fontanelle approach of fifty five preterm neonates with duplex Doppler sonography and analyzed the waveform and calculated pulsatility index were increased with increasing gestational age, birth weight, and age of the neonate, but resistive indices decreased. In sick babies, characteristic resistive index increment were seen in patients with intraventricular hemorrhage, but no statistical difference was seen in patients with respiratory distress syndrome. Our results suggest that duplex Doppler sonography is a use ful noninvasive means of monitoring cerebrohemodynamics in normal pretem neonates and flow change of sick babies.

Effect of Intracarotid Cold Saline Infusion during Cerebral ischemia on Brain Edema in the Rabbit: Sae Yeon Kim, Kyu Taek Choi; Yeungnam Univ J Med. 1995;12(2):260-268. Published online December 31, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.2.260

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Abstract PDF: Ischemia results when the decrease in tissue perfusion exceeds the tissues ability to increase an oxygen extraction from the blood. Brain edema has been defined as an abnormal accumulation of fluid within brain parenchyma associated with a volumetric enlargement of the brain tissue. In most instances, the labelling of edema as vasogenic or cytotoxic is only relative. For cerebral protection, there were many possible techniques which could increase or maintain cerebral perfusion and reduce cerebral metabolic demand for oxygen. This study was carried out the effect of mild Brain hypothermia which was induced by infusion with cold saline into the carotid artery, during brief episodes of transient global ischemia on postischemic brain edema in rabbit. Eight rabbits were anesthetized with halothane and mechanically ventilated with oxygen. For isolated cerebral perfusion, polyethylene catheter was inserted left carotid artery for infusion of cold saline, external carotid artery was ligated, vertebral arteries were cauterized, right carotid artery was snared for ischemia and femoral artery and vein were also cannulated for monitoring and drug treatment. At 3 hours after transient global ischemia, specific gravity of cerebral cortex and hippocampus was compared with no-perfusion group, perfusion with cold saline group and normal group. There was no significant differences in physiologic variables among the groups before transient global ischemia. But during transient global ischemia, brain temperature of perfusion group was decreased when compared to no perfusion group. Specific gravity of cerebral cortex and hippocampus of no-perfusion group and perfusion group was statistically significant when compared to normal group (p<0.01). The results of this study suggested that mild brain hypothermia with intracarotid cold saline infusion during brief episodes of transient global ischemia had decreased postischemic brain edema in rabbit.

Case Report

A BRW Stereotaxic Biopsy of Brain Stem Glioma.: Seung Chan Beak, Byung Yon Choi, Choong Bae Moon, Yong Chul Chi, Soo Ho Cho; Yeungnam Univ J Med. 1986;3(1):343-349. Published online December 31, 1986; DOI: https://doi.org/10.12701/yujm.1986.3.1.343

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Abstract PDF: Histopathological diagnosis of brain stem glioma should be performed for the purpose of the determination of its management and clinical course, but its surgical biopsy has been followed by high mortality and morbidity. We performed the tissue sampling for histological examination with BRW stereotaxic system under local anesthesia successfully.

Original Article

Clinical Investigation of Childhood Epilepsy.: Han Ku Moon, Yong Hoon Park; Yeungnam Univ J Med. 1985;2(1):103-111. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.103

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Abstract PDF: Childhood epilepsy which has high prevalence rate and inception rate is one of the commonest problem encountered in pediatrician. In contrast with epilepsy of adult, in childhood epilepsy, more variable and varying manifestations are found because the factors of age, growth and development exert their influences in the manifestations and the courses of childhood epilepsy. Moreover epilepsy children have associated problems such as physical and mental handicaps, psychological disorders and learning disability. For these reasons pediatrician who deals with epileptic children experiences difficulties in making diagnosis and managing them. In order to improve understanding and management of childhood epilepsy, authors reviewed 103 cases of epileptic patients seen at pediatric department of Yeungnam University Hospital retrospectively. The patients were classified according to the type of epileptic seizure. Suspected causes of epilepsy, associated conditions of epileptic patients, age incidence and the findings of brain CT were reviewed. Large numbers of epileptic patients (61.2%) developed their first seizures under the age of 5. The most frequent type of epileptic seizure was generalized tonic-clonic, tonic, clonic seizure (49.5%), followed by simple partial seizure with secondary generalization (17.5%), simple partial seizure (7.8%), atypical absence (5.8%) and unclassified seizure (5.8%). In 83.5% of patients, we could not find specific cause of it, but in 16.5% of cases, history of neonatal hypoxia (4.9%), meningitis (3.9%), prematurity (1.9%), small for gestational age (1.0%), CO poisoning (1.0%), encephalopathy (1.0%) were found. 30 cases of patients had associated diseases such as mental retardation, hyperactivity, delayed motor milestones or their combinations. The major abnormal findings of brain CT performed in 42 cases were cortical atrophy, cerebral infarction, hydrocephalus and brain swelling. This review stressed better designed classification of epilepsy is needed and with promotion of medical care, prevention of epilepsy is possible in some cases. Also it is stressed that childhood epilepsy requires multidisciplinary therapy and brain CT is helpful in the evaluation of epilepsy with limitation in therapeutic aspects.

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