1.Usefulness of Videofluoroscopic Swallow Study with Mixed Consistency Food for Patients with Stroke or Other Brain Injuries.
Si Hyun KANG ; Don Kyu KIM ; Kyung Mook SEO ; Jong Hyun SEO
Journal of Korean Medical Science 2011;26(3):425-430
This study evaluated the feasibility of mixed consistency foods test in patients with dysphagia which developed after stroke or other brain injuries. The findings of a videofluoroscopic swallow study (VFSS) were compared using single versus mixed consistency foods. Forty-nine patients with stroke or other brain injuries who had no significant abnormal findings in the single consistency food VFSS and started regular hospital diet were recruited for this study. Twenty-five (51%) of the 49 patients showed normal findings whereas 24 (49%) patients showed abnormal findings in the mixed consistency food VFSS. Abnormal findings included posterior spillage of liquid prematurely to pyriform sinus (n = 23), laryngeal penetration (n = 6), subglottic aspiration in the oral preparatory phase of swallowing (chewing), solid components (n = 2), and significant (more than 10%) residue in valleculae or pyriform sinus (n = 2). There was an increased risk of abnormal findings in mixed consistency food VFSS such as aspiration and penetration when a patient showed delayed pharyngeal delay time in single consistency food using liquids. In conclusion, VFSS protocols using mixed consistency foods would be useful before starting regular diet for patients after stroke or other brain injuries.
Brain Injuries/*physiopathology/radiography
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*Deglutition
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Deglutition Disorders/*physiopathology/radiography
;
*Eating
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Fluoroscopy/*methods
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Food
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Humans
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Mastication
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Stroke/*physiopathology/radiography
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Video Recording
2.Dynamic changes of the CT perfusion parameters in the embolic model of cerebral ischemia.
Weiwei, CHEN ; Jianpin, QI ; Jinhua, ZHANG ; Wenhua, HUANG ; Jinmei, SONG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2004;24(6):615-7
To study the dynamic changes of CT perfusion parameters during the first 12 h in the embolic cerebral ischemia models. Local cerebral ischemia model were established in 7 New Zealand white rabbits. All CT scans were performed with a GE Lightspeed 16 multislice CT. Following the baseline scan, further CT perfusion scans were performed at the same locations 20 min, 1-6 h and 8, 10 and 12 h after the embolus delivery. Maps of all parameters were obtained by CT perfusion software at each time point. The brains, taken 12 h after the scan, were sliced corresponding to the positions of the CT slices and stained by 2,3,5-triphenyltetrazolium chloride (TTC). On the basis of the TTC results, the ischemic sides were divided into 3 regions: core, penumbra and the relatively normal region. The changes of all parameters were then divided into 3 stages. In the first two hours (the first stage), the CBV dropped more remarkably in the core than in the penumbra but rose slightly in the relatively normal region while the CBF decreased and MTT, TTP extended in all regions to varying degrees. In the 2nd-5th h (the second stage), all the parameters fluctuated slightly around a certain level. In the 5th-12th h (the third stage), the CBV and CBF dropped, and MTT and TTP were prolonged or shortened slightly in the core and penumbra though much notably in the former while the CBV, CBF rose and MTT, TTP were shortened remarkably in the relatively normal region. We experimentally demonstrated that the location and extent of cerebral ischemia could be accurately assessed by CT perfusion imaging. The pathophysiology of the ischemia could be reflected by the CT perfusion to varying degrees.
Blood Flow Velocity
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Brain Ischemia/physiopathology
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Brain Ischemia/*radiography
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Cerebrovascular Circulation
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Stroke/physiopathology
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Tomography, X-Ray Computed
4.Recent advances of study on hereditary diffuse leukoencephalopathy with spheroids.
Chinese Journal of Medical Genetics 2014;31(3):330-333
Hereditary diffuse leukoencephalopathy with neuroaxonal spheroids (HDLS) is a rare autosomal dominant leukoencephalopathy disease, and colony stimulating factor 1 receptor (CSF1R) is the only gene in which mutations are known to cause HDLS. HDLS should be suspected in individuals with progressive neurological decline, characteristic MR imaging findings, and positive family history. This article reviews recent advance in imaging findings, clinical manifestations, genetic counseling and management in HDLS.
Brain
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diagnostic imaging
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Humans
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Leukoencephalopathies
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diagnosis
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diagnostic imaging
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genetics
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physiopathology
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Radiography
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Spheroids, Cellular
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cytology
5.Study on the relative specificity of the heart and lung meridians in brain with fMRI.
Zi-jian WU ; Rong-lin CAI ; Chun-sheng XU ; Ling HU ; Lu HE ; Wu-bin HU ; Chuan-fu LI ; Yi-ping ZHOU
Chinese Acupuncture & Moxibustion 2011;31(6):529-534
OBJECTIVETo study the central modulation mechanism on the relative specificity of the Heart and Lung Meridians and to provide the experimental evidence for deeply study on correlation between meridian-viscera and brain.
METHODSTen healthy students in Anhui College of TCM were chosen and a modified block design was adopted. After 32 time points of resting and 32 of rotation needling, then 48 of resting and 32 stimulating, and 16 resting time points, functional imagings were collected at last. All the process would last for 10 min 44 sec. Acupuncture work was finished by one acupuncturist with extensive experience by acupuncture at the left Shenmen (HT 7) or Taiyuan (LU 8) with the disposable sterile stainless steel needle, and uniform reinforcing-reducing method was used with frequency of 1 Hz and depth of 1.0 cm. After the experiment, the sensation of acupuncture and the other feeling or psychic process were inquired and recorded detailedly. These data were analyzed by AFNI software.
RESULTSAcupuncture at Taiyuan (LU 8) could excite the contralateral frontal lobe, apical lobe, cerebral ganglion, VI, VIII areas and inferior semilunar lobule of cerebellum, and restrain bilateral callosal gyrus and homolateral gyrus rectus. Acupuncture at Shenmen (HT 7) could excite the contralateral IV-VIII areas of cerebellum, and homolateral VI, VII areas of cerebellum, and restrain parts of homolateral apical lobe.
CONCLUSIONAcupuncture at Shenmen (HT 7) of the Heart Meridian and Taiyuan (LU 8) of the Lung Meridian can excite or restrain different brain areas, indicating that there are relatively specific corresponding brain areas for the Heart Meridian and Lung Meridian.
Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Brain ; diagnostic imaging ; physiopathology ; Female ; Heart ; physiopathology ; Humans ; Lung ; physiopathology ; Magnetic Resonance Imaging ; Male ; Meridians ; Radiography ; Young Adult
6.Correlation of brain CT findings and developmental outcome in patients with spastic cerebral palsy.
Eun Sook PARK ; Chang Il PARK ; Ju Kang LEE ; Shin Young YIM
Yonsei Medical Journal 1998;39(2):103-108
Brain computed tomography (CT) is a useful tool for evaluating the pathologic findings in the brains of children with neurologic abnormalities. Brain CT investigation and the Munchner Funtionelle Entwicklungs Diagnostik (MFED) developmental assessment was performed in 88 patients with spastic cerebral palsy. The incidence of abnormal brain CT findings in patients with spastic cerebral palsy was 69.3%. The group with pathologic CT findings had a greater possibility of having developmental delay than the group with normal CT findings (p < 0.05). However, there was no significant relationship between the specific MFED categories and the types of brain CT abnormalities. Pathological CT findings could offer important prognostic information indicating a higher risk concerning the grade of developmental delay.
Adolescence
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Adult
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Atrophy
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Brain/radiography*
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Cerebral Palsy/radiography*
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Cerebral Palsy/physiopathology*
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Cerebral Palsy/complications
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Child
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Child Development/physiology*
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Developmental Disabilities/etiology
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Female
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Human
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Male
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Middle Age
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Muscle Spasticity/radiography
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Muscle Spasticity/physiopathology
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Time Factors
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Tomography, X-Ray Computed*
7.Magnetic resonance imaging findings in bilateral basal ganglia lesions.
Annals of the Academy of Medicine, Singapore 2009;38(9):795-798
INTRODUCTIONRadiologists may encounter bilaterally symmetrical abnormalities of the basal ganglia on magnetic resonance imaging (MRI), typically in the context of diffuse systemic, toxic or metabolic diseases. A systematic approach and broad knowledge of pathology causing this uncommon group of conditions would be useful.
MATERIALS AND METHODSThis review uses illustrative images to highlight metabolic conditions, such as Leigh's syndrome, citrullinaemia, hypoglycaemia or carbon monoxide poisoning, as well as other causes of bilateral basal ganglia lesions such as osmotic myelinolysis, deep cerebral venous thrombosis and Creutzfeldt-Jakob disease.
RESULTSCareful assessment of radiological findings outside the basal ganglia, such as involvement of the cortex, white matter, thalamus and pons, together with clinical correlation, may be helpful in narrowing the differential diagnosis, and directing further radiological, biochemical or genetic investigations. Recent advances in MR technology have resulted in newer techniques including diffusion-weighted (DW) MR imaging and MR spectroscopy (MRS); these may be helpful if appropriately used.
CONCLUSIONSAbnormal MRI findings in the basal ganglia should not be interpreted in isolation. A systematic approach including DW MR imaging, MRS, and a broad knowledge of diffuse systemic, toxic or metabolic diseases is helpful.
Basal Ganglia Diseases ; diagnosis ; diagnostic imaging ; physiopathology ; Brain Diseases, Metabolic ; diagnosis ; diagnostic imaging ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Radiography
8.Brainstem Auditory Evoked Potentials in Acute Carbon Monoxide Poisoning.
Yonsei Medical Journal 1985;26(1):29-34
Of 32 cases suffering from acute carbon monoxide (CO) poisoning brainstem auditory evoked potential (BAEP) abnormalities were exhibited in 8 cases. the abnormalities of BAEPs could be divided into two patterns: a peripheral pattern (6 cases) of prolongation of latency to wave 1 without prolongation of interpeak latency, and a central pattern (2 cases) of prolongation of latencies to all waves and interpeak latencies. The indicence of BAEP abnormality tended to increase in accordance with an unconscious duration of more than 24 hours; during acute CO poisoning. A BAEP abnormality exhibiting a peripheral pattern usually returned to normal within one month after anoxia, but cases showing central pattern of BAEP abnormality died during acute anoxic insult due to the possible involvement of the brainstem. Thus, BAEPs can be used for evaluating the functional intergrity of the auditory pathways and for providing prognostic values in acute CO poisoning.
Acute Disease
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Adolescent
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Adult
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Aged
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Basal Ganglia/radiography
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Brain Stem/physiopathology*
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Carbon Monoxide Poisoning/physiopathology*
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Evoked Potentials, Auditory*
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Female
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Human
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Male
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Middle Age
;
Tomography, X-Ray Computed
9.Correlation analysis on changes between cognitive ability and brain fMRI after acupoint thread embedding in Alzheimer's disease patients.
You-long ZHOU ; Hong-yan HAN ; Jian-ping JIA
Chinese Journal of Integrated Traditional and Western Medicine 2008;28(8):689-693
OBJECTIVETo explore the mechanism of acupoint thread embedding (ATE) in treating Alzheimer's disease (AD) by means of brain functional magnetic resonance imaging (fMRI).
METHODSTwenty-six patients with mild to moderate AD were assigned to the tested group and the control group in pairing, 13 in each group. ATE was performed in patients of the tested group at Shenmen (HT7), Fenglong (ST40), Taixi (KI3) and Zusanli (ST36) acupoints, once every month for 6 times in total; but for patients of the control group only sham operation was done at the same acupoints. The correlation between cognitive ability and fMRI were assessed by comparing the scores of Mini-Mental State Examination (MMSE) and Alzhemer's Disease Assessment Scale-Cognitive section (ADAS-Cog), monitored at two time points, namely, in one week before starting treatment and 1 week after terminating 6-month treatment. Furthermore, fMRI was detected to obtain the data of the cerebral blood oxygen content before treatment and 6 months after completing the 6-month therapeutic course. Correlation analysis was conducted on the obtained data using software SPM.
RESULTSAfter treatment, changes of MMSE score significently increased in the test group (P < 0.01) and decreased in the control group (P < 0.01), and ADAS-Cog decreased in the test group (P < 0.01) and increased in the control group (P < 0.05), showing statistical significance between the two groups (P < 0.01, P < 0.05). The activated regions related with the change of MMSE were mainly inferior frontal gyrus, middle frontal gyrus, superior frontal gyrus, transverse temporal gyrus, on the left cerebrum and superior frontal gyrus, middle frontal gyrus, precentral gyrus, hippocampal gyrus, cingulate gyrus, postcentral gyrus, paracentral lobule on the right cerebrum; those related with change of ADAS-Cog were superior frontal gyrus, middle frontal gyrus, fusiform gyrus, inferior temporal gyrus, hippocampal gyrus on the left cerebrum, and superior frontal gyrus, middle frontal gyrus, precentral gyrus, fusiform gyrus, transverse temporal gyrus, postcentral gyrus, middle occipital gyrus on the right cerebrum.
CONCLUSIONATE could improve the cognitive ability of AD patients, its possible mechanism may be through the activation on the cognition related regions of frontal, temporal lobe and marginal system, as well as those of cerebellum.
Acupuncture Points ; Acupuncture Therapy ; Aged ; Aged, 80 and over ; Alzheimer Disease ; diagnostic imaging ; physiopathology ; therapy ; Brain ; diagnostic imaging ; physiopathology ; Catgut ; Cognition ; Female ; Humans ; Magnetic Resonance Angiography ; Male ; Radiography
10.Effects of electroacupuncture on resting-state encephalic functional connectivity network in patients with PTSD.
Chengqiang ZHENG ; Lingxiao TAN ; Tianxiu ZHOU ; Hong ZHANG
Chinese Acupuncture & Moxibustion 2015;35(5):469-473
OBJECTIVETo explore the central regulatory mechanism of electroacupuncture (EA) on patients with post-traumatic stress disorder (PTSD).
METHODSFourteen patients of PTSD were selected as study objects and treated with "regulating mind and restoring consciousness" acupuncture method, in which Baihui (GV 20) and Shenting (GV 24) were used as main acupoints and Sishencong (EX-HN 1) and Fengchi (GB 20) were used as supporting acupoints for acupuncture. After the arrival of qi, Han's acupoint nerve stimulator was connected for 30 min per treatment, three times a week for consecutive 12 weeks. Before treatment and 12 weeks into treatment, the clinician administered PTSD scale (CAPS), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were evaluated; a Siemens 3.0 T magnetic resonance imaging system was used to perform resting-state scan, and bilateral hippocampus were taken as region of interested to perform encephalic function connectivity analysis.
RESULTSAfter the treatment, the scores of CAPS, SAS and SDS were all reduced compared with those before treatment (all P<0.05) ; function connectivity was enhanced in bilateral hippocampus, right posterior central gyrus and left superior parietal lobule (2.3 CONCLUSIONElectroacupuncture has certain improving effects on PTSD symptoms, which is likely to be related with enhancing the connectivity between parietal lobe and hippocampus, suppressing the connectivity between hippocampus and parahippocampal gyrus, amygdaloid, leading to an indirect influence on limbic system.
Acupuncture Points
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Adolescent
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Adult
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Brain
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diagnostic imaging
;
physiopathology
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Electroacupuncture
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Female
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Humans
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Magnetic Resonance Imaging
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Male
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Radiography
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Stress Disorders, Post-Traumatic
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diagnostic imaging
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physiopathology
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therapy
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Young Adult