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Among the nuclear medicine imaging methods available today, H215O-PET is most widely used by cognitive neuroscientists to examine regional brain function via the measurement of regional cerebral blood flow (rCBF). The short half-life of the radioactively labeled probe, 15O, often allows repeated measures from the same subjects in many different task conditions. H215O-PET, however, has technical limitations relative to other methods of functional neuroimaging, e.g., fMRI, including relatively poor time and spatial resolutions, and, frequently, insufficient statistical power for analysis of individual subjects. However, recent technical developments, such as the 3-D acquisition method provide relatively good image quality with a smaller radioactive dosage, which in turn results in more PET scans from each individual, thus providing sufficient statistical power for the analysis of individual subject's data. Furthermore, the noise free scanner environment H215O PET, along with discrete acquisition of data for each task condition, are important advantages of PET over other functional imaging methods regarding studying state-dependent changes in brain activity. This review presents both the limitations and advantages of 15O-PET, and outlines the design of efficient PET protocols, using examples of recent PET studies both in the normal healthy population, and in the clinical population.
Brain ; Cognition ; Functional Neuroimaging ; Half-Life ; Magnetic Resonance Imaging ; Noise ; Nuclear Medicine ; Positron-Emission Tomography

Homeroom teachers are not usually nutrition professionals, but they spend a lot of time with students in elementary school classrooms. This study was conducted to determine the association of homeroom teachers’ nutrition education with the dietary habits of their classroom children. The subjects were 131 homeroom teachers and their 1,102 children from 17 elementary schools in Gyeonggi, Korea. Self-administered questionnaires to collect information on dietary habits were conducted in December 2016. The dietary habits were determined with the adherences to the Dietary Guidelines for Adults and Children, respectively, by coding the better diet life with a higher score. The significances between groups according to teachers’ implementation of nutrition education (106 implemented, 25 not implemented) were analyzed by using SPSS at P＜0.05. Implementing nutrition education was not associated with the dietary habits of teachers themselves, but their students. Therefore, the students of teachers who implemented nutrition education had significantly higher adherence to 8 items out of 19 items (P＜0.05, P＜0.01). More of the students considered themselves as non-picky eaters (P＜0.05), tried to eat all the foods served at school lunch even when it contained unwanted ingredients (P＜0.01), and agreed on the need of nutrition education (P＜0.01), as compared to their counterparts. Conclusively, this study suggests that nutrition education delivered by homeroom teachers may be associated with more desirable dietary habits of students, even though homeroom teachers are not nutrition professionals. Therefore, efforts should be undertaken to develop and provide proper contents for homeroom teachers to use in nutrition education for elementary students.

A ketogenic diet (KD) is a dietary approach to treat intractable epilepsy. The KD begins with hospitalization and the child and their parents can adapt to the KD for 1-2 weeks. Recently, various type of dietary intervention such as the modified Atkins diet (MAD) and the low glycemic index treatment (LGIT) have been performed. Since 2010, we carried out the KD, MAD, and LGIT for total of 802 patients; 489 patients (61%) for the KD, 147 patients (18.3%) with the MAD, and 166 patients (20.7%) for the LGIT. In this report, application of these dietary practices in Severance Hospital is shared.
Child* ; Diet, Carbohydrate-Restricted ; Epilepsy* ; Glycemic Index ; Hospitalization ; Humans ; Ketogenic Diet* ; Meals* ; Parents

OBJECTIVE: The focus of this study is brain plasticity associated with semantic aspects of language function in patients with medial temporal lobe epilepsy (mTLE). METHODS: Using longitudinal functional magnetic resonance imaging (fMRI), patterns of brain activation were observed in twelve left and seven right unilateral mTLE patients during a word-generation task relative to a pseudo-word reading task before and after anterior temporal section surgery. RESULTS: No differences were observed in precentral activations in patients relative to normal controls (n = 12), and surgery did not alter the phonological-associated activations. The two mTLE patient groups showed left inferior prefrontal activations associated with semantic processing (word-generation > pseudo-word reading), as did control subjects. The amount of semantic-associated activation in the left inferior prefrontal region was negatively correlated with epilepsy duration in both patient groups. Following temporal resection, semantic-specific activations in inferior prefrontal region became more bilateral in left mTLE patients, but more left-lateralized in right mTLE patients. The longer the duration of epilepsy in the patients, the larger the increase in the left inferior prefrontal semantic-associated activation after surgery in both patient groups. Semantic activation of the intact hippocampus, which had been negatively correlated with seizure frequency, normalized after the epileptic side was removed. CONCLUSION: These results indicate alternation of semantic language network related to recruitment of left inferior prefrontal cortex and functional recovery of the hippocampus contralateral to the epileptogenic side, suggesting an intra- and inter-hemispheric reorganization following surgery.
Anterior Temporal Lobectomy ; Brain ; Epilepsy ; Epilepsy, Temporal Lobe ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Plastics ; Prefrontal Cortex ; Seizures ; Semantics ; Temporal Lobe

OBJECTIVE: Using functional magnetic resonance imaging, cerebral language areas were determined during a series of language tasks in normal strong right-handed subjects. METHODS: Twelve normal right-handed volunteers were examined on a 1.5T MR unit. Language task paradigms included two phonological tasks involving meaningless letters and sentences, and four semantic tasks using different types of words. Each language task was examined using a separate scan consisted of three blocks separated by rest periods. BOLD (blood oxygenation level dependent) signals during language tasks were compared using 24 sec alternating rest periods during which subjects concentrated on a plus symbol. After preprocessing and statistically analyzing individual data, group analysis (p<0.001, k=50) was performed using SPM99 software. RESULTS: Meaningless letter reading was more efficient than sentence reading, in terms of delineating brain regions related to phonological processing, we found significant regions in the left inferior frontal gyrus (IFG), left thalamus, bilateral cingulate gyri, right anterior superior temporal gyrus (STG), right IFG, and left inferior parietal lobule (IPL). During semantic tasks, left IFG, left posterior middle temporal gyrus, left IPL, bilateral medial frontal gyrus, right posterior STG, right parahippocampal, and fusiform gyri were found to be activated. CONCLUSION: During the two phonological tasks, normal strongly right-handed people more actively used the left IFG, right anterior temporal lobe, and right IFG than during semantic processing, whereas during the four semantic tasks, these subjects more actively used the bilateral posterior temporal and right medial temporal lobes.
Brain ; Magnetic Resonance Imaging* ; Oxygen ; Rabeprazole ; Semantics* ; Temporal Lobe ; Thalamus ; Volunteers

Purpose: The metabolic activity and demand usually increase in seriously ill patients, especially in patients with a brain injury (BI). These nutritional demands have been traditionally satisfied using predictive equations (PEs). Recently, indirect calorimetry (IC) has been used widely because it is more accurate than other methods. This study measured the energy expenditures (EE) using IC (GE, CARESCAPE B650, Helsinki, Finland) and calculated the PEs simultaneously in patients with BI. Methods: This study was conducted on 55 patients with a BI for three years (2017.7∼2020.8), who were mechanically ventilated within a hospital for ≤seven days. The EE values using IC were measured once in each patient, and the EE values using PE were calculated using 5 PEs (ESPEN, Harris-Benedict, HB; Frankenfield, FK; Penn state, PS; and Faisy) at the same time.The 55 patients were divided into two groups, acute group (39 patients; ≤3 hospital days group, AG) and subacute group (16 patients; ＞3 hospital days group, SG) according to the time, and the values were obtained. Results: There were no differences in the patient’s characteristics between the two groups, including age, gender, severity of the condition (Simplified Acute Physiology Score II), and anthropometric parameters. In AG, the energy expenditure values using PEs were significantly lower than those using IC in the three PEs (IC 1,712.0±476 kcal, ESPEN 1,558.6±324 kcal, P=0.038, HB 1,582.4±273 kcal, P=0.037, PS 1,530.8±340 kcal, P=0.005). In SG, the EE value using PEs did not differ significantly from that using IC. Conclusion An accurate assessment of EE is critical for seriously ill patients. These results showed that the previously well-known PEs might not be correct, particularly in acute patients with BI. Therefore, it is recommended that the EE values be obtained using IC, at least in acute patients with BI.

Purpose: The metabolic activity and demand usually increase in seriously ill patients, especially in patients with a brain injury (BI). These nutritional demands have been traditionally satisfied using predictive equations (PEs). Recently, indirect calorimetry (IC) has been used widely because it is more accurate than other methods. This study measured the energy expenditures (EE) using IC (GE, CARESCAPE B650, Helsinki, Finland) and calculated the PEs simultaneously in patients with BI. Methods: This study was conducted on 55 patients with a BI for three years (2017.7∼2020.8), who were mechanically ventilated within a hospital for ≤seven days. The EE values using IC were measured once in each patient, and the EE values using PE were calculated using 5 PEs (ESPEN, Harris-Benedict, HB; Frankenfield, FK; Penn state, PS; and Faisy) at the same time.The 55 patients were divided into two groups, acute group (39 patients; ≤3 hospital days group, AG) and subacute group (16 patients; ＞3 hospital days group, SG) according to the time, and the values were obtained. Results: There were no differences in the patient’s characteristics between the two groups, including age, gender, severity of the condition (Simplified Acute Physiology Score II), and anthropometric parameters. In AG, the energy expenditure values using PEs were significantly lower than those using IC in the three PEs (IC 1,712.0±476 kcal, ESPEN 1,558.6±324 kcal, P=0.038, HB 1,582.4±273 kcal, P=0.037, PS 1,530.8±340 kcal, P=0.005). In SG, the EE value using PEs did not differ significantly from that using IC. Conclusion An accurate assessment of EE is critical for seriously ill patients. These results showed that the previously well-known PEs might not be correct, particularly in acute patients with BI. Therefore, it is recommended that the EE values be obtained using IC, at least in acute patients with BI.

Epithelial-myoepithelial carcinoma (EMC) is a rare low grade malignant tumor of the salivary glands and it shows a characteristic biphasic population of epithelium and myoepithelium. It shows various cytologic and histologic features, so making an exact diagnosis is difficult. We report here on two cases of epithelial-myoepithelial carcinoma arising from the parotid gland and we compare the cytologic findings of the aspirated samples with the histologic findings of the tumors. We think the finding of mixed pattern of large, clear myoepithelia and small epithelia is the most valuable finding in the diagnosis of EMC.
Biopsy, Fine-Needle ; Epithelium ; Parotid Gland ; Salivary Glands

PURPOSE: Determining an appropriate thresholding is crucial for PDG PET analysis since strong control of Type I error could fail to find pathological differences between early Alzheimer' disease (AD) patients and healthy normal controls. We compared the SPM results on FDG PET imaging of early AD using uncorrected p-value, random-field based corrected p-value and false discovery rate (FDR) control. MATERIALS AND METHODS: Twenty-eight patients (66+/-7 years old) with early AD and 18 age-matched normal controls (68+/-6 years old) underwent FDG brain PET. To identify brain regions with hypo-metabolism in group or individual patient compared to normal controls, group images or each patient's image was compared with normal controls using the same fixed p-value of 0.001 on uncorrected thresholding, random-field based corrected thresholding and FDR control. RESULTS: The number of hypo-metabolic voxels was smallest in corrected p-value method, largest in uncorrected p-value method and intermediate in FDG thresholding in group analysis. Three types of result pattern were found. The first was that corrected p-value did not yield any voxel positive but FDR gave a few significantly hypometabolic voxels (8/28, 29%). The second was that both corrected p-value and FDR did not yield any positive region but numerous positive voxels were found with the threshold of uncorrected p-values (6/28, 21%). The last was that FDR was detected as many positive voxels as uncorrected p-value method (14/28, 50%). CONCLUSIONS: FDR control could identify hypo-metabolic areas in group or individual patients with early AD. We recommend FDR control instead of uncorrected or random-field corrected thresholding method to find the areas showing hypometabolism especially in small group or individual analysis of FDG PET.
Brain ; Dementia* ; Humans