Background and Objectives: Cognitive behavioral therapy (CBT) is a treatment option for subjective tinnitus. There are many reports on its clinical efficacy, but the protocol has not been well established. The purpose of this study was to set an outpatient-based CBT protocol and evaluate its clinical efficacy for tinnitus.Subjects and Method A total of 85 chronic tinnitus patients was assessed in this prospective study. After evaluating for eligibility, 30 patients completed CBT based on a protocol of 5 weekly sessions in an outpatient setting. Therapeutic efficacy was assessed by Tinnitus Handicap Inventory (THI) questionnaires and visual analogue scale (VAS) for tinnitus. The initial scores were compared with the final scores, which were assessed a month after the fifth CBT session. Results: The results showed that CBT reduced THI and VAS scores significantly (p<0.05). Conclusion The results of the study suggest that an outpatient-based CBT protocol can be clinically beneficial for patients with tinnitus.

Background: This study aimed to compare the mechanical characteristics of four fixation methods including an anatomical suprapectineal quadrilateral surface (QLS) plate in hemipelvic models of anterior column–posterior hemitransverse acetabular fractures typical in elderly patients. Methods: In total, 24 composite hemipelvic models were used and allocated to four groups: group 1, pre-contoured anatomical suprapectineal QLS plate; group 2, suprapectineal reconstruction plate with two periarticular long screws; group 3, suprapectineal reconstruction plate with a buttress reconstruction plate; group 4, suprapectineal reconstruction plate with a buttress T-plate. Axial structural stiffness and displacement of each column fragment in four different fixation constructs were compared. Results: Multiple group comparisons of axial structural stiffness demonstrated significant difference (p = 0.001). Although there was no significant difference between groups 1 and 2 (p = 0.699), group 1 showed greater stiffness than groups 3 and 4 (p = 0.002 and 0.002, respectively). Group 1 showed less displacement in the anterior region of the anterior fragment than group 4 (p = 0.009) and in the posterior region than groups 3 and 4 (p = 0.015 and p = 0.015, respectively). However, group 1 demonstrated greater displacement than group 2 in the posterior region of the posterior fragment (p = 0.004), while showing similar displacement to groups 3 and 4. Conclusions The anatomical suprapectineal QLS plate provided the mechanical stability comparable or superior to other existing fixations in osteoporotic models of anterior column–posterior hemitransverse acetabular fractures typical in the elderly. However, additional plate modification would be needed for better stability and outcomes.

Objectives: The aim of this study was to evaluate brain activity in youth during chewing gum and wood stick using functional magnetic resonance imaging (fMRI). Methods: Two participants chewed wax gums and wood stick on the rhythm of 1 Hz during MRI scanning. The task paradigm was a block design and each chewing-rest procedure was repeated five times for 30s. Results: The brain regions activated during chewing gum and wood stick were the precentral gyrus, postcentral gyrus, supplementary motor area, thalamus cerebellum. The medial prefrontal cortex (mPFC), anterior cingulate cortex (ACC), hippocampus, and precuneus were additionally activated by mastication of the wood stick. Brain activation induced by chewing wood stick was higher than chewing gum. Conclusions Our results suggest that mastication contribute to cognitive improvement through brain activity, this effect is stronger during chewing wood than gum. Therefore, eating harder foods may improve cognitive function more effectively.

Fear memory recruits various brain regions with long-lasting brain-wide subcellular events. The medial prefrontal cortex processes the emotional and cognitive functions required for adequately handling fear memory. Several studies have indicated that subdivisions within the medial prefrontal cortex, namely the prelimbic, infralimbic, and anterior cingulate cortices, may play different roles across fear memory states. Through a dedicated cytoarchitecture and connectivity, the three different regions of the medial prefrontal cortex play a specific role in maintaining and extinguishing fear memory. Furthermore, synaptic plasticity and maturation of neural circuits within the medial prefrontal cortex suggest that remote memories undergo structural and functional reorganization. Finally, recent technical advances have enabled genetic access to transiently activated neuronal ensembles within these regions, suggesting that memory trace cells in these regions may preferentially contribute to processing specific fear memory. We reviewed recently published reports and summarize the molecular, synaptic and cellular events occurring within the medial prefrontal cortex during various memory stages.

Gadolinium contrast agents (CAs) are integral components of clinical magnetic resonance imaging (MRI). However, safety concerns have arisen regarding the use of gadolinium CAs, due to their association with nephrogenic systemic fibrosis (NSF). Furthermore, recently the long-term retention of Gd²⁺-based CAs in brains patients with normal renal function raised another possible safety issue. The safety concerns of Gd²⁺-based CAs have been based on the ligand structure of Gd²⁺-based CAs, and findings that Gd²⁺-based CAs with linear ligand structures showed much higher incidences of NSF and brain retention of CAs than Gd²⁺-based CAs with macrocyclic ligand structure. In the current study, we report the in vivo biodistribution profile of a new highly stable multifunctional Gd²⁺-based CA, with macrocyclic ligand structure (HNP-2006). MR imaging using HNP-2006 demonstrated a significant contrast enhancement in many different organs. Furthermore, the contrast enhanced tumor imaging using HNP-2006 confirmed that this new macrocyclic CA can be used for detecting tumor in the central nervous system. Therefore, this new multifunctional HNP-2006 with macrocyclic ligand structure shows great promise for whole-body clinical application.
Brain ; Central Nervous System ; Contrast Media ; Gadolinium ; Humans ; Incidence ; Magnetic Resonance Imaging ; Nephrogenic Fibrosing Dermopathy

PURPOSE: To separate and evaluate the low frequency spontaneous fluctuation BOLD signals from the functional magnetic resonance imaging data using sensorimotor active task. MATERIALS AND METHODS: Twenty female archery players and twenty three control subjects were included in this study. Finger-tapping task consisted of three cycles of right finger tapping, with a subsequent 30 second rest. Blood oxygenation level-dependent (BOLD) data were collected using T2*-weighted echo planar imaging at a 3.0 T scanner. A 3-D FSPGR T1-weighted images were used for structural reference. Image processing and statistical analyses were performed using SPM5 for active finger-tapping task and GIFT program was used for statistical analyses of low frequency spontaneous fluctuation BOLD signal. RESULTS: Both groups showed the activation in the left primary motor cortex and supplemental motor area and in the right cerebellum for right finger-tapping task. ICA analysis using GIFT revealed independent components corresponding to contralateral and ipsilateral sensorimotor network and cognitive-related neural network. CONCLUSION: The current study demonstrated that the low frequency spontaneous fluctuation BOLD signals can be separated from the fMRI data using finger tapping paradigm. Also, it was found that these independent components correspond to spontaneous and coherent neural activity in the primary sensorimotor network and in the motor-cognitive network.
Cerebellum ; Echo-Planar Imaging ; Female ; Fingers ; Humans ; Magnetic Resonance Imaging ; Motor Cortex ; Oxygen

Functional magnetic resonance imaging (fMRI) was used to assess the temporal response of neural activation in healthy subjects while they performed the Iowa Gambling Test (IGT), which utilizes decisions involving ambiguity and risk. The IGT was divided into five blocks of 20 trials; analysis showed that activity in the medial prefrontal cortex (mPFC) moves gradually from the dorsal to the ventral mPFC over the course of the IGT. These findings suggest that cognitive division of the mPFC, including the dorsal portion of the anterior cingulated cortex (ACC), plays a major role in ambiguous decision making and that the aspect of the IGT corresponding to risky decision making is associated with significant activity within the corticolimbic network strongly implicated in emotion and reinforcement. Our results also suggest that decisions made under ambiguity and decisions made under risk situations can be further divided into sub-phases based on the neural network involved.
Decision Making ; Gambling ; Iowa ; Magnetic Resonance Imaging ; Prefrontal Cortex ; Reinforcement (Psychology)

PURPOSE: The objective of this work to construct eigenvalue maps that have information of magnitude of three primary diffusion directions using diffusion tensor images. MATERIALS AND METHODS: To construct eigenvalue maps, we used a 3.0T MRI scanner. We also compared the Moore-Penrose pseudo-inverse matrix method and the SVD (single value decomposition) method to calculate magnitude of three primary diffusion directions. Eigenvalue maps were constructed by calculating of magnitude of three primary diffusion directions. We did investigate the relationship between eigenvalue maps and fractional anisotropy map. RESULTS: Using Diffusion Tensor Images by diffusion tensor imaging sequence, we did construct eigenvalue maps of three primary diffusion directions. Comparison between eigenvalue maps and Fractional Anisotropy map shows what is difference of Fractional Anisotropy value in brain anatomy. Furthermore, through the simulation of variable eigenvalues, we confirmed changes of Fractional Anisotropy values by variable eigenvalues. And Fractional anisotropy was not determined by magnitude of each primary diffusion direction, but it was determined by combination of each primary diffusion direction. CONCLUSION: By construction of eigenvalue maps, we can confirm what is the reason of fractional anisotropy variation by measurement the magnitude of three primary diffusion directions on lesion of brain white matter, using eigenvalue maps and fractional anisotropy map.
Anisotropy ; Axis, Cervical Vertebra* ; Brain ; Diffusion Tensor Imaging* ; Diffusion* ; Image Processing, Computer-Assisted* ; Magnetic Resonance Imaging

Purpose: To evaluate the tracing of optic nerve tract using manganese enhanced magnetic resonance imaging. Materials and Methods: After injecting 30 microliter of MnCl2 (1 mol) into the retina of female New Zealand white rabbit, the contrast enhancements at major anatomical structures of optic nerve tract were evaluated by high resolution T1-weighted images 12 hours, 24 hours, and 48 hours after MnCl2 injection using 3D FSPGR (Fast Spoiled Gradient Recalled echo) pulse sequence at 1.5 T clinical MR scanner with high performance gradient system. Also, for quantitative evaluation, the signal-to-noise ratios of circular ROI on anatomical locations were measured. Results: The major structures on the optic nerve tract were enhanced after injecting MnCl2. The structures, which showed enhancement, were right optic nerve, optic chiasm, left optic tract, left lateral geniculate nucleus, left superior colliculus. The structures on the contralateral optic pathway to the right retina were enhanced whereas the structures on the ipsilateral pathway did not show enhancement. Conclusion: The Mn transport through axonal pathway of optic nerve system was non-invasively observed after injecting MnCl2 at the retina, which is the end terminal of optic nerve system. This Mn transport seems to occur by voltage gated calcium (Ca2+) channel and in case of direct injection into the retina, the fast transport pathway of voltage gated calcium channel seems to be responsible for Mn transport.
Axons ; Calcium ; Calcium Channels ; Evaluation Studies as Topic ; Female ; Humans ; Magnetic Resonance Imaging ; Manganese ; New Zealand ; Optic Chiasm ; Optic Nerve ; Retina ; Signal-To-Noise Ratio ; Superior Colliculi ; Visual Pathways*

PURPOSE: To evaluate the NMR relaxation properties of newly developed high performance paramagnetic. MATERIALS AND METHODS: 4-aminomethylcyclohexane carboxylic acid (0.63 g, 4 mmol) was mixed with the suspension solution of DMF (15 mL) and DTPA-bis-anhydride (0.71 g, 2 mmol) to synthesize the ligand. The ligand was then mixed with Gd2O3 (0.18 g, 0.5 mmol) to synthesize Gd-chelate. For the measurement of magnetic relaxivity of paramagnetic compounds, the compounds were diluted to 1mM and then the relaxation times were measured at 1.5T(64 MHz). Inversion-recovery pulse sequence was employed for T1 relaxation measurement and CPMG(Carr-Purcell-Meiboon-Gill) pulse sequence was employed for T2 relaxation measurement. Using MATLAB(Version 7.1) program, T1 magnetic relaxation map, R1 map, T2 magnetic relaxation map and R2 map were developed to represent magnetic relaxation time and magnetic relaxivity as image. RESULTS: Compared to R1=4.9 mM(-1) sec(-1) and R2= 4.8 mM(-1) sec(-1) of Omniscan (Gadodiamide), which is commercially available paramagnetic MR agent, R1 of SUK090(Gd-C32H74N5O24) was 12.46 mM(-1) sec(-1) and R1 of SUK091(Gd-C34H78N5O24) was 12.77 mM(-1) sec(-1). However, R1 of SUK092(Gd-C30H56N5O17) was decreased to 2.09 mM(-1) sec(-1). In case of R2, SUK090(Gd-C32H74N5O24) was 8.76 mM(-1) sec(-1) and SUK091(Gd-C34H78N5O24) was 7.60 mM(-1) sec(-1) whereas SUK092(Gd-C30H56N5O17) CONCLUSION: Among three new paramagnetic complexes, SUK090(Gd-C32H74N5O24) and SUK091(Gd-C34H78N5O24) showed higher T1, T2 magnetic relaxation rates than that of commercially available paramagnetic MR agent and thus expected to have more contrast enhancement effect.
Relaxation*