Saeyoon Kim

Diffusion tensor imaging demonstrated radiologic differences between diplegic and quadriplegic cerebral palsy.

Little information is available on the use of imaging for the classification of cerebral palsy patients. The present study examined the radiological differences between quadriplegic cerebral palsy patients (QCP), diplegic cerebral palsy patients (DCP) and normal control subjects (NC) by performing diffusion tensor imaging (DTI) of the corticospinal tract (CST) of upper and lower extremities. Twenty-three cerebral palsy patients (11 QCP, 12 DCP) and 12 NC were enrolled. DTI were scanned using a 1.5 T and the CST images were analyzed using FMRIB software. We measured the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the CST. Compared to DCP and NC, QCP had decreased mean FA and increased mean ADC values of the CSTs of upper and lower extremities. The mean FA values of the lower extremities in DCP were significantly decreased, compared to NC; however this was not observed for the mean FA value of the upper extremities. The DTI results of the CST in QCP and DCP significantly corresponded with their typical clinical manifestation. DTI may thus be a very powerful modality to assess the state of CST in cerebral palsy patients.

CST recovery in pediatric hemiplegic patients: Diffusion tensor tractography study

Many diffusion tensor imaging (DTI) studies have reported an association between corticospinal tract (CST) injury and motor dysfunction. In this study, we investigated CST recovery in 29 pediatric patients with clinical hemiplegia using DTI. We measured the fractional anisotropy (FA), apparent diffusion coefficient (ADC), and asymmetric anisotropy (AA) of both CSTs. The patients were classified into three groups according to severity of CST disruption of the more affected hemisphere. DTI was followed up for 9.34 ± 2.07 months after initial evaluation. The FA value of the more affected CST showed a significant decrease compared to the opposite side at initial and follow up evaluation, respectively (p<0.05). The FA value of both CSTs showed a significant increase at follow up compared to the initial evaluation, while more changes were observed on the more affected side, compared with the less affected side (p<0.05). AA showed a significant decrease at follow up, and showed significant correlation with interval change of FA value of the more affected side, not with that of the less affected side (r=0.543, p<0.05). 19 patients showed change of CST integrity. In the current study, the results of DTI showed recovery of the CST and provided radiologic evidence for a scientific basis of brain plasticity in pediatric patients.

Suitability of nonwoven fusible interlining to the thin worsted fabrics

Functions of interlinings to the shell fabric are to improve the garment formability for a beautiful silhouette and elastic potential to the deformed fabric during wearing, and also are to enhance appearance and wearing properties of the garment. The objective of this study is to analyse suitability of nonwoven fusible interlining to the thin worsted fabric with various fabric structural parameters. For the purpose of this study, specimens with various weft yarn twists and weft densities of thin worsted fabrics are prepared. Three nonwoven fusible interlinings with different structure which were made of nylon/polyester were used for adhering to the thin worsted fabrics. Mechanical properties of these 24 adhesive fabrics fused with three nonwoven interlinings are measured by the KES‐FB System for analysing the suitability of nonwoven fusible interlinings to the thin worsted fabrics with various fabric structural parameters. Some mechanical properties of fused fabrics are analysed and discussed with repetition of dry cleaning of adhesive fabrics for performing effects of dry cleaning to the suitability of nonwoven fusible interlining to the shell fabrics.

Identification of the anterior corticospinal tract in the human brain using diffusion tensor imaging

The corticospinal tract (CST) is generally classified into the crossed lateral CST and the uncrossed anterior CST. No diffusion tensor imaging study for identification of the anterior CST in the human brain has been conducted. Using diffusion tensor imaging, we attempted to identify the anterior CST and investigate the characteristics of the anterior CST in the normal human brain. We recruited 15 healthy volunteers for this study. Diffusion tensor images were scanned using 1.5T. For the whole CST, two regions of interest were placed on the CST area of the pons and upper medulla. By contrast, for the anterior CST, an additional region of interest was given on the anterior funiculus of the upper cervical cord. The anterior CSTs, which originated from the cerebral cortex descended through the known pathway of the CST, and terminated in the anterior funiculus of the upper cervical cord. Compared with whole CSTs, the anterior CSTs showed decreased fiber number, fractional anisotropy, and apparent diffusion coefficient (P<0.05). The mean fiber number of the anterior CST was 12.4% of the whole CSTs. We identified the anterior CST and found that it has the characteristics of less directionality and fewer fibers in comparison with the whole CST. We believe that the methodology and results of this study would be helpful in research on motor control in the normal human brain and motor recovery mechanisms following brain injury.

Characteristics of the aberrant pyramidal tract in comparison with the pyramidal tract in the human brain

BackgroundThe aberrant pyramidal tract (APT) refers to the collateral pathway of the pyramidal tract (PT) through the medial lemniscus in the midbrain and pons. Using diffusion tensor tractography (DTT), we investigated the characteristics of the APT in comparison with the PT in the normal human brain.ResultsIn thirty-four (18.3%, right hemisphere: 20, left hemisphere: 14) of the 186 hemispheres, the APTs separated from the PT at the upper midbrain level, descended through the medial lemniscus from the midbrain to the pons, and then rejoined with the PT at the upper medulla. Nine (26.5%) of the 34 APTs were found to originate from the primary somatosensory cortex without a primary motor cortex origin. Values of fractional anisotropy (FA) and tract volume of the APT were lower than those of the PT (P < 0.05); however, no difference in mean diffusivity (MD) value was observed (P > 0.05).ConclusionWe found that the APT has different characteristics, including less directionality, fewer neural fibers, and less origin from the primary motor cortex than the PT.

Medial Lemniscus Lesion in Pediatric Hemiplegic Patients without Corticospinal Tract and Posterior Thalamic Radiation Lesion

Objectives: Using diffusion tensor imaging (DTI), we investigated the state of medial lemniscus (ML), corticospinal tract (CST), and posterior thalamic radiation (PTR), which were expected as probable reasons for clinical hemiplegia in pediatric patients, especially those who showed impaired fine motor control and proprioception, but no definite motor weakness or spasticity. Methods: We recruited 13 hemiplegic patients and 8 age-matched healthy control subjects. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) for the bilateral ML, CST, and PTR were calculated and compared between the affected hemisphere of the patient (AP), the unaffected hemisphere of the patient (UP), and the mean value of the bilateral hemispheres in control subjects (MC). Results: FA and ADC values for the CST and PTR did not differ significantly between the AP, UP, and MC subgroups (p > 0.05). However, the FA value for the ML in AP showed a significant decrease, compared with that in UP (p = 0.012) and MC (p = 0.047). DTT for the CST and PTR showed preserved integrity and ML in the UP also had continuity to the cortex; however, ML in AP showed disruption. Conclusions: Using DTI, we demonstrated that the ML lesion might be related to clinical hemiplegia in pediatric patients.

Degenerative changes of the corticospinal tract in pediatric patients showing deteriorated motor function: A diffusion tensor tractography study

Abstract Objective: We attempted to demonstrate the corresponding degenerative changes of the affected corticospinal tract (CST) in pediatric patients with deteriorated motor function using diffusion tensor tractography (DTT). Methods: We recruited three pediatric patients (corrected age: 2, 6 and 47 months, respectively) who showed impaired motor function. Results: DTT in each patient showed interruption of the CSTs of the hemisphere contralateral to the side of motor impairment. Despite motor impairment and abnormal DTT findings, none of the three patients received rehabilitative therapy. The patients (corrected age: 9, 53 and 59 months, respectively) and their parents visited our clinic again due to deterioration of motor functions. Follow-up DTT of all evaluated patients showed significant degenerative changes in the affected CSTs in accordance with the aggravation of motor impairment. Conclusion: We presented degenerative changes of the affected CSTs in pediatric patients according to the deterioration of motor function.

A Case of Cecal Volvulus Presenting with Chronic Constipation in Lissencephaly

Cecal volvulus is uncommon in pediatric patients and there are few reports of cecal volvulus with cerebral palsy. Here, we report the case of a 19-year-old male patient who presented with abdominal distension, a history of cerebral palsy, refractory epilepsy due to lissencephaly, and chronic constipation. An abdominal x-ray and computed tomography without contrast enhancement showed fixed dilated bowel intensity in the right lower abdomen. Despite decompression with gastric and rectal tube insertion, symptoms did not improve. The patient underwent an exploratory laparotomy that revealed cecal volvulus. Cecal volvulus usually occurs following intestinal malrotation or previous surgery. In this patient, however, intestinal distension accompanying mental disability and chronic constipation resulted in the development of cecal volvulus. We suggest that cecal and proximal large bowel volvulus should be considered in patients presenting with progressive abdominal distension combined with a history of neuro-developmental delay and constipation.

Exotropia in a pediatric patient with rhabdomyolysis caused by an insect sting

Various ocular and systemic reactions have been associated with insect sting. However, insect stings have been rarely reported to cause exotropia and diplopia. We encountered exotropia in a 6-year-old child with rhabdomyolysis of the left lower extremities caused by an insect sting. Exotropia and diplopia developed within 1 day after the sting and improved completely 1 week after the onset of symptoms. Clinicians should be aware of the potential for the development of exotropia in patients with insect stings, which requires careful follow-up.

Physical properties of ZrC/Al2O3 imbedded heat storage woven fabrics

This study investigated different physical properties of ZrC/Al2O3 imbedded heat storage woven fabrics. ZrC and Al2O3 imbedded heat storage PET filaments were spun on the pilot spinning equipment, respectively. Various physical properties of ceramic imbedded fabrics made of ZrC and Al2O3 imbedded filaments were measured and compared with those of the regular PET woven fabric. The surface temperatures of the ZrC and Al2O3 imbedded fabrics were higher than that of the regular fabric. Water absorption rate of ceramic imbedded fabrics was better than that of the regular fabric and drying property was inferior to that of regular fabric. Breathability by water vapour resistance(Ref) of ZrC imbedded fabric was superior to that of regular fabric. Heat keepability rates of the ceramic imbedded fabrics were higher than that of the regular fabrics, which revealed a good heat storage property of the ZrC/Al2O3 imbedded fabrics.