Brain SPECT 영상의 Attenuation Correction 방법들에 대한 비교

조진우,김창호,나수경,이귀원,Jo, Jin U,Kim, Chang Ho,Na, Soo Kyung,Lee, Gui Won 대한핵의학기술학회 2012 핵의학 기술 Vol.16 No.2

이 연구의 목적은 Brain SPECT (Single Photon Emission Computed Tomography)의 Non-attenuation correction (AC-non) 영상에 대한 attenuation correction(AC) 방법 중 Chang's method와 CT based attenuation correction(AC-CT) 사이의 count를 비교하기 위함이다. phantom study는 증류수로 채워진 hoffman 3D phantom에 $^{99m}Tc$ 37Mbq을 투여하였고, patient study는 normal volunteer에 $^{99m}Tc$-HMPAO 750Mbq를 정맥주입하고 Siemens사의 Symbia T6로 Brain SPECT 영상을 획득하였고 뇌 정량 분석을 하였다. 각각의 방법들을 적용한 transverse image는 같은 위치에서 재구성 되었으며 각각 10, 20, 30번째 slice에서 6개의 region of interest(ROI)를 그려 AC-non 과 AC-CT 그리고 Chang's method의 count를 비교하였다. phantom study에서 AC-non, AC-CT, Chang's method의 각각 평균 count는 $4606.8{\pm}511.3$, $16794.6{\pm}2429.4$, $8752.6{\pm}896.5$이었으며 patient study에서 $5460.8{\pm}519.6$, $15320{\pm}1171.6$, $12795{\pm}1422.1$이었다. phantom study에서 AC-CT와 AC-non 사이의 비는 3.70이고 Chang's method와 AC-non 사이의 비는 1.92였으며 patient study에서는 각각 2.85, 2.38이었다. 우리는 이 연구를 통하여 AC-CT가 Chang's method보다 더 높은 AC을 해준다는 걸 알 수 있었다. 그리고 Chang's method는 patient study에서의 AC 값이 phantom study에서의 AC값보다 더 높다는 것을 알 수 있었다. brain SPECT/CT를 시행하는 경우 scatter correction을 같이 시행하고 bone에 의한 감쇠 정보를 반영할 수 있는 AC-CT가 chang's method보다 정확하다 할 수 있겠다. Purpose : The purpose of this study was to compare count between Chang's method and CT-based attenuation correction (AC-CT) among the attenuation correction (AC) methods for non-attenuation correction (AC-non) images of Brain SPECT (Single Photon Emission Computed Tomography). Materials and Methods : We injected $^{99m}Tc$ 37Mbq in a Hoffman 3D phantom filled with distilled water in the phantom study, and injected intravenously $^{99m}Tc$-HMPAO 740Mbq in a normal volunteer in the patient study, and then obtained Brain SPECT images with Symbia T6 of Siemens and conducted quantitative brain analysis. Transverse images to which each method was applied were rebuilt at the same position, and 6 regions of interest (ROI) were drawn on each of Slice No. 10, 20 and 30 and then the counts of AC-non, AC-CT and Chang's method were compared. Results : The mean counts of AC-non, AC-CT and Chang's method were $4606.8{\pm}511.3$, $16794.6{\pm}2429.4$, and $8752.6{\pm}896.5$, respectively, in the phantom study and $5460.8{\pm}519.6$, $15320{\pm}1171.6$ and $12795{\pm}1422.1$, respectively, in the patient study. In the phantom study, the ratio of AC-CT to AC-non was 3.70 and the ratio of Chang's method to AC-non was 1.92, and in the patient study, they were 2.85 and 2.38, respectively. Conclusion : From this study, we found that AC-CT makes higher AC than Chang's method. In addition, when Chang's method was used, AC in the patient study was higher than that in the phantom study. These results need to be considered also in other examinations.

Effect of Total Hip Arthroplasty on Ipsilateral Lower Limb Alignment and Knee Joint Space Width: Minimum 5-Year Follow-up

Choi Yun Seong,Park Jung-Wee,Kim Tae Woo,Kang Kee Soo,Lee Young-Kyun,Koo Kyung-Hoi,Chang Chong Bum 대한의학회 2023 Journal of Korean medical science Vol.38 No.20

Background: This study aimed to 1) assess the effect of total hip arthroplasty (THA) on coronal limb alignment, namely, the hip–knee–ankle angle (HKA), 2) identify factors that determine changes in the HKA, and 3) determine whether alignment changes influence the knee joint space width. Methods: We retrospectively evaluated 266 limbs of patients who underwent THA. Three types of prostheses with neck shaft angles (NSAs) of 132°, 135°, and 138° were used. Several radiographic parameters were measured in the preoperative and final radiographs (at least 5 years after THA). A paired t-test was used to confirm the effect of THA on HKA change. Multiple regression analysis was performed to identify radiographic parameters related to HKA changes following THA and changes in knee joint space width. Subgroup analyses were performed to reveal the effect of NSA change on the HKA change, and the proportion of total knee arthroplasty usage and changes in radiographic parameters between maintained joint space and narrowed joint space groups were compared. Results: The preoperative mean HKA was 1.4° varus and increased to 2.7° varus after THA. This change was related to changes in the NSA, lateral distal femoral angle, and femoral bowing angle. In particular, in the group with a decrease in NSA of > 5°, the preoperative mean HKA was largely changed from 1.4° varus to 4.6° varus after THA. The prostheses with NSA of 132° and 135° also led to greater varus HKA changes than those with an NSA of 138°. Narrowing of the medial knee joint space was related to changes in the varus direction of the HKA, decrease in NSA, increase in femoral offset. Conclusion: A large reduction in NSA can lead to considerable varus limb alignment after THA, which can have adverse effects on the medial compartment of the ipsilateral knee.

보조호르몬요법을 받는 여성 유방암 환자의 모발 변화와 치료 실태에 대한 기초 연구

이재경 ( Jae Kyung Lee ),김창현 ( Chang-hyun Kim ),홍동균 ( Dongkyun Hong ),정경은 ( Kyung Eun Jung ),서영준 ( Young-joon Seo ),김창덕 ( Chang-deok Kim ),이진선 ( Jin Sun Lee ),권인선 ( In Sun Kwon ),박상현 ( Sanghyun Park ),이영 대한피부과학회 2021 대한피부과학회지 Vol.59 No.7

Background: Hormone therapy, which includes tamoxifen and aromatase inhibitors, is the most common adjuvant therapy used for breast cancer. However, only a few studies have reported endocrine therapy induced alopecia. Objective: We investigated the effects of long-term adjuvant hormone therapy on hair in patients with breast cancer, in addition to patients’ concerns and current treatment for hair loss. Methods: Patients completed a questionnaire that included information on self-perceived hair changes after each adjuvant therapy session, distress, and current treatment for hair loss. Using a folliscope, we measured hair density and thickness in each patient and in healthy controls. Results: The study included 93 patients with breast cancer (mean age 51.9±9.8 years). The density and hair thickness were 106.36±21.85 hairs/cm2 and 0.07±0.01 mm in the patient group and 147.86±30.67 hairs/cm2 and 0.07±0.01 mm in the control group (n=98, mean age 52.10±8.40 years), respectively. The mean hair density was significantly lower in the patient group than in the control group; however, no statistically significant intergroup difference was observed in hair thickness. Among 76 patients who perceived hair changes after adjuvant therapy, 71.1% (n=54) were distressed with regard to hair changes. However, only 7.8% of the patients, including two who were treated by dermatologists, currently received treatment for hair changes. Conclusion: Dermatologists should be familiar with hair changes in patients with breast cancer and provide appropriate education to encourage patients to consult dermatologists for hair loss and thinning after breast cancer treatment. (Korean J Dermatol 2021;59(7):521∼526)

가강수량의 변화패턴과 기후인자와의 상관성 분석

이다래 ( Darae Lee ),한경수 ( Kyung Soo Han ),권채영 ( Chaeyoung Kwon ),이경상 ( Kyeong Sang Lee ),서민지 ( Minji Seo ),최성원 ( Sungwon Choi ),성노훈 ( Noh Hun Seong ),이창석 ( Chang Suk Lee ) 대한원격탐사학회 2016 大韓遠隔探査學會誌 Vol.32 No.3

수증기는 지구 장파 복사에너지의 주요 흡수인자이다. 따라서 수증기량의 변화를 모니터링하고 변화의 원인을 세밀하게 조사하는 것은 필수적이다. 본 연구에서는 위성관측에 의해 얻어지는 Total Precipitable Water (TPW)자료를 사용하여 가강수량의 변화패턴을 모니터링 하고자 한다. 또한 기후인자들 중 수증기를 통해 생성되어 수증기의 변화패턴을 분석하는데 있어 중요한 역할을 하는 강수량과 다른 기후인 자들에 비해 비교적 주기적으로 나타나는 엘니뇨를 통해 가강수량의 변화패턴과 기후인자와의 상관성분석을 실시하고자 한다. 본 연구에서는 TERRA/AQUA 위성의 Moderate-Resolution Imaging Spectroadiometer (MODIS) 센서를 통해 관측된 TPW의 장기적인 변화와 한반도 중남부지방의 강수량변화를 정량적으로 분석 하고, 이들의 관계를 엘니뇨와 함께 비교하였다. 이를 통해 엘니뇨의 발생이 한반도 중남부지방의 강수량과 TPW의 변화에 영향을 주고 있는 지에 대해 조사하고자 한다. 먼저, 시계열 분석을 통해 TPW와 중남부지방 강수량의 변화를 정량적으로 산출하고 anomaly분석을 통해 이들의 변화를 세밀하게 분석한 결과 서로 반대 의 양상을 띠는 부분이 발견되어 엘니뇨의 anomaly분석결과와 비교하였다. 그 결과 대부분 같은 양상을 띠고 있던 TPW와 강수량이 엘니뇨가 발생한 후 서로 반대의 양상을 띠는 것을 확인하였다. Water vapor is main absorption factor of outgoing longwave radiation. So, it is essential to monitoring the changes in the amount of water vapor and to understanding the causes of such changes. In this study, we monitor temporal variability of Total Precipitable Water (TPW) which observed by satellite. Among climate variables, precipitation play an important part to analyze temporal variability of water vapor because it is produced by water vapor. And El Nino is one of climate variables which appear regularly in comparison with the others. Through them, we analyze relationship between temporal variability of TPW and climate variable. In this study, we analyzed long-term change of TPW from Moderate-Resolution Imaging Spectroadiometer (MODIS) data and change of precipitation in middle area of Korea peninsula quantitatively. After these analysis, we compared relation of TPW and precipitation with El Nino. The aim of study is to research El Nino has an impact on TPW and precipitation change in middle area of Korea peninsula. First of all, we calculated TPW and precipitation from time series analysis quantitatively, and anomaly analysis is performed to analyze their correlation. As a result, TPW and precipitation has correlation mostly but the part had inverse correlation was found. This was compared with El Nino of anomaly results. As a result, TPW and precipitation had inverse correlation after El Nino occurred. It was found that El Nino have a decisive effect on change of TPW and precipitation.

Causes and Predictive Factors Associated with “Diagnosis Changed” Outcomes in Patients Notified as Tuberculosis Cases in a Private Tertiary Hospital

( Byung Ju Kang ),( Kyung Wook Jo ),( Tai Sun Park ),( Jung Wan Yoo ),( Sei Won Lee ),( Chang Min Choi ),( Yeon Mok Oh ),( Sang Do Lee ),( Woo Sung Kim ),( Dong Soon Kim ),( Tae Sun Shim ) 대한결핵 및 호흡기학회 2013 Tuberculosis and Respiratory Diseases Vol.75 No.6

Background: The aim of our study was to evaluate the “diagnosis changed” rate in patients notified as tuberculosis (TB) on the Korean TB surveillance system (KTBS). Methods: A total of 1,273 patients notified as TB cases on the KTBS in one private tertiary hospital in 2011 were enrolled in the present study. Patients were classified into three groups: “diagnosis maintained”, “diagnosis changed” (initially notified as TB, but ultimately diagnosed as non-TB), and “administrative error” (notified as TB due to administrative errors). Results: Excluding 17 patients in the “administrative error” group, the “diagnosis maintained” and “diagnosis changed” groups included 1,097 (87.3%) and 159 patients (12.7%), respectively. Common causes of “diagnosis changed” were nontuberculous mycobacterial (NTM) disease (51.7%, 61/118), and pneumonia (17.8%) in cases notified as pulmonary TB, and meningitis (19.5%, 8/41) and Crohn`s disease (12.2%) in cases notified as extrapulmonary TB. Being older than 35 years of age (odds ratio [OR], 2.18) and a positive acid-fast bacilli stain (OR, 1.58) were positive predictors and a TB-related radiological finding (OR, 0.42) was a negative predictor for a “diagnosis changed” result via multivariate logistic regression analysis in pulmonary TB cases. Conclusion: Because of a high “diagnosis changed” rate in TB notifications to the KTBS, the TB incidence rate measured by the KTBS may be overestimated. Considering the worldwide trend toward increased NTM disease, the “diagnosis changed” rate may increase over time. Thus, when reporting the annual TB notification rate in Korea, the exclusion of “diagnosis changed” cases is desirable.

Causes and Predictive Factors Associated with "Diagnosis Changed" Outcomes in Patients Notified as Tuberculosis Cases in a Private Tertiary Hospital

Kang, Byung Ju,Jo, Kyung-Wook,Park, Tai Sun,Yoo, Jung-Wan,Lee, Sei Won,Choi, Chang-Min,Oh, Yeon-Mok,Lee, Sang-Do,Kim, Woo Sung,Kim, Dong Soon,Shim, Tae Sun The Korean Academy of Tuberculosis and Respiratory 2013 Tuberculosis and Respiratory Diseases Vol.75 No.6

Background: The aim of our study was to evaluate the "diagnosis changed" rate in patients notified as tuberculosis (TB) on the Korean TB surveillance system (KTBS). Methods: A total of 1,273 patients notified as TB cases on the KTBS in one private tertiary hospital in 2011 were enrolled in the present study. Patients were classified into three groups: "diagnosis maintained", "diagnosis changed" (initially notified as TB, but ultimately diagnosed as non-TB), and "administrative error" (notified as TB due to administrative errors). Results: Excluding 17 patients in the "administrative error" group, the "diagnosis maintained" and "diagnosis changed" groups included 1,097 (87.3%) and 159 patients (12.7%), respectively. Common causes of "diagnosis changed" were nontuberculous mycobacterial (NTM) disease (51.7%, 61/118), and pneumonia (17.8%) in cases notified as pulmonary TB, and meningitis (19.5%, 8/41) and Crohn's disease (12.2%) in cases notified as extrapulmonary TB. Being older than 35 years of age (odds ratio [OR], 2.18) and a positive acid-fast bacilli stain (OR, 1.58) were positive predictors and a TB-related radiological finding (OR, 0.42) was a negative predictor for a "diagnosis changed" result via multivariate logistic regression analysis in pulmonary TB cases. Conclusion: Because of a high "diagnosis changed" rate in TB notifications to the KTBS, the TB incidence rate measured by the KTBS may be overestimated. Considering the worldwide trend toward increased NTM disease, the "diagnosis changed" rate may increase over time. Thus, when reporting the annual TB notification rate in Korea, the exclusion of "diagnosis changed" cases is desirable.

항공사진을 이용한 방포항 인근 해빈의 장기간 해안선 변화 분석

김백운 ( Baeck Oon Kim ),윤공현 ( Kong Hyun Yun ),이창경 ( Chang Kyung Lee ) 대한원격탐사학회 2013 大韓遠隔探査學會誌 Vol.29 No.5

장기간 해안선 변화 자료의 구축을 통해 해안선의 시·공간적인 변화 양상을 분석하고, 이에 근거하여 해안침식의 향후 경향을 파악하는 일은 연안관리에 매우 중요한 역할을 한다. 본 연구에서는 수치항공사진을 이용하여 방포항 인근 해안지역의 장기간(1985년 ~ 2009년) 해안선 변화 탐지를 위해 항공삼각측량, 지상기준점측량, 수치도화, 그리고 해안선 변화율을 산정하였다. 그 결과 방포해빈과 꽃지해빈의 해안선은 각각 0.2 m/yr와 최대 0.8 m/yr로 침식된 것으로 파악되었다. 또한 등고선 변화 통하여 꽃지 해빈의 북부지역에서 침식현상이 가장 뚜렷하게 나타났으며 표고 1 m 간격의 등고선은 최대 45 m 후퇴하였음을 알수 있었다. 이러한 변화는 다양하고 복합적인 요인에 의해 발생할 수 있으며 주된 요인은 1990년대 말에 설치된 해변 옹벽이 해안침식을 일으키는 주요 원인으로서 추정되고 있다. To analyze tendency of temporal and spatial change of shorelines and to estimate rate of shoreline changes using long-term shoreline change data is very important for the coastal environmental management. In this study, investigation was conducted to estimate the rate of shoreline changes using long-term shoreline change data from the year 1985 to 2009 aerial photographs. In this process aerial triangulation, GPS surveying and digital mapping was done for the estimation of changes. As the results, shorelines of Bangpo and Kkotji Beach retreated at a maximum rate of 0.2 m/yr and 0.8 m/yr, respectively. The shoreline could be changed by various factors. However, it was presumed that coastal erosion has been mainly affected by retaining wall constructed in the late 1990s.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

선천눈꺼풀처짐 교정술 후 발생한 난시변화

이동섭,김준모,우경인,장혜란,Dong Sub Lee,Joon Mo Kim,Kyung In Woo,Hae Ran Chang 대한안과학회 2006 대한안과학회지 Vol.47 No.9

Purpose: To determine postoperative astigmatic changes after surgery for congenital ptosis and the astigmatic changes depending on surgical method and to discern cases of postoperatively developed anisometropia or amblyopia. Methods: Fifty-one patients who underwent surgery due to congenital ptosis were reviewed. Refraction or cycloplegic refraction was conducted preoperatively and 3 to 6 months after surgery to measure astigmatic changes. Astigmatic changes in operated eyes were compared to control eyes. Astigmatic changes were compared depending on surgical method. Results: The mean astigmatism was 1.33±1.29D preoperatively and 1.48±1.13D postoperatively (P=0.10) and the mean astigmatic change in the ptotic and control eye was an increase in cylinder +0.56±0.55D and +0.68±0.72D (P=0.37). The mean astigmatic change of patients receiving frontalis sling was +0.57±0.67D which was similar to those who received levator resection (+0.56±0.50D). Newly developed anisometropia was found in three patients postoperatively due to an increase in astigmatism, but newly developed amblyopia was not found. Conclusions: The increase of astigmatism by ptosis surgery was not statistically significant and there was no statistically significant difference when accounting for surgical method. However, it is necessary to monitor refractive error carefully in younger patients to prevent amblyopia because postoperative increase of astigmatism can cause anisometropia.

Ischemia-Related Changes in Galanin Expression in the Dentate Hilar Region after Transient Forebrain Ischemia in Gerbils

LEE, Hyeon Yong,HWANG, In Koo,KIM, Dae Ho,KIM, Jung Hwa,KIM, Chang Ho,LIM, Beong Ou,KANG, Tae-Cheon,BANG, Kyung Hwan,SEONG, Nak Sul,LEE, Hak Ju,KIM, Jong Dai,WON, Moo Ho Japanese Association for Laboratory Animal Science 2005 EXPERIMENTAL ANIMALS Vol.54 No.1

<P>Although galanin (GAL) protects hippocampal neurons from ischemic damage, no study has examined ischemia-related changes in endogenous GAL in the hippocampal dentate gyrus. We investigated the chronological changes of GAL, well-known as the potassium channel opener, expression in the dentate gyrus at various times after 5 min of transient forebrain ischemia in gerbils. A few GAL-immunoreactive (IR) neurons were found in the polymorphic layer of the sham-operated group. Three hours after ischemia-reperfusion, the pattern of GAL immunoreactivity was similar to that of the sham-operated group and the number of GAL-IR neurons and immunoreactivity were highest 12 h after ischemic insult. At this time, GAL-IR neurons in the polymorphic layer showed strong GAL immunoreactivity. Thereafter, GAL-IR neurons and immunoreactivity significantly decreased in the dentate hilar region. Four days after ischemic insult, GAL-IR neurons were not detectable. In addition, the results of a Western blot study showed a pattern of GAL expression similar to the immunohistochemical changes. GAL protein content also was highest 12 h after ischemia. In conclusion, the increased expression of endogenous GAL in the dentate gyrus after ischemia is related to response to the ischemic damage.</P>