• Title/Summary/Keyword: 도플러

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Effect of Non-perceptual Sensory Stimulation Intensity Using Transcutaneous Electrical Nerve Stimulation on Cerebral Blood Flow (경피신경전기자극기를 이용한 비지각적 감각자극 강도가 뇌혈류에 미치는 영향)

  • Ju-Yeon Jung;Chang-Ki Kang
    • Science of Emotion and Sensibility
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    • v.27 no.2
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    • pp.81-90
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    • 2024
  • In this study, we aimed to determine the effect on cerebral blood vessels of various stimulus intensities using transcutaneous electrical nerve stimulation (TENS). In particular, we wanted to monitor changes in blood flow and structural changes in the blood vessels in the common carotid artery (CCA) through low-intensity electrical stimulation that can cause non-perceptual sensory stimulation. Twenty-four healthy adults in their 20s participated in this study. Three stimulus intensities (below the sensory threshold, at the sensory threshold, and above the sensory threshold) were applied in random order. Changes in blood flow velocity according to the intensity of TENS stimulus were measured by placing the Doppler ultrasound transducer 1 cm below the CCA bifurcation, and the vascular structure was measured using B-mode imaging. C-mode Doppler and B-mode images were acquired before, during, and after the intervention for each stimulus, and changes in blood pressure were measured in each session. As a result, it was confirmed that peak systolic velocity (PSV) decreased significantly after the intervention in non-perceived sensory stimulation below the threshold, compared to other thresholds (p = .008). In particular, the PSV decreased by 3.04% on average compared to before stimulation (p = .011). However, there was no significant change in the CCA diameters before and after stimulation at all intensities. It was found that short-term, non-perceptual sensory stimulation was effective in reducing the blood flow rate without causing significant changes in either the blood vessel diameter or blood pressure. This change appears to be caused by a decrease in blood flow due to the effect of subtle vasodilation at non-perceptual sensory stimulation, and at stimulation intensity higher than that, the sympathetic nerves in the blood vessels are stimulated excessively and the blood vessels constrict. Therefore, this study can be rated as an important attempt to control blood flow through stimulation without such a psychological burden and sensory discomfort in the carotid area.

Clinical Observations of 30 Children with Nutcracker Syndrome (Nutcracker 증후군 환아 30례에 대한 임상적 고찰)

  • Lee Dong Woo;Juhn Ji Hyun;Lee Jae Seung;Kim Myung Joon
    • Childhood Kidney Diseases
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    • v.5 no.1
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    • pp.9-14
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    • 2001
  • Purpose : This study was undertaken to investigate clinical aspects of nutcracker syndrome in children including sexual distribution, age of onset, the ratio of peak flow velocity between the narrowed and dilated portions in the left renal vein and prevalence of hematuria or proteinuria. Materials and Method : The subjects included 30 patients diagnosed with nutcracker syndrome using Doppler sonography from September 1999 to January 2001 in Severance Hospital, Department of Pediatric Nephrology. The diagnostic criteria for nutcracker syndrome was a peak flow velocity of ratio is more than 5.0. Results : Patients consisted of 14 males and 16 females. The mean age was 9.19${\pm}$2.31 years old and the ratio of peak flow velocity was 8.52${\pm}$2.24. Age of onset us higher in males 9.68${\pm}$2.82 year old than in females, 8.76${\pm}$1.72 year old respectively(P<0.05). But there was no difference in the ratio of peak flow velocities ; 8.45${\pm}$2.31 in the male group , 8.58${\pm}$2.25 in the female group(P>0.05). There was no difference in the age of onset and the ratio of peak flow velocity between patients with hematuria and without hematuria. Among patients with nutcracker syndrome, 24 cases of hematuria, 3 cases of proteinuria only, and 3 cases of hematuria with proteinuria. Conclusion : In children of school age, early diagnosis of nutcracker syndrome and consistent follow up is worthy of consideration, especially ill the prevention of sequelae. (J. Korean Soc Pediatr Nephrol 5 : 9-14, 2001)

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Early Clinical Experience in Valve Replacement Using On-X Prosthetic Heart Valve (On-X 기계판막을 이용한 판막치환술의 단기성적분석)

  • 김인섭;김우식;신용철;유환국;김병열;정성철
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.742-748
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    • 2004
  • The On-X valve was recently introduced. It was the aim of this study to assess the safety and feasibility from the data derived from 28 patients who underwent aortic and/or mitral valve replacement with this prosthesis in National Medical Center. Material and Method: From May 1999 and May 2003, a series of 28 consecutive patients who had been implanted with 32 On-X prosthesis were reviewed, The operative procedure comprised of 12 MVR, 10 AVR and 6 DVR. The study followed the guidelines of AATS/STS. Mean follow-up was 27 months (total 04 patient-years). Result: Early ($\leq$30 days) mortality was 7.44% (2/28) and no late mortality occurred in the study. Total actuarial freedom from mortality at 2 years was 92.86$\pm$4.87% for all cases, 100% for MVR, 90$\pm$9.49% for AVR, and 83.3$\pm$1.52% for DVR. Thromboembolic event occurred in 2 MVR patients and that was the only complication; therefore, the linearized incidence of valve related complications was 3.17%/ patient-years for all cases and 6.5%/patient-years for MVR and the actuarial freedom from valve related complications at 2 years was 84.85$\pm$10.75%. Preoperatively, 24 (85.71%) patients were in NYHA functional class III or IV but postoperatively, 25 (89,29%) patients were in NYHA functional class I or II. The levels of hemoglobin, hematocrit, serum LDH, reticulocyte rate and indirect bilirubin were all within normal range at postoperative 3 month. In mitral position, the peak gradient was 6.1$\pm$1.8 mmHg and the mean gradient was 3.0$\pm$0.6 mmHg and EOA were 2.54$\pm$0.56 $m^2$, 2.39$\pm$0.73 $m^2$, 2.34$\pm$0.55 $m^2$, 2.40$\pm$0.63 $m^2$ at 27 mm, 29 mm, 31 mm, 33 mm respectively. In aortic postion, the peak gradient was 21.1 $\pm$14.12 mmHg and the mean gradient was 12.3$\pm$6.52 mmHg. Conclusion: Since there was no significant difference in the postoperative mortality, valve related complications and echocardiographic hemodynamic data compared to standard bileaflet design and since there was an improvement in the NYHA functional class and normal values of hemolytic indicators, it can be assumed that On-X valve is safe and feasible. However, accumulation of cases and long-term follow-up of this patient group is needed to establish this result.

Development of an anisotropic spatial interpolation method for velocity in meandering river channel (비등방성을 고려한 사행하천의 유속 공간보간기법 개발)

  • You, Hojun;Kim, Dongsu
    • Journal of Korea Water Resources Association
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    • v.50 no.7
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    • pp.455-465
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    • 2017
  • Understanding of the two-dimensional velocity field is crucial in terms of analyzing various hydrodynamic and fluvial processes in the riverine environments. Until recently, many numerical models have played major roles of providing such velocity field instead of in-situ flow measurements, because there were limitations in instruments and methodologies suitable for efficiently measuring in the broad range of river reaches. In the last decades, however, the advent of modernized instrumentations started to revolutionize the flow measurements. Among others, acoustic Doppler current profilers (ADCPs) became very promising especially for accurately assessing streamflow discharge, and they are also able to provide the detailed velocity field very efficiently. Thus it became possible to capture the velocity field only with field observations. Since most of ADCPs measurements have been mostly conducted in the cross-sectional lines despite their capabilities, it is still required to apply appropriate interpolation methods to obtain dense velocity field as likely as results from numerical simulations. However, anisotropic nature of the meandering river channel could have brought in the difficulties for applying simple spatial interpolation methods for handling dynamic flow velocity vector, since the flow direction continuously changes over the curvature of the channel shape. Without considering anisotropic characteristics in terms of the meandering, therefore, conventional interpolation methods such as IDW and Kriging possibly lead to erroneous results, when they dealt with velocity vectors in the meandering channel. Based on the consecutive ADCP cross-sectional measurements in the meandering river channel. For this purpose, the geographic coordinate with the measured ADCP velocity was converted from the conventional Cartesian coordinate (x, y) to a curvilinear coordinate (s, n). The results from application of A-VIM showed significant improvement in accuracy as much as 41.5% in RMSE.

Mid-term Results of Mitral Valve Repair in Mitral Regurgitation (승모판 폐쇄부전중에서 승모판막 재건술 및 중기성적)

  • Yun, Yang-Gu;Jang, Byeong-Cheol;Yu, Gyeong-Jong;Kim, Si-Ho
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.24-31
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    • 1996
  • Between January 1992 and February 1995, 36 patients with mitral regurgitation were treated by a mitral repair There wert nineteen men and seventeen women whose mean age was 41.8 years, ranged from 10 to 71. Seventeenth patients had dystrophic change of mitral valve, twelve patients had rheumatic change of mitral valve, second patients had infective change of mitral valve and another fifth patients had functional change of mitral valve. Operation proced res were suture annuloplasty (35 cases), resection of leaflet (25 cases), chordal shortening(9 cases) and commisurotomy(1 cases). These procedures were combined in most patients. Two third of the patients were in New York Heart Association class III or IV and four fifth of the patients were in mitral regurgitation grade III or IV by doppler echocardiogram. After mitral valve repair, the patients were improved hemodynamic, echocardiographic data and functional class. Intraoperative TEE had been used in all most patients after weaning of bypass. If there remained MR more than grade 2, the valve was re-repaired or replacement. There were no operative death. The late mortality was 5.5% and cause of death was congestive heart failure. Patients have been followed up from 3 to 40 months, mean 15. Second patients underwant reoperation due to recurred mitral regurgitation, 4 and 19 days after the operation. During reoperation, we found that the repair suture was disrupted in both patients. Th s expierence demonstrated that intraoperative TEE is accurate and predictable and excellent immediate and mid-term results have been achieved by mitral valve repair.

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Quantitative Assessment of Myocardial Tissue Velocity in Normal Children with Doppler Tissue Imaging : Reference Values, Growth and Heart Rate Related Change (소아에서 도플러 조직영상을 이용한 최대 심근 속도의 계측 : 정상 추정치 및 성장 및 심박동수에 따른 변화)

  • Kim, Se Young;Hyun, Myung Chul;Lee, Sang Bum
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.846-856
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    • 2005
  • Purpose : To measure the peak myocardial tissue velocities and patterns of longitudinal motion of atrioventricular(AV) annuli and assess body weight and heart rates-related changes in normal children. Methods : Using pulsed wave Tissue Doppler Imaging(TDI), we measured peak systolic, early and late diastolic myocardial velocities in 72 normal children at six different sites in apical-4 chamber (A4C) view and at four different sites in apical-2 chamber(A2C) view and compared those values with each other, also observing effects with body weights and heart rates. Longitudinal motions of the AV annuli were measured at three different sites in A4C. Results : There were no significant differences of the TDI parameters between gender, ECHO-machines and among the three Doctors performing TDI. Peak myocardial velocities were significantly higher at the base of the heart than in the mid-ventricular region and in the right lateral ventricular wall than in the left lateral ventricular wall or IVS. The TDI parameters showed no significant correlation with fractional shortening(%). Peak systolic and early diastolic myocardial velocities had no correlation with heart rates, but peak late diastolic velocities and A/E ratio correlated positively with heart rates. Correlations between the TDI parameters and body weight were inconsistent. Absolute longitudinal displacement and % displacement were not differ between gender and not correlated with the TDI parameters. Conclusion : We measured the peak myocardial velocities with TDI and the longitudinal motion of the AV annuli using M-mode echocardiography in normal children. With more large scale evaluation, we may establish reference values in normal children and broaden clinical applicabilities in congenital and acquired heart diseases.

UNDERWATER DISTRIBUTION OF VESSEL NOISE (선박소음의 수중분포에 관한 연구)

  • PARK Jung Hee
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.10 no.4
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    • pp.227-235
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    • 1977
  • The noise pressure scattered underwater on account of the engine revolution of a pole and liner, Kwan-Ak-San(G. T. 234.96), was measured at the locations of Lat. $34^{\circ}47'N$, Long. $128^{\circ}53'E$ on the 16th of August 1976 and Lat. $34^{\circ}27'N$, Long. $128^{\circ}23'E$ on the 28th of July, 1977. The noise pressure passed through each observation point (Nos. 1 to 5), which was established at every 10m distance at circumference of outside hull was recorded when the vessel was cruising and drifted. In case of drifting, the revolution of engine was fixed at 600 r. p. m. and the noise was recorded at every 10 m distance apart from observation point No. 3 in both horizontal and vertical directions with $90^{\circ}$ toward the stern-bow line. In case of cruising, the engine was kept in a full speed at 700 r.p.m. and the sounds passed through underwater in 1 m depth were also recorded while the vessel moved back and forth. The noise pressure was analyzed with sound level meter (Bruel & Kjar 2205, measuring range 37-140 dB) at the anechoic chamber in the Institute of Marine Science, National Fisheries University of Busan. The frequency and sound waves of the noise were analyzed in the Laboratory of Navigation Instrument. From the results, the noise pressure was closely related to the engine revolution shelving that the noise pressure marked 100 dB when .400 r. p. m. and increase of 100 r. p. m. resulted in 1 dB increase in noise pressure and the maximum appeared at 600 r. p. m. (Fig.5). When the engine revolution was fixed at 700 r. p. m., the noise pressures passed through each observation point (Nos. 1 to 5) placed at circumference of out side hull were 75,78,76,74 and 68 dB, the highest at No.2, in case of keeping under way while 75,76,77,70 and 67 dB, the highest at No.3 in case of drifting respectively (Fig.5). When the vessel plyed 1,400 m distance at 700 r.p.m., the noise pressure were 67 dB at the point 0 m, 64 dB at 600m and 56 dB at 1,400m on forward while 72 at 0 m, 66 at 600 m and 57 dB at 1,400 m on backward respectively indicating the Doppler effects 5 dB at 0 m and 3 dB at 200 m(Fig.6). The noise pressures passed through the points apart 1,10,20,30,40 and 50 m depth underwater from the observation point No.7 (horizontal distance 20 m from the point No.3) were 68,75,62,59,55 and 51 dB respectively as the vessel was being drifted maintaining the engine revolution at 600 r. p. m. (Fig. 8-B) whereas the noise pressures at the observation points Nos.6,7,8,9 and 10 of 10 m depth underwater were 64,75,55,58,58 and 52 dB respectively(Fig.8-A).

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The Usefulness of 3T-TOF MR angiography in Patients with Cerebral Infarction (뇌졸중 환자에서 3 Tesla 자기공명혈관조영술의 유용성)

  • Han, Je-Hee;Chung, Tae-Woong;Yoon, Woong;Jang, Nan-Kyu;Shin, Sang-Soo;Lim, Hyo-Soon;Song, Sang-Gook;Jeong, Yong-Yeon;Kang, Heoung-Keun;Seo, Jeong-Jin
    • Investigative Magnetic Resonance Imaging
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    • v.9 no.2
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    • pp.94-100
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    • 2005
  • Purpose : This study was designed to evaluate the usefulness of 3T-TOF MR angiography (3T-TOF MRA) compared with transcranial Doppler sonography (TCD) and conventional angiography (CA) in patients with suspected cerebral infarction. Materials and Methods : Fifty four patients with clinical symptoms of cerebral infarction were involved in this study, and had undergone 3T-TOF MRA and TCD, with CA in 11 patients. On the basis of divisions of the carotid artery, four groups were designated: group I, both vertebral arteries and basilar artery; group II, segment between 2 cm below bifurcation of common carotid artery and genu portion of internal carotid artery; group III, segment between petrous portion of internal carotid artery and bifurcation of anterior and middle cerebral artery; group IV, from bifurcation of anterior and middle cerebral artery to thier distal branches. Two radiologists retrospectively reviewed the vascular imaging and stenosis in 3T-TOF MRA, TCD, and CA. Results : A total of 432 arteries, 108 in each group, were available. The assessment of vascular imaging quality in 3T-TOF MRA is scored 2.98, 2.96, 2.91, 2.88 in 4 groups, respectively. Agreement among 3T-TOF MR angiography, TCD, and CA was high. Conclusion : 3T-TOF MR angiography may be useful method for the assessment of stenotic lesions of cranial vasculature in patients with cerebral infarction.

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Morphologic Changes of the Pulmonary Arteries after Stent Implantation on Branch Pulmonary Artery Stenosis - Impact of Pulmonary Insufficiency - (폐동맥 분지협착에 스텐트 삽입 후 유발되는 폐동맥의 형태변화 - 폐동맥 폐쇄 부전의 역할 -)

  • Kim, Me Jin;Kang, Du Cheol;Choi, Jae Young;Lee, Jong Kyun;Sul, Jun Hee;Lee, Sung Kyu
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.67-75
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    • 2003
  • Purpose : Intravascular stent implantation for the treatment of postoperative branch pulmonary artery(PA) stenosis has been used successfully. However, the cross sectional area of contralateral branch PA does not regress in spite of the successful dilation of the stenotic branch PA after stent implantation. We analyzed the morphologic and hemodynamic factors on the size of branch PA after successful stent implantation. Methods : The subjects in our study were 23 children who had undergone stent implantaion from Jan. 1995 to Jul. 2002 in the Division of Yonsei Pediatric Cardiology. We evaluated the cross sectional area index(CSAI) of branch PA before and after stent implantation at follow-up catheterization. We also investigated factors such as residual pulmonary stenosis, pulmonary regurgitation(PR), systolic pressure of right ventricle, and lung perfusion scan. Results : The CSAI of the RPA without stenosis changed from mean $238{\pm}17mm^2/BSA$ to mean $249{\pm}20mm^2/BSA$(P=0.47), but didn't regress. The CSAI of the LPA with stenosis was increased effectively by stent implantation from the mean $102{\pm}12mm^2/BSA$ to mean $125{\pm}11mm^2/BSA$(P< 0.05). At follow up after stent implantation, the CSAI of PA is correlated with the residual PR fraction after stent implantation. Conclusion : In a group with increased residual PR, CSAI of RPA was found to be significantly increased between the pre- and post-stages of stent implantation. So, we suspect that the pulmonary regurgitation remaining after right ventricle outlet tract(RVOT) dilatation surgery is correlated with the increase in CSAI of RPA.

Prenatal diagnosis and clinical course of restrictive foramen ovale in otherwise normal heart (단순 조기 난원공 협착의 산전 진단과 임상경과)

  • Lee, Ji Joung;Lee, Min A;Rhee, Yun ee;Chang, Mea Young;Kil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.268-271
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    • 2007
  • Purpose : Premature narrowing of the foramen ovale is rare but serious clinical entity. Prenatal narrowing or obstruction of the foramen ovale shows symptoms such as right heart failure, fetal hydrops, triscupid regurgitation, left heart obstructive disease, and supraventricular tachycardia. This study aimed to assess the prenatal diagnosis and postnatal clinical course of restrictive foramen ovale in utero in otherwise normal heart. Methods : The subjects were five patients diagnosed with restrictive foramen ovale in utero from January 2001 to June 2005 at Chungnam National University Hospital. The diagnostic criteria was defined when the maximum diameter in a 4-chamber view is less than 2.5 mm and there is a continuous doppler velocity at the foramen ovale of more than 0.6m/s. Results : At the time of diagnosis of restrictive foramen ovale, gestation age was 34~37 wks, and chief complaints were fetal arrhythmia(2 cases), pericardial effusion, Ebstein anomaly and subaortic stenosis. Two cases which were diagnosed fetal hydrops and supraventricular tachycardia delivered by emergent cesarian section. Five cases were found to have right heart dilatation on echocardiogram after birth, but right heart dilatation became normalized at day 7 after birth and the clinical courses were not eventful. Conclusion : Identifying an obstructed foramen ovale in the fetus warrants the further search for additional cardiac and extracardiac anomalies, which may alter the prognosis. Delivery should be induced if possible in cases of foramen ovale obstruction with signs of cardiac decompensation.