• Title/Summary/Keyword: 비침습적 검사

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Manual of Transcranial Doppler Ultrasonography (경두개 도플러 초음파 검사 지침서)

  • Ho Tae JEONG;Soo Na JEON;Sol HAN
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.3
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    • pp.277-287
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    • 2024
  • Transcranial Doppler (TCD) ultrasound is a crucial non-invasive tool for assessing cerebral blood flow and is widely used to diagnose and monitor cerebrovascular diseases. This paper reaffirms the importance of TCD, details examination methods and precautions, and provides a guide for practitioners. TCD evaluates the blood flow velocity to assess stenosis, occlusion, and hemodynamic changes. Distinguishing between increased blood flow volume and decreased vessel diameter based solely on velocity is challenging, necessitating a comprehensive approach to integrating clinical findings and hemodynamic changes. The reliability of TCD results depends on the skill of the examiner and requires standardized procedures and continuous training. Advances in automation and artificial intelligence promise enhanced accuracy and reliability. Future research should focus on validating and clinically applying these technologies. This paper is a review of the clinical significance of TCD, methods, and precautions, offering a valuable guide for practitioners and highlighting the potential benefits of ongoing advancements in TCD for the diagnosis and treatment of cerebrovascular diseases.

Noninvasive Prenatal Diagnosis using Cell-Free Fetal DNA in Maternal Plasma: Clinical Applications

  • Yang, Young-Ho;Han, Sung-Hee;Lee, Kyoung-Ryul
    • Journal of Genetic Medicine
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    • v.8 no.1
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    • pp.1-16
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    • 2011
  • Owing to the risk of fetal loss associated with prenatal diagnostic procedures (amniocentesis, chorionic villus sampling), noninvasive prenatal diagnosis (NIPD) is ultimate goal of prenatal diagnosis. The discovery of circulating cell-free fetal DNA (cffDNA) in maternal plasma in 1997 has opened up new probabilities for NIPD by Dr. Lo et al. The last decade has seen great development in NIPD. Fetal sex and fetal RhD status determination by cffDNA analysis is already in clinical use in certain countries. For routine use, this test is limited by the amount of cell-free maternal DNA in blood sample, the lack of universal fetal markers, and appropriate reference materials. To improve the accuracy of detection of fetal specific sequences in maternal plasma, internal positive controls to confirm to presence of fetal DNA should be analyzed. We have developed strategies for noninvasive determination of fetal gender, and fetal RhD genotyping using cffDNA in maternal plasma, using real-time quantitative polymerase chain reaction (RT-PCR) including RASSF1A epigenetic fetal DNA marker (gender-independent) as internal positive controls, which is to be first successful study of this kind in Korea. In our study, accurate detection of fetal gender through gestational age, and fetal RhD genotyping in RhD-negative pregnant women was achieved. In this assay, we show that the assay is sensitive, easy, fast, and reliable. These developments improve the reliability of the applications of circulating fetal DNA when used in clinical practice to manage sex-linked disorders (e.g., hemophilia, Duchenne muscular dystrophy), congenital adrenal hyperplasia (CAH), RhD incompatibility, and the other noninvasive pregnant diagnostic tests on the coming soon. The study was the first successful case in Korea using cffDNA in maternal plasma, which has created a new avenue for clinical applications of NIPD.

Cervical Vascular Diseases Rarely Observed by Duplex Sonography: 3 Cases (이중초음파에서 드물게 관찰되는 목 부위의 혈관질환: 3례)

  • Han, Minho;Seo, Kangsik;Choi, Junghye
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.1
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    • pp.131-136
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    • 2021
  • Duplex sonography is used widely in various medical fields because of its repeatability and low cost. In particular, the carotid duplex sonography is a useful non-invasive test for diagnosing cerebrovascular disease and predicting the prognosis. In clinical practice, it is very important to reduce the test time and improve accuracy. The patient's clinical information must be known in advance to perform carotid duplex sonography quickly and accurately. Despite this, there are often difficulties finding new cervical vascular diseases that are not mentioned in the clinical information. Therefore, knowing a variety of cases can lead to fast and accurate results. In this context, this paper reports three cases of cervical vascular disease discovered unexpectedly during carotid duplex sonography: CASE 1, internal carotid artery occlusion and cerebral arteries branched from the external carotid artery; CASE 2, internal jugular vein thrombosis; CASE 3, microembolism observed in the vertebral artery.

Evaluation of the Effectiveness of Color Consulting Services to Improve the School Environment, Seoul Report Results (서울시 학교환경개선 컬러컨설팅 효과성 평가 용역 결과보고)

  • Kim, Sun-Hyun;Kim, Yongh-Hyeon
    • Journal of the Korean Institute of Educational Facilities
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    • v.24 no.2
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    • pp.18-24
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    • 2017
  • 본 연구는 청소년 스트레스 호르몬 변화를 보기위한 연구로 컬러 컨설팅 환경개선에 따른 스트레스 호르몬 변화를 연구하였다. 청소년 스트레스 연구들에 따르면, 아동이나 청소년도 성인만큼 스트레스를 경험하고 있고 청소년들의 스트레스는 정서적 부적응과 신체적 건강에도 영향을 미친다. 스트레스가 지속되면 부신피질에서 스테로이드 호르몬인 코티솔도 분비하는 근거를 통해 환경변화로 생긴 코티솔 분비를 측정하였다. 코티솔 분비를 통한 스트레스 반응 정도 측정은 침해성을 최소화하기 위한 간편한 방법인 타액검사로 실시하였으며 비 침습적인 방법으로 특별한 장비나 도움이 없이 수집할 수 있었고 부작용이 적은 효율적 검사였다. 연구 결과 전체 학생(46명)의 코티솔은 환경개선 사전($0.121{\pm}0.087{\mu}g/dL$)에 비해 사후($0.096{\pm}0.058{\mu}g/dL$)에 감소하였고(t=1.718, p=.093) 중고등학생(36명)의 코디솔은 사전($0.137{\pm}0.092{\mu}g/dL$)에 비해 사후($0.104{\pm}0.062{\mu}g/dL$)에 감소하였으며, 유의수준 10%에서 통계적으로도 유의미한 차이를 보였다(t=1.750, p=.089). 따라서 환경 개선 전에 비해 환경 개선 후 청소년들의 스트레스가 감소되었음을 알 수 있다. 하지만 초등학생(10명)의 코티솔은 사전($0.064{\pm}0.023{\mu}g/dL$)에 비해 사후($0.065{\pm}0.016{\mu}g/dL$)에 변화를 보이지 않아, 유의수준 5%에서 통계적으로 유의미한 변화는 나타나지 않았다(t=-0.121, p=0.906). 따라서 후두엽이 발달하는 중학생 시기는 환경 변화에 민감하며 색채 자극에 크게 영향을 미치는 시기인 만큼 본 연구에서 환경전후로 검사한 코티솔 분비의 측정값도 감소함을 볼 수 있었다. 하지만 본 연구는 환경 변화에 코티솔 분비량에 유의미한 변화를 나타내지 않은 초등학생들은 스트레스 호르몬 변화에는 차이가 없었지만 환경변화의 자극이 없었다고 볼 수는 없다.

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Endovenous 980-nm Diode Laser Treatment of Incompetent Great Saphenous Vein (정맥 내 980-nm 다이오드 레이저를 이용한 대복재정맥 역류의 치료)

  • Kim, Kun-Il;Jo, Tae-Jun;Lee, Jae-Woong;Hong, Ki-Woo;Lee, Won-Yong
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.97-102
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    • 2007
  • Background: Endovenous laser treatment has recently been introduced as a less invasive technique, with many good results reported, A 980-nm diode laser was used on the great saphenous vein (GSV) occlusions in patients with varicose veins, due to GSV reflux, and the therapeutic effects analyzed. Material and Method: Between September 2003 and February 2006, 238 patients (332 cases) with GSV reflux underwent endovenous laser treatment with a 980-nm diode laser. Operative procedures were simultaneous endovenous laser treatment and ambulatory phlebectomy. The preoperative clinical findings, postoperative complications and postoperative duplex US follow up results at 1 and 3 months were reviewed. Result: Postoperative complications were ecchymosis in almost cases, paresthesia 68 cases (20.5%) and skin burn in 3 cases (0.9%). Follow up duplex US revealed 26 and 10 cases at 1 and 3 months of GSV reflux or partial recanalization, with therapeutic success rates of 91.3 and 87.9%, respectively. Conclusion: The treatment of GSV occlusion with an endovenous laser is less invasive than traditional GSV stripping, but relatively high recanalization was experienced, possibly due to inadequate laser power, laser fiber pullback speed or an extremely dilated GSV. However, continuous attempts will be required to reduce the recanalization after the procedure, with accurate follow up using duplex US.

Classification of Tongue Coating for Tongue Diagnosis in Korean Medicine (한의학의 설진을 위한 설태 분류 방법)

  • Kim, Keun-Ho;Choi, Eun-Ji;Lee, Si-Woo;Kim, Jong-Yeol
    • Proceedings of the KIEE Conference
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    • 2008.07a
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    • pp.1985-1986
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    • 2008
  • 혀의 상태는 인체 내부의 생리적 병리적 특성의 변화를 나타내므로, 한의학에서 중요한 지수가 된다. 한의학에서 설진 방법은 환자의 설질과 설태의 변화를 관찰함으로써 질병을 진찰하는 방법이므로, 편리할 뿐만 아니라 비침습적이고, 널리 쓰이고 있다. 그러나 설진은 광원, 환자의 자세, 한의사의 상태와 같은 검사 환경에 의해 영향을 받는다. 표준화된 진단을 위한 자동 진단 시스템을 개발하기 위하여 질병의 예후를 판단할 수 있는 설태 분류 방법은 필수적이지만, 컬러의 경계가 모호하므로 설태와 설질을 구분하기는 매우 어렵다. 이 논문에서 분할된 설체 내에서 컬러를 계층적으로 분류하여 설태를 분류하는 방법을 제안한다. 또한 설태 영역을 정확하게 분할하도록 하였다. 제안된 방법은 표준화된 진단을 가능하도록 한다.

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Management of an Open Comminuted Fracture of the Metacarpus using Circular External Skeletal Fixation in a Korean Water Deer (Hydropotes inermis argyopus) (고라니에서 발생한 손허리뼈 개방 복합골절의 원형 외부골격고정법 적용)

  • Heo, Su-Young;Jeong, Seongmok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.359-362
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    • 2015
  • A Korean water deer was rescued after being hit by a motor vehicle. Clinical and radiographic examination revealed a grade III open fracture of the right metacarpus with severe soft tissue injury. The water deer underwent closed reduction of the fracture, which was stabilized by the application of the Ilizarov method of 4-ring circular external skeletal fixation (CESF) as a minimally invasive technique. The water deer was successfully released into the wild. CESF was advantageous for the stabilization of open comminuted fracture and the management of a severely contaminated wound in a Korean water deer. CESF can be used successfully in wild deer with good tolerance and minimal complications.

A study of Conjunctival Cellular Changes in Dry Eye Patients by Impression Cytology (Impression cytology를 이용한 건성안의 결막 세포변화에 관한 연구)

  • Kim, Jai-Min;Kho, Eun-Gyung;Chae, Soo-Chul;Kim, Soon-Ae
    • Journal of Korean Ophthalmic Optics Society
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    • v.9 no.2
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    • pp.333-343
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    • 2004
  • Impression cytology refers to application of cellulose acetate filter material to the ocular surface to remove the superficial layers of the conjunctival epithelium. The technique is non-invasive, is easy to perform, causes minimal discomfort to the patient, and can be used to follow changes in the conjunctival ocular surface over time. With this method, the morphology of the conjunctival ocular surface can be studied and the degree of squmaous metaplasia assessed. This study was performed to evaluate the conjunctival surface by impression cytology in dry eye patients. A total of 70 students with no contact lens wearing history were recruited. Subjects were required to fill in a McMonnies dry eye symptom questionnaire. The non-invasive tear thinning time(TIT) test of each subject was measured, followed by Schirmer tear test(STI), tear film break-up time(TBUT) tests and Rose-bengal staining were performed as a baseline. Conjunctival epithelial cells from the inferior bulbar conjunctiva were harvested by the impression cytology technique. The specimens collected were labelled and stained with PAS(Periodic Acid Schift)-haematoxylin. The goblet cells and conjunctival epithelial cells were observed under a light microscope of 400x magnification. The specimens were classified according to the Nelson Grading scale which was based on the degree of squamous metaplasia such as changes of goblet cells density, size/form, N:C(nucleus : cytoplasm) ratio. Dry eye patients were observed morphological changes of the epithelial cells, different nuclear alterations, decrease of the goblet cells density. The degree of cytological changes was related to severity of dry eye conditions. When the epithelial cell morphology was graded according to the system described by Nelson, specimens from the control group revealed 91.43% of the eyes to be grade 0 and 8.57% to be grade 1, whereas of the dry eye patients, 20% were grade 0, 42.86% grade 1, 34.29% grade 2 and 2,86% grade 3. Impression cytology represents a non- or minimally invasive biopsy of the ocular surface epithelium with no side effects or contraindications. It has demonstrated to be a useful diagnostic aid for a wide variety of processes involving the ocular surface. This technique is a safe, simple method and may help increase understanding of various ocular surface alterations in dry eye patients.

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Analysis of image using fibroscan value in the Ultrasound of Elastography for liver lesions (간병변 초음파영상에서의 탄성초음파를 이용한 영상분석)

  • Lee, Jeong-Hyun;Kim, Jung Hun;Kim, Changsoo
    • Proceedings of the Korea Contents Association Conference
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    • 2014.11a
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    • pp.433-434
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    • 2014
  • 최근 간질환 검사의 비침습적인 방법으로 탄성초음파가 각광받고 있는 추세이다. 그러나 진단결과와 탄성초음파 결과 값에 따른 표준 진단 매뉴얼이 없는 실정이다. 따라서 본 연구에서는 탄성초음파 수치에 따른 간질환의 종류와 B-mode 영상 간의 경향을 알아보고자 하였다. 그리고 환자의 우측 늑간 초음파 B-mode 영상평가 파라미터인 평균, 신호 대 잡음비, 최대신호 대 잡음비, 엔트로피로 분석하고, 동일 부위에 시행한 탄성초음파 수치와의 비교를 통해 경향을 연구하였고, 그 기준을 제시하고자 하였다.

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Carotid Artery Disease in Duplex Sonography: 3 Cases (이중초음파에서 관찰된 목동맥 질환: 3례)

  • Han, Minho;Choi, Junghye;Seo, Gang Sik;Nam, Hyo Suk
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.1
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    • pp.114-118
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    • 2019
  • Duplex sonography has been used to non-invasively diagnose carotid artery disease and to follow up patients with this disease. In carotid artery disease, carotid mobile thrombus and dissection are rarely detected by duplex sonography in patients with cerebrovascular events. In particular, carotid dissection occurs when a small tear forms in the tunica intima and makes 2 lumens in the carotid artery, including true and false lumens. This study reports 3 rare cases of carotid mobile thrombus, spontaneous carotid dissection, and carotid dissection in Takayasu arteritis.