• Title/Summary/Keyword: 신경전도검사

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고 선량율 근접 및 온열치료 병용 삽입관의 제작과 특성

  • 추성실;김성규
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2003.09a
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    • pp.52-52
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    • 2003
  • 악성종양을 치료하는 방법중 방사선과 온열요법은 가장 강력한 치료방법으로 연구되어왔으며 이를 병용함으로 서 상승효과를 얻을 수 있다. 인체조직에 41$^{\circ}C$ 이상의 열을 가하면 세포질의 단백질변성으로 세포에 손상을 주어 세포가 사멸하게 되며 세포의 생존율은 가열시간 즉 열량에 따라 지수적으로 감소한다. 온열은 세포주기중 방사선 저항성이 매우 큰 DNA 합성시기와 산도가 높을 때 감수성이 매우 크기 때문에 방사선과 병용요법은 상호 상승효과를 가져온다. 이와 같이 온열을 이용한 악성종양의 치료가능성은 생물학적 기초연구와 임상시험에서 경이적인 효과를 얻을 수 있었으나 아직 까지 가열방법과 온도분포측정이 큰 과제로 남아있으며 주위건강조직의 가열을 피하면서 인체 깊은 곳에 존재하는 종양에만 집중 가열하는 방법인 삽입형 온열치료방법에 대한 연구가 집중되었다. 한편 방사선 치료방법은 주위 건강조직의 피폭을 최소로 줄이고 종양에만 집중 조사가 요구되며 자궁암, 유방암, 뇌암등 부피가 작고 집중적 치료를 요하는 종양은 방사성동위원소를 이용한 근접 삽입치료 (Brachyradiotherapy)가 큰 효과를 나타내고 있다 방사선과 온열의 병행 치료를 위하여 방사선 삽입 치료에 사용한 선원 삽입관을 그대로 두고 삽입관 속에 방사성 동위원소 대신 온열 전극을 넣어 열을 가하는 방사선 온열 병용치료방법을 고안하였으며 방사선과 온열병용에 사용할 최적 삽입관의 제작과 이에 따른 온도분포의 측정과 최적삽입방법을 결정하였다. 방사선 삽입치료용 폴리에찌렌 삽입관의 외부에 금박을 입혀 라디오파 첨극을 삽입할 때 서로 연결되도록 고안 제작함으로서 방사선 삽입치료와 자입식 온열치료를 동시에 만족하게 수행할 수 있는 병용삽입관 (Flexible thermoradiotherapy probes)을 제작하였다. 전도율이 큰 금박부위가 직접 조직에 접촉됨으로 라디오파의 전달이 용이하며 금박의 길이를 2 cm 에서 5 cm 로 구분제작 함으로서 종양의 크기와 모양에 따라 선택할 수 있도록 하였다. 라디오파를 이용한 온열분포의 측정은 인체조직과 전기적 특성이 비슷한 물질인 한천 팬텀 제작하여 사용하였으며 온도분포 측정은 열전대와 서머그람으로 시행하였다. 생체조직 내에서의 온도분포와 온열효과를 관찰하기 위하여 직접 개의 뇌를 이용하여 시행하였으며 4 개의 전극을 이용하여 43$^{\circ}C$로 50분간 가열하고 일주일후 개를 회생시켜 개 뇌에 대한 조직학적 검사를 시행하였다. 한편 팬텀 표면에서 중앙부로 안테나 길이가 2 cm 인 4 개의 전극을 1 cm 간격으로 정사각형이 되도록 삽입하여 가열하였을 때 90% 등온곡선이 반경 1.25의 원형으로 균일하게 분포되었고 종단면상 삽입관의 길이에 따라 균일한 온도분포가 이루어졌다. 전극을 2 cm 간격으로 삽일 하였을 때 90% 등온곡선이 1.75 반경으로 거의 4 각형의 균일한 분포를 얻었으나 전극의 간격이 증가하면 전도율이 떨어져서 전극 중심부에 불균일한 온도분포를 형성하였다. 동물실험에서 정상 개의 뇌 실질에 자입하여 직접 정방형의 중심을 43$^{\circ}C$로 유지하며 50분간 온열 요법을 시행한 후 관찰한 조직병리학적 소견은 liquefactive necrosis, pyknosis of neuronal element 및 polymorphonuclear leukocytes들의 회백질에서 급성기에 관찰되었고 liquefactive necrosis 주위에 lipid-laden macrophage들이 관찰됨이 공통적인 특정이었으며 후기변화로 괴사조직 주위로 신경교세포의 증식이 관찰되었다.

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Clinical Study for Tinnitus by Pure Tone Audiometry (이명환자의 순음청력검사에 대한 임상적 고찰)

  • 김종남;조정란
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.39.1-39
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    • 1981
  • The author presents clinical study for 111 cases of tinnitus with pure tone audiometry from Jan. 1, 1978 to Dec. 31, 1980 in department of otolaryngology, Ewha Womans University Hospital. The results were as follows; 1) Male to Female ratio was as 1 : 1, and peak age incidence was in the age group of 21 to 30. 2) Most frequent duration was 1 month to 1 year in the cases of the tinnitus. 3) The patient who complained tinnitus only was 10.0% and the patient who complained tinnitus with hearing impairment was 72.0% in the cases of tinnitus. 4) The affected site in the tinnitus, in order of frequency were; Both ear 38.7% Left ear 32.4% Right ear 28.9% 5) The drum finding, in order frequency were; Normal 48.0% Retraction 33.1% Perforation 8.4% 6) The degree of hearing loss in the audiometry were; Normal 29.2% Moderate severe 22.7% 7) The shape of hearing impairments were; High tone loss 46.9% Flat 33.0% Low tone loss 11.9% 8) The occurrence of $C_{5}$ dip was 11.0% in cases of the tinnitus. 9) The classification of hearing loss were; Sensorineural hearing loss 46.9% Mixed hearing loss 33.1 % Conductive hearing loss 20.1%

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The Efficacy of Nerve Conduction Study on Tarsal Tunnel Syndrome (족근관 증후군에서의 신경 전도 검사의 효용성)

  • Yoon, Ji-Young;Lee, Kyung-Chan;Oh, Won-Seok;Hong, Jin-Hun;Kwak, Ji-Hoon;Park, Hong-Ki
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.1
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    • pp.23-26
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    • 2016
  • Purpose: Nerve conduction study (NCS) test is a standard diagnostic study of the tarsal tunnel syndrome. The purpose of this study was to determine the relation between the results of the NCS and postoperative clinical results. Materials and Methods: From June 2004 to July 2015, 104 patients were diagnosed with tarsal tunnel syndrome and treated surgically. Of 104 patients diagnosed through NCS preoperatively and postoperatively, 41 patients were included in this study. There were 23 male and 18 female patients with mean age of 49.2 years old and the average follow-up period was 15.5 months. NCS, pain visual analogue scale (VAS) score, and subjective satisfaction were examined preoperatively and postoperatively. Results: On the preoperative NCS, 32 patients (78.0%) were positive and 9 patients (22.0%) were negative, and 32 positive NCS patients consisted of 9 positive (28.1%), 16 improved (50.0%), and 7 negative (21.9%) postoperatively. VAS score was 7.4 preoperatively and 4.4 postoperatively. According to satisfaction, there were 8 excellent (19.5%), 21 good (51.2%), 6 fair (14.6%), and 6 poor (14.6%) patients. For 32 patients who were positive on the preoperative NCS, the postoperative VAS score was 4.87 and there were 7 excellent (21.9%), 16 good (50.0%), 4 fair (12.5%), and 5 poor (15.6%) patients. Sixteen patients were negative on the postoperative NCS, with a VAS score of 3.75, 1 excellent (6.3%), 11 good (68.8%), 2 fair (12.5%), and 2 poor (12.5%). There was no statistical correlation between the preoperative NCS and postoperative VAS score (p=0.10), between preoperative NCS and postoperative satisfaction (p=0.799), between preoperative NCS and postoperative VAS score (p=0.487), and between postoperative NCS and postoperative satisfaction (p=0.251). Conclusion: For patients diagnosed with tarsal tunnel syndrome and treated surgically, NCS showed little correlation with postoperative result.

Effect of Mood and Personality Characteristics on Psychophysiological Responses (기분과 성격특성이 정신생리적 반응에 미치는 영향)

  • Koo, Moon-Sun;Yu, Bum-Hee
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.59-66
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    • 2001
  • Objectives: This study examined the effect of mood and personality characteristics on psychophysiological responses measured by a biofeedback system in a normal population. Methods: Fifty healthy volunteers without any history of medical or psychiatric illnesses participated in this study. We measured the Spielberger trait anxiety inventory, Beck depression inventory, and Eysenck personality questionnaires in these subjects. Using the J & J biofeedback system, we also measured skin temperature, electrodermal response, forearm and frontal electromyography (EMG)s in 3 experimental conditions of baseline, stress, and recovery phases. Results: Trait anxiety did not show any significant correlation with psychophysiological responses except stress response in forearm EMG levels(r=0.282, p<0.05). Depressed mood was negatively correlated with forearm EMG levels in baseline (r=-0.299, p<0.05) and recovery phases(r=-0.314, p<0.05). Subjects with relatively high levels of depressed mood showed different stress and recovery responses in frontal EMG levels compared with those with relatively low levels of depressed mood (F=4.26, p<0.05). Extroverted subjects showed higher levels of forearm EMG than introverted ones in stress phase. Conclusion: Mood and personality characteristics in healthy subjects are closely related with psychophysiological responses measured by a biofeedback system. We suggest that mood and personality characteristics should be considered as important variables in analyzing abnormal psychophysiological responses in some psychiatric patients.

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Psychophysiological Characteristics of Insomnia Patients Measured by Biofeedback System (바이오피드백을 이용하여 측정한 불면증 환자의 정신생리적 특징)

  • Huh, Sung-Young;Lee, Jin-Seong;Kim, Sung-Gon;Kim, Ji-Hoon;Jung, Woo-Young
    • Sleep Medicine and Psychophysiology
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    • v.22 no.2
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    • pp.70-76
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    • 2015
  • Background and Objectives: Insomnia is the most prevalent sleep disorder in the general population and is considered to be a disorder of hyperarousal. The aim of this study was to measure the psychophysiological responses in insomnia patients using a biofeedback system, and to compare them with results from normal healthy subjects. Materials and Methods: Eighty patients with primary insomnia (35 males and 45 females, average age $49.71{\pm}12.91years$) and 101 normal healthy controls (64 males and 37 females, average age $27.65{\pm}2.77$) participated in this study. Electromyography (EMG), heart rate (HR), skin conductance (SC), skin temperature (ST), and respiratory rate (RR) were recorded using a biofeedback system during 5 phases (baseline, stress 1, recovery 1, stress 2, recovery 2) of a stress reactivity test, and average values were calculated. Difference in values between the two groups in each corresponding phase was analyzed with independent t-test, and change in values across phases of the stress reactivity test was analyzed with paired t-test (all two-tailed, p<0.05). Results: Compared to normal controls, insomnia patients had higher EMG in all 5 phases (baseline : $7.72{\pm}3.88{\mu}V$ vs. $4.89{\pm}1.73{\mu}V$, t = -6.06, p<0.001 ; stress 1 : $10.29{\pm}5.16{\mu}V$ vs. $6.63{\pm}2.48{\mu}V$, t = -5.84, p<0.001 ; recovery 1 : $7.87{\pm}3.86{\mu}V$ vs. $5.17{\pm}2.17{\mu}V$, t = -5.61, p<0.001 ; stress 2 : $10.22{\pm}6.07{\mu}V$ vs. $6.98{\pm}2.98{\mu}V$, t = -4.37, p<0.001 ; recovery 2 : $7.88{\pm}4.25{\mu}V$ vs. $5.17{\pm}1.99{\mu}V$, t = -5.27, p<0.001). Change in heart rate across phases of the stress reactivity test were higher in normal controls than in insomnia patients (stress 1-baseline : $6.48{\pm}0.59$ vs. $3.77{\pm}0.59$, t = 3.22, p = 0.002 ; recovery 1- stress 1 : $-5.36{\pm}0.0.59$ vs. $-3.16{\pm}0.47$, t = 2.91, p = 0.004 ; stress 2-recovery 1 : $8.45{\pm}0.61$ vs. $4.03{\pm}0.47$, t = 5.72, p<0.001 ; recovery 2-stress 2 : $-8.56{\pm}0.65$ vs. $4.02{\pm}0.51$, t = -5.31, p<0.001). Conclusion: Psychophysiological profiles of insomnia patients in a stress reactivity test were different from those of normal healthy controls. These results suggest that the sympathetic nervous system is more highly activated in insomnia patients.

Monte-Carlo Simulations of Non-ergodic Solute Transport from Line Sources in Isotropic Mildly Heterogeneous Aquifers (불균질 등방 대수층 내 선형오염원으로부터 기원된 비에르고딕 용질 이동에 관한 몬테카를로 시뮬레이션)

  • Seo Byong-min
    • Journal of Soil and Groundwater Environment
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    • v.10 no.6
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    • pp.20-31
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    • 2005
  • Three dimensional Monte-Carlo simulations of non-ergodic transport of a lion-reactive solute plume by steady-state groundwater flow under a uniform mean velocity in isotropic heterogeneous aquifers were conducted. The log-normally distributed hydraulic conductivity, K(x), is modeled as a random field. Significant efforts are made to reduce tile simulation uncertainties. Ensemble averages of the second spatial moments of the plume and plume centroid variances were simulated with 1600 Monte Carlo runs for three variances of log K, ${\sigma}_Y^2=0.09,\;0.23$, and 0.46, and three dimensionless lengths of line plume sources normal to the mean velocity. The simulated second spatial moment and the plume centroid variance in longitudinal direction fit well to the first order theoretical results while the simulated transverse moments are generally larger than the first order results. The first order theoretical results significantly underestimated the simulated dimensionless transverse moments for the aquifers of large ${\sigma}_Y^2$ and large dimensionless time. The ergodic condition for the second spatial moments is far from reaching in all cases simulated, and transport In transverse directions may reach ergodic condition much slower than that in longitudinal direction. The evolution of the contaminant transported in a heterogeneous aquifer is not affected by the shape of the initial plume but affected mainly by the degree of the heterogeneity and the size of the initial plume.