• 대한교통학회지
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• 제26권4호
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• pp.7-16
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• 2008

서울시 도시고속도로 진출부에 극심한 정체가 다수 발생하고 있는데, 이러한 진출부 정체의 주원인으로 진출램프 하류부교차로의 처리용량 부족, 비효율적인 신호운영 등이 지적되고 있다. 이에 하류부교차로의 설계 및 운영 개선을 통한 진출램프 하류부 교차로의 혼잡 관리가 필요하다. 본 연구에서는 도시고속도로 진출램프 하류부교차로의 개선 사례인 중동 IC를 중심으로 분석하였다. 고속도로와 간선도로가 교차 시 다이아몬드 IC가 주로 사용되고 양자택일로 SPUI가 사용되는데, 이 다이아몬드 IC와 SPUI의 운영을 중동 IC에 적용해 시뮬레이션 등으로 분석하여 그 효율성을 비교하였다. 분석 결과 다이아몬드 IC로 운영 시 4 phase with overlaps 적용 등의 신호운영 개선으로 진출부 혼잡 개선이 가능하고, frontage road가 없는 경우 SPUI가 다이아몬드 IC보다 더 효과적일 수 있으나 frontage road가 있으면 다이아몬드 IC가 SPUI보다 더 효율적인 것으로 나타났다. 본 연구 결과를 토대로 진출램프 하류부교차로의 효율적인 운영을 통해 하류부교차로 뿐만 아니라 도시고속도로 본선의 혼잡을 최소화할 수 있을 것으로 기대된다.

• Korean Journal of Radiology
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• 제22권3호
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• pp.395-404
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• 2021

Objective: To compare the utility of computed tomography perfusion (CTP) and three different 4-point scoring systems in computed tomography angiography (CTA) in confirming brain death (BD) in patients with and without skull defects. Materials and Methods: Ninety-two patients clinically diagnosed as BD using CTA and/or CTP for confirmation were retrospectively reviewed. For the final analysis, 86 patients were included in this study. Images were re-evaluated by three radiologists according to the 4-point scoring systems that consider the vessel opacification on 1) the venous phase for both M4 segments of the middle cerebral arteries (MCAs-M4) and internal cerebral veins (ICVs) (A60-V60), 2) the arterial phase for the MCA-M4 and venous phase for the ICVs (A20-V60), 3) the venous phase for the ICVs and superior petrosal veins (ICV-SPV). The CTP images were independently reviewed. The presence of an open skull defect and stasis filling was noted. Results: Sensitivities of the ICV-SPV, A20-V60, A60-V60 scoring systems, and CTP in the diagnosis of BD were 89.5%, 82.6%, 67.4%, and 93.3%, respectively. The sensitivity of A20-V60 scoring was higher than that of A60-V60 in BD patients (p < 0.001). CTP was found to be the most sensitive method (86.5%) in patients with open skull defect (p = 0.019). Interobserver agreement was excellent in the diagnosis of BD, in assessing A20-V60, A60-V60, ICV-SPV, CTP, and good in stasis filling (κ: 0.84, 0.83, 0.83, 0.83, and 0.67, respectively). Conclusion: The sensitivity of CTA confirming brain death differs between various proposed 4-point scoring systems. Although the ICV-SPV is the most sensitive, evaluation of the SPV is challenging. Adding CTP to the routine BD CTA protocol, especially in cases with open skull defect, could increase sensitivity as a useful adjunct.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.180-193
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• 2022

Pediatric inflammatory bowel disease (PIBD) is a multisystem disorder characterized by intestinal and extraintestinal manifestations and complications. Cerebrovascular events (CVE) are rare extraintestinal complications in patients with PIBD. Statistics show that 3.3% patients with PIBD and 1.3-6.4% adult patients with inflammatory bowel disease (IBD) experience CVE during the course of the disease. Therefore, this study aimed to review the records of children with IBD who developed CVE during the course of the disease. We retrospectively reviewed 62 cases of PIBD complicated by CVE. The mean patient age at the time of thrombotic events was 12.48±4.13 years. The incidence of ulcerative colitis was significantly higher than that of Crohn's disease (43 [70.5%] vs. 13 [21.3%] patients). Most patients (87.93%) were in the active phase of IBD at the time of CVE. The mean time interval between the onset of IBD and CVE was 20.84 weeks. Overall, 11 (26.83%) patients showed neurological symptoms of CVE at disease onset. The most frequent symptom on admission was persistent and severe headaches (67.85%). The most common site of cerebral venous thrombosis was the transverse sinuses (n=23, 53.48%). The right middle cerebral artery (n=3, 33.34%) was the predominant site of cerebral arterial infarction. Overall, 41 (69.49%) patients who were mostly administered unfractionated heparin or low-molecular-weight heparin (56.09%) recovered completely. Patients with IBD are at a risk of thromboembolism. CVE may be the most common type of thromboembolism. Based on these findings, the most common risk factor for CVE is IBD flares. In patients with CVE, anticoagulant therapy with heparin, followed by warfarin, is necessary.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1993년도 춘계학술대회
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• pp.116-119
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• 1993

In this paper, we implemented a pulse wave type oximeter system that continuously measure the of oxyhemoglobin saturation of the arterial blood(SaO2) and pulse rate with non-invasively. We use the transmission type and reflection type transducer for comparison the percentage of hemoglobin oxgen saturation. The light Iron the two kind of LEDs is transmitted through the tissue, then received by a single photodiode with alternatively. By the phase sensitive detection circuit, the output of the photodiode is separated in to red and near infrared signal. We calculated a ratio of light transmittance between two kind of LEDs, and then, it is applied to the oxgen saturation coefficent calculation formular.

• The Korean Journal of Physiology and Pharmacology
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• 제4권6호
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• pp.445-453
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• 2000

The present investigation tested the hypothesis that the activation of protein kinase G (PKG) leads to a phosphorylation of $Ca^{2+}-activated$ potassium channel $(K_{Ca}\;channel)$ and is involved in the activation of $K_{Ca}$ channel activity in cerebral arterial smooth muscle cells of the rabbit. Single-channel currents were recorded in cell-attached and inside-out patch configurations of patch-clamp techniques. Both molsidomine derivative 3-morpholinosydnonimine-N-ethylcarbamide $(SIN-1,\;50\;{\mu}M)$ and 8-(4-Chlorophenylthio)-guanosine-3',5'-cyclic monophosphate $(8-pCPT-cGMP,\;100\;{\mu}M),$ a membrane-permeable analogue of cGMP, increased the $K_{Ca}$ channel activity in the cell-attached patch configuration, and the effect was removed upon washout of the drugs. In inside-out patches, single-channel current amplitude was not changed by SIN-1 and 8-pCPT-cGMP. Application of ATP $(100\;{\mu}M),$ cGMP $(100\;{\mu}M),$ ATP+cGMP $(100\;{\mu}M\;each),$ PKG $(5\;U/{\mu}l),$ ATP $(100\;{\mu}M)+PKG\;(5\;U/{\mu}l),$ or cGMP $(100\;{\mu}M)+PKG\;(5\;U/{\mu}l)$ did not increase the channel activity. ATP $(100\;{\mu}M)+cGMP\;(100\;{\mu}M)+PKG\;(5\;U/{\mu}l)$ added directly to the intracellular phase of inside-out patches increased the channel activity with no changes in the conductance. The heat-inactivated PKG had no effect on the channel activity, and the effect of PKG was inhibited by 8-(4-Chlorophenylthio)-guanosine-3',5'-cyclic monophosphate, Rp-isomer $(Rp-pCPT-cGMP,\;100\;{\mu}M),$ a potent inhibitor of PKG or protein phosphatase 2A (PP2A, 1 U/ml). In the presence of okadaic acid (OA, 5 nM), PP2A had no effect on the channel activity. The $K_{Ca}$ channel activity spontaneously decayed to the control level upon washout of ATP, cGMP and PKG, and this was prevented by OA (5 nM) in the medium. These results suggest that the PKG-mediated phosphorylations of $K_{Ca}$ channels, or some associated proteins in the membrane patch increase the activity of the $K_{Ca}$ channel, and the activation may be associated with the vasodilating action.

• 한국임상수의학회지
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• 제35권3호
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• pp.93-96
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• 2018

This study aimed to establish an injection protocol to determine the precise CT scan timing in canine abdominal multi-phase CT using the test bolus method. Three dynamic scans with different contrast injection parameters were performed using a crossover design in eight normal beagle dogs. A contrast material was administered at a fixed dose of 200 mg iodine/kg as a test bolus for dynamic scans 1 and 2, and 600 mg iodine/kg as a main bolus for dynamic scan 3. The contrast materials were administered with 1 ml/s in dynamic scan 1, and 3 ml/s in dynamic scan 2 and 3. The mean arrival time to the appearance of aortic enhancement in dynamic scan 3 was similar to that in dynamic scan 2, and different significantly to that in dynamic scan 1. The mean arrival time to the peak aortic and pancreatic parenchymal enhancement in dynamic scan 3 was similar to that in dynamic scan 1, and different significantly to that in dynamic scan 2. In multi-phase CT scan, a test bolus should be injected with the same injection duration of a main bolus, to obtain the precise arrival times to peak of arterial or pancreatic parenchymal enhancement.

• Journal of Nutrition and Health
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• 제32권5호
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• pp.561-569
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• 1999

In the atherosclerotic subjects, arterial endothelial cell injury and plaque formation are suspected to be strong causable factors in developing acute coronary syndrome, and it was revealed that platelets have a very important role in this case. Women are exposed to atherosclerosis at a different degree after menopause or oral contraception. The purpose of this study was to determine the effects of endogenous and exogenous estrogen on the degree of platelet aggregation in platelet rich plasma(PRP) in twenty nonsmoking healthy Korean women for 12 weeks. The subjects were assigned to three groups: (1) eight women aged 49 to 60(yr) for the postmenopausel(Pst) group, (2) eight, aged 22 to 30(yr) for the premenopausa(Pre) group, (3) four, aged 23 to 30(yr) for the oral contraceptive (OC) group which used triphasic OC formulation. Fasting blood sample were obtained from the subjects, (1) once per 6 weeks in the Pst group, (2) every phase of the menstrual cycle in the Pre group, (3) each once during and after OC administration in the OC group. ADP, collagen and epinephrine were used as aggregating reagents, and platelet aggregation and time(Δt: time reaching to the maximum point of aggregation) in PRP were measured at the maximum point of aggregation in five minutes. All the data were adjusted for dietary effects, personality type and body mass index(BMI) by using analysis of covariation(ANCOVA). Platelet aggregation to ADP and collagen(MADP and MCOLL) were not significantly different among the three groups, and Δt to ADP and collagen(TADP and TCOLL) were not either. But maximum platelet aggregability and Δt to epinephrine(MEPIN and TEPIN) were significantly different among the three groups, and the OC group showed the lowest value (p<0.01). Maxtimum platelet aggregability and Δt during the menstrual cycle were not significantly different in the Pre group. Any other significant differences in the maximum platelet aggregability and Δt were found between oral contraception phase and washing out phase(menstruation) in the OC group. In results, maximum platelet aggregability and aggregation time to ADP and collagen seemed not to be affected by endogenous and exogenous estrogen, even though MEPIN and TEPIN showed significantly low in the OC group among the three groups.

• 대한교통학회지
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• 제27권5호
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• pp.17-28
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• 2009

도시의 급변하는 교통수요에 대응하기 위해서 지속적으로 교통시설을 공급하는 데에는 한계가 있으므로 맹목적인 시설공급보다는 현재 교통시설에서의 운영관리측면이 강조되고있다. 특히 신호교차로들로 이루어진 단속류에서는 연동을 고려한 각 교차로별 최적신호시간 부여가 중요하다. 그러나 방향별로 부여된 신호시간이 단속류의 통과용량에 주요 변수인 것을 감안할 때 첨두시와 같이 교통수요가 급증하는 상황에서 보호좌회전 신호를 포함하는 4현시 신호운영을 지속적으로 유지하는 것은 방향별 통과용량에서의 한계가 있으며, 이에 대응하여 기존 과포화 신호제어 방법으로 내부미터링 기법에 대한 연구도 그동안 진행되어왔으나 실시간 신호제어시스템 상의 대기행렬 검지기 설치 부재로 인해 적용되지 못하고 있는 실정이다. 본 연구에서는 도시 간선도로의 지정체를 완화하기 위한 새로운 방법으로 현재 삼성역 교차로에서 운영 중에 있는 제한적 좌회전 신호운영 방안을 간선가로축을 대상으로 적용하였다. 이것은 시간대에 따라 주방향에 대한 좌회전 흐름을 직진 후 U턴으로 유도하여 현시수를 감소시키고 직진 신호시간을 최대화하여 통과용량을 증가시키는 신호제어 방법을 적용하는 것이다. 단, 본 신호제어에 대한 적용은 대상구간의 기하구조와 교통상황 조건 등에 따라 결정되어져야 하며, 이를 위해 기존의 교통 신호등 설치기준과 같이 각 교통상황 조건별로 명확한 적용기준이 필요하다.

• Investigative Magnetic Resonance Imaging
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• 제25권3호
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• pp.172-182
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• 2021

Purpose: We evaluated the diagnostic performance of LI-RADS version 2018 using gadoxetic acid enhanced MRI for recurrent but untreated HCC in patients with prior history of HCC. Materials and Methods: We enrolled 50 consecutive patients who 1) prior history of treatment of HCC, 2) underwent liver surgery for radiological/clinical diagnosis of new HCC between 2013 to 2018, 3) had gadoxetic acid enhanced MRI within one month before surgery, and 4) did not have more than five HCCs or infiltrative tumors only. Two radiologists reviewed MRI and determined the presence of LR3, LR4 and LR5 observations except previously treated tumors based on LI-RADS version 2018 in consensus. We sub-classified LR4 into LR4m (LR4 with major features only) and LR4u (LR4 upgraded from LR3 by ancillary features). LR4u were further sub-classified into LR4ua (with arterial phase hyperenhancement) and LR4un (without arterial phase hyperenhancement). Results: PPV for LR5, LR4 and LR3 observations for recurrent HCC were 100%, 61.5% and 25.0%, respectively. 100% (3/3) of LR4m were HCC. However, PPV of LR4u was 56.5%. PPV of LR4ua and LR4un were 73.3% and 25.0%, respectively. Sensitivity of LR5 and LR5+LR4 observations as a diagnostic threshold were 32.1% and 89.3%, respectively. Sensitivity for LR5+LR4m+LR4ua observations for diagnosis of HCC were 83.7% and significantly superior to that of LR5 without significant deterioration of specificity (75.0%). Conclusion: In patients with prior history of HCC, LR4 observations by major features or with APHE may be regarded as recurrent HCCs given high sensitivity and comparable specificity/PPV to LR5 observations.

• Investigative Magnetic Resonance Imaging
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• 제25권4호
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• pp.313-322
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• 2021

Purpose: To find diagnostic image features, to compare diagnostic performance of multiphase CT versus gadoxetic acid disodium-enhanced MRI (GAD-MRI), and to evaluate the impact of analyzing Liver Imaging Reporting and Data System (LI-RADS) imaging features, for distinguishing combined hepatocellular-cholangiocarcinoma (CHC) from hepatocellular carcinoma (HCC). Materials and Methods: Ninety-six patients with pathologically proven CHC (n = 48) or HCC (n = 48), diagnosed June 2008 to May 2018 were retrospectively analyzed in random order by three radiologists with different experience levels. In the first analysis, the readers independently determined the probability of CHC based on their own knowledge and experiences. In the second analysis, they evaluated imaging features defined in LI-RADS 2018. Area under the curve (AUC) values for CHC diagnosis were compared between CT and MRI, and between the first and second analyses. Interobserver agreement was assessed using Cohen's weighted κ values. Results: Targetoid LR-M image features showed better specificities and positive predictive values (PPV) than the others. Among them, rim arterial phase hyperenhancement had the highest specificity and PPV. Average sensitivity, specificity, and AUC values were higher for MRI than for CT in both the first (P = 0.008, 0.005, 0.002, respectively) and second (P = 0.017, 0.026, 0.036) analyses. Interobserver agreements were higher for MRI in both analyses (κ = 0.307 for CT, κ = 0.332 for MRI in the first analysis; κ = 0.467 for CT, κ = 0.531 for MRI in the second analysis), with greater agreement in the second analysis for both CT (P = 0.001) and MRI (P < 0.001). Conclusion: Rim arterial phase hyperenhancement on GAD-MRI can be a good indicator suggesting CHC more than HCC. GAD-MRI may provide greater accuracy than CT for distinguishing CHC from HCC. Interobserver agreement can be improved for both CT and MRI by analyzing LI-RADS imaging features.