• 대한한방내과학회지
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• 제44권5호
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• pp.1071-1082
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• 2023

Objective: The purpose of this study is to report the efficacy of using Korean medicine treatment with cold hypersensitivity of the hands and feet with lumbar spinal herniated intervertebral disc. Case presentation: We used Korean medicine treatment (Gyejigabuja-tang, acupuncture) to treat a hospitalized patient with cold hypersensitivity of the hands and feet with lumbar spinal herniated intervertebral disc. To evaluate the treatment, we used the Numerical Rating Scale (NRS). The degree of cold hypersensitivity of the hands and feet was also evaluated using evaluation paper. The generic health status was measured using the European Quality of Life-5 Dimensions (EQ-5D) scale. The 31-year-old female underwent 13 days of inpatient treatment. Her pattern identification was that both hands and feet are cold (BiYangHeo) types. The treatments were herbal medicine and acupuncture. She took Gyejigabuja-tang for 13 days. She also received acupuncture for 20 minutes twice a day at LI11 (曲池), L14 (合谷), TE5 (外關) on her hands, LR3 (太衝), SP6 (三陰交), SP9 (陰陵泉) ST36 (足三里), GB41 (足臨泣) on Feet, GV4 (命門), GV3 (腰陽關), BL23 (腎兪), BL24 (氣海兪), BL25 (大腸兪), and BL26 (關元兪) on the low back. After 2 weeks of treatment, the NRS scale of her cold hypersensitivity of hands and feet symptoms dropped from NRS 7 to NRS 3, and her low back pain dropped from NRS 6 to NRS 3. Her cold hypersensitivity of hands and feet evaluation paper score decreased from 64 to 32, and her EQ-5D increased from 0.487 to 0.681. After the end of treatment, continued symptom improvements and no significant side effects were confirmed. Results: These findings suggest that Korean medical treatment (Gyejigabuja-tang, acupuncture) may be effective for treating cold hypersensitivity of hands and feet with lumbar spinal herniated intervertebral disc. The NRS, evaluation paper, and EQ-5D scores improved after treatment, with no side effects.

• Korean Journal of Radiology
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• 제21권10호
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• pp.1178-1186
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• 2020

Objective: To evaluate the incidence and risk factors of emetic complications associated with the intravenous administration of low-osmolality iodinated contrast media (ICM) in children undergoing computed tomography (CT). Materials and Methods: All children who underwent contrast-enhanced CT between April 2017 and July 2019 were included. Pediatric patients were instructed on the preparative dietary protocol at our institution. Experienced nurses in the radiology department monitored the children during the CT scans and recorded any emetic complications in their electronic medical records. These data were used to calculate the incidence of emetic complications. Various patient factors and technical factors, including fasting duration, the type and volume of ICM, and ongoing chemotherapy, were evaluated to identify risk factors for emetic complications using univariate and multivariate logistic regression analyses. Results: Among the 864 children (mean age, 8.4 ± 5.7 years) evaluated, 18 (2.1%) experienced emetic complications (6 experienced nausea only and 12 experienced nausea and vomiting). None of the children developed aspiration pneumonia. The mean fasting duration of patients with emesis was 7.9 ± 5.7 hours (range, 3-21 hours), whereas that of patients without nausea was 8.7 ± 5.7 hours (range, 0-24 hours). Fasting duration was not associated with the development of nausea and vomiting (p = 0.634). Multivariate logistic regression analysis revealed that ongoing chemotherapy (odds ratio [OR] = 4.323; 95% confidence interval [CI] = 1.430-13.064; p = 0.009), iomeprol use (OR = 7.219; 95% CI = 1.442-36.146; p = 0.016), and iohexol use (OR = 5.241; 95% CI = 1.350-20.346; p = 0.017) were independent risk factors for emetic complications. Conclusion: Only a small proportion (2.1%) of children experienced nausea or vomiting after exposure to low-osmolality ICM. Many children underwent excessive fasting; however, fasting duration was not associated with nausea and vomiting. Moreover, ongoing chemotherapy and the use of iomeprol or iohexol were identified as potential risk factors for emetic complications in children.

• Korean Journal of Radiology
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• 제24권4호
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• pp.338-348
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• 2023

Objective: Patients with a history of ischemic stroke are at risk for a second ischemic stroke. This study aimed to investigate the relationship between carotid plaque enhancement on perfluorobutane microbubble contrast-enhanced ultrasonography (CEUS) and future recurrent stroke, and to determine whether plaque enhancement can contribute to risk assessment for recurrent stroke compared with the Essen Stroke Risk Score (ESRS). Materials and Methods: This prospective study screened 151 patients with recent ischemic stroke and carotid atherosclerotic plaques at our hospital between August 2020 and December 2020. A total of 149 eligible patients underwent carotid CEUS, and 130 patients who were followed up for 15-27 months or until stroke recurrence were analyzed. Plaque enhancement on CEUS was investigated as a possible risk factor for stroke recurrence and as a possible adjunct to ESRS. Results: During follow-up, 25 patients (19.2%) experienced recurrent stroke. Patients with plaque enhancement on CEUS had an increased risk of stroke recurrence events (22/73, 30.1%) compared to those without plaque enhancement (3/57, 5.3%), with an adjusted hazard ratio (HR) of 38.264 (95% confidence interval [CI]:14.975-97.767; P < 0.001) according to a multivariable Cox proportional hazards model analysis, indicating that the presence of carotid plaque enhancement was a significant independent predictor of recurrent stroke. When plaque enhancement was added to the ESRS, the HR for stroke recurrence in the high-risk group compared to that in the low-risk group (2.188; 95% CI, 0.025-3.388) was greater than that of the ESRS alone (1.706; 95% CI, 0.810-9.014). A net of 32.0% of the recurrence group was reclassified upward appropriately by the addition of plaque enhancement to the ESRS. Conclusion: Carotid plaque enhancement was a significant and independent predictor of stroke recurrence in patients with ischemic stroke. Furthermore, the addition of plaque enhancement improved the risk stratification capability of the ESRS.

• Korean Journal of Radiology
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• 제24권4호
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• pp.294-304
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• 2023

Objective: We aimed to investigate whether image standardization using deep learning-based computed tomography (CT) image conversion would improve the performance of deep learning-based automated hepatic segmentation across various reconstruction methods. Materials and Methods: We collected contrast-enhanced dual-energy CT of the abdomen that was obtained using various reconstruction methods, including filtered back projection, iterative reconstruction, optimum contrast, and monoenergetic images with 40, 60, and 80 keV. A deep learning based image conversion algorithm was developed to standardize the CT images using 142 CT examinations (128 for training and 14 for tuning). A separate set of 43 CT examinations from 42 patients (mean age, 10.1 years) was used as the test data. A commercial software program (MEDIP PRO v2.0.0.0, MEDICALIP Co. Ltd.) based on 2D U-NET was used to create liver segmentation masks with liver volume. The original 80 keV images were used as the ground truth. We used the paired t-test to compare the segmentation performance in the Dice similarity coefficient (DSC) and difference ratio of the liver volume relative to the ground truth volume before and after image standardization. The concordance correlation coefficient (CCC) was used to assess the agreement between the segmented liver volume and ground-truth volume. Results: The original CT images showed variable and poor segmentation performances. The standardized images achieved significantly higher DSCs for liver segmentation than the original images (DSC [original, 5.40%-91.27%] vs. [standardized, 93.16%-96.74%], all P < 0.001). The difference ratio of liver volume also decreased significantly after image conversion (original, 9.84%-91.37% vs. standardized, 1.99%-4.41%). In all protocols, CCCs improved after image conversion (original, -0.006-0.964 vs. standardized, 0.990-0.998). Conclusion: Deep learning-based CT image standardization can improve the performance of automated hepatic segmentation using CT images reconstructed using various methods. Deep learning-based CT image conversion may have the potential to improve the generalizability of the segmentation network.

• Korean Journal of Radiology
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• 제23권9호
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• pp.901-910
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• 2022

Objective: This study aimed to assess the technical feasibility, efficacy, and safety of the safe triangular working zone (STWZ) approach applied in percutaneous vertebroplasty (PV) for spinal metastases involving the posterior part of the vertebral body. Materials and Methods: We prospectively enrolled 87 patients who underwent PV for spinal metastasis involving the posterior part of the vertebral body, with or without the STWZ approach, from January 2019 to April 2022. Forty-nine patients (27 females and 22 males; mean age ± standard deviation [SD], 57.2 ± 11.6 years; age range, 31-76 years) were included in group A (with STWZ approach), accounting for 54 vertebrae. Thirty-eight patients (18 females and 20 males; 59.1 ± 10.9 years; 29-81 years) were included in group B (without STWZ approach), accounting for 57 vertebrae. Patient demographics, procedure-related variables, and pain relief as assessed using the visual analog scale (VAS) were collected at different time points. Tumor recurrence in the vertebrae after PV was analyzed using Kaplan-Meier curves. Results: The STWZ approach was successful from T1 to L5 without severe complications. Cement filling was satisfactory in 47/54 (87.0%) and 25/57 (43.9%) vertebrae in groups A and B, respectively (p < 0.001). Cement leakage was not significantly different between groups A and B (p = 1.000). Mean VAS score ± SD before and 1 week and 1, 3, 6, 9, and 12 months after PV were 7.6 ± 1.8, 4.2 ± 2.0, 2.7 ± 1.9, 1.9 ± 1.5, 1.7 ± 1.4, 1.7 ± 1.1, and 1.6 ± 1.3, respectively, in group A and 7.2 ± 1.7, 4.0 ± 1.3, 3.4 ± 1.6, 2.4 ± 1.2, 1.8 ± 1.0, 1.4 ± 0.5, and 1.7 ± 0.9, respectively, in group B. Kaplan-Meier analysis showed a lower tumor recurrence rate in group A than in group B (p = 0.001). Conclusion: The STWZ approach may represent a new, safe, alternative/auxiliary approach to target the posterior part of the vertebral body in the PV for spinal metastases.

• Korean Journal of Radiology
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• 제22권7호
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• pp.1044-1053
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• 2021

Objective: Motion-corrected averaging with a single-shot technique was introduced for faster acquisition of late-gadolinium-enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging while free-breathing. We aimed to evaluate the image quality (IQ) of free-breathing motion-corrected single-shot LGE (moco-ss-LGE) in patients with hypertrophic cardiomyopathy (HCM). Materials and Methods: Between April and December 2019, 30 patients (23 men; median age, 48.5; interquartile range [IQR], 36.5-61.3) with HCM were prospectively enrolled. Breath-held single-shot LGE (bh-ss-LGE) and free-breathing moco-ss-LGE images were acquired in random order on a 3T MR system. Semi-quantitative IQ scores, contrast-to-noise ratios (CNRs), and quantitative size of myocardial scar were assessed on pairs of bh-ss-LGE and moco-ss-LGE. The mean ± standard deviation of the parameters was obtained. The results were compared using the Wilcoxon signed-rank test. Results: The moco-ss-LGE images had better IQ scores than the bh-ss-LGE images (4.55 ± 0.55 vs. 3.68 ± 0.45, p < 0.001). The CNR of the scar to the remote myocardium (34.46 ± 11.85 vs. 26.13 ± 10.04, p < 0.001), scar to left ventricle (LV) cavity (13.09 ± 7.95 vs. 9.84 ± 6.65, p = 0.030), and LV cavity to remote myocardium (33.12 ± 15.53 vs. 22.69 ± 11.27, p < 0.001) were consistently greater for moco-ss-LGE images than for bh-ss-LGE images. Measurements of scar size did not differ significantly between LGE pairs using the following three different quantification methods: 1) full width at half-maximum method; 23.84 ± 12.88% vs. 24.05 ± 12.81% (p = 0.820), 2) 6-standard deviation method, 15.14 ± 10.78% vs. 15.99 ± 10.99% (p = 0.186), and 3) 3-standard deviation method; 36.51 ± 17.60% vs. 37.50 ± 17.90% (p = 0.785). Conclusion: Motion-corrected averaging may allow for superior IQ and CNRs with free-breathing in single-shot LGE imaging, with a herald of free-breathing moco-ss-LGE as the scar imaging technique of choice for clinical practice.

• 한국지리정보학회지
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• 제13권4호
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• pp.111-124
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• 2010

지표면의 환경변화를 관측하는 것은 토지사용과 기후변화, 기상연구, 농업, 지표면의 에너지 균형 및 환경시스템에 매우 중요한 연구로 이용되어지고 있다. 최근 위성영상을 이용한 변화탐지는 국지 단위 환경변화 탐지를 위해 그 필요성이 높아지고 있는 실정이며, 특히 잦은 개발과 변화로 주기적인 탐지가 필요한 도심지역의 변화탐지는 국토환경변화 및 지역계획 연구에 대한 효율적인 의사결정 지원이 가능하므로 그 활용성이 매우 높아지고 있다. 이러한 배경으로, 위성 영상을 이용한 원격탐사 자료를 활용한 분석은 비교적 짧은 시간에 광범위한 지역의 영상 정보를 취득할 수 있기 때문에 국토 환경변화 관리 분야에서의 적용 가능성이 높다. 본 연구에서는 인공위성 자료를 활용하여 변화탐지를 수행할 때 공간정보 추출의 정확성을 높이는 기술 개발을 위해 시계열자료의 통계적 분석을 통한 변화탐지기법 개발을 수행하였다. 전처리된 자료를 이용하여 정규화 식생지수를 산출하고 K-mean clustering 무감독 분류를 통해 처리된 데이터를 연구영역의 10년간 자료를 이용한 평균 정규화 식생지수 값과 표준편차 값을 계산하여 각각의 화소별 상대적인 변화량을 측정하여 변화 정도를 탐지하였다. 일반적으로 변화 탐지 수행 시, 태양광 채널을 이용할 경우 기하학적 특성에 의해 발생하는 방향성 효과를 보정하여야 한다. 본 연구에서는 대기 보정과 방향성 보정이 수행된 중 저해상도 정규화 식생지수를 이용하여 객관적인 변화 임계치 값을 결정하였다. 연구결과 반사도 값의 차이를 이용한 변화탐지보다 객관적이고 명확하게 변화지역을 탐지할 수 있었다.

• Journal of Acupuncture Research
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• 제21권4호
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• pp.177-196
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• 2004

Objective : Rheumatoid arthritis is an autoimmune disease that pathogenesis is not fully understood and one of the most intractable musculoskeletal diseases. The concern in the immunopathogenesis of rheumatoid arthritis has been increased since 1980's and many immunotherapeutic agents including disease-modifying antirheumatic drugs (DMARDs) were developed and became the mainstay of treatment of rheumatoid arthritis. However, the cure of the disease has hardly been achieved. In oriental medicine, rheumatoid arthritis is related to Bi-Zheng(痺證), that presents pain, swelling, andlor loss of joint function as major clinical manifestations, and also known to be deeply involved in suppression of immune function related to weakness of Jung-Ki(正氣). The herbal medicine, empirically used, could be a potential resource of development of new immunotherapeutic agents for rheumatoid arthritis. Methods : We developed a search strategy using terms to include "rheumatoid arthritis and herbal medicine" combined with "Chinese medicine" and/or "Oriental medicine". The search was focused on experimental studies of herbal medicine (January 1999 to May 2004), which is known to have effects on immune function of patients with rheumatoid arthritis. Computerized search used Internet databases including KISS and RISS4U (Korea), CNKI (China), MOMJ (Main Oriental Medicine Journal, Japan), and PubMed. The articles were selected from journals of universities or major research institutes. Results : The literature search for experimental studies on effects of herbal medicine on immunity of rheumatoid arthritis retrieved a total of 21 articles (Korea; 8, China ; 12, Japan ; 1). Of 21 articles, 10 were related to single-drug formula, 2 to drug interaction, and 9 to multi-drug formula. Single-drug formula was mainly used for aqua-acupuncture and researches on active components. Studies of drug interaction emphasized harmony of Ki-Hyul(氣血) and balance of Han-Yeul(寒熱). Multi-drug regimen was mainly found among formulas for Bo-Ki-Hyul(補氣血) and Bo-Sin(補腎). Conclusion : Studies on rheumatoid arthritis were performed both in vitro and in vivo in vitro study, LPS-stimulated splenocytes and synoviocytes were treated with herbal medicine, resulting in proliferation and activation of immune cells and suppression of cytokine activities in vivo study CIA animal model demonstrated that herbal medicine decreased antibody production and improved function of immune cells. In cellular and molecular study herbal medicine showed profound effects on the level of mRNA expression of certain cytokines related to immune function. This study revealed that herbal medicine has significant immune modulatory action and could be used for recovery of immune dysfunction of rheumatoid arthritis patients.

• 한국토양비료학회지
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• 제45권6호
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• pp.1173-1178
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• 2012

논에서 온실가스 배출에 영향을 주는 가장 큰 요인인 물관리를 통하여 온실가스 감축효과를 파악하고자, 춘천시 신북읍 천전리에 위치한 강원대학교 벼 시험포장에서 메탄과 아산화질소 배출 시험을 수행하였다. 벼 재배에서 상시담수, 간단관개 (중간낙수 1회 처리, 6월 11일~6월 20일) 그리고 SRI 물 관리 농법 처리 등을 조성하여 수량, 쌀의 품질, 온실가스 배출량 비교 및 온실가스 감축효과를 조사한 결과는 다음과 같다. 1. 물 관리별 벼 수량은 SRI 처리에서 $6,341kg\;ha^{-1}$로 가장 수량이 높았으며, 상시담수 (CF)에 비해 간단관개(ID)와 SRI 처리에서 각각 13.8%와 11.3% 증수되었다. 2. 재배기간 중 시기별 용수 사용량은 상시담수 처리가 $46.6m^3$, 간단관개 $39.5m^3$, SRI 물 관리 $24.5m^3$로 나타나, 상시담수 대비 각각 15.2% (간단관개), 47.4% (SRI)의 농업용수를 절감한 것으로 나타났다. 3. 벼 재배기간 온실가스 총 배출량을 지구온난화잠재력(GWP)으로 환산한 결과, 상시담수에 비해 간단관개가 65.5%, 그리고 SRI 물 관리 농법은 71.8%의 온실가스 감축효과가 있는 것으로 나타났다.

• Journal of Acupuncture Research
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• 제22권1호
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• pp.77-90
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• 2005

신경병리성 동통이 유발된 백서에 대하여 위중(委中), 후계(後谿), 위중배후계(委中配後谿) 전월(電鉞) 및 침자(鍼刺)가 물리적 이질통, 냉각 이질통, c-Fos 단백발현과 AchE 발 현 등에 미치는 영향을 측정한 결과 다음과 같은 결론을 얻었다. 1. 물리적 이질통 반응에 있어서는 Control군에 비해 전침(電鍼)군에서는 EA-BL40 +SI03군이, 침자(鍼刺)군에서는 AC-SI03군이 모두 6일째에 유의하게 감소하였다. 2. 냉각 이질통 반응에 있어서는 Control군에 비해 전침(電鍼)군에서는 EA-Sl03군과 EA-BI40+ SI03군이, 침자(鍼刺)군에서는 AC-Sl03군이 모두 6 일째에 유의하게 감소하였다. 3. Periaqeductal gray(PAG) 부위의 c-Fos 단백 발현에 있어서는 Control군에 비해 전침(電鍼)군에서는 EA-BL40+SI03군이, 침자(鍼刺)군에서는 AC-SI03군이 유의한 감소를 보였다. 4. Periaqeductal gray(PAG) 부위의 AchE 발현에 있어서는 Control군에 비해 전침(電鍼)군에서는 EA-BL40+SI03군이, 침자(鍼刺)군에서는 AC-SI03 군이 유의한 감소를 보였다.