• 한국방사선학회논문지
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• 제15권1호
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• pp.29-35
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• 2021

본 연구의 목적은 주기적으로 follow up CT를 촬영하는 뇌출혈 환자에게 조영제의 양을 줄임으로써 줄이기 전과 후의 영상의 화질의 차이가 있는지에 관하여 조사하는 것이었고, 줄이기 전과 후의 영상을 검사한 후 MMWP 프로그램을 이용하여 각각의 혈관 위치에 ROI를 설정하여 화질을 평가하였다. 먼저 Rt. CCA, Lt.CCA. Rt.MCA, Lt.MCA, Basilar artery에 각각 ROI를 잡았다. 둘째, 잡은 ROI에 대한 평균값과 표준편차값을 구하였다. 셋째, 구해진 평균값과 표준편차 값을 통하여 SNR과 CNR을 구하였다. 구하여진 SNR값과 CNR값을 T-test 통계를 구한 결과 SNR에 대한 결과 값은 Rt.CCA 0.765, Lt.CCA 0.871, Rt.MCA 0.343, Lt.MCA 0.235, Basilar artery 0.916이며, CNR에 대한 결과 값은 Rt.CCA 0.088, Lt.CCA 0.069, Rt.MCA 0.818, Lt.. MCA 0.579, Basilar artery 0.878로 나타났다. 구해진 SNR값과 CNR값을 통하여 통계를 구한 결과값이 조영제를 줄이기 전과 후의 영상의 화질에 차이가 없는 것으로 나타났다. 따라서 본 연구가 주기적으로 CT검사를 하는 환자들에게 조영제에 대한 부담이 덜어질 수 있는 지표가 되기를 바랍니다.

• 한국방사선학회논문지
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• 제6권5호
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• pp.357-363
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• 2012

본 연구는 두부 컴퓨터 단층 촬영 검사 시 적응식 통계적 반복 재구성법인 알고리즘을 적용하여 노이즈 및 화질평가, 피폭선량의 감소에 대하여 알아보고자 하였다. 두부 CT 검사 시 ASIR를 적용하지 않은 군[A군], ASIR 50 % 적용한군 [B군]으로 나누어 검사하였다. 팬텀연구에서 측정된 CT 노이즈 평균값의 측정결과는 B군이 A군보다 중심부(A)와 주변부(B, C, D)에서 각 각 46.9 %, 48.2 %, 43.2 %, 47.9 %가 감소되었다. 영상화질 평가에서 정량적 분석방법으로 CT 값(number)을 측정하여 잡음(noise) 정도를 분석하였다. 영상 잡음은 A군과 B군 사이에는 통계적으로 유의한 차이가 있었으며, A군이 B군보다 영상 잡음이 유의하게 높았다(group A ;우엽에서 31.87 HU, 좌엽에서 31.78 HU, group B ; 우엽에서 26.6 HU, 좌엽에서 30.42 HU : P<0.05). 영상의 정성적 평가방법으로 두부 임상 영상 평가표에 의해 평가한 결과 80점 만점에 A군의 관찰자 1의 점수는 73.17 점, 관찰자 2의 점수는 74.2 점으로 평가하였으며, B군의 관찰자 1의 점수는 71.77 점, 관찰자 2의 점수는 72.47 점으로 평가하였다. 통계적으로 유의한 차이가 없었으며(P>0.05), 진단에 적절한 영상을 보였다. 피폭선량은 ASIR 50 % 적용하여 검사함으로써 영상의 질적 저하 없이 방사선 피폭선량을 47.6 % 감소 시킬수 있었다. 결론적으로 임상 부위에 ASIR가 적용이 된다면 훨씬 더 적은 선량으로도 검사가 가능할 것으로 사료되며, 검사 시에 검사자가 판단하는데 있어 긍정적인 요인이 될 것으로 사료된다.

• 한국임상수의학회지
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• 제26권5호
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• pp.490-494
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• 2009

A 2-year-old Maltese and a 5-month-old Yorkshire terrier were presented with ataxia. Tetraparesis was observed in a 9-year -old Yorkshire terrier. The localizations of the lesions suggested brain or cervical spinal cord by the neurological examination, and the following images was achieved: radiography, axial images of computed tomography (CT), reconstruction image of CT such as multi-planar reformation(MPR) and 3-dimensional(3D) reconstruction and magnetic resonance imaging (MRI). On radiography, the misalignment between atlas (C1) and axis (C2), absent dens of axis, and increased space between the dorsal arch of C1 and spinous process of C2 were found. The discontinuation between dens and body of C2 was identified through axial CT images, and the fragmentation of dens separated from axis was observed through MPR and 3D image in all case. The hyperintense lesions and the spinal cord compression on T2-weighted MR images were represented in a dog with tetraparesis, the others represented only spinal cord compression. Three dogs were diagnosed as atlantoaxial instability (AAI) by dens fracture of C2. The dog with tetraparesis was euthanized due to guarded prognosis. The others were recovered completely. It is difficult to differentiate dens fracture of C2 from abnormal dens such as agenesis and hypoplasia. We thought that CT is very useful to evaluate the dens of C2 and differentiate the causes of AAI, and the reconstruction images of CT such as MPR and 3D make the translation of the fragmented dens or axis of AAI more precisely evaluate.

• Journal of Korean Neurosurgical Society
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• 제53권3호
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• pp.194-196
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• 2013

Isolated abducens nerve paresis related to ruptured vertebral artery (VA) aneurysm is rare. It usually occurs bilaterally or ipsilaterally to the pathologic lesions. We report the case of a contralateral sixth nerve palsy following ruptured dissecting VA aneurysm. A 38-year-old man was admitted for the evaluation of a 6-day history of headache. Abnormalities were not seen on initial computed tomography (CT). On admission, the patient was alert and no signs reflecting neurologic deficits were noted. Time of flight magnetic resonance angiography revealed a fusiform dilatation of the right VA involving origin of the posterior inferior cerebellar artery. The patient suddenly suffered from severe headache with diplopia the day before the scheduled cerebral angiography. Neurologic examination disclosed nuchal rigidity and isolated left abducens nerve palsy. Emergent CT scan showed high density in the basal and prepontine cistern compatible with ruptured aneurismal hemorrhage. Right vertebral angiography illustrated a right VA dissecting aneurysm with prominent displaced vertebrobasilar artery to inferiorly on left side. Double-stent placement was conducted for the treatment of ruptured dissecting VA aneurysm. No diffusion restriction signals were observed in follow-up magnetic resonance imaging of the brain stem. Eleven weeks later, full recovery of left sixth nerve palsy was documented photographically. In conclusion, isolated contralateral abducens nerve palsy associated with ruptured VA aneurysm may develop due to direct nerve compression by displaced verterobasilar artery triggered by primary thick clot in the prepontine cistern.

• 대한한방내과학회지
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• 제22권4호
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• pp.647-657
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• 2001

In the oriental medicine field, researches have been in progress regarding oriental medical factors. I also carried out a clinical study on stroke, from which I discovered meaningful results about important factors that impact on the prognosis of stroke. We studied 132 patients after diagnosis of stroke through a Brain-CT scan and MRI sea, to the oriental internal medicine department at the Hospital affiliated to Oriental Medical College, Dongeui University. All the patients showed meaningful improvement in the examination of their symptoms after four weeks, compared with the first week. Between strokes involving meridian system and strokes involving internal organs, the symptom of paralysis caused by strokes involving meridian system, which patients were in favorable initial condition, had improved significantly and that by strokes involving internal organs had not. The group whose initial bowel movement since the stroke was delayed, whose coating on the tongue was thick or the tongue was dry, whose pulse was tachycardiac, or who had a history of hypertension or diabetics showed a significantly worse symptom after 4 weeks than that of groups in the opposite cases.

• The Korean Journal of Pain
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• 제18권1호
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• pp.52-55
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• 2005

Complications following a well conducted epidural steroid injection are rare. A 50-year-old man developed a headache and neck stiffness 2 days after a lumbar epidural steroid injection. Under the impression of aseptic meningitis, fluid and nonsteroidal anti-inflammatory drug therapy was started immediately after cerebrospinal fluid (CSF) sampling. The CSF was turbid, and revealed a white blood cell count, protein, glucose and pressure of $550/{\mu}l$ (98% lymphocyte), 107.9 mg/dl, 48 mg/dl (serum 113 mg/dl) and $17cmH_2O$, respectively. The CSF stain and culture, and antibody test and polymerase chain reaction for pathogens were negative. A computed tomography (CT) scan of the brain revealed no abnormality, and a chest roentgenogram and the results of the neurological examination were normal. Under the impression of aseptic meningitis, the condition was managed conservatively, without antibiotics. Seven days later, the clinical symptoms had improved, and the patient discharged.

• 대한한방내과학회지
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• 제19권2호
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• pp.50-59
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• 1998

Background : Vascular dementia occurs mainly due to cerebral vascular disease. So we performed this clinical study to investigate the incidence and characteristics of vascular dementia in stroke patients. Methods : This study was performed on the patients hospitalized from April 1, 1998 to August 31, 1998 at the department of circulatory internal medicine, hospital of Oriental medicine, Kyung-Hee University, and diagnosed cerebral infarction or hemorrhage by Brain CT or MRI. we devided the patients into two groups; vascular dementia group and non dementia group according to MMSE-K(Mini Mental State Examination Korean version), Hasegawa dementia scale. Patients were diagnosed dementia using DSM-IV. We compared general characteristics, stoke types and laboratory findings between the two groups and investigated the correlationship between MMSE-K and Hasegawa dementia scale. Results : Results showed that the incidence of vascular dementia was about 27.8% in stroke patients. The greater number of subjects with dementia were women in the lower educational classes and had lower MBI(Moderfied Bathel Index) scores. Vascular dementia were more common in patients with large brain lesion size($>20cm^3$). There was a positive correlationship between Hasegawa scores and MMSE-K.

• Tuberculosis and Respiratory Diseases
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• 제40권3호
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• pp.301-307
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• 1993

Intravascular bronchioloalveolar tumor is now recognized as a pulmonary form of hemangioendothelioma(HE). HE is an unusual tumor of adult life which is characterized by proliferation of an "epithelioid" or "spindle" endothelial cell. In the lung it usually presents as multiple bilateral slowly growing nodules less than 2 cm in diameter. The aetiology and pathogenesis of this disease are unknown. Spindle cell HE occurs at any age, but approximately one half of patient are 25 years of age or younger and males are affected twice more frequently than females. On light microscopic examination, the tumor show mild cellular atypia, nearly absent mitoses and electron-microscopic studies reveal evidence of endothelial cell differentiation. Intracytoplasmic localization of Factor VIII-related antigen is demonstrated on immunohistochemical study, which confirmed the endothelial origin of the tumor. No effective therapy is yet known for HE, but survival of this tumor can be quite long. However, one half of the patient have died, usually of progressive pulmonary insufficiency. This 19-yr-old male complained of Rt. chest pain and intermittent hemoptysis. Simple chest film and chest CT scan showed the Rt. pleural effusion, variable sized bilateral pulmonary nodules, irregular large heterogenous tumor with well enhancement and extensive necrosis in the anterior mediastinum. The mediastinal mass was biopsied and diagnosed as spindle cell HE by light microscopic finding and immunohistochemical studies.

• 대한한방내과학회지
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• 제21권1호
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• pp.39-45
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• 2000

Object : SPECT which can visualize the distribution of CBF was operated to find the basic evidence by objective and scientific inspection on the fact that how the oriental medical treatment for stroke patients can effect CBF. Method : This study made 18 cases an object of research. These patients came to the Dongshin Univ. Oriental Medical Hospical within 5 days from the first attack, were diagnosed as stroke from Brain CT and MAl and were in the hospital for over 4 weeks at least. They were taken acupunture treatment, negative technique and herbal medication. And this study operated SPECT at the instance of admission and at the 4th week after admission 2 times and compared the change of CBF. Results : I operated SPECT on 18 CVA patients and got a result on the change of blood supplies in brain as follows; In the 2nd SPECT compared with 1st, out of the 1st and 2nd SPECT, there are 10 cases(55.6%) of increase and 8 cases (44.4%) of decrease. According to L/Cb11 evauation standard, the 1 st and the 2nd changes of blood supplies in SPECT shows decrese from $0.830{\pm}0.071$ to $0.801{\pm}0.067$. On the other hand, according to L/C standard shows a minute increase from $0.894{\pm}0.079$ to $0.895{\pm}0.091$. But there is nothing meaningful. I treated patients' group with risk factors and the other patients' group without risk factors and observed the changes of blood supplies respectively. And therefore Patients' group without risk factors shows an meaningful increase of blood supplies from $0.835{\pm}0.076$ to $0.796{\pm}0.069$ L/Cbll and also an increase from $0.921{\pm}0.029$ to $0.939{\pm}0.029$ by L/C. But this result by L/C is not significant. Conclusion : As mentioned above, I treated CVA patients through oriental medical therapies using SPECT and researched the changes of blood supplies in their brains. But I could' t get any meaningful result. However, I think only after solving some problems in this treatment and quantifing the changes of blood supplies, this results can be the standard of scientific examination about oriental medical treatments.

• 대한핵의학회지
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• 제30권4호
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• pp.476-483
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• 1996

임상적으로 뇌종양과 방사선 치료 후 발생한 괴사의 감별은 매우 중요한 문제이다. 그러나 임상 증상이나 방사선학적 소견으로 양자를 감별하는 것은 매우 어렵다. 이에 저자 등은 방사선 치료 후 재발과 괴사를 감별하는데 있어 T1-201 SPECT의 역할을 알아보고자 하였다. 대상은 뇌종양으로 진단 받고 개두술 및 방사선 치료나 감마 나이프 수술을 받은 후 증상의 악화로 내원하여 T1-201 SPECT를 시행한 환자 중 조직학적으로 확진된 20명으로 하였다. T1-201 SPECT는 일단 육안적으로 비정상적 탈륨 섭취 여부를 판별한 다음 비정상적 탈륨 섭취가 있는 경우에 한하여 탈륨 섭취 지수를 구하여 2.5이상인 경우를 종양의 재발로 간주하였으며, 병리조직 소견과 비교하였다. 재수술 또는 조직검사상 20명중 16명이 재발 또는 양성종양의 악성전환으로 나타났으며, T1-201 SPECT 상에서는 18명에서 2.5이상의 높은 탈륨 섭취 지수로 종양 양성이었다. 17예에서 일치를 보였는데 진양성 15예, 진음성 2예였고, 3예에서 불일치를 보였는데 모두 위양성이었다. 조직소견을 기준으로한 예민도, 특이도, 양성 예측율 및 음성 예측율은 각각 100%, 40%, 83%, 100%였다. 결론적으로 뇌종양의 방사선 치료 후 재발과 괴사를 감별하는데 있어 T1-201 SPECT는 높은 예민도와 음성 예측율을 갖는 유용한 검사이다. 상대적으로 낮은 특이도는 조직병리 검사를 시행함에 있어 표본선택오차와 임상가의 검사의뢰 편견이 있을 수 있음을 고려하여 좀 더 많은 수의 환자를 대상으로 한 연구가 있어야 할 것이다.