• 한방안이비인후피부과학회지
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• 제11권1호
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• pp.300-318
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• 1998

Background : The vasoreactivity of cerebral artery is currently the subject of increasing interest. Transcranial Doppler Sonography(TCD) is an accurate method of monitoring the blood flow velocities of the cerebral artery. We wished to assess the vasoreactivity between age-matched normal and cerebral infarction group. Method : We performed TCD findings in 40 normals and 20 cb-inf. subjects who arrived at hospital during 48 hours after attack. The former were devided into twenties normal group and fifties normal group. Result : 1. Fibrinogen levels showed significant changes between age-matched normal and cb-inf. group. 2. $V^{MEAN}$ of the both side Carotid Siphon during rest state increased significantly in cb-inf. group as compared with the age-matched normal group. 3. $V^{MEAN}and\;V^{MAX}$ of the both side carotid siphon during breath-hold state increased significantly in cb-inf. group as compared with the age-matched normal group. 4. Vasoreactivity of cerebral artery increased significantly in cb-inf. group as compared with the age-matched normal group. 5. $V^{MEAN}and\;V^{MAX}$ of the both side Radial artery during heat-stimuration state increased significantly in cb-inf. group as compared with the age-matched normal group. 6. Vasoreactivity of Radial artery increased significantly in cb-inf. group as compared with the age-matched normal group.

• Journal of Chest Surgery
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• 제13권3호
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• pp.212-218
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• 1980

A severe crushing injury of the chest produce a very striking syndrome referred to as traumatic asphyxia. This syndrome is characterized by bluish-red discoloration of the skin which is limited to the distribution of the valveless veins of the head and neck. And also if it is characterized by bilateral subconjunctival hemorrhages and neurological manifestations. But these clinical entities faded away progressively in a few weeks. Apporximately 90% of the patients who live for more than a few hours will recover from traumatic asphyxia when it occurs as a single entity. And so, death results from either severe associated injuries of from subsequent infection, rather than from pulmonary or cardiac insufficiency in traumatic asphyxia. We have experienced 4 cases of traumatic asphyxia with severe crushing thoracic injuries at department of the chest surgery, Captial Armed forces General Hospital during about 3 years from April 1977 to Aug. 1980. The 1st 22 year-old male was struct 2$\frac{1}{2}$ ton truck on the road and was transferred to this hospital immediately. He had taken tracheostomy due to severe dyspnea with contusion pneumonia and for removal of a large amount of bronchial secretion. The 2nd case was 23 year-old male who was got buried in a chasm. In this case, the heavy metal post tumbled over him back while at work. The 3rd case was 39 year-old male who leapt out of a window in 5th story while fire broke out in living room by oil stove heating. He had multiple rib fracture with right hemothor x and right colle's fracture and pelvic bone fracture. The last 22 year-old male was run over by a gun carriage. The wheel of this gun carriage passed over his thorax and right chin. He was brought to this hospital by helicopter. when he was first examined at emergency room, he was in semicomatose state and has pneurmomediastinum with multiple rib fracture and severe subcutaneous emphysema. As soon as he arrived, bilateral closed thoracostomy was performed and cardiopulmonary resuscitation was done. In hospital 8th weeks, chest series showed fibrothorax in right side even if chest wall stabilized. All 4 cases had multiple petechiae over their facees and chest and bilateral subconjunctival hemorrhages referred to as traumatic asphyxia. 3 cases except one case who received splenectomy, had been suffered from contusion pneumonia and had been treated with respiratory care. In these 3 cases, they had warning of impending injury before accident, and took a deep breath hold it and braces himself. And also, even if he had not impending fear in remaining one case, he had taken a deep breath and had got valsalva maneuver for pulling off the heavy metal post. Intrathoracic pressure rose suddenly and resulted to traumatic asphyxia in this situation. All these cases were recovered completely without sequelae except one fibrothorax, right.

• 대한방사선기술학회지:방사선기술과학
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• 제41권3호
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• pp.193-199
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• 2018

The purpose of this study was to evaluate the convenience and image quality of patients with acute lumbar pain patients at a general hospital in Daejeon using ancillary devices for postural changes and correction. The results of the study are summarized as follows. First, the Turbo S pin Echo technique(TS E) using ancillary equipment has the highest image evaluation rating with an average score of 4.440, which is highly valuable on a diagnosis. Second, the average score for patient the questionnaire 'When using ancillary equipment, I feel that my body is calibrated to side without bias.' was shown as 4.440, which is very useful for the correction of the patient's body when using ancillary equipment. Finally, Breath Hold technique(BH) is very effective in shortening test time of acute lumbar pain patients, because it can reduce test time 86.4% faster than Turbo Spin Echo technique(TSE). The results of the study showed that the use of ancillary equipment to perform the test through the side lying postures helped to reduce the pain and control the patient's breathing, and the diagnostic value of the image was high.

• Physical Therapy Rehabilitation Science
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• 제9권1호
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• pp.25-35
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• 2020

Objective: To compare the effects of joint mobilization, gym ball exercises, and breathing exercises on breathing pattern disorders and joint position sense in persons with chronic lower back pain. Design: Three-group pretest-posttest design. Methods: Thirty-six individuals with chronic low back pain who were undergoing a postural correction and vertebral movement at a rehabilitation center participated in this study. The subjects were randomly divided into the joint mobilization group (n=12), gym ball exercises group (n=12), and the breathing exercises group (n=12). The exercises were applied for 40 minutes a day, twice a week for a total of 12 weeks. Measurement tools included the end-tidal CO₂ (ETCO₂), respiration rate (RR), breath hold time, Nijmegen Questionnaire (NQ), excursion, and joint position error (JPE). Results: The groups showed significant differences in the ETCO₂, RR, NQ, Excursion and JPE test before and after the intervention (p<0.05). The differences between the groups were significant in the group that received the gym ball and breathing exercises in ETCO₂ and RR (p<0.05). The differences between the groups were most significant in the group that received breathing exercises in NQ and excursion (p<0.05). The differences between the groups were significant in the group that received the gym ball and breathing exercises in JPE Lt. and Rt. (p<0.05). Conclusions: All three interventions had a significant impact on the biomechanical changes, respiratory variables, and joint position sense in participants with chronic lower back pain. Breathing exercises were found to be particularly effective in improving respiratory parameters.

• Korean Journal of Radiology
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• 제1권3호
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• pp.152-158
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• 2000

Objective: The purpose of this study was to compare the effectiveness of MR urography (MRU) with that of ultrasonography (US) in the evaluation of urinary tract when this failed to opacify during excretory urography (EXU). Materials and Methods: Twelve urinary tracts in 11 patients were studied. In each case, during EXU, the urinary system failed to opacify within one hour of the injection of contrast media, and US revealed dilatation of the pelvocalyceal system. Patients underwent MRU, using a HASTE sequence with the breath-hold technique; multi-slice acquisition was then performed, and the images were reconstructed using maximal intensity projection. Each set of images was evaluated by three radiologists to determine the presence, level, and cause of urinary tract obstruction. Results: Obstruction was present in all twelve cases, and in all of these, MRU accurately demonstrated its level. In this respect, however, US was successful in only ten. The cause of obstruction was determined by MRU in eight cases, but by US in only six. In all of these six, MRU also successfully demonstrated the cause. Conclusion: MRU is an effective modality for evaluation of the urinary tract when this fails to opacify during EXU, and appears to be superior to US in demonstrating the level and cause of obstruction.

• Journal of Cardiovascular Imaging
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• 제31권2호
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• pp.71-82
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• 2023

BACKGROUND: Cardiac magnetic resonance fingerprinting (cMRF) enables simultaneous mapping of myocardial T1 and T2 with very short acquisition times. Breathing maneuvers have been utilized as a vasoactive stress test to dynamically characterize myocardial tissue in vivo. We tested the feasibility of sequential, rapid cMRF acquisitions during breathing maneuvers to quantify myocardial T1 and T2 changes. METHODS: We measured T1 and T2 values using conventional T1 and T2-mapping techniques (modified look locker inversion [MOLLI] and T2-prepared balanced-steady state free precession), and a 15 heartbeat (15-hb) and rapid 5-hb cMRF sequence in a phantom and in 9 healthy volunteers. The cMRF_5-hb sequence was also used to dynamically assess T1 and T2 changes over the course of a vasoactive combined breathing maneuver. RESULTS: In healthy volunteers, the mean myocardial T1 of the different mapping methodologies were: MOLLI 1,224 ± 81 ms, cMRF_15-hb 1,359 ± 97 ms, and cMRF_5-hb 1,357 ± 76 ms. The mean myocardial T2 measured with the conventional mapping technique was 41.7 ± 6.7 ms, while for cMRF_15-hb 29.6 ± 5.8 ms and cMRF_5-hb 30.5 ± 5.8 ms. T2 was reduced with vasoconstriction (post-hyperventilation compared to a baseline resting state) (30.15 ± 1.53 ms vs. 27.99 ± 2.07 ms, p = 0.02), while T1 did not change with hyperventilation. During the vasodilatory breath-hold, no significant change of myocardial T1 and T2 was observed. CONCLUSIONS: cMRF_5-hb enables simultaneous mapping of myocardial T1 and T2, and may be used to track dynamic changes of myocardial T1 and T2 during vasoactive combined breathing maneuvers.

• Korean Journal of Radiology
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• 제2권1호
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• pp.21-27
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• 2001

Objective: To identify and evaluate the lateral border zone by comparing the size and distribution of the abnormal signal area demonstrated by MR imaging with the infarct area revealed by pathological examination in a reperfused myocardial infarction cat model. Materials and Methods: In eight cats, the left anterior descending coronary artery was occluded for 90 minutes, and this was followed by 90 minutes of reperfusion. ECG-triggered breath-hold turbo spin-echo T2-weighted MR images were initially obtained along the short axis of the heart before the administration of contrast media. After the injection of Gadomer-17 and Gadophrin-2, contrast-enhanced T1-weighted MR images were obtained for three hours. The size of the abnormal signal area seen on each image was compared with that of the infarct area after TTC staining. To assess ultrastructural changes in the myocardium at the infarct area, lateral border zone and normal myocardium, electron microscopic examination was performed. Results: The high signal area seen on T2-weighted images and the enhanced area seen on Gadomer-17-enhanced T1WI were larger than the enhanced area on Gadophrin-2-enhanced T1WI and the infarct area revealed by TTC staining; the difference was expressed as a percentage of the size of the total left ventricle mass (T2= 39.2 %; Gadomer-17 =37.25 % vs Gadophrin-2 = 29.6 %; TTC staining = 28.2 %; p < 0.05). The ultrastructural changes seen at the lateral border zone were compatible with reversible myocardial damage. Conclusion: In a reperfused myocardial infarction cat model, the presence and size of the lateral border zone can be determined by means of Gadomer-17- and Gadophrin-2-enhanced MR imaging.

• 대한방사선기술학회지:방사선기술과학
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• 제32권1호
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• pp.101-106
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• 2009

본 연구는 FLASH 펄스파형을 이용하여 숙임각(flip angle ; FA)변화에 따른 T1 강조영상의 신호강도(signal intensity ; SI)와 대조도 대 잡음비(contrast to noise ratio ; CNR)를 비교함으로써 복부검사에서의 최적의 T1효과를 나타내기 위한 FA를 알아보고자 하였다. 2008년 9월부터 12월까지 본원을 내원하여 복부 MRI 검사를 시행한 환자 20명(남 : 12명, 여 : 8명, 연령 범위 : $28{\sim}63$세, 평균 : 51세)을 대상으로 하였다. 영상 장비는 3Tesla MR scanner(Magnetom Tim Trio, SIEMENS, Germany)였으며, 8 channel body array coil을 사용하였다. 사용된 영상변수는 FLASH 펄스파형과 TR : 120 ms, TE : minimum, FOV : $360{\times}300\;mm$, Matrix : $256{\times}224$, Slice : 6 mm, scan time : 15초로 Breath-hold 기법을 이용하였다. 복부 영상은 물 신호를 동시에 측정하기 위해 관심영역(FOV) 안에 물을 채운 50 ml syringe를 놓고 $10^{\circ}$부터 $90^{\circ}$까지 $10^{\circ}$ 간격으로 FA에 변화를 주면서 얻었다. 획득한 영상은 간(liver), syringe내부의 물(water), 비장(spleen), background의 신호강도(SI)와 대조도 대 잡음비(CNR)를 각각 측정하였으며 신호강도는 관심영역을 설정한 다음 각 부위에서 3번씩 측정하고 그 평균값을 구하였다. 영상 전체의 평가에서는 변이계수(coefficient of variation)를 적용하여 전체영상의 신호강도 균일도를 알아보았고 통계 분석은 SPSS for window version 17.0을 이용하였다. 간(liver)의 신호강도는 $475.54{\pm}81.76$으로 FA $40^{\circ}$에서 가장 높게 나타났으며 syringe내부의 물의 신호는 $475.97{\pm}68.98$로 FA $20^{\circ}$에서 가장 높았으며 FA가 높아짐에 따라 다른 조직의 신호보다 많은 감소를 보였다. 비장의 신호는 $443.02{\pm}55.77$로 FA $30^{\circ}$에서 가장 높은 신호강도를 보였으며 FA가 높아짐에 따라 신호가 감소하였다. 조직의 신호강도에서 Liver vs Water와 Liver vs Spleen은 FA $30^{\circ}$를 제외한 전 구간에서 통계적으로 유의한 차이를 보였고 Water vs Spleen은 FA $60^{\circ}$, FA $70^{\circ}$, FA $80^{\circ}$에서만 유의한 차이를 보였다(p < 0.01). 전체영상의 신호강도는 $175.42{\pm}57.93$으로 FA $10^{\circ}$에서 가장 낮게 나타났으며 FA가 높아짐에 따라 증가하다가 떨어지는 양상을 보였다. 또한 변이계수(coefficient of variation)는 FA $10^{\circ}$와 FA $20^{\circ}$에서 33.02와 31.43으로 가장 높게 나타났다. FA $10^{\circ}$와 FA $20^{\circ}$는 전체영상의 신호강도 균일도가 다소 떨어지는 영상으로 왜곡이 심하게 나타났다. CNR은 liver-water에서 FA $30^{\circ}$에서 12.73으로 가장 낮게 나타났고 FA $10^{\circ}$에서 -46.97, FA $80^{\circ}$에서 29.36으로 가장 높게 나타났다. liver-spleen의 CNR에서는 FA $10^{\circ}$에서 -3.18로 가장 낮게 나타났으며 FA $80^{\circ}$에서 9.65로 가장 높게 나타났다. 결론적으로 FLASH 펄스 파형을 사용한 복부 영상에서 최적의 T1효과를 나타내기 위해서는 FA $80^{\circ}$를 사용하는 것이 유용할 것으로 생각된다.

• Investigative Magnetic Resonance Imaging
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• 제7권1호
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• pp.22-30
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• 2003

목적 : 본 연구에서는 호흡멈춤 K-space 분할 2D-FASTCARD 자기공명영상 기법에 의한 관상동맥우회로내의 혈류개방성 검사의 임상 적 유용성을 조사하였다. 대상 및 방법: 관상동맥우회로 시술을 한 38명의 환자에서 내유동맥의 수는 36개이었고 대복제정맥편은 56개였다. 2차원 FASTCARD 기법을 이용하여 sagittal과 transverse평면에서 13-18초 동안 호흡을 멈추고 영상을 심장박동주기에 맞추어 획득하였다. 신호크기-영상의 hard copy를 이용하여 관상동맥우회로가 예상되는 지점에서 혈류에 의한 작은 원형부분이 밝게 보이면 해당 graft가 개방되었다고 판독하였다. 결과: 시술 환자의 다양한 관상동맥우회술의 양상에 따라 분류하여 Sagittal평면과 transverse 평면에서 내유동맥편과 대복제정맥편의 개방성을 검사하였다 좌회선지관상동맥의 분지로 연결되는 대복제정맥편은 Sagittal평면에서, 좌전하행지 관상동맥 혹은 그의 분지나 우관상동맥으로 연결되는 내유동맥편 혹은 대복제정맥편은 transverse평면에서 최대 감도의 개방성 영상을 보였다. 전체 38명의 환자 중에 23명의 영상획득 가능환자에서 45개의 관상동맥우회로가 보였으며 9개가 보이지 않았다. 증상이 있던 두 명의 환자중 2개의 관상 동맥우회로가 보이지 않았다. 결론: 호흡멈춤 K-space 분할 2D-FASTCARD 자기공명영상 기법으로 관상동맥우회로의 혈류 개방성의 비침습적 평가가 가능하다. 그러나 이 방법으로 보이지 않는 관상동맥 우회로는 조영제를 사용한 자기공명 혈관조영술이나 일반 혈관조영술등의 방법으로 그 진위를 재검사하여 확진하는 것이 필요하다.

• 대한방사선치료학회지
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• 제26권1호
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• pp.29-35
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• 2014

목 적 : 본 연구는 이미 상용화가 시작된 호흡 동조 체적 세기조절 회전 방사선 치료(Gated RapidArc) 이전의 자동화가 되지 않는 장비들에서 호흡 동조 방사선 치료(Gated radiation therapy)와 체적 세기조절 회전 방사선 치료(VMAT)를 동시에 시행할 수 있게 Gated RapidArc의 정확성을 분석하여 유용성을 평가하고, 진폭모드(Amplitude mode)를 이용하여 Gated RapidArc가 자동으로 되지 않는 장비에 환자를 적용하여 보고자 하였다. 대상 및 방법 : 방사선량 분포의 분석은 물 등가물질 고체 팬톰과 GafChromic 필름(EBT2 QD+, USA)을 이용하였으며, Film QA (ver. 2.2, USA) 필름 분석 프로그램을 이용하여 Gamma 인자(3%, 3 mm)를 분석하였다. 또한, 삼차원 선량 분포의 정확도를 확인하기 위해서 Matrixx(IBA Dosimery, Germany) 선량 측정 장비와 Compass(IBA Dosimetry, Germany) 선량 분석 프로그램을 이용하였다. 고체 팬톰을 이용한 호흡 동조 주기 신호는 4D 팬톰(Dynamic Thorax Phantom, CIRS, USA)과 Varian RPM(Real-Time Position Monitor) 호흡 동조 시스템을 이용하여 만들었으며, 자유호흡(free breathing)과 호흡정지(breath holding) 시에 따른 방사선량 분포를 각각에 대하여 분석 평가하였다. 환자에게 적용하기 위하여 2013년 2월부터 2013년 8월까지 간암환자 4명을 대상으로 4DCT의 영상을 얻기 위하여 충분한 호흡주기 연습후에 환자의 호흡주기에 맞게 위상모드(Phase mode)를 이용하여 환자가 고글의 호흡주기 패턴을 눈으로 보고 정확하게 따라할 수 있도록 하면서 4DCT의 영상을 획득하였다. Gated RapidArc 치료를 위하여 진폭모드(Amplitude mode)의 호흡주기를 만들어 3회 호흡을 시행한 후 40%~60%의 구간에서 5~6초 호흡을 참을 수 있도록 연습을 하고, 치료 시 40%~60%의 구간에서 환자가 숨을 참을 때 Beam On 버튼을 눌러주는 방식의 반자동으로 치료를 시행하였다. 결 과 : 비 호흡 및 호흡 동조 체적 세기조절 회전 방사선 치료기법 간의 절대선량은 전산화 치료 계획을 이용한 계산값과 1% 이내의 차이를 보였으며, 치료 기법 간의 차이 또한 1% 이내의 차이를 보였다. Gamma 인자(3%, 3 mm)는 99% 이상의 일치함을 보였으며, 각 장기별 선량 차이는 대체로 95% 이상의 일치함을 보였다. 또한 호흡 동조 체적 세기조절 회전 방사선 치료를 위하여 만든 진폭모드(Amplitude mode)의 호흡주기와 실제 환자의 호흡주기가 잘 일치하는 것을 볼 수 있었다. 결 론 : 비 호흡 동조와 호흡 동조 시 체적 세기조절 회전 방사선 치료간의 절대 선량 및 방사선량의 분포가 매우 잘 일치함을 보였다. 이는 호흡 동조 체적 세기조절 회전 방사선 치료 기법을 이용하여 호흡에 따라 움직이는 흉부나 복부의 종양 치료에 적용이 가능한 것으로 사료된다. 또한 실제 치료환자를 대상으로 고글을 통하여 진폭모드(Amplitude mode)의 호흡주기를 만들어 Gated RapidArc가 자동으로 되지 않는 장비에 치료를 적용한 결과, 5~6초정도 정지된 호흡에서 호흡 동조 체적 세기조절 회전 방사선 치료가 원활히 이루어짐을 알 수 있었다.