• The KIPS Transactions:PartA
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• v.14A no.2
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• pp.77-84
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• 2007

The intima media thickness(IMT) of the carotid artery from B mode ultrasound images has recently been proposed as the most useful index of individual atherosclerosis and can be used to predict major cardiovascular events. Ultrasonic measurements of the IMT are conventionally obtained by manually tracing interfaces between tissue layers. The drawbacks of this method are the inter and intra observer variability and its inefficiency. In this paper, we present a multiresolution snake method combined with the dynamic programming, which overcomes the various noises and sensitivity to initialization of conventional snake. First, an image pyramid is constructed using the Gaussian pyramid that maintains global edge information with smoothing in the images, and then the boundaries are automatically detected in the lowest resolution level by minimizing a cost function based on dynamic programming. The cost function includes cost terms which are representing image features and geometrical continuity of the vessel interfaces. Since the detected boundaries are selected as initial contour of the snake for the next level, this automated approach solves the problem of the initialization. Moreover, the proposed snake improves the problem of converging th the local minima by defining the external energy based on multiple image features. In this paper, our method has been validated by computing the correlation between manual and automatic measurements. This automated detection method has obtained more accurate and reproducible results than conventional edge detection by considering multiple image features.

• The Journal of the Society of Stroke on Korean Medicine
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• v.21 no.1
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• pp.21-32
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• 2020

■ Objectives 당귀작약산 단회 복용으로 정상인의 총경동맥 탄력도에 미치는 영향을 평가하고자 하였다. ■ Methods 본 연구는 정상인 남성을 대상으로 한 전향적 무작위 대조군 교차시험연구다. 모든 대상자들은 임의로 당귀작약산 복용군과 비복용군인 대조군으로 나누어졌다. 1주일 간격으로 총 2회 방문하며, 첫 번째 방문 시에 당귀작약산 복용군은 당귀작약산 1포(2.5g)과 물을 제공받고, 대조군은 물만 제공받아 복용하였다. 두 번째 방문 시 첫 번째 방문과 반대로 당귀작약산을 복용했던 복용군은 물만 제공받고, 물만 복용했던 피험자들은 당귀작약산 1포와 물을 제공받았다. 물은 100 cc로 매번 동일하게 제공되었다. 모든 대상자들은 복용 직전과 복용 2시간, 4시간 후에 총경동맥 탄력도, 혈압, 총경동맥 내막-중막 두께와 맥박수를 측정하였다. ■ Results 총 20명의 정상인 남성이 모집되었으며, 시간에 따라 당귀작약산 복용 후의 총경동맥 탄력도가 대조군에 비하여 유의하게 상승한 것이 확인되었다. 내막-중막 두께, 혈압 및 맥압, 맥박은 유의한 변화가 나타나지 않았다. ■ Conclusion 당귀작약산의 단회 복용으로 총경동맥 탄력도가 즉시 개선되는 것을 확인하였고, 이로써 당귀작약산이 동맥 경직도 완화 및 탄성의 개선에 영향을 미친다는 것을 알 수 있었다.

• Korean Journal of Pharmacognosy
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• v.40 no.4
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• pp.400-407
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• 2009

The purpose of this study is to investigate hypotensive effect of BDR-29, new herbal preparation of Cassiae Semen, Prunellae Spica, Uncariae Ramulus et Uncus, and Tribuli Semen, in stroke-prone spontaneously hypertensive rats (SHR-SP). SHR-SP were treated with BDR-29 at a dose of 100, 200 mg/kg/day orally for 13 weeks. In the BDR-29 treat group, mean blood pressure and systolic blood pressure were significantly reduced (p<0.05). In phenylephrine-precontracted arota and carotid artery, BDR-29 induced endothelium-dependent vascular relaxation. Hematological findings and biochemical examination revealed no evidence of specific toxicity related to BDR-29. In addition, BDR-29 was markedly attenuated intima-media thickness of thoracic aorta with progression of atherosclerosis. SHR-SP were treated with BDR-29 were significantly increased eNOS expression in arota. These results indicated that BDR-29 improves blood pressure as well as initial atherosclerotic lesion.

• Journal of Korean Neurosurgical Society
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• v.45 no.5
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• pp.284-288
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• 2009

Objective : Our retrospective study aimed to determine whether 16-slice computerized tomography (CT) angiography optimized sharp kernel is suitable for the evaluation of visibility, luminal patency and re-stenosis of intracranial stents in comparison with conventional angiography. Methods : Fifteen patients with symptomatic intracranial stenotic lesions underwent balloon expandable stent deployment of these lesions (10 middle cerebral arteries, 2 intracranial vertebral arteries, and 3 intracranial internal carotid arteries). CT angiography follow-up ranged from 6 to 15 months (mean follow-up, 8 months) after implantation of intracranial stents and conventional angiography was confirmed within 2 days. Curved multiplanar reformations with maximal intensity projection (MIP) with optimal window settings for assessment of lumen of intracranial stents were evaluated for visible lumen diameter, stent patency (contrast distal to the stent as an indirect sign), and re-stenosis by two experienced radiologists who blinded to the reports from the conventional angiography. Results : All of stents deployed into symptomatic stenotic lesions. All stents were classified as patent and no re-stenosis, which was correlated with results of conventional angiography. Parts of the stent lumen could be visualized in all cases. On average, 57% of the stent lumen diameter was visible using optimized sharp kernel. Significant improvement of lumen visualization (22%, p<0.01) was observed using the optimized sharp kernel compared with the standard sharp kernel. Inter-observer agreements on the measurement of lumen diameter and density were judged as good, respectively (p<0.05). Conclusion : Sixteen-slice CT using the optimized sharp kernel may provide a useful information for evaluation of lumen diameter patency, and re-stenosis of intracranial stents.

• Korean Journal of Clinical Pharmacy
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• v.31 no.3
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• pp.198-204
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• 2021

Background: Cardiovascular (CV) disease is known as one of the major causes of death from disease worldwide. Statin therapy plays a pivotal role in atherosclerotic cardiovascular disease (ASCVD) lowering the LDL-cholesterol level effectively. The purpose of this study was to evaluate the association of the intensity of statin therapy in adult patients of Korea and the risk of ASCVD of the patient group. Methods: We used data from sample of patients from the Health Insurance Review and Assessment Service (HIRA-NPS-2018). We analyzed the patterns of prescribing statins including types of statin, statin intensity, and number of patients with ASCVD or risk of ASCVD. Results: 155,512 patients were included in the analysis, and 27,950 patients (18.0%) was over 75 years. High-intensity statin usage was increased in ASCVD patients compared with the low-intensity statin use. The OR (odds ratio) of high-intensity statin were increased in myocardial infarction patients compared with low-intensity statin use showing the highest OR; 12.40 (95% CI; 9.48-16.22). At patient groups of angina, ischemic heart disease and carotid disease, high-intensity statin prescription rate was increased compared with low-intensity statin. However, there was no statistical significance between both statin prescription rates in patients of peripheral arterial disease, abdominal aneurysm, diabetic mellitus and atherosclerosis. Conclusion: The statin prescription rate showed intensity increasing tendency according to the risk of ASCVD. More aggressive statin therapy might be beneficial for the ASCVD patients based on the recent guidelines of dyslipidemia.

• The Journal of Internal Korean Medicine
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• v.31 no.3
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• pp.578-585
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• 2010

Objectives : Coldness of hands and feet has been regarded to be associated with blood circulation. This study was performed to assess the correlation between erythrocyte deformability and coldness of hands and feet. Methods : 145 patients who had taken an erythrocyte deformability test were selected for this study among hospitalized patients within 4 weeks after their cerebral infarction at the Internal Medical Department at Kyunghee Oriental Medical Center from August 2008 to August 2009. We divided the selected patients into two groups, with and without of coldness of hands and feet groups. The two groups were compared on risk factors for atherosclerosis and examined for variables including erythrocyte deformability. Results : 1. On demographic variables of the patients, only body mass index was significantly lower in the coldness of hands and feet group than the control group. There was no significant difference of the rate of hypertension, diabetes mellitus, hyperlipidemia, ischemic heart disease, smoking, drinking and carotid artery stenosis between the two groups. 2. According to blood test, the coldness of hands and feet group showed significantly lower erythrocyte deformability index than the control group. 3. Body mass index and erythrocyte deformability index showed a close relationship with coldness of hands and feet in multivariate analysis. Conclusions : The correlation between the erythrocyte deformability and coldness of hands and feet in cerebral infarction patients were decreased erythrocyte deformability participated in the mechanism of coldness of hands and feet.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.9
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• pp.4313-4319
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• 2013

The purpose of our study is to shorten the scanning time and minimize the inconveniences of the patients in acquisition of the black blood images using the signal void effect in the fast spin echo technique while keeping the diagnostic value of the test. Thirty-two consecutive patients who underwent black blood MR imaging were examed with additional double inversion recovery (DIR) sequence and the conventional fast spin echo (FSE) sequence. Signal to Noise Ratio (SNR) and Contrast to Noise Ratio (CNR) of the internal carotid arteries' lumen were compared in T1 and T2 weighted images to determine whether there are differences between the two techniques for depiction of the signal void effect inside the vessel wall. The FSE images showed lower SNR values than the DIR images in both of the T1 and T2 weighted images (11.49% and 13.66% respectively). While the CNR values were higher in the FSE images than in the DIR images in both of the T1 and T2 weighted images (8.69% and 7.55% respectively).There was no significant difference between the two techniques for either of the SNR or CNR (p>0.05, p>0.05 respectively). The DIR and the FSE images demonstrated almost identical imaging patterns. Therefore, it is anticipated that the use of FSE technique in acquisition of the black blood imaging could reduce the inconveniences of the patients during the scanning and minimize exam time while keeping the diagnostic value of the test.

• Clinical and Experimental Pediatrics
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• v.49 no.4
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• pp.368-374
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• 2006

Purpose : The prevalence of obesity in children is increasing rapidly. Epidemiologic studies suggest that obesity induced atherosclerosis may start in childhood. We investigated whether obese children show early abnormalities of the arterial wall and endothelial dysfunction. Methods : Thirty-eight obese children(14-16 years old of age, male, body mass index $29.40{\pm}3.18kg/m^2$) and forty-five age and sex-matched healthy control children(body mass index $18.43{\pm}1.01kg/m^2$) were enrolled. Their carotid artery intima-media thickness(IMT) and brachial artery flowmediated dilation(FMD) response were measured by high-quality ultrasound system, and compliance, distensibility, stiffness index, incremental elastic modulus and wall stress were calculated by equation. In addition, we looked at the relations between these arterial features and metabolic cardiovascular risk factors. Results : The obese children had significantly increased IMT($0.52{\pm}0.09mm$ vs $0.40{\pm}0.07mm$, P< 0.001) and markedly impaired FMD($7.35{\pm}7.78$ percent vs $20.34{\pm}16.81$ percent, P<0.001) than the healthy controls. But the compliance and distensibility were lower, and the stiffness index, incremental elastic modules and wall stress were higher in the obese group than the control group, but not statistically significantly. Body mass index was highly associated with increased IMT(r=0.612, P<0.001) and reduced FMD(r=-0.414, P<0.001). Conclusion : We showed the deleterious effect of child obesity on both early functional and structural atherosclerotic markers. The ultrasonic findings will be used for screening and follow up markers to identify high-risk patients among obese children.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.1
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• pp.8-16
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• 2008

Purpose: To assess the effect of extracranial-intracranial (EC-IC) bypass surgery on hemodynamic improvement, we evaluated serial regional cerebral hemodynamic change of the middle cerebral artery (MCA) in symptomatic patients with atherosclerotic occlusion of the internal carotid artery (ICA) or MCA using $^{99m}Tc$-ECD acetazolamide stress brain perfusion SPECT (Acetazolamide SPECT). Materials and Methods: The patients who had suffered a recent stroke with atherosclerotic ICA or MCA occlusion underwent EC-IC bypass surgery and Acetazolamide SPECT at 1 week before and three to six months after surgery. For image analysis, attenuation corrected images were spatially normalized to SPECT templates with SPM2. Anatomical automated labeling was applied to calculate mean counts of each Volume-Of-Interest (VOI). Seven VOIs of bilateral frontal, parietal, temporal regions of the MCA territory and the ipsilateral cerebellum were defined. Using mean counts of 7 VOIs, cerebral perfusion index and perfusion reserve index were calculated. Results: Seventeen patients (M:F =12:5, mean age $53{\pm}2yr$) were finally included in the analysis. The cerebral blood flow of the parietal region increased at 1 week (p = 0.003) and decreased to the preoperative level at 3-6 months (p = 0.003). The cerebrovascular reserve of the frontal and parietal regions increased significantly at 1 week after surgery (p<0.01) and improved further at 3-6 months. Conclusion: Cerebrovascular reserve of the MCA territory was significantly improved at early postoperative period after EC-IC bypass and kept improved state during long-term follow-up, although cerebral blood flow did not significantly improved. Therefore, cerebrovascular reserve may be a good indicator of postoperative hemodynamic improvement resulted from bypass effect.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.790-798
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• 1999

Background: As the early outcome after coronary artery bypass grafting(CABG) has been stabilized, neurologic complication has now become one of the most important morbidity. The aim of this study was to find out the risk factors associated with the neurologic complications after CABG. Material and Method: In 351 patients who underwent CABG, the incidence and features of neurologic complications, with associated perioperative risk factors, were retrospectively reviewed. Neurologic complication was defined as a new cerebral infarction confirmed by postoperative neurologic examination and radiologic studies, or delayed recovery of consciousness and orientation for more than 24 hours after the operation. Result: Neurologic complications occurred in 18 patients(5.1%), of these nine(2.6%) were diagnosed as having new cerebral infarctions(stroke). Stroke was manifested as motor paralysis in four patients, mental retardation or orientation abnormality in four, and brain death in one. Statistical analysis revealed the following variables as significant risk factors for neurologic complications by both univariate and multivariate analyses: cardiopulmonary bypass longer than 180 minutes, atheroma of the ascending aorta, carotid artery stenosis detected by Duplex sonography, and past history of cerebrovascular accident or transient ischemic attack. Age over 65 years, aortic calcification detected by simple X-ray, and intraoperative myocardial infarction were significant risk factors by univariate analysis only. Neither the severity of carotid artery stenosis nor technical modifications such as cannulation of the aortic arch or single clamp technique, which were expected to affect the inciden e of neurologic complications, had significant relationship with the incidence. Conclusion: This study confirmed the strong association between neurologic complications after CABG and atherosclerosis of the arterial system. Therefore, to minimize the incidence of neurologic complications, systematic evaluation focused on atherosclerotic lesions of the arterial system followed by adequate alteration of operative strategy is needed.