• Title/Summary/Keyword: Pressure Resonance

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Late Gadolinium Enhancement of Left Ventricular Papillary Muscles in Patients with Mitral Regurgitation

  • Su Jin Lim;Hyun Jung Koo;Min Soo Cho;Gi-Byoung Nam;Joon-Won Kang;Dong Hyun Yang
    • Korean Journal of Radiology
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    • v.22 no.10
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    • pp.1609-1618
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    • 2021
  • Objective: Arrhythmogenic mitral valve prolapse (MVP) is an important cause of sudden cardiac death characterized by fibrosis of the papillary muscles or left ventricle (LV) wall, and an association between late gadolinium enhancement (LGE) of the LV papillary muscles and ventricular arrhythmia in MVP has been reported. However, LGE of the papillary muscles may be observed in other causes of mitral regurgitation, and it is not limited to patients with MVP. This study was to evaluate the association of LGE of the LV papillary muscles or ventricular wall on cardiac magnetic resonance imaging (CMR) and ventricular arrhythmia in patients with mitral regurgitation. Materials and Methods: This study included 88 patients (mean age ± standard deviation, 58.3 ± 12.0 years; male, 42%) with mitral regurgitation who underwent CMR. They were allocated to the MVP (n = 43) and non-MVP (n = 45) groups, and their LGE images on CMR, clinical characteristics, echocardiographic findings, and presence of arrhythmia were compared. Results: LV myocardial wall enhancement was more frequent in the MVP group than in the non-MVP group (28% vs. 11%, p = 0.046). Papillary muscle enhancement was observed in 7 (7.9%) patients. Of the 43 patients with MVP, 15 (34.8%) showed LGE in the papillary muscles or LV myocardium, including 12 (27.9%) with LV myocardial wall enhancement and 4 (9.3%) with papillary muscle enhancement. One patient with bilateral diffuse papillary muscle enhancement experienced sudden cardiac arrest due to ventricular fibrillation. Univariable logistic regression analysis showed that high systolic blood pressure (BP; odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01-1.09; p = 0.027) and ventricular arrhythmia (OR, 6.84; 95% CI, 1.29-36.19; p = 0.024) were significantly associated with LGE of the papillary muscles. Conclusion: LGE of the papillary muscles was present not only in patients with MVP, but also in patients with other etiologies of mitral regurgitation, and it was associated with high systolic BP and ventricular arrhythmia. Papillary muscle enhancement on CMR should not be overlooked.

Paradoxical Upper Airway Obstruction and Central Sleep Apnea Developed After Anterior Cervical Spine Fusion (전방경추융합술 후 발생한 역설상기도폐쇄 및 중추성 수면 무호흡)

  • Lee, Sang Haak;Choi, Young Mee;Park, Ye Ree;Kang, Ji Ho;Kim, Young Kyoon;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak;Moon, Hwa Sik
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.3
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    • pp.295-298
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    • 2005
  • We report a case of a 48-year-old man with a paradoxic upper airway obstruction and central sleep apnea that developed after an anterior cervical spinal fusion. Nine months before being admitted to this hospital, he was diagnosed with a herniated intervertebral disc between the 5th and 6th cervical spine, and the first operation was carried out. Two months later, a pseudoarthrosis has developed and a second operation, an anterior interbody fusion of the C5 and C6 using autogenous strut bone graft, was performed. After the second operation, he began to complain of snoring, excessive daytime sleepiness, insomnia, and a bizarre sound heard near the upper airway during breathing. Nasopharyngoscope and magnetic resonance imaging disclosed a paradoxical narrowing of the nasopharynx during expiration. On the overnight polysomnography, the apnea index was 8.7/h (central apnea, 7.0/h; obstructive apnea, 1.7/h). Nasal continuous positive airway pressure was applied, but he complained of pressure-intolerance, and laser-assisted uvulopalatoplasty was then performed. Two months after surgery, clinical symptoms as well as the apneas had improved markedly. We suggest that this paradoxic upper airway obstruction might be associated with the anterior cervical spinal surgery even though the mechanism is unclear. This case also emphasizes that an upper airway obstruction can contribute to the development of central sleep apnea.

Mineralogical Studies of the Tourmaline for Medicinal Applications by Production Localities (본초 광물로서의 활용을 위한 산지별 전기석의 광물학적 연구)

  • Jie, Yan;Kim, Seon-ok;Park, Hee Yul;Park, Maeng-Eon
    • Economic and Environmental Geology
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    • v.51 no.4
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    • pp.345-358
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    • 2018
  • In this study, we have performed electron probe micro analyzer (EPMA), X-ray differaction (XRD), inductively coupled plasma spectroscopy (ICP), Fourier transform Raman spectroscopy (FT-Raman), far-infrared (FIR), nuclear magnetic resonance (NMR), and pH-DO Analyses for characterizing medicinal mineralogy aspect of the black tourmaline (Shantung, china), black and pink tourmaline (Minas Geraris, Brazil), black touemaline (Daeyu mine, Korea). In addition, heating effects of the tourmaline sauna as well as the effects of tourmaline powder-added soap on skin troubles have been investigated. It has been revealed that chemical composition of the tourmaline is either high in Fe-, Al-, B-rich types. Ratio of the K-Ca, Na-K, and Fe-B reflects the component change property of solid solution. $CaO/CaO+Na_2O$ and MgO/FeO+MgO ratio show high positive correlation. When tourmaline reacts with distilled water, extended reaction time DO values approximately decrease and it stabilizes at DO = 10. Otherwise, pH values increase until 6 hours and it stabilizes at pH = 8 after 24 hours. Distilled water changes to alkaline when it reacts with tourmaline powder and particles. Tourmaline showed lower absorption spectrum strength and transmittance at short wave, where absorption spectrum wavelength and strength were determined by the content of the composition elements and characteristics of crystallography. Increase of the Fe content has been confirmed to be the cause for the reduction of irradiation. For the chemical composition and spectral property of the tourmaline particle samples, it has been found that Si and Fe contents show positive correlation with Far-Infrared irradiation, while Al and Mg contents show negative correlation. For tourmaline powder, it has been confirmed that $^{17}O-NMR$ FWHM (full width at half maximum) decreases when reacts with distilled water. Tourmaline sauna (approximately $100^{\circ}C$) was found to increase $0.5-1.5^{\circ}C$ of body temperature, average of 12 heartbeat, and 10mg Hg of blood pressure. Tourmaline soap had very good aesthetic effect to skin and was confirmed to have above the average improvements to skin troubles (e.g., allergy or atopy).

Usefulness of Acoustic Noise Reduction in Brain MRI Using Quiet-T2 (뇌 자기공명영상에서 Quiet-T2 기법을 이용한 소음감소의 유용성)

  • Lee, SeJy;Kim, Young-Keun
    • Journal of radiological science and technology
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    • v.39 no.1
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    • pp.51-57
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    • 2016
  • Acoustic noise during magnetic resonance imaging (MRI) is the main source for patient discomfort. we report our preliminary experience with this technique in neuroimaging with regard to subjective and objective noise levels and image quality. 60 patients(29 males, 31 females, average age of 60.1) underwent routine brain MRI with 3.0 Tesla (MAGNETOM Tim Trio; Siemens, Germany) system and 12-channel head coil. Q-$T_2$ and $T_2$ sequence were performed. Measurement of sound pressure levels (SPL) and heart rate on Q-$T_2$ and $T_2$ was performed respectively. Quantitative analysis was carried out by measuring the SNR, CNR, and SIR values of Q-$T_2$, $T_2$ and a statistical analysis was performed using independent sample T-test. Qualitative analysis was evaluated by the eyes for the overall quality image of Q-$T_2$ and $T_2$. A 5-point evaluation scale was used, including excellent(5), good(4), fair(3), poor(2), and unacceptable(1). The average noise and peak noise decreased by $15dB_A$ and $10dB_A$ on $T_2$ and Q-$T_2$ test. Also, the average value of heartbeat rate was lower in Q-$T_2$ for 120 seconds in each test, but there was no statistical significance. The quantitative analysis showed that there was no significant difference between CNR and SIR, and there was a significant difference (p<0.05) as SNR had a lower average value on Q-$T_2$. According to the qualitative analysis, the overall quality image of 59 case $T_2$ and Q-$T_2$ was evaluated as excellent at 5 points, and 1 case was evaluated as good at 4 points due to a motion artifact. Q-$T_2$ is a promising technique for acoustic noise reduction and improved patient comfort.