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Comparative Analysis of Signal Intensity and Apparent Diffusion Coefficient at Varying b-values in the Brain : Diffusion Weighted-Echo Planar Image ($T_2^*$ and FLAIR) Sequence (뇌의 확산강조 영상에서 b-value의 변화에 따른 신호강도, 현성확산계수에 관한 비교 분석 : 확산강조 에코평면영상($T_2^*$ 및 FLAIR)기법 중심으로)

  • Oh, Jong-Kap;Im, Jung-Yeol
    • Journal of radiological science and technology
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    • v.32 no.3
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    • pp.313-323
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    • 2009
  • Diffusion-weighted imaging (DWI) has been demonstrated to be a practical method for the diagnosis of various brain diseases such as acute infarction, brain tumor, and white matter disease. In this study, we used two techniques to examine the average signal intensity (SI) and apparent diffusion coefficient (ADC) of the brains of patients who ranged in age from 10 to 60 years. Our results indicated that the average SI was the highest in amygdala (as derived from DWI), whereas that in the cerebrospinal fluid was the lowest. The average ADC was the highest in the cerebrospinal fluid, whereas the lowest measurement was derived from the pons. The average SI and ADC were higher in $T_2^*$-DW-EPI than in FLAIR-DW-EPI. The higher the b-value, the smaller the average difference in both imaging techniques; the lower the b-value, the greater the average difference. Also, comparative analysis of the brains of patients who had experienced cerebral infarction showed no distinct lesion in the general MR image over time. However, there was a high SI in apparent weighted images. Analysis of other brain diseases (e.g., bleeding, acute, subacute, chronic infarction) indicated SI variance in accordance with characteristics of the two techniques. The higher the SI, the lower the ADC. Taken together, the value of SI and ADC in accordance with frequently occurring areas and various brain disease varies based on the b-value and imaging technique. Because they provide additional useful information in the diagnosis and treatment of patients with various brain diseases through signal recognition, the proper imaging technique and b-value are important for the detection and interpretation of subacute stroke and other brain diseases.

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Surgical Experiences for Non-ST-segment Elevation Acute Coronary Syndrome (ST분절의 상승을 동반하지 않은 급성 관동맥 증후군의 수술 치험)

  • Yu Song-Hyeon;Lim Sang-Hyun;Chang Byung-Chul;Yoo Kyung-Jong;Hong You-Sun
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.754-758
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    • 2006
  • Background: Surgical role for acute coronary syndrome has been reduced in recent years due to development of drug eluting stent. We evaluated the surgical results of acute coronary syndrome in our hospital. Material and Method: Between January 2001 and August 2005, 416 patients underwent coronary artery bypass grafting (CABG) under diagnosis of non-ST-elevation acute coronary syndrome (NSTE ACS). Mean age was $61.8{\pm}9.0$ years and 276 (66.3%) patients were male. 324 (77.9%) patients had triple vessel disease and 92 (22.1%) had left main disease at angiographic study. 236 (56.7%) patients had hypertension and 174 (41.8%) had diabetes mellitus. Conventional on-pump CABG was performed in 194 patients (46.6%) and off-pump CABG in 222 (53.4%). Total arterial revascularization with no touch technique was done in 97 patients (23.3%). The number of total distal anastomosis was 1,306 and the number per patient was $3.21{\pm}1.71$. Result: Surgical mortality rate was 1.0% (4 patients) and postoperative complication rate was 15.6% (65 patients). Graft patency was checked at mean $3.7{\pm}7.6$ months (from 1 to 37 months) postoperatively with multi-directional computed tomography in 152 patients. Left internal mammary artery was patent in 95.3%, right internal mammary artery in 98.1%, radial artery in 92.2% and saphenous vein in 89.0%. Conclusion: The surgical treatment of NSTE ACS showed relatively low mortality rate and good graft patency rate. Further study is needed to compare the long term results with drug eluting stent.

Outcome of Patch Angioplasty for Left Main Coronary Ostial Stenosis (좌주관상동맥 개구부 협착에서의 혈관성형술의 결과)

  • Kang, Chang-Hyun;Na, Chan-Young;Seo, Hong-Joo;Kim, Jae-Hyun;Lee, Cheul;Chang, Yoon-Hee;Hwang, Seong-Wook;Baek, Man-Jong;Oh, Sam-Se;Kim, Woong-Han;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.56-63
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    • 2004
  • Background: Patch angioplasty is an alternative surgical procedure to coronary artery bypass grafting (CABG) for left main coronary ostial stenosis. The purpose of this study is to evaluate the outcome of patch angioplasty by analyzing the short-term and long-term results. Material and Method: Twenty nine patients who had undergone patch angioplasty due to left main coronary ostial stenosis between July 1991 and May 2003 were enrolled in the study. The mean age of the patients was 53.1 $\pm$12.5 years. There were 8 males and 21 females, and there were 12 female patients who had no risk factor for atherosclerosis. Twenty six (89.7%) patients showed isolated coronary ostial stenosis without any distal coronary lesion. Result: Anterior approach was used in 28 patients and superior approach was used in one patient. Transsection of the main pulmonary artery was used in one patient. Concomitant CABG was performed in 4 patients because of left anterior descending artery lesions in 3 patients and unstable postoperative hemodynamic status in one patient. Hospital mortality had occurred in one patient (3.4%) and late mortality also in one patient, therefore the overall 5 year survival rate was 91.2$\pm$6.1%. Seventeen coronary angiographies were done in 13 patients (44.8%) postoperatively. Two distal patch stenoses, 1 proximal patch stenosis, and 1 new right coronary ostial lesion were identified and 3 percutaneous interventions and 1 CABG were performed during the follow-up period. The overall 5 year freedom from reintervention rate was 82.4 $\pm$ 8.5%. Aortic regurgitation less than grade 1 had developed postoperatively in 4 patients and one patient showed progression of preexisting aortic regurgitation from grade II to III. Conclusion: Patch angioplasty in left main coronary ostial lesion showed acceptable short-term and long-term results in this study. However, restenosis at the patch anastomosis site and aortic regurgitation should be carefully investigated during the follow-up period.

The Effect of Textile Industry on the Workers' Blood Pressure (섬유공장(纖維工場)의 소음(騷音)이 근로자(勤勞者)들의 혈압(血壓)에 미치는 영향(影響))

  • Lee, Jong-Young
    • Journal of Preventive Medicine and Public Health
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    • v.17 no.1
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    • pp.25-29
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    • 1984
  • To assess the effect of noise on the blood pressure of workers, 70 weaving and 70 refining female workers in 15 to 24 years of ages were tested for the changes of blood pressure before and after exposure to the noise. The noise levels at work place were 99 dB (A) for weavers and 80 dB(A) for refiners. The mean age of refiners was 17,7 years and that of weavers was 18.6 years, and the difference in mean ages was statistically significant (p<0.05). The means of heights, weights and working durations were not significantly different between two groups. The mean systolic blood pressure of the weavers was 112.5mmHg before exposure to the noise and it was increased to 115.7mmHg after exposure to 99 dB(A) of noise for 30 minutes, and the mean diastolic blood pressure from 71.6mmHg to 74.1mmHg. These increments of blood pressure were statististically significant (p<0.05). The mean systolic blood pressure of the refiners was decreased from 108.9mmHg to 106.7mmHg after exposure to 80 dB(A) of noise for 30 minutes, and the mean diastolic blood pressure from 67.3mmHg to 67.1mmHg. These changes of blood pressure were not statistically significant. The mean systolic and diastolic blood pressure of the weavers before exposure to the noise were significantly higher than that of refiners (p<0.05). The difference of blood pressure between refiners and weavers was significantly associated with noises (p<0.05), and not ages and their interactions. The study results support the hypothesis that exposure to excessive noise increases the blood pressure of workers.

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Environmental Health Surveillance of Low Birth Weight in Seoul using Air Monitoring and Birth Data (2002년 서울시 대기오염과 출생 자료를 이용한 저체중아 환경보건감시체계 연구)

  • Seo, Ju-Hee;Kim, Ok-Jin;Kim, Byung-Mi;Park, Hye-Sook;Leem, Jong-Han;Hong, Yun-Chul;Kim, Young-Ju;Ha, Eun-Hee
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.5
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    • pp.363-370
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    • 2007
  • Objectives: The principal objective of this study was to determine the relationship between maternal exposure to air pollution and low birth weight and to propose a possible environmental health surveillance system for low birth weight. Methods: We acquired air monitoring data for Seoul from the Ministry of Environment, the meteorological data from the Korean Meteorological Administration, the exposure assessments from the National Institute of Environmental Research, and the birth data from the Korean National Statistical Office between January 1, 2002 and December 31, 2003. The final birth data were limited to singletons within $37{\sim}44$ weeks of gestational age. We defined the Low Birth Weight (LBW) group as infants with birth weights of less than 2500g and calculated the annual LBW rate by district. The air monitoring data were measured for $CO,\;SO_2,\;NO_2,\;and\;PM_{10}$ concentrations at 27 monitoring stations in Seoul. We utilized two models to evaluate the effects of air pollution on low birth weight: the first was the relationship between the annual concentration of air pollution and low birth weight (LBW) by individual and district, and the second involved a GIS exposure model constructed by Arc View 3.1. Results: LBW risk (by Gu, or district) was significantly increased to $1.113(95%\;CI=1.111{\sim}1.116)\;for\;CO,\;1.004(95%\;CI=1.003{\sim}1.005)\;for\;NO_2,\;1.202(95%\;CI=1.199{\sim}1.206\;for\;SO_2,\;and\;1.077(95%\;CI=1.075{\sim}1.078)\;\;for\;PM_{10}$ with each interquartile range change. Personal LBW risk was significantly increased to $1.081(95%\;CI=1.002{\sim}1.166)\;for\;CO,\;1.145(95%\;CI=1.036{\sim}1.267)\;for\;SO_2,\;and\;1.053(95%\;CI=1.002{\sim}1.108)\;for\;PM_{10}$ with each interquartile range change. Personal LBW risk was increased to $1.003(95%\;CI=0.954{\sim}1.055)\;for\;NO_2$, but this was not statistically significant. The air pollution concentrations predicted by GIS positively correlated with the numbers of low birth weights, particularly in highly polluted regions. Conclusions: Environmental health surveillance is a systemic, ongoing collection effort including the analysis of data correlated with environmentally-associated diseases and exposures. In addition. environmental health surveillance allows for a timely dissemination of information to those who require that information in order to take effective action. GIS modeling is crucially important for this purpose, and thus we attempted to develop a GIS-based environmental surveillance system for low birth weight.

Blood Picture of Army Pack Horses(Jeju Horses) (군용타마(軍用馱馬)(제주마(濟州馬))의 혈액상(血液像))

  • Mun, Gyeong Gi;Lee, Do Pil;Chung, Soon Tong
    • Korean Journal of Veterinary Research
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    • v.15 no.2
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    • pp.147-152
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    • 1975
  • Although considerable research has been done on the blood picture of the horse, hot-blooded and cold-blooded, little work has been made of the blood picture of the army pack horse, Jeju horse. The object of the present investigation was to make good this deficiency, and to suggest standard for the blood picture of army pack horses kept under the regular military training and the ideal feeding in the heart of a mountain. Blood samples were drawn from the jugular vein through a 15-gauge bleeding needle from 41 males and 28 females, aging 3 to 9 years old. It was taken between seven and nine o'clock in the morning. Animals were handled as quietly as possible to avoid any excitation. No restraint other than a halter was used. Enumeration of erythrocyte, total and differential leukocyte count, determination of hemoglobin in blood, and the value of packed cell volume were male in the usual manner, and erythrocytic constant was calculated by the method of Wintrobe. Erythrocyte count was $7.83{\pm}0.20(4.95{\sim}11.05){\times}10^6/mm^3$(SE). This value was much lower than hot-horses, but slightly higer than the values of cold-horse reported from foreign country. Concentration of hemoglobin in blood was $13.0{\pm}0.33(9.5{\sim}17.8)g/100ml$. This value was much higher than that of cold-horses observed by the other authors, approaching to the values of hot-horses. Packed cell volume was $32.1{\pm}0.92(22{\sim}42)ml/100ml$. This vague was a little higher than that of the other cold-horses. Mean corpuscular volume was $41.5{\pm}1.20(26.6{\sim}59.3){\mu}m^3$. This value matched so well with the other results recorded by various investigators. Mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration were $16.9{\pm}0.43(12.3{\sim}25)$ pg and $41.0{\pm}0.45(29.1{\sim}51.1)g/100ml$, respectively. These values were significantly higher than the values found by the other investigations. Total leukocyte enumeration was $10.5{\pm}0.41(5.6{\sim}17.9){\times}10^3/mm^3$, being considered as normal. And differential leukocyte count of neutrophil was $44.5{\pm}2.23(15{\sim}76)%$, $5,527{\pm}234(2,231{\sim}9,144)/mm^3$, of lymphocyte $50.5{\pm}1.19(19{\sim}77)%$, $4,307{\pm}125(1,456{\sim}11,098)/mm^3$, of monocytel (0~4)%, $105(0{\sim}352)/mm^3$, of eosiophil 3.2(0~14)%, $340(0{\sim}1,232)/mm^3$ and of basophil 0.25(0~3)%, $23(0{\sim}236)/mm^3$. The percentage of the differential count obtained from the present work showed a good agreement with the results of various authors. Of the horses examined monocyte was found from 42 horses, eosinophil from 62 horses and basophil from 10 horses. No significant differences recognized between male and female horses, and the effect of age was not observed between three to nine years old. Judging from the blood picture of the present investigation, it could be stated that the army pack horses on training were kept better than the average farming conditions.

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Mitral Valve Repair for Active and Healed Endocarditis (급성 혹은 치유된 심내막염 환자에서의 승모판막성형술)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Sae;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Kang, Chang-Hyun;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Kim, Wook-Sung;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.820-827
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    • 2003
  • Background: Mitral valve repair rather than replacement for mitral regurgitation (MR) offers a number of well-accepted benefits. However, the surgical results of repair for mitral valve endocarditis remain largely unknown. Material and Method: Fourteen patients who underwent mitral valve repair for MR caused by mitral valve endocarditis from April 1995 through October 2001 were reviewed retrospectively. There were 9 male patients and mean age was 32$\pm$10 years. Four patients had previous embolism and 2 had active infections. The grade of MR were III in 6 patients and IV in 8. Operatively, mitral annuloplasty was performed in 12 patients and various valvuloplasty techniques were applied in all patients. One patient had immediate valve replacement due to residual MR after weaning of cardiopulmonary bypass. Result: There was no early operative death. Early postoperative transthoracic echocardiography revealed no or grade I of MR and no or mild mitral stenosis in 13 patients. After the mean follow-up of 36 months, there was no late death, and no or grade I of MR in 11 patients (84.6%) and no or mild mitral stenosis in 12 patients (92.3%). Reoperation required in one patient (7.1%). The cumulative freedom from recurrent MR and valve-related reoperation at 5 years were 91$\pm$9% and 75$\pm$22%, respectively. Conclusion: This study suggests that mitral valve repair for mitral regurgitation caused by endocarditis offers good early and intermediate survival and functional improvement without reinfection, and it is an attractive alternative to valve replacement in selective patients with bacterial endocariditis.

Clinical Characteristics of Bronchopulmonary Dysplasia by Type and Severity (기관지폐이형성증의 유형 및 중증도에 따른 임상적 특징)

  • Shim, Gyu-Hong;Lee, Hyun-Ju;Kim, Eun-Sun;Lee, Jin-A;Choi, Chang-Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.21-33
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    • 2010
  • Purpose : The increased survival of preterm infants in the neonatal intensive care unit recently has resulted in an increased frequency of bronchopulmonary dysplasia (BPD), especially with atypical forms. However, there have been few studies compairing classic and atypical BPD. The aim of this study was to investigate the differences between these two types of BPD. Methods : Infants with a gestational age less than 32 weeks born at the Seoul National University Hospital and Bundang Seoul National University Hospital from May 2004 to April 2007 were included. The data were categorized in 2 groups, classic and atypical BPD. We determined the incidence of BPD, and compared perinatal factors and postnatal managements between two groups. Results : Among 260 study subjects, 141 (54.2%) infants had BPD. Classic BPD infants were 64 and atypical BPD infants were 77. Comparison of differences between 2 groups, classic BPD infants were associated with respiratory distress syndrome, patent ductus arteriosus, intrauterine growth restriction, more high-frequency ventilator (HFV) use, low 1 and 5 minute Apgar scores. Atypical BPD infants were associated with antenatal steroid use, maternal premature rupture of membrane and chorioamnionitis (CAM). In multivariate analysis, more HFV use was associated with classic BPD. Antenatal steroid use, clinical CAM and histological CAM were associated with atypical BPD. Conclusion : The results of this study showed that antenatal factors (antenatal steroid use, clinical CAM, histological CAM) were associated with atypical BPD and postnatal factors (HFV used more) were associated with classic BPD. Further studies are needed for prevention and treatment of BPD.

Perfusion Impairment in Infantile Autism on Brain SPECT Using Tc-99m ECD : Comparison with MR Findings (유아 자폐증 환아에서의 Tc-99m ECD를 이용한 뇌 단일 광전자 방출 전산화 단층 촬영술상의 관류 저하: 자기 공명 영상과의 비교 분석)

  • Ryu, Young-Hoon;Lee, Jong-Doo;Yoon, Pyeong-Ho;Kim, Dong-Ik;Oh, Young-Taik;Lee, Sun-Ah;Lee, Ho-Bun;Shin, Yee-Jin;Lee, Byung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.320-329
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    • 1997
  • Neuroanatomic substrate of autism has been the subjects of continuing investigation. Because previous studies had not demonstrated consistent and specific neuroimaging findings in autism and most studies comprised adults and school-aged children, we performed a retrospective review in search of common functional and anatomical abnormalities with brain SPECT using Tc-99m ECD and correlative MRI The patient population was composed of 18 children aged 28 to 89 months(mean age : 55 months) who met the diagnostic criteria of autism as defined in the DSM-IV and CARS. Brain SPECT was performed after intravenous injection of 185-370MBq of Tc-99m ECD using brain dedicated annular crystal gamma camera. MRI was performed in all patients including T1, T2 axial and T1 sagittal sequences. SPECT data were visually assessed. Thirteen patients had abnormal SPECT scan revealing focal areas of decreased perfusion. Decreased perfusion of cerebellar vermis(12/18), cerebellar hemisphere(11/18), thalami(13/18), basal ganglia(4/18), posterior parietal(7/18), and temporal(4/18) area were noted on brain SPECT. Whereas, only 3 patients had abnormal MR findings which were subtle volume loss of parieto-occipital white matter in 3 and mild thinning of posterior body of corpus callosum in 2 and slightly decreased volume of cerebellar vermis in 1. Comparison of the numbers of abnormal findings revealed that regional cerebral blood flow (rCBF) abnormalities seen on SPECT were more numerous than anatomical abnormalities seen on MRI. In conclusion, extensive perfusion impairment involving cerebellum, thalami and parietal lobe were found in this study. SPECT may be more sensitive in reflecting pathophysiology of autism than MRI. However, further studies are mandatory to determine the significance of thalamic and parietal perfusion impairment in autism.

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Consideration of Standardized Uptake Value (SUV) According to the Change of Volume Size through the Application of Astonish TF Reconstruction Method (Astonish TF 재구성 기법의 적용을 통한 체적 크기의 변화에 따른 표준섭취계수(SUV)에 관한 고찰)

  • Lee, Juyoung;Nam-Kung, Sik;Kim, Ji-Hyeon;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.115-121
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    • 2014
  • Purpose: In addition to improving the quality of the PET image, through much research, the development of various programs are performed. Astonish TF reconstruction techniques by Philips can confirm the improved contrast of the lesion. Also, It's image reconstruction of 2 mm is possible with rapid reconstruction rate than conventional. In this study, we compared and evaluated Standardized Uptake Value (SUV) in accordance with the 2 mm reconstruction techniques and traditional 4 mm from the $^{18}F-FDG$ PET whole body image. Materials and Methods: In the phantom experiment, NEMA IEC body phantom (sphere: 10, 13, 17, 22, 28, 37 mm) was used to obtain images by using GEMINI TF 64 PET/CT (Philips, Cleveland, USA). Also, In the clinical images, we performed $^{18}F-FDG$ PET/CT examination to 30 women (age: $55.1{\pm}11.3$, BMI: $24.1{\pm}2.9$) with a diagnosis of breast cancer. After that, we reconstructed images in 2 mm and 4 mm respectively. The region of interest was drawn to acquired images. Since then, we measured SUV and statistically analyzed with SPSS ver.18 by using EBW (Extended Brilliance Workstation) NM ver.1.0. Results: After analyzing the result of the phantom study, there was a tendency that the bigger hot sphere size, the higher SUV. If you compared the 2 mm reconstruction techniques to 4 mm, it increased 95.78% in 10 mm, 50.60% in 13 mm, 25.00% in 17 mm, 30.04% in 22 mm, 31.81% in 28 mm, and 27.84% in 37 mm. Through the result of the analysis of the 2 mm reconstruction techniques and 4 mm in clinical images, it appeared that SUV of 2 mm was higher than that of 4 mm. Also the smaller the volume was, the more the change rate increased. Conclusion: After analyzing the result of the clinical picture and phantom experiments applied by Astonish TF reconstruction techniques, as the size of the volume was small, the change rate of the SUV increased. Therefore, it was necessary to further research about the SUV correction for accurate and active utilization of 2 mm reconstruction techniques which had excellent lesion discrimination ability and contrast in clinic.

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