• Title/Summary/Keyword: Transcranial Doppler(TCD)

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The Study on the Appropriate Workforce Estimation of Clinical Technologists for Job Creation in the Field of Ultrasonic Inspection

  • Bae, Hyung-Joon;Kim, Dae-Sik;Lee, Og kyoung;Kim, Chul-Seung;Choi, Sun Young;An, Young-Hoi;Kim, Eun-Young;Kang, Kun-Woo;Jang, Jin-Yong
    • Biomedical Science Letters
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    • v.25 no.4
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    • pp.381-389
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    • 2019
  • The physiological function test is the only patient contact area in the field of clinical laboratory. We need to recruit and encourage the experts due to requiring the expertise and long time for examination. However, there is currently no rule for estimating optimal workforce in the field of physiological function tests. The purpose of this study is to establish the basis of the studies for mid- to long-long term job creation in the field of ultrasound by evaluating the number of appropriate tests and appropriate workforce. We calculated the quantitative and qualitative workload for the number of appropriate tests and appropriate workforce using online questionnaire. All statistical analyses were performed using SPSS version 18.0 (SPSS Inc., Chicago, IL, USA). A total of 216 respondents were 48 (22.2%) male and 168 (77.8%) female. A total of 157 laboratories were 62 (39.5%) for echocardiography, 91 (58.0%) for the transcranial Doppler (TCD) and 4 (5.7%) for the carotid ultrasound. The mean number of appropriate tests was 10 ± 2 in the echocardiography, 9 ± 2 in TCD and 11 ± 2 in the carotid ultrasound. In addition, the number of laboratories required to recruit employees for appropriate workforce was 19 in echocardiography, 18 in TCD, and 0 in carotid ultrasound. The number of hospital required to recruit workforce were 7 primary hospitals, 22 secondary hospitals, 7 third hospitals. This study can be used as an important data as the first study at present time when the data on the workforce status and work environment of the ultrasonic laboratories is insufficient. Based on the quantitative and qualitative workloads, the number of appropriate tests and appropriate workforce can support mid- to long-long term job creation in the field of ultrasound.

Cerebral Blood Flow Velocity Measurement by TCD: The Effects of Interferential Current (TCD를 이용한 뇌혈류속도 측정: 간섭전류의 효과)

  • Lee Mun-Hwan;Han Jong-Man
    • The Journal of Korean Physical Therapy
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    • v.17 no.2
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    • pp.126-147
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    • 2005
  • TCD(transcranial doppler, TCD) units is a equipment that measure a blood flow velocity in the middle cerebral artery(MCA), anterior cerebral artery(ACA), posterior cerebral artery(PCA), and vertebral artery(VA). The aim of this study was to determine the influence on cerebral blood flow velocity according to different stimulation frequency of interferential currents. 50 patients who has a cervical pain were participated in this study and randomly divided into one of the three experimental, placebo, and control group: (1)IFS 1; $10{\sim}30Hz$ was applied, (2)IFS 2; $30{\sim}50Hz$ was applied, (3)IFS 3; $50{\sim}100Hz$ was applied, (4)placebo; suction only applied, and (5)control; neither suction nor interferential stimulation applied. In the IFS groups, interferential stimulations were applied through four suction electrodes application from the 5th cervical to the 1st thoracic level. The results were as follow; 1. MCA was statistically significant with IFS 1, IFS 2, IFS 3, and Placebo group(p<0.05), But there was no statistical significance between IFS 1 and IFS 3 group(p>0.05). 2. ACA was statistically significant with IFS 1, IFS 2, and IFS 3 group(p<0.05). And IFS 1 was more statistical significance than IFS 3 group on ACA(p<0.05). 3. PCA was statistically significant with IFS 1, IFS 2, and IFS 3 group(p<0.05). And IFS 1 was more statistical significance than IFS 3 group on PCA(p<0.05). 4. VA was statistically significant with IFS 1, IFS 2, and IFS 3 group(p<0.05). And IFS 1 was more statistical significance than IFS 3 group on VA(p<0.05).

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Post-Carotid Endarterectomy Cerebral Hyperperfusion Syndrome : Is It Preventable by Strict Blood Pressure Control?

  • Kim, Kyung Hyun;Lee, Chang-Hyun;Son, Young-Je;Yang, Hee-Jin;Chung, Young Sub;Lee, Sang Hyung
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.159-163
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    • 2013
  • Objective : Cerebral hyperperfusion syndrome (CHS) is a serious complication after carotid endarterectomy (CEA). However, the prevalence of CHS has decreased as techniques have improved. This study evaluates the role of strict blood pressure (BP) control for the prevention of CHS. Methods : All 18 patients who received CEA from February 2009 through November 2012 were retrospectively reviewed. All patients were routinely managed in an intensive care unit by a same protocol. The cerebral perfusion state was evaluated on the basis of the regional cerebral blood flow (rCBF) study by perfusion computed tomography (pCT) and mean velocity by transcranial doppler (TCD). BP was strictly controlled (<140/90 mm Hg) for 7 days. When either post-CEA hyperperfusion (>100% increase in the rCBF by pCT or in the mean velocity by TCD compared with preoperative values) or CHS was detected, BP was maintained below 120/80 mm Hg. Results : TCD and pCT data on the patients were analyzed. Ipsilateral rCBF was significantly increased after CEA in the pCT (p=0.049). Post-CEA hyperperfusion was observed in 3 patients (18.7%) in the pCT and 2 patients (12.5%) in the TCD study. No patients developed clinical CHS for one month after CEA. Furthermore, no patients developed additional neurological deficits related to postoperative cerebrovascular complications. Conclusion : Intensive care with strict BP control (<140/90 mm Hg) achieved a low prevalence of post-CEA hyperperfusion and prevented CHS. This study suggests that intensive care with strict BP control can prevent the prevalence of post-CEA CHS.

Effect of Exercises on the Cerebral Blood Flow (운동이 뇌 혈류 변화에 미치는 영향)

  • Song, Myung-Soo;Choi, Su-Hee
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.1 no.2
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    • pp.1-9
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    • 2003
  • The purpose of this study was to analyze the effect given to the variable details which disturb the flow of blood in brain artery disease through Aerobic exercises. It chose the subjects of study : 5 persons in an exercise group and 5 persons in a non-exercise group. Peak brain blood velocity, mean velocity, and resistance & artery stricture ratio were measured with TCD, measure machine for brain artery blood flow. The conclusion of the study was as follows: 1. At pre-test of an exercises group and a non-exercise group, PBV, MBV, BRI, ASI of a non-exercise group were showed much lower in the variation of left common carotid artery(LCCA). 2. At post-test of an aerobic exercises group and a non-exercise group, PBV, MBV, BRI, ASI of a non-exercise group were showed just a little decrease ratio but were not significant different in the variation of left common carotid artery(LCCA). Viewing on the base of these result, continuing exercises promote the functional improvement of the heart blood system and were showed the positive variation of artery stricture ratio according to brain blood flow velocity, the pulse and resistance or blood velocity. Therefore programs for prescriptions through aerobic exercises must be developed in many ways.

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The Effects of Myofascial Relaxation on Blood Flow Velocity of the Cranial Artery and Pain Level in Cervicogenic Headache Patients (근막이완술이 경추성 두통환자의 뇌혈류와 통증수준에 미치는 영향)

  • Lee, Joon-Hee;Kang, Da-Haeng;Kang, Jeong-Il
    • The Journal of Korean Physical Therapy
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    • v.22 no.5
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    • pp.49-56
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    • 2010
  • Purpose: The aim of this study was to evaluate a possible role for cranial artery velocity in cervicogenic headache. Methods: We studied 13 patients with cervicogenic headaches (M=9, F=4, age=$24.50{\pm}3.50\;y$) these were compared to 20 normal subjects (M=10, F=10, age=$23.30{\pm}2.90\;y$). Cervicogenic headache patients were divided into two groups (a myofascial relaxation group, a placebo group). Pain levels were measured using a visual analog scale (VAS). Transcranial Doppler (TCD) ultrasound recordings were used to measure blood flow velocity in the cranial artery. Results: Cervicogenic headache patients exhibited a significantly lower blood flow velocity in the middle cerebral artery. The patients who received an intervention had a significantly higher blood flow velocity in the left middle cerebral artery, right vertebral artery and basilar artery. Compared to the placebo group, the myofascial relaxation group exhibited a significantly decreased level of pain. Conclusion: Cervicogenic headache is pain referred to the head from a source in the cervical spine. Manual therapy affect to cervical spine and soft tissue as well as the passage of these vessels and nerves to recover because it is thought to be able to help.

Effects of Silver Spike Point Therapy on Blood Flow of the Middle Cerebral Arteries in Headache Patients When Applied to Acupuncture Points (경혈에 적용한 은침점 자극치료가 두통환자의 중대뇌동맥 혈류속도 및 통증에 미치는 영향)

  • Seo, Hyo-Seok;Yun, Young-Dae
    • Korean Journal of Acupuncture
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    • v.25 no.3
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    • pp.29-41
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    • 2008
  • Objectives : The aim of this study is to examine the effects of SSP(silver-spike point) therapy, applied to acupuncture points, on the middle cerebral arteries blood flows of sample group(tention-type headache patients, n=12) and control group(non tension-type headache patients, n=12), and on the reduction of their headaches, when applied to acupuncture points. Methods : We stimulated 6 acupuncture points for headache with the SSP(three times a week for three weeks), and measured VAS(visual analogue scale) and the blood flow of the middle cerebral arteries with TCD(transcranial doppler ultrasonography). Results : The blood flow of the middle cerebral artery and VAS of the sample group and the control group were compared four times(initial, 1weeks, 2weeks, 3weeks) and significant differences in the measurements were found at 3 weeks(p<.05). The blood flow of the middle cerebral artery of the sample group was significantly increased, and VAS was significantly decreased in both groups. Conclusions : The silver-spike-point low-frequency electrical-stimulation treatment, applied to acupuncture points, can significantly increase the blood flow of the middle cerebral arteries in headache patients and can thus alleviate their headaches.

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The Effects of Cervical Manipulation on Blood Flow Velocity of Cranial Artery and Pain Level in Cervicogenic Headache Patients

  • Kang, Da-Haeng;Park, Seung-Kyu;Kang, Jeong-Il;An, Chang-Sik;Kim, Yong-Nam;Yoon, Hee-Jong;Koo, Ja-Pung;Chang, Duncan;Lee, Joon-Hee
    • Journal of International Academy of Physical Therapy Research
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    • v.1 no.2
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    • pp.99-106
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    • 2010
  • The purpose of this study was to identify the effects of manipulation on the velocity of cerebral blood flow and level of pain in cervicogeinc headache patients. The velocity of cerebral blood flow of 30 cervicogeinc headache patients(male=15, female=15, age=$24.00{\pm}3.60$) and 33 normal subjects(male=15, female=18, age=$23.27{\pm}3.00$) was compared. The 30 cervicogeinc headache patients were divided into suboccipitalis relaxation group, cervical manipulation group, and placebo group, and each were given different interventions. The velocity of cerebral blood flow and pain level was measured before intervention, and 1, 2, 3 weeks after intervention. The velocity of cerebral blood flow was measured with the Transcranial Doppler(TCD), and pain level was measured with visual analog scale(VAS). Blood flow velocity of middle cerebral artery in cervicogeinc headache patients was slower than those in healthy subjects. Physical therapy intervention did not have significant effect on velocity of cerebral blood flow, but slowly decreased at intervention for pain level increased. The suboccipitalis relaxation group and cervical manipulation group showed significant effect in decreasing pain level compared to the placebo group(p<.05). Directly applied manipulation therapy in the neck area not only has effect on joint of cervical and soft tissue but also on blood vessels and nerves which pass the neck area, and because of those results of manual therapy seems to help recovery.

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Application of Neurophysiological Studies in Clinical Neurology (임상신경생리 분야에서의 신경생리적 검사법의 응용)

  • Lee, Kwang-Woo;Park, Kyung-Seok
    • Annals of Clinical Neurophysiology
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    • v.1 no.1
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    • pp.1-9
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    • 1999
  • Since Hans Berger reported the first paper on the human electroencephalogram in 1920s, huge technological advance have made it possible to use a number of electrophysiological approaches to neurological diagnosis in clinical neurology. In majority of the neurology training hospitals they have facilities of electroencephalography(EEG), electromyography(EMG), evoked potentials(EP), polysomnography(PSG), electronystagmography(ENG) and, transcranial doppler(TCD) ete. Clinicials and electrophysiologists should understand the technologic characteristics and general applications of each electrophysiological studies to get useful informations with using them in clinics. It is generally agreed that items of these tests are selected under the clinical examination, the tests are performed by the experts, and the test results are interpretated under the clinical background. Otherwise these tests are sometimes useless and lead clinicians to misunderstand the lesion site, the nature of disease, or the disease course. In this sense the clinical utility of neurophysiological tests could be summerized in the followings. First, the abnormal functioning of the nervous system and its environments can be demonstrated when the history and neurological examinations are equivocal. Second, the presence of clinically unsuspected malfunction in the nervous system can be revealed by those tests. Finally the objective changes can be monitored over time in the patient's status. Also intraoperative monitoring technique becomes one of the important procedures when the major operations in the posterior fossa or in the spinal cord are performed. In 1996, the Korean Society for Clinical Neurophysiology(KSCN) was founded with the hope that it will provide the members with the comfortable place for discussing their clinical and academic experience, exchanging new informations, and learning new techniques of the neurophysiological tests. The KSCN could collaborate with the International Federation of Clinical Neurophysiology(IFCN) to improve the level of the clinical neurophysiologic field in Korea as will as in Asian region.1 In this paper the clinical neurophysiological tests which are commonly used in clinical neurology and which will be delt with and educated by the KSCN in the future will be discussed briefly in order of EEG, EMG, EP, PSG, TCD, ENG, and Intraoperative monitoring.

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Effects of Hap-Kok(LI4) and Jok-Sam-Lee(ST36) Acupuncture on Cerebral Blood Flow in In-Young(ST9) (합곡(合谷) 및 족삼이(足三里) 혈(穴) 자침이 인영혈(人迎穴)부위의 뇌혈류에 미치는 영향)

  • Lee, Chung-Sik;Park, Bo-Ra;Seo, Jong-Hoon;Kang, Hyung-Won;Lyu, Yeoung-Su;Kim, Tae-Heon
    • Journal of Oriental Neuropsychiatry
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    • v.18 no.1
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    • pp.143-151
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    • 2007
  • Objective : This study was performed to evaluate the effects of Hap-Kok(LI4) and Jok-Sam-Lee(ST36) acupuncture on blood flow in In-Young(ST9). Method : Monitoring of TCD was examined in each 25's healthy men and wemen in 20s before and after acupucture on both(right and left) Hap-kok(LI4) and was done on both(right and left) Jok-Sam-Lee(ST36) by different group with same condition. Mean velocity and Pulsatility index analyzed from TCD at both In-Young(ST9). Both group was acupuctured for 15-20 minutes laying at bed. Results : The results showed a significant($p{\le}0.05:$ Paired T-test) decrease in mean velocity and increase in pulsatility index at both group. Conclusion : These results suggest that acupuncture could have a specific effect on blood flow called In-Young acupoint.

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Changes of Microembolic Signals after Heart Valve Surgery (심장 판막 수술 후 미세색전의 변화)

  • 조수진;이은일;백만종;오삼세;나찬영
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.316-320
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    • 2003
  • Background: The detection of circulating microemboli by transcranial Doppler ultrasonography (TCD) has the potential to select the patients with high risk for future symptomatic brain embolism. We prospectively evaluated the positive rate and the frequency of microembolic signals (MES) before and after the heart valve surgery (HVS). Material and Method: Fifty in-patients with heart valve disease were enrolled in this study. Patients with history of previous stroke or heart valve surgery were excluded. Two unilateral TCD monitoring sessions were peformed from middle cerebral artery for 1-hour, before and after HVS. Result: Mechanical Heart valves were implanted in 28 patients, tissue valves were implanted in 10 patients, and remaining 12 patients received mitral valve repair. Positive rate of MES was significantly increased after HVS (50%), compared to that of before HVS (8%, p=0.00). There was no relation between MES after HVS and intensity of anticoagulation, cardiac rhythm, patients' age, and history of hypertension. The positive rate of MES after implantation of mechanical heart valve (71.4%) was significantly higher than those after implantation of tissue valve or mitral valve plasty (p=0.002). Conclusion: Positive rate of MES was increased significantly after the implantation of HVS. The changes of MES in those with mechanical prosthesis may be related to the increased risk or embolism after Hvs.