• Annals of Clinical Neurophysiology
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• 제1권1호
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• pp.60-63
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• 1999

Transcranial Doppler(TCD) is an important diagnostic tool for evaluating the patients with stroke. It has some advantages and unique role when compared with other neuroimaging modalities. Recent development of transcranial color-coded Doppler(TCD) improves the limitation and pitfalls of TCD. The current indications of TCD are as follows: 1. Screening and evaluation of the intracranial major vessels 2. early detection and follow-up of vasospasm due to SAH 3. emboli detection (high-imtensity transient signals, HITs) 4. dignosis and follow-up of subclavian steal 5. evaluation of intracranial collaterals when the extracranial ICA has severe stenosis or occlusion 6. evaluation of cerebral perfusion pressure (intracranial pressure) 7. evaluation of arteriovenous malformation 8. diagnosis and follow-up of arterial dissenction 9. diagnosis and follow-up of venous sinus thrombosis (experimental).

• 대한중풍순환신경학회지
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• 제6권1호
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• pp.45-53
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• 2005

Objective : This study was performed to examine the relationship between cerebral blood vessel with meridian by using Transcranial Doppler Ultrasonography(TCD) Method : Monitoring of TCD was examined in 10 healthy people in their twenties (mean age was 26.5±1.00). Each examination was performed before & after acupuncture. Three Meridian were tested. Those were Stomach Meridian, Bladder Meridian & Gallbladder Meridian. Maximum velocity and Mean velocity were analyzed from TCD on different vessel. Result : The results showed significant(p<0.05; Wilcoxon signed rank test) change in some cerebral blood flow after acupuncture. Conclusion : There was the relationship between Meridian and cerebral blood vessel.

• 대한임상검사과학회지
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• 제50권4호
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• pp.477-483
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• 2018

뇌혈류 초음파 검사는 비침습적인 방법으로 대뇌 혈관 혈류 속도와 방향을 도플러 원리로 측정하는 검사이다. 뇌혈류 초음파 검사의 박동지수는 원위부 혈관 저항을 반영하는 측정 지표이며 대뇌 소혈관 질환 발생과 확산지표로 사용되고 있다. 본연구의 목적은 허혈성 뇌졸중 환자에서 기저 동맥의 박동지수에 영향을 미치는 위험 인자를 평가하는데 있다. 2014년 1월부터 2015년 5월까지 내원 환자를 대상으로 뇌혈류 초음파 검사 박동지수를 측정하여 기저동맥 박동지수 대상자 422명을 선정하였다. 기저동맥 박동지수를 종속변수로 하여 단변량 분석을 실시하였고, 박동지수에 영향을 미치는 인자를 변수에 특징을 고려하여 다중회귀 분석을 실시하였다. 단변량 분석 결과 박동지수에 영향을 미치는 인자는 연령, 고혈압 유무, 당뇨 유무, 고지혈증 유무, 적혈구용적으로 나타났다(P<0.1) 다중회귀분석을 실시한 결과 연령(P<0.001), 당뇨 유무(P=0.004), 고지혈증 유무(P=0.041)가 통계적으로 유의한 결과를 보였다. 뇌혈류 초음파 검사의 박동지수에 영향을 미치는 위험인자는 고령, 당뇨, 고지혈증이다. 이후 추가적인 연구를 통하여 두 개 내 박동지수 증가는 고령, 당뇨, 고지혈증을 반영하는 지표로 활용 될 수 있을 것으로 생각된다.

• Journal of Korean Neurosurgical Society
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• 제44권2호
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• pp.63-66
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• 2008

Objective : The purpose of this study is to investigate the correlation between various transcranial Doppler (TCD) ultrasonography parameters and clinical vasospasm after aneurysmal subarachnoid hemorrhage (SAH). Methods : This study enrolled 40 patients presented with aneurysmal SAH between September 2006 and August 2007. We measured differences of mean blood flow velocity (BFVm), highest systolic blood flow velocity (BFVh), and Lindegaard ratio (LR) in the middle cerebral artery on TCD examination. These parameters were evaluated for correlation with clinical vasospasm by univariate analysis and the receiver operating characteristic analysis. Results : Twelve patients (30%) developed clinical vasospasm. The best TCD parameters for the detection of clinical vasospasm were revealed to be differences of BFVm, BFVh, and LR values between $1^{st}$ TCD test and $3^{rd}$ TCD (7 cm/s. 11.5 cm/s, 0.45 respectively). The positive predictive value of anyone of three parameters was 60% and the negative predictive value was 100%. Conclusion : TCD is still considered a useful tool for screening clinical vasospasm. To confirm the predictive value of the above parameters. further prospective study will be needed.

• 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.

• 대한임상검사과학회지
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• 제42권3호
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• pp.155-160
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• 2010

Transcranial Doppler ultrasonography (TCD) allows measurement of blood flow velocity to be made from the basal intracerebral vessels. Blood flow velocity in TCD is highly affected not only by blood vessel diameter, blood flow volume, blood viscosity, but also age and sex. Therefore, the study is focused on the correlation between TCD measurement index and sex/age. Subjects were 214 (male 147, famale 67) who had TCD for headache and stroke evaluations at Dongguk University Ilsan Hospital neurology department from December 2009 to April 2010. Sex did not show significant differences with mean flow velocity (MFV), peak systolic flow velocity (PSFV), end diastolic flow velocity (EDFV), pulsatility index (PI) and resistance index (RI) in middle cerebral artery (MCA). Although age also did not show significant differences with MFV and PSFV, EDFV has statistically decreased with age, and PI and RI has statistically increased with age. In addition, age showed significant correlation with MFV, EDFV, PI and RI, but not with PSFV. Therefore, TCD is definitely correlated with age and sex, so that those influencial factors must be considered when being tested.

• Journal of Korean Neurosurgical Society
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• 제39권1호
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• pp.20-25
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• 2006

Objective : The authors analyze prospectively the result of transcranial doppler[TCD] in normal pressure hydrocephalus and compared its cerebral blood flow parameters to radionuclide cerebrospinal fluid[CSF] flow study, postoperative brain computed tomography[CT] findings and clinical outcome, and studied the relationship between cerebral hemodynamics and clinical performance. Methods : Twenty five patients with hydrocephalus undertook pre- and post-operative TCD but only preoperative CSF flow study was performed. Mean flow velocity[Vm], pulsatility index[PI] and resistance index[RI] were assessed through TCD and changes in ventricle size and cortical gyral atrophy were checked through brain CT. Results : Postoperative hydrocephalus showed an increase in Vm[ACA P=0.037, MCA P=0.034], decrease in PI[ACA P=0.019, MCA P=0.017] and decrease in RI [ACA P=0.017, MCA P=0.021] compared to preoperative TCD parameters in the postoperative improvement group. In the postoperative improvement group, postoperative TCD parameters correlated with CSF flow study grade [Vm : $R^2=-0.75$, PI : $R^2=0.86$, RI : $R^2=0.78$] and ventriculocranial ratio change correlated with PI change [$R^2=0.73$]. The convexity gyral atrophy and initial TCD parameters showed close relationship to outcome. Conclusion : PI and RI can be used as an indicator of post operative prognosis, and with the addition of CSF flow study values, can also be used as a tool to predict pre-op and post-op patient status and successful shunt surgery.

• Journal of Acupuncture Research
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• 제21권3호
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• pp.83-97
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• 2004

Objective : This study was performed to evaluate the effect acupuncture on cerebral blood flow by Transcranial Doppler Ultrasonography(TCD). Methods : Monitoring of TCD was examined in stroke patients before and after acupuncture on seven points of CVA. Mean Velocity, pulsatility index, systolic velocity, diastolic velocity values are analyzed from TCD at middle cerebral artery. Results : The results showed a insignificant(p>0.05: Paired T-test) decrease in mean velocity, pulsatility index, systolic velocity, diastolic velocity, which was measured at normal middle cerebral artery. The results showed a significant($p{\leq}0.05$: Paired T-test) decrease in mean velocity, pulsatility index, systolic velocity, which was measured at injuried middle cerebral artery, except diastolic velocity. Conclusion : These results suggest that acupuncture could have a specific effect on injuried cerebral artery.

• Annals of Clinical Neurophysiology
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• 제14권1호
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• pp.20-24
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• 2012

Background: Migraine patients can be sensitive to external or internal stimuli, such as light, noise, or hormonal changes. Using transcranial Doppler ultrasonography (TCD) with breath-holding method, we evaluated the changes of cerebrovascular reactivity (CVR) to hypercapnia in women with migraine without aura between fasting and postprandial period. Methods: Twelve women with migraine without aura and the same number of age and sex-matched healthy controls with no significant history of headache participated in this study. Using TCD examinations, we studied mean flow velocity in middle cerebral artery with better temporal window. Each subject was examined consecutively before and after a standard meal, together with serum glucose level and blood pressure. CVR was evaluated with breath-holding index (BHI). Results: Postprandial-BHI (mean+SD) was significantly higher than fasting-BHI (mean+SD) in patients group but not in controls (in patient group; postprandial-BHI=1.38, fasting-BHI=1.08, in control group; postprandial-BHI=1.25, fasting-BHI=1.18, P=0.021 and 0.239, respectively). After meal, serum glucose level was significantly enhanced but blood pressure was not in both groups. Serum glucose level of patients showed a tendency of mild positive correlation with BHIs (${\gamma}$=0.448, P=0.032). Conclusions: Although exact mechanisms are unclear, cerebrovascular reactivity of some women with migraine without aura may be influenced by prandial state.

• 대한의생명과학회지
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• 제15권1호
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• pp.17-23
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• 2009

The prevalence of patent foramen ovale (PFO) in healthy persons was estimated as about $10{\sim}25%$ and was up to 40% in patients with stroke. Transesophageal echocardiography (TEE) was considered to be the most sensitive method to detect PFO and was used as the gold standard. Transcranial doppler sonography (TCD) of the middle cerebral artery (MCA) during a contrast (saline bubble) injection has recently been proposed as an alternative detecting method for PFO. In this study, we would like to know the difference between TCD value and TEE value in subjects with cryptogenic ischemic stroke. We performed TCD and TEE tests to detect PFO on 64 patients (30 women and 34 men, mean age was 59.4 years) with cryptogenic ischemic stroke. PFO prevalence through TCD was 45.3% (29 of 64 patients) and the prevalence through TEE was 34.4% (22 of 64 patients). There was no statistical significance between PFO test and TCD test (P=0.206). But TCD had a sensitivity of 90.9% (20 of 22 patients), specificity of 78.6% (33 of 42 patients), positive predictive value of 69.0% (20 of 29 patients), and negative predictive value of 94.3% (33 of 35 patients). We concluded that TCD was a highly sensitive method for detecting a right-left shunt. Therefore, the non-invasive TCD test is a method more effective than the anti-invasive TEE test in the cost and evaluation of the existence or nonexistence of right to left shunt in addition to the screening method of the cerebrovascular disorder. Considering these points, TCD test could be recommended for patients with cryptogenic ischemic stroke as a useful and convenient method for screening of the existence or nonexistence of a right to left shunt caused by PFO.