• 대한방사선기술학회지:방사선기술과학
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• 제40권2호
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• pp.213-218
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• 2017

최근 고위험 임신군이 증가함에 따라 과거에 비해 음향파워 세기가 높은 도플러초음파 이용이 산전 진단에서 점차 증가하고 있으며, 여러 기관에서 가이드라인을 설정하여 과도한 노출을 자제하고 있다. 따라서 본 연구에서는 장시간 초음파검사 실시에 따른 검사모드 별 체표면의 온도변화를 알아보고 열효과에 영향을 받지 않는 노출시간을 고찰해 보고자 하였다. 시간경과에 따른 B mode, C mode, PD mode 별 초음파를 조사한 부위와 조사하지 않은 부위의 온도변화를 측정하여 차이를 비교하였으며 B mode는 초음파 조사 후 10분, 50분에서, C mode는 20분부터, PD mode는 30분부터 온도변화에 유의한 차이를 나타내었다(p<0.01). 측정시점에 따라 3개의 mode에서 모두 온도상승에 차이를 보였으며(p<0.000), PD mode가 가장 온도변화에 민감한 반응을 나타내었다. 또한 초음파 노출시간이 증가함에 따라 온도상승 시간이 짧아짐을 알 수 있었다. 따라서 배아나 태아를 관찰하기 위한 초음파검사 시 과도한 검사시간을 피하여 진단목적으로만 신속하게 사용할 것을 권고한다.

• 한국방사선학회논문지
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• 제17권3호
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• pp.385-392
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• 2023

카롤리병은 섬유낭성 간질환이다. 상염색체 열성 장애로 담관의 선천적 다발성 확장이 특징이다. 카롤리병을 진단하는 방법으로 전산화단층촬영, 자기공명영상 검사, 담관 조영술, 초음파 검사가 있다. 전산화단층촬영검사는 섬유다낭성 간 질환을 감지하고 구별하는데 필수적이며, 간 내 담관의 확장을 판별하는 데 유용하다. 하지만 조영제를 사용함으로써 일어날 수 있는 부작용에 대한 인지가 필요하다. 자기공명영상검사는 대표적으로 자기공명담췌관조영술 방법을 이용한다. 비침습적 검사로 환자의 고통을 경감할 수 있고, 담췌관부의 해부학적 구조와 병변 유무를 쉽고 빠르게 관찰이 가능하다. 담관 조영술은 비대해진 담관 전체에 걸친 여러 낭성 확장을 직접 시각화할 수 있는 효과적인 진단 방법이다. 하지만 이 시술 또한 침습적인 시술이므로 진단이 아닌 치료 목적으로 권장된다. 초음파 검사는 전산화단층촬영과 유사한 소견을 확인할 수 있다. 간동맥 뿌리는 기존의 그레이 스케일 초음파에서 증명하기 쉽지 않다. 하지만 관 내 혈관 뿌리를 가진 확장된 담관을 묘사할 수 있을 뿐만 아니라 관 내 색상 도플러 신호를 쉽게 식별할 수 있다는 점에서 임상적 가치를 갖고 있다. 최근엔 영상진단의 발전으로 전산화단층촬영 검사, 자기공명영상 검사, 담관 조영술, 초음파 검사 등으로 조기 진단이 가능해졌다. 조기 진단을 통해 치료 후에 장기적인 예후가 개선될 수 있도록 영상 진단 발전에 더욱 기여하고자 각 검사별 카롤리병에 대하여 어떠한 양상이 나타나는지 고찰하였다

• Journal of Korean Neurosurgical Society
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• 제52권3호
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• pp.172-178
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• 2012

Objective : The aim of this study was to determine the role of intra-arterial (IA) nimodipine injections for cerebral vasospasm secondary to ruptured subarachnoid hemorrhage (SAH) and to investigate the factors that influence vasodilation and clinical outcomes. Methods : We enrolled 29 patients who underwent aneurysm clipping for ruptured cerebral aneurysms between 2009 and 2011, and who received IA nimodipine after subsequently presenting with symptomatic vasospasm. The degree of vasodilation shown in angiography was measured, and the correlation between the degree of vasodilation and both the interval from SAH to cerebral vasospasm and the interval from clipping to cerebral vasospasm was determined. The change in blood flow rate after IA injection was assessed by transcranial Doppler ultrasound. Multiple clinical parameters were completed before and after IA nimodipine injection to evaluate any improvements in clinical symptoms. Results : For eight patients, Glasgow Coma Scale (GCS) scores increased by two or more points. The regression analysis demonstrated a positive correlation between the change in GCS scores after IA nimodipine injection and the change in blood vessel diameter (p=0.025). A positive correlation was also observed between the interval from SAH to vasospasm and the change in diameter (p=0.040); and the interval from clipping to vasospasm and the change in diameter (p=0.022). Conclusion : IA nimodipine injection for SAH-induced vasospasm led to significant vasodilation in angiography and improvement in clinical symptoms without significant complications. Our findings suggest that IA nimodipine injection should be utilized when intractable vasospasm develops despite rigorous conservative management.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.719-724
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• 2011

Purpose: Previous studies of the facial artery have shown significant anatomical variability in this region. The vascular anatomy of the region is considered unreliable in predicting the ideal pedicle. Preoperative imaging has been suggested as a means of improving preoperative awareness, with Doppler ultrasound as useful tools. Multi-detector row angiographic computed tomography (angio CT) is a significant improvement, providing noninvasive operator-independent details of the vascular anatomy. This tool was used to perform an $in$ $vivo$ anatomical study of the facial artery, demonstrating the usefulness of facial angio CT in planning the facial reconstruction. Methods: Eleven consecutive patients underwent facial angio CT of the facial vasculature with the anatomical details of the facial artery assessed. Results: Facial angio CT could demonstrate the size and course of the facial vasculature, particularly the facial artery. Conclusion: The vascular anatomy of the facial artery is highly variable, and thus there is a role for preoperative imaging. Facial angio CT can demonstrate cases where there is an aberrant or non-preferred anatomy, or select the method of a facial reconstruction.

• The Korean Journal of Pain
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• 제14권1호
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• pp.37-40
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• 2001

Background: It had been reported by authors that linear polarized infrared light radiation (Superizer: SL) near the stellate ganglion had a similar effect on the change of skin temperature of hand compared with the stellate ganglion block (SGB). We hypothesized that this was due to dilatation of vessels and an increased blood flow. The aim of this study was to measure the velocity of blood flow in peripheral vessels after linear polarized infrared light radiation near the stellate ganglion and to compare the effect of SL with that of SGB using local anesthetics. Methods: Forty patients whose clinical criteria were matched for the symptoms of SGB were selected for study. We radiated the stellate ganglion by linear polarized infrared light radiation and measured the blood flow of radial artery using Ultrasound Doppler blood flow meter before and after 10, 20 and 30 minutes post-radiation. After 3 days, SGB was performed using 8 ml of 1% mepivacaine to the same patient, and the radial artery blood flow was measured in the same manner. Results: The blood flow velocity was increased by 40% and 27% at 10 min and 20 min after SL and by 42% and 41% at 10 min and 20 min after SGB. However, there was no statistically significant difference in blood flow velocity between SGL and SGB. Conclusions: We could conclude that linear polarized radiation is a clinically simple and useful noninvasive therapeutic tool in clinical area.

• Archives of Plastic Surgery
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• 제38권3호
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• pp.315-318
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• 2011

Purpose: An aneurysm is defined as a permanent, localized dilation of an artery with a 50% increase in diameter over its expected normal diameter. Aneurysms can be classified by cause as traumatic and nontraumatic. Traumatic aneurysms can be divided into true and false aneurysms. Nontraumatic causes of peripheral artery aneurysms include mycotic, atherosclerotic, inflammatory, and idiopathic. In the hand, true aneurysms occurring at the common digital artery have been rarely reported. We present a rare case of a true aneurysm of the common digital artery that was resected and reconstructed using a reversed vein graft. Methods: A 49-year-old male patient was refered to our institution with a $0.73{\times}0.44{\times}1.37cm$ sized pulsating mass between 2nd and 3rd flexor digitorum tendons on Lt. palm area. The mass had been present for 5 years and had increased in size over the previous year. No history of trauma was reported. After a physical examination and ultrasound sonography review, a diagnosis of aneurismal dilatation of common digital artery was made. Surgical treatment by excision of the aneurysm, and a reversed vein graft was performed. Results: Histologic examination of the specimen ($3.4{\times}0.7cm$) showed aneurismal dilatation, with elastin fibers present in the arterial wall. The lesions were healed without any complications and there were no evidence of recurrence. Doppler examination of the reconstruction showed good perfusion. Conclusion: Early excision is recommended to relieve symptoms and avoid neurologic damage. Also, artery reconstruction can be performed by primary end-to-end anastomosis or the placement of a reversed interposition vein graft. Micro surgical repair was the only possible treatment in this case. The authors believe that the vascular anatomy should always be restored as natural as possible.

• Smart Structures and Systems
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• 제26권5호
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• pp.657-666
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• 2020

A rotational pulse-echo ultrasonic propagation imager that can inspect cylindrical specimens for material nondestructive evaluations is proposed herein. In this system, a laser-generated ultrasonic bulk wave is used for inspection, which enables a clear visualization of subsurface defects with a precise reproduction of the damage shape and size. The ultrasonic waves are generated by a Q-switched laser that impinges on the outer surface of the specimen walls. The generated waves travel through the walls and their echo is detected by a Laser Doppler Vibrometer (LDV) at the same point. To obtain the optimal Signal-to-Noise Ratio (SNR) of the measured signal, the LDV requires the sensed surface to be at a right angle to the laser beam and at a predefined constant standoff distance from the laser head. For flat specimens, these constraints can be easily satisfied by performing a raster scan using a dual-axis linear stage. However, this arrangement cannot be used for cylindrical specimens owing to their curved nature. To inspect the cylindrical specimens, a circular scan technology is newly proposed for pulse-echo laser ultrasound. A rotational stage is coupled with a single-axis linear stage to inspect the desired area of the specimen. This system arrangement ensures that the standoff distance and beam incidence angle are maintained while the cylindrical specimen is being inspected. This enables the inspection of a curved specimen while maintaining the optimal SNR. The measurement result is displayed in parallel with the on-going inspection. The inspection data used in scanning are mapped from rotational coordinates to linear coordinates for visualization and post-processing of results. A graphical user interface software is implemented in C++ using a QT framework and controls all the individual blocks of the system and implements the necessary image processing, scan calculations, data acquisition, signal processing and result visualization.

• Archives of Reconstructive Microsurgery
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• 제25권2호
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• pp.49-55
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• 2016

Purpose: Soft tissue defects in the lumbosacral area can be challenging to treat, and various methods to accomplish this have been proposed, including the use of perforator flaps. Herein, we present our experience with superior gluteal artery perforator (SGAP) and inferior gluteal artery perforator (IGAP) flaps for the reconstruction of lumbosacral defects. Materials and Methods: From March 2013 to July 2016, 28 cases (27 patients) of lumbosacral defects were treated by reconstruction with SGAP or IGAP flaps. The defects were caused by pressure sores (21 cases), burns (3 cases), tumor resection (2 cases), scars (1 case), or foreign body infection (1 case). Reliable perforators around the defect were found using Doppler ultrasound. The perforator flaps were elevated with a pulsatile perforator and rotated to cover the defects. Results: Twenty-three SGAP and 5 IGAP flap reconstructions were performed. The mean flap size was $9.2{\times}6.1cm^2$ (range, $5{\times}3cm^2$ to $16{\times}10cm^2$). Donor sites were closed by primary closure. Partial flap necrosis occurred in two cases, and minor complications of wound dehiscence occurred in 3 cases, which were healed by primary closure. The mean follow-up period was 4.4 months (range, 1~24 months). Conclusion: Gluteal-based perforator flaps can be safely harvested due to pliability and reliable vascularity in the gluteal area, reducing donor site morbidity without sacrificing the underlying muscles. Thus, these flaps are useful options for the reconstruction of lumbosacral defects.

• 한국전문물리치료학회지
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• 제9권2호
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• pp.107-113
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• 2002

This study was conducted to determine the effects of deep breathing exercise and ankle exercise on blood flow velocity in the femoral vein. Sixteen healthy male students were recruited from Yonsei University, at Wonju. The blood flow velocities in the femoral vein were measured under three different conditions: resting, deep breathing, and ankle exercise. All subjects were given a 5-minute relaxing time in supine position prior to the study. Using a doppler ultrasound with a 8 MHz probe, the peak blood flow velocities were collected in a twenty-second-period at each condition. The subjects took a rest in between trials for the blood flow to return to its resting levels. The result showed a significant difference in peak blood flow velocities under those three conditions (p<.001). The peak blood flow velocity was highest in ankle exercise condition. The peak blood velocity was significantly higher in deep breathing condition compared with the resting condition. As a result, it is revealed that not only the muscular contractions but also the deep breathing exercises induced facilitating effects of venous return. Either of the exercise methods can be recommended to prevent blood stasis in patients with risk of deep vein thrombosis after cardiac or lower extremity surgery.

• 한국컴퓨터정보학회:학술대회논문집
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• 한국컴퓨터정보학회 2019년도 제60차 하계학술대회논문집 27권2호
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• pp.19-22
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• 2019

상완동맥은 어깨에서부터 팔꿈치까지 내려오는 상완골의 내측부에 존재하며 혈압을 측정할 때 사용되는 혈관이다. 이 혈관은 골절로 인해 찢어지거나, 또는 혈액순환에 문제가 생겨 혈관이 막히는 경우가 발생한다. 이러한 경우 혈관의 상태를 확인하기 위하여 색조 도플러 초음파 검사를 사용하지만, 사용자에 따라 영상을 통한 판단 기준이 다르다는 문제점이 발생한다. 따라서 본 논문에서는 FCM과 Fuzzy Decision Tree를 이용한 영상 처리를 통해 일관성 있는 판단기준을 세우기 위한 혈류의 속도를 제안한다. 색조 도플러 초음파 영상에서의 상완 동맥을 추출하여 기울기를 이용한 FCM 알고리즘을 통해 소속도를 추출한 뒤 퍼지 룰에 적용하여 의사 결정 트리로 등급을 분류하고 결과적으로 혈류 속도를 추출한다. 색조 도플러 초음파 영상에서 환자의 개인 정보를 보호하기 위해 개인 정보 영역을 제거하여 ROI 영역을 추출하고 ROI 영역을 이진화를 통하여 상완동맥이 있는 영역을 추출한다. 이진화 된 ROI 영역에서 혈관 영상의 혈류 방향으로의 무게중심을 설정하고 각각의 픽셀과 무게중심 선과의 거리를 이용하여 소속도를 추출한 후 FCM을 사용하여 최적의 기울기를 선정한다. FCM을 통해 추출한 최종 소속도를 이용하여 퍼지 룰에 적용한 뒤 계산된 T-norm과 소속도의 분산을 이용하여 의사 결정 트리를 형성 트리의 단말 노드들은 각 픽셀을 분류한다. 분류되어진 데이터들의 노드별 소속도 평균을 구한 뒤 디퍼지화를 통해 COG(Center of Gravity)를 계산한다. 마지막으로 그 값을 이용하여 혈류 속도에 영향을 미치는 정도를 계산한 뒤 최종 혈류의 속도를 제안한다.