• Proceedings of the Korean Society of Computer Information Conference
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• 2019.07a
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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.

• Korean Journal of Exercise Nutrition
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• v.13 no.1
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• pp.37-44
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• 2009

The purpose of this study was to investigate the change of bone metabolic parameters between climbing exercise training and treadmill running training with alpha lipoic acid supplementation in ovariectomized rats. Fifty-six Sparague-Dawley, 8 weeks of age, were assigned into nine groups: normal control at pre-test (Pre-NC), normal control at post-test (NC), sham-sedentary (SS), ovariectomized-control (OVX-Con), ovariectomized-ALA inject (OVX-ALA), ovariectomized-climbing exercise (OVX-CE), ovariectomized-ALA inject+climbing exercise (OVX-ACE), ovariectomized-treadmill exercise (OVX-TE) and ovariectomized-ALA inject+treadmill exercise (OVX-ATE). The climbing exercise group voluntarily climbed the 200 cm tower to drinking water from the bottle set at the top of it. The treadmill exercise group was performed the 60 min treadmill running with grade 6-8%, and velocity 10-15 m/min. The frequency of exercise training was performed 6 days per wk in both training intervention. For the comparison of bone metabolic responses following to different training intervention, the strength, length and weight of femur, total bone density, bone mineral contents, deoxypyridioline, osteocalcin and parathyroid hormone, estradiol and lutenizing hormone were measured in this study. The body weight was higher in the OVX-Con, OVX-ALA and OVX-TE groups as compared to NC group. The total bone mineral density of OVX-ACE showed a higher value than SS, OVX-Con, OVX-ATE and OVX-TE. But urine and blood metabolic parameters showed no significance among groups. In conclusion, this study results suggested that climbing exercise training and alpha lipoic acid supplementation may an effective intervention for prevention of osteoporosis in ovriectomized rats.

• Journal of Medicine and Life Science
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• v.20 no.3
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• pp.115-125
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• 2023

Arteriovenous fistula flow dysfunction is the leading cause of vascular access thrombosis and loss in patients undergoing hemodialysis. However, data regarding the influence of access flow rate measurements on the long-term outcomes of access are limited. This study aims to identify accesses at a high risk of thrombosis and loss among patients undergoing hemodialysis by measuring the access flow rate and exploring an optimal threshold value for predicting future access thrombosis. We enrolled 220 patients with arteriovenous fistula undergoing hemodialysis. The primary outcome was the occurrence of access thrombosis. Access flow rates were measured monthly using the ultrasound dilution method and were averaged using all measurements from patients with patent access. In patients experienced access thrombosis, those immediately before the thrombosis were selected. Using these data, we calculated the access flow rate threshold for thrombosis occurrence by analyzing the receiver operating characteristic curve, and the patients were divided into two groups according to whether access flow rates were higher or lower than 400 mL/min. During a median follow-up period of 3.1 years, 4,510 access flows were measured (median measurements per patient, 33 times; interquartile range, 11-54). A total of 65 access thromboses and 19 abandonments were observed. Access thrombosis and loss were higher in the lowflow group than in the high-flow group. This study revealed that low access flow rates are strongly associated with access thrombosis occurrence and subsequent loss of arteriovenous fistulas in patients undergoing hemodialysis.

• Korean Journal of Community Nutrition
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• v.29 no.2
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• pp.81-96
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• 2024

Objectives: This study aimed to investigate arterial stiffness index, physical activity, and food and nutrient intake in middle-aged adults over 40 years when the incidence of cardiovascular disease begins to increase. Methods: This study included 106 subjects (48 males and 58 females) aged between 40 and 64 years. The arterial stiffness index (brachial-ankle pulse wave velocity [baPWV], and ankle-brachial index [ABI]) were measured using a blood pressure pulse wave testing device. Physical activity was assessed using the Korean version of the Global Physical Activity Questionnaire, and food and nutrient intake was calculated using the Food Frequency Questionnaire. Results: The mean age of the subjects was 54.4 years. Although the ABI of the subjects was within the normal range, they were divided into tertiles to compare physical activity and food and nutrient intake. In males, the time spent on moderate to vigorous physical activity (MVPA) was significantly higher in T3 (600.6 min/week) than in T1 (304.4 min/week). In females, the time spent in sedentary behavior was significantly lower in T3 (294.5 min/week) than in T1 (472.1 min/week). In addition, the frequency of fish consumption was significantly higher in T3 (1.27 frequency/day) than in T1 (0.64 frequency/day) in females. Polyunsaturated fatty acid (PUFA) and ω-3 fatty acid intake, adjusted for energy intake, were significantly positively correlated with ABI (r = 0.200 and r = 0.218, respectively). Conclusions: High MVPA (in males), low sedentary behavior (in females), and PUFA and ω-3 fatty acid intake through fish consumption may be associated with low peripheral artery stiffness. Therefore, arteriosclerosis can be prevented through physical activity and proper dietary therapy.

• Journal of agricultural medicine and community health
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• v.36 no.2
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• pp.101-112
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• 2011

Objectives: The aim of this study is to determine arterial stiffness levels as measured by brachial-ankle pulse wave velocity (baPWV) and to identify the association between arterial stiffness and inflammatory markers, in healthy adults over 50 years old. Methods: The study population consisted of 4617 persons over the age of 50 years who participated in the baseline survey of the Dong-gu Study, which was conducted in 2007 and 2008. Arterial stiffness was measured using baPWV. A multiple regression analysis was performed to assess the relationship between conventional cardiovascular risk factors and inflammatory markers, including white blood cell (WBC) counts, high-sensitive C-reactive protein (hs-CRP), and gamma glutamyltransferase (GGT). Results: After adjustment for conventional cardiovascular risk factors including sex, age, smoking status, body mass index, systolic blood pressure, fasting glucose, hypertension or diabetic medication, total cholesterol, triglycerides, uric acid, and alanine aminotransferase, baPWV was significantly associated with WBC counts (${\beta}$=0.158, p<0.0001), hs-CRP (${\beta}$=0.244, p=0.026), and GGT (${\beta}$=0.003, p<0.0001). Conclusion: This study shows that arterial stiffness correlates with inflammatory markers. Arterial stiffness may be used as a composite risk factor to identify persons with higher risk for cardiovascular disease. Additionally, arterial stiffness may be a marker for future cardiovascular disease and a target for prevention.

• Journal of Chest Surgery
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• v.35 no.10
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• pp.712-723
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• 2002

Substantial alterations in cerebral blood flow(CBF) are known to occur during cardiopulmonary bypass(CPB). Many investigators have speculated that these changes may be responsible for both minor and major cerebral damages after CPB. More recently, these changes in CBF have been observed to be intimately related to the arterial carbon dioxide tension(Pa$CO_2$) maintained during CPB. The present study was prospectively designed to investigate the clinical effects of normocapnic and hypercapnic CPB on the cerebral oxygen metabolism in cardiac surgery Material and Method: Thirty-six adult patients scheduled for elective cardiac surgery were randomized to either normocapnic group (Pa$CO_2$35~40 mmHg, n＝18) or hypercapnic group(Pa$CO_2$, 45~55 mmHg, n＝18) with moderately hypothermic nonpulsatile CPB(nasopharyngeal temperature of 29~3$0^{\circ}C$). In each patient, middle cerebral artery blood flow velocity( $V_{MCA}$), cerebral arteriovenous oxygen content difference (C(a-v) $O_2$), cerebral oxygen extraction(COE), cerebral metabolic rate for oxygen(CMR $O_2$), cerebral oxygen transport( $T_{E}$ $O_2$), $T_{E}$ $O_2$/CMR $O_2$ ratio, cerebral desaturation(internal jugular bulb blood oxygen saturation $\leq$ 50%), and arterial and jugular bulb blood gas were evaluated throughout the operation. Postoperative neuropsychologic complications were assessed in all patients. All variables were compared between the two groups. Result: VMCA(169.13 $\pm$ 8.32 vs 153.11 $\pm$8.98%), TE $O_2$(1,911.17$\pm$250.14 vs 1,757.40$\pm$249.56), $T_{E}$ $O_2$,/CMR $O_2$ ratio(287.38$\pm$28.051 vs 246.77$\pm$25.84), $O_2$ tension in internal jugular bulb (41.66$\pm$9.19 vs 31.50$\pm$6.09 mmHg), and $O_2$saturation in internal jugular bulb(68.97$\pm$10.96 vs 58.12$\pm$12.11%) during CPB were significantly lower in normocapnic group(p＝0.03), whereas hypercapnic group had lower C(a-v) $O_2$(3.9$\pm$0.3 vs 4.9$\pm$0.3 mL/dL), COE(0.3$\pm$0.03 vs 0.4$\pm$0.03), CMR $O_2$(5.8 $\pm$0.5 vs 6.8$\pm$0.6), and arterial blood pH(7.36$\pm$0.09 vs 7.46$\pm$0.07, p＝0.04) during CPB. Hypercapnic group had lower incidence of cerebral desaturation than normocapnic group(3 vs 9 patients, p=0.03). Duration of the neuropsychologic complication(delirium) were shorter in hypercapnic group than in normocapnic group(36 vs 60 hrs, p＝0.009). Conclusion: These findings suggest that hypercapnic CPB may have salutary effects on the cerebral oxygen metabolism and postoperative neurologic outcomes in cardiac surgery.surgery.

• Journal of Korean Public Health Nursing
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• v.10 no.2
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• pp.103-118
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• 1996

It is to be growing up the interest of community health affairs through visiting nursing care. The health medical treatment of Korea has been changed largely on the period. The juvenile population has decreased. This means that is has took the population consensus of advanced national organization to be increased by the old age. The transition of disease has changed from the contagious disease importance to the chronicity disease omportance because the domestic district population has experienced the sudden urbanization circumstance district population has experienced the sudden urbanization circumstance to be growing up $70\%$ of the whole population. When the nursing service has common function to be delivering from all direction to home, this study is getting the great important phase velocity in order to manage the kernel questional adult chronicity disease of health medical institution at the present age. (1) community over system or with people particularity (2) the first of third step medical treatments. The variety of medical treatments organization has quantity of the delivery manpower and specially between consumers and rdlated person. A qualitative difference is showed at the purpose to be seizing. That research related person is use at district health center in Seoul, by foundation on nurse registration book of H collage hospital and public health registration book. According the chronicity disease. age. and sex. nature agree-able standard 54 people took the content analysis on nurse registration book of total 108 people. The results of the study were as follows: 1. General background factors are houses or kind of medical facilities and number of patients in family. The first medical treatment is more patients than third medical treatment organization. The first medical treatment of economic environment os appering to be worse. 2. The chronicity disease frequency have been different speciality according to medical treatment organization. On case of the first medical treatment. Diabetes and High Blood Pressure were good but Cerebrum Vascular Accident(CVA) showed many for bed case. In addition. the number of family is comparative large exception of CVA on according for moving condition and health more than the first medical treatment. However. family condition. whole family percentage is decreasing preferably through the potential resource is increasing by the number of and the construction of family. The ability of real resource is considered to be low. 3. The average percentage of nurse service has appered to be differed two groups by the first step medical treatment(33.72 times) and third step medical treatment(45.70 times). However, the difference (the first step medical treatment and third step medical treatment) is to be limited to issue the medicine at the service. The condition of nurse care was the indirect nursing care. Supportiong area was to be related to volunteer service and administration support. 4. The various nursing care average percentage of the chronicity disease was increased by orders of Diabetes. High Blood Pressure. and CVA in examination result and the medical treatment. The indirect nursing care was also same. At third step medical treatment, orders of chronicity disease were same. The case of other area on service conditions were increased by order of Diabetes. High Blood Pressure, and CVA. However. it is never appearing the difference at bottleneck affairs nursing care. 5. When the visiting nursing care demand particularly. the average percentage of nursing care from the first step medical treatment that the time under a person is many more than the time over two people. However, there was no difference in statistic. Third step medical treatment is $49.81\%$ at the time under a person. The average nursing care service is appeared by more many when the visiting nursing care demand is a few by 12.83 at the time over two people. 6. By visiting nursing care percentage to be frequency that nursing care averaghe percentage and inter-relation are large. The related factor of the first medical treatment is 0.96. However, the related factor of third medical treatment has shown the decreased 0.49 for the condition of relation more than that. Therefore. the nursing care average percentage is related to the visiting times of a nurse. This result is be showing the obvious fact that the first step medical treatment is few more than third step medical treatment.

• Investigative Magnetic Resonance Imaging
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• v.8 no.1
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• pp.17-23
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• 2004

Purpose : To evaluate changes in total cerebral blood flow (tCBF) with aging, parenchymal volume changes and vascular abnormalities, using 2 dimensional (D) phase-contrast magnetic resonance imaging (PC MRI). Materials and Methods : Routine brain MRI including T2 weighted image, time-of-flight (TOF) MR Angiography (MRA) and 2D PC MRI were performed in 73 individuals, including 12 volunteers. Normal subjects (12 volunteers, and 21 individuals with normal MRI and normal MRA) were classified into groups according to age (18-29, 30-49 and 50-66 years). For the group with abnormalities in brain MRIs, cerebral parenchymal volume changes were scored according to the T2 weighted images, and atherosclerotic changes were scored according to the MRA findings. Abnormal groups were classified into 4 groups: (i) mild reduction in volume, (ii) marked reduction in volume by parenchymal volume and atherosclerotic changes, and (iii) increased volume and (iv) Moya-moya disease. Volumetric flow was measured at the internal carotid artery (ICA) and vertebral artery bilaterally using the velocity-flow diagrams from PC MRI, and combined 4 vessel flows and tCBF were compared among all the groups. Results : The age-specific distribution of tCBFs in normal subjects were as follows: $12.0{\pm}2.1ml/sec$ in 18-29 years group, $11.8{\pm}1.9ml/sec$ in 30-49 years group, $10.9{\pm}2.2ml/sec$ in 50-66 years group. The distribution of tCBFs in the different subsets of the abnormal population were as follows: $9.5{\pm}2.5ml/sec$ in the group with mild reduction in volume, $7.6{\pm}2.0ml/sec$ in the group with marked reduction in volume, and $7.3{\pm}1.2ml/sec$ and $7.0{\pm}1.1ml/sec$ in the increased parenchymal volume and Moya-moya disease groups respectively. Conclusion : Total cerebral blood flow decreases with increasing age with a concomitant reduction in parenchymal volumes and increasing atherosclerotic changes. It is also reduced in the presence of increased parenchymal volume and Moya-moya disease.2D PC MRI can be used as a tool to evaluate tCBF with aging and in the presence of various conditions that can affect parenchymal volume and cerebral vasculature.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1109-1118
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• 2009

Purpose : Metabolic syndrome (MS), characterized by obesity and insulin resistance, elicits risk factors such as hyperlipidemia, hypertension, and glucose intolerance with additive effects on atherosclerosis, leading to cardiovascular diseases. The purposes of this study were to evaluate the prevalence of MS among overweight and obese adolescents and to investigate the impact of obesity on the cardiovascular system. Methods : In all, 684 adolescents were included in the study. Blood pressure, body mass index (BMI), fasting blood glucose, total cholesterol, triglyceride, low-density-lipoprotein (LDL)-cholesterol, high-density-lipoprotein (HDL)-cholesterol, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and high-sensitive C-reactive protein (hs-CRP) were measured in the patients with a BMI of >85 percentile. Brachial-ankle pulse wave velocity (BaPWV) and ankle brachial index were measured using Vascular Profiler (VP)-1000. Results : MS was confirmed in 19.5% of the overweight and obese adolescents and 50.8% of the obese adolescents. The systolic and diastolic blood pressure, height, weight, fat mass, %fat, BMI, obesity index, and waist circumference were higher in the overweight and obese adolescents with MS. Moreover, the triglyceride, AST, ALT, and hs-CRP levels were higher, whereas HDL-cholesterol level was significantly lower in this group. The overweight and obese adolescents with MS showed shorter diastolic and systolic times, higher heart rate and BaPWV, and longer E-wave deceleration time by echocardiography. Conclusion : Overweight and obese adolescents showed characteristic MS features such as hypertension and hyperlipidemia. Thus, obese adolescents predisposed to MS should be provided early treatment for obesity.

• Journal of Chest Surgery
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• v.35 no.6
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• pp.420-429
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• 2002

Moderate hypothermic cardiopulmonary bypass (CPB) has commonly been used in cardiac surgery. Several cardiac centers recently practice normothermic CPB in cardiac surgery, However, the clinical effect and safety of normothermic CPB on cerebral metabolism are not established and not fully understood. This study was prospectively designed to evaluate the clinical influence of normothermic CPB on brain metabolism and to compare it with that of moderate hypothermic CPB. Material and Method: Thirty-six adult patients scheduled for elective cardiac surgery were randomized to receive normothermic (nasopharyngeal temperature ＞34.5 $^{\circ}C$, n=18) or hypothermic (nasopharyngeal temperature 29~3$0^{\circ}C$, n=18) CPB with nonpulsatile pump. Middle cerebral artery blood flow velocity (VMCA), cerebral arteriovenous oxygen content difference (CAVO$_{2}$), cerebral oxygen extraction (COE), modified cerebral metabolic rate for oxygen (MCMRO$_{2}$), cerebral oxygen transport (TEO$_{2}$), cerebral venous desaturation (oxygen saturation in internal jugular bulb blood$\leq$50 %), and arterial and internal jugular bulb blood gas analysis were measured during six phases of the operation： Pre-CPB (control), CPB-10 min, Rewarm-1 (nasopharyngeal temperature 34 $^{\circ}C$ in the hypothermic group), Rewarm-2 (nasopharyngeal temperature 37 $^{\circ}C$ in the both groups), CPB-off and Post-CPB (skin closure after CPB-off). Postoperaitve neuropsychologic complications were observed in all patients. All variables were compared between the two groups. Result： VMCA at Rewarm-2 was higher in the hypothermic group (153.11$\pm$8.98%) than in the normothermic group (131.18$\pm$6.94%) (p＜0.05). CAVO$_{2}$ (3.47$\pm$0.21 vs 4.28$\pm$0.29 mL/dL, p＜0.05), COE (0.30$\pm$0.02 vs 0.39$\pm$0.02, p＜0.05) and MCMRO$_{2}$ (4.71 $\pm$0.42 vs 5.36$\pm$0.45, p<0.05) at CPB-10 min were lower in the hypothermic group than in the normothermic group. The hypothermic group had higher TEO$_{2}$ than the normothermic group at CPB-10 (1,527.60$\pm$25.84 vs 1,368.74$\pm$20.03, p＜0.05), Rewarm-2 (1,757.50$\pm$32.30 vs 1,478.60$\pm$27.41, p＜0.05) and Post-CPB (1,734.37$\pm$41.45 vs 1,597.68$\pm$27.50, p＜0.05). Internal jugular bulb oxygen tension (40.96$\pm$1.16 vs 34.79$\pm$2.18 mmHg, p＜0.05), saturation (72.63$\pm$2.68 vs 64.76$\pm$2.49 %, p＜0.05) and content (8.08$\pm$0.34 vs 6.78$\pm$0.43 mL/dL, p<0.05) at CPB-10 were higher in the hypothermic group than in the normothermic group. The hypothermic group had less incidence of postoperative neurologic complication (delirium) than the normothermic group (2 vs 4 patients, p＜0.05). Lasting periods of postoperative delirium were shorter in the hypothermic group than in the normothermic group (60 vs 160 hrs, p<0.01). Conclusion: These results indicate that normothermic CPB should not be routinely applied in all cardiac surgery, especially advanced age or the clinical situations that require prolonged operative time. Moderate hypothermic CPB may have beneficial influences relatively on brain metabolism and postoperative neuropsychologic outcomes when compared with normothermic CPB.