• The Journal of Korean Medicine
• /
• v.40 no.3
• /
• pp.198-223
• /
• 2019

Objectives: The purpose of this study was to investigate the effect of Korean medicine treatment on facial asymmetric treatment in 5 cases of facial asymmetry correction by non - surgical treatment such as acupucture, chuna treatment, FCST (Functional cerebrospinal technique) and cranial osteopathy. Methods: We analyzed the initial charts of 5 patients who had undergone facial asymmetry in a Korean medicine clinic and measured the position and distance using the photograph, lateral cephalograms, and whole body radiograms. The results were as follows. Results: To quantify both soft and hard tissues to confirm the results of Korean medicine treatment of facial asymmetry, soft tissues quantitatively measure the displacement of the face, the slope of the left and right eyes, and the slope of the lip in order to grasp the positional displacement of the mandible. As a result, on the average, the correction effect as measured by the angle difference between A and C is $1.8{\pm}0.57$, the correction effect as measured by the angle difference between B and C is $1.4{\pm}0.89$, and the angle difference between D and the horizontal plane is $1.9{\pm}0.89$, and the angle difference between E and the horizontal plane is $1.9{\pm}0.89$. The result of reduced angle difference between A and C means that the head position shifted from the center of the body to the unilateral side was shifted to the center. The decrease in the angle difference between B and C means the restoration of the maxillary distortion relative to the mandible. In hard tissues, numerical values were measured based on the skull standard. The average distortion of the skull was $1.9{\pm}0.67$, and the distortion of the lower eye was $1.4{\pm}0.41$. Conclusion: General studies on facial asymmetric treatment are limited to treatments such as surgery and orthodontics. However, this study confirmed the possibility that facial asymmetry could be corrected by Korean medical treatment consisting of reversible non-surgical treatment rather than irreversible treatment such as surgery or orthodontic treatment. In particular, Korean medicine treatment is effective for muscular asymmetry, soft asymmetry, functional asymmetry, etc. The facial asymmetric treatment of Korean medicine is not limited to the face-centered correction, but the asymmetry of the whole body may be corrected as well.

• Journal of Chest Surgery
• /
• v.31 no.8
• /
• pp.739-748
• /
• 1998

Background: It has been well documented that transient occlusion of the coronary artery causes myocardial ischemia and finally cell death when ischemia is sustained for more than 20 minutes. Extensive studies have revealed that ischemic myocardium cannot recover without reperfusion by adequate restoration of blood flow, however, reperfusion can cause long-lasting cardiac dysfunction and aggravation of structural damage. The author therefore attempted to examine the effect of postischemic reperfusion on myocardial ultrastructure and to determine the rationales for recanalization therapy to salvage ischemic myocardium. Materials and methods: Young Holstein-Friesian cows(130∼140 Kg body weight; n=40) of both sexes, maintained with nutritionally balanced diet and under constant conditions, were used. The left anterior descending coronary artery(LAD) was occluded by ligation with 4-0 silk snare for 20 minutes and recanalized by release of the ligation under continuous intravenous drip anesthesia with sodium pentobarbital(0.15 mg/Kg/min). Drill biopsies of the risk area (antero-lateral wall) were performed at just on reperfusion(5 minutes), 1-, 2-, 3-, 6-, 12-hours after recanalization, and at 1-hour assist(only with mechanical respiration and fluid replacement) after 12-hour recanalization. The materials were subdivided into subepicardial and subendocardial tissues. Tissue samples were examined with a transmission electron microscope (Philips EM 300) at the accelerating voltage of 60 KeV. Results: After a 20-minute ligation of the LAD, myocytes showed slight to moderate degree of ultrastructural changes including subsarcolemmal bleb formation, loss of nuclear matrix, clumping of chromatin and margination, mitochondrial destruction, and contracture of sarcomeres. However, microvascular structures were relatively well preserved. After 1-hour reperfusion, nuclear and mitochondrial matrices reappeared and intravascular plugging by polymorphonuclear leukocytes or platelets was observed. However, nucleoli and intramitochondrial granules reappeared within 3 hours of reperfusion and a large number of myocytes were recovered progressively within 6 hours of reperfusion. Recovery was apparent in the subepicardial myocytes and there were no distinct changes in the ultrastructure except narrowed lumen of the microvessels in the later period of reperfusion. Conclusions: It is likely that the ischemic myocardium could not be salvaged without adequate restoration of coronary flow and that the microvasculature is more resistant to reversible period of ischemia than subendocardium and subepicardium. Therefore, thrombolysis and/or angioplasty may be a rational method of therapy for coronarogenic myocardial ischemia. However, it may take a relatively longer period of time to recover from ischemic insult and reperfusion injury should be considered.

• The Korean Journal of Nuclear Medicine
• /
• v.32 no.2
• /
• pp.129-136
• /
• 1998

Purpose: Myocardial SPECT is an effective test for detecting coronary artery disease in the general population. But the diagnostic accuracy between sexes is not defined. The purpose of this study is to compare the diagnostic accuracy between males and females. Materials and Methods: One hundred and seventy seven male and 98 female patients who underwent myocardial SPECT within 1 month of coronary angiography were studied. Myocardial SPECTS were considered abnormal if fixed or reversible perfusion defects were detected. Stenosis severity of ${\geq}$ 50% luminal diameter reduction of any artery defined coronary artery disease (CAD). Results: Overall sensitivity for detection of CAD was 98% in men and 97% in women (p=not significant). However, specificities, accuracies, and positive predictive values (PPV) in men and women were 49% vs 31% (p<0.05), 81% vs 57% (p<0.01), 78% vs 48% (p<0.01), respectively. Diagnostic accuracies for detection of right coronary artery disease were not different in both sexes, however, accuracies for detection of left anterior descending artery disease and left circumflex artery disease were significantly lower in female (p<0.05). Conclusion: A significant difference of diagnostic accuracy between sexes, especially in LAD and LCx disease, was noted. Artifacts from breast attenuation might be a cause for the lower diagnostic accuracy in female.

• The korean journal of orthodontics
• /
• v.29 no.3 s.74
• /
• pp.361-374
• /
• 1999

Intraoral filled type of orthodontic appliance can cause reversible or irreversible damages such as gingivitis, periodontitis, enamel decalcification, dental caries, root resorption, and pulpal changes. Such adverse effects are brought by increase in dental plaque as well as oral flora. Such an increase causes gingival inflammation and enamel decalcification. The purpose of this study is to get klowledge on initial changes in dental plaque, gingivitis, and enamel decalcification after bonding fixed orthodontic appliances according to time flow, gender, and sides(right/left) of premolar region. For control group, 48 students of dental college, Yonsei university(26 males, 22 females) were chosen; for experimental group, 73 orthodontic patients(36 males, 37 females) who will be treated with fixed appliances were chosen. All the subjects had no systemic disease, juvenile periodontitis and all the females had passed their ,menarche. Tooth brushing instruction was given to all the subjects prior to the experiment. For control group, plaque index, gingival index, and decalcification index were measured twice at 3 weeks interval ; for experimental group, the same was done prior to, 3, 6, 9 weeks after bonding fixed appliances. The following results were obtained: 1. In plaque index 3 weeks after placement of appliances, and it showed gradual increase afterwards. 2. In gingival index3 weeks after placement of appliances, and afterwards it showed increase at a faster rate than plaque index. 3. Enamel decalcification began to show between 3 and 6 weeks after bonding fixed appliances. Decalcification index began to increase 6 weeks after appliance placement, but there was no statistical significance. 4. When the comparison was made between two sides of premolar region, the right side showed greater index in plaque and gingival index of experimental group.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.16 no.2
• /
• pp.49-56
• /
• 2012

Purpose : Gated myocardial perfusion SPECT provides not only myocardial perfusion status, but various functional parameters of left ventricle (LV). The purpose of this study was to analyze ejection fraction (EF) for correlation and difference between $^{201}Tl$ gated myocardial perfusion SPECT and echocardiography depending on extent of perfusion defect, gender and LV volumes. Materials and Methods : From April 2011 to May 2012, we analyzed 291 patients (male:female =165:126; mean: $64.6{\pm}10.8$ years) who were examined both $^{201}Tl$ gated myocardial perfusion SPECT and echocardiography at less than 7 days apart in our hospital. 101 patients showed perfusion defect and the rest of the people without any defect. We applied automatic analysis (Quantitative gated SPECT, QGS), and calculated EF, End-diastolic volume (EDV) and End-systolic volume (ESV) from Stress (G-Stress) and Rest (G-Rest) studies. And we analyzed the correlation and difference for EF between $^{201}Tl$ gated SPECT and echocardiography. Results : The correlation of LVEF among G-Stress, G-Rest and echocardiography was quite a good (G-Stress vs. G-Rest: r=0.909, G-Stress vs. echocardiography: r=0.833, G-Rest vs. echocardiography: r=0.825). And there were significant differences in EDV, ESV and EF in total patients (p<0.01). The normal group showed significant difference in EF (p<0.01) and the group with perfusion defect also demonstrated significant difference (a group with reversible defect: p<0.01, fixed defect: p<0.01) depending on extent of perfusion defect. We analyzed difference in normal group by gender. In normal group, there was no significant difference (p>0.05) in EF from men. However, there was a significant difference (p<0.01) from women. When we classified two groups by average size of EDV in Korean women, there was no significant difference in a group of above average size of EDV (p>0.05). Conclusion : When compared among Stress and Rest of $^{201}Tl$ gated SPECT and echocardiography, we confirmed that there was a good correlation for LVEF. But there were significant differences among three studies. And extent of perfusion defect, gender and LV volumes are independent determinants of the accuracy of LVEF. So, it is hard to compare and interchange quantitative indices among modalities. We should take additional researches to prove results of our study.

• The Korean Journal of Nuclear Medicine
• /
• v.39 no.1
• /
• pp.9-14
• /
• 2005

Purpose: Abnormal myocardial perfusion may be caused by ventricular preexcitation, but its location, extent, severity and correlation with accessory pathway (AP) are not established. We evaluated perfusion patterns on myocardial perfusion SPECT and location of AP in patients with WPW (Wolff-Parkinson-White) syndrome. Materials and Methods: Adenosine Tc-99m MIBI or Tl-201 myocardial perfusion SPECT was performed in 11 patients with WPW syndrome. Perfusion defects (PD) were compared to AP location based on ECG with Fitzpatrick's algorithm or electrophysiologic study and radiofrequency catheter ablation. Results: Patients had atypical chest discomfort or no symptom. Risk of coronary artery disease (CAD) was below 0.1 in 11 patients using the nomogram to estimate the probability of CAD. Coronary angiography was performed in 4 patients (mid-LAD 50% in one, normal in others). In 4 patients, AP localization was done by electrophysiologic study and radiofrequency catheter ablation (RFCA). Small to large extent ($11.0{\pm}8.5%$, range:$3{\sim}35%$) and mild to moderate severity ($-71{\pm}42.7%$, range:$-2l7{\sim}-39%$) of reversible (n=9) or fixed (n=1) perfusion defects were noted. One patient with right free wall (right lateral) AP showed normal. PD locations were variable following the location of AP. One patient with left lateral wall AP was followed 6 weeks after RFCA and showed significantly decreased PD on SPECT with successful ablation. Conclusion: Myocardial perfusion defect showed variable extent, severity and location in patients with WPW syndrome. Abnormal perfusion defect showed in most of all patients, but it did not seem to be correlated specifically with location of accessory pathway and coronary artery disease. Therefore myocardial perfusion SPECT should be interpreted carefully in patients with WPW syndrome.

• Journal of the Korean Child Neurology Society
• /
• v.26 no.4
• /
• pp.280-283
• /
• 2018

Magnetic resonance imaging (MRI) is recommended for patients with epileptic seizures to rule out an underlying focal lesion. However, abnormalities in idiopathic generalized epilepsy, including childhood absence epilepsy, cannot usually be identified using brain imaging modalities such as MRI. Peri-ictal MRI abnormalities have been most commonly reported secondary to status epilepticus and are rarely observed in patients with focal seizures and generalized tonic-clonic seizures. Transient peri-ictal MRI abnormalities in absence epilepsy are extremely rare. A five-year-old girl presented with a three-day history of absence seizures that persisted despite continued treatment with sodium valproate. Electroencephalography showed bursts of generalized 3-Hz spike-and-wave discharges, during and after hyperventilation. Abnormal cortex thickening in the left perisylvian region was detected on T2-weighted brain MRI, and cortical dysplasia or a tumor was suspected. The patient started treatment with lamotrigine and was seizure-free after one month. The abnormal MRI lesion was completely resolved at the two-month follow-up. We report on a patient with childhood absence epilepsy and reversible brain MRI abnormalities in the perisylvian region. To our knowledge, this is the first report of transient MRI abnormalities after absence seizures. Transient peri-ictal MRI abnormalities should be considered for differential diagnosis in patients with absence seizures and a focal abnormality on brain MRI.

• The Korean Journal of Nuclear Medicine
• /
• v.38 no.6
• /
• pp.486-491
• /
• 2004

Purpose: factor analysis and independent component analysis (ICA) has been used for handling dynamic image sequences. Theoretical advantages of a newly suggested ICA method, ensemble ICA, leaded us to consider applying this method to the analysis of dynamic myocardial $H_2^{15}O$ PET data. In this study, we quantified patients' blood flow using the ensemble ICA method. Materials and Methods: Twenty subjects underwent $H_2^{15}O$ PET scans using ECAT EXACT 47 scanner and myocardial perfusion SPECT using Vertex scanner. After transmission scanning, dynamic emission scans were initiated simultaneously with the injection of $555{\sim}740$ MBq $H_2^{15}O$. Hidden independent components can be extracted from the observed mixed data (PET image) by means of ICA algorithms. Ensemble learning is a variational Bayesian method that provides an analytical approximation to the parameter posterior using a tractable distribution. Variational approximation forms a lower bound on the ensemble likelihood and the maximization of the lower bound is achieved through minimizing the Kullback-Leibler divergence between the true posterior and the variational posterior. In this study, posterior pdf was approximated by a rectified Gaussian distribution to incorporate non-negativity constraint, which is suitable to dynamic images in nuclear medicine. Blood flow was measured in 9 regions - apex, four areas in mid wall, and four areas in base wall. Myocardial perfusion SPECT score and angiography results were compared with the regional blood flow. Results: Major cardiac components were separated successfully by the ensemble ICA method and blood flow could be estimated in 15 among 20 patients. Mean myocardial blood flow was $1.2{\pm}0.40$ ml/min/g in rest, $1.85{\pm}1.12$ ml/min/g in stress state. Blood flow values obtained by an operator in two different occasion were highly correlated (r=0.99). In myocardium component image, the image contrast between left ventricle and myocardium was 1:2.7 in average. Perfusion reserve was significantly different between the regions with and without stenosis detected by the coronary angiography (P<0.01). In 66 segment with stenosis confirmed by angiography, the segments with reversible perfusion decrease in perfusion SPECT showed lower perfusion reserve values in $H_2^{15}O$ PET. Conclusions: Myocardial blood flow could be estimated using an ICA method with ensemble learning. We suggest that the ensemble ICA incorporating non-negative constraint is a feasible method to handle dynamic image sequence obtained by the nuclear medicine techniques.