• Investigative Magnetic Resonance Imaging
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• v.9 no.2
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• pp.94-100
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• 2005

Purpose : This study was designed to evaluate the usefulness of 3T-TOF MR angiography (3T-TOF MRA) compared with transcranial Doppler sonography (TCD) and conventional angiography (CA) in patients with suspected cerebral infarction. Materials and Methods : Fifty four patients with clinical symptoms of cerebral infarction were involved in this study, and had undergone 3T-TOF MRA and TCD, with CA in 11 patients. On the basis of divisions of the carotid artery, four groups were designated: group I, both vertebral arteries and basilar artery; group II, segment between 2 cm below bifurcation of common carotid artery and genu portion of internal carotid artery; group III, segment between petrous portion of internal carotid artery and bifurcation of anterior and middle cerebral artery; group IV, from bifurcation of anterior and middle cerebral artery to thier distal branches. Two radiologists retrospectively reviewed the vascular imaging and stenosis in 3T-TOF MRA, TCD, and CA. Results : A total of 432 arteries, 108 in each group, were available. The assessment of vascular imaging quality in 3T-TOF MRA is scored 2.98, 2.96, 2.91, 2.88 in 4 groups, respectively. Agreement among 3T-TOF MR angiography, TCD, and CA was high. Conclusion : 3T-TOF MR angiography may be useful method for the assessment of stenotic lesions of cranial vasculature in patients with cerebral infarction.

• The Journal of Internal Korean Medicine
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• v.25 no.3
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• pp.418-426
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• 2004

Objectives : This study was designed to research whether transcranial doppler ultrasound(TCD) can yield a suitable diagnosis or prognosis for dizziness. Methods : To evaluate the blood flow, we measured the mean velocity(Vm), peak systolic velocity(Vs) and pulsatility index(PI) of the middle cerebral artery(MCA), vertebral artery(VA) and basilar artery(BA) in 54 dizziness patients and 44 normal subjects. To investigate the difference between dizziness patients and normal subjects, we selected 54 dizziness patients diagnosed normal by Brain MRI, and 44 normal subjects who did not have any symptoms of hyperlipemia, hypertension, diabetes melitus, heart disease, or smoking, diagnosed normal by Brain MRI. 30-69 year olds were divided into 30-49 year olds, 50-59 year olds and 60-69 year olds. Results : In normal subjects, there was a significantly higher Vm, Vs in the MCA and BA, and Vs in the VA of female subjects, and there was a significant difference in PI in the MCA and BA increasing with age. In comparison with normal subjects, dizziness patients had a significantly lower Vm in the BA. Male dizziness patients had significantly lower PI in the MCA. 30-49 year olds had significantly lower Vm in the BA. Conclusions : The significant difference in blood flow velocities in the BA between dizziness patients and normal subjects suggests that dizziness is related to blocking of blood flow in the BA and that diagnosis and prognosis can be made through TCD. More detailed study of dizziness patients will be needed.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.2
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• pp.126-135
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• 2018

This study examined whether the difference in the middle cerebral artery (MCA) velocities can predict the prognosis of stroke and whether the prognostic impact differs among stroke subtypes. Transient ischemic attack (TIA) or acute ischemic stroke patients, who underwent a routine evaluation and transcranial Doppler (TCD), were included in this study. The MCA asymmetry index was calculated using the relative percentage difference in the mean flow velocity (MFV) between the left and right MCA: (|RMCA MFV-LMCA MFV|/mean MCA MFV)${\times}100$. The stroke subtypes were determined using the TOAST classification. Poor functional outcomes were defined as a mRS score ${\geq}3$ at 3 months after the onset of stroke. A total of 988 patients were included, of whom 157 (15.9%) had a poor functional outcome. Multivariable analysis showed that only the MCA asymmetry index was independently associated with a poor functional outcome. ROC curve analysis showed that adding the MCA asymmetry index to the prediction model improved the discrimination of a poor functional outcome from acute ischemic stroke (from 88.6% [95% CI, 85.2~91.9] to 89.2% [95% CI, 85.9~92.5]). The MCA asymmetry index has an independent prognostic value for predicting a poor short-term functional outcome after an acute cerebral infarction. Therefore, TCD may be useful for predicting a poor functional outcome in patients with acute ischemic stroke.

• 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.

• 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).

• 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.

• 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.

• 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.

• 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.

• 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.