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Diffusion-weighted MR Imaging of Hypoxic-Ischemic Encephalopathy (저산소성-허혈성 뇌증의 확산강조영상 소견)

  • Choi, Hye-Young;Choi, Dae-Seob;Ryoo, Jae-Wook;Cho, Jae-Min;Ko, Eun-Sook;Shin, Tae-Beom;Na, Jae-Beom;Choi, Nak-Cheon
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.1
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    • pp.49-54
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    • 2008
  • Purpose : The purpose of this study was to determine the characteristics of hypoxic-ischemic encephalopathy (HIE) on diffusion-weighted imaging (DWI) and the role of DWI for the diagnosis of HIE. Materials and Methods : Six patients with HIE underwent MRI including DWI. MR examinations were performed within 4 - 32 days (mean, 11.8 days) after hypoxic brain insult. We assessed the distribution of the lesions and compared the DWI and T2, FLAIR images for the subjective conspicuity of the lesions. Results : In all patients, symmetrical hyperintense lesions were demonstrated in the bilateral basal ganglia on T2, FLAIR, and DWI. On ADC map image, the lesions were hypointense in four of six patients and isointense in other two patients. Lesion conspicuity on DWI was higher than on T2 and FLAIR images in four of six patients and similar in other two patients. For the involvement of the cortex and subcortical white matter, in five of six patients, bilateral symmetric hyperintense lesions were seen on T2, FLAIR, and DWI. Lesion conspicuity on DWI was higher than on T2 and FLAIR images in three of them and similar in other two patients. On ADC map image, the lesions showed hypointensity in three of five patients and isointensity in other two patients. For the involvement of the deep cerebral white matter, T2, FLAIR, and DWI showed bilateral symmetric hyperintense lesions in four of six patients. Among them, Lesion conspicuity on DWI was higher than on T2 and FLAIR images in only one patient. Conclusion : HIE is characterized by symmetrical hyperintense lesions in the bilateral basal ganglia, cerebral cortex, and white matter on DWI and the lesions are more conspicuously demonstrated on DWI than on T2 and FLAIR images.

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Prenatal diagnosis and clinical course of restrictive foramen ovale in otherwise normal heart (단순 조기 난원공 협착의 산전 진단과 임상경과)

  • Lee, Ji Joung;Lee, Min A;Rhee, Yun ee;Chang, Mea Young;Kil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.268-271
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    • 2007
  • Purpose : Premature narrowing of the foramen ovale is rare but serious clinical entity. Prenatal narrowing or obstruction of the foramen ovale shows symptoms such as right heart failure, fetal hydrops, triscupid regurgitation, left heart obstructive disease, and supraventricular tachycardia. This study aimed to assess the prenatal diagnosis and postnatal clinical course of restrictive foramen ovale in utero in otherwise normal heart. Methods : The subjects were five patients diagnosed with restrictive foramen ovale in utero from January 2001 to June 2005 at Chungnam National University Hospital. The diagnostic criteria was defined when the maximum diameter in a 4-chamber view is less than 2.5 mm and there is a continuous doppler velocity at the foramen ovale of more than 0.6m/s. Results : At the time of diagnosis of restrictive foramen ovale, gestation age was 34~37 wks, and chief complaints were fetal arrhythmia(2 cases), pericardial effusion, Ebstein anomaly and subaortic stenosis. Two cases which were diagnosed fetal hydrops and supraventricular tachycardia delivered by emergent cesarian section. Five cases were found to have right heart dilatation on echocardiogram after birth, but right heart dilatation became normalized at day 7 after birth and the clinical courses were not eventful. Conclusion : Identifying an obstructed foramen ovale in the fetus warrants the further search for additional cardiac and extracardiac anomalies, which may alter the prognosis. Delivery should be induced if possible in cases of foramen ovale obstruction with signs of cardiac decompensation.

Investigation of Post-seismic Sites Using Local Seismic Tomography in the Korean Peninsula (지진 토모그래피를 이용한 한반도의 과거진원지역의 특성 연구)

  • Kim So-Gu;Bae Hyung-Sub
    • Economic and Environmental Geology
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    • v.39 no.2 s.177
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    • pp.111-128
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    • 2006
  • Three dimensional crustal structure and source features of earthquake hypocenters on the Korean peninsula were investigated using P and S-wave travel time tomography. The main goal of this research was to find Vp/Vs anomalies at earthquake hypocenters as well as those of crustal structure of basins and deep tectonic settings. This allowed fer the extrapolation of more detailed seismotectonic force from the Korean peninsula. The earthquake hypocenters were found to have high Vp/Vs ratio discrepancies (VRD) at the vertical sections. High V/p/Vs ratios were also found in the sedimentary basins and beneath the Chugaryong Rift Zone (CRZ), which was due to mantle plume that subsequently solidified with many fractures and faults which were saturated with connate water. The hypocenters of most earthquakes were found in the upper crust for Youngwol (YE), Kyongju (KE), Hongsung (HE), Kaesong (KSE), Daekwan (DKE), and Daehung (DHE) earthquakes, but near the subcrust or the Moho Discontinuity for Mt. Songni (SE), Sariwon (SRE) and Mt. Jiri (JE) earthquakes. Especially, we found hot springs of the Daekwan, Daehung and Unsan regions coincide with high VRD. Also, this cannot rule out the possibility that there are some partial meltings in the subcrust of this region. High VRD might indicate that many faults and fractures with connate water were dehydrated when earthquakes took place, reducing shear modulus in the hypocenter areas. This is can be explained by due to the fact that a point source which is represented by the moment tensor that may involve changes in volume, shear fracture, and rigidity. High Vp/Vs ratio discrepancies (VRD) were also found beneath Mt. Backdu beneath 40 km, indicating that magma chamber existed beneath Mt. Backdu is reducing shear modulus of S-wave velocity.

Evaluation of Detector Dependency on Collimator in SRS: Compared Detectors; CC01, CC13, SFD (뇌정위적 방사선수술 시 콜리메이터 크기 변화에 따른 검출기 의존성 평가)

  • Bae, Yong-Ki;Bang, Dong-Wan;Park, Byung-Moon;Kang, Min-Yeong;Kim, Yeon-Rye
    • The Journal of Korean Society for Radiation Therapy
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    • v.20 no.2
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    • pp.109-113
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    • 2008
  • Purpose: To evaluate the detector dependency in the various collimator size for Stereotactic Radiosugery (SRS). Materials and Methods: This study was performed with 6 MV photon beam (Varian 21EX, Varian, US) and the measurement detectors are used by ion chamber CC01, CC13 (Wellhofer, Germany) and stereotactic diode detector (SFD, Wellhofer, Germany). SRS collimator size was used by ${\varphi}$5, 10, 20, 30 mm (Brain Lab, Germany). Percentage depth dose (PDD) was measured at SSD 100 cm and field size 10×10 cm from individual detectors. Ouput factor was measured by using same setup of PDD and with maximum dose depth. Data was normalized at field size $10{\times}10\;cm$. Beam profile was measured at SSD 100 cm in SRS collimator ${\varphi}$10, 30 mm and field $10{\times}10\;cm$ and a comparison of FWHM (full width half maximum), penumbra width (20~80%). Results: The CC13 detector was overestimated 16% than other detectors from the PDD in the 5 mm collimator. Output factors were underestimated CC01 28%, CC13 72% in the 5 mm collimator and CC01 9.6%, CC13 25% in the 10 mm collimator than the SFD. Maximum difference was 3% at the FWHM of the dose profile in the 10 mm collimator and difference of the 30 mm collimator was 0% at the FWHM. Penumbra width was increased CC01 122%, CC13 194% in the 10 mm collimator and CC01 68%, CC13 185% in the 30 mm collimator than the SFD. Conclusion: It is very important for accurate dosimetry to select a detector in small field. The SFD was considered with the most accurate dosimeter for small collimator dosimetry in this study.

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Operative treatment for Proximal Humeral Fracture (상완골 근위부 골절의 수술적 요법)

  • Park Jin-Young;Park Hee-Gon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.168-175
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    • 2003
  • Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.

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제주도 지하수자원의 최적 개발가능량 선정에 관한 수리지질학적 연구

  • 한정상;김창길;김남종;한규상
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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    • 1994.07a
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    • pp.184-215
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    • 1994
  • The Hydrogeologic data of 455 water wells comprising geologic and aquifer test were analyzed to determine hydrogeoloic characteristics of Cheju island. The groundwater of Cheju island is occurred in unconsolidated pyroclastic deposits interbedded in highly jointed basaltic and andesic rocks as high level, basal and parabasal types order unconfined condition. The average transmissivity and specific yield of the aquifer are at about 29,300m$^2$/day and 0.12 respectively. The total storage of groundwater is estimated about 44 billion cubic meters(m$^3$). Average annual precipitation is about 3390 million m$^3$ among which average recharge amount is estimated 1494 million m$^3$ equivalent 44.1% of annual precipitation with 638 million m$^3$ of runoff and 1256 million m$^3$ of evapotranspiration. Based on groundwater budget analysis, the sustainable yield is about 620 million m$^3$(41% of annual recharge)and rest of it is discharging into the sea. The geologic logs of recently drilled thermal water wens indicate that very low-permeable marine sediments(Sehwa-ri formation) composed of loosely cemented sandy sat derived from mainly volcanic ashes, at the 1st stage volcanic activity of the area was situated at the 120$\pm$68m below sea level. And also the other low-permeable sedimentary rock called Segipo-formation which is deemed younger than former marine sediment is occured at the area covering north-west and western part of Cheju at the $\pm$70m below sea level. If these impermeable beds are distributed as a basal formation of fresh water zone of Cheju, most of groundwater in Cheju will be para-basal type. These formations will be one of the most important hydrogeologic boundary and groundwater occurences in the area.

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Dose Distribution and Characterization for Radiation Fields of Multileaf Collimateor System (방사선 입체조형치료용 다엽콜리메이터의 특성과 조직내 선량분포 측정)

  • Chu, Sung-Sil;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.77-85
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    • 1996
  • Purpose : Multileaf collimator(MLC) is very suitable tool for conformal radio-therapy and commissioning measurements for a multileaf collimator installed on a dual energy accelerator with 6 and 10MV photons are required, For modeling the collimator with treament planning software, detailed dosimetric characterization of the multileaf collimator including the penumbra width, leaf transmission between leaf leakage and localization of the leaf ends and sides is an essential requirement. materials and Methods : Measurement of characteristic data of the MLC with 26 pair block leaves installed on CLINAC 2100C linear accelerator was performed. Low sensitive radiographic film(X-omatV) was used for the penumbra measurement and separate experiments using radiographic film and thermoluminescent dosimeters were performed to verify the dose distribution, Measured films were analized with a photodensitometer of WP700i scanner. Results : For 6 & 10 MV x-ray energies, approximately $2.0\%$ of photons incident on the multileaf collimator were transmitted and an additional $0.5\%$ leakage occurs between the leaves. Localizing the physical end of the leaves showed less than 1mm deviation from the $50\%$ decrement line and this difference is attributed to the curved shaped end on the leaves One side of a sin히e leaf corresponded to the $50\%$ decrement line, but the opposite face was aligned with a lower value. This difference is due to the tongue and groove used to decrease between leaf leakage. Alignment of the leaves to form a straight edge resulted larger penumbra at far position from isocenter as compare with divergent alloy blocks. When the MLC edge is stepped by sloping field, the isodose lines follow the leaf pattern and Produce scalloping isodose curves in tissue. The effective penumbra by 45 degree stepped MLC is about 10mm at 10cm depth for 6MV x-ray. The difference of effective penumbra in deep tissue between MLC and divergent alloy blocks is small (5mm). Conclusion : Using the characteristic data of MLC, the MLC has the clinlical acceptability and suitability for 3-D conformal radiotherapy except small field size.

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Microbial Community Composition Associated with Anaerobic Oxidation of Methane in Gas Hydrate-Bearing Sediments in the Ulleung Basin, East Sea (동해 울릉분지 가스 하이드레이트 매장 지역의 메탄산화 미생물 군집 조성 및 분포)

  • Cho, Hyeyoun;Kim, Sung-Han;Shin, Kyung-Hoon;Bahk, Jang-Jun;Hyun, Jung-Ho
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.20 no.1
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    • pp.53-62
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    • 2015
  • To elucidate the microbial consortia responsible for the anaerobic methane oxidation in the methane hydrate bearing sediments, we compared the geochemical constituents of the sediment, the rate of sulfate reduction, and microbial biomass and diversity using an analysis of functional genes associated with the anaerobic methane oxidation and sulfate reduction between chimney site (UBGH2-3) on the continental slope and non-chimney site (UBGH2-10) on the basin of the Ulleung Basin. From the vertical profiles of geochemical constituents, sulfate and methane transition zone (SMTZ) was clearly defined between 0.5 and 1.5 mbsf (meters below seafloor) in the UBGH2-3, and between 6 and 7 mbsf at the UBGH2-10. At the UBGH2-3, the sulfate reduction rate (SRR) in the SMTZ exhibited was appeared to be $1.82nmol\;cm^{-3}d^{-1}$ at the depth of 1.15 mbsf. The SRR in the UBHG2-10 showed a highest value ($4.29nmol\;cm^{-3}d^{-1}$) at the SMTZ. The 16S rRNA gene copy numbers of total Prokaryotes, mcrA, (methyl coenzyme M reductase subunit A), and dsrA (dissimilatory sulfite reductase subunit A) showed the peaks in the SMTZ at both sites, but the maximum mcrA gene copy number of the UBGH2-10 appeared below the SMTZ (9.8 mbsf). ANME-1 was a predominant ANME (Anaerobic MEthanotroph) group in both SMTZs of the UBGH2-3 and -10. However, The sequences of ANME-2 were detected only at 2.2 mbsf of the UBGH2-3 where high methane flux was observed because of massive amount of gas hydrate at shallow depth. And Desulfosarcina-Desulfococcus (DSS) that is associated with ANME-2 was detected in 2.2 mbsf of the UBHG2-3. Overall results demonstrate that ANME-1 and ANME-2 are considered as significant archaeal groups related to methane cycle in the subsurface sediment of the East Sea, and ANME-2/DSS consortia might be more responsible for methane oxidation in the methane seeping region than in non-seeping region.

A Study on Dose Assessment by 18F-FDG injected into Patients (환자에게 주입된 18F-FDG 의한 선량 평가에 대한 연구)

  • Kim, Chang-Ju;Kim, Jang-Oh;Jeong, Geun-Woo;Shin, Ji-Hey;Lee, Ji-Eun;Jeon, Chan-Hee;Min, Byung-In
    • Journal of the Korean Society of Radiology
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    • v.14 no.4
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    • pp.467-475
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    • 2020
  • The purpose of this study is to assess doses to 18F-FDG, a radioactive drug, during PET examinations, to alleviate anxiety about radiation in patients and carers, to minimize the indiscriminate examination progress caused by medical institution personnel and space clearance problems, and health examination. The dose assessment was measured using a thermo-fluorescent dosimeter (TLD) and an electronic personal dosimeter (EPD) at the location of the cervical (hypothyroid), thorax (heart), and lower abdomen (breeding line) which are the three highest tissue areas of the radiation tissue weighting. In addition, spatial dose rates and radioactivity in urine were measured using GM counters and ion boxes. The results are as follows: First, the personal dosimeter TLD was measured 0.0425±0.0277 mSv in the cervical region, 0.0440±0.0386 mSv in the thorax and 0.0485±0.0436 mSv in the lower abdomen, with little difference in the heart dose depending on radiation sensitivity. The EPD was measured at 0.942±0.141 mSv/h immediately after the cervical position, and 0.192±0.031 mSv/h after 120 minutes. Immediately after the thorax position, 0.516±0.085 mSv/h, 120 minutes later 0.128±0.040 mSv/h. Immediately after the lower abdomen position, 0.468±0.091 mSv/h, and after 120 minutes 0.105±0.021 mSv/h were measured. The spatial dose rate at the GM counter was measured immediately at 0.041±0.005 mSv/h, 120 minutes later at 0.014±0.002 mSv/h. The radioactivity in urine using ion chamber was measured at 0.113±0.24 MBq/cc after 60 minutes and 0.063±0.13 MBq/cc after 120 minutes. As a result, 18F-FDG should be administered, dose re-evaluated two hours after the PET test is completed, and caregivers should be avoided. In addition, it is deemed necessary to provide patients and carers with sufficient explanations and expected values of exposure dose to avoid reckless testing. It is hoped that the data tested in this study will help patients and families relieve anxiety about radiation, and that the radiation workers' exposure management system and institutional improvements will contribute to the development of medical radiation.

The Effect of Human Albumin Infusion on the Clinical Course of Steroid Sensitive Nephrotic Syndrome (인알부민 투여가 스테로이드 반응성 신증후군의 임상경과에 미치는 영향)

  • Lee Soo Jin;Jeong Ji A;Hwang Soo Ja;Lee Seung Joo
    • Childhood Kidney Diseases
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    • v.4 no.2
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    • pp.102-110
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    • 2000
  • Purpose : Intravenous infusion of albumin has been widely und to relieve severe nephrotic edema in spite of beneficial or harmful effects. The purpose of this study is to examine the harmful effect of albumin on the clinical course of steroid sensitive nephrotic syndrome(SSNS). Method : We prospectively randomized the patients with nephrotic syndrome(biopsy proven or clinically compatible to minimal change nephrotic syndrome) into the albumin group(20$\%$ albumin 1 g/kg) or control group(5$\%$ D/W) between March 1997 and September 1999 at Ewha University Mokdong Hospital. We compared the clinical course of the albumin group(n=13) with the control group(n=13). Results : 1. The duration of steroid therapy until complete remission in the albumin group was significantly longer than the control group($13.7{\pm}6.4\;days\;vs\;7.5{\pm}2.8\;days$)(P<0.05). 2. The remission duration to the first relapse was significantly shorter in the albumin group ($94{\pm}63.5$ days) than the control group($190{\pm}106.4$ days)(P< 0.05). There was no significant difference in the relapse rate within 1 year after complete remission[77$\%$ (10/13) vs 46$\%$ (6/13)](P>0.05) and the relapse frequency per year($1.9{\pm}0.8\;vs\;1.5{\pm}0.5$) between the albumin and control groups. 3. Spot urine protein/creatinine ratio significantly increased in the albumin group at post-albumin 2, 4 days(P<0.05). There was no significant difference in the change of the daily percent weight loss, blood pressure, serum Na, K concentration between the albumin and control groups. Conclusion : Albumin infusion in SSNS delayed the response to steroid and shortened the remission duration to the first relapse. Albumin should be carefully used in nephrotic edema.

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