• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2018년도 춘계학술대회
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• pp.184-187
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• 2018

뇌경색의 예방 및 치료에 있어서 가장 중요한 요소는 대뇌 혈류량을 증가시키는 것이다. 대뇌 혈류를 증가시키는 방법으로는 기본적으로 약물에 의한 방법과 수술 또는 동맥 내에 의료 기구를 직접 삽입하는 침습적인 시술(NeuroFloTM) 등이 있다. 본 논문에서 제안하는 비 침습적인 대뇌 혈류 증가 장치는 합병증 유발 확률이 적고, 환자의 혈압 상태에 따라 치료 수준을 정할 수 있으므로 환자의 부담을 덜어줄 수 있다. 이러한 비 침습적인 대뇌 혈류 증가 장치 구현에 있어, 환자에게 알맞은 치료 수준을 제공하기 위한 정확한 평균 동맥압 값을 측정하는 것이 중요하다. 따라서 노이즈를 제거하기 위해 아날로그 필터 및 디지털 필터를 사용하였고, 피크 값 검출을 위한 알고리즘, 펌프제어 알고리즘 등을 사용하였다.

• Journal of Korean Neurosurgical Society
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• 제54권4호
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• pp.289-295
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• 2013

Objective : Cerebral vasospasm is a common and potentially devastating complication of aneurysmal subarachnoid hemorrhage (aSAH). Inflammatory processes seem to play a major role in the pathogenesis of vasospasm. C-reactive protein (CRP) constitutes a highly sensitive inflammatory marker. Elevation of serum CRP levels has been demonstrated in patients with aSAH. The purpose of the current study was to evaluate the possible relationship between CRP levels in the serum and transcranial Doppler (TCD) and the development of vasospasm in patients with aSAH. Methods : A total of 61 adult patients in whom aSAH was diagnosed were included in the study from November 2008 to May 2011. The patients' demographics, Hunt and Hess grade, Fisher grade, CT scans, digital subtraction angiography studies, and daily neurological examinations were recorded. Serial serum CRP measurements were obtained on days 1, 3, 5, 7, 9, 11 and 13 and TCD was measured on days 3, 5, 7, 9, 11 and 13. All patients underwent either surgical or endovascular treatment within 24 hours of their hemorrhagic attacks. Results : Serum CRP levels peaked on the 3rd postoperative day. There were significant differences between the vasospasm group and the non-vasospasm group on the 1st, 3rd and 5th day. There were significant differences between the vasospasm group and the non-vasospasm group on the 3rd day in the mean middle cerebral artery velocities on TCD. Conclusion : Patients with high levels of CRP on the 1st postoperative day and high velocity of mean TCD on the 3rd postoperative day may require closer observation to monitor for the development of vasospasm.

• 대한한방내과학회지
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• 제42권5호
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• pp.808-819
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• 2021

Objectives: This study considered the effectiveness of integrative Korean medical treatment for stress-induced hypertensive patients without the use of conventional medication. Methods: A 62-year-old female with stress-induced hypertension (HTN) was hospitalized for 33 days. Her pattern identification was ascendant hyperactivity of liver yang (Ganyangsanghang)-type HTN. Herbal medicine and acupuncture were used for the treatment: Cheonggansoyo-san for 33 days and Chunwangbosim-dan for 15 days, together with acupuncture for 20 minutes twice a day. Blood pressure was checked daily during hospitalization with a digital sphygmomanometer in the brachial artery. Results: After 33 days of treatment, blood pressure decreased. The Handicap Inventory (DHI) scale and Pittsburg Sleep Quality Index (PSQI) scores both decreased. The patient also reported fewer complaints. A five-month follow-up after discharge, with no further treatment, confirmed stable blood pressure. Symptom improvements continued with no significant side effects. Conclusions: This study indicates that Korean medical treatment is effective for stress-induced hypertensive patients.

• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.35-45
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• 2019

Objective : To describe our experiences with a fully equipped high-end digital subtraction angiography (DSA) system within a hybrid operating room (OR). Methods : A single-plane DSA system with 3-dimensional rotational angiography, cone-beam computed tomography (CBCT), and real-time navigation software was used in our hybrid OR. Between April 2014 and January 2018, 191 sessions of cerebrovascular procedures were performed in our hybrid OR. After the retrospective review of all cases, the procedures were categorized into three subcategorical procedures : combined endovascular and surgical procedure, complementary rescue procedure during intervention and surgery, and frameless stereotaxic operation. Results : Forty-nine of 191 procedures were performed using hybrid techniques. Four cases of blood blister aneurysms and a ruptured posterior inferior cerebellar artery aneurysm were treated using bypass surgery and endovascular trapping. Eight cases of ruptured aneurysm with intracranial hemorrhage (ICH) were treated by partial embolization and surgical clipping. Six cases of ruptured arteriovenous malformation with ICH were treated by Onyx embolization of nidus and subsequent surgical removal of nidus and ICH. Two (5.4%) of the 37 cases of pre-mature rupture during clipping were secured by endovascular coil embolization. In one (0.8%) complicated case of 103 intra-arterial thrombectomy procedures, emergency surgical embolectomy with bypass surgery was performed. In 27 cases of ICH, frameless stereotaxic hematoma aspiration was performed using $XperGuide^{(R)}$ system (Philips Medical Systems, Best, the Netherlands). All procedures were performed in single sessions without any procedural complications. Conclusion : Hybrid OR with a fully equipped DSA system could provide precise and safe treatment strategies for cerebrovascular diseases. Especially, we could suggest a strategy to cope flexibly in complex lesions or unexpected situations in hybrid OR. CBCT with real-time navigation software could augment the usefulness of hybrid OR.

• Journal of Korean Neurosurgical Society
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• 제64권4호
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• pp.514-523
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• 2021

Objective : Aneurysm volume quantification (AVQ) using the equation of ellipsoid volume is widely used although it is inaccurate. Furthermore, AVQ with 3-dimensional (3D) rendered data has limitations in general use. A novel universal method for AVQ is introduced for any diagnostic modality and application to any shape of aneurysms. Methods : Relevant AVQ studies published from January 1997 to June 2019 were identified to determine common methods of AVQ. The basic idea is to eliminate the normal artery volume from 3D model with the aneurysm. After Digital Imaging and Communications in Medicine (DICOM) data is converted and exported to stereolithography (STL) file format, the 3D STL model is modified to remove the aneurysm and the volume difference between the 3D model with/without the aneurysm is defined as the aneurysm volume. Fifty randomly selected aneurysms from DICOM database were used to validate the different AVQ methods. Results : We reviewed and categorized AVQ methods in 121 studies. Approximately 60% used the ellipsoid method, while 24% used the 3D model. For 50 randomly selected aneurysms, volumes were measured using 3D Slicer, RadiAnt, and ellipsoid method. Using 3D Slicer as the reference, the ratios of mean difference to mean volume obtained by RadiAnt and ellipsoid method were -1.21±7.46% and 4.04±30.54%, respectively. The deviations between RadiAnt and 3D Slicer were small despite of aneurysm shapes, but those of ellipsoid method and 3D Slicer were large. Conclusion : In spite of inaccuracy, ellipsoid method is still mostly used. We propose a novel universal method for AVQ that is valid, low cost, and easy to use.

• 대한중풍순환신경학회지
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• 제18권1호
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• pp.23-29
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• 2017

A case of a 47-year-old male patient with Lt.hand pain & cold sensation due to Thrombotic occlusion of Lt. brachial a. is presented. He was treated with acupuncture, electroacupuncture and herbal medicine - 桂枝茯苓丸(Gyejibongnyeong-hwan, Keishibukuryo-gan). We used NRS of pain and Digital Infrared Thermal Image(DITI) to evaluate the progress. After 11days of treatment, there were notable improvement in pain scale, DITI. Korean medical treatment may be effective in treating thrombotic occlusion.

• Investigative Magnetic Resonance Imaging
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• 제1권1호
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• pp.94-102
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• 1997

목적: 자기공명혈관조영술(magnetic resonance angiography: MRA)을 이용하여 뇌동맥류를 비침습적 방법으로 진단하고자 하는 시도가 있었지만 크기가 3mm 이하인 경우 진단에 애로가 많았다. 뇌동맥류의 진단에 있어 최근 개발된 고해상도, 고속의 slice interpolation 자기 공명혈관조영술과 디지탈 감산 혈관조영술(digital subtraction angiography: DSA)의 결과를 전향적으로 비교하여 보편적인 선별 검사법으로 가능성을 확인하고자 하였다. 대상 및 방법: 총 19명의 환자에서 26개의 뇌동맥류를 대상으로 하였다. 모두 자기공명혈관조영술을 먼저 촬영하여 기원혈관, 동맥류경부의 확인, 인근 작은 혈관과의 연관관계등을 확인한 후 디지탈 감산 혈관조영술을 시행하여 비교하였다. 영상은 1.5T 초전도형기계(Vision, Siemens, erlangen, Germany)를 이용하여 slice interpolation 을 이용한 자기공명혈관조영술로 촬영하였다. 촬영은 TR / TE / FA = 30 / 6.4 / 25, matrix $512{\times}160$, 관찰면 $200{\times}150$, 촬영시간 7분 42초, 유효 두께 0.7mm, 총 두께가 102.2mm로 하여 대공(foramen magnum)에서 전뇌동맥(anterior cerebral artery)의 A3 부위까지 충분히 포함되도록 하였다. 영상분석은 최대강도투사(maximum intensity projection: MIP)를 사용하였으며 두개강내 동맥류가 있는 경우 다면재구성(multiplanar reconstruction: MPR) 기법을 사용하였다. 결과: 19명의 환자중 2명이 3개, 3명이 2개, 나머지 14명이 각각 1개씩의 두개강내 동맥류를 가져 모두 26개 였으며 파열된 동맥류가 14개였고 파열되지 않은 동맥류가 12 개이었다. 크기가 2mm 이하가 8개, 3-5mm가 9개, 6-9mm가 7개이며 10mm이상이 2개가 있었다. 처음 검사에서 자기공명혈관조영술과 디지탈 감산 혈관조영술에서 23개의 동맥류중 내경동맥에 1mm 크기의 동맥류 1개를 제외한 25개를 각각 발견할 수 있어 96%의 예민도를 보였으나 진음성과 위음성은 없어 특이도를 측정할 수 없었다. 크기와 모양을 확인하는데 자기공명혈과조영술과 다면재구성을 동시에 사용한 경우 디지탈 감산 혈관조영술과 같은 성적을 보인 반면 동맥류 경부와 기원혈관을 확인하는데도 자기공명혈관조영술의 다면재구성을 동시에 사용한 경우가 자기공명혈관조영술 또는 디지탈 감산 혈관조영술만 사용한 경우 보다 월등히 좋았다. 결론: Slice interpolation 기법을 이용한 고해상 자기공명혈관조영술은 두개강내 동맥류를 검사하는데 디지탈 감산 혈관조영술과 동일한 성적을 보여 앞으로 비침습적 일차 선별 검사법으로 가능할 것으로 생각된다.

• 대한디지털의료영상학회논문지
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• 제15권2호
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• pp.45-53
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• 2013

Purpose : Fixed way of mAs previously Low Extremity Computed Tomography Angiography(LECTA) examination were used. Automatic Current Selection(ACS) to use for the purpose of reducing the dose when Low Extremity Computed Tomography Angiography examining patients. Materials and methods : Were analyzed from July 2011 to July 2012 MDCT examination of Dose Length Product(DLP) LECTA 116 Case. It was defined as previous inspection methods(Old protocol). CT workstation is set to 100 mAs and 150 mAs protocol based on the patient's weight 70kg examined by LECTA. We defined as 'New protocol' that applies to ACS. The data collection period are 76 cases from October 2012 to January 2013 Results : 1. Average Total DLP of 'Old protocol' is 3602.943 $mGy^*cm$. 2. Average Total DLP of 'New protocol' is 1762.977 $mGy^*cm$. 3. Due to the 'New Protocol' use of Total DLP was reduced by approximately 51 %. Phase-specific dose reduction is as follows. Pre(33.62 %), Artery(64.63 %), Delay(49.0 %) 4. Using One way ANOVA Analysis of fluctuations obtained DLP is as follows. 'Old protocol', 'New protocol' a value of P < 0.001, P = 0.882 values were obtained. Conclusions : Dose reduction of 51 % is a useful study that proves. The results obtained using the ACS, the effects of a dose reduction of 51 % was obtained. Therefore, it has been proven to be a useful way. Statistics using SPSS version came out of the 'Old protocol' P-value P < 0.0001. This result means that the DLP a large difference values. On the other hand, The results of the 'New protocol' was P = 0.882. These results means to that small and regularly was fluctuations of the dose. The use of ACS, you can get a reduction of the dose and will able to get the effect of reducing the dose errors.

• Korean Journal of Acupuncture
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• 제24권3호
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• pp.205-221
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• 2007

Objectives : Aims of this study is to investigate the effects of $LU8{\cdot}KI7$ in rat induced by experimental focal ischemia. Materials and methods : The focal ischemia was induced by intraluminal filament insertion into middle cerebral artery. The groups divided into 6groups, control; no therapy group after ischemia-induced, AT1; acupuncture therapy group at $LU8{\cdot}KI7$ after ischemia-induced, AT2; acupuncture therapy at $LU8{\cdot}KI7$ bilaterally and the needle was twirled and rotated forward with the thumb of the right hand 9times, AT3; acupuncture therapy at $LU8{\cdot}KI7$ bilaterally and the needle was twirled and rotated forward with the forefinger of the right hand 9times, AT4; acupuncture therapy at$LU8{\cdot}KI7$ bilaterally and the needle was inserted to the direction following the flowing route of the meridian(digital direction), AT5; acupuncture therapy at $LU8{\cdot}KI7$ bilaterally, the needle was inserted to the direction following the flowing route of the meridian(digital direction) and the needle was twirled and rotated forward with the thumb of the right hand 9times. Acupuncture therapy was carried out 7times during 2weeks after focal ischemia-induced. The anti-apoptotic and neuroprotective effects of acupuncture are observed by Bax, Bcl-2, mGluR5, cytochrome c, Cresyl violet and ChAT-stain. Results : The intensity of Bax was decreased in AC1, AC4, AC5 group, was increased in AC2, AC3 group. The intensity of Bcl-2 was increased in AC2, AC3, AC4, AC5 group. The intensity of mGluR5 was decreased in AC1 group, was increased in AC4, AC5 group. The intensity of Cytochrome c was increased in ACI, AC2 group, was decreased in AC4, AC5 group. The density of neurons stained by Cresyl violet was increased in all group without control group. The density of ChAT was increased in AC2, ACS group. Conclusions : Our study suggests that AC5 group show anti-apoptotic and neuroprotective effects on cholinergic neuron in focal cerebral ischemia of the stroke in rats.

• 대한수의학회지
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• 제39권1호
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• pp.230-239
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• 1999

Digital color doppler ultrasonographic system(DCDUS) has a lot of diagnostic functions. One of these is a detection of low velocity vessels in the organs of abdominal cavity. The purpose of study was to determine the clinical usefulness of DCDUS. Interlobar artery resistive index(RI), pulsatility index(PI) and systolic diastolic ratio(SDr) were measured for diagnosis of obstructed urinary tract. RI, PI and SDr were a measure of intrarenal blood flow impedance. This study was consisted of 2 groups. The normal group was studied in 16 normal adult dogs and the study group was studied 7 dogs with surgically induced, unilateral ureteral obstruction. In the study group, parameters were checked in normal condition and on 1, 2, 3, 5, 7 and 10th day after ligation. The result were summarized as follows. In the normal group, RI, PI and SDr of the left kidney was $0.65{\pm}0.04$, $1.25{\pm}0.12$ and $292.45{\pm}29.40$, respectively. RI, PI and SDr of the right kidney were $0.64{\pm}0.05$, $1.28{\pm}0.20$ and $282.25{\pm}37.26$, respectively. In the study group, RI of the left kidney induced ligation was increased significantly on 1, 2, 3, 5, 7 and 10th day. RI of the left kidney on 1, 2, 3, 5, 7 and 10th day were $0.75{\pm}0.05$, $0.71{\pm}0.03$, $0.74{\pm}0.04$, $0.74{\pm}0.02$, $0.73{\pm}0.02$ and $0.73{\pm}0.04$, respectively. PI of the left kidney was increased significantly on 1, 3, 5 and 7th day. PI of the left kidney on 1, 3, 5 and 7th day were $1.57{\pm}0.21$, $1.54{\pm}0.24$, $1.60{\pm}0.15$ and $1.60{\pm}0.26$, respectively. SDr of the left kidney increased significantly on 1, 2, 3, 5 and 7th day. SDr of the left kidney on 1, 2, 3, 5 and 7th day were $412.18{\pm}86.69$, $352.14{\pm}47.05$, $399.77{\pm}65.54$, $369.43{\pm}48.34$ and $365.57{\pm}22.46$, respectively(p<0.05). In the study group, RI of the left kidney was more increased than that of the right kidney on 1, 2, 3, 5, 7 and 10th day. PI of the left kidney was more increased than that of the right kidney on 1, 3, 5, and 7th day. SDr of the left kidney was more increased than that of the right kidney on 1, 2, 3, 5 and 7th day(p<0.05). RI was effective in the diagnosis of an acute unilateral ureteral obstruction. PI and SDr were insufficient in the diagnosis of an acute unilateral ureteral obstruction.