• Title/Summary/Keyword: Motion Study

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Is a Camera-Type Portable X-Ray Device Clinically Feasible in Chest Imaging?: Image Quality Comparison with Chest Radiographs Taken with Traditional Mobile Digital X-Ray Devices (카메라형 휴대형 X선 장치는 흉부 촬영에서 임상적 사용이 가능한가?: 기존의 이동형 디지털 X선 장치로 촬영한 흉부 X선 사진과 영상품질 비교)

  • Sang-Ji Kim;Hwan Seok Yong;Eun-Young Kang;Zepa Yang;Jung-Youn Kim;Young-Hoon Yoon
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.138-146
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    • 2024
  • Purpose To evaluate whether the image quality of chest radiographs obtained using a camera-type portable X-ray device is appropriate for clinical practice by comparing them with traditional mobile digital X-ray devices. Materials and Methods Eighty-six patients who visited our emergency department and underwent endotracheal intubation, central venous catheterization, or nasogastric tube insertion were included in the study. Two radiologists scored images captured with traditional mobile devices before insertion and those captured with camera-type devices after insertion. Identification of the inserted instruments was evaluated on a 5-point scale, and the overall image quality was evaluated on a total of 20 points scale. Results The identification score of the instruments was 4.67 ± 0.71. The overall image quality score was 19.70 ± 0.72 and 15.02 ± 3.31 (p < 0.001) for the mobile and camera-type devices, respectively. The scores of the camera-type device were significantly lower than those of the mobile device in terms of the detailed items of respiratory motion artifacts, trachea and bronchus, pulmonary vessels, posterior cardiac blood vessels, thoracic intervertebral disc space, subdiaphragmatic vessels, and diaphragm (p = 0.013 for the item of diaphragm, p < 0.001 for the other detailed items). Conclusion Although caution is required for general diagnostic purposes as image quality degrades, a camera-type device can be used to evaluate the inserted instruments in chest radiographs.

Comparison and evaluation of volumetric modulated arc therapy and intensity modulated radiation therapy plans for postoperative radiation therapy of prostate cancer patient using a rectal balloon (직장풍선을 삽입한 전립선암 환자의 수술 후 방사선 치료 시 용적변조와 세기변조방사선치료계획 비교 평가)

  • Jung, hae youn;Seok, jin yong;Hong, joo wan;Chang, nam jun;Choi, byeong don;Park, jin hong
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.45-52
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    • 2015
  • Purpose : The dose distribution of organ at risk (OAR) and normal tissue is affected by treatment technique in postoperative radiation therapy for prostate cancer. The aim of this study was to compare dose distribution characteristic and to evaluate treatment efficiency by devising VMAT plans according to applying differed number of arc and IMRT plan for postoperative patient of prostate cancer radiation therapy using a rectal balloon. Materials and Methods : Ten patients who received postoperative prostate radiation therapy in our hospital were compared. CT images of patients who inserted rectal balloon were acquired with 3 mm thickness and 10 MV energy of HD120MLC equipped Truebeam STx (Varian, Palo Alto, USA) was applied by using Eclipse (Version 11.0, Varian, Palo Alto, USA). 1 Arc, 2 Arc VMAT plans and 7-field IMRT plan were devised for each patient and same values were applied for dose volume constraint and plan normalization. To evaluate these plans, PTV coverage, conformity index (CI) and homogeneity index (HI) were compared and $R_{50%}$ was calculated to assess low dose spillage as per treatment plan. $D_{25%}$ of rectum and bladder Dmean were compared on OAR. And to evaluate the treatment efficiency, total monitor units(MU) and delivery time were considered. Each assessed result was analyzed by average value of 10 patients. Additionally, portal dosimetry was carried out for accuracy verification of beam delivery. Results : There was no significant difference on PTV coverage and HI among 3 plans. Especially CI and $R_{50%}$ on 7F-IMRT were the highest as 1.230, 3.991 respectively(p=0.00). Rectum $D_{25%}$ was similar between 1A-VMAT and 2A-VMAT. But approximately 7% higher value was observed on 7F-IMRT compare to the others(p=0.02) and bladder Dmean were similar among the all plan(P>0.05). Total MU were 494.7, 479.7, 757.9 respectively(P=0.00) for 1A-VMAT, 2A-VMAT, 7F-IMRT and at the most on 7F-IMRT. The delivery time were 65.2sec, 133.1sec, 145.5sec respectively(p=0.00). The obvious shortest time was observed on 1A-VMAT. All plans indicated over 99.5%(p=0.00) of gamma pass rate (2 mm, 2%) in portal dosimetry quality assurance. Conclusion : As a result of study, postoperative prostate cancer radiation therapy for patient using a rectal balloon, there was no significant difference of PTV coverage but 1A-VMAT and 2A-VMAT were more efficient for dose reduction of normal tissue and OARs. Between VMAT plans. $R_{50%}$ and MU were little lower in 2A-VMAT but 1A-VMAT has the shortest delivery time. So it is regarded to be an effective plan and it can reduce intra-fractional motion of patient also.

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Essay on Form and Function Design (디자인의 형태와 기능에 관한 연구)

  • 이재국
    • Archives of design research
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    • v.2 no.1
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    • pp.63-97
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    • 1989
  • There is nothing more important than the form and function in design, because every design product can be done on the basis of them. Form and Function are already existed before the word of design has been appeared and all the natural and man-made things' basic organization is based on their organic relations. The organic relations is the source of vitality which identifies the subsistance of all the objects and the evolution of living creatures has been changed their appearances by the natural law and order. Design is no exception. Design is a man-made organic thing which is developed its own way according to the purposed aim and given situations. If so, what is the ultimate goal of design. It is without saying that the goal is to make every effort to contribute to the -human beings most desirable life by the designer who is devoting himself to their convenience and well-being. Therefore, the designer can be called the man of rich life practitioner. This word implies a lot of meanings since the essence of design is improving the guality of life by the man-made things which are created by the designer. Also, the things are existed through the relations between form and function, and the things can keep their value when they are answered to the right purpose. In design, thus, it is to be a main concern how to create valuable things and to use them in the right way, and the subject of study is focused on the designer's outlook of value and uk relations between form and function. Christopher Alexander mentioned the importance of form as follows. The ultimate object of design is form. Every design problem begins with an effort to achieve fittness between the form and its context. The form is the solution to the problem: the context defmes the problem. In other words, when we speak of design, the real object of discussion is not form alone, but the ensemble comprising the form and its context. Good fit is a desirable property of this ensemble which relates to some particular division of the ensemble into form and context. Max Bill mainatined how important form is in design. Form represents a self-contained concept, and its embodiment in an object results in that object becoming a work of art. Futhermore, this explains why we use form so freguently in a comparative sense for determining whether one thing is less or more beautiful than another, and why the ideal of absolute beauty is always the standard by which we appraise form, and through form, art itself. Hence form has became synonymous with beauty. On the other hand, Laszlo Moholy-Nagy stated the importance of function as follows. Function means the task an object is designed to fulfill the task instrument is shaping the form. Unfortunately, this principle was not appreciated at the same time but through the endeavors of Frank Lloyd Wright and of the Bauhaus group and its many collegues in Europe, the idea of functionalism became the keynote of the twenites. Functionalism soon became a cheap slogan, however, and its original meaning blurred. It is neccessary to reexamine it in the light of present circumstances. Charles William Eliot expressed his idea on the relations between function and beauty. Beauty often results chiefly from fittness: indeed it is easy to manitain that nothing is fair except what is fit its uses or functions. If the function of the product of a machine be useful and valuable, an the machine be eminently fit for its function, it conspicuously has the beauty of fittness. A locomotive or a steamship has the same sort of beauty, derived from the supreme fittness for its function. As functions vary, so will those beauty..vary. However, it is impossible to study form and function in separate beings. Function can't be existed without form, and without function, form is nothing. In other words, form is a function's container, and function is content in form. It can be said that, therefore, the form and function are indispensable and commensal individuals which have coetemal relations. From the different point of view, sometimes, one is more emphasized than the other, but in this case, the logic is only accepted on the assumption of recognizing the importance of the other's entity. The fact can be proved what Frank Hoyd wright said that form and function are one. In spite of that, the form and function should be considered as independent indivisuals, because they are too important to be treated just as the simple single one. Form and function have flexible properties to the context. In other words, the context plays a role as the barometer to define the form and function, also which implies every meaning of surroun'||'&'||'not;dings. Thus, design is formed under the influence of situations. Situations are dynamic, like the design process itself, in which fixed focus can be cripping. Moreover, situations control over making the good design. Judging from the respect, I defined the good design in my thesis An Analytic Research on Desigh Ethic, "good design is to solve the problem by the most proper way in the situations." Situations are changeable, and so is design. There is no progress without change, but change is not neccessarily progress. It is highly desirable that there changes be beneficial to mankind. Our main problem is to be able to discriminate between that which should be discarded and that which should be kept, built upon, and improved. Form and Function are no exception. The practical function gives birth to the inevitable form and the $$\mu$ti-classified function is delivered to the varieties of form. All of these are depended upon changeable situations. That is precisely the situations of "situation de'||'&'||'not;sign", the concept of moving from the design of things to the design of the circumstances in which things are used. From this point of view, the core of form and function is depended upon how the designer can manage it efficiently in given situations. That is to say that the creativity designer plays an important role to fulfill the purpose. Generally speaking, creativity is the organization of a concept in response to a human need-a solution that is both satisfying and innovative. In order to meet human needs, creative design activities require a special intuitive insight which is set into motion by purposeful imagination. Therefore, creativity is the most essential quality of every designer. In addition, designers share with other creative people a compulsive ingenuity and a passion for imaginative solutions which will meet their criteria for excellence. Ultimately, it is said that the form and function is the matter which belongs to the desire of creative designers who constantly try to bring new thing into being to create new things. In accordance with that the main puppose of this thesis is to catch every meaning of the form and function and to close analyze their relations for the promotion of understanding and devising practical application to gradual progression in design. The thesis is composed of four parts: Introduction, Form, Function and Conclusion. Introduction, the purpose and background of the research are presented. In Chapter I, orgin of form, perception of form, and classification of form are studied. In Chapter II, generation of function, development of function, and diversification of function are considered. Conclusion, some concluding words are mentioned.ioned.

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Dosimetric Comparison of One Arc & Two Arc VMAT Plan for Prostate cancer patients (Prostate Cancer 환자에 대한 One Arc와 Two Arc VMAT Plan의 선량 측정 비교 분석)

  • Kim, Byoung Chan;Kim, Jong Deok;Kim, Hyo Jung;Park, Ho Chun;Baek, Jeong Ok
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.107-116
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    • 2018
  • Purpose : Intensity-modulated radiation therapy(IMRT) has been widely used for radiation therapy of Prostate Cancer because it can reduce radiation adverse effects on normal tissues and deliver more dose to the Prostate than 3D radiation therapy. Volumetric modulated arc therapy(VMAT) has been widely used due to recent advances in equipment and treatment techniques. VMAT can reduce treatment time by up to 55 % compared to IMRT, minimizing motion error during treatment. Materials and Methods : In this study, compared the MU and DVH values of 10 patients with prostate cancer by classifying them into 4 groups with 5 LN-Prostate groups and 5 Only-Prostate. And DQA measurements were performed using ArcCHECK and MapCHECK. Results : The results of Target and OAR dose distribution of Prostate patients are as follows. $D_{max}$ was in the range of 100~110 % in 4 groups, and more than 110 % of hot spot was not seen. Only-Prostate ($P_1$, $P_2$) without LN had a satisfactory dose distribution for the target dose, but slightly better for 2 arc plan($P_2$) than 1 arc plan($P_1$). The target dose $D_{98%}$ distribution in the LN-Prostate ($P_{L1}$, $P_{L2}$) group showed better 2 arc plan($P_{L2}$) than 1 arc plan($P_{L1}$), But in the case of 1 arc plan($P_{L1}$), the target dose $D_{98%}$ value was not enough. In OAR, the dose distribution of 1 Arc($P_1$) Plan and 2 Arc($P_2$) Plan in the Only-Prostate ($P_1$, $P_2$) Group satisfied the prescribed dose value. But, The dose distribution of 1 arc($P_1$) was slightly higher. In LN-Prostate OAR, 1 Arc($P_{L1}$) Plan showed higher dose than the prescribed dose. The Gamma evaluation pass rate of ArcCHECK and MapCHECK calculated from the DQA measurements was slightly higher than 99 % and the mean error range of the point dose measurements using the CC04 ion chamber was less than 1 %. Conclusion : In this study, Only-Prostate ($P_1$, $P_2$) group, the dose of 2 Arc plan was better. However, considering the treatment time and MU value, 1 Arc treatment method was more suitable. In the LN-Prostate ($P_{L1}$, $P_{L2}$) group, 2 Arc($P_{L2}$) treatment method showed better results and satisfied with Target $D_{98%}$ and OAR prescription dose.

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Evaluation of usefulness of the Gated Cone-beam CT in Respiratory Gated SBRT (호흡동조 정위체부방사선치료에서 Gated Cone-beam CT의 유용성 평가)

  • Hong sung yun;Lee chung hwan;Park je wan;Song heung kwon;Yoon in ha
    • The Journal of Korean Society for Radiation Therapy
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    • v.34
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    • pp.61-72
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    • 2022
  • Purpose: Conventional CBCT(Cone-beam Computed-tomography) caused an error in the target volume due to organ movement in the area affected by respiratory movement. The purpose of this paper is to evaluate the usefulness of accuracy and time spent using the Gated CBCT function, which reduces errors when performing RGRT(respiratory gated radiation therapy), and to examine the appropriateness of phase. Materials and methods: To evaluate the usefulness of Gated CBCT, the QUASARTM respiratory motion phantom was used in the Truebeam STxTM. Using lead marker inserts, Gated CBCT was scaned 5 times for every 20~80% phase, 30~70% phase, and 40~60% phase to measure the blurring length of the lead marker, and the distance the lead marker moves from the top phase to the end of the phase was measured 5 times. Using Cedar Solid Tumor Inserts, 4DCT was scanned for every phase, 20-80%, 30-70%, and 40-60%, and the target volume was contoured and the length was measured five times in the axial direction (S-I direction). Result: In Gated CBCT scaned using lead marker inserts, the axial moving distance of the lead marker on average was measured to be 4.46cm in the full phase, 3.11cm in the 20-80% phase, 1.94cm in the 30-70% phase, 0.90cm in the 40-60% phase. In Fluoroscopy, the axial moving distance of the lead marker on average was 4.38cm and the distance on average from the top phase to the beam off phase was 3.342cm in the 20-80% phase, 3.342cm in the 30-70% phase, and 0.84cm in the 40-60% phase. Comparing the results, the difference in the full phase was 0.08cm, the 20~80% phase was 0.23cm, the 30~70% phase was 0.10cm, and the 40~60% phase was 0.07cm. The axial lengths of ITV(Internal Target Volume) and PTV(Planning Target Volume) contoured by 4DCT taken using cedar solid tumor inserts were measured to be 6.40cm and 7.40cm in the full phase, 4.96cm and 5.96cm in the 20~80% phase, 4.42cm and 5.42cm in the 30~70% phase, and 2.95cm and 3.95cm in the 40~60% phase. In the Gated CBCT, the axial lengths on average was measured to be 6.35 cm in the full phase, 5.25 cm in the 20-80% phase, 4.04 cm in the 30-70% phase, and 3.08 cm in the 40-60% phase. Comparing the results, it was confirmed that the error was within ±8.5% of ITV Conclusion: Conventional CBCT had a problem that errors occurred due to organ movement in areas affected by respiratory movement, but through this study, obtained an image similar to the target volume of the setting phase using Gated CBCT and verified its usefulness. However, as the setting phase decreases, the scan time was increases. Therefore, considering the scan time and the error in setting phase, It is recommended to apply it to patients with respiratory coordinated stereotactic radiation therapy using a wide phase of 30-70% or more.

The Comparison of Quantitative Indices by Changing an Angle of LAO View in Multi-Gated Cardiac Blood Pool Scan (게이트 심장 혈액풀 스캔에서 좌전사위상 각도의 변화에 따른 정량적 지표 비교)

  • Yoon, Soon-Sang;Nam, Ki-Pyo;Ryu, Jae-Kwang;Kim, Seong-Hwan
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.57-61
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    • 2012
  • Purpose: The multi-gated cardiac blood pool scan is to evaluate the function of left ventricle (LV) and usefully observe a value of ejection fraction (EF) for a patient who is receiving chemotherapy. To calculate LVEF, we should adjust an angle of left anterior oblique (LAO) view to separate both ventricles. And by overlapped ventricles, it is possible to affect LVEF. The purpose of this study is to investigate and compare quantitative indices by changing an angle of LAO view. Materials and methods: We analyzed the 49 patients who were examined by multi-gated cardiac blood pool scan in department of nuclear medicine at Asan Medical Center from June to September 2011. Firstly, we acquired "Best septal" view. And then, we got images by addition and subtraction of angle for LAO view to anterior and lateral. We compared three LAO views for 20 people by 5 degrees and 39 people by 10 degrees. And we analyzed quantitative indices, EF, end diastole and end systole counts, by automated and manual region of interest (ROI) modes. Results: Firstly, we analyzed quantitative indices by automated ROI mode. In case of 5 degrees, the averages of EF are $61.0{\pm}7.5$, $62.1{\pm}7.1$, $60.9{\pm}6.7%$ ($p$=0.841) in LAO, LAO $-5^{\circ}$ and LAO $+5^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). In case of 10 degrees, the averages of EF are $62.4{\pm}9.5$, $62.3{\pm}10.8$, $61.6{\pm}.9.3%$ ($p$=0.938) in LAO, LAO $-10^{\circ}$ and LAO $+10^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). Secondly, we analyzed quantitative indices by manual ROI mode. In case of 5 degrees, the averages of EF are $62.8{\pm}7.1$, $63.6{\pm}7.5$, $62.7{\pm}7.3%$ ($p$=0.903) in LAO, LAO $-5^{\circ}$ and LAO $+5^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). In case of 10 degrees, the averages of EF are $65.5{\pm}9.0$, $66.3{\pm}8.7$, $63.5{\pm}.9.3%$ (p=0.473) in LAO, LAO $-10^{\circ}$ and LAO $+10^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). Conclusion: When an image is nearly "Best septal" view, the difference of LAO angle would not affect to change LVEF. Although there was no difference in quantitative analysis, deviations could happen when to interpret wall motion qualitatively by reading physicians.

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Study on Medical Records In ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ ("삼국사기(三國史記)"에 기록된 의약내용(醫藥內容) 분석)

  • Shin, Soon-Shik;Choi, Hwan-Soo
    • Journal of The Association for Neo Medicine
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    • v.2 no.1
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    • pp.35-54
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    • 1997
  • We tried to observe the features of ancient medical practice by analysing the records related to medicine in the book, ${\ulcorner}$the Historical Records of the Three Kingdom${\lrcorner}$ of which content includes the features of medicine in mythology, plague, delivery of twins, drugs, medical system, shamanism, constitutional medicine, psychiatry, forensic medicine, deformity, a spa, medical phrase, health and welfare work, religion, death. physiological anatomy, Taoist medicine, acupuncture, the occult af of transformation and etc. Our initial concern was about where to draw line as of medical field and we defined medicine in more broad meaning. The book ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ describes the world of mythology by way of medicine which is not clearly a conventional one. There appears records of birth of multiple offsprings 7 times in which cases are of triplets or more. Delivering multiple offsprings were rare phenomenon though such fertility was highly admired. This shows one aspect of ancient country having more population meant more power of the nation. Of those medical records conveyed in that book includes stories of childbirth such as giving birth to a son after praying, giving birth to Kim Yoo-shin after 20 months after mother's dream of conception, and a song longing for getting a laudable child. Plagues were prevalent throughout winter to spring season and one can observe various symptoms of plagues in the record. Of these epidemic diseases, cold type might have been more common than the heat one. Appearance of epidemic diseases frequently coincided with that of natural disasters that this suggests a linkage between plague and underlying doctrine on five elements' motion and six kinds of natural factors. There exists only a few names of diseases such as epidemic disease, wind disease, and syndrome characterized by dyspnea. Otherwise there appeared only afflictions that were not specified therefore it remains cluless to keep track of certain diseases of prevalence. Since this ${\ulcorner}$Historical Records of the Three Kingdoms'${\lrcorner}$ wasn't any sort of medical book, words and terms used were not technical kind and most were the ones used generally among lay people. Therefore any mechanisms of the diseases were hardly mentioned. Some of medicinal substances such as Calculus Bovis, Radix Ginseng, Gaboderma Luciderm, magnetitum were also in use in those days. 53 kinds of dietary supplies appears in the records and some of these might have been used as medicinal purpose. Records concerning dicipline of one's body includes activities such as hunting, archery, horseback riding etc. In Shilla dynasty there were positions such as professor of medicine, Naekongbong(內供奉), Kongbong's doctor(供奉醫師), Kongbong's diviner(供奉卜師). As an educational facility, medical school was built at the first year of King Hyoso's reign and it's curricula included various subjects as ${\ulcorner}$Shin Nong's Herbal classic${\lrcorner}$, ${\ulcorner}$Kabeul classic of acupuncture and moxbustion${\lrcorner}$, ${\ulcorner}$The Plain Questions of the Yellow Emperor's Classic of Internal Medicine${\lrcorner}$, ${\ulcorner}$Classic of Acupuncturer${\lrcorner}$, ${\ulcorner}$The Pulse Classic${\lrcorner}$, ${\ulcorner}$Classic of Channels and Acupuncture Points${\lrcorner}$ and ${\ulcorner}$Difficult Classic${\lrcorner}$. There were 2 medical professors who were in charge of education. To establish pharmacopoeia, 2 Shaji(舍知), 6 Sha(史), 2 Jongshaji(從舍知) were appointed. In Baekje dynasty, Department of Herb was maintained. Doing praying for the sake of health, doing phrenology also can be extended to medical arena. Those who survived over 100 years of age appear 3 times in the record, while 98 appears once. The earliest psychiatrist Nokjin differentiated symptoms to apply either therapies using acupuncture and drug or psychotherapy. There appears a case of rape, a case of burying alive with the dead, 8 cases of suicide that can characterize a prototype of forensic medicine. Deformity-related records include phrases as follow: 'there seems protrudent bone behind the head', 'a body which has two heads, two trunks, four arms.', 'a body equipped with two heads' In those times spa can be said to be used as a place for he리ing, convalescence, and relaxation seeing the records describing a person pretended illness and went to spa to enjoy with his friends. Priest doctors and millitary surgeons were in charge of the medical sevice in the period of the Three Kingdoms by the record written by Mookhoja(墨胡子) and Hoonkyeom(訓謙). Poor diet and regimen makes people more vulnerable to diseases. So there existed charity services for those poor people who couldn't live with one's own capacity such as single parents, orphans, the aged people no one to take care and those who are ill. The cause of affliction was frequently coined with human relation. There appeared the phenomenon of releasing prisoners and allowing people to become priests at the time of king's suffering. Besides, as a healing procedure, sutra-chanting was peformed. There appears 10 cases of death related records which varies from death by drowning, or by freezing, death from animals, death from war, death from wightloss and killing oneself at the moment of spouse's death and etc. There also exist certain records which suggest the knowledge of physiology and anatomy in those times. Since the taoist books such as ${\ulcorner}$Book of the Way and Its Power(老子道德經)${\lrcorner}$ were introduced in the period of Three Kingdoms, it can be considered that medicine was also influenced by taoism. Records of higher level of acupuncture, records which links the medicine and occult art of transformation existed. Although limited, we could figure out the medical state of ancient society.

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Clinical Significance of Reverse Redistribution on Tc-99m MIBI and T1-201 Myocardial Perfusion SPECT Images (Tc-99m MIBI와 T1-201 심근 SPECT에서 역재분포의 임상적 의의)

  • Song, Ho-Cheon;Bom, Hee-Seung;Kim, Ji-Yeul;Jeong, Myung-Ho;Gill, Kwang-Chae;Park, Joo-Hyung;Cho, Jeong-Gwan;Park, Jong-Choon;Kang, Jung-Chaee
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.1
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    • pp.95-103
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    • 1996
  • Reverse redistribution(RRD) refers to a perfusion defect that develops or becomes more evident on rest imaging compared with the stress imaging. This phenomenon was not uncommonly noted on myocardial perfusion single photon emission computed tomography (SPECT). However, the clinical significance and pathophysiological mechanism of RRD were unclear. The aim of this study was to evaluate the incidence and clinical significance of RRD on either dipyridamole T1-201 or Tc-99m MIBI myocardial perfusion SPECT. RRD was defined as ${\geq}10%$ decrease in relative T1-201 and Tc-99m MIBI uptakes on rest images compared to the stress images or as an appearance of new perfusion defects on rest images. It was observed in both T1-201 (44/463, 9.5%) and Tc-99m MIBI (124/999, 12.4%) myocardial SPECTs similarly, with an overall incidence of 11.5%(168/1462). Many apparent)y unrelated disease groups showed the finding: post-revascularization(53.9%), coronary artery disease(24.6%), myocardial infarction(12.3%), and those with normal coro-nary arteries (9.2%). Clinical and angiographic characteristics of 65 consecutive patients who underwent coronary arteriography in 168 patients who had RRD on myocardial perfusion SPECT were reviewed. Tc-99m MIBI was used in 44 patients, and T1-201 was used in 21 patients. Of the 81 myocardial segments analyzed which showed RRD, 32 segments(39.5%) were in septum, 24(29.5%) in inferior wallL, 12(14.8%) in anterior wall, 7(8.7%) in apex and 6(7.4%) in lateral wall. There was no clear association between RRD and coronary arterial stenosis or Presence of collateral circulations. Ventriculographical wall motion was evaluated in 27 regions with RRD; it was normal in 12 regions, hypokinetic in 12 regions and dyskinetic in 3 regions. In 14 of 21 patients who showed RRD on T1-201 myocardial SPECT, T1-201 reinjection was performed immediately after the 3-4 hour redistribution studies. Ten of 14 (71.4%) showed enhanced T1-201 activity(${\geq}10%$ increased) after reinjection. We conclude that RRD is not related to mode of stress or radiopharmaceuticals. RRD might represent many inhomogeneous pathophysiological processes.

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M-mode Ultrasound Assessment of Diaphragmatic Excursions in Chronic Obstructive Pulmonary Disease : Relation to Pulmonary Function Test and Mouth Pressure (만성폐쇄성 폐질환 환자에서 M-mode 초음파로 측정한 횡격막 운동)

  • Lim, Sung-Chul;Jang, Il-Gweon;Park, Hyeong-Kwan;Hwang, Jun-Hwa;Kang, Yu-Ho;Kim, Young-Chul;Park, Kyung-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.736-745
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    • 1998
  • Background: Respiratory muscle interaction is further profoundly affected by a number of pathologic conditions. Hyperinflation may be particularly severe in chronic obstructive pulmonary disease(COPD) patients, in whom the functional residual capacity(FRC) often exceeds predicted total lung capacity(TLC). Hyperinflation reduces the diaphragmatic effectiveness as a pressure generator and reduces diaphragmatic contribution to chest wall motion. Ultrasonography has recently been shown to be a sensitive and reproducible method of assessing diaphragmatic excursion. This study was performed to evaluate how differences of diaphragmatic excursion measured by ultrasonography associate with normal subjects and COPD patients. Methods: We measured diaphragmatic excursions with ultrasonography on 28 healthy subjects(l6 medical students, 12 age-matched control) and 17 COPD patients. Ultrasonographic measurements were performed during tidal breathing and maximal respiratory efforts approximating vital capacity breathing using Aloka KEC-620 with 3.5 MHz transducer. Measurements were taken in the supine posture. The ultrasonographic probe was positioned transversely in the midclavicular line below the right subcostal margin. After detecting the right hemidiaphragm in the B-mode the ultrasound beam was then positioned so that it was approximately parallel to the movement of middle or posterior third of right diaphragm. Recordings in the M-mode at this position were made throughout the test. Measurements of diaphragmatic excursion on M-mode tracing were calculated by the average gap in 3 times-respiration cycle. Pulmonary function test(SensorMedics 2800), maximal inspiratory(PImax) and expiratory mouth pressure(PEmax, Vitalopower KH-101, Chest) were measured in the seated posture. Results: During the tidal breathing, diaphragmatic excursions were recorded $1.5{\pm}0.5cm$, $1.7{\pm}0.5cm$ and $1.5{\pm}0.6cm$ in medical students, age-matched control group and COPD patients, respectively. Diaphragm excursions during maximal respiratory efforts were significantly decreased in COPD patients ($3.7{\pm}1.3cm$) when compared with medical students, age-matched control group($6.7{\pm}1.3cm$, $5.8{\pm}1.2cm$, p< 0.05}. During maximal respiratory efforts in control subjects, diaphragm excursions were correlated with $FEV_1$, FEVl/FVC, PEF, PIF, and height. In COPD patients, diaphragm excursions during maximal respiratory efforts were correlated with PEmax(maximal expiratory pressure), age, and %FVC. In multiple regression analysis, the combination of PEmax and age was an independent marker of diaphragm excursions during maximal respiratory efforts with COPD patients. Conclusion: COPD subjects had smaller diaphragmatic excursions during maximal respiratory efforts than control subjects. During maximal respiratory efforts in COPD patients, diaphragm excursions were well correlated with PEmax. These results suggest that diaphragm excursions during maximal respiratory efforts with COPD patients may be valuable at predicting the pulmonary function.

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A Study on Dance Historical Value of Jaein Line Dance by Han Seong-jun (한성준을 통해 본 재인 계통춤의 무용사적 가치 연구)

  • Choung, Soung Sook
    • (The) Research of the performance art and culture
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    • no.19
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    • pp.347-378
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    • 2009
  • Those who were from Jaeincheon and Jaein line entertainers played great roles during transition period from traditional society to modern society, and even at present the dances of them are the representative traditional dances of Korea and the matrix of Korean originality. Nevertheless, Korea dance field has given little importance to these dances, but too much importance to Gibang dance in studying traditional dances, which causes the studies on Jaein line danced to be superficial or separate. Therefore, the aims of this article are to analyze the dances of Jaein line by Han Seong-jun, who was representative for the dances, and to appraise the historical value of them. Han Seong-jun(1874-1942) was the most influential dummer and dancer of his day in Japanese colonial times, and has been recognized as one of the masters of traditional dances. He established autonomy of traditional dances by reorganizing, collecting and stage-formalizing the dances, and systemized transmitting ways for various folk dances including a Buddhist dance, which made it possiblefor those dances to be traditional dances of Korea and the bases for creative dances. The values of Jaein line dances, which were transmitted through Han, are the following: First, the dances have been designated as national or regional intangible cultural assets, and, as the representative traditional arts, we proudly show them to the world. Second, the dances, as one of the genres of Korean dances, are the subjects of younger scholars' studies. Third, the dances become one of the representative examples of revivals of traditional dances, which tend to be extinct during modernization times, and contribute to establishing national identity and subjectivity. In addition, they contribute to discovering and transmitting other traditional dances. Fourth, the dances enable many dancers to make association, that is, Association for Preservation of Traditional Dances,for the transmitting the dances, and to distribute the dances and get many dancers to transmit the dances. Furthermore, as new performance repertories, they give another pleasure to the audience. In addition to the above, as a base for expansion of Korean creative dances, Han's dances have other values such as the following: First, in searching for a new methodology for creation, he played an important role in rediscovering the foundation in the tradition, and tried to discover nationalidentity by employing the traditional dances for expression of theme. Second, he contributed to drastically dissolving the genres by expanding the gesture language from motion factors of traditional dances, which can be compared to the modern dance. Third, he tried new challenging approaches to re-create the tradition, and contributed to pursuing the simple elements of our traditional dances as traditional aesthetics. While the dances of Jaein line have such values as the above, there are also some problems around the dances, such as the confusion in the process of transmission resulted from different transmission forms and transmitters, which we must no longer leave as it is. Furthermore, it is urgent that the rest of Jaein line dances be recovered and designated as intangible cultural assets for the sound transmission of the traditional dances.