• Korean Journal of Radiology
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• 제22권8호
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• pp.1352-1368
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• 2021

Objective: For an accurate dynamic contrast-enhanced (DCE) MRI analysis, exact baseline T1 mapping is critical. The purpose of this study was to compare the pharmacokinetic parameters of DCE MRI using synthetic MRI with those using fixed baseline T1 values. Materials and Methods: This retrospective study included 102 patients who underwent both DCE and synthetic brain MRI. Two methods were set for the baseline T1: one using the fixed value and the other using the T1 map from synthetic MRI. The volume transfer constant (K^trans), volume of the vascular plasma space (v_p), and the volume of the extravascular extracellular space (v_e) were compared between the two methods. The interclass correlation coefficients and the Bland-Altman method were used to assess the reliability. Results: In normal-appearing frontal white matter (WM), the mean values of K^trans, v_e, and v_p were significantly higher in the fixed value method than in the T1 map method. In the normal-appearing occipital WM, the mean values of v_e and v_p were significantly higher in the fixed value method. In the putamen and head of the caudate nucleus, the mean values of K^trans, v_e, and v_p were significantly lower in the fixed value method. In addition, the T1 map method showed comparable interobserver agreements with the fixed baseline T1 value method. Conclusion: The T1 map method using synthetic MRI may be useful for reflecting individual differences and reliable measurements in clinical applications of DCE MRI.

• 성인간호학회지
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• 제20권3호
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• pp.489-499
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• 2008

Purpose: The purpose of this study was to assess the importance and contribution of 9 nursing outcomes and their indicators that could be applied to cerebrovascular patients. Methods: Data were collected from 175 neurosurgical nurses working at two university affiliated hospitals and five secondary hospitals located in Gwang-ju. The Fehring method was used to estimate outcome content validity(OCV) and outcome sensitivity validity(OSV) of nursing outcomes and their indicators. Stepwise regression was used to evaluate relationship between outcome and its indicators. Results: The core outcomes identified by the OCV were Tissue Perfusion: Cerebral, Nutritional Status, Neurological Status, and Wound Healing: Primary Intention, whereas highly supportive outcomes identified by the OSV were Oral Health, Self-Care: ADL, and Nutritional Status. All the critical indicators selected for Fehring method were not included in stepwise regression model. By stepwise regression analysis, the indicators explained outcomes from 19% to 52% in importance and from 21% to 45% in contribution. Conclusion: This study identified core and supportive outcomes and their indicators which could be useful to assess the physical status of cerebrovascular patients. Further research is needed for the revision and development of nursing outcomes and their indicators at neurological nursing area.

• 대한인간공학회지
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• 제24권4호
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• pp.47-53
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• 2005

This study aim to investigate the effects of supply of oxygen enhances cerebral activation through increased activation in the brain and using a 3 Tesla fMRI system. Five volunteers (right handed, average age of 21.3) were selected as subjects for this study. Oxygen supply equipment that provides 30% oxygen at a constant rate of 15L/min was given using face mask. A 3 Tesla fMRI system using the EPI BOLD technique, and three-pulse sequence technique get of the true axial planes scanned brain images. The author can get the perfusion images of the brain by oxygen inhalation with susceptibility contrast EPI sequence at the volunteers. Complex movement consisted of a finger task in which subjects flexed and extended all fingers repeatedly in union, without the fingers touching each other. Both task consisted of 96 phases including 6 activations and rests contents. Post-processing was done on MRDx software program by using cross-correlation method. The result shows that there was an improvement in performance and also increased activation in several areas in the oxygen method. These finding demonstrates that while performing cognitive tasks, oxygen administration was due to increase of cerebral activation.

• 성인간호학회지
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• 제26권5호
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• pp.573-583
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• 2014

Purpose: Cardiac arrest has multiple characteristics that need to be approached as an integrated method according to the various changes in the body system. This study was performed to develop a useful guideline for early detection of cardiac arrest by revealing the attributes of cardiac arrest through a concept analysis. Methods: This study was conducted according to the Walker and Avant's concept analysis method. Systematic literature review and in-depth interview with nurses who experienced cardiac arrest situation were conducted. Based on the literature reviews and in-depth interviews with nurses, the attributes and the empirical referents of the concept of cardiac arrest were elicited. Results: The definable attributes of cardiac arrest were 1) loss of consciousness, 2) abnormal respiratory condition, 3) abnormal cardiovascular signs. Cardiac arrest was found to occur by several antecedents such as cardiac problem, non-cardiac problem, or general problem, whereas ischemia and re-perfusion injury, which can lead to multiple organ failure and death, were derived as consequences. Conclusion: In this study, the concept analysis eliciting attributes and empirical referents is found to be useful as a guideline for understanding and managing cardiac arrest. Based on these findings, clinical providers are expected to make a precise and rapid decision on cardiac arrest and respond quickly, which may increase survival rate of the patients underwent the arrest event.

• Biotechnology and Bioprocess Engineering:BBE
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• 제8권5호
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• pp.279-285
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• 2003

Lidocaine and galactose loading tests were performed on a bioartificial liver (BAL), an extracorporeal medical device incorporating living hepatocytes in a cartridge without a transport barrier across the membranes. The concentration changes were analyzed using pharmacokinetic equations to evaluate the efficacy and limitation of the proposed method. Lidocaine and galactose were found to be suitable drugs for a quantitative evaluation of the BAL functions, as they did not interact with the plasma proteins or blood vessels, making their concentrations easy to determine. The drug concentration changes after drug loading were easily analyzed using pharmacokinetic equations, and the BAL functions quantitatively expressed by pharmacokinetic parameters, such as the clearance (CL) and galactose elimination capacity (GEC). In addition, these two drugs have already been used in clinical tests to evaluate human liver functions over long periods, and lidocaine CL values and GEC values reported for a normal human liver. Thus, a comparison of the CL and GEC values for the BAL and a natural liver revealed what proportion of normal liver functions could be replaced by the BAL.

• 약학회지
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• 제46권2호
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• pp.124-128
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• 2002

The nitrone-based free radical trapping reagent, $\alpha$-phenyl-n-tert-butyl nitrone (PBN) has been proposed as therapeutic agent for stroke. We used this for model drug of development of new drug for neuroprotection. The purpose of this study was to evaluate the blood-brain barrier (BBB) permeability of PBN in Sprague-Dawly (SD) rats. The BBB transport of PBN was investigated in SD rats using internal carotid artery perfusion (ICAP) method at a rate of 4 mι/min for 15 second. We also obtained pharmacokinetic parameters of PBN using single intravenous injection technique. When we estimated BBB permeability of PBN with ICAP method, the brain volume of distribution of PBN was 60.0 $\pm$ 12.0 $\mu\textrm{g}$/ι. The brain uptake of PBN after IV injection at 120 min was 0.15 $\pm$ 0.01%ID/g. The PBN was transported to the brain through the BBB well in rats, because PBN is small molecule (MW 177) and lipid-soluble (log P 1.23) compound.

• Journal of Pharmaceutical Investigation
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• 제24권2호
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• pp.95-104
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• 1994

Inclusion complexes of ketoconazole(KT) with ${\alpha}^_$, ${\beta}^_$cyclodextrin(CD) and $dimethy1-{\beta}-cyclodextrin$ (CD) and $dimethy1-{\beta}-cyclodextrin(DM{\beta}CD)$ as nasal absorption enhancer were prepared in 1: 2 molar ratios by freeze-drying and solvent evaporation methods. In order to compare with the intrinsic absorptivity of KT in the jejunum(J) and the nasal cavity(N), the in situ simultaneous perfusion method was employed. The in situ recirculation study revealed that KT-CD inclusion complexes with the greater stability constant and the faster dissolution rate proportionally increased the absorption of KT in the J and N of rats. The rank order of apparent KT permeability$(P_{app}\;:\;cm/sec\;{\time}\;1O^{-5}{\pm}S.E.)$, corrected by surface area of absorption, was $5.10{\pm}0.3(N,\; KT-DM{\beta}CD)$ )> $4.13{\pm}0.4(N,\;KT-{\beta}-CD)$ )> $3.52{\pm}0.2(N,\;KT-{\alpha}-CD)$ )> $2.76{\pm}0.3(J,\; KT-DM{\beta}CD)$ )> $2.61{\pm}0.5(J,\;KT-{\beta}-CD)$ )> $2.42{\pm}0.4(J,\;KT-{\alpha}-CD)$ at pH 4.0. The in crease in permeability of $KT-DM{\beta}CD$ inclusion complex was 2.6 folds in the J and 4.5 folds in the N when the perfusing solution was changed from the buffer(pH 4.0) to saline. The absorption rate of $KT-DM{\beta}CD$ inclusion complex after nasal administration was more rapid than those of ketoconazole alone and $KT-DM{\beta}CD$ inclusion complex after oral administration to rats. In comparision with an oral administration of ketoconazole suspension in corn oil, the relative bioavailability was calculated 137.3% for the oral and 195.0% for nasal $KT-DM{\beta}CD$ inclusion complex in rats. The present results suggest that $KT-DM{\beta}CD$ inclusion complex may serve as a potential nasal absorption enhancer for the nasal delivery of ketoconazole.

• Journal of Chest Surgery
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• 제31권5호
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• pp.481-487
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• 1998

하행대동맥의 급성박리에 대한 외과적 치료에 대해서는 논란이 많다. 하행대동맥의 급성 박리병변이 수술적응이 될 경우 대동맥 차단시간은 30분 이상 소요될 수 있으므로 척수손상을 예방하기 위해 대동맥 차단부위 하방에 혈류를 유지하기 위한 여러 방법이 소개되었다. 저자들은 파열(혈흉) 및 쇼크의 합병증을 동반한 하행 대동맥의 급성 박리증 8예를 체외순환법을 이용하여 수술하고 그 방법에 대한 안전성과 효용성을 찾고자 하였다. 체외순환방법에 있어서는 대동맥병변의 상하에 2개의 동맥카뉼라를 넣어 대동맥 차단으로 수술 도중 상하체의 혈류공급을 동시에 이루어지도록 하였고, 산화기로 정맥혈의 환류를 위해 우심방이나 좌대퇴정맥에 정맥관을 삽입하였다. 비교적 장시간의 대동맥 차단에도 불구하고 수술후 8예 모두에서 척수손상은 없었다. 2예(25%)의 병원사망(각각 술후 31일과 41일)은 비교적 고령에서 지연성 합병증인 폐농양, 호흡부전증 등에 의해 발생했다. 주위조직의 부종 및 연약함 때문에 수술시간이 연장될 수 있는 급성 하행동맥 박리증에서 체외 순환방법하의 인공혈관 대치술은 대동맥 차단시간의 연장에 의한 척수 허혈손상을 피할 수 있는 안전하고 효과적인 외과적 치료방법이 될 수 있을 것으로 사료된다.

• 대한핵의학회지
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• 제39권4호
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• pp.224-230
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• 2005

목적: 심근의 최대탄성도는 전부하 후부하에 독립적인 지표로서 SPECT를 이용하여 좌심실의 국소탄성도($rE_{max}$)를 비침습적으로 측정하였다. 게이트 심근 SPECT 영상에서 국소부피변화를 얻고, 요골동맥 긴장도를 측정하여 중심동맥의 압력 곡선을 얻어 측정한 최대탄성도를 관상동맥우회로 수술 전후 환자를 대상으로 수술전후 관류 및 기능지표와 비교하여보았다. 대상 및 방법: 관상동맥우회로 수술이 결정되어 시행한 환자 21명(남:여=17:4, $58{\pm}12$세)을 대상으로 $^{201}TI$ 휴식기 영상과 디피리다몰 부하 $^{99m}Tc$-sestamibi 게이트 SPECT를 수술전과 수술 후 3개월째 시행하였다. 동시에 요골동맥으로부터 압력곡선을 얻었다. 기능과의 관계를 보기 위해서 관류와 심벽두꺼워짐을 탄성도와 비교하였으며, 심벽두꺼워짐이 20%미만일 때 수술 후 10%이상 호전되지 않는 기능이상 분절에 대해 수술 전후의 탄성도를 비교하였다. 결과: 수술 전 탄성도가 $2.41{\pm}1.64$ mmHg/mL에서 $2.78{\pm}1.83$ mmHg/mL 으로 수술 후에 증가하였으나, 관류와 심벽두꺼워짐과는 낮은 상관성을 보였다. (r=0.35, p<0.001). 관류 60% 이상의 분절에서는 $2.65{\pm}1.67$ mmHg/mL 이었으나, 관류나 낮은 분절의 탄성도는 $1.30{\pm}1.24$ mmHg/mL 였다. 심벽두꺼워짐이 40% 이상 되는 분절의 수술 전 탄성도는 $3.01{\pm}1.92$ mmHg/mL 였고, 기능이 조금 약한 부분인 40%에서 20% 사이의 심벽두꺼워짐 값을 가진 분절에서는 $2.40{\pm}1.19$ mmHg/mL로 심각한 기능이상을 반영하는 20%미만 분절의 탄성도는 $1.13{\pm}0.89$ mmHg/mL의 분포를 보였다. 수술 전 심벽두꺼워짐이 20% 미만일 때 수술 후 10%이상 회복을 보인 생존심근와 그렇지 않은 비생존심근사이의 수술 전후 탄성도는 $1.27{\pm}1.07$ mmHg/mL에서 $1.79{\pm}1.48$ mmHg/mL, $0.97{\pm}0.59$ mmHg/mL에서 $1.22{\pm}0.71$ mmHg/mL로 생존심근의 수술 후 값의 향상이 조금 더 높았다. 그러나, 심벽두꺼워짐의 정도가 탄성도 높아짐의 정도 사이에는 상관성이 없었다(r=0.007). 결론: 수술 전 $rE_{max}$는 관류와 심벽두꺼워짐과 상관성이 약하게 있었다. 기능이상이면서 생존능이 있는 심근의 탄성도는 수술 후 증가하였지만 심벽두꺼워짐의 향상과는 상관성이 없었다. 심근기능의 전부하 후부하에 독립적인 지표인 탄성도는 실제 부피의 증가와 연관되지 않으면서도 생존능이 있는 심근의 기준과 일치하는 양상을 보였으므로 독립적인 매개변수로 사용될 수 있을 것으로 기대한다.

• The Korean Journal of Physiology
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• 제9권1호
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• pp.13-22
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• 1975

From the study of movements of $Ca^{++}$ in frog cardiac muscle, Niedergerke (1963) postulated that $Ca^{++}$ necessary for the cardiac contraction is stored in a specific pool. Langer et al (1967) and DeCaro (1967) also found a close relationship between the change of $Ca^{++}$ flux kinetics and the change of contractile force. According to the studies of several investigators, Ca II (Bailey and Dressel 1968) or phase I and II (Langer 1965, Langer et al 1967, 1971) in the $Ca^{++}$ washout curve was associated with cardiac contractility. This investigation was aimed to elucidate the anatomical region of the contractile active $Ca^{++}$ pool. At the same time, it was assumed in this study that $Ca^{++}$ in the sarcoplasmic reticulumn represents one of the major intracellular $Ca^{++}$ pool and cardiac contractility was also dependent on the intracellular $Ca^{++}$ concentration. Consequently, this experiment was performed at different temperatures to activate to activate inhibit the deactivating process of activated $Ca^{++}$ in the intracellular space to see if changes in the contractility decay curve existed at different temperatures. The isolated hearts of rabbits and turtles (Amyda maackii) were attached to the perfusion apparatus according to the method employed by Bailey and Dressel (1968). The isolated hearts were initally perfused with a full Ringer solution containing 2 mg/ml of inulin for 1 hr, and then $Ca^{++}$ and inulin-free Ringer solution was perfused while the isometric tension was recorded and a serial sample of perfusion fluid dripping from the cardiac apex was collected for 10 sec throughout experimental period. The above procedure was performed at $23^{\circ}C$, $30^{\circ}C$ and $38^{\circ}C$ on the rabbit heart and $10{\sim}13^{\circ}C$, $10^{\circ}C$, $25^{\circ}C$, $30^{\circ}C$ and $35^{\circ}C$ on the turtle heart. After determination of $Ca^{++}$ and inulin concentration of the samples, the $Ca^{++}$, inulin washout curve and the contractile tensin decay curve were analysed according to the method of Riggs (1963). The results were summarized as follows; 1. In the rabbit heart, there are 2 inulin compartments, 3 $Ca^{++}$ compartments and sing1e exponential decay of contractile tension. In the turtle heart, there are $1{\sim}2$ inulin compartments, $1{\sim}2$ $Ca^{++}$ compartments and $1{\sim}2$ phases of contractile tension decay. The fact that the inulin space was divided into 3 compartments in the washout curve in these hearts indicates the presence of heterogeneity in cardiac perfusion, i.e., overfused and underperfused area. 2. Ca I a9d Ca II in these hearts were found to have $Ca^{++}$ in the ECF compartments because their half times in the washout curves were far smaller than those of the inulin washout curves in the rabbit heart and similar to those of the inulin washout curves in the turtle heart. Ca III in the rabbit heart may have originated from the intracellular $Ca^{++}$ store. But no Ca III in the turtle heart was found. This may be due to the fact that the iutracellular $Ca^{++}$ pool in the turtle heart was too small to detect using this experimental procedure since sarcoplasmic reticulumn in the turtle heart is poorly developed. 3. In the rabbit heart, there were no chages in the half time of Ca I, Ca II, inulin I and inulin II at different temperatures, but the half time of Ca III was significantly prolonged at lower temperatures, and the half time of the contractile tension decay tended to be prolonged at lower temperatures but this was not significant. In the turtle heart, there were no changes in the half time of Ca I, Ca II, inulin 1, inulin II and phase I of the contractile tension decay at different temperatures, but the half time of phase II of the contractile tension decay was significantly prolonged at lower temperatures. This finding indicates that intracellu!ar $Ca^{++}$ in these hearts was also responsible particulary for maintaining the cardiac contractility at the lower temperatures. 4. The half times of contractile tension decay were shorter than those of Ca II in the $Ca^{++}$ washout curves in both animal hearts. According to the above results it was shown that $Ca^{++}$ in ECF is primarily and $Ca^{++}$ in the intracellular space is partially associated with the cardic contractility.