소아 심장 CT 검사시 Dual Source CT의 High pitch mode를 이용한 선량감소에 관한 연구

이예나(Ya Na Lee),강헌효(Heon Hyo Kang),손성실(Sung Sil Son),박찬혁(Chan Hyuk Park),현진경(Jin Kyung Hyun),신명호(Myung Ho Shin),김준혁(Jun Hyuk Kim),강동원(Dong Won Kang) 대한CT영상기술학회 2012 대한CT영상기술학회지 Vol.14 No.1

I. Purpose This study examines if accurate images can be realized with less dose than sequential mode, one of the existing methods applying DSCT’s high-pitch mode in pediatric cardiography. II. Materials and Methods For 20 patients who came to our hospital from Jan. 1 to Jun. 30, 2011, a test was carried out using MDCT 128 channel dual source; Somatom Definition Flash (Siemens Medical System: Germany). As the test method, the veins of the lower limbs of the patients were secured and contrast medium of 7ml was injected at 0.3ml/s anda CT scan was carried out about 36 s. later. Af first, sequential mode was used, and then high-pitch mode was followed as follow-up examination. The DLP (Dose Length Product) provided by the equipment and effective dose were compared for the assessment of the dose exposed to the patients, after the CT scan. The effective does was calculated by multiplying children’s chest index: 0.021 of the effective dose rate of EUR16262 (European Guide) to DLP value. The images scaned in high-pitch method were compared and assessed quantitatively by a heart decoding specialist and 2 radiologists if the typical diseases of pediatric cardiacs such as coarctation of aorta, atresia of the pulmonary artery and Tetralogy of Fallot can be assessed. III. Results When it was compared to sequential mode, one of the existing cardiography, the effective dose exposed to the patient had decrease by 32% in high-pitch mode. As a result of a comparison with imaging assessment, it was also evaluated as a better imaging than sequential mode IV. Conclusion Pediatric Cardiography using high pitch in Dual source MDCT showed superior effects on the reduction of exposed does than sequential mode, which is considered a useful testing method. 목적 본 연구에서는 소아 심장 검사 시 DSCT의 High-pitch mode를 적용하여 기존의 검사방법 중 하나인 Sequential mode보다 적은 선량으로도 정확한 영상을 구현할 수 있는지 알아본다. 대상 및 방법 2011년 1월 1일부터 6월 30일까지 본원에 내원한 20명의 환자를 대상으로 하여 MDCT 128 channel dual source; Somatom Definition Flash(Siemens medical system: Germany) 장비를 사용하여 검사를 시행하였다. 검사방법은 환자의 하지에 정맥을 확보하고 조영제를 0.3 ml/s로 7ml를 주입한 후 36초 후에 CT검사를 하였다. 처음에는 Sequential mode로 검사한 후 추적 검사할 땐 High-pitch mode로 검사한다. 환자가 받은 피폭선량의 평가는 선량평가는 CT검사 후 장비에서 제공하는 DLP(dose length product)와 유효선량(effective dose)를 비교하였다. 유효선량은 DLP 값에 EUR16262(European Guide) 유효선량비 중 소아 흉부 지수 0,021을 곱하여 계산하였다. 검사한 영상을 심장 판독 전문의 1명과 방사선사 2명이 high-pitch mode로 검사한 영상을 소와 심장의 대표적 질환인 대동맥협착증, 폐동맥 폐쇄증, 팔로씨 사증을 평가할 수 있는지 비교하여 정성적으로 평가하였다. 결과 기존의 심장 검사방법 중 하나인 Sequential mode와 비교했을 때 High pitch mode로 검사했을 때에 32%의 선량 감소 효과가 있었다. 또한 영상 평가 비교 결과 Sequential mode 보다 좋은 영상으로 평가되었다. 결론 Dual source MDCT로 소아심장 검사를 할 때 high pitch mode를 이용하면 sequential mode로 검사했을 때보다 환아가 받는 피폭선량은 낮고 더 우수한 영상을 획득하여 심장질환을 진단하는데 유용한 검사법으로 사료된다.

바터 팽대부에 생긴 유암종 1예

강명주,지삼룡,박석주,이재익,조영완,김준영,박성재,박은택,이연재,이상혁,설상영,배상균 인제대학교 2006 仁濟醫學 Vol.27 No.-

Carcinoid tumors have been reported in a wide range of organs but most commonly involve the lungs, bronchi and gastrointestinal tract. Within the gastrointestinal tract, appendix is the most common location for carcinoid, followed by the distal small intestine, the rectum, and the stomach. Among these, primary involvement of the ampulla of Vater is extremely rare. We report a case of carcinoid tumor of ampulla of Vater. A 62-year-old man presented with epigastric soreness. Gastroduodenal endoscopy showed hyperemic bulging mass on ampulla of Vater and diagnosed as carcinoid tumor by histologic finding, with immunohistochemical study. In ^(111)In-octreoscan, tumor had regional lymph node metastasis, but no evidence of distant metastasis. Pancreatoduodenectomy with lymph node dissection was performed.

Methazolamide 복용 후 발생한 Stevens-Johnson Syndromex

정종호,이은정,김태형,전원선,우광진,양미연,강병일,은준영,추은주,전민혁 순천향의학연구소 2010 Journal of Soonchunhyang Medical Science Vol.16 No.1

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Comparison of follitropin ${\beta}$ administered by a pen device with follitropin ${\beta}$ administered by a conventional syringe in patients undergoing IVF-ET

Kang, Hyuk-Jae,Kim, Chung-Hoon,Ahn, Jun-Woo,Lee, Hyang-Ah,Kim, Sung-Hoon,Chae, Hee-Dong,Kang, Byung-Moon The Korean Society for Reproductive Medicine 2011 Clinical and Experimental Reproductive Medicine Vol.38 No.1

Objective: To compare the effectiveness and convenience of a pen device for the self-administration of follitropin ${\beta}$ with a conventional syringe delivering follitropin ${\beta}$ solution in patients undergoing IVF-ET. Methods: GnRH agonist long protocol was used for controlled ovarian stimulation (COS) in all subjects. A total of 100 patients were randomized into the pen device group or the conventional syringe group on the first day of COS. Local tolerance reactions were assessed within 5 minutes, at 1 hour and at 3 hours after each injection. On the day of hCG injection, patients were asked to rate their overall pain and convenience experienced with self-injection on a visual anlaogue scale (VAS). Results: There were no differences in patients' characteristics between the two groups. The duration of COS was significantly shorter in the pen device group than in the conventional syringe group. Patients included in the pen device group needed a significantly smaller amount of follitropin ${\beta}$. However, no differences between the two groups were found in IVF results and pregnancy outcome. The incidence of local pain within 5 minutes, at 1 hour and at 3 hours after the injection was significantly lower in the pen device group. VAS scores indicated that injections using the pen device were significantly less painful and more convenient. Conclusion: The pen device for self-administration of follitropin ${\beta}$ is less painful, safer and more convenient for the patients, and can be more effective because of the shorter duration and smaller dose of follitropin ${\beta}$ when compared with the conventional syringe.

Systems biological approaches to the cardiac signaling network

Kang, Jun Hyuk,Lee, Ho-Sung,Kang, Yun-Won,Cho, Kwang-Hyun Oxford University Press 2016 Briefings in bioinformatics Vol.17 No.3

<P>Recent systems biological studies of cardiac systems have greatly advanced our understanding of cardiac physiology with a particular focus on the excitation-contraction coupling. With these advancements, there is a growing interest in systems analysis of the cardiac signaling network because its dynamical property is closely associated with cardiac diseases. In this article, we review recent attempts at computational modeling of the cardiac signaling network and provide a system-level perspective on the analysis of the large-scale cardiac signaling network. We discuss why the systems biological approach is useful and what novel insights it can provide for the development of personalized therapeutic strategies for cardiac diseases in the post-genomic era.</P>

A case report: Congenital long QT syndrome type (초)

( Jun Hyuk Kang ),( Jae Seok Park ),( Ji Eun Ban ),( Jae Hyung Park ),( Jin Seok Kim ),( Jong Il Choi ),( Hong Euy Lim ),( Sang Weon Park ),( Young Hoon Kim ) 대한내과학회 2010 대한내과학회 추계학술대회 Vol.2010 No.-

A comparison between central blood pressure values obtained by the Gaon system and the SphygmoCor system.

Kang, Jun Hyuk,Lee, Dae In,Kim, Sua,Kim, Sun Won,Im, Sung Il,Na, Jin Oh,Choi, Cheol Ung,Lim, Hong Euy,Kim, Jin Won,Kim, Eung Ju,Han, Seung Woo,Rha, Seung-Woon,Seo, Hong Seog,Oh, Dong Joo,Park, Chang G Japanese Society of Hypertension 2012 Hypertension research Vol.35 No.3

<P>Central pulse pressure is correlated with carotid atherosclerosis and the incidence of cardiovascular events more significantly than brachial pulse pressure. Augmentation index (Aix) has been shown to be an independent predictor of cardiovascular morbidity and mortality. Pulse wave analysis using the Gaon system allows for the estimation of central blood pressure (CBP), corrected augmentation index (Aix@HR75), ejection duration (ED) and subendocardial viability ratio (SEVR), and is widely used in clinical research in Korea. However, the accuracy of this system is controversial. From February 2008 to March 2011, 99 patients were recruited for this study. Measurements were taken both by the Gaon system and the SphygmoCor system on the same day for all study participants. The estimated values of CBP, Aix@HR75, ED and SEVR for the two systems were compared using paired t-tests, simple correlation analyses and Bland-Altman plots. Systolic blood pressure (SBP) estimated by the two systems was significantly (P<0.001) correlated; the coefficient was 0.982. The two s.d. of the difference in SBP between these systems was quite small--<7?mm?Hg. Aix@HR75, ED and SEVR as estimated by the two systems were also significantly correlated, although they, especially SEVR, showed much weaker correlations than were observed in SBP: coefficients for Aix@HR75, ED and SEVR were 0.727, 0.648 and 0.230, respectively. We assessed the CBP of Korean patients estimated by the two systems and observed that the correlations of Aix, ED and SEVR were weaker than that of CBP. Such variations may be due to the difference in measuring methods between the devices. As even a slight change in pulse waveforms may result in a large difference in estimations, parameters, including Aix@HR75, ED and SEVR, should be carefully interpreted by experienced clinicians.</P>

Highly efficient hybrid light-emitting device using complex of CdSe/ZnS quantum dots embedded in co-polymer as an active layer

Kang, Byoung-Ho,Seo, Jun-Seon,Jeong, Sohee,Lee, Jihye,Han, Chang-Soo,Kim, Do-Eok,Kim, Kyu-Jin,Yeom, Se-Hyuk,Kwon, Dae-Hyuk,Kim, Hak-Rin,Kang, Shin-Won The Optical Society 2010 Optics express Vol.18 No.17

<P>We propose a highly efficient hybrid light-emitting device (LED) with a single active layer where CdSe/ZnS quantum dots (QDs) are dispersed as a guest material in a conjugated polymer (co-polymer) matrix used for a host material. In our structure, the QDs act on light-emitting chromophores by trapping the migrating excitons in the co-polymer matrix via F?rster energy transfer, and improve the charge balance within the co-polymer by trapping the injected electron carriers. Experimental results show that the electroluminescent properties highly depend on the doping density of the QDs within the co-polymer matrix, where the luminance as well as the external current efficiency are initially enhanced with increasing the concentration of the dispersed QDs in the co-polymer solution, and then such properties are degraded due to aggregation of the QDs. We can get the maximum brightness of 9,088 cd/m(2) and the maximum external current efficiency of 7.5 cd/A in mixing ratio of the QDs by 1.0 wt%. The external current efficiency is enhanced by over 15 times and the turn-on voltage is reduced in comparison with the corresponding values for a reference device that uses only a co-polymer as an active layer.</P>

Silencing Histone Deacetylase 7 Alleviates Transforming Growth Factor-β1-Induced Profibrotic Responses in Fibroblasts Derived from Peyronie's Plaque

Kang, Dong Hyuk,Yin, Guo Nan,Choi, Min-Ji,Song, Kang-Moon,Ghatak, Kalyan,Minh, Nguyen Nhat,Kwon, Mi-Hye,Seong, Do-Hwan,Ryu, Ji-Kan,Suh, Jun-Kyu Korean Society for Sexual Medicine and Andrology 2018 The World Journal of Men's Health Vol.36 No.2

<P><B>Purpose</B></P><P>Epigenetic modifications, such as histone acetylation/deacetylation and DNA methylation, play a crucial role in the pathogenesis of inflammatory disorders and fibrotic diseases. The aim of this study was to study the differential gene expression of histone deacetylases (HDACs) in fibroblasts isolated from plaque tissue of Peyronie's disease (PD) or normal tunica albuginea (TA) and to examine the anti-fibrotic effect of small interfering RNA (siRNA)-mediated silencing of HDAC7 in fibroblasts derived from human PD plaque.</P><P><B>Materials and Methods</B></P><P>For differential gene expression study, we performed reverse-transcriptase polymerase chain reaction for HDAC isoforms (1–11) in fibroblasts isolated from PD plaque or normal TA. Fibroblasts isolated from PD plaque were pretreated with HDAC7 siRNA (100 pmol) and then stimulated with transforming growth factor-β1 (TGF-β1, 10 ng/mL). Protein was extracted from treated fibroblasts for Western blotting. We also performed immunocytochemistry to detect the expression of extracellular matrix proteins and to examine the effect of HDAC2 siRNA on the TGF-β1-induced nuclear translocation of Smad2/3 and myofibroblastic differentiation.</P><P><B>Results</B></P><P>The mRNA expression of HDAC2, 3, 4, 5, 7, 8, 10, and 11 was higher in fibroblasts isolated from PD plaque than in fibroblasts isolated from normal TA tissue. Knockdown of HDAC7 in PD fibroblasts inhibited TGF-β1-induced nuclear shuttle of Smad2 and Smad3, transdifferentiation of fibroblasts into myofibroblasts, and abrogated TGF-β1-induced production of extracellular matrix protein.</P><P><B>Conclusions</B></P><P>These findings suggest that specific inhibition of HDAC7 with RNA interference may represent a promising epigenetic therapy for PD.</P>

Reference diameter and characteristics of the distal radial artery based on ultrasonographic assessment

( Jun-won Lee ),( Jung-woo Son ),( Tae-hwa Go ),( Dae Ryong Kang ),( Sang Jun Lee ),( Se Eun Kim ),( Dong-hyuk Cho ),( Young Jun Park ),( Young Jin Youn ),( Min-soo Ahn ),( Sung Gyun Ahn ),( Jang-youn 대한내과학회 2022 The Korean Journal of Internal Medicine Vol.37 No.1

Background/Aims: While distal radial artery (DRA) access is increasingly being used for diagnostic coronary angiography, limited information is available regarding DRA size. We aimed to determine the DRA reference diameters of Korean patients and identify the predictors of DRA diameter < 2.3 mm. Methods: The outer bilateral DRA diameters were assessed using a linear ultrasound probe in 1,162 consecutive patients who underwent transthoracic echocardiography. The DRA diameter was measured by the perpendicular angle in the dorsum of the hand, and the average values were compared by sex. DRA diameter < 2.3 mm was defined as unsuitable for routine diagnostic coronary angiography using a 5 Fr introducer sheath. Results: The mean DRA diameters were 2.31 ± 0.43 mm (right) and 2.35 ± 0.45 mm (left). The DRA was smaller in women than men (right: 2.15 ± 0.38 mm vs. 2.43 ± 0.44 mm, p < 0.001; left: 2.18 ± 0.39 mm vs. 2.47 ± 0.45 mm, p < 0.001). The DRA diameter was approximately 20% smaller than the radial artery diameter. A total of 630 (54.2%) and 574 (49.4%) patients had DRA diameter < 2.3 mm in the right and left hands, respectively. Female sex, low body mass index (BMI), and low body surface area (BSA) were significant predictors of DRA diameter < 2.3 mm. Conclusions: We provided reference DRA diameters for Korean patients. Approximately 50% of the studied patients had DRA diameter < 2.3 mm. Female sex, low BMI, and low BSA remained significant predictors of DRA diameter < 2.3 mm.