The aim of this study was to examine the association between egg consumption and the risk of chronic disease in Korean adult females using the 2013 Korea National Health and Nutrition Examination Survey. A total of 1,230 subjects aged 40~64 were classified into the 4 groups according to the number of egg consumed per week: <1, 1~2.9, 3~5, ≥5.1 As egg consumption increased, the intake of energy, protein, fiber, cholesterol, calcium, potassium, riboflavin, and vitamin C increased. The percentage of the subjects with lower intake of energy, protein, calcium, iron, vitamin A, riboflavin, niacin, and vitamin C than the estimated average requirement in the <1 group were the highest among the groups. The blood lipid profile including total cholesterol and LDL-cholesterol was not significantly different among the 4 egg groups. The higher egg consumption was inversely related to a lower odds ratio of metabolic syndrome, hypertriglycemia, hyperglycemia, hypoHDL-cholesterolemia, and hypertension. This result indicates that egg consumption does not elevate the plasma cholesterol level and has a beneficial effect of decreasing the risk of chronic disease. (175)

The purpose of this study was to evaluate the concentration of airborne particulate matter and heavy metals in the houses of the respiratory tract disease patients and a control group of residents in the city of Gwangyang. The particulate matter was measured using a mini-volume air sampler and then weighed three times using a micro balance to calculate the weighted average value. The heavy metals in the particulate matter were extracted using a hot plate and analyzed using an inductively coupled plasma/mass spectrometer. The average concentration of particulate matter in the outdoor air (34.478 μm/m3) was higher than that in the indoor air (16.794 μm/m3), showing a statistically significant difference (p<0.001). The average concentration of copper, manganese and chromium in the indoor and outdoor air were higher in the houses of those in the study group than those of the control group. In addition, there was a generally high correlation between particulate matter in the outdoor air and heavy metals in the indoor and outdoor air concentration (p<0.05).

목적: 기존의 전안부에 떨어뜨리는 topical agents 방식은 후안부의 망막 신생혈관 질환에 대해 효과적인 치료제 전달 방식이 될 수 없다. 우리는 Alginate를 사용하여 생분해성을 가지고, 보다 적은 횟수의 주입술과 철 나노입자로인해 선택적으로 약물을 방출 할 수 있어, 직접적이고 효과적인 망막변성 질환을 치료할 수 있는 Ferrogel 이식체(Fe3O4-RGD – Alginate)를 고안하였다. Alginate는 그 자체의 특성 때문에 gel 형성시 자연적으로 nano size기공이 형성된다. 우리는 손상이 적고 형태를 유지하며 건조 할 수 있는 CO2 초임계 건조 장치(Critical Point Dryer)를 사용하여 기존의 얼음의 결정을 이용한 macro-porous ferrogel의 기공사이즈를 nano scale로 조절하였다. 이에 따라 Ferrogel의 세포부착성과 약물 로딩/방출에 관련된 기공 크기의 조절, 유사 환경을 조성하기 위한 인공 유리체 합성과 dish를 제작하여 약물방출에 관한 in vitro 실험 모델을 연구하였다. 방법: Sodium alginate와 세포부착 RGD- peptide를 합성하기 위해, Alginate 0.1 g에 MES buffer 5 ml,EDC 5 mg, sulfo-NHS 2.8 mg, RGD-peptide 100μg를 균질하게 섞고, 동결건조 시켰다. Ferrogel을 제작하기 위해 MES buffer(pH 6)에 RGD-peptide가 결합된 Sodium Alginate(SA-R) 1wt%와 가교 결합제인 Adipic acid dihydrazide 5mM, Fe3o4 nano –particle 13wt%, HOBt hydrate, EDC를 균질하게 섞어주었다. 그 후, 즉시 틀에 넣고 2시간 동안 굳혀준다. 굳혀진 Gel의 잔류시약을 제거하기 위해 대용량의 삼차증류수에 2일 동안 넣어 두었다. 그런 다음, macro–porous의 기공을 만들기 위해 –20℃에 얼린 후, 동결건조 시켰고, nano- porous의 기공을 만들기 위해, 잔류시약 제거 후, 초임계 건조 장치를 이용해 말렸다. 인공유리체를 만들기 위해 PBS, Hyaluronic acid(HA 1wt%), triethylamin, glycidyl methacrylate, tetrabutylammonium bromide를 순차적으로 섞고 , 광 개시제 Irgacure 2959와 N-vinyl-pyrrolidinone을 넣어 고안한 몰드에 UV light( 250~450nm)를 30분 동안 노출시키고 PBS로 2일 동안 투석 시켰다. Alginate의 RGD부착 유무를 Ninhydrin assay와 H-NMR로 확인하고, gel 상태에서 counting방법으로 세포부착 성을 평가하였다. Ferrogel의 기공성 평가를 위해 주사전자현미경 (SEM)을 사용하였고, 인공유리체의 합성을 H-NMR과 육안으로 평가하였다. 결과: SA-R의 Ninhydrin assay에서 RGD-peptide 양이 10ug, 100ug 중에 100ug일 때 흡 광도가 더 높게 나타났고, H-NMR에서 SA에 부착된 NH2-resonance(6.8~7.2ppm picks) 를 확인 할 수 있었다. SA-R의 세포부착성에서 SA보다 약 11배 더 부착이 된 것을 확인 할 수 있었다. 또한 macro–기공의 평균 장축 사이즈는 510㎛, nano-기공의 평균장축 사이즈는 97nm로 나타났다. H-NMR에서 인공유리체의 Hyaluronic acid에 Vinyl group의 접합 (picks :5.7, 6.2 ppm)을 확인 할 수 있었고, uv 합성 후, gel 형태를 유지함을 관찰 할 수 있었다. 결론: 세포부착성을 높이기 위해 SA-R의 RGD-peptide의 양이 100ug이 보다 적합하다 고려된다. 또한 nano–porous한 ferrogel을 만들기 위한 방법으로 초임계 건조 방법이 적합한 것으로 생각된다. 약물 로딩된 ferroegl의 in vitro 약물실험 모델로써 인공유리체의 합성과 특정 몰드에 대한 적합한 성형성을 확인 할 수 있었다. 앞서 인공유리체의 MTT실험을 거쳐, 세포를 seeding하여, 세포부착성을 가지는 ferrogel을 부착시킨 후, 자기장에 따른 약물 방출을 실험이 가능할 것으로 사료된다.

Purpose: The purpose of this study was to understand the lived experience of a main caregiver, in charge of a family member with a severe chronic disease. Methods: The participants of this study were 13 main caregivers, who have a family member with a severe chronic disease. The data were analyzed through the phenomenological research method. Results: This research concluded with: one core theme, five theme clusters and 13 themes. The one core theme was: ‘My Life is Not Mine.’ The five theme clusters include: ‘The Dark Days Ahead, of What We Do,’ ‘Serious Pressure,’ ‘My Body is Broken (caregivers),’ ‘Overcoming,’ and finally ‘Endless, Long and Long tunnel.’ Conclusion: We must emphasize to a main caregiver of a chronic disease patient, to the fact that their life should be theirs, not the patients. In addition, we need to be attentive of their well-being, as well as the chronic disease Patients, and sensitively responsive to their problems.

The purpose of this study is to analyze the distribution of Candida species in patients with oral disease and clarify the distinction of Candida culture test according to its isolation technique. 75 samples was isolated from 42 patients who visited Chonnam National University Dental Hospital due to oral disease from December 2015 to August 2016. For isolating the candida sampling, saliva sampling and oral swabbing were used. Acquired sampling was cultured in CHROMagar Candida Culture Medium, which indicates the candida species as color. Of the 42 patients, C. albicans was the most frequently isolated species in 39 patients. For 17 patients out of 21 who underwent saliva sampling and oral swabbing simultaneously, oral swabbing was quantitatively underestimated comparing to saliva sampling. 12 samples in 21 samples having particular Candida species were not isolated by oral swabbing. Considering the possibility of fungal infection in various oral disease, it is recommended to perform not only oral swabbing but saliva sampling when isolating Candida.

This study was conducted to investigate the risk of chronic disease as predicted by abdominal obesity in Korean adult females. Data on 2,738 adult females aged 40~64 yrs was obtained from the 2013~2014 Korean National Health Nutrition Examination Survey. The subjects were divided into normal (n=1,835), abdominal obesity (AO, n=73), and BMI-diagnosed abdominal obesity (BMI-AO, n=505) groups based on the NCEP-ATP III guidelines and by applying the KSSO definition regarding waist circumference. Triglyceride blood levels, fasting blood sugar levels, systolic blood pressure, and diastolic blood pressure were higher in the AO and BMI-AO groups than in the normal group. The HDL-cholesterol levels of subjects in the two abdominal groups were lower as compared to those of subjects in the normal group. The mean adequacy ratio was lower among subjects in the AO and BMI-AO groups than among those in the normal group. Moreover, the NAR and INQ scores of some micro-nutrients in both of the abdominal obesity groups were lower than those in the normal group. Both the AO and BMI-AO groups showed significantly higher risks of hypertriglycemia, hyperglycemia, hypertension, hypoHDL-cholesterolemia, and metabolic syndrome than were shown by the normal group. Notably, as compared to the normal group, the AO group showed higher risk of hypercholesterolemia, hyperLDL-cholesterolemia, hypertriglycemia, and metabolic syndrome than did the BMI-AO group. This finding suggests that it is essential to develop prevention programs including programs for those with abdominal obesity despite their having a BMI within the normal range.

Purpose: The purpose of this study was understanding of real experiences of the subjects taking anti-psychotics medication. Methods: The subjects of this study were 14 mentally ill patients hospitalized in C National Hospital. The interview data were analyzed with ethnography researchmethod. Results: 26 themes were drawn, and they were categorized into 5 categories. The 1st category was the stage not to acknowledge themselves as mentally ill patients, as mentally ill patients were forced to be hospitalized in the mental hospital by their family, when their mental illness developed. The second category was the stage to endure difficulties while taking medication. The third category was the stage to experience recurrence of disease. The fourth category is the stage to experience improvement of mental illness with medication. The fifth category is the stage to reflect thembecause of the improvement of mental illness, and to express confidence and will about medication after being discharged from the hospital. Conclusion:Nurses actually have to provide total care bymaking thementally ill patients feel comfortable not to have resistance about medication, when they are hospitalized, closely observing medication actions and side effects, and sharing difficulties felt by the patients.

This study analyzed symptoms of MSDs(Musculokeletal Disorders) associated with characteristics of smartphone usage based on questionnaire survey. This study also tried to identify their relationship based on the results from questionnaire survey. A total of 943 subjects participated for the survey. The results in terms of symptoms associated with smartphone usage were as follows; 1) 49.8% of respondents experienced symptoms associated with MSDs, 2) 35.9%, 34.0%, 22.1%, 21.7% and 20.9% of respondents had symptoms at shoulder, neck, elbow, wrist, and fingers respectively, 3) The effect of ‘daily time of data use’, ‘monthly costs’ for MSDs of respondents was significant. Specifically, this study has some significance since it tries to identify the relationship between MSDs symptoms and characteristics of smartphone usage. The results of the study can be good basis for better design and user guidelines of smartphone to prevent MSDs associated with smartphone usage.

Abstract : 확산강조영상은 골격근 손상이 있을 때 조기에 근육의 신호강도 변화를 알 수 있고 양성과 악성 척추 질환 감별 진단에 유용하다고 보고되고 있다. 이에 본원에서 전이성 척추질환에 시행하고 있는 확산강조영상에 Inversion Time과 Fat saturation을 비교하여 영상의 차이를 알아보고자 하였다. 전이성 척추암을 의심하는 환자 17명을 대상으로 조사 하였으며 병변 과 정상 부위의 신호 대 잡음비(SNR)를 측정하여 대조도 대잡음비(CNR)를 구하였으며, 병변의 구분 정도 및 병변의 검출능력과 전반적인 영상의 평가를 하였다. 정략적 정성적으로 분석한 결과 전이성 척추질환에 사용하는 확산강조영상은 Inversion Time을 이용하는 것 이 영상의 질이 높게 평가 되었다. 목 적 : 확산강조영상은 골격근 손상이 있을 때 조기에 근육의 신호강도 변화를 알 수 있고 양성과 악성 척추 질환감별 진단에 유용하다고 보고되고 있다. 이에 본원에서 전이성 척추질환에 시행하고 있는 확산강조영상에 Inversion Time과 Fat saturation을 비교하여 영상의 차이를 알아보고자 하였다. 대상 및 방법 : 2013년 12월에서 2014년 1월까지 본원 종양내과 처방의 전이성 척추암을 의심하는 환자 17명을 대상으로 조사 하였다. 남자 9명 여자 8명으로 평균 연령은 59세였다. 검사에 사용된 장비는 3.0T 자기공명 영상 장비(Siemens skyra 3.0T), 18ch body matrix coil와 spine matrix coil을 이용하여 검사 하였으며 Inversion Time이 적용된 확산강조영상의 매게 변수는 (TR/TE:1200/65ms, Fov:340mm, FA:90°,b-value: 50.900, Slice thickness/gap:5/0mm, Matrix:150×150, TI:240ms)이고 ,Fat saturation을 적용한 확산강조영상의 매개 변수로는 (TR/TE:8000/65ms, Fov:340mm, FA:90°, b-value:50.900 slice thickness/gap:5/0mm, matrix:150×150) 공통적으로 사용된 Diffusion scheme는 Bipolar를 이용하여 영상을 획득 하였으며, 병변 과 정상 부위의 신호 대 잡음비(SNR)를 측정하여 대조도 대 잡음비(CNR)를 구하였으며, 병변의 구분 정도 및 병변의 검출능력과 전반적인 영상의 평가를 방사선사 3명 전문의 2명에게 의뢰하여 정성적 분석을 하였다. 결 과 : 정량적 분석 결과 Inversion Time과 Fat saturation을 적용한 확산강조영상의 평균 신호대 잡음비는 Bone 98.4/70.4. Spine cord 72.2/44.5. Muscle 38.4/29.6. 으로 측정되었고. Bone과 Meta resion의 평균 대조도 대 잡음비는 89.6/67.5로 측정되었으며 Spine cord와 Muscle 의 평균 대조도 대 잡음비는 68.5/42.1로 측정 되었다.(p<0.05). 정성적 분석으로는 적추 질환시 사용한 확산강조영상을 영상의학과 판독의2명, 방사선사 3명 에게 의뢰하여 인공물 발생정도, 해부학적 구조의 명확도, 영상 선명도 및 전체적인 영상의 질을 평가한 결과 Inversion Time와 Fat saturation 영상이 4.3/4.1로측정 되었다(p<0.05). 결 론 : 확산강조영상은 환자의 병변 검출에서 중요한 영상을 묘사 하는데 이용되고 있는 검사 방법이다. 이에 전이 성척추 질환을 대상으로 한 확산강조영상은 TI time이 정량적으로 유용하였으나 정성적 결과 두 영상의 차이는 뚜렷하지 않았다. 결론적으로 일반적인 척추 자기공명영상 검사와 병행하여 확산강조영상을 이용하면 다양한 척추 질환에 보다 정확한 진단에 도움이 될 거라 사료된다. 본 연구의 제한점으로 다양한 b-value를 적용하지 못했고 전이성 척추질환을 대상으로 하여 결론을 도출한 점이다.

법무부는 정신장애자 범죄가 점진적으로 증가함에 따라 이들을 전문적으로 치료하고 사회적응능력을 향상시키고 이들의 재범을 방지하기 위해 정신질환 수용자들을 위한 정신보건센터를 2012년 이후 4개의 지방교정청관할하에 개원하였다. 이 연구의 목적은 정신질환수용자들이 정신보건센터에서 치료관련 프로그램, 교육프로그램, 훈련프로그램 등 각종 프로그램이 참가자들의 정신관련 치료와 사회적응능력 향상에 도움이 되는지를 알기 위해 각종 프로그램에 대한 분석이 필요하다. 또한 정신보건센터의 운영방식과 교도소 내의 정신보건센터와 지역보건센터와의 연계방안을 고려해야 할 필요성이 있다. 그리고 정신질환자를 위한 보건센터를 더욱 발전시키기 위해서는 외국주요국의 정신질환수형자에 대한 교정처우는 어떠한지를 살펴본 후 우리의 수형자를 위한 정신보건센터의 발전방안을 모색하고자 한다.

This study tried to identify the problems associated with the posture to be analyzed and tried to suggest guidelines for MSDs(Musculoskeletal Disorders) evaluation based on working posture. A total of 50 jobs from 3 different types of industries(electronics, hospitals, automobiles) were used for MSDs evaluation study which was done by 6 observers. Two indexes were applied to identify the problem in this study which were percentage of agreement and counter-time-error rate. Specifically, ‘counter-time-error rate’ represented a degree of consistency in terms of selecting the posture to be analyzed time after time. Main results of the study were as follows; 1) The average percentage of agreement for representative posture for whole body was relatively higher than that for representative postures for individual body parts, 2) The counter-time-error rate(%) has been reduced as the evaluation process has repeated for the same job. 3) The counter-time-error rate(%) for electronics, hospitals, and automobiles were 63.4%, 61.2%, and 67.3% respectively. 4) The counter-time-error rate(%) for the job with the work cycle of 0.5 to 2 minutes were lower than that of the jobs with the work cycles less than 0.5 minute or greater than 2 minute. 5) The work cycles and the number of trials had significant effects on counter-time-error rate while the types of industries did not have significant effects on counter-time-error rate. Some guidelines could be prepared from the results of the study. Probably, there should have an extension in terms of form and matter for this study in order to have more practical output.

Objective : This study is a descriptive examination related to musculoskeletal disorders and the risk factors between pediatric and adult occupational therapists as a way to provide basic information for the purpose of preventing musculoskeletal disorders.Methods : This study surveyed 101 occupational therapists who are employed at ten general hospitals and social welfare centers in Seoul and Gyeonggi-do, South Korea. A questionnaire was used as the research tool for determining their socio-demographic characteristics, job satisfaction, workload, task frequency, and symptoms of musculoskeletal disorders. The data were analyzed using the SPSS Version 17.0.Results : The waist and back are the areas that pediatric and adult therapists complain about being the most painful. The next problem areas are the shoulders followed by the neck. When reviewing the occurrence of factors that influence musculoskeletal disorders according to the body area, the results show that these factors increased 4 to 15 times depending on the therapist's posture while treating patients, conducting their workload, and frequently doing tasks.Conclusion : The results show that the prevalence rate of musculoskeletal disorders of occupational therapists is significantly higher. To enhance the posture and physical task environment for therapists working in a diverse range of departments, further studies are needed.

Immunoglobulin G4 (IgG4)-related disease is a newly named fibroinflammatory condition characterized by tumefactive lesions that contain dense lymphoplasmacytic infiltrates rich in IgG4-positive cells. Elevated serum IgG4 concentrations also often accompany IgG4-related disease. Many medical conditions that were long viewed as diseases confined to single organs (e.g., Mikulicz disease, type 1 autoimmune pancreatitis, Riedel’s thyroiditis, multifocal fibrosclerosis, inflammatory pseudotumor, mediastinal fibrosis, retroperitoneal fibrosis, and etc.) are now designated as part of the spectrum of IgG4-related disease. The preferred nomenclature suggested by a committee of international experts uses the prefix “IgG4-related-” for individual organ involvement, regardless of the organ system affected. One exception is type 1 autoimmune pancreatitis (IgG4-related pancreatitis). Comprehensive diagnostic criteria for IgG4-related disease and organ-specific diagnostic criteria (e.g., IgG4- related dacryoadenitis and sialadenitis, type 1 autoimmune pancreatitis, IgG4-related kidney disease and IgG4-related sclerosing cholangitis) can aid clinicians in the diagnosis of this erratic condition.

Objective: The aim of this study was to analyze factors indicating preventive removal of mandibular third molars by determining associated symptoms, pathologies, eruption state, position and angulation types of mandibular third molars. Study design: A retrospective study was made of 436 patients(200 females, 236 males), aged between 12 and 81 years (mean: 29.93 years) undergoing panoramic radiographic examinations. Total 700 mandibular third molars were analyzed. They were divided by age, sex, position and angulation of mandibular third molars, bony coverage, and associated pathologies- caries, pericoronitis, periodontitis, cyst, root resorption of adjacent teeth. Results: Among 409 pathologies associated with mandibular third molars, pericoronitis accounted for 34.2%(140 cases), which was the most common lesion, caries in the second and third molars for 28.9%, caries in the second molars for 11%(45 cases). Periodontitis showed in 7%(29 cases). In 4 cases, root resorption of adjecent tooth showed. The position which showed predominant pathologic lesion according to the Pell and Gregory classification was ⅡA(86.5%), followed by ⅡB(71.6%). Mandibular third molars without bony coverage(64.8%) showed pathologies frequently. Conclusions: The removal of mandibular third molars must be determined by the perceived risk if the teeth are not removed. The position and inclination of the third molars, bony coverage, age and sex of patients can be the important evidence in the decision making process.

The purpose of this study was to synthetically examine the relationship between systemic diseases and periodontal diseases. The data of the Fifth Korea National Health and Nutrition Examination Survey were used. SPSS 18.0 for Windows was applied for statistical analysis. The surveyed data were analyzed by using independent sample t-test for the difference between Body Mass Index and clinical test according to the existence of periodontal disease, and X2test for the relationship between periodontal disease and systemic disease. Multiple logistic regression analysis was used in order to figure out the influence upon the existence of periodontal disease prevalence among general characteristics and relevant factors to systemic disease. As results, the value of high density lipoprotein (HDL) and HBA1C were statistically significant, depending on the presence of periodontal disease. As for the relationship between periodontal disease and systemic disease, hypertension (odds ratio 1.362, p<.05), cardiovascular disease (odds ratio 2.118, p<.05), arthritis (odds ratio 1.289, p<.05) and cirrhosis (odds ratio 6.124, p<.05) were statistically significant. In conclusion, the majority of the systemic diseases such as cardiovascular system, diabetes, and liver diseases have been considered to have relationship with periodontal disease. To strengthen oral health education is needed to enhance systemic health as well as oral health. Moreover, basic biological research should be followed to support this surveyed study.

The study targeted Japanese employees who have visited hospital for spinal disorder. The study analyzed work environment and pain relief methods of work-related back pain patients, and the relationship between back pain and other body parts. The purpose of this study was to provide draw up measures for patients with back pain and to provide basic data for the sustainable prevention program. The study result of back pain, in other words, employees suffering from lumbago, had disparity between occupations; the highest number of patients were made up of 16-years or above long-serving employees, and below 5-years of short-serving employees. There were more patients complaining of chronic lumbago than acute lumbago, and patients recognized poor posture as the primary cause of lumbago. Furthermore, 99.5% of spinal disorder patients complain back pain, 23.2% use only alternative therapy, and 15.2% visit clinic and hospital with alternative therapy. Patients showed pain reduction and high satisfaction after using alternative therapy. The study targeted Japanese employees where complement therapy is more generalized than that of Korea, and thus there should be multilateral management programs provided in Korea as well.

In this paper, we present a serious game that can prevent elderly people from brain illness using natural finger interaction and Fumanet exercise. As population of elderly people has continually grown in our society, brain illness like dementia can be naturally observed, which makes treatment cost up rapidly. Hence, we propose Leap-Motion based serious game for elderly people, which uses natural finger motions to interact with game contents. In our approach, we enhance finger motion recognition rate by adding auxiliary conditions that is superior to ordinary Leap-Motion APIs. Finally, we have also carried out user study and quantitative analysis to verify our methods.

The purpose of this study was to synthetically examine the relationship between systemic diseases and periodontal diseases. The data obtained from the Fifth Korea National Health and Nutrition Examination Survey were used. SPSS 18.0 for Windows was applied for statistical analysis. The surveyed data were analyzed by using independent sample t-test for the difference between Body Mass Index and clinical test according to the existence of periodontal disease, and X2 test for the relationship between periodontal disease and systemic disease. Multiple logistic regression analysis was used in order to figure out the influence upon the periodontal disease prevalence among general characteristics and systemic diseases. As results, the values of high density lipoprotein (HDL) and HBA1C were statistically significant, depending on the presence of periodontal disease. As for the relationship between periodontal disease and systemic disease, hypertension (odds ratio 1.362, p<.05), cardiovascular disease (odds ratio 2.118, p<.05), arthritis (odds ratio 1.289, p<.05) and cirrhosis (odds ratio 6.124, p<.05) were statistically significant. According to Multiple logistic regression analysis, gender (odds ratio 1.24, p<.05), alcohol intake (odds ratio 1.25, p<.05), cardiovascular diseases (odds ratio 1.56, p<.05), and liver cirrhosis (odds ratio 1.17, p<.05) were related to the prevalence of periodontal diseases. In conclusion, the systemic diseases such as cardiovascular system, diabetes, and liver diseases revealed to have relationship with periodontal disease. To strengthen oral health education is needed to enhance systemic health as well as oral health. Moreover, basic biological research should be followed to support this surveyed study.

목 적 : 확산강조영상은 골격근 손상이 있을 때 조기에 근육의 신호강도 변화를 알 수 있고 양성과 악성 척추 압박골절의 감별 진단에 유용하다고 보고 되고 있지만 질환에 따른 현성확산계수(Apparent Diffusion Coefficient:ADC)의 연구는 많이 보고 되고 있지 않다. 이에 단순 압박 골절과 전이성 척추암이 b value에 따라서 어떠한 변화가 있는지를 알아보고자 본원에서 시행하고 있는 b value 0 400,1400(s/mm²)를 이용하여 각각의 Signal Intensity의 표준화된 값과 물 분자의 확산 정도를 수치화 하는 ADC, 그리고 신호대 잡음비(Signal to Noise:SNR)를 비교하였다. 대상 및 방법 : 2013년 3월부터 2013년 12월까지 MR판독에서 단순복합골절과 전이성 척추암을 의심하는 환자 중 전자의무기록상 확정된 환자로 두 질환 별로 11명씩 총 22명을 대상으로 하였고 평균연령은 각 질환 별로71.2, 56.6세다. 검사장비는 1.5 Tesla Achieva MRI시스템과 Syn-Spine Coil를 사용하였다. Sequence는 DWI SE-EPI Sagittal(Diffusion Weighted Imaging Spin Echo-Echo Planar Imaging Sagittal)영상으로 TR(ms) 1988, TE(ms) 68, FOV(mm) 300, Mat. 128×128, Thk.(mm) 4, Gap(mm) 0.4, Slice 13, b-factor(s/mm²) 0,400,1400의 Parameter를 이용하였다. 데이터 분석은 확산강조영상 b value 0(s/mm²) 영상에서 SI(Signal Intensity)가 높은 질환 부위에 ROI(Region of Interest)를 잡았고 정상부위는 질환부위 바로 위에서 측정하였다. MRIcro Program을 사용하여 b-value 0, 400, 1400(s/mm²)의 영상으로 각각의 SI를 구하였고 b-value의 각 영상을 가지고 Metlab Software를 이용하여 ADC map을 구하여 이 영상을 가지고 MRIcro Program을 사용해 동일한 위치에 ROI를 적용하여 ADC를 구하였다. 데이터 분석은 첫째 두 질환 별로 b value 0 기준으로 400, 1400(s/mm²)의 SI를 표준화하여 비교 분석하였고(SI400/SI0, SI400/SI0) 둘째 두 질환의 정상부위와 질환부위의 ADC와 SNR를 비교 분석하였다. 통계의 유의성은 MS Excel 의 T-Test를 이용하였다. 결 과 : 단순압박골절의 표준화 값(SI400/SI0, SI400/SI0)은 0.47±0.04, 0.23±0.03이고 전이성 척추암의 표준화 값 (SI400/SI0, SI400/SI0)은 0.57±0.07, 0.32±0.08로 나왔고 두 질환 별 표준화 값은 통계적으로 유의하게 나왔다 (p<0.05). 단순압박골절 질환부위의 b value 400(s/mm²)과1400(s/mm²)에 대한 ADC(mm²/s)는 1.70±0.16, 0.93±0.28이고 전이성 척추암은 1.24±0.21, 0.80±0.15로 측정되었다. 두 질환에서 b value 400(s/mm²)에 대한 ADC(mm²/s)는 통계적으로 유의하게 나왔으나(p<0.05) b value 1400(s/mm²)에 대한 ADC(mm²/s)는 유의하지 않았다(p>0.05). 단순압박골절과 전이성 척추암 질환부위의 b value(0/400/1400(s/mm²) 에 따른 SNR 보면 65.61±2.61/36.32±2.92/20.22±2.16, 48.40±2.72/39.27±7.51/23.02±6.25로 측정되었다. 결 론 : 위 연구는 본원에서 검사하고 있는 b value 0,400,1400(s/mm²)을 이용하여 연구를 하였으며 b value 400(s/mm²)에서 두 질환에서의 표준화 된 값과 현성확산계수의 확연한 차이가 있었다. 결론적으로 일반적인 척추 자기공명영상 검사와 병행하여 확산강조영상의 현성확산계수를 가지고 다양한 척추 질환에 적용시킨다면 보다 정확한 진단에 도움이 될 거라 사료된다. 본 연구의 제한점으로 다양한 b value를 적용하지 못했고 성별, 나이, 각 질환의 병기 및 시기, 전이암의 최초 발병 부위를 정립하지 않았으며 측정 부위를 조영제를 사용한 영상이 아닌 단순히 b value 0(s/mm²)에서 고신호 강도가 나오는 곳의 데이터로 결론을 도출한 점은 앞으로 보완해야 할 것이다.