핵의학 간담도 스캔 시, 전면상과 우측 측면상에서의 담낭박출률에 대한 비교 및 고찰

이은별,김재일,도용호,임정진,조성욱,노경운,Lee, Eun-Byeol,Kim, Jae-Il,Do, Yong-Ho,Llm, Jung-Jin,Cho, Sung-Wook,Noh, Gyeong-Woon 대한핵의학기술학회 2018 핵의학 기술 Vol.22 No.2

핵의학 간담도 검사 시, 담낭의 수축력을 정량적으로 평가하기 위하여 지방식(fatty meal)을 이용한 전면상에서의 담낭박출률(gallbladder ejection fraction ; GB EF%)을 진단에 이용하고 있다. 하지만, 담낭과 다른 구조물이 전면상에서 겹쳐질 경우, 담낭 박출률 평가가 정확히 이루어지지 않는다. 이러한 오차를 줄이기 위해 본 연구에서는 전면상과 우측 측면상에서 계산한 GBEF%의 유의한 차이가 있는 지 알아보고자 한다. 본원에 내원한 임의의 환자 50명을 대상으로 $^{99m}Tc$-Mebrofenin 370 MBq를 정맥주사 후 간담도 검사를 실행하였다. 검사는 SKYLIGHT(Philips, United States)을 이용하여 10분, 20분, 30분, 60분, 그리고 지방식(치즈와 우유)을 시행하고 30분 후에 90분 째, 전면상과 우측 측면 영상을 획득하였다. JETstream workspace 프로그램에서 60분째와 90분째 전면상과 우측 측면상에서 GBEF%을 구하였다. 보다 정확한 관심영역 설정을 위해 CT영상을 참고하였고, 4명의 방사선사가 동일한 영상에서의 GBEF%을 구하여 평균값을 계산하였다. 통계분석프로그램SPSS version23(SPSS Inc. USA)을 이용하여 전면상과 우측 측면상에서 GBEF%의 차이에 유의한 차이가 있는지 평가하였다. 무작위 50명 환자의 전면상에서 GBEF%의 평균값은 63.2고, 우측 측면상에서 GBEF%의 평균값은 62.7으로 전면상 대비 우측 측면상에서 0.5% 감소하였다. 전면상과 우측 측면상에서 GBEF%의 대응표본 t-검정 결과 P>0.05으로 유의한 차이가 없었다. 이를 통해 전면상에서 담낭과 다른 구조물이 분리되지 않아 담낭박출률의 오차가 발생하는 경우, 우측 측면상을 이용하여 GBEF%을계산하면 보다 더 정확한 담낭박출률이 평가되는 것으로 사료된다. Purpose In case of nuclear medical hepatobiliary scan, To quantitatively evaluate contractility of a gallbladder, gallbladder ejection fraction (GBEF%) is calculated from anterior images using fatty meal. However, when a gallbladder and other organs overlap on an anterior image, the gallbladder ejection fraction is not accurately evaluated. In order to reduce this error, the objective of our study was to figure out whether there is a significant difference in GBEF% calculated from the anterior and right lateral images. Materials and Methods After intravenous injection of 99mTc-Mebrofenin 370 MBq to randomly 50 patients who visited our hospital, we started to examine nuclear hepatobiliary scan. Using skylight(Philips, United States), we acquired anterior and right lateral image at 10 minutes, 20 minutes, 30 minutes, 60 minutes, 90minutes after injection. Using images at 60 and 90 minutes, gallbladder ejection fraction (GBEF%) was calculated from the anterior and right lateral images using JETstream workspace. For drawing more accurate ROI, CT images were referenced and 4 radiologists calculated the GBEF% in the same image and calculated the average value. We assessed whether there was a significant difference in GBEF% calculated from the anterior and right lateral images using SPSS program(Statistical Package for the Social Science, SPSS Ver.18 Inc. USA). Results About randomly 50 patients, the average value of the GBEF% calculated from the anterior image was 63.212 and the average value of the GBEF% calculated from the right lateral image was 62.666. GBEF% decreased 0.433% on the right lateral image compared with anterior image. Result of paired sample t-test, p value is over 0.05. So, there was no significant difference in GBEF% calculated from the anterior and right lateral images. Conclusion In the case that a gallbladder and other organs are not separated on an anteior image, Right lateral image would be better to acquire more accurate GBEF% than using anterior image.

Cyclophosphamide에 의해 유도된 면역저해 마우스에서 도라지 추출물의 면역기능 조절 효과

이은별(Eun Byeol Lee),이성현(Sung Hyen Lee),박양규(Yang-Gyu Park),최지혜(Ji-Hye Choi),이혜경(Hye Kyung Lee),장환희(Hwan Hee Jang),황경아(Gyeong-A Hwang),최정숙(Jung-Suk Choe),박신영(Shin Young Park),최애진(Ae Jin Choi),황인국(In Guk 동아시아식생활학회 2019 동아시아식생활학회지 Vol.29 No.4

The root of Platycodon grandiflorum (PG) has been used as a food and a traditional oriental medicine to treat diseases such as asthma, bronchitis and pulmonary tuberculosis. However, not much research has been conducted on its effects to stimulate immune system in an immuno-suppressed model. This study was performed to examine the immunomodulative effects of PG in immuno-suppressed mice and this immune-suppression was induced by cyclophosphamide. The immunostimulating effects of ethanol PG extract in this in vivo model were examined by measuring the body and immune related organ weights, the serum immunoglobulin and cytokine levels, the splenocytes proliferation rate and the NK cell activity. After the experiment, there was no significant difference in the body, thymus and spleen weights of all the groups. The serum IgA and IgM values increased in the PG-treated groups. However, the significant difference from the control was shown only in the PG-2A group. The serum Th1 type cytokines (IL-1β, IL-12, IFN-γ) levels increased in the PG groups, and the PG-2A group showed significantly higher serum Th1 type cytokines values than those of the control group. The Th2 cytokines (IL-6, TNF-α) decreased in the PG groups and a significant difference of the serum Th2 type cytokines values was found in the PG-A group. Splenic T cell proliferation increased in the PG groups, but there was no significant difference as compared to that of the experimental groups. Splenic NK cell activity significantly increased in the PG groups. Thus, the PG extract can increase the serum immunoglobulin level, the Th1 cytokine levels and the NK cell activity, and can normalize the Th2 cytokines levels. The results suggest that PG has a great potential as a healthy food by itself or as a supplement.

고관절 치환술 후 추나치료 효과: 체계적 문헌고찰 및 메타분석

이은별 ( Eun-byeol Lee ),김현지 ( Hyeon-ji Kim ),김채영 ( Chae-young Kim ),안희덕 ( Hee-duk Ahn ) 한방재활의학과학회 2022 한방재활의학과학회지 Vol.32 No.2

Objectives This study was conducted to assess the effect of chuna manual therapy after hip arthroplasty. Methods We searched across 9 electronic databases (PubMed, Cochrane Library, Wangfang data, China National Knowledge Infrastructure [CNKI], Oriental Medicine Advanced Searching Integrated System [OASIS], National Digital Science Library [NDSL], Korean Medical Database [KMBASE], Koreanstudies Information Service System [KISS], Research Information Sharing Service [RISS]) to find randomized controlled clinical trials for chuna manual therapy after hip arthroplasty. Results On inclusion criteria, 11 appropriate studies were included and analyzed. The deep vein thrombosis incidence of the chuna manual therapy group was statistically lower than the conventional treatment group (p=0.0002). Chuna manual therapy significantly improved the Harris hip score compared with conventional treatment (p< 0.00001). Also, chuna manual therapy combined with herbal fumigation therapy significantly elevated the hip joint function score of Harris hip score compared with the conventional therapy group (p<0.00001). Conclusions The systematic review showed that chuna manual therapy had significant effects on hip arthroplasty. Nonetheless, considering the high risk of bias and geographic bias, further research with well-designed studies is required to support the effectiveness of chuna manual therapy. (J Korean Med Rehabil 2022;32(2):95-103)

후방 요추체간 유합술을 시행한 척추 전위증 환자의 한방 재활치료 프로토콜을 적용한 임상 치료 효과: 증례 보고

이은별 ( Eun-byeol Lee ),박나리 ( Na-ri Park ),이윤진 ( Yun-jin Lee ),강석범 ( Seok-beom Kang ),우창훈 ( Chang-hoon Woo ),안희덕 ( Hee-duk Ahn ),양두화 ( Doo-hwa Yang ) 한방재활의학과학회 2021 한방재활의학과학회지 Vol.31 No.1

Objectives The objective of this study is to propose postoperative rehabilitation for spondylolisthesis after posterior lumbar interbody fusion (PLIF) in Korean medicine and to report its effectiveness. Methods There were two patients who were received Korean medicine with acupuncture, herbal medicine, cupping and exercise treatment after PLIF. Patients were evaluated numeric rating scale (NRS), Oswestry disability index (ODI), pain free walking distance (PFWD), Korean modified index (K-MBI), EuroQol-5 dimension (EQ-5D) index. Results Case 1 was improved NRS from 7 to 3, Case 2 was improved NRS from 7 to 2. Also, ODI, PFWD, K-MBI, EQ-5D score were improved in both cases. Conclusions This study suggests that Korean medicine rehabilitation could be effective for spondylolisthesis after PLIF. (J Korean Med Rehabil 2021;31(1):165-173)

슬관절 전치환술 환자에 적용한 추나치료 : 체계적 문헌고찰 및 메타분석

이은별(Eun-Byeol Lee),이윤진(Yun-Jin Lee),김현지(Hyeon-Ji Kim),안희덕(Hee-Duk Ahn),양두화(Doo-Hwa Yang) 척추신경추나의학회 2021 척추신경추나의학회지 Vol.16 No.1

Objectives To assess the effectiveness of chuna manual therapy for patients with total knee arthroplasty. Methods We searched 9 electronic databases(KISS, NDSL, RISS, OASIS, KMBASE, Cochrane Library, PubMed, CNKI, Wangfang data) using the keywords ‘total knee arthroplasty OR total knee replacement’ and ‘tuina OR chuna’ to identify RCTs that investigated the effectiveness of Chuna manual therapy after total knee arthroplasty. Results 23 RCTs were selected based on inclusion criteria. The systematic review showed positive effect of using chuna manual therapy after total knee arthroplasty. Conclusions 23 studies reported that chuna manual therapy had significant effects on total knee arthroplasty. However, many studies were exposed to probable high risk of bias. Also, all of the studies were published in one overseas country. Therefore, further research is required using well-designed RCTs to support the effectiveness of chuna manual therapy.

Gamma Camera에 있어 측면 선란선의 영향에 대한 평가

김재일,이은별,조성욱,노경운,강건욱,Kim, Jae-Il,Lee, Eun-Byeol,Cho, Seong-Wook,Noh, Kyeong-Woon,Kang, Keon-Wook 대한핵의학기술학회 2018 핵의학 기술 Vol.22 No.1

검출기 외부에 강한 선원은 collimator와 상호 작용으로 산란선이 만들어지게 되는데, 그 산란선이 영상에 얼마나 영향을 주는지 평가하고자 한다. SKY LITE를 사용하여, phantom study의 경우, $^{99m}Tc$ 1.11 GBq를 점선원으로 만들어 검출기 주변을 $10^{\circ}$ 간격으로 돌아가면서 측정하여 각 각도에서의 산란선의 정도를 계수율과 스펙트럼으로 분석을 하였다. Patient study의 경우, 3-phase bone scan을 하는 환자를 대상으로, blood flow와 blood pool 영상을 획득하면서 산란선의 양과 스펙트럼을 분석하였다. 추가로 blood pool 검사 시, 환자의 손위에 납가운을 올려놓고 영상을 획득하였고, 환자의 몸에 납가운을 입히고 영상을 획득하여 각 영상에서의 산란선과 스펙트럼을 비교, 평가하였다. 그 결과, phantom study의 경우, 후방에서는 산란선의 없었지만, 측면부터 전방 $50^{\circ}$ 까지는 산란선이 많이 검출 되었다. patient study의 경우 blood flow 영상과 blood pool 영상에서 환자 몸에서 나온 감마선으로 인해 생긴 산란선이 입사됨을 알 수 있었다. 그리고 납가운은 손 위를 차폐하는것 보다, 환자 몸을 차폐 하는 것이 산란선이 많이 줄었다. 그러므로 외부에 강한 선원이 존재하고, hand blood flow, blood pool 검사처럼 계수 자체가 낮을 검사를 할 경우, 몸에서 나오는 선원 자체를 차폐하는 것이 산란선을 줄이는데 보다 효과가 있으며, 영상에서도 배후 방사선을 줄이는데 효과가 있음을 알 수 있었다. Purpose Generally, a collimator that installed in front of detector set a direction of gamma ray and remove a scatter ray. By the way, a lateral or oblique scatter ray is detected into crystal through collimator. At this study, we will evaluate a mount of count and spectrums of lateral scatter ray. Materials and Methods We used the SKY LITE (philips, netherlands) as a gamma camera, and $^{99m}Tc$, 1.11 GBq point source as a phantom. we put this point source at backside 50 cm of detector. After acquiring this for 1 min, we turned a detector next 10 degrees. Likely this, we acquired images at every 10 degrees from $0^{\circ}$ to $360^{\circ}$, analyzed images and spectrums. In case of patient study, we choose a 3 phase bone scan patient who had a hand disease, because scatter rays from body would detect on crystal. After acquiring blood flow and blood pool images, we analyzed images and spectrums. Additional, we put a lead gown on patient's hand, body. And then we compared and evaluated 3 type blood pool images (non lead gown, lead gown on a hand and on body). Results In case of phantom study, scatter ray counts at backside ($270^{\circ}-90^{\circ}$) are same with a background count. By the way, counts of scatter ray of oblique side ($0^{\circ}-50^{\circ}$, $220^{\circ}-270^{\circ}$) are 100-600 cps, furthermore, counts at frontside are over 4 Mcps. In case of patient study, a counts of hand blood pool scan are 1510 cps. But counts of hand with lead gown on hands and on body are each 1554 cps, 1299 cps. Conclusion Therefore, even though there is a collimator in front of detector, lateral scatter rays detect on crystal and affect to images and spectrums. Especially, if there is a high activity source at outside of detector when we examine low activity organs like hands or foot, we have to shield and remove the source at outside for a good image.

단순성 비만에 대한 추나요법의 효과 : 체계적 문헌고찰과 메타분석

이윤진(Yun-Jin Lee),이은별(Eun-Byeol Lee),김현지(Hyeon-Ji Kim),안희덕(Hee-Duk An),양두화(Doo-Hwa Yang) 척추신경추나의학회 2021 척추신경추나의학회지 Vol.16 No.1

Objectives The purpose of this study was to investigate the effectiveness of Chuna manual therapy (CMT) in the treatment of simple obesity. Methods We used seven databases to perform a literature search using the keywords “Chuna OR Tuina” AND “Obesity.” We selected randomized clinical trials in which Chuna was used as the main method for treating simple obesity. The risk of bias was assessed by three independent researchers using the Cochrane risk of bias. Results A total of 14 RCTs were selected and analyzed. The results of the meta-analysis showed a significantly higher efficacy rate in the patient group treated with CMT as the main treatment than that in the control group. Conclusions The results of this systematic review suggest that CMT is effective in the treatment of simple obesity. However, given the limitations such as the small number of studies and the high risk of bias in the studies, additional research is needed to lend further support to this claim.

강황 지하부 부산물의 플라보노이드 성분 (정정안내문)

안달래(Dal Rae Ahn),이은별(Eun Byeol Lee),안민실(Min Sil Ahn),김반지(Ban Ji Kim),이소연(So Yeon Lee),이태관(Tae Gwan Lee),임혜원(Hye Won Lim),이현용(Hyeon Yong Lee),배종진(Jong Jin Bae),김대근(Dae Keun Kim) 한국생약학회 2013 생약학회지 Vol.44 No.4

기억력 손상 마우스에서 흑미 호분층 추출물의 인지능력 개선 효과

최지혜(Ji Hye Choi),이은별(Eun Byeol Lee),장환희(Hwan Hee Jang),박용순(Youn Soon Park),이성현(Sung Hyen Lee) 한국약용작물학회 2021 한국약용작물학회지 Vol.29 No.5

산후 유즙분비부전에 대한 추나 치료

김채영(Chae-Young Kim),이은별(Eun-Byeol Lee),김현지(Hyeon-Ji Kim),안희덕(Hee-Duk Ahn) 척추신경추나의학회 2022 척추신경추나의학회지 Vol.17 No.1

Objectives : To evaluate the effectiveness of Chuna manual therapy (CMT) for post- partum hypogalactia. Methods : Using nine electronic databases, we selected 13 randomized controlled trials (RCTs) that applied CMT for postpartum hypogalactia and conducted a meta- analysis. The risk of bias was assessed using the Cochrane risk of bias tool. Results : Meta-analysis showed statistically significant results for CMT in terms of effective rate and breast filling degree compared to the other treatment groups (p<0.05). Conclusions : Our study showed clinical evidence of CMT efficacy for postpartum hypogalactia. Further studies are required to support our findings.