By using the MR T2 map technique, this study intends, first, to measure the change of T2 values of cartilage between healthy people and patients with osteoarthritis and, second, to assess the form and the damage of cartilage in the knee-joint, through which this study would consider the utility of the T2 map technique. Thirty healthy people were selected based on their clinical history and current status and another thirty patients with osteoarthritis of the knee who were screened by simple X-ray from November 2007 to December 2008 were selected. Their T2 Spin Echo (SE hereafter) images for the cartilage of the knee joint were collected by using the T2 SE sequence, one of the multi-echo methods (TR: 1,000 ms; TE values: 6.5, 13, 19.5, 26, 32.5. 40, 45.5, 52). Based on these images, the changes in the signal intensity (SI hereafter) for each section of the cartilage of the knee joint were measured, which yielded average values of T2 through the Origin 7.0 Professional (Northampton, MA 01060 USA). With these T2s, the independent samples T-test was performed by SPSS Window version 12.0 to run the quantitative analysis and to test the statistical significance between the healthy group and the patient group. Closely looking at T2 values for each anterior and lateral articular cartilage of the sagittal plane and the coronal plane, in the sagittal plane, the average T2 of the femoral cartilage in the patient group with arthritis of the knee ($42.22{\pm}2.91$) was higher than the average T2 of the healthy group ($36.26{\pm}5.01$). Also, the average T2 of the tibial cartilage in the patient group ($43.83{\pm}1.43$) was higher than the average T2 in the healthy group ($36.45{\pm}3.15$). In the case of the coronal plane, the average T2 of the medial femoral cartilage in the patient group ($45.65{\pm}7.10$) was higher than the healthy group ($36.49{\pm}8.41$) and so did the average T2 of the anterior tibial cartilage (i.e., $44.46{\pm}3.44$ for the patient group vs. $37.61{\pm}1.97$ for the healthy group). As for the lateral femoral cartilage in the coronal plane, the patient group displayed the higher T2 ($43.41{\pm}4.99$) than the healthy group did ($37.64{\pm}4.02$) and this tendency was similar in the lateral tibial cartilage (i.e., $43.78{\pm}8.08$ for the patient group vs. $36.62{\pm}7.81$ for the healthy group). Along with the morphological MR imaging technique previously used, the T2 map technique seems to help patients with cartilage problems, in particular, those with the arthritis of the knee for early diagnosis by quantitatively analyzing the structural and functional changes of the cartilage.
Kim, Eun Ji;Kim, Hae Sook;Hur, Man Hoe;Lee, Sang Geel
Clinical and Experimental Pediatrics
/
v.45
no.10
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pp.1204-1212
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2002
Purpose : Early surfactant therapy with either gentle ventilation, high-frequency ventilation or aggressive weaning of mechanical ventilation are principles for the treatment of respiratory distress syndrome(RDS). We studied to determine the accessibility of noninvasive nasal continuous positive airway pressure(CPAP) rather than mechanical ventilation by invasive intubation after early surfactant therapy. Methods : The study group consisted of 14 infants who were born and diagnosed with moderate respiratory distress syndrome and received early surfactant therapy with nasal CPAP of PEEP 5-6 cm $H_2O$ within two hours after birth in the Fatima neonatal intensive care unit for two years from January 1999 to August 2001. The control group consisted of 15 infants who were diagnosed with the disease and could be weaned from mechanical ventilator within five days after birth during the same period. Results : The characteristics, the severity of clinical symptoms and laboratory findings in the two groups at birth showed no significant difference. Neither did the interim analysis of laboratory data in two groups. Of 14 infants in the study group who received nasal CPAP after early surfactant therapy, only two infants showed weaning failure with this therapy. In the response cases, duration of CPAP was five days and mean airway pressure was $5.4{\pm}0.5cm$$H_2O$. Two had the complication of CPAP with abdominal distension. Final complications and outcomes in the two groups showed no signifcant difference(P>0.05). Conclusion : The clinical courses in the two groups showed no significant difference. Therefore, we suggest that early surfactant therapy with noninvasive nasal CPAP is a simple and safe method rather than aggressive weaning after invasive mechanical ventilation in moderate respiratory distress syndrome.
Background : Idiopathic pulmonary fibrosis (IPF) is a diffuse inflammatory and fibrosing process that occurs within the interstitium and alveolus of the lung with invariably poor prognosis. The major problem in management of IPF results from the variable rate of disease progression and the difficulties in predicting the response to therapy. The purpose of this retrospective study was to evaluate the short-term efficacy of steroid and immunosuppressive therapy for IPF and to identify the pre-treatment determinants of favorable response. Method : Twenty patients of IPF were included. Diagnosis of IPF was proven by thoracoscopic lung biopsy and they were presumed to have active progressive disease. The baseline evaluation in these patients included clinical history, pulmonary function test, bronchoalveolar lavage (BAL), and chest high resolution computed tomography (HRCT). Fourteen patients received oral prednisolone treatment with initial dose of 1mg/kg/day for 8 to 12 weeks and then tapering to low-dose prednisolone (0.25mg/kg/day). Six patients who previously had experienced significant side effects to steroid received 2mg/kg/day of oral cyclophosphamide with or without low-dose prednisolone. Follow-up evaluation was performed after 6 months of therapy. If patients met more than one of followings, they were considered to be responders : (1) improvement of more than one grade in dyspnea index, (2) improvement in FVC or TLC more than 10% or improvement in DLco more than 20% (3) decreased extent of disease in chest HRCT findings. Result : One patient died of extrapulmonary cause after 3 month of therapy, and another patient gave up any further medical therapy due to side effect of steroid. Eventually medical records of 18 patients were analyzed. Nine of 18 patients were classified into responders and the other nine patients into nonresponders. The histopathologic diagnosis of the responders were all nonspecific interstitial pneumonia (NSIP) and that of nonresponders were all usual interstitial pneumonia (UIP) (p<0.001). The other significant differences between the two groups were female predominance (p<0.01), smoking history (p<0.001), severe grade of dyspnea (p<0.05), lymphocytosis in BAL fluid ($23.8{\pm}16.3%$ vs $7.8{\pm}3.6%$, p<0.05), and less honeycombing in chest HRCT findings (0% vs $9.2{\pm}2.3%$, p<0.001). Conclusion : Our results suggest that patients with histopathologic diagnosis of NSIP or lymphocytosis in BAL fluid are more likely to respond to steroid or immunosuppressive therapy. Clinical results in large numbers of IPF patients will be required to identify the independent variables.
Although the purpose of orthodontic treatment is to increase the function and aesthetics of the jaws as well as to increase stability, there are side effects from the treatment itself such as root resorption and alveolar bone resorption. Such resoiption of the apical root is unpredictable and may even proceed into the dentin layer. Once the process has begun, it is irreversible. By evaluating the effects of different oral habits, especially that ef nail biting, and their correlation with the root and the periodontal tissues, the appropriate biomechanics for orthodontic treatment can be taken into consideration. The possibility of root resorption and alveolar bone loss during orthodontic treatment can also be considered. Also, any legal problems that might occur may be pondered as well. Among the male md female patients of the ages 10~15, 63 were chosen as the test group with known nail biting habits at time of examination and within the same age range those without nail biting habits as the control group. The test group was composed of 30 males and 33 females. The control group had 31 males and 32 females. The result from this study were as follows : 1. Of the 63 patients of both the test and control groups, the male-to-female-ratio was 1:1, and had no statistically significant difference in male and female root resorption. 2. In comparing crown length of the test and control groups, no significant difference existed, but in root length, maxillary and mandibular right and left central incisors and mandibular right lateral incisors had a smaller value. (p<0.001) 3. Average crown-to-root ratio of the test group on the periapical view show a noticeably high value for the maxillary and mandibular right and left central incisors and mandibular right and left lateral incisors. (p<0.01) 4. In comparing and evaluating the alveolar bone loss measured from the cemento-enamel junction to the alveolar bone crest, mesial surfaces of the maxillary and mandibular right and left central incisors and distal surface of maxillary right central incisor of the test group showed greater loss of crestal bone than the control. (p<0.05)
The biocompatibility of the titanium has been estabilished through various experimental studies such as cell culture toxicity test, pyrogen test, mutagen test and others. In order to confirm biocompatibility after fabrication of titanium and to clarify the difference between the bone reaction after insertion of the lathed titanium rods and the bone reaction after insertion of the finished and polished rods, both rods were implanted into the proximal femur of a rabbit. Histologic reactions in the bone were observed according to the ASTM standards at the intervals of 6 weeks, 12 weeks and 26 weeks after implantation. The result were as follows : In 6 weeks after implantation of lathed titanium rods, inflammatory reactions, such as minimal degree infiltration of polymorphonuclear leukocytes and lymphocytes were observed in all cases. This was thought to he caused by surgical trauma. However, inflammatory cell infiltration was not seen after implantation of polished and finished rods in all cases. The cellular infiltration and the histologic reaction of the hone after implantation of lathed group were significantly more pronounced than those after implantation of the finished group. In 12 weeks after implantation of lathed rods, two of four cases revealed a minimal degree of cellular infiltration. No inflammatory cell infiltration was demonstrated after implantation of the finished group. The cellular infiltration and histologic reaction seemed to be more pronounced in the lathed group, but they were not significant statistically. At 26 weeks after implantation of the lathed and finished group, there was no cellular infiltration in both groups. New bone formation was observed up 26 weeks, and no difference between lathed titanium rods and finished titanium rods were apparent. Mild bone necrosis was observed in 1 case out of 11 cases in which lathed titanium rods were implanted. Bone necrosis was not observed in the finished titanium rod group. Fibrosis was observed in both groups, but differences were not significant between the experimental groups. In the lathed titanium rods group and the shorter interval group, inflammatory cell infiltration was significantly higher. Finished titanium rods and longer interval groups had markedly decreased tendences in histologic reaction ratings. As a conclusion, although certificated titanium might be safe to use, difference of biocompatibility were observed depending on the method of surface finish. By identifying biocompatibility as a long-term standardized animal study, we can develop progressed internal fixation device that is safe for human beings.
Journal of the korean academy of Pediatric Dentistry
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v.33
no.4
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pp.643-652
/
2006
The purpose of this study was to elucidate the size and morphologic characteristics of maxillary primary first molars in Korean children using three-dimensional laser scanner and compare three-dimensional image with preformed stainless steel crown. Scanned three-dimensional images of dental cast taken from 132 children(male 62, female 70) by three-dimensional laser scanner(Breuckmann opto-Top HE100, INUS, Korea) were used. Mesiodistal diameter, buccolingual diameter, occlusogingival height and crown shape of each image were calculated by Rapidform 2004 program(INUS, Korea). The values were statistically compared by independent samples t-test with 95% of significant level. The results were as follows : 1. No significant difference in crown size was found between left and right maxillay primary first molar(p>0.05). 2, Significant difference in mesiodistal diameter, buccolingual diameter, buccal occlusogingival height was found between male and female (p<0.05), and crown size of male was bigger than that of female. 3. Average image of maxillay primary first molar was shaped three-dimensionally and measured. In comparison with 3M stainless steel crown, this image was similar with No.4 or No.5 SS crown in male, No.4 in female. In comparison with ILSUNG SS crown, this image was similar with No.5 in male, No.4 in female. 4 Mesiolingual line angle area, distolingual line angle area and buccogingival ridge were more obvious in average image than 3M stainless steel crown. ILSUNG SS crown was more square and had longer mesiodistal diameter than average 3D image.
Purpose : Secondary electrons generated by interaction between Primary X-rar beam and block tray in megavoltage irradiation, result in excess soft radiation dose to the surface layer To reduce the surface dose from the electron contamination, electron filters were attached under the tray when a customized block was used. Materials and Methods : Cu, Al or Cu/Al combined Plate with different thickness was used as a filter and the surface dose reduction was measured for each case. The measurement to find optimal filter was performed with $10m\times10cm$ field size and 78.5cm source to surface distance. The measurement points are positioned with 2mm intervals from surface to maximum build-up point. To acquire the effect of field size dependence on optimal electron filter, the measurement was performed from $4cm\times4cm\;to\;25cm\times25cm$ field sizes. Results : The surface dose was slowly increased by increasing irradiation field but rapidly increased beyond $15cm\times15cm$ field size. Al plate was found to be inadequate filter because of the failure to have surface dose kept lowering than the dose of deep area. Cu 0.5mm plate and Cu/Al=0.28mm/1.5mm combined plate were found to be optimal filters. By using these 2 filters, the absorbed dose to the surface layer was effectively reduced by $5.5\%,\;11.3\%,\;and\;22.3\%$ for the field size $4cm\times4cm,\;10m\times10cm,\;and\;25cm\times25cm$, respectively. Conclusion : The surface dose attributable to electron contamination had a dependence on field size. The electron contamination was increased when tray was used. Specially the electron contamination in the surface layer was greater when the larger field was used. 0.5mm Cu Plate and Cu/Al=0.28mm/15mm combined plates were selected as optimal electron filters. When the optimal electron filter was attached under the tray, excessive surface dose was decreased effectively The effect of these electron filters was better when a larger field was used.
Lee, Chang Yeol;Kim, Woo Chul;Kim, Hun Jeong;Ji, Young Hoon;Kim, Kum Bae;Lee, Sang Hoon;Min, Chul Kee;Jo, Gwang Hwan;Shin, Dong Oh;Kim, Seong Hoon;Huh, Hyun Do
Progress in Medical Physics
/
v.25
no.4
/
pp.255-263
/
2014
The dosimetry of very small fields is challenging for several reasons including a lack of lateral electronic equilibrium, large dose gradients, and the size of detector in respect to the field size. The objective of this work was to evaluate the suitability of a new commercial synthetic diamond detector, namely, the PTW 60019 microDiamond, for the small field dosimetry in cyberknife photon beams of 6 different collimator size (from 5 mm to 30 mm). Measurements included dose linearity, dose rate dependence, output factors (OF), percentage depth doses (PDD) and off center ratio (OCR). The results were compared to those of pinpoint ionization chamber, diamond detector, microLion liquid Ionization chamber and diode detector. The dose linearity results for the microDiamond detector showed good linearly proportional to dose. The microDiamond detector showed little dose rate dependency throughout the range of 100~600 MU/min, while microLion liquid Ionization chamber showed a significant discrepancy of approximately 5.8%. The OF measured with microDiamond detector agreed within 3.8% with those measured with diode. PDD curves measured with silicon diode and diamond detector agreed well for all the field sizes. In particular, slightly sharper penumbras are obtained by the microDiamond detector, indicating a good spatial resolution. The results obtained confirm that the new PTW 60019 microDiamond detector is suitable candidate for application in small radiation fields dosimetry.
Vocal nodules and polyps are much more frequent in singers, public speakers, teachers and actors. Voice trauma and voice misuse, at times associated with mild inflammatory reaction, appear to be important in their etiology. It is generally agreed that vocal cord nodules and polyps are inflammatory in nature and they arise in the subepithelial layer of loose connective tissue of the vocal cord. Since the junction of anterior and middle thirds of the membranous cord and has the greatest amplitude of vibration. This is the site of predilection for vocal cord nodules. The author performed laryngomicrosurgery for 70 cases of vocal nodules and polyps at Ewha Womans University Hospital during the period of 5 years. The result obtained were as follows ; 1) Surgical excision is not necessarily the best approach because vocal nodules in the early stages will resolve with the simplest voice therapy. 2) In children, surgery is rarely indicated because most nodules in children regress during adolescence. 3) For patients who use their voices professionally, voice therapy is indicated for three months. 4) If after three month of conservative treatment the cord lesion does not improve and the patient it still dissatisfied with his voice, laryngomicrosurgery can then be considered. 5) The small cuffed endotracheal tube in the interarytenoid space helps to keep the cords immobile and in an abducted position. 6) Removal of the nodule shoule be started by gentle retraction posteriorly and as soon as a tear appears anterior to the nodule. 7) On occasion it is preferable to start the dissection with a siccle knife while the nodule is held on the stretch. 8) Voice rest should be maintained for a week following which the free edges of the cords are usually healed.
To develop natural food preservatives for extending the shelf-life of jeotkal (salted and fermented seafood), antimicrobial substances were extracted from 32 types of medicinal herbs and edible plants using 95% ethanol. Among the extracts, Glycyrrhizae radix, Curcumae domestica, Galla rhois, and Resina pini showed relatively high inhibitory effects on the growth of the microorganisms isolated from the deteriorated jeotkal. We selected and tested the extract from Recina pini as a natural jeotkal preservative. This ethanol extract was purified partially by adding equal quantity of water, through which 77% of insoluble materials were removed as impurities. In manufacturing modified jeotkal using squid, sucrose and starch syrup were substituted with sorbitol, $glucono-{\delta}-lactone$ was added instead of vitamin C and lactic acid, and sterilized hot pepper was used instead of natural one. The shelf-life of modified jeotkal was prolonged by 4 days compared with the control jeotkal when stored at $20^{\circ}C$, while that of modified jeotkal containing 1.0% partially purified Recina pini extract was prolonged by 6 days compared to the control. The same tests were conducted for the changran (stomach and intestine of Alaska pollack) jeotkal preservation. The shelf-life of the control jeotkal was 24 days, whereas the modified jeotkal and the Resina pini extract-containing modified jeotkal maintained their qualities without changes in microbial and chemical characteristics for 90 days at $20^{\circ}C$ storage.
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