• Title/Summary/Keyword: 병원 의학

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Risk Assessment of Dermatolymphangioadenitis by Lymphoscintigraphy in Patients with Lower Extremity Lymphedema (하지림프부종 환자에서 림프신티그라피를 이용한 피부림프선염 위험도 평가)

  • Choi, Joon-Young;Hwang, Ji-Hye;Park, Jung-Mi;Lee, Kyung-Han;Kim, Sang-Eun;Kim, Dong-Ik;Lee, Byung-Boong;Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.2
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    • pp.143-151
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    • 1999
  • Purpose: Dermatolymphangioadenitis (DLA) is a common and serious complication of lymphedema which deteriorates lymphatic function. The purpose of this study was to assess the risk of DLA by lymphos-cintigraphy in patients with lower extremity lymphedema. Materials and Methods: The subjects were 59 edematous lower extremities of 50 patients without previous episode of DLA and 12 lower extremities of 6 controls. Whole body images were acquired 1 min and 2 hr after subcutaneous injection of 37 MBq of Tc-99m-antimony sulfide colloid into interdigital spaces of both feet before therapy for lymphedema. The lymphosintigraphic and clinical variables were compared between groups with or without occurrence of DLA during clinical follow up. Results: There were 20 episodes of DLA in 12 extremities during clinical follow-up (19 :6 months). On univariate analysis, there were significant differences in ilioinguinal lymph node uptake, uptake pattern of main lymphatic vessel, clinical stage and therapy compliance between the two groups. After multivariate analysis, only the uptake pattern of main lymphatic vessel and therapy compliance fore confirmed to be independent variables. In other words, non-visualized main lymphatic vessel and poor compliance to therapy were more frequent in extremities with subsequent occurrence of DLA. Conclusion: Lymphoscintigraphy can be used to predict the risk of DLA and may thus be helpful for determining the initial therapeutic plan in patients with lower extremity lymphedema.

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The Evaluation of Dynamic Continuous Mode in Brain SPECT (Brain SPECT 검사 시 Dynamic Continuous Mode의 유용성 평가)

  • Park, Sun Myung;Kim, Soo Yung;Choi, Sung Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.15-22
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    • 2017
  • Purpose During Brain SPECT study, critical factor for proper study with $^{99m}Tc-ECD$ or $^{99m}Tc-HMPAO$ is one of the important causes to patent's movement. It causes both improper diagnosis and examination failure. In this study, we evaluated the effect of Dynamic Continuous Mode Acquisition compared to Step and Shoot Mode to raise efficacy and reject the data set with movement, as well as, be reconstructed in certain criteria. Materials and Methods Deluxe Jaszczak phantom and Hoffman 3D Brain phantom were used to find proper standard data set and exact time. Step and Shoot Mode and Dynamic Continuous Mode Acquisition were performed with SymbiaT16. Firstly, Deluxe Jaszczak phantom was filled with $Na^{99m}TcO_4$ 370 MBq and obtained in 60 minutes to check spatial resolution compared with Step and Shoot Mode and Dynamic Continuous Mode. The second, the Hoffman 3D Phantom filled with $Na^{99m}TcO_4$ 74 MBq was acquired for 15 Frame/minutes to evaluate visual assessment and quantification. Finally, in the Deluxe Jaszczak phantom, Spheres and Rods were measured by MI Apps program as well as, checking counts with the frontal lobe, temporal lobe, occipital lobe, cerebellum and hypothalamus parts was performed in the Hoffman 3D Brain Phantom. Results In Brain SPECT Study, using Dynamic Continuous Mode rather than current Step and Shoot Mode, we can do the reading using the 20 to 50 % of the acquired image, and during the test if the patient moves, we can remove unneeded image to reduce the rate of restudy and reinjection. Conclusion Dynamic Continuous Mode in Brain study condition enhances effects compared to Step and Shoot Mode. And also is powerful method to reduce reacquisition rate caused by patient movement. The findings further indicate that it suggest rejection limit to maintain clinical value with certain reconstruction factors compared with Tomo data set. Further examination to improve spatial resolution, SPECT/CT should be the answer for that.

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Public Attitudes Toward Dying with Dignity and Hospice.Palliative Care (품위 있는 죽음과 호스피스.완화의료에 대한 일반 국민들의 태도)

  • Yun, Young-Ho;Rhee, Young-Sun;Nm, So-Young;Chae, Yu-Mie;Heo, Dae-Seuk;Lee, So-Woo;Hong, Young-Seon;Kim, Si-Young;Lee, Kyung-Sik
    • Journal of Hospice and Palliative Care
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    • v.7 no.1
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    • pp.17-28
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    • 2004
  • Purpose: Even though there have been various efforts for the dying with dignity of terminal patients, no researches focused on the public attitudes. Methods: In February 2004, we sampled 1,055 persons over 20 years of age from the sixteen cities and local districts of Korea through the quota sampling method according to their gender, age, and location. We conducted a telephone survey with a structured questionnaire on the attitudes toward dying with dignity and hospice palliative care. Results: The most important conditions for the dying with dignity on the patients' views were 'removing burdens for other people' (27.8%). Over the half of the samples chose their home as a preference for place of death (54.8%). 82.3% of the respondents agreed to the idea of withdrawing the medically futile life-sustaining treatment. Fifty seven percents of the answered public said that they intended to use the hospice service in case of terminal illness. Eighty percents thought that health care insurance should cover hospice service, and 80.9% gave positive response to the necessity of advance directives. Respondents emphasized 'the financial support for the terminal patients' (29.8%), 'covering hospice service with health insurance' (16.5%), and 'the education and public relation for settlement of desirable dying culture and hospice service' (15.9%) as the roles and responsibilities of the government for the dying with dignity. Conclusion: This study shows that there is a possibility of significant consensus on hospice and palliative care system for the dying with dignity of patients and reduction of the suffering for their families among the general public.

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Parental Behavior Influence on the Onset and Severity of Anorexia Nervosa and Bulimia Nervosa (부모의 양육태도가 섭식장애의 발병과 심각도에 미치는 영향)

  • Lee, Jung Eun;Lee, Jung-Hyun;Jung, Young-Chul;Park, Jun Young;Kee, Namkoong;Park, Dong Wha;Kim, Kyung Ran
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.1
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    • pp.3-11
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    • 2015
  • Objectives:To determine the influence of parental behaviors on the onset and severity of eating disorders, this study compared aspects of perceived parental styles, according to eating disorder subtypes and age at onset in Korean women with eating disorders. Methods:One hundred and sixty-seven patients with eating disorders[Anorexia Nervosa (AN), N=49; Bulimia Nervosa(BN), N=118] were recruited for this study. Perceived parent behaviors were assessed with Parental Behavior Inventory(PBI) self-rating scale. The study subjects also completed the Eating Disorder Inventory -2 (EDI-2) to assess the severity of eating disorder symptoms. Results:In anorexia nervosa, early onset group(<16 years) reported low paternal affection and high paternal rational expression, low maternal interference than group with age at onset over 16 years. The severity of eating disorder symptoms was negatively associated with mother affection and rational expression in two subtypes of eating disorder(AN and BN). On stepwise regression analysis, paternal affection and maternal over-protection were associated with age of onset only in AN group and maternal affection was associated with the severity of symptoms in both groups of eating disorder. Conclusions:Considering the role of family function and perceived parental styles could help improve the management of eating disorders. These results emphasize the importance of fathers' role in the eating disorder on the age of onset, a relatively unexplored area of eating disorder research. Also, we investigated the importance of mothers' affection on the severity of symptoms.

A Study on the Optimal Image Acquisition Time of 18F- Flutemetamol using List Mode (LIST mode를 이용한 18F-Flutemetamol 의 최적 영상획득 시간에 관한 연구)

  • Ryu, Chan-Ju
    • Journal of the Korean Society of Radiology
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    • v.15 no.6
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    • pp.891-897
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    • 2021
  • With the development of Amyloid PET Tracer, the accuracy of Alzheimer's diagnosis can be improved through the identification of beta-amyloid neurites. However, the long image acquisition time of 20 minutes can be difficult for the patient. PET/CT scans are sensitive to patient movement and may partially affect test results. In this study, we studied the proper image acquisition time without affecting the quantitative evaluation of the image through the list mode acquisition method according to the time of the distribution of radioactive drugs in the body. The list mode includes information about time compared to the existing frame mode, and it is easy to analyze data because it can reconstruct images about the time that researchers want. The research method obtained a reconstructed image by time using a list mode of 5min frame/bed, 10min frame/bed, 15min frame/bed, and 20min frame/bed to compare the difference between signal-to-pons take ratio (SNR) and lesion-to-pons uptake ratio (LPR) and the difference in reading time to obtain an appropriate image. As a result of quantitative analysis, when measuring in list mode, SUVmean values decreased in 6 regions of interest as the image acquisition time increased, but showed the largest difference in 5 min/bed images, followed by 10 min/bed and 15 min/bed. As a result, the difference in SUVmean values decreased. Therefore, it was found that SUVmean values at 15 min/bed did not differ enough to not affect image evaluation. There was no difference in LPR values. As a result of the qualitative analysis, there was no change in the reading findings according to the PET image acquisition time and there was no significant difference in the qualitative analysis score of the image reconstruction according to time. As a result of the study, there is no significant difference between 15 min/bed and 20 min/bed images during the 18F-flutemetamol PET/CT test, so it can be said that it is clinically useful to reduce the image acquisition time selectively using 15 min/bed via list mode depending on the patient's condition.

A Study on the Establishment and Operation of a Regulatory Response Framework in connection with the Regulatory Strength of the Licensing Policy for New Medical Devices -Focusing on the Application of FMEA- (의료기기 신제품의 인허가정책 규제강도에 연계한 규제대응 프레임워크 수립 및 운영에 관한 연구 - FMEA 적용을 중심으로 -)

  • Kim, Gyosu;Ru, Gyuha;Kim, Yeonhee
    • Journal of Technology Innovation
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    • v.28 no.4
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    • pp.1-26
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    • 2020
  • Due to the spread of Corona 19 around the world, Infectious Disease Medicine and New Medical Devices such as Diagnostic Agent are being rapidly developed and launched, and for the fast supply and demand of these, each country has eased import regulations or has implemented policies for fast approval(NIDS, 2020). On the other hand, New Developed Medical Devices that are not related to New Infectious Diseases, they are still entering the market through strict licensing and licensing regulations, such as delay and cancellation in the test inspection process, etc. Therefore, This Study specialized in the government-managed laws encountered when New Medical Devices enter the market, derive Factors influencing the Strength of Regulations, analyzes the Strength of Regulations, and proposes a Regulatory Response Framework. The Research Method was conducted by Literature Research, was applied by Failure Mode and Effects Analysis(FMEA) Method, Expert Interview(1st): Idea Collection, Expert Interview(2nd): Validation, and Priority through the Application Process of FMEA Method. A Method of Quantifying the Intensity of Regulation was proposed by multiplying the Impact of the Influencing Factors for each stage of regulation and the Burden Impact for each type of Regulatory Affairs to find the Importance of the Regulatory Factors and multiplying the Severity of the Regulatory Impact. The Implications are that major overseas countries and the Korean government are actively responding with Special Regulatory Policies and Mitigation Policies for fast licensing of New Developed Medical Devices in accordance with Corona 19. It is expected that the direction for improvement of regulations and measures to respond to regulations will be implemented so that a more proactive and preemptive response to the regulatory process of the licensing policy for New Devices can be achieved.

3D Histology Using the Synchrotron Radiation Propagation Phase Contrast Cryo-microCT (방사광 전파위상대조 동결미세단층촬영법을 활용한 3차원 조직학)

  • Kim, Ju-Heon;Han, Sung-Mi;Song, Hyun-Ouk;Seo, Youn-Kyung;Moon, Young-Suk;Kim, Hong-Tae
    • Anatomy & Biological Anthropology
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    • v.31 no.4
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    • pp.133-142
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    • 2018
  • 3D histology is a imaging system for the 3D structural information of cells or tissues. The synchrotron radiation propagation phase contrast micro-CT has been used in 3D imaging methods. However, the simple phase contrast micro-CT did not give sufficient micro-structural information when the specimen contains soft elements, as is the case with many biomedical tissue samples. The purpose of this study is to develop a new technique to enhance the phase contrast effect for soft tissue imaging. Experiments were performed at the imaging beam lines of Pohang Accelerator Laboratory (PAL). The biomedical tissue samples under frozen state was mounted on a computer-controlled precision stage and rotated in $0.18^{\circ}$ increments through $180^{\circ}$. An X-ray shadow of a specimen was converted into a visual image on the surface of a CdWO4 scintillator that was magnified using a microscopic objective lens(X5 or X20) before being captured with a digital CCD camera. 3-dimensional volume images of the specimen were obtained by applying a filtered back-projection algorithm to the projection images using a software package OCTOPUS. Surface reconstruction and volume segmentation and rendering were performed were performed using Amira software. In this study, We found that synchrotron phase contrast imaging of frozen tissue samples has higher contrast power for soft tissue than that of non-frozen samples. In conclusion, synchrotron radiation propagation phase contrast cryo-microCT imaging offers a promising tool for non-destructive high resolution 3D histology.

The Effects of Group Play Activities Based on Ayres Sensory Integration® on Sensory Processing Ability, Social Skill Ability and Self-Esteem of Low-Income Children With ADHD (Ayres의 감각통합(Ayres Sensory Integration®) 그룹 놀이 활동이 저소득층 ADHD 아동의 감각처리능력, 사회적 기술능력과 자아존중감에 미치는 효과)

  • Lee, Nahael;Chang, Moonyoung;Lee, Jaeshin;Kang, Jewook;Yeo, Seungsoo;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.16 no.2
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    • pp.1-14
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    • 2018
  • Objective : The present study investigated the effects of group play activities based on Ayres Sensory $Integration^{(R)}$ (ASI) on sensory processing ability, social skill ability and self-esteem of low-income children with attention deficit hyperactivity disorder (ADHD). Methods : A total of 20 low-income participants with children with ADHD were recruited and divided into an experimental group (n=10) and a control group (n=10). Sensory processing ability was measured via the Short Sensory Profile (SSP). Social skill ability was measured via the Social Skills Rating System (SSRS). To measure self-esteem, the Rosenberg's self- esteem scale was used. The experimental group received the $ASI^{(R)}$ group play activities for 50 minutes, twice per week for six weeks, while the control group did not receive an intervention. Level of significance of all statistical analyses was .05. Results : Social skill ability (F=4.443, p=.05), cooperation (F=5.328, p=.035) and self-esteem (F=5.358, p=.033) differed significantly between groups after the intervention. Conclusion : Our findings indicate that the group play activities based on $ASI^{(R)}$ are effective in improving social skill ability and self-esteem. This study provided a theoretical basis for the claim that sensory integration therapy should be applied in general elementary schools.

The Effect of Woogakseungmatang Extract on NO Production in LPS- Stimulated RAW 264.7 Cells (우각승마탕이 LPS로 유도된 RAW 264.7 세포에서 NO 생산에 미치는 영향)

  • Jo, Na Young
    • Korean Journal of Acupuncture
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    • v.35 no.4
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    • pp.166-173
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    • 2018
  • Objectives : Woogakseungmatang is a prescription medication mainly used to treat facial paralysis in Korean medicine. The purpose of this study is to investigate the effects of Woogakseungmatang on anti-inflammation and anti-oxidation. Methods : Woogakseungmatang was extracted using hot water. Cytotoxicity was assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT) method; nitric oxide(NO) production and Prostaglandin $E_2$ ($PGE_2$) production in RAW cells treated with Woogakseungmatang were investigated; and the cytokine changes associated with inflammation were examined. The antioxidant capacity of Woogakseungmatang was measured using the 1,1-diphenyl-2-picrylhydrazyl (DPPH) method. Results : RAW cells treated with Woogakseungmatang showed 90% cell viability at a $100-{\mu}g/ml$ concentration. NO production was decreased by 15% at a $100-{\mu}g/ml$ concentration. $PGE_2$ production was decreased by 18% at a $100-{\mu}g/ml$ concentration. Interleukin $1{\beta}$ ($IL-1{\beta}$), interleukin 6(IL-6), and tumor necrosis factor-${\alpha}$ ($TNF-{\alpha}$) were significantly reduced at $100{\mu}g/ml$ compared with those in the control group. The DPPH free radical scavenging capability was more than 50% at $100{\mu}g/ml$. Conclusions : Woogakseungmatang showed only a slight anti - inflammatory effect at $100{\mu}g/ml$ and it was difficult to confirm the concentration-dependent anti-inflammatory effect. Therefore, this study means to confirm the potential anti-inflammatory effects of Woogakseungmatang. Based on this research, more systematic and diverse studies should be conducted.

Correlation between Carotid Intima-media Thickness and Risk Factors for Atherosclerosis (경동맥 내중막 두께에 따른 죽상경화반의 위험요인과의 상관관계)

  • An, Hyun;Lee, Hyo Yeong
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.339-348
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    • 2019
  • The purpose of this study was to investigate the effect of carotid artery ultrasound Respectively. The carotid intima-media thickness is known to have a significant correlation with cardiovascular disease and cerebrovascular disease. We investigated the relationship between carotid intima - media thickness, body mass index, waist circumference, the blood lipid value, fasting blood glucose, glycated hemoglobin, and blood pressure using carotid artery ultrasound. The carotid artery ultrasound was considered to be abnormality of IMT thickness over 0.8 mm and the presence or absence of atherosclerotic plaque was evaluated. Serological tests were used to compare the geologic value, fasting blood glucose level, and glycated hemoglobin. As a result, waist circumference (=.022), low density cholesterol (=.004), fasting blood glucose level (.019), and glycemic index (.002) were analyzed as predictors of atherosclerosis. In the ROC curve analysis, sensitivity was 87.80% (95% CI: 73.8-95.9), specificity was 41.67% (95% CI: 30.2-53.9), sensitivity was 78.05% (95% CI: 62.4-89.4) in low density lipoprotein, Specificity was 50.00% (95% CI: 38.0-62.0), sensitivity was 73.11% (95% CI: 57.1-85.8), specificity was 61.11 (95% CI: 48.9-72.4) and sensitivity was 82.93%-91.8) and a specificity of 43.06% (31.4-55.3). In logistic regression analysis, the risk of atherosclerosis was 0.248 times at waist circumference (WC)> 76 cm, 3.475 times at low-density lipoprotein (LDL-C) ${\geq}124mg/dL$, 0.618 at HbA1c> 5.4% It appeared as a times. We suggest that prospective study of carotid artery ultrasound should be performed for the effective prevention of cardiovascular diseases.