• Title/Summary/Keyword: 신경학적 검사

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The Resting and Exercise Related Oxygen Desaturation as the Associated Factor for Sleep Related Oxygen Desaturation in Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자의 수면 중 산소포화도 감소에 대한 예측인자로서 안정시 및 운동시 산소포화도)

  • Shin, Chang-Jin;Lee, Kwan-Ho;Park, Hye-Jung;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.231-238
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    • 1999
  • Background: Nocturnal hypoxemia occurs in patients with chronic obstructive pulmonary disease(COPD) and the detection and treatment of nocturnal hypoxemia should be part of the management of COPD patients. We performed this study to evaluate the factors influencing to sleep related arterial oxygen desaturation($SaO_2$) in patients with COPD. Methods: Resting and exercise cardiopulmonary function test, polysomnography, and $SaO_2$ during resting, exercise and sleep were measured in 12 patients with COPD. Results: The $SaO_2$ fell twice as much during sleep as during maximal exercise($13.1{\pm}9.3%$ fall in nocturnal $SaO_2$ vs. $6.4{\pm}3.3%$, p<0.05). Fall in nocturnal $SaO_2$ was well correlated with mean exercise $SaO_2$(r=-0.78, p<0.05), minimum exercise $SaO_2$(r=-0.90, p<0.01), and resting $SaO_2$(Cr=-0.82, p<0.05). Lowest sleep $SaO_2$ was well correlated with mean exercise $SaO_2$(r=0.80, p<0.05), lowest exercise $SaO_2$(r=0.90, p<0.01), and resting $SaO_2$(r=0.84, p<0.05). Conclusion: Resting and exercise $SaO_2$ was well correlated with nocturnal $SaO_2$, but exercise study add no additional information to predicting the nocturnal oxygen desaturation in patients with COPD.

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The Effect of External Radiation Therapy for Intracrania1 Arteriovenous Malformation - Conventional Radiation Therapy vs Stereotactic Radiosurgery - (뇌동정맥성 기형의 외부방사선 치료 효과)

  • Kim In Ah;Jang Hong Suk;You Mi Ryung;Yoon Sei Chul;Kim Moon Chan;Shinn Kyung Sub;Bahk Yong Whee
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.53-58
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    • 1991
  • From February 1987 through July 1990, the seventeen cases of inoperable intracranial arteriovenous malformation (AVM) were treated using 6 MV linear accelerator at the Division of Therapautic Radiology, Kang Nam 51. Mary's Hospital. Of seventeen cases, fourteen were male and three were female. Ages ranged from 10 to 51 years (median age of 25 years). The main symtoms were headache, epilepsy and hemiparesis in decreasing order of frequency. The middle cerebral artery is the most common origin of the feeding vessel $(41.2\%)$. Four were treated by conventionally fractionated radiation therapy (CRT, thirteen were treated by stereotactic radiosurgery (RS). duration or follow-up in CRT and RS group were 4 to 43 months (median 33 months) and 3 to 12 months (median 13 months), respectively. When the response was assessed by radiologic follow-up study, two of four CRT group showed minimal response. Of thirteen cases of RS group, two $(15.4\%)$ showed complete response, five $(38\%)$ partial response, two $(15.4\%)$ minimal response and four $(30.7\%)$ no response by the same assessment. There was no statistical significance in terms of follow-up period (p=0.22), size of lesion (p=0.82) and treated dose (p=0.05). Further accumulation of experience is recommended with proper case selection and sufficient follow-up period.

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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.

Recurrent ossifying and cemento-ossifying fibroma of the jaws;report of 2 cases (재발된 골섬유종과 백악질골섬유종)

  • Ryu, Sun-Youl;Oh, Hee-Kyun;Kim, Geon-Jung;Yun, Young-Su;Choi, Hong-Ran
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.297-308
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    • 1989
  • These are two case reports of recurrent ossifying and cemento-ossifying fibroma in a year or 5 months following conservative treatment. Ossifying fibroma or cemento-ossifying is a relatively uncommon benign fibro-osseous tumor of the jaws, and is generally believed to originate from periodontal ligaments. In recent, it is not demanded more differentiation of ossifying, cementifying and cemento-ossifying fibroma due to the thought that these lesions represent a spectrum of the same disease process rather than separate entities. The tumor commonly presents as an asymptomatic mass lesion and is usually well-circumscribed clinically so that conservative surgical excision has been the treatment of choice, but on occasion extended surgical procedures may become necessary, especially for those tumors which demonstrate rapid expansions and are poorly encapsulated (either initially or when recurrent) and when tumor growth is progressed aggressively or recurrent. En-bloc resection of mandible with iliac bone and inferior alveolar nerve graft was performed in case 1, recurrent cemento-ossifying fibroma of 32-year old male patient, and extended surgical enucleation of mass including normal marginal bone was done in case 2, recurrent ossifying fibroma of 72-year old female patient. By follow-up check of the patients, we obtained good result without any sings of recurrence.

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Lipomatous Tumors in Hand (수부에 발생한 지방종성 종양)

  • Lee, Kwang-Hyun;Lee, Bong-Gun;Bong, Hyun-Jong
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.131-139
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    • 2008
  • Purpose: Lipomatous tumor occurred in hand is very rare. There is a broad spectrum of lipomatous tumors including lipomas, variants of lipomas, lipomatosis, liposarcomas and so on. We report the clinical features of 11 cases of lipomatous tumor which occurred in hand. Materials and Methods: Between 1992 and 2008, 11 cases were histologically diagnosed as lipomatous tumor in hand. We reviewed all medical records and clinical photographs retrospectively and ascertained recurrence by telephone interview. Results: Eight cases were ordinary lipomas. Three cases were angiolipoma, fibrolipoma and atypical lipoma respectively. Four cases occurred in finger, two cases in thenar area, two cases in hypothenar area, one case in palm, two cases in wrist. All cases were situated on volar surface. All patients complained of palpable masses. One patient with subungal angiolipoma felt pain. There was no neurologic sign or vascular symptom preoperatively. In one case, postoperative complication (hypoesthesia in $5^{th}$ finger) was developed. There was no local recurrence. Conclusion: In our study, lipomatous tumors occurred in hand did not recur. Patients mainly complained of feeling of lump. Pain was uncommon symptom. Postoperative complication was rare if operation was performed carefully.

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Effects of Goal Management Training According to Bilateral Activities of Autism Spectrum Disorders: Pilot Study (자폐스펙트럼 장애 아동에게 목표관리 훈련이 양측활동에 미치는 영향: 예비연구)

  • Ahn, Si-Nae
    • Journal of Korean Society of Neurocognitive Rehabilitation
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    • v.10 no.2
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    • pp.1-7
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    • 2018
  • The study has compared normally developed children and children who were diagnosed as autism spectrum in goal management training them to observe the effect. The research was conducted to four normally developed children and four children who were diagnosed as autism spectrum, and all subjects were provided with identical goal management training. The children and the caregivers have selected desired objectives activity, and all three activities were followed by goal management training. Intervention periods were conducted ten times in total, two times a week for five weeks, and eight subjects in the two groups were trained one on one by the researcher. The training time was 40 minutes for every session. The descriptive statistics and frequency analysis were used as the statistical method, and the Mann-Whitney test, the nonparametric statistical analysis, was conducted to compare the difference between the two groups. Goal management training for two groups did not show a statistically significant difference in terms of the performance status of Canadian Occupational Performance Measure (p>.05). In the summary of Bruininks-Oseretsky Test of Motor Proficiency (2nd) which evaluates the motor skill, there was a statistically significant difference between the autism spectrum disorder group and normal group (p<.05). Additionally, the two groups showed a statistically significant difference in eye-hand coordination sub-test among Developmental Test of Visual Perception (2nd) which evaluates the visual perception performance (p<.05). The research has confirmed the applicability of goal management training to children with autism spectrum compared to the normally developed children, and it has confirmed the effectiveness of the training.

Deep Learning in Thyroid Ultrasonography to Predict Tumor Recurrence in Thyroid Cancers (인공지능 딥러닝을 이용한 갑상선 초음파에서의 갑상선암의 재발 예측)

  • Jieun Kil;Kwang Gi Kim;Young Jae Kim;Hye Ryoung Koo;Jeong Seon Park
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1164-1174
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    • 2020
  • Purpose To evaluate a deep learning model to predict recurrence of thyroid tumor using preoperative ultrasonography (US). Materials and Methods We included representative images from 229 US-based patients (male:female = 42:187; mean age, 49.6 years) who had been diagnosed with thyroid cancer on preoperative US and subsequently underwent thyroid surgery. After selecting each representative transverse or longitudinal US image, we created a data set from the resulting database of 898 images after augmentation. The Python 2.7.6 and Keras 2.1.5 framework for neural networks were used for deep learning with a convolutional neural network. We compared the clinical and histological features between patients with and without recurrence. The predictive performance of the deep learning model between groups was evaluated using receiver operating characteristic (ROC) analysis, and the area under the ROC curve served as a summary of the prognostic performance of the deep learning model to predict recurrent thyroid cancer. Results Tumor recurrence was noted in 49 (21.4%) among the 229 patients. Tumor size and multifocality varied significantly between the groups with and without recurrence (p < 0.05). The overall mean area under the curve (AUC) value of the deep learning model for prediction of recurrent thyroid cancer was 0.9 ± 0.06. The mean AUC value was 0.87 ± 0.03 in macrocarcinoma and 0.79 ± 0.16 in microcarcinoma. Conclusion A deep learning model for analysis of US images of thyroid cancer showed the possibility of predicting recurrence of thyroid cancer.

Diagnostic Performance Using a Combination of MRI Findings for Evaluating Cognitive Decline (인지기능 저하평가를 위한 MR 영상 소견 조합의 진단능)

  • Jin Young Byun;Min Kyoung Lee;So Lyung Jung
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.184-196
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    • 2024
  • Purpose We investigated potentially promising imaging findings and their combinations in the evaluation of cognitive decline. Materials and Methods This retrospective study included 138 patients with subjective cognitive impairments, who underwent brain MRI. We classified the same group of patients into Alzheimer's disease (AD) and non-AD groups, based on the neuropsychiatric evaluation. We analyzed imaging findings, including white matter hyperintensity (WMH) and cerebral microbleeds (CMBs), using the Kruskal-Wallis test for group comparison, and receiver operating characteristic (ROC) curve analysis for assessing the diagnostic performance of imaging findings. Results CMBs in the lobar or deep locations demonstrated higher prevalence in the patients with AD compared to those in the non-AD group. The presence of lobar CMBs combined with periventricular WMH (area under the ROC curve [AUC] = 0.702 [95% confidence interval: 0.599-0.806], p < 0.001) showed the highest performance in differentiation of AD from non-AD group. Conclusion Combinations of imaging findings can serve as useful additive diagnostic tools in the assessment of cognitive decline.

Results of Stereotactic Radiosurgerv with Linear Accelerator for Intracranial Arteriovenous Malformation (두개강내 동정맥기형에서 선형가속기를 이용한 방사선수술의 결과)

  • Lee Kang Kyoo;Park Kyung Ran;Lee Jong Young;Lee Yong Ha
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.215-224
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    • 1997
  • Purpose : Stereotactic radiosurgery with external beam irradiation successfully obliterates carefully selected intracranial arteriovenous malformation (AVM) . We Present clinical and radiological long term results after treatment with a single high dose irradiation using a linear accelerator. Materials and Methods : Rrom January 1991 to June 1994, fifteen patients with intracranial AVM were treated in our hospital with the stereotactic radiosurgery using a linear accelerator. The radiation was delivered using a 6 MV linear accelerator. The prescribed doses at the isocenter varied from 1800 to 2500cGy (median : 2000cGy) and were given as a sin91e fraction. The radiation doses at the periphery of the lesion typically corresponded to the 80-90% isodose line. In 14 patients, complete clinical and/or radiological follow-up examination were available. Results : Angiography was available in 13 patients with a follow-up Period from 18 months to 27 months. Of 13 patients, the overall complete obliteration rate was 92.3% (12 patients). This incidence did not correlate with lesion size. Seizure, headache and progressive neurologic deficit were complete recovered. One Patient experienced hemorrhage at 2 months after treatment. One patient developed radiation induced brain edema in the white matter surrounding nidus at 16 months after treatment and showed complete resolution of the edema in MR image obtained at 27 months after treatment. After a follow-up period of up to 6 years, no radiation induced severe late complications occurred. Conclusion : We conclude that stereotactic radiosurgery using a linear accelerator is an effective and safe therapy for symptomatic and surgically inaccessible intracranial AVMs and the results compare favorably to the more expensive and elaborate systems that are currently available for stereotactic radiosurgery.

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NEW ANTIDEPRESSANTS IN CHILD AND ADOLESCENT PSYCHIATRY (소아청소년정신과영역의 새로운 항우울제)

  • Lee, Soo-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.12-25
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    • 2003
  • Objectives:As increasing number of new antidepressants have been being introduced in clinical practice, pharmacological understanding has been broadened. These changes mandate new information and theories to be incorporated into the treatment process of children with depressive disorders. In light of newly coming knowledge, this review intended to recapitulate the characteristics of new antidepressants and to consider the pivotal issues to develope guidelines for the treatment of depression in childhood and adolescence. Methods:Searching the Pub-Med online database for the articles with the key words of 'new', 'antidepressants' and 'children' ninety-seven headings of review articles were obtained. The author selected the articles of pertinent subjects in terms of either treatment guideline or psychopharmacology of new antidepressants. When required, articles about the clinical effectiveness of individual antidepressants were separatedly searched. In addition, the safety information of new antidepressants was acquired by browsing the official sites of the United States Food and Drugs Administration and Department of Health and Human Services. Results:1) For the clinical course, treatment phase, and treatment outcome, the reviews or treatment guidelines adopted the information from adult treatment guidelines. 2) Systematic and critical reviews unambiguously concluded that selective serotonin reuptake inhibitors(SSRIs) excelled tricyclic antidepressants( TCAs) for both efficacy and side effect profiles, and were recommend for the first-line choice for the treatment of children with depressive disorders. 3) New antidepressants generally lacked treatment experiences and randomized controlled clinical trials. 4) SSRIs and other new antidepressants, when used together, might result in pharmacokinetic and/or pharmacodynamic drug-to-drug interaction. 5) The difference of the clinical effectiveness of antidepressants between children and adults should be addressed from developmental aspects, which required further evidence. Conclusion:Treatment guidelines for the pharmacological treatment of childhood and adolescence depression could be constructed on the basis of clinical trial findings and practical experiences. Treatment guidelines are to best serve as the frame of reference for a clinician to make reasonable decisions for a particular therapeutic situation. In order to fulfill this role, guidelines should be updated as soon as new research data become available.

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