• Title/Summary/Keyword: 통증 측정

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MR T2 Map Technique: How to Assess Changes in Cartilage of Patients with Osteoarthritis of the Knee (MR T2 Map 기법을 이용한 슬관절염 환자의 연골 변화 평가)

  • Cho, Jae-Hwan;Park, Cheol-Soo;Lee, Sun-Yeob;Kim, Bo-Hui
    • Progress in Medical Physics
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    • v.20 no.4
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    • pp.298-307
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    • 2009
  • 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.

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The Causes Analysis for the Number of Patients Waiting in General X-ray Room (Focus on Utilization of Quality Improvement (QI)) (일반촬영실의 환자대기건수에 대한 원인별 분석 - QI 활용을 중심으로 -)

  • Dong, Kyung-Rae;Chung, Woon-Kwan;Kim, Chang-Bok;Park, Yong-Soon;Kim, Ho-Sung;Im, In-Chul;Lee, Chang-Lae;Shin, Gyoo-Seul
    • Journal of radiological science and technology
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    • v.31 no.4
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    • pp.337-346
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    • 2008
  • A questionaire survey was conducted for patients who had been examined at the Department of Radiology to investigate the items that need to be improved. Brainstorming was also conducted by team members to suggest the tactics that can efficiently perform the QI activity by selecting the most frequently answered topics for the reduction of waiting time of x-ray examination. From September 2006 to November 2007, number of patients before and after conducting QI was compared for 3 months by each category differentiated by types of detailed causes. A patient case was set as one shooting for one patient. After conducting QI, the waiting cases before conducting QI were evaluated for the method of improvement for 3 month through the QI team discussion and conducted by following the improvement method for the next 1 month and the waiting cases were measured and the difference before and after the QI activity was compared in percentage. 1. When patient waiting cases were compared before and after conducting QI activity against the causes of repetition, it resulted in 3.9% of reduction effect. 2. When patient waiting cases were compared before and after conducting QI activity against the causes for the lack of guiding, it resulted in 1.1% of reduction effect. 3. When patient waiting cases were compared before and after conducting QI activity against the causes of miss-inputting prescription, it resulted in 1.1% of reduction effect. 4. When patient waiting cases were compared before and after conducting QI activity against the causes for emergency patients, patients with acute pain and discomfort patients, it resulted in 12.0% of reduction effect. 5. When patient waiting cases were compared before and after conducting QI activity against the causes for shooting overlapping of outpatients and hospitalized patients, it resulted in 4.7% of reduction effect. There are many factors to reduce the patient waiting cases in radiography. The first step is for radiology department to find these factors through QI, to improve them, which is the reason why the QI team is organized to perform the QI activities.

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Effects of Shoulder Muscle Strength on Terminal Range by Humeral Head Retroversion (상완골 후경각이 가동역에 따른 견관절 근력에 미치는 영향)

  • Park, Si-Young;Lee, Dong-Jun
    • Journal of Life Science
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    • v.20 no.4
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    • pp.549-554
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    • 2010
  • Increased external rotation and decreased internal rotation have been noted to occur progressively in the throwing shoulders of baseball pitchers. The purpose of this study was to provide descriptive data for terminal range eccentric antagonist/concentric agonist shoulder muscle strength in collegiate baseball pitchers with humeral head retroversion diagnosed through MRI. The dominant and non-dominant shoulders of 9 asymptomatic baseball pitchers were tested through a range of 20 degrees of external rotation to 90 degrees of internal rotation using the Biodex system 3 isokinetic dynamometer at speeds of $90^{\circ}/s$ and $180^{\circ}/s$. Differences between the dominant and non-dominant shoulders were assessed using the paired samples t-test. Total range of motion, measured at $90^{\circ}$ of glenohumeral abduction, was $180.1^{\circ}$ for dominant shoulders and $183.7^{\circ}$ for non-dominant shoulders. Humeral head retroversion measured $47.6{\pm}6.1^{\circ}$ in dominant and $37.8{\pm}5.3^{\circ}$ in non-dominant extremities. The mean internal rotator concentric contraction (IR-Con) showed a significant difference compared to $31.5{\pm}5.1$ (Nm) in dominant and $38.7{\pm}5.2$ (Nm) in non-dominant shoulders at $180^{\circ}/s$ (p<0.05). The mean external rotator eccentric contraction (ER-Ecc) showed a significant difference compared to $20.3{\pm}4.7$ (Nm) in dominant and $25.1{\pm}3.7$ (Nm) in non-dominant shoulders at $90^{\circ}/s$ (p<0.05). There is a pattern of increased external rotation and decreased internal rotation in the dominant extremity that significantly correlates with an increase in humeral retroversion.

Midterm Results of the Modified Kidner Procedure for the Symptomatic Accessory Navicular in Athletes (운동 선수에서 발생한 동통성 부주상골의 변형 Kidner 술식의 중기 결과)

  • Lee, Kyung Tai;Kim, Ki Chun;Young, Ki Won;Park, Young Uk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.2
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    • pp.82-86
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    • 2012
  • Purpose: The purpose of this study was retrospectively to evaluate the results of the modified Kidner procedure for symptomatic accessory navicular in athletes. Materials and Methods: Between July 1999 and December 2004, 26 feet in 22 patients with symptomatic accessory navicular who had underwent modified Kidner procedure were available for clinical follow-up, and 12 cases in 9 patients were available for clinical and radiological follow-up with a minimum follow-up of 5 years were included in this study. All those patients had symptomatic accessory navicular bone who underwent modified Kidner procedure. American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, Visual Analogue Scale (VAS), and satisfaction rate were investigated. Talo-first metatarsal (T-MT1) angle, talo-calcaneal (TC) angle, and calcaneal pitch (CP) angle were measured in standing lateral radiograms. Results: AOFAS score was improved from $40.8{\pm}7.5$ (32~57) preoperatively to $88.7{\pm}8.0$ (72~100) postoperatively, and the difference was significant (p<0.01). VAS was improved from $7.0{\pm}0.9$ (5~9) preoperatively to $1.8{\pm}0.8$ (1~4) postoperatively, and the difference was significant (p<0.01). At the lastest follow up, 11 feet were very satisfied, 11 feet satisfied, and 4 feet unsatisfied (a satisfaction rate 85.0%). No significant difference was observed for T-MT1 angle (p=0.67), TC angle (p=0.93), and CP angle (p=0.49). Conclusion: Modified Kidner procedure for the symptomatic accessory navicular showed satisfactory results and is appeared to be one of the useful treatments.

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Identification of Genes Connected with the Sensitivity to 5-FU and Cisplatin in Squamous Cell Carcinoma Cell Lines (편평세포암 세포주에서 5-FU와 Cisplatin에의 감수성과 관련된 유전자의 동정)

  • Choi, Na-Young;Kim, Ok-Joon;Lee, Geum-Sug;Kim, Byung-Gook;Kim, Jae-Hyeong;Jang, Youn-Young;Lim, Won-Bong;Chong, Min-A;Choi, Hong-Ran
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.287-300
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    • 2005
  • Squamous cell carcinoma (SCC) in head and neck show a variability in the response to chemotherapy, even when it present with similar histological tumor type, grade, and clinical stage. The purpose of present study it to identify predictive bio-marker for the sensitivity or resistance to conventional chemotherapeutic agents, 5-fluorouracil (5-FU) and Cisplatin Oral cancer cell lines were used in present study. MTT assay was performed to evaluate the sensitivity and/or resistance to 5-FU and Cisplatin. And RT-PCR was carried out for evaluation of the mRNA expressions of various genes associated with mutation, inflammation (COX pathway), cell cycle, senescence and extracellular matrix (ECM). The molecules which are correlated with the sensitivity to 5-FU are XPA, XPC, OGG, APEX, COX-2, PPAR, Cyclin E, Cyclin B1, CDC2, hTERT, hTR, TIMP-3, TIMP-4 and HSP47. And the molecules are correlated with the sensitivity to Cisplatin are COX-1, iNOS, eNOS, PCNA, collagen 1 and MMP-9. Taken together, when choosing the appropriate chemotherpeutic agents for patients, considering the molecules which are correlated or reversely correlated is helpful to choose the resonable agents for cancer patients.

Reliability of a Questionnaire for Evaluation of Dry Mouth Symptoms (구강건조증 증상 평가를 위한 설문지의 신뢰도에 관한 연구)

  • Lee, Jeong-Yun;Lee, Young-Ok;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.30 no.4
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    • pp.383-389
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    • 2005
  • Xerostomia is defined as a subjective complaint of dry mouth that may be perceived when there is insufficient mucosal wetting. However, the diagnosis and treatment of xerostomia is not that simple because of the fact that the subjective awareness of dry mouth is not always correlated with a diminution in the flow of saliva and there is always a difference between individuals in salivary flow rates needed for normal oral function. In the present study, the aim was to develop a questionnaire to evaluate the dry mouth symptoms and to analyze its reliability and usability as a diagnostic and analytic tool for xerostomia. The questionnaire which consists of 6 Visual Analogue Scale(VAS) type questions to evaluate the subjective oral dryness and 4 questions to evaluate behavior to avoid oral dryness was developed and administered twice with 1 week's interval to the healthy 88 young adults without dry mouth symptoms(44 males and 44 females; mean age was $25.6{\pm}3.1$ years in male and $24.3{\pm}2.1$ years in female). The results were as follows. 1 The intraclass correlation coefficients of 6 questions to evaluate the subjective oral dryness were as significantly high as 0.767 for the degree of oral dryness at other times of the day, 0.850 for the amount of saliva in the mouth, and 0.791 for the degree of effect on daily life due to oral dryness and as high as 0.563 for the degree of oral dryness at night or on awakening, 0.674 for the degree of oral dryness during eating, and 0.641 for the degree of difficulty in swallowing foods. 2. Cronbach's alpha value of 6 questions was 0.982. It can be concluded that the series of questions to evaluate the subjective oral dryness has high internal consistency. 3. Cohen's kappa values of 4 questions to evaluate behavior to relieve oral dryness were as significantly high as 0.850 for the frequency of keeping a glass of water at the bedside and as high as 0.506 the frequency of awakening during sleeping due to oral dryness, 0.419 for the frequency of sipping liquids to aid in eating dry foods, and 0.407 for the frequency of using a candy or chewing gum due to oral dryness. From the results, it can be concluded that the questionnaire consisting of 6 VAS type questions to evaluate the subjective oral dryness and 4 questions to evaluate behavior to relieve oral dryness has reliability of good to excellent level, and that the series of 6 VAS type questions has significantly high internal consistency to evaluate the subjective oral dryness.

Short-term Outcomes of Arthroscopic Transtendinous Repair in Partial Articular Side Tears of the Rotator Cuff (회전근 개 부분 관절측 파열에 대한 관절경적 경 건 봉합술의 단기 결과)

  • Shin, Sung-Ryong;Yoo, Yon-Sik;Kim, Do-Young;Lee, Sang-Soo;Jeong, Un-Seob;Choi, Hyun-Seok
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.112-117
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    • 2008
  • Purpose: This study prospectively evaluated the outcome of arthroscopic transtendinous repair as a treatment for partial articular side tears of the rotator cuff. Materials and Methods: Fifteen patients with symptomatic, partial articular side tears of the rotator cuff underwent modified transtendinous repair. The patient's mean age was 52.5 years and the mean duration of symptoms was 33.7 weeks. The visual analogue scale (VAS), the ASES score, the active ROM of the shoulder and the patient's satisfaction were evaluated both preoperatively and postoperatively. The clinical results were analyzed using the Wilcoxon's signed rank test. Results: The mean VAS was $6.6\pm1.1$ before treatment and $0.4\pm0.6$ at 6 month, and the ASES scores for all the patients were significantly better over the six-month period of follow-up (p<0.05). The mean active ROM in abduction was $94.3\pm22.3$ before treatment, $108.7\pm16.3$ at 1 month (p=0.0041) and $164.3\pm5.3$ at six months (p=0.0006). In flexion, it was $105.0\pm23.8$ before treatment, $119.0\pm17.4$ at 1 month(p=0.0075) and $174.3\pm5.3$ at six months (p=0.0006). At the final follow-up, 94% of patients were satisfied or very satisfied after operation. Conclusion: We experienced satisfactory clinical results after a short-term follow-up of arthroscopic transtendinous repair, and we believed this to be an effective procedure for patients with partial articular side tears of the rotator cuff.

The Research of Comparison Evaluation on the Decline in Artifact Using Respiratory Gating System in PET-CT (PET-CT 검사 시 호흡동조 시스템을 이용한 인공물 감소에 대한 비교 평가)

  • Kim, Jin-Young;Lee, Seung Jae;jung, Suk;Park, Min-Soo;Kang, Chun-Goo;Im, Han-Sang;Kim, Jae-Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.2
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    • pp.63-67
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    • 2015
  • Purpose Among various causes that influence image quality degradation, various methods for decrease in Artifact occurred by respiration of patients are being used. Among them, this study intended to evaluate CTAC Shift correction method and additional scan compare to the Scan(Q static scan) using respiratory gated system. Materials and Methods This study was conducted on 10 patients, and used PET-CT Discovery 710 (GE Healthcare, MI, USA) and Varian's RPM system. 5.18 Mbq per kg of $^{18}F$-FDG was injected on patients, asked them to take a rest for 1 hour in the bed, and conducted test after urination. Images were visualized through Q static scan, CTAC Shift correction method, Additional scan based on the Whole body scan(WBS) with Artifact. Decrease in Artifact was compared in each image, conducted Gross Evalution, and measured changes of SUVmax. Results For image obtained through the CTAC Shift correction method through WBS with Artifact, 12~56%, Q static scan image showed 17~54% of change rate and Additional Scan showed -27~46% of change rate. In Blind Test, the CTAC Shift correction image showed the highest point with 4 points, Q static scan image showed 3.5 points, and Additional scan image showed 3.4 points. The standardized WBS scan through Oneway ANOVA and three types of Scan method showed significant difference(p<0.05), and did not show significant difference between the three Scan methods(p>0.05). However, the three Scan methods showed significant difference in Blind test. Conclusion Additional scan and Q static scan require more time than the CTAC Shift correction method, there is concern about excessive exposure to patients by CT rescan and Q static scan is difficult to apply on patients with inconsistent respiration or irregular respiration cycle due to pain. For CTAC Shift correction method, limited correction is possible and the range is limited as well. It is considered as a useful method of improving diagnostic value when hospitals use the system appropriately and develop various advantageous factors of each method.

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Low Dose Spinal Anesthesia for Ambulatory Surgery of Varicose Vein (하지정맥류의 외래수술을 위한 저용량 척추마취)

  • Yang, Jin-Sung;Park, Young-Woo;Lee, Jae-Wook;Won, Yong-Soon;Shin, Hwa-Kyun;Lee, Dong-Gi
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.233-237
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    • 2009
  • Background: Bupivacaine with fentanyl might be suitable as the spinal anesthesia for performing ambulatory surgery to treat varicose vein. Material and Method: Thirty patients who underwent spinal anesthesia for a varicose vein operation were enrolled in this study. They were classified into 2 groups of either fentanyl 25ug mixed with bupivacaine 4mg (group FB4) or bupivacaine 8mg (group B8). We compared the groups for the success of the analgesia, the recovery time from sensory and motor block, the side effects and the postoperative complications. Result: The groups did not differ significantly regarding the success of analgesia (13 of 15 [group FB4], 15 of 15 [group B8]). None of the patients were converted to general anesthesia due to surgical pain. None of the patients required medication for hypotension and/or bradycardia. The operative and nonoperative side effects of motor block (tested for by using a modified Bromage scale) was significantly lower in group FB4 than that in group B8, as checked at 2 hours after spinal anesthesia (p<0.05). Recovery from spinal block was significantly quicker in group FB4 than that in group B8 (p<0.05). The first voluntary micturition time did not differ significantly (6.5 hours v 4.5 hours [p=0.143]) between the groups, but a nelatone catheter was inserted into 2 of the group B8 patients due to dysuria. Conclusion: Adequate intraoperative analgesia and hemodynamic stability and faster mobilization were achieved using bupivacaine 4mg with fentanyl 25ug. Low dose spinal anesthesia with fentanyl is suitable for performing ambulatory surgery to treat varicose vein.

One Anchor Double Fixation (OADF) Technique for Arthroscopic Bony Bankart Repair (두가닥의 봉합사를 가진 봉합나사못을 이용한 새로운 관절경적 골성 방카르트 병변 봉합술)

  • Choi, Eui-Sung;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Shon, Hyun-Chul;Cho, Byung-Ki;Bae, Seung-Hwan
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.40-46
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    • 2010
  • Purpose: The aim of this study was to evaluate the usefulness of arthroscopic Bony Bankart repair using a One Anchor Double Fixation Technique. Materials and Method: Seventeen patients with a Bony Bankart lesion were treated using the One Anchor Double Fixation Technique (OADF Technique). There were 13 males and 4 females. The average age was 24 years (range 17-42). The average follow-up period was 22.3 months. One 3.0 mm suture anchor with doubly loaded sutures was inserted into the glenoid rim. One suture strand was passed the around the small bony fragment and tied first. Another suture strand was passed through the capsule and tied over the bony fragment. The result was measured using Rowe's evaluation index & KSS score. The glenoid defect & bony fragment were measured by 3D-CT scan. Results: Rowe's evaluation index on the final follow-up showed an overall improvement from an average of 54 (range, 23-71) to 83.4 (range 71-90). Of the 17 cases, 13 were excellent, 3 were good, and 1 was fair. KSS scores showed improvement from an average of 71 (range 49-82) to 92.5 (range 82-94). There were no cases where pain continued to the final follow-up, and no cases being re-dislocated during the follow-up period. For six cases, we confirmed the bony healing of the bony Bankart lesion by CT. Conclusion: Bony Bankart lesion repair using this new method achieves excellent clinical results with low recurrence rates and is considered another choice for bony Bankart lesions.