• Title/Summary/Keyword: CSF Analysis

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Utility Analysis for Pegfilgrastim in DLBCL Patients on R-CHOP Regimen (항암치료를 받는 미만성거대비세포 림프종 환자에서 페그필그라스팀에 대한 효용성 평가)

  • Jung, Hee Won;Kim, Jeong Mee;Min, Myung Sook;Lee, Young Mee;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.151-158
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    • 2015
  • Objective: This study was designed to compare pegfilgrastim and filgrastim in diffuse large B-cell lymphoma (DLBCL) patients treated with a rituximab with cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone (R-CHOP) regimen in terms of clinical efficacy and cost-effectiveness. Method: Clinical efficacy was measured by trough level of absolute neutrophil count (ANC), days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, duration of ANC recovery to baseline value, days of ANC less than $0.5{\times}10^9cells/L$, and difference of peak and trough level of ANC during 1 cycle of R-CHOP regimen. To evaluate cost-effectiveness, total prices of used filgrastim and pegfilgrastim within 1 cycle of R-CHOP were analyzed. Results: In terms of clinical efficacy, trough level of ANC and days to ANC recovery showed statistical significance. The median trough levels of ANC with administration of filgrastim and pegfilgrastim were 0.18 and 1.94 (p = 0.021), respectively, and the median durations of ANC recovery to baseline value were 5.5 days and 2 days (p = 0.023), respectively. For the median days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, days of ANC less than $0.5{\times}10^9cells/L$, and difference of peak and trough level of ANC during 1 cycle of R-CHOP, the pegfilgrastim group performed better than the filgrastim group. However the difference was not statistically significant. In terms of overall expense during 1 cycle of R-CHOP, pegfilgrastim is about 3.43 times more expensive than filgrastim. Conclusion: Pegfilgrastim is more efficient than filgrastim in terms of clinical efficacy. In terms of prices, pegfilgrastim is more expensive than filgrastim for patients, but it is more convenient in clinical use. Therefore, pegfilgrastim should be the preferred choice of G-CSF for neutropenic patients. Further comparative study of pegfilgrastim and filgrastim is needed.

A Study on the Establishment Strategy of Specialized Institution for Commercializing Railway Technology (철도기술사업화 전문기관 설립방안에 관한 연구)

  • Kim, Jin-Soo;Kwon, Sok Chang;Choi, Hyo-Sun;Jeon, Joong Won
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.3
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    • pp.1531-1540
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    • 2014
  • Since railway industry is becoming important globally, Korea government and private enterprises invest huge amount of R&D expenditure to develop railway technologies. However, ratio of successful commercialization of technology is very limited. establishment strategy of specialized institution for commercializing railway technologies is very important research issue. For example, France and Japan support railway commercialization through the specialized organization in leading the global railway industry. This study propose the critical success factors of the establishment of railway commercialization and suggest relative importance of CSF's through the hierarchical analysis. As a result, the financial resource plan(0.505) and the commercialization strategy(0.193) are important factors at the first level, and the government funding plan(0.220) and the legal/institutional support(0.150) are important factors for the commercialization organization at the second level.

Analytical trends in mass spectrometry based metabolomics approaches of neurochemicals for diagnosis of neurodegenerative disorders (퇴행성신경질환의 진단을 위한 신경전달물질 대사체의 질량 분석법 동향)

  • Lee, Na-Kyeong;Jeon, Won-Jei;Jeong, Seung-Woo;Byun, Jae-Sung;Lee, Wonwoong;Hong, Jongki
    • Analytical Science and Technology
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    • v.30 no.6
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    • pp.355-378
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    • 2017
  • Because neurochemicals are related to homeostasis and cognitive and behavioral functions in human body and because they enable the diagnosis of numerous neurodegenerative disorders, there has been increasing interest in the development of analytical platforms for neurochemical profiling in biological samples. In particular, mass spectrometry (MS)-based analytical methods combined with chromatographic separation have been widely used to profile neurochemicals in metabolic pathways. However, development of delicate sample preparation procedures and highly sensitive instrumental detection is necessary considering the trace levels and chemical instabilities of neurochemicals in biological samples. Therefore, in this review, analytical trends in MS-based metabolomics approaches to neurochemicals in multiple biological samples, such as urine, blood, CSF, and biological tissues, are discussed. This paper is expected to contribute to the development of an analytical platform to discover biomarkers that will aid diagnosis, prognosis, and treatment of neurodegenerative disorders.

Global analysis of Aseptic Meningitis in Pusan Area in 1997 (1997년에 부산지역에서 유행한 무균성 뇌막염)

  • Park, Young Hee;Kim, Won Jung;Son, Byeong Hee;Kim, Sung Won
    • Pediatric Infection and Vaccine
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    • v.5 no.1
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    • pp.115-120
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    • 1998
  • Purpose : In the summer 1997, there was an outbreak of aseptic meningitis in Pusan area. We report the clinical features and viral studies of aseptic meningitis in Pusan area in 1997. Methods : 265 children with aseptic meningitis who had been admitted to Department of Pediatrics, St. Benedict Hospital between April to October 1997 were included. Results : 1) Male-to-female ratio was 1.7:1. 2) Mean age was $6.2{\pm}3.29$ years. 3) It occured mostly April to October. 4) Clinical manifestations were fever 99.6%, vomiting 99.2%, headache 99.2%, rash 6.0%. 5) The duration of fever was $3.34{\pm}2.21$ days. 6) The duration of admission was $5.3{\pm}3.21$ days. 7) WBC count in peripheral blood were $11,200{\pm}4,163/mm^3$. 8) WBC count in CSF were $156.1{\pm}394.7/mm^3$. 9) Causative agents were coxsackievirus B5, echovius 6, 30, type nonspecific enterovirus. Conclusion : Aseptic meningitis in 1997 compared with that in 1996 had clinical feature of increase in age, decrease in duration of fever and incidende of rash. It occurred mostly April to October in 1997 and May to October in 1996. Causative agents were coxackievirus B5, echovirus 6, 30, type nonespecific enterovirus in 1997, and echovirus 9, coxsackievirus A24, type nonespecific enterovirus in 1996.

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A Study of Influence of Filgrastim on PET/CT In Diffuse Large B cell Lymphoma (미만성 거대 B 세포 림프종 환자에서 Filgrastim 사용이 PET/CT 영상에 미치는 영향에 대한 고찰)

  • NamKoong, Hyuk;Park, Hoon-Hee;Ban, Yung-Gak;Kang, Sin-Chang;Kim, Sang-Kyoo;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.17-23
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    • 2009
  • Purpose: It has been known that PET/CT is very valuable in follow-up study of diffuse large B cell lymphoma (DLBCL). Generally, in DLBCL, radiotherapy and chemotherapy has been progressed, because the lesion hasn‘t been limited to one site. And, it has lead to the decrease of leukocyte like neutropenia, due to myelosuppression of chemotherapy. So, in that case, administration of Filgrastim (Granulocyte colony-stimulating factor; G-CSF) is universal. However, in short time after administration, PET/CT has limitation to offer accurate images, through the uptake of $^{18}F$-FDG is increased in the region that is activated bone marrow by hematopoietic growth. Therefore, the aim of this study is that PET/CT in a certain period of time after administration of Filgrastim is able to show normal degree of $^{18}F$-FDG uptake. Materials and Methods: 10 patients under follow-up study of diffuse large B cell lymphoma were examined in this study from January, 2007 to January, 2009 (Male: 4 persons; Female: 6 persons; The mean age: 53.8 years old; The mean weight: 57.3 Kg). Using PET/CT (Discovery STe; GE Healthcare, Milwaukee, WI, USA), whole body images were acquired in 1 hour after $^{18}F$-FDG injection. For image analysis, each ROI ($120\;mm^2$) was drawn on $C^6$ (the sixth C-spine), $L_4$ (the forth L-spine), liver, spleen, and lung, then SUV (Standard Uptake Value)s were measured. We compared with each uptake between in 1-day and 5~7 days after administration of Filgrastim at same patient, so confirmed significance about these by SPSS version 12. Results: In case of $C_6$, $L_4$, spleen, every SUV of 1 day later was remarkably higher than that of 5~7 days later, but liver and lung were similar. Also, the images acquired after 5~7 days distinct remarkably and show normal degree of $^{18}F$-FDG uptake, because uptake of bone was almost disappeared. Conclusions: In this study, each SUV was prominent difference as a period of time after Filgrastim’s administration. And Filgrastim makes concentrate uptake of $^{18}F$-FDG in bone, but, after 5~7 days, bone‘s uptake was greatly decreased. Therefore, we are able to infer a certain period of time that shows normal degree of uptake, by numerical value proven. Also, we consider that this study contribute to advanced study about the other agent like Pegfilgrastim, Lenograstim besides Filgrastim, afterwards.

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Result of Radiation Therapy of Cerebellar Medulloblastoma - with Emphasis on the Neuraxis Dose - (전중추신경계 조사선량을 중심으로 한 수아세포종의 방사선치료성적)

  • Kim Joo Young;Kim Il Han;Ha Sung Whan;Park Charn Il
    • Radiation Oncology Journal
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    • v.11 no.1
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    • pp.69-77
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    • 1993
  • Treatment of cerebellar medulloblastoma has been much improved with modern surgical technique for gross total tumor removal and adequate radiation therapy for the whole craniospinal axis. Questions have been arosen about the optimal radiation dose for the preventive treatment of whole cranium and whole spinal axis. Recently, many authors have reported their treatment results as comparable to older data, using lower than conventional dose of 3,600 cGy-4,000 cGy. For 50 patients treated between 1981 and 1990 at the Department of Radiation Therapy of SNUH, retrospective analysis was done for the treatment result, especially the neuraxis control, by radiation dose for the presymptomatic area of the disease. Analysis only by total spinal dose did not give any significant difference. But further analysis by following patient group; 3,600 cGy/150 cGy (n=6), 3,000 cGy/150 cGy (n=10), 2,400 cGy/150 cGy (n=17) and 2,400 cGy/100-120 cGy (n=11) showed significant improvement of neuraxis control by decreasing order (p =0.003). There was no significant difference in overall survival between the groups. For the 19 patients who had been confirmed initially as having no neuraxis disease, TDF 30 was the cur-off value that could prevent neuraxis failure (p =0.004). We couldn't define any TDF value that give reasonable control for the patient group with positive CSF study at initial diagnosis.

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Clinical Analysis and Surgical Results of Skull Base Meningiomas (뇌기저부 수막종의 임상분석 및 수술성적)

  • Kim, Young Wook;Jung, Shin;Kim, Jae Sung;Lee, Jung Kil;Kim, Tae Sun;Kim, Jae Hyoo;Kim, Soo Han;Kang, Sam Suk;Lee, Je Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1437-1444
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    • 2000
  • Objectives : Traditionally intracranial meningiomas are regarded as benign and curable tumors. About half of all intracranial meningiomas locate in the skull base region. However, surgical removal of these tumors may be challenging and require special considerations. Here general aspects of skull base meningiomas including clinical presentation, surgical approaches, complications and their recurrence rate are discussed based on our experiences. Methods : A retrospective analysis of 61 consecutive patients with skull base meningioma among 210 patients of meningioma between 1989 and 1998 were done. Results : There were 41 women and 20 men ranging from 13 to 74 years(mean 52 years). These tumors were divided into seven categories according to location : olfactory groove(n=9), sphenoid ridge(n=16), cavernous sinus(n =2), tuberculum sellae(n=8), tentorium(n=13), cerebellopontine angle(n=12), and foramen magnum meningiomas (n=1). Surgical approaches were selected on the basis of the tumor attachment, size and extension on preoperative radiologic findings. Total removal(Simpson grade I and II) was achieved in 50 cases(82%), and subtotal removal (Simpson grade III) in 11 patients(18%). According to WHO classification, there were 52 of cases of benign meningioma( 86%), 6 atypical cases(10%), and 3 malignant cases(5%). The most common postoperative complications were CSF leakage(23.0%) and cranial nerve injury(8.2%). Three patient died related with tumor(one was due to surgical complication and the other two due to recurrence) but three patients died from other systemic causes. Mean follow-up period was 51.7 months after surgery. Recurrence occurred in six patients(10.9%) ; three with tentorial meningioma, two with sphenoid ridge, and one in cerebellopontine angle. Conclusion : With advances in neuroradiology and microsurgical techniques, the surgical outcome of miningiomas has been markedly improved with acceptable morbidity and mortality rates. Overall, our surgical results of skull base meningiomas is comparable to other reports. Therefore, with the appropriate operative strategy and techniques, these tumors can be completely removed and good surgical results can be expected.

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Development of a Korean Standard Structural Brain Template in Cognitive Normals and Patients with Mild Cognitive Impairment and Alzheimer's Disease (정상노인 및 경도인지장애 및 알츠하이머성 치매 환자에서의 한국인 뇌 구조영상 표준판 개발)

  • Kim, Min-Ji;Jahng, Geon-Ho;Lee, Hack-Young;Kim, Sun-Mi;Ryu, Chang-Woo;Shin, Won-Chul;Lee, Soo-Yeol
    • Investigative Magnetic Resonance Imaging
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    • v.14 no.2
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    • pp.103-114
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    • 2010
  • Purpose : To generate a Korean specific brain template, especially in patients with Alzheimer's disease (AD) by optimizing the voxel-based analysis. Materials and Methods : Three-dimensional T1-weighted images were obtained from 123 subjects who were 43 cognitively normal subjects and patients with 44 mild cognitive impairment (MCI) and 36 AD. The template and the corresponding aprior maps were created by using the matched pairs approach with considering differences of age, gender and differential diagnosis (DDX). We measured several characteristics in both our and the MNI templates, including in the ventricle size. Also, the fractions of gray matter and white matter voxels normalized by the total intracranial were evaluated. Results : The high resolution template and the corresponding aprior maps of gray matter, white matter (WM) and CSF were created with the voxel-size of $1{\times}1{\times}1\;mm$. Mean distance measures and the ventricle sizes differed between two templates. Our brain template had less gray matter and white matter areas than the MNI template. There were volume differences more in gray matter than in white matter. Conclusion : Gray matter and/or white matter integrity studies in populations of Korean elderly and patients with AD are needed to investigate with this template.

Visualization and Localization of Fusion Image Using VRML for Three-dimensional Modeling of Epileptic Seizure Focus (VRML을 이용한 융합 영상에서 간질환자 발작 진원지의 3차원적 가시화와 위치 측정 구현)

  • 이상호;김동현;유선국;정해조;윤미진;손혜경;강원석;이종두;김희중
    • Progress in Medical Physics
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    • v.14 no.1
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    • pp.34-42
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    • 2003
  • In medical imaging, three-dimensional (3D) display using Virtual Reality Modeling Language (VRML) as a portable file format can give intuitive information more efficiently on the World Wide Web (WWW). The web-based 3D visualization of functional images combined with anatomical images has not studied much in systematic ways. The goal of this study was to achieve a simultaneous observation of 3D anatomic and functional models with planar images on the WWW, providing their locational information in 3D space with a measuring implement using VRML. MRI and ictal-interictal SPECT images were obtained from one epileptic patient. Subtraction ictal SPECT co-registered to MRI (SISCOM) was performed to improve identification of a seizure focus. SISCOM image volumes were held by thresholds above one standard deviation (1-SD) and two standard deviations (2-SD). SISCOM foci and boundaries of gray matter, white matter, and cerebrospinal fluid (CSF) in the MRI volume were segmented and rendered to VRML polygonal surfaces by marching cube algorithm. Line profiles of x and y-axis that represent real lengths on an image were acquired and their maximum lengths were the same as 211.67 mm. The real size vs. the rendered VRML surface size was approximately the ratio of 1 to 605.9. A VRML measuring tool was made and merged with previous VRML surfaces. User interface tools were embedded with Java Script routines to display MRI planar images as cross sections of 3D surface models and to set transparencies of 3D surface models. When transparencies of 3D surface models were properly controlled, a fused display of the brain geometry with 3D distributions of focal activated regions provided intuitively spatial correlations among three 3D surface models. The epileptic seizure focus was in the right temporal lobe of the brain. The real position of the seizure focus could be verified by the VRML measuring tool and the anatomy corresponding to the seizure focus could be confirmed by MRI planar images crossing 3D surface models. The VRML application developed in this study may have several advantages. Firstly, 3D fused display and control of anatomic and functional image were achieved on the m. Secondly, the vector analysis of a 3D surface model was defined by the VRML measuring tool based on the real size. Finally, the anatomy corresponding to the seizure focus was intuitively detected by correlations with MRI images. Our web based visualization of 3-D fusion image and its localization will be a help to online research and education in diagnostic radiology, therapeutic radiology, and surgery applications.

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Exploratory Case Study for Key Successful Factors of Producy Service System (Product-Service System(PSS) 성공과 실패요인에 관한 탐색적 사례 연구)

  • Park, A-Rum;Jin, Dong-Su;Lee, Kyoung-Jun
    • Journal of Intelligence and Information Systems
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    • v.17 no.4
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    • pp.255-277
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    • 2011
  • Product Service System(PSS), which is an integrated combination of product and service, provides new value to customer and makes companies sustainable as well. The objective of this paper draws Critical Successful Factors(CSF) of PSS through multiple case study. First, we review various concepts and types in PSS and Platform business literature currently available on this topic. Second, after investigating various cases with the characteristics of PSS and platform business, we select four cases of 'iPod of Apple', 'Kindle of Amazon', 'Zune of Microsoft', and 'e-book reader of Sony'. Then, the four cases are categorized as successful and failed cases according to criteria of case selection and PSS classification. We consider two methodologies for the case selection, i.e., 'Strategies for the Selection of Samples and Cases' proposed by Bent(2006) and the seven case selection procedures proposed by Jason and John(2008). For case selection, 'Stratified sample and Paradigmatic cases' is adopted as one of several options for sampling. Then, we use the seven case selection procedures such as 'typical', 'diverse', 'extreme', 'deviant', 'influential', 'most-similar', and 'mostdifferent' and among them only three procedures of 'diverse', 'most?similar', and 'most-different' are applied for the case selection. For PSS classification, the eight PSS types, suggested by Tukker(2004), of 'product related', 'advice and consulancy', 'product lease', 'product renting/sharing', 'product pooling', 'activity management', 'pay per service unit', 'functional result' are utilized. We categorize the four selected cases as a product oriented group because the cases not only sell a product, but also offer service needed during the use phase of the product. Then, we analyze the four cases by using cross-case pattern that Eisenhardt(1991) suggested. Eisenhardt(1991) argued that three processes are required for avoiding reaching premature or even false conclusion. The fist step includes selecting categories of dimensions and finding within-group similarities coupled with intergroup difference. In the second process, pairs of cases are selected and listed. The second step forces researchers to find the subtle similarities and differences between cases. The third process is to divide the data by data source. The result of cross-case pattern indicates that the similarities of iPod and Kindle as successful cases are convenient user interface, successful plarform strategy, and rich contents. The differences between the successful cases are that, wheares iPod has been recognized as the culture code, Kindle has implemented a low price as its main strategy. Meanwhile, the similarities of Zune and PRS series as failed cases are lack of sufficient applications and contents. The differences between the failed cases are that, wheares Zune adopted an undifferentiated strategy, PRS series conducted high-price strategy. From the analysis of the cases, we generate three hypotheses. The first hypothesis assumes that a successful PSS system requires convenient user interface. The second hypothesis assumes that a successful PSS system requires a reciprocal(win/win) business model. The third hypothesis assumes that a successful PSS system requires sufficient quantities of applications and contents. To verify the hypotheses, we uses the cross-matching (or pattern matching) methodology. The methodology matches three key words (user interface, reciprocal business model, contents) of the hypotheses to the previous papers related to PSS, digital contents, and Information System (IS). Finally, this paper suggests the three implications from analyzed results. A successful PSS system needs to provide differentiated value for customers such as convenient user interface, e.g., the simple design of iTunes (iPod) and the provision of connection to Kindle Store without any charge. A successful PSS system also requires a mutually benefitable business model as Apple and Amazon implement a policy that provides a reasonable proft sharing for third party. A successful PSS system requires sufficient quantities of applications and contents.