• Title/Summary/Keyword: Clinical analysis

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Postoperative External Beam Radiotherapy for Retroperitoneal Soft Tissue Sarcoma (후복막 연조직 육종의 수술 후 외부 방사선 치료)

  • Jang, Na-Young;Kim, Il-Han;Choi, Jin-Hwa;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.26 no.3
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    • pp.135-141
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    • 2008
  • Purpose: To evaluate the clinical outcomes and prognostic factors in retroperitoneal soft tissue sarcomas treated by postoperative radiotherapy. Materials and Methods: The records of 23 patients with retroperitoneal soft tissue sarcomas, who underwent postoperative radiotherapy between 1985 and 2003, were analyzed. The median follow-up period was 77 months (range, $8{\sim}240$ months). A total of 21 patients presented with primary disease, and two patients presented with recurrent disease. Liposarcomas and leiomyosarcomas represented 78% of the diagnosed tumor cases. Moreover, 17 cases were of high grade (grade 2 or 3). The median tumor size was 13 cm (range, $3{\sim}50\;cm$). Complete excision was achieved in 65% of patients. The median radiation dose was 50.4 Gy (range, 45.0 to 59.4 Gy), with conventional fractionation. Results: The 5-year overall, local recurrence-free, and distant metastasis-free survival rates were 68%, 58%, and 71%, respectively. Eleven patients experienced local recurrence, while 9 patients experienced distant metastasis. The most common site for distant metastasis was the liver. A univariate analysis revealed that adjacent organ invasion and age (>60 years) as the significant risk factors contributing to the prediction of poor overall survival. Moreover, multivariate analyses indicated that adjacent organ invasion remained significantly associated with a higher risk of death. In addition, patient age (>60 years) was the other identified risk factor for local recurrence by univariate and multivariate analyses. Except for one case of grade 3 diarrhea, no patient suffered grade 3 or higher complications. Conclusion: Our results were comparable to previous reports in that adjacent organ invasion and patient age (>60 years) were significant predictors of poor survival and tumor recurrence, respectively.

A STUDY OF DENTAL CROWDING AND ITS RELATIONSHIP TO MANDIBULAR INCISOR SHAPE BY MODEL ANALYSIS IN ADOLESCENTS (청소년 석고 모형 분석에 의한 하악절치 형태와 치아밀집의 상관관계에 관한 연구)

  • Surh, Jeong-Eun;Baik, Hyoung-Seon
    • The korean journal of orthodontics
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    • v.25 no.5 s.52
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    • pp.593-604
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    • 1995
  • Mandibular incisor crowding is one of the most common features of malocclusion and is interesting characteristic in view of relapse and stability after orthodontic treatment. There are many potential factors in the etiology of lower anterior crowding. The tooth size variation is one of them, but biologic significance for the faciolingual width of the teeth has been overlooked. Peck and Peck reported that persons with ideal mandibular incisor alignment were shown to have incisor with smaller mesiodistal and larger faciolingual dimensions than persons with incisor crowding. On the basis of these findings they suggested MD/FL index as a clinical guideline for the assessment for lower incisor crowding. The present study was undertaken to examine the relationship between mandibular incisor crowding and mandibular incisor dimension, and determine their correlation with arch length discrepancy. 154 dental casts of people from 11 to 17 years of age were made, and were divided into normal group with irregularity index less than of 1, and crowding group with irregularity index greater than 1.The casts were measured and analyzed statistically. The results were as follows. 1. The mean mesiodistal width for mandibular incisor was larger in crowding group, and has significant difference in central inciosr measurement. There are no significant differences in the faciolingul width and MD/FL index. 2. Irregularity index has significant correlation coefficients with mesiodistal width and MD/FL index for mandibular incisor in crowding group, but no correlation with faciolingual width. It also has correlation with maxillary and mandibular arch length discrepancy, total tooth material, mandibular intercanine width, and mandibular inter first premolar width. 3. Upper and lower arch length discrepancy have significant correlation with mesiodistal width of mandibular incisor and overbite, but have no correlation with faciolingual width. Lower arch lenth discrepancy has significant correlation with MD/FL index for mandibular incisor and upper arch length discrepancy has correlation with MD/FL index for mandibular lateral incisor. 4. Significant differences were observed between normal and crowding group for the mandibular arch length discrepancy and overbite.

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Skeletal relapse and dental change during intermaxillary fixation after mandibular setback (외과적 하악 후퇴술 후 악간고정기간 중의 골격성 재발과 치열의 변화)

  • Chang, Chong-On
    • The korean journal of orthodontics
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    • v.29 no.4 s.75
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    • pp.457-466
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    • 1999
  • It has been reported that skeletal relapse and dental change after mandibular setback do occur not only after intermaxillary fixation(IMF) removal but also during IMF The side effects of skeletal relapse during IMF have clinical importance because they can cause many Postoperative orthodontic Problems. Generally, the Prevention of solid union between segments, compensatory tooth movement, anterior openbite, etc. have been cited as the side effects of jaw displacement. The purpose of this study was to evaluate the skeletal relapse and dental change during IMF. The material consisted of 28 patients who were treated by BSSRO(bilateral sagittal split ramus osteotomy), wire osteosynthesis, IMF for correction of mandibular prognathism. Through cephalometric analysis, the amount and direction of surgical movement, skeletal relapse and dental change during IMF were measured. The correlation between surgical movement and skeletal relapse, between skeletal relapse and dental changes were evaluated. The following conclusions were obtained; 1. Distal segment was repositioned backward and upward, proximal segment showed clockwise rotation during surgery. 2. During ]m, anterior portion of distal segment was displaced backward and posterior portion was displaced upward. Proximal segment was displaced upward with forward movement of p-Go(gonion of proximal segment). Backward surgical movement of p-GO was significantly correlated with forward displacement of p-Go. 3. Overjet and overbite were not changed during IMF. The compensatory tooth movements during IMF were characterized by retroclination of upper incisors md retroclination, extrusion of lower incisors. These compensatory tooth movements had statistically significant correlation with upward displacement of d-Go (gonion of distal segment).

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Comparison of Myogenous and Arthrogenous Pain Patients of Temporomandibular Disorders using Research Diagnostic Criteria for Temporomandibular Disorders (측두하악장애 연구진단기준(RDC/TMD)를 이용한 측두하악장애의 근육성 동통과 관절성 동통 환자군의 비교)

  • Park, Joo Sun;Kim, Dong Hee;Chung, Jin Woo
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.233-242
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    • 2012
  • The purposes of this study were to compare psychological profiles, to investigate the differences in the clinical characteristics, and to compare treatment outcomes between myogenous pain and arthrogenous pain subgroups of temporomandibular disorder (TMD) based on Research Diagnostic Criteria for Temporomandibular disorders (RDC/TMD). Two hundred and fifty two patients diagnosed as TMD were divided into three groups based on the RDC/TMD axis I diagnostic guidelines; myogenous pain group, arthrogenous pain group, and mixed pain (both myogenous pain and arthrogenous pain) group. RDC/TMD history questionnaire was administered to each patient and depression, somatization, jaw disability, pain intensity, disability days, and graded chronic pain scale were analyzed. Bruxism, clenching, insomnia, headache, and unilateral chewing were assessed in a standardized TMD dysfunction questionnaire and the duration of onset, chronicity of pain, treatment period, the effectiveness of the treatment, and improvement of symptoms also analyzed. Myogenous pain group had higher depression (p=0.002), and somatization scales (p<0.001) than the arthrogenous pain group. Mixed pain group showed higher pain intensity (p=0.008), disability days (p<0.001), graded chronic pain scale (p=0.005), somatization (p<0.001), and depression scores (p=0.002) than the arthrogenous pain group. Jaw disability did not show any significant differences among the three groups (p=0.058). Arthrogenous pain group reported more limitation of mouth opening than myogenous pain group (p=0.007). Duration of onset showed that the arthrogenous pain group had lowest prevalence of chronicity among three groups (p=0.002). Mixed pain group patients showed lowest symptom improvements among three groups (p=0.007). Multiple linear regression analysis results showed that the treatment effectiveness was significantly associated with somatization score (${\beta}$=-0.251, p=0.03).

A RESEARCH ON RISK FACTORS OF ADOLESCENT SEXUAL BEHAVIORS (청소년의 성행동 위험요인에 관한 연구)

  • Park, In-Seon;Baek, Yeon-Ok;Han, In-Young
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.138-148
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    • 2001
  • The focus of the research was on identifying the risk factors that may result in unprepared intercourse among the adolescent from an ecological systems prospective. A survey questionnaire was conducted from September through December 1999 to 2326 youths, ages from 13-18 years old. After eliminating thirty respondents from Unwed Mother's Home we found that 8.8% of the remaining respondents had experienced sexual intercourse. Of those, 5% of the female and 13.4% of male adolescents has had sexual intercourse, showing 2.7 times more for the male sample population. Broken down to age groups, 3.2% of the thirteen years old group and 19.2% of the eighteen years old group had experienced intercourse, an almost six fold increase in the older age group. To find out the differences between those who had and not had experienced intercourse the group was then divided into two comparative groups by same sex and age variables. Findings from comparative analysis identified five ecological system risk factors among the youth sample that had intercourse;First, individual factor:adolescents who thought less of themselves or didn't consider their potentials, those more exposed other risk behaviors such as drinking, smoking, drugs, runaway and come in contact with pornography, those who thought they knew more about sex and etc. Second, family factor:those who thought family was less important, had less supportive family, higher or lower income family and etc. Third, peer factor:Both groups thought friends were important and had their support. The group with intercourse experience seems to be think that more peers are experiencing other risk behavior. Fourth, school factor:Those in the group who had experienced intercourse seems to think school is less important and with lower academic achievements. Fifth, community factor:There were no statistical significant differences found between the two groups. The overall results from this study implies that if we want to prevent our youths from having unprepared intercourse during adolescence the significance of having meaningful emerging self, family relationship and school experience is important. This study identified the risk factors leading to adolescent sexual intercourse but further research is necessary in finding out about their predictability.

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A Comparative Analysis of Blood Estradiol-17${\beta}$ Levels According to Varying Regimens of $Clomid^{(R)}$(Clomiphene citrate) Administration in Induced Ovulated Menstrual Cycles ($Clomid^{(R)}$(Clomiphene citrate)의 투여시기와 용량을 변수로 한 혈중 $Estradiol-17{\beta}$의 동태에 관한 연구)

  • Chang, H.J.;Suh, B.H.;Lee, J.H.
    • Clinical and Experimental Reproductive Medicine
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    • v.15 no.1
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    • pp.40-52
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    • 1988
  • Estradiol-17${\beta}$($E_2$) levels in the blood were estimated according to varying the time and amount of the administration of $Clomid^{(R)}$. $Clomid^{(R)}$ were administered on the 2nd, 3rd and 4th menstrual day corresponding to the recruitment period and on the 5th menstrual day corresponding to the selection period of the ovarian follicles, respectively. And $Clomid^{(R)}$ were administered 50 mg, 100 mg and 150 mg/day, repectively. The effects of the sequential HMG to $E_2$ levels in the blood were also estimated. The results were as following : 1. Blood $E_2$ levels according to the day and amount of administration of $Clomid^{(R)}$ were the highest in the group 3(D $2{\sim}6$, 150 mg/day, with HMG) and the lowest in the group 6(D $5{\sim]9$, 50 mg/day, without HMG). $E_2$ levels showed increasing tendency to 0 day. 2. In the cases of the administration of $Clomid^{(R)}$ during the $2nd{\sim}6th$ menstrual day, $E_2$ levels according to the amount were similar among groups and showed increasing tendency daily. 3. In the cases of administration of $Clomid^{(R)}$ during the $2nd{\sim}6th$ menstrual day, $E_2$ levels according to the sequential HMG independent of the amount of $Clomid^{(R)}$ were higher in the with HMG group than without HMG groups. 4. In the case of the administration of $Clomid^{(R)}$ during the $5th{\sim}9th$ menstrual day, $E_2$ levels according to the amount were the highest in the 100 mg/day group and the lowest in the 50mg/day group. 5. In the cases of administration of $Clomid^{(R)}$ independent of the amount during the 5th${\sim}$9th menstrual day, $E_2$ levels according to the sequential HMG were higher in the with HMG group than without HMG group. 6. $E_2$ levels according to the amount independent of the day of the administration of $Clomid^{(R)}$ were the highest in the 100 mg/day group and 150 mg/day, 50 mg/day group in low sequence. 7. $E_2$ levels according to the sequential HMG independent of the day and amount of the administration of $Clomid^{(R)}$ were higher in the with HMG group than the without HMG group. 8. $E_2$ levels according to the day of the administration of $Clomid^{(R)}$ independent of the amount of $Clomid^{(R)}$ and sequential HMG were the highest in the group D 2${\sim}$6 and the lowest in the group D 5${\sim}$9. According to the above results, there were higher $E_2$ levels in the group with sequential HMG than without HMG. Therefore, the hypothesis, postulated initially by the author, was not verified that sequential HMG would not affect the $E_2$ levels which were related to the process of the selection of the ovarian follicle in the connection with 'FSH window'. Because it may be the stimulation after the selection of later predominant follicle. And the highest level of $E_2$ was estimated in the $Clomid^{(R)}$ 150 mg/day group with sequential HMG on the 2nd${\sim}$6th day, and the higher levels were estimated in the 2nd${\sim}$6th day, 3rd${\sim}$7th day and 4th${\sim}$8th day groups than the 5th${\sim}$9th day group. The lower levels were estimated in the $Clomid^{(R)}$ 50 mg/day group without HMG than 100 mg/day and 150 mg/day on the 5th${\sim}$9th day. Therefore, further study will be needed that combines analyses of the E2 levels in the blood according to the various administration of $Clomid^{(R)}$ with or without sequential HMG and determination of the numbers and size of the ovarian follicles by ultrasonogram.

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Quantitative Analysis of GBCA Reaction by Mol Concentration Change on MRI Sequence (MRI sequence에 따른 GBCA 몰농도별 반응에 대한 정량적 분석)

  • Jeong, Hyun Keun;Jeong, Hyun Do;Kim, Ho Chul
    • Journal of the Institute of Electronics and Information Engineers
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    • v.52 no.2
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    • pp.182-192
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    • 2015
  • In this paper, we introduce how to change the reaction rate as mol concentration when we scan enhanced MRI with GBCA(Gadolinium Based Contrast Agent), Also show the changing patterns depending on diverse MRI sequences which are made by different physical principle. For this study, we made MRI phantom ourselves. We mixed 500 mmol Gadoteridol with Saline in each 28 different containers from 500 to 0 mmol. After that, MR phantom was scanned by physically different MRI sequences which are T1 SE, T2 FLAIR, T1 FLAIR, 3D FLASH, T1 3D SPACE and 3D SPCIR in 1.5T bore. The results were as follows : *T1 Spin echo's Total SI(Signal Intensity) was 15608.7, Max peak was 1352.6 in 1 mmol. *T2 FLAIR's Total SI was 9106.4, Max peak was 0.4 1721.6 in 1 mmol. *T1 FLAIR's Total SI was 20972.5, Max peak was 1604.9 in 1 mmol. *3D FLASH's Total SI was 20924.0, Max peak was 1425.7 in 40 mmol. *3D SPACE 1mm's Total SI was 6399.0, Max peak was 528.3 in 3 mmol. *3D SPACE 5mm's Total SI was 6276.5, Max peak was 514.6 in 2 mmol. *3D SPCIR's Total SI was 1778.8, Max peak was 383.8 in 0.4 mmol. In most sequences, High signal intensity was shown in diluted lower concentration rather than high concentration, And also graph's max peak and pattern had difference value according to the each different sequence. Through this paper which have quantitative result of GBCA's reaction rate depending on sequence, We expect that practical enhanced MR protocol can be performed in clinical field.

The Correlation Between Early Clinical State and Functional Outcome in Acute Stroke Patients (급성기 뇌졸증 환자의 상태와 기능회복도와의 상관관계)

  • Choi, Eun-Jung;Lee, Won-Chul
    • The Journal of Dong Guk Oriental Medicine
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    • v.6 no.2
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    • pp.167-190
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    • 1998
  • Nowadays there were two tendencies of studies about prognostic factors in stroke. One way was to define prognostic factors according to the radiological features. And the other way was to define according to the mental state, recognition, perception, motors, language, urinary&bowel incontinence etc.. The former could be objectively investigated, while the latter was difficult. The purpose of this study was to determine which variables would be predictors of stroke and which factors would be affect predictions most. The subjects of this study were 32 patients who were admitted to the Dept. of Internal Medicine, Dongguk Univ. College of Oriental Medicine whthin 48 hours from attack, Medical records were reviewed FIM, CNS, NIH stroke scale. We compared each sub-items of FIM, CNS, NIH stroke scale about mental state, recognition, perception, motors, language, urinary&bowel incontinence with MBI score at 4 weeks from admission. Also, we analyzed the correlations of sub-items and groups which devided into 5 according to independence of MBI score. And we found out the most influent factors with multiple regression analysis. The major results were as follows; 1. In mean of MBI score at 4 weeks of each groups devided low, middle, high score at mental state, recognition, perception, motors, language, urinary&bowel incontinence items, there were statistical differences in all items. 2. The mental state and lim ataxia sub-items had no significant correlations with groups divided according to independence of MBI score. All the other items were significantly correlated. 3. The most influent factors was recognition. The second was sensory and the third was bowel incontinence. 4. The most influent scales was FIM, and the second was CNS, and NlH had no statistical significancy.

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Study of Motion-induced Dose Error Caused by Irregular Tumor Motion in Helical Tomotherapy (나선형 토모테라피에서 불규칙적인 호흡으로 발생되는 움직임에 의한 선량 오차에 대한 연구)

  • Cho, Min-Seok;Kim, Tae-Ho;Kang, Seong-Hee;Kim, Dong-Su;Kim, Kyeong-Hyeon;Cheon, Geum Seong;Suh, Tae Suk
    • Progress in Medical Physics
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    • v.26 no.3
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    • pp.119-126
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    • 2015
  • The purpose of this study is to analyze motion-induced dose error generated by each tumor motion parameters of irregular tumor motion in helical tomotherapy. To understand the effect of the irregular tumor motion, a simple analytical model was simulated. Moving cases that has tumor motion were divided into a slightly irregular tumor motion case, a large irregular tumor motion case and a patient case. The slightly irregular tumor motion case was simulated with a variability of 10% in the tumor motion parameters of amplitude (amplitude case), period (period case), and baseline (baseline case), while the large irregular tumor motion case was simulated with a variability of 40%. In the phase case, the initial phase of the tumor motion was divided into end inhale, mid exhale, end exhale, and mid inhale; the simulated dose profiles for each case were compared. The patient case was also investigated to verify the motion-induced dose error in 'clinical-like' conditions. According to the simulation process, the dose profile was calculated. The moving case was compared with the static case that has no tumor motion. In the amplitude, period, baseline cases, the results show that the motion-induced dose error in the large irregular tumor motion case was larger than that in the slightly irregular tumor motion case or regular tumor motion case. Because the offset effect was inversely proportion to irregularity of tumor motion, offset effect was smaller in the large irregular tumor motion case than the slightly irregular tumor motion case or regular tumor motion case. In the phase case, the larger dose discrepancy was observed in the irregular tumor motion case than regular tumor motion case. A larger motion-induced dose error was also observed in the patient case than in the regular tumor motion case. This study analyzed motion-induced dose error as a function of each tumor motion parameters of irregular tumor motion during helical tomotherapy. The analysis showed that variability control of irregular tumor motion is important. We believe that the variability of irregular tumor motion can be reduced by using abdominal compression and respiratory training.

Compare the Clinical Tissue Dose Distributions to the Derived from the Energy Spectrum of 15 MV X Rays Linear Accelerator by Using the Transmitted Dose of Lead Filter (연(鉛)필터의 투과선량을 이용한 15 MV X선의 에너지스펙트럼 결정과 조직선량 비교)

  • Choi, Tae-Jin;Kim, Jin-Hee;Kim, Ok-Bae
    • Progress in Medical Physics
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    • v.19 no.1
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    • pp.80-88
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    • 2008
  • Recent radiotherapy dose planning system (RTPS) generally adapted the kernel beam using the convolution method for computation of tissue dose. To get a depth and profile dose in a given depth concerened a given photon beam, the energy spectrum was reconstructed from the attenuation dose of transmission of filter through iterative numerical analysis. The experiments were performed with 15 MV X rays (Oncor, Siemens) and ionization chamber (0.125 cc, PTW) for measurements of filter transmitted dose. The energy spectrum of 15MV X-rays was determined from attenuated dose of lead filter transmission from 0.51 cm to 8.04 cm with energy interval 0.25 MeV. In the results, the peak flux revealed at 3.75 MeV and mean energy of 15 MV X rays was 4.639 MeV in this experiments. The results of transmitted dose of lead filter showed within 0.6% in average but maximum 2.5% discrepancy in a 5 cm thickness of lead filter. Since the tissue dose is highly depend on the its energy, the lateral dose are delivered from the lateral spread of energy fluence through flattening filter shape as tangent 0.075 and 0.125 which showed 4.211 MeV and 3.906 MeV. In this experiments, analyzed the energy spectrum has applied to obtain the percent depth dose of RTPS (XiO, Version 4.3.1, CMS). The generated percent depth dose from $6{\times}6cm^2$ of field to $30{\times}30cm^2$ showed very close to that of experimental measurement within 1 % discrepancy in average. The computed dose profile were within 1% discrepancy to measurement in field size $10{\times}10cm$, however, the large field sizes were obtained within 2% uncertainty. The resulting algorithm produced x-ray spectrum that match both quality and quantity with small discrepancy in this experiments.

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