• Title/Summary/Keyword: Clinical investigation

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Evaluation of Sperm Penetration Ability according to Various Morphological Characteristics of Spermatozoa (정자의 여러가지 형태학적 특징에 따른 정자 침투능의 평가)

  • Kim, J.H.;Jung, K.W.;Lew, Y.O.;Kwon, D.J.;Lim, Y.T.;Kim, J.H.;Nha, D.J.;Lee, J.W.
    • Clinical and Experimental Reproductive Medicine
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    • v.21 no.1
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    • pp.31-41
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    • 1994
  • Morphological estimation of human spermatozoa is complicated by the fact that there is great natural variation in shape. This natural variation in shapes makes it difficult to say which forms are associated with infertility and which are normal variations. Possibly post coital test or in vitro cervical mucus penetration tests will help to clarify this question by showing which sperm are capable of penetration. The purpose of this investigation was performed to assess distribution of various morphological abnormalities according to the ability of sperm to penetrate cervical mucus. The sperm-mucus penetration using hen's egg white as substituting mucus for human cervical mucus was done in 45 fertile men with normal semen analysis and 122 infertile men with abnormal seminal parameters more than one. The female partners of 122 infertile couples showed normal results in the female fundamental test for fertility. Conventional semen analysis was evaluated according to the WHO standard normal(l980). The detailed classification of the abnormal sperm was made according to David et al(l975). The vitality of the sperm samples determined by eosin yellow-nigrosin stainig according to the method of Eliasson(l977). Results were as follw; 1. The patients had significantly lower total sperm count, motility (%), normal morphology (%), viability and total functional sperm fractions(TFSF) than fertile donors. 2. The mean value of sperm penetration distance of the patients(28.69${\pm}$11.02mm) showed significantly lower than fertile donors(37.33${\pm}$5.49mm). And 43/45 fertile donors(95.5%) as well as 57/122 patients(46.7%) had over 30mm in sperm penetration distance respectively. While 2/45 fertile donors(4.5 %) and 65/122 patient(53.3%) had under 30mm in sperm penetration distance respectively. 3. The morphological abnormalities in fertile donors were significantly lower 23.04${\pm}$5.83% (head = 12.89${\pm}$4.98, neck=6.11${\pm}$3.83%, and tail=3.43${\pm}$2.65%), compared to 36.03${\pm}$14. 40% in patients(head = 15.98 8.60%, neck 11.20${\pm}$6.56% and tail=8.70${\pm}$6.55%). Also, 3 types of sperm abnormalities including head, neck and tail were significantly lower in patient than fertile donors, respectively. Both the patients and fertile donors showed higher distribution of sperm with abnormal head than abnormal neck and tail. 4. The mean morphological abnormalities(SP>30mm) of the patients(30.68 11.64%; head = 15.95${\pm}$9.35%, neck=8.14${\pm}$4.21 %, tail=6.56${\pm}$5.64%) were significantly lower compared to patients(40.72${\pm}$15.01 %; head=16.02${\pm}$7.69%, neck 13.89${\pm}$7.82%, tail=1O.58${\pm}$6.75%) under 30mm in sperm penetration distance. Also, both groups over 30mm and under 30mm in sperm penetration showed distance higher distribution of sperm with abnormal head than abnormal neck and tail. The morphological abnormalities of head did not show significant difference but abnormal neck and tail were significant difference between the over 30mm and under 30mm group in sperm penetration distance.

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The Investigation Regarding the Psychiatric Consultation of the Inpatient from General Hospital (일 종합병원 입원 환자의 정신과 자문 의뢰의 최근 3년간의 특성에 대한 연구)

  • Lee, Soo-Jin;Lee, Joong-Kwaun;Wang, Kwuan-Shu;Kim, Jung-Gee;Cho, Dong-Hwan;Kim, Hyun-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.1
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    • pp.49-59
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    • 2005
  • Objectives: This clinical study investigates the status of psychiatric consultation from 2001 to 2003 at Maryknoll General Hospital, located in Busan to evaluate the characteristic patterns of current psychiatric consultation and to contribute for further data of consultation study. Methods : The subjects of this study were hospitalized at Maryknoll General Hospital from 1 January, 2001 to 31 December, 2003, who were referred for psychiatric consultation during hospitalization. This study was analysed demographic data, reason for referral, psychiatric diagnosis by patient's chart and psychiatrist's report retrospectively. Results : 1) The psychiatric consultation rates was 1.72%. 2) There was 47.8% in referral among the age group over 60 years, especially the age group over 70 years was 20.3%. 3) The most frequent referral source was department of internal medicine(72.5%). 4) The frequency of psychiatric consultation was the highest at March and the lowest at December. 5) The reasons of psychiatric consultation, according to frequency, were affective change, somatic symptom without abnormal finding. And drug intoxication. alcohol problem were increased. 6) Somatoform disorder was the most common psychiatric diagnosis followed by depressive disorder, organic mental disorder. The diagnosis of somatoform disorder, depressive disorder, alcohol dependence were increased, but anxiety disorder, organic mental disorder were decreased. 7) Pharmacotherapy was the most recommendation, and diagnostic procedure and psychotherapy were increased. Conclusion : In review of consultation referral subjects, the referral rate was 1.72%. The consultation referral of the old(over 60 years) was 42.8%, and annually increased. The most frequent request source was from department of internal medicine. The reasons of consultation referral was the most due to affect change. The recommendation of pharmacotherapy was the most numerous. and psychotherapy was increased annually. Further studies warranted on geriatric psychiatric consultation, pattern change of consultation.

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The Investigation Regarding the Dose Change due to the Heterogeneity of Prostate Cancer Treatment with IMRT (전립선암의 세기조절 방사선치료 시 불균질부에 의한 선량변화에 관한 고찰)

  • Yoon, Il-Kyu;Park, Jang-Pil;Lee, Jae-Hee;Park, Heung-Deuk
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.2
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    • pp.107-112
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    • 2007
  • Purpose: The pelvic phantom was fabricated in the following purposes: (1) Dose verification of IMRT plan using Eclipse planning computer, (2) to study the interface effect at the interface between rectal wall and air. The TLD can be inserted in the pelvic phantom to confirm the dose distribution as well as uncertainty at the interface. Materials and Methods: A pelvic phantom with the dimension of 30 cm diameter, 20 cm height and 20 cm thickness was fabricated to investigate the dose at the rectal wall. The phantom was filled with water and has many features like bladder, rectum, and prostate and seminal vesicle (SV). The rectum is made of 3 cm-dimater plastic pipe, and it cab be blocked by using a plug, and film can be inserted around the rectal wall. The phantom was scanned with Philips Brillance scanner and various organs such as prostate, SV, and rectal wall, and bladder wall were delineated. The treatment parameters used in this study are the same as those used in the protocols in the SNUH. TLD chips are inserted to the phantom to evaluate the dose distribution to the rectal wall (to simulate high dose gradient region), bladder wall and SV (to simulate the high dose region) and 2 spots in anterior surface (to simulate the low dose region). The TLD readings are compared with those of the planning computer (ECLIPSE, Varian, USA). Results: The target TLD doses represented as the prostate and SV show excellent agreements with the doses from the RTP within +/-3%. The rectal wall doses measured at the rectal wall are different from the those of the RTP by -11%. This is in literatures called as an interface effect. The underdosages at the rectal wall is independent of 3 heterogeneity correction algorithm in the Eclipse RTP. Also the low dose regions s represented as surface in this study were within +/-1%. Conclusion: The RTP estimate the dosage very accurately withihn +/-3% in the high dose (SV, or prostate) and low dose region (surface). However, the dosage at the rectal wall differed by as much as 11% (In literatures, the underdosage of 9$\sim$15% were reported). This range of errors occurs at the interface, for example, at the interface between lung and chest wall, or vocal cord. This interface effect is very important in clinical situations, for example, to estimate the NTCP (normal tissue complication probability) and to estimate the limitations of the current RTP system. Monte-carlo-based RTP will handle this issue correctly.

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The Clinical Study on the Constitutional symptomatic pattern of Soyangin and Taeumin inpatients in stroke (중풍입원환자(中風入院患者)의 소양인(少陽人)·태음인(太陰人) 체질병증유형(體質病證類型)에 관한 임상적(臨床的) 고찰(考察))

  • Lee, Jun-hee;Koh, Byung-hee;Song, Il-byung
    • Journal of Sasang Constitutional Medicine
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    • v.12 no.1
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    • pp.120-135
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    • 2000
  • Objective ; The purpose of this study is to find out the constitutional symptomatic pattern of Soyangin and Taeumin through investigation of difference between two groups in stroke. Method ; 70 inpatients(Soyangin 31, Taeumin 39) in stroke, admitted into Kyung-Hee Oriental Hospital from 1. July. 1999 to 20. Sept. 1999, were investigated through questionnare which consists of 16 parts 155 questions, and the problems which have significant difference between Soyangin and Taeumin group were analyzed statistically. Result 1. The analysis of general characteristic difference between Soyangin and Taeumin group (1) The number of Soyangin patients is 31, Taeumin 39 and the number of Male patients 43, Female 27. (2) The mean weight of Taeumin group is heavier than that of Soyangin group and the degree of obesity of Taeumin group higher. (3) The number of patients who have smoking history is more at Soyangin group. (4) In neurological problem, dizziness is more complained of in Soyangin group. 2. The analysis about the result of Questionnare (1) In problems related with 'Sleeping', the time of going to bed and getting up and the duration of sleeping are more irregular in Taeumin group. (2) In problems related with 'Defecation', the shape of stool is more variable in Taeumin group. (3) In problems related with 'Urination', Soyangin group have more complaint. (4) In problems related with 'The condition of digestion', Taeumin group have a good appetite and more compalint in lower abdominal region, but on the contrary Soyangin group lose appetite and have more complaint in upper abdominal region. (5) In problems related with 'Head and Face', Soyangin group have more complaint. (6) In problems related with 'Eye, Ear and Nose', Soyangin group have more complaint at eye and ear. (7) In promlems related with 'Chest region', Soyangin group easily feel choked up and Taeumin group heart throbs. (8) In problems related with 'Skin', Taeumin group easily feel change of color tone at skin and Soyangin group dry.

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THE ANTICANCER EFFECT OF PACLITAXEL($Taxol^{(R)}$) IN ORAL SQUAMOUS CELL CARCINOMA XENOGRAFT (이종 이식된 구강편평세포 암종에서 Paclitaxel ($Taxol^{(R)}$)의 항암 효과)

  • Kim, Ki-Hwan;Kim, Chul-Hwan;Han, Se-Jin;Lee, Jae-Hoon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.2
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    • pp.95-110
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    • 2006
  • The treatment for oral and maxillofacial carcinoma with chemotherapeutic agents is evaluated by many effective methods to reduce the tumor mass and cancer cell proliferation. However these chemotherapy have many serious side effects, such as bone marrow suppression, renal toxicity, G-I troubles. Therefore a possible approach to develop a clinically applicable chemotherapeutic agent is to screen anticancer activity of Taxol which is known to have very little side effect and have been used to breast cancer and ovarian carcinoma. Taxol is a new anti-microtubular anti-cancer agent extracted from the bark of the Pacific yew, Taxus brevifolia. Paclitaxel(Taxol) acts by promoting tubulin polymerization and over stabilizing microtubules agianst depolymerization. Despite the constant improvements of methods of the cancer treatment especially chemotherapy, the rate of cancer metastasis and recurrent are not decreased. Thus the investigation of new drug which have very little side effect and a possible clinically application continues to be a high priority. Considering that the Taxol have shown very effective chemotherapeutic agent with relatively low toxicity in many solid tumors, it deserves to evaluate its efficacy in oral squamous cell carcinoma. In this study, to investigate the in-vivo and in-vitro anti-cancer efficacy of Taxol in oral squamous cell carcinoma and lastly, the potency of Paclitaxel in the clinical application for oral cancer was evaluated. In vivo study, after HN22 cell line were xenografted in nude mice, the growth of tumor mass was observed, 3 mg/Kg taxol was injected intraperitoneally into nude mice containing tumor mass. The methods of these study were measurement of total volume of tumor mass, histopathologic study, immunohistochemical study, drug resistance assay, growth curve, MTT assay, flow cytometry, cDNA microarray in vivo and in vitro. The results were obtained as following. 1. The visual inspection of the experimental group showed that the volume of the tumor mass was slightly decreased but no significant difference with control group. 2. Ki-67 index was decreased at weeks 4 in experimental group. 3. Microscopic view of the xenografted tumor mass showed well differentiated squamous cell carcinoma and after Taxol injection, some necrotic tissue was seen weeks 4. 4. The growth curve of the tumor cells were decreased after 1day Taxol treatment. 5. According to the MTT assay, HN22 cell line showed relative drug resistancy above $5\;{\mu}g/ml$ concentrations of Taxol. 6. In drug resistance assay, the decrease of cell counts was seen relatively according to concentration. 7. In Flow cytometry, G2M phase cell arrests were seen in low concentration of the Taxol, while S phase cell arrests were seen in high concentration of the Taxol. 8. Using cDNA microarray technique, variable gene expression of ANGPTL4, TXNRD1, FAS, RRAGA, CTGF, CYCLINEA, P19, DUSP5, CEBPG, BTG1 were detacted in the oral squamous cell carcinoma cell after taxol treatment. In this study paclitaxel is effective against oral squamous cell carcinoma cell lines in vitro, but week effect was observed in vivo. So we need continuous study about anticancer effect of taxol in vivo in oral squamous cell carcinoma.

Usefulness of $^{99m}Tc$ Methoxyisobutylisonitrile Lung SPECT in Benign and Malignant Lesion of the Lungs (폐의 양성 및 악성 병변에서 $^{99m}Tc$ Methoxyisobutylisonitrile Lung SPECT의 진단적 가치)

  • Kim, Seong-Suk;Kim, Ki-Beom;Cho, Young-Bok;Cho, In-Ho;Lee, Kyung-Hee;Chung, Jin-Hong;Lee, Hyoung-Woo;Lee, Kwan-Ho;Lee, Hyun-Woo;Kim, Mi-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.54-62
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    • 1996
  • Background: $^{99m}Tc$ MIBI(Methoxyisobutylisonitrile complex), a member of the isonitrile class of coordination compounds, is a lipophilic cation presently under investigation for clinical use as myocardial perfusion imaging agent and is widely used to detect myocardial infarction. Preliminary reports indicate that $T_1$-201 accumulate in human neoplasm and several authors reported $^{99m}Tc$ MIBI may also localized in primary malignant tumor and metastatic deposits from lung cancer. We evaluated the uptake of $^{99m}Tc$ MIBI in lung cancer and localization of mediastinal and other site metastasis, and compared the benign lesion of the lung. Method: Thirty four patients of lung cancer and ten patients of benign lung lesion were studied with chest CT and $^{99m}Tc$ MIBI Lung SPECT. $^{99m}Tc$ MIBI uptake ratio was assessed by TR/NL(Lung lesion/ Normal area), HT/NL (Heart/Normal area) and HT/TR(Heart/Lung lesion). Results: 1) All lung cancer patients showed increased uptakes of $^{99m}Tc$ MIBI in malignant lung lesion and Tc-99m MIBI uptake was also increased in mediastinal and lymph node metastasis except two cases. 2) There was significant different ratio of TR/NL between malignant and benign lesion, $3.79{\pm}1.82$ and $1.67{\pm}0.63$ on planar images, respectively(p<0.001). 3) There was no significant difference of $^{99m}Tc$ MIBI uptake ratio between squamous cell carcinoma, small cell carcinoma and adeno carcinoma($3.64{\pm}1.66$, $3.57{\pm}0.72$, $4.31{\pm}2.28$ respectively). Conclusion: $^{99m}Tc$ MIBI lung SPECT was useful in the localization of tumor and mediastinal or other site metastatic lesion in lung cancer and also in the differential diagnosis between benign and malignant lesion.

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Aberrant Methylation of p16 Tumor Suppressor Gene and Death-Associated Protein Kinase in Non-Small Cell Lung Carcinoma (비소세포폐암 조직에서 p16 종양억제유전자와 Death-Associated Protein Kinase의 Aberrant Methylation의 양상)

  • Kim, Yun-Seong;Lee, Min-Ki;Jung, Kyung-Sik;Kim, Ki-Uk;Kim, Young-Dae;Lee, Hyung-Ryul;Lee, Chang-Hoon;Seok, Ju-Won;Kim, Yong-Ki;Jun, Eun-Sook;Choi, Young-Min;Rha, Seo-Hee;Park, Soon-Kew
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.2
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    • pp.108-121
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    • 2001
  • Background : The $p16^{INK4a}$ (p16) twnor suppressor gene is frequently inactivated in hwnan non-small cell lung cancers (NSCLCs), predominantly through homozygous deletion or in association with aberrant promotor hypermethylation. Death-associated protein kinase (DAPK) gene influences interferon $\gamma$-induced apoptotic cell death and has important role in metastasis of lung cancer in animal model. Hypermethylation of promoter region of DAP kinase gene may suppress the expression of this gene. Methods : This study was performed to investigate the aberrant methylation of p16 or DAP kinase in 35 resected primary NSCLCs by methylation-specific PCR (MSP), and demonstrated frequency, diagnostic value and clinical implication of aberrant methylation of two genes. Results : Thirty-two cases were male patients, and 3 cases were female patients with an average age was 57. $8{\pm}10.5$ years. The histologic types of lung cancer were 22 of squamous cell carcinoma, 12 of adenocarcinoma, 1 of large cell carcinoma. Pathologic stages were 11 cases of stage I (1 IA, 10 IB), 13 cases of stage II (1 IIA, 12 IIB), and 11 cases of stage III (9 IIIA, 2 IIIB). Regarding for the cancer tissue, p16 aberrant methylation was noted in 13 case of 33 cases (39.4%), DAP kinase in 21 cases of 35 cases (60%). Age over 55 year was associated with p16 aberrant methylation significantly (p<0.05). Methylation status of two genes was not different by smoking history, histologic type, size of tumor, lymph node metastasis and disease progression of lung cancer. There was no correlation between p16 and DAP kinase hypermethylation. Conclusion: This investigation demonstrates that aberrant methylation of p16 tumor suppressor gene or DAP kinase showed relatively high frequency (74.3%) in NSCLCs, and that these genes could be a biologic marker for early detection of lung cancer.

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Investigation of Perfusion-weighted Signal Changes on a Pulsed Arterial Spin Labeling Magnetic Resonance Imaging Technique: Dependence on the Labeling Gap, Delay Time, Labeling Thickness, and Slice Scan Order (동맥스핀표지 뇌 관류 자기공명영상에서 라벨링 간격 및 지연시간, 표지 두께, 절편 획득 순서의 변화에 따른 관류 신호변화 연구)

  • Byun, Jae-Hoo;Park, Myung-Hwan;Kang, Ji-Yeon;Lee, Jin-Wan;Lee, Kang-Won;Jahng, Geon-Ho
    • Progress in Medical Physics
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    • v.24 no.2
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    • pp.108-118
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    • 2013
  • Currently, an arterial spin labeling (ASL) magnetic resonance imaging (MRI) technique does not routinely used in clinical studies to measure perfusion in brain because optimization of imaging protocol is required to obtain optimal perfusion signals. Therefore, the objective of this study was to investigate changes of perfusion-weighed signal intensities with varying several parameters on a pulsed arterial spin labeling MRI technique obtained from a 3T MRI system. We especially evaluated alternations of ASL-MRI signal intensities on special brain areas, including in brain tissues and lobes. The signal targeting with alternating radiofrequency (STAR) pulsed ASL method was scanned on five normal subjects (mean age: 36 years, range: 29~41 years) on a 3T MRI system. Four parameters were evaluated with varying: 1) the labeling gap, 2) the labeling delay time, 3) the labeling thickness, and 4) the slice scan order. Signal intensities were obtained from the perfusion-weighted imaging on the gray and white matters and brain lobes of the frontal, parietal, temporal, and occipital areas. The results of this study were summarized: 1) Perfusion-weighted signal intensities were decreased with increasing the labeling gap in the bilateral gray matter areas and were least affected on the parietal lobe, but most affected on the occipital lobe. 2) Perfusion-weighted signal intensities were decreased with increasing the labeling delay time until 400 ms, but increased up to 1,000 ms in the bilateral gray matter areas. 3) Perfusion-weighted signal intensities were increased with increasing the labeling thickness until 120 mm in both the gray and white matter. 4) Perfusion-weighted signal intensities were higher descending scans than asending scans in both the gray and white matter. We investigated changes of perfusion-weighted signal intensities with varying several parameters in the STAR ASL method. It should require having protocol optimization processing before applying in patients. It has limitations to apply the ASL method in the white matter on a 3T MRI system.

Colon Perforation during Air Enema Reduction of Intussusception (소아 장중첩증에서 공기 주입 정복술 시행 도중 발생한 장천공)

  • Kim, Yong Kuk;Im, Hae Ra;Lee, Gwang Hoon;Han, Soo Jin;Sun, Yong Han;Ryoo, Eell;Cho, Kang Ho;Tchah, Hann;Lee, Hak Soo
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.37-41
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    • 2003
  • Purpose : Although air enema reduction has been known as a good method of diagnosis and treatment of intussusception, it could develop colon perforation. However, there have been few studies about this complication. So we analyzed the risk factors of colon perforation during air enema reduction in patients with intussusception. Methods : We reviewed the charts of 12 colon perforation patients during air enema reduction of intussusception, who were admitted to Gil Medical Center from Jan. 1990 to Dec. 2001. Their age, sex, major symptoms, length of time till hospital visit, types of intussusception, operative findings and pathologic reports were reviewed. Results : Among 657 cases, 596 patients(90.7%) were successfully treated, but 12 patients(1.83%) failed in air enema reduction and had colon perforation. In patients with colon perforation the male to female ratio was 11 : 1, and average age was 5.3 months. The most common symptom at the time of hospital visit was vomiting(91.7%). Cyclic irritability(75.0%), bloody stool(75.0%) and abdominal mass(41.7%) were also noted. The average length of time between symptom onset and hospital visit was 44.7 hours. Types of intussusception were predominantly ileocolic, ileocecal, and ileoileocolic. The site of perforation was most commonly found at the proximal part of intussusception including ascending colon(50%) and transverse colon(50%). Most cases were uncomplicated, and had a single perforation. Pathologic reports showed hemorrhagic necrosis and mesenteric laceration at the site of colon perforation. Complications of colon perforation were tension pneumoperitonium(58.3%), requiring immediate decompression. Conclusion : The chance of colon perforation during air enema reduction increases in cases with small bowel obstruction on simple abdominal x-ray of a patient younger than 6 months, delay in time till hospital visit and higher air pressure during reduction. Therefore more careful investigation is needed in these cases.

Voxel-based Investigations of Phase Mask Effects on Susceptibility Weighted Images (화소 간 분석을 이용하여 자화율 가중 영상(SWI)에 나타난 위상 마스킹의 효과 분석)

  • Hwang, Eo-Jin;Kim, Min-Ji;Kim, Hyug-Gi;Ryu, Chang-Woo;Jahng, Geon-Ho
    • Progress in Medical Physics
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    • v.24 no.1
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    • pp.25-34
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    • 2013
  • To investigate effects of phase mask on susceptibility-weighted images (SWI) using voxel-based analyses in normal elderly subjects. A three-dimensional (3D) gradient echo sequence ran to obtain SWIs in 20 healthy elderly subjects. SWIs with two (SWI2) and four (SWI4) phase multiplications were achieved with positive (PSWI) and negative (NSWI) phase masks to investigate phase mask effects. The voxel-based comparisons were performed using paired t-tests between PSWI and NSWI and between SWI2 and SWI4. Differences of signal intensities between magnitude images and SWI4 were larger than those between magnitude images and SWI2s. Differences of signal intensities between magnitude images and PSWIs were larger than those between magnitude images and NSWIs. Moreover, the signal intensities from NSWI2s and NSWI4s were greater than those from PSWI2s and PSWI4s, respectively. More differences of signal intensities between NSWI4 and PSWI4s were found than those between NSWI2s and PSWI2s in the whole brain images. The voxel-based analyses of SWI could be beneficial to investigate susceptibility differences on the entire brain areas. The phase masking method could be chosen to enhance brain tissue contrast rather than to enhance venous blood vessels. Therefore, it is recommended to apply voxel-based analyses of SWI to investigate clinical applications.