• Title/Summary/Keyword: Clinical patterns

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Clinical Values of Cold-Heat Pattern Diagnosis by the Nasal Endoscopy for Patients with Cough (기침에 대한 비내시경을 이용한 한열변증(寒熱辨證)의 임상적 가치평가)

  • Lee, Hee-Beom;Park, Eui-Keun;Baek, Hyun-Jung;Lee, Beom-Joon;Jung, Sung-Ki;Jung, Hee-Jae
    • The Journal of Internal Korean Medicine
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    • v.35 no.3
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    • pp.274-287
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    • 2014
  • Objectives: This study was aimed to figure out an agreement between the diagnosis of nasal endoscopy and a preexisting questionnaire focusing on Cold-Heat pattern. Methods: 52 patients with cough who met the criteria filled out a pattern questionnaire and the examiner looked at their nasal cavities through nasal endoscopy. According to the checked questionnaire results, the subjects were identified by 6 patterns. After examining subject's mucous membrane of oropharynx and nasal cavity through nasal endoscopy, we classified each to the Cold or Heat group. Correlation between questionnaire and nasal endoscopy results was analyzed. Results: In diagnosing Cold-Heat, there was no significant difference by McNemar test (p=0.227) between nasal endoscopy and the questionnaire, and the two methods agreed moderately (${\kappa}=0.428$). The color of mucous membrane of oropharynx and the Cold-Heat pattern on questionnaire agreed slightly (${\kappa}=0.133$). The color of mucous membrane of nasal cavity and the Cold-Heat pattern on questionnaire agreed fairly (${\kappa}=0.384$). In the patients with cough related to upper respiratory tract, they got higher diagnosis accuracy than the patients with cough related to lower respiratory tract did. Similarly, external cough patients got higher diagnosis accuracy than internal cough patients did. Conclusions: To identify Cold or Heat, examining oropharynx and nasal cavity using nasal endoscopy is a meaningful method in patients with cough, showing that two diagnosis methods which use nasal endoscopy and questionnaire agreed moderately. Especially, it is more useful diagnosing patients with cough related to the upper respiratory tract than diagnosing the patients with cough related to the lower respiratory tract.

Study on the Possibility of Quantitative Measurement of Abdominal Examinations in Korean Medicine - A Focus on Diagnosis of Abdominal Coldness in Functional Dyspepsia Patients - (한의 복진 정량화 연구 - 기능성 소화불량 환자의 복냉 진단을 중심으로 -)

  • Lee, Jae-hong;Cho, Soo-ho;Ko, Seok-jae;Kim, Jin-sung;Park, Jae-woo
    • The Journal of Internal Korean Medicine
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    • v.39 no.4
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    • pp.495-510
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    • 2018
  • Objective: This study was designed to investigate the possibility of quantification of the diagnosis of abdominal coldness (AC) in patients with functional dyspepsia (FD). Methods: Forty-four patients with FD were enrolled in this study. Three Korean medicine doctors each randomly examined all abdomens. Diagnosis of AC was made by consensus of at least two of the doctors. Body temperature (oral by digital oral thermometer) and skin temperature (by digital infrared thermal imaging [DITI]) were measured, followed by administration of the Cold and Heat questionnaire (CHQ) and the Instrument of Pattern Identification for Functional Dyspepsia (IPIFD). Results: Of the 44 patients with FD, 22 were assigned to the AC group and 22 to the non-AC group. The concordance rate of diagnosis among the three doctors was 63.6% (28/44), with a ${\kappa}$ of 0.504, indicating means moderate agreement). Neither the oral nor the skin temperatures showed statistically significant differences between the AC and non-AC groups. However, the CHQ scores and 'Simultaneous Occurrence of Cold and Heat Syndromes pattern' scores of the IPIFD were higher in AC group and showed statistically significant differences (p=0.010 and 0.009). Conclusions: This is the first study conducting quantitative measurements of abdominal coldness in patients with FD. Although oral and skin temperature showed no statistical significance between AC and non-AC groups, the concordance rate of diagnosis of AC among the three Korean Medicine doctors was moderate. The CHQ scores and 'Simultaneous Occurrence of Cold and Heat Syndromes pattern' scores of the IPIFD also suggest that diagnosis of AC is relevant to cold and heat patterns, and these questionnaires could be utilized as supportive data for the diagnosis of AC. Further studies should be conducted for the purpose of quantifying and standardizing abdominal examinations in Korean Medicine.

Current Understanding and Practices of Breast feeding by Mothers (모유수유에 대한 산모의 의식과 실천 현황)

  • Park, Eun Young;Cho, Su Jin;Lee, Keun
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1162-1165
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    • 2005
  • Purpose : The objective of this survey was to develop an operational plan for breast feeding education. In order to comprehend current breast feeding patterns, we aimed to examine the knowledge, attitude and practices regarding breast feeding of mothers and to compare the data with a similar study done 6 years ago. Methods : A total of 127 mothers who delivered healthy babies at Ewha Womans University Dongdaemun Hospital were interviewed and asked to complete a survey on their perception of breast feeding during their postpartum stay in the hospital. A follow up phone interview was carried out at 1, 2 and 3 months after delivery and similar questions were asked. Results : At the time of delivery, 96.1 percent of mothers planned to breast feed, including 73.2 percent of exclusive breast feeding and 22.8 percent of mixed feeding. The duration of breast feeding planned was mostly 7-12 months. Breast feeding had been recommended by family members. Between 1-3 months, exclusive breast feeding was maintained at least 50 percent but a large number of mothers who had practiced mixed feeding changed to formula feeding. This trend demonstrates an increase in the rate of breast feeding at 3 months compared to a similar study done in 1999. The main reasons for discontinuing breast feeding were insufficient amount of milk(35.0 percent) and return to work(27.5 percent). Conclusion : Breast feeding rate has increased in Korea since 1999 but failure to continue exclusive breast feeding still occurs mainly within the first month after delivery. Breast feeding education should focus on supportive care to mothers practicing mixed feeding.

Quality Assurance of Multileaf Collimator Using Electronic Portal Imaging (전자포탈영상을 이용한 다엽시준기의 정도관리)

  • ;Jason W Sohn
    • Progress in Medical Physics
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    • v.14 no.3
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    • pp.151-160
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    • 2003
  • The application of more complex radiotherapy techniques using multileaf collimation (MLC), such as 3D conformal radiation therapy and intensity-modulated radiation therapy (IMRT), has increased the significance of verifying leaf position and motion. Due to thier reliability and empirical robustness, quality assurance (QA) of MLC. However easy use and the ability to provide digital data of electronic portal imaging devices (EPIDs) have attracted attention to portal films as an alternatives to films for routine qualify assurance, despite concerns about their clinical feasibility, efficacy, and the cost to benefit ratio. In this study, we developed method for daily QA of MLC using electronic portal images (EPIs). EPID availability for routine QA was verified by comparing of the portal films, which were simultaneously obtained when radiation was delivered and known prescription input to MLC controller. Specially designed two-test patterns of dynamic MLC were applied for image acquisition. Quantitative off-line analysis using an edge detection algorithm enhanced the verification procedure as well as on-line qualitative visual assessment. In conclusion, the availability of EPI was enough for daily QA of MLC leaf position with the accuracy of portal films.

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Physical Modeling of Chemical Exchange Saturation Transfer Imaging

  • Jahng, Geon-Ho;Oh, Jang-Hoon
    • Progress in Medical Physics
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    • v.28 no.4
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    • pp.135-143
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    • 2017
  • Chemical Exchange Saturation Transfer (CEST) imaging is a method to detect solutes based on the chemical exchange of mobile protons with water. The solute protons exchange with three different patterns, which are fast, slow, and intermediate rates. The CEST contrast can be obtained from the exchangeable protons, which are hydroxyl protons, amine protons, and amide protons. The CEST MR imaging is useful to evaluate tumors, strokes, and other diseases. The purpose of this study is to review the mathematical model for CEST imaging and for measurement of the chemical exchange rate, and to measure the chemical exchange rate using a 3T MRI system on several amino acids. We reviewed the mathematical models for the proton exchange. Several physical models are proposed to demonstrate a two-pool, three-pool, and four-pool models. The CEST signals are also evaluated by taking account of the exchange rate, pH and the saturation efficiency. Although researchers have used most commonly in the calculation of CEST asymmetry, a quantitative analysis is also developed by using Lorentzian fitting. The chemical exchange rate was measured in the phantoms made of asparagine (Asn), glutamate (Glu), ${\gamma}-aminobutyric$ acid (GABA), glycine (Gly), and myoinositol (MI). The experiment was performed at a 3T human MRI system with three different acidity conditions (pH 5.6, 6.2, and 7.4) at a concentration of 50 mM. To identify the chemical exchange rate, the "lsqcurvefit" built-in function in MATLAB was used to fit the pseudo-first exchange rate model. The pseudo-first exchange rate of Asn and Gly was increased with decreasing acidity. In the case of GABA, the largest result was observed at pH 6.2. For Glu, the results at pH 5.6 and 6.2 did not show a significant difference, and the results at pH 7.4 were almost zero. For MI, there was no significant difference at pH 5.6 or 7.4, however, the results at pH 6.2 were smaller than at the other pH values. For the experiment at 3T, we were only able to apply 1 s as the maximum saturation duration due to the limitations of the MRI system. The measurement of the chemical exchange rate was limited in a clinical 3T MRI system because of a hardware limitation.

A Review of Static Blood Pattern in Stroke Pattern Diagnosis (한의 중풍 변증 표준화 연구에서 어혈증에 관한 고찰)

  • Lee, Jung-Sup;Kim, So-Yeon;Kang, Byoung-Kab;Ko, Mi-Mi;Kim, Jeong-Cheol;Oh, Dal-Seok;Kim, Yoon-Sik;Lee, In;Cho, Ki-Ho;Chen, Chan-Yong;Han, Chang-Ho;Bang, Ok-Sun
    • The Journal of Internal Korean Medicine
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    • v.30 no.4
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    • pp.813-820
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    • 2009
  • Background : Static blood is a kind of etiological factor including stagnated blood and blood overflowed out of the vessels. It is one of the causes of stroke in oriental medicine. Objectives : The purpose of this study was to evaluate the static blood pattern and its indicators in stroke pattern diagnosis. Methods : For the standardization of pattern diagnosis in stroke, we set 5 patterns (Fire-heat, Dampness-phlegm, Static blood, Qi deficiency, Yin deficiency) and developed 61 indicators. Patients with a first-ever stroke, within 1 month after the onset of stroke. Two physicians checked the indicators independently. They then performed pattern diagnosis and rechecked the indicators which were referred to pattern diagnosis. If pattern identifications were diagnosed the same, it would confirm pattern identification. We examined the frequency of all indicators and referred indicators in static blood pattern patients. Results : In 859 patients, static blood pattern was shared by 24(2.8%). The indicators which affect static blood pattern were mainly rough pulse and bluish purple tongue, other indicators were not major effectors. Conclusion : This result shows that it is inconsistent to set up static blood pattern as a major pattern in stroke. Nevertheless, static blood is still a valuable concept in the clinical field. Other study methods will be required to establish the pattern diagnostic indicators for static blood pattern.

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Characterization of Human Thigh Adipose-derived Stem Cells (사람의 허벅지지방유래 줄기세포의 특성 분석)

  • Heo, Jin-Yeong;Yoon, Jin-Ah;Kang, Hyun-Mi;Park, Se-Ah;Kim, Hae-Kwon
    • Development and Reproduction
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    • v.14 no.4
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    • pp.233-241
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    • 2010
  • Human adipose stem cells are an abundant, readily available population of multipotent progenitor cells that reside in adipose tissue and these cells have characteristics very similar to bone marrow mesenchymal stromal cells (BMMSCs). However, liposuction procedure, donor age, body mass index, and harvesting sites might generate differences in the initial cell population and the preparations are a heterogeneous mixture of precursors with different subsets. Therefore, in this study, we investigated the characteristics of human thigh adipose stem cells and the differentiation potential into mesodermal and endodermal lineage. Thigh adipose stem cells maintained fibroblast-like morphology similar to BM-MSCs and they underwent average 56.5 doublings and produced $5{\times}10^{22}$ cells. These cells expressed SCF, Oct4, nanog, vimentin, CK18, FGF5, NCAM, Pax6, BMP4, HNF4a, nestin, GATA4, HLA-ABC, and HLA-DR genes at p3 and they also expressed Oct4, Thy-1, FSP, vWF, vimentin, desmin, CK18, CD54, CD4, CD106, CD31, a-SMA, HLA-ABC proteins. Moreover, they could differentiate into mesodermal lineage cells such as adipocyte, osteoblast and chondrocyte. In addition, they also differentiated into insulin secreting cells in our culture condition. In conclusion, human thigh adipose stem cells retain proliferative potential and expression patterns similar to BM-MSCs and they also differentiate into various cell types. Thus, human thigh adipose stem cells might be useful alternative cell source for clinical application.

Preparation and Biocompatibility of Medical Fiber from Novel Regenerated Cellulose from Styela clava tunic (미더덕껍질의 재생셀룰로오스를 이용한 의료용 섬유의 제조 및 생체적합성)

  • Song, Sung Hwa;Kim, Ji Eun;Choi, Jun Young;Park, Jin Ju;Lee, Mi Rim;Song, Bo Ram;Lee, Yechan;Kim, Hong Sung;Lee, Jae Ho;Lim, Yong;Hwang, Dae Youn;Jung, Young Jin
    • Textile Coloration and Finishing
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    • v.30 no.2
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    • pp.117-129
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    • 2018
  • Cellulose has been widely applied into various medical fields including scaffolding, tissue engineering and tissue formation. In this study, we manufactured cellulose medical fiber from Styela clava tunics(SCT-CS) and analyzed the tensile strength, elongation at break, fluid uptake and surface morphology. And then, the biocompatibility and toxicity of SCT-CS were measured in Sprague-Dawley(SD) rats after the implantation for 30, 60 and 90 days. The level of tensile strength and fluid uptake were lower in SCT-CS than chromic catgut(CCG), while elongation at break level were maintained the higher in SCT-CS. Also, the roughness with pronounced surface patterns as a result of in vivo degradation was significantly greater in CCG than this of SCT-CS although these levels gradually appeared with time in both groups. After implantation for 90 days, SCT-CS and CCG was successfully implanted around muscle of thigh without any significant immune response. Furthermore, no significant alterations were measured in serum parameters and the specific pathological features induced by most toxic compounds for liver and kidney toxicity. Therefore, these results suggest that SCT-CS showing good biocompatibility and non-toxicity can be successfully prepared from cellulose powder of SCT as well as has the potential for use as a powerful biomaterial for medical sutures.

Long Head of the Biceps Tendon Lesion Associated with Rotator Cuff Tear (회전근 개 파열과 동반된 상완 이두 건 장두의 병변)

  • Kim, Young-Kyu;Kim, Dong-Wook;Lee, Jong-Hun
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.64-71
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    • 2010
  • Purpose: To evaluate pathologic patterns and outcomes of treatment of a biceps tendon lesion associated with a rotator cuff tear. Materials and Methods: We reviewed 92 patients (i) who underwent surgery for a cuff tear, (ii) for whom the biceps lesion could be observed retrospectively, and (iii) had a minimum follow-up of 2 years. The pathology of biceps tendon was classified into 4 types: tenosynovitis, fraying or hypertrophy, tear, and instability. All but the 4 with massive cuff tears were repaired. The biceps lesions were treated with debridement in 30, tenotomy in 10, tenodesis in 8, and recentering in 4. UCLA scoring was used for clinical results. Results: Seventy patients had a biceps lesion, 19 tenosynovitis, 22 fraying or hypertrophy, 21 a tear, and 8 instability. A biceps lesion was observed in 63% of cases of cuff tears below the medium size, and in 88% of cases with cuff tears above the large size. UCLA scores according to the pathology of the biceps lesion were 29.6 in the absence of a biceps lesion, and 28.3 in its presence. UCLA scores in patients with tenotomy or tenodesis for associated biceps tendon lesions were 28.2. Conclusion: There is a greater incidence and severity of a biceps lesion with a larger cuff tear. Therefore, the cause of a biceps lesion might be related to the cause of the cuff tear. Among the several options of treatment for biceps lesion, tenotomy or tenodesis may be particularly effective in providing pain relief.

The Overexpression of p53 in Head and Neck Squamous Cell Carcinoma as Prognostic Marker (두경부 편평 세포암에서 예후인자로서의 p53 발현)

  • Jeong Seung-Won;Lee Hyung-Seok;Park Chul-Won;Park Yong-Wook;Park Chan-Keum;Jang Se-Jin;Tae Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.169-173
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    • 2001
  • Objectives: The p53 tumor suppressor gene encodes a nuclear transcription factor that is critical regulator of cell growth and proliferation through its action in cell-cycle checkpoint control. The wide variety of stressful stmuli which include DNA damage, hypoxia, heat shock, metabolic changes activate the p53 protein, which in turn drives a series of events that culminate either in cell cycle arrest or apoptosis. Mutations of the p53 gene is the most common genetic alteration in human cancer. This gene is altered in approximately 40-60% of head and neck cancers. Whereas the wild-type form of the p53 protein plays a central role in cell-cycle control in response to DNA damage, most of the mutant forms are unable to do so. The high levels of p53 protein expression in tissues are related to the increased cellular proliferative activity and may be associated with the poor clinical outcome. To determine whether the expression of the p53 protein has prognostic significance and is associated with patterns of treatment failure in head and neck squamous cell carcinoma (HNSCC), We analyzed p53 overexpression in 40 cases of HNSCC. Materials and Methods: Immunohistochemical analysis with a monoclonal antibody (DO7) specific for p53 protein was used to detect expression of the protein in formalin-fixed, paraffin-embedded tumor samples from 40 HNSCC. We evaluated p53 protein expression and analyzed the relationship between the p53 overexpression and age, sex, primary tumor site, stage, survival rate, recurrence. All reported P values resulted from two-sided statistical tests. Results: Overexpression of p53 was detected in 20 cases(50%) among 40 cases of HNSCC. The p53 overexpression was not associated with age, sex, primary tumor site, stage, recurrence and survival rate. Conclusions: In our results, p53 was not significant prognostic factor in HNSCC. Based on many previous studies, It is evident that p53 has a certain role in tumorigenesis of HNSCC. So, the further study is needed to evaluate the prognostic significance of p53 in HNSCC.

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