• Title/Summary/Keyword: Dynamic diagnosis

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Respiratory Severity Score as a Predictive Factor for the Mortality of Congenital Diaphragmatic Hernia

  • Ahn, Ja-Hye;Jung, Young Hwa;Shin, Seung Han;Kim, Hyun-Young;Kim, Ee-Kyung;Kim, Han-Suk
    • Neonatal Medicine
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    • v.25 no.3
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    • pp.102-108
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    • 2018
  • Purpose: Congenital diaphragmatic hernia (CDH) is rare but potentially fatal. The overall outcome is highly variable. This study aimed to identify a simple and dynamic parameter that helps predict the mortality of CDH patients in real time, without invasive tests. Methods: We conducted a retrospective chart review of 59 CDH cases. Maternal and fetal information included the gestational age at diagnosis, site of defect, presence of liver herniation, and lung-to-head ratio (LHR) at 20 to 29 weeks of gestational age. Information regarding postnatal treatment, including the number of days until surgery, the need for inhaled nitric oxide (iNO), the need for extracorporeal membrane oxygenation (ECMO), and survival, was collected. The highest respiratory severity score (RSS) within 24 hours after birth was also calculated. Results: Statistical analysis showed that a younger gestational age at the initial diagnosis (P<0.001), a lower LHR (P=0.001), and the presence of liver herniation (P=0.003) were prenatal risk factors for CDH mortality. The RSS and use of iNO and ECMO were significant factors affecting survival. In the multivariate analysis, the only remaining significant risk factor was the highest preoperative RSS within 24 hours after birth (P=0.002). The area under the receiver operating characteristic curve was 0.9375, with a sensitivity of 91.67% and specificity of 83.87% at the RSS cut-off value of 5.2. The positive and negative predictive values were 82.14% and 92.86%, respectively. Conclusion: Using the RSS as a prognostic predictor with simple calculations will help clinicians plan CDH management.

A Study on the Effects of Maximum Voluntary Clenching on the Tooth Contact Points and Masticatory Muscle Activities in Patients with Temporomandibular Disorders (측두하악장애환자에 있어서 수의적 악물기시의 치아접촉점 및 저작근 활성에 관한 연구)

  • Jae-Kap Choi;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • v.15 no.1
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    • pp.105-115
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    • 1991
  • The purpose of the study was to evaluate the occlusal stability at the moment of dynamic occlusal tooth contact and to investigate the correlation between the occlusal stability and the masticatory muscle activities. It also evaluated the effect of short-term use of occlusal splints on the occlusal stability and the masticatory muscle activities in patients with temporomandibular disorders during maximum voluntary clenching by synchondronized with temporomandibular disorders during maximum voluntary clenching by synchronized use of the T-Scan system(Tekscan, Inc, USA) and K6-Diagnostic system(Myo-tronics Research, Inc, USA) The author measured its distance from retruded contact position(RCP) to intercuspal position(IP), average of contact intervals(ACI), total left-right statistics(TLR), average muscle activities of masseter and anterior temporal muscles during maximum voluntary clenching in 20 patients with temporomandibular disorders and 22 dental students as a control group. The data were compared between two groups and investigated for any correlations between the parameters. The results were as follows : 1. Both of the mean average of contact intervals and the mean absolute value of total left-right statistics during maximum voluntary clenching were increased in the patient group when compared with the control group. 2. Muscular disharmony of anterior temporal muscles of patient group is significantly greater than that of control group. However, muscular disharmony of masseter muscles of patient group is not significantly greater than that of control group. 3. There were significant correlations between muscular disharmony of anterior temporal muscles and average of contact intervals as well as total left-right statistics, and also between muscular disharmony of masseter muscles and total left-right statistics. 4. There were not any significant correlations between distance from RCP to IP and any other parameters. 5. There were a significant decrease in total left-right statistics and muscular disharmony of anterior temporal muscles during maximum voluntary clenching after a 1week use of occlusal splint in the patient group.

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Clinical and Statistical Analysis in 452 Cases of Nasal Bone Fracture Patients (코뼈 골절 환자 452례에 대한 임상 통계학적 분석)

  • Kang, Jae-Hoon;Bang, Yoo-Hyun;Lee, Yong-Hae;Choi, Chang-Yong
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.775-782
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    • 2011
  • Purpose: Nasal bone fracture is most common facial bone fracture. The cause of fractures is mainly trauma such as fighting, automobile accident and fall down, and it commonly involves young males. Very frequently nasal bone fractures are associated with other facial injuries such as orbital bone fracture, maxillary bone fracture and nasal septal deformities. Because of various dynamic directions of power are involved, phenomenon of fractures are also various and treatment cannot be simple. Methods: We studied and analyzed retrospectively 452 cases nasal bone fractures from January 2008 to December 2010. Diagnosis were made with physical examination, Nasal bone X-rays, Facial bone CT and 3D facial bone CT. Four surgeons are involved in treatments of these patients and applied different procedure along patient's condition and deformity. We analyzed the cause of nasal bone fractures, deformities, associate injuries and applied surgical technique, and patient's satisfaction rate. In this study, old nasal bone fractures were excluded. Results: Young male group was most commonly sustained nasal bone fracture and physical violence was most common cause of injury. 64 of 452 patient was involved associate injuries of face. Closed reduction were applied 246 cases and C-arm quide reduction were 167 cases and in 20 cases lateral osteotomy were applied. Approximately, more than 80% of the Patients were satisfied with the outcomes. Conclusion: Diagnosis and treatment of nasal bone fractures are considered simple but because of various deformity and associate injuries, treatment is not always simple and universal. Time to time, we face unsatisfied patient after treatment of nasal bone fractures. For obtaining satisfactory result, cause of injury and state of deformities and associate injuries such as nasal septal deformity should be evaluated properly and proper treatment should be applied.

Computational Analysis of Tumor Angiogenesis Patterns Using a Growing Brain Tumor Model

  • Shim, Eun-Bo;Kwon, Young-Keun;Ko, Hyung-Jong
    • International Journal of Vascular Biomedical Engineering
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    • v.2 no.1
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    • pp.17-24
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    • 2004
  • Tumor angiogenesis was simulated using a two-dimensional computational model. The equation that governed angiogenesis comprised a tumor angiogenesis factor (TAF) conservation equation in time and space, which was solved numerically using the Galerkin finite element method. The time derivative in the equation was approximated by a forward Euler scheme. A stochastic process model was used to simulate vessel formation and vessel elongation towards a paracrine site, i.e., tumor-secreted basic fibroblast growth factor (bFGF). In this study, we assumed a two-dimensional model that represented a thin (1.0 mm) slice of the tumor. The growth of the tumor over time was modeled according to the dynamic value of bFGF secreted within the tumor. The data used for the model were based on a previously reported model of a brain tumor in which four distinct stages (namely multicellular spherical, first detectable lesion, diagnosis, and death of the virtual patient) were modeled. In our study, computation was not continued beyond the 'diagnosis' time point to avoid the computational complexity of analyzing numerous vascular branches. The numerical solutions revealed that no bFGF remained within the region in which vessels developed, owing to the uptake of bFGF by endothelial cells. Consequently, a sharp, declining gradient of bFGF existed near the surface of the tumor. The vascular architecture developed numerous branches close to the tumor surface (the brush-border effect). Asymmetrical tumor growth was associated with a greater degree of branching at the tumor surface.

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Ultrasonographic Guidance in Acute Achilles Tendon Rupture (급성 아킬레스 건 파열에서의 초음파 이용)

  • Lee, Tae-Hoon;Lee, Hee-Dong;Kim, Hak-Jun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.8 no.1
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    • pp.26-30
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    • 2015
  • There are many traumatic foot and ankle problems in orthopaedic fields. Though it is not life-threatening problems, a delay in accurate diagnosis and treatments can danger limb function and therefore correct diagnosis can prevent long-term complications. Achilles tendon rupture is relatively common injury for active sports people. Ultrasonography is cost-effective, irradiation -free, effective for evaluation of soft tissues and dynamic analysis. It has been growing importance in Achilles tendon rupture. Ultrasonography is a diagnostic tool in Achilles tendon rupture. Physical examination and patient history is needed to diagnose Achilles tendon without image, but it is missed up by 20% in private clinic. Discontinuity of normal fibrillar architecture seen on an ultrasonographic image is diagnostic for Achilles tendon rupture, and can be accentuated by the performance of dorsi-flexion and plantar flexion, while observing in real time. And ultrasonography is a reliable method for serial observation after surgical treatment or conservative treatment.

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Cervical stabilization exercise using the Sling system (슬링(Sling) 시스템을 이용한 경부 안정화 운동)

  • Kwon, Jae-Hoak;Cho, Mi-Ju;Park, Min-Chull;Kim, Suhn-Yeop
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.8 no.2
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    • pp.57-71
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    • 2002
  • Cervical pain is a rapid increase that is owing to a flexion-extension whiplash injury, unappropriated posture, chronical repetition injury from abdominal position of head and neck, excessive repeating work, chronical deficiency of excercise. Because of that is bring about muscle unbalance, tightness of cervical extensor muscle, weakness of cervical deep flexor muscles, instability of cervical region and reduction of proprioceptive sensor. Recent the role of muscle is more emphasized for preservation of sine stabilization. And cognition of integrated muscular system, importance for the operation and relation is increased to maintain stability of the motor system and pertinent function. Therefore we are going to introduce the sling exercise and stabilization exercise method for advanced efficient of cervical and upper limb and for the muscle strengthening to importance cervical stabilization through neurological program as control the reaction of cervical stabilization. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensory-motor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovascular exercise, group exercise, personal exercise at home Sensory-motor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercise on an unstable surface, there by achieving optimum stimulation of the sensory-motor apparatus.

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A Study on the Diagnostic Detection Ability of the Artificial Proximal Caries by Digora$\textregistered$ (Digora$\textregistered$ 영상시스템을 이용한 인접면 인공 치아우식병소의 진단능에 관한 연구)

  • Oh Kyung-Ran;Choi Eui-Hwan;Kim Jae-Duk
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.28 no.2
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    • pp.415-433
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    • 1998
  • Digora system is an intraoral indirect digital radiography system utilizing storage phosphor image plate. It has wide dynamic range which allows it to decrease the patient s exposure time and may increase diagnostic ability through image processing (such as edge enhancement, grey scale conversion, brightness change, and contrast enhancement). And also, it can transmit and storage image information. The purpose of this study was to evaluate the diagnostic ability of artificial proximal caries between Conventional radiograph and Digora images(unenhanced image, brightness & contrast controlled image, and edge enhanced image). ROC(Receiver Operating Characteristic) analysis, paired t-tests, and F-tests were done for the statistical evaluation of detectability. The following results were acquired: 1. In Grade I lesions, the mean ROC areas of Conventional radiograph, Digora unenhanced image, Digora controlled image, and Digora edge enhanced image were 0.953, 0.933, 0.965, 0.978 (p>0.05). 2. In Grade II lesions, the mean ROC areas of Conventional radiograph, Digora unenhanced image, Digora controlled image, and Digora edge enhanced image were 0.969, 0.964, 0.988, 0.994. Among theses areas, there was just statistical significance between Diagnostic abilities of Digora edge enhanced image and Conventional radiograph (p<0.05). 3. In the Interobserver variability, the ROC curve areas of Digora edge enhanced image was lowermost in these areas, regardless of the Carious lesion depths. In conclusion, intraoral indirect digital system, Digora system, has the potential possibility as an alternative of Conventional radiograph in the diagnosis of proximal caries.

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On Diagnosis Measurement under Dynamic Loading of Ball Bearing using Numerical Thermal Analysis and Infrared Thermography (전산 열해석 및 적외선 열화상을 이용한 볼베어링의 동적 하중에 따른 진단 계측에 관한 연구)

  • Hong, Dong-Pyo;Kim, Ho-Jong;Kim, Won-Tae
    • Journal of the Korean Society for Nondestructive Testing
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    • v.33 no.4
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    • pp.355-360
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    • 2013
  • With the modern machinery towards the direction of high-speed development, the thermal issues of mechanical transmission system and its components is increasingly important. Ball bearing is one of the main parts in rotating machinery system, and is a more easily damaged part. In this paper, bearing thermal fault detection is investigated in details Using infrared thermal imaging technology to the operation state of the ball bearing, a preliminary thermal analysis, and the use of numerical simulation technology by finite element method(FEM) under thermal conditions of the bearing temperature field analysis, initially identified through these two technical analysis, bearing a temperature distribution in the normal state and failure state. It also shows the reliability of the infrared thermal imaging technology. with valuable suggestions for the future bearing fault detection.

Clinical and Radiological Findings of Discogenic Low Back Pain Confirmed by Automated Pressure Controlled Discography

  • Kim, Hyung-Gon;Shin, Dong-Ah;Kim, Hyoung-Ihl;Yoo, Eun-Ae;Shin, Dong-Gyu;Lee, Jung-Ok
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.333-339
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    • 2009
  • Objective : Few studies on the clinical spectrum of automated pressure-controlled discography (APCD)-defined positive discs have been reported to date. Thus, the present study was undertaken to analyze clinical parameters critical for diagnosis of discogenic pain and to correlate imaging findings with intradiscal pressures and pain responses in patients with APCD-positive discs. Methods : Twenty-three patients who showed APCD-positive discs were selected for analysis. CT discogram findings and the degrees of nuclear degeneration seen on MRI were analyzed in comparison to changes of intradiscal pressure that provoked pain responses; and clinical pain patterns and dynamic factors were evaluated in relation to pain provocation. Results : Low back pain (LBP), usually centralized, with diffuse leg pain was the most frequently reported pattern of pain in these patients. Overall, LBP was most commonly induced by sitting posture, however, standing was highly correlated with L5/S1 disc lesions (p<0.01). MRI abnormalities were statistically correlated with grading of CT discogram results (p<005); with most pain response observed in CT discogram Grades 3 and 4. Pain-provoking pressure was not statistically correlated with MRI grading. However, it was higher in Grade 3 than Grade 4. Conclusion : APCD-positive discs were demonstrated in patients reporting centralized low back pain with diffuse leg pain, aggravated by sitting and standing. MRI was helpful to assess the degree of nuclear degeneration, yet it could not guarantee exact localization of the painful discs. APCD was considered to be more useful than conventional discography for diagnosis of discogenic pain.

Evaluation of the Anti-Tumor Effects of Paclitaxel-Encapsulated pH-Sensitive Micelles

  • Han, Jong-Kwon;Kim, Min-Sang;Lee, Doo-Sung;Kim, Yoo-Shin;Park, Rang-Woon;Kim, Kwang-Meyung;Kwon, Ick-Chan
    • Macromolecular Research
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    • v.17 no.2
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    • pp.99-103
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    • 2009
  • We evaluated the efficacy of pH-sensitive micelles, formed by methoxy poly(ethylene glycol)-b-poly($\beta$)-amino ester) (PEG-PAE), as carriers for paclitaxel (PIX), a drug currently used to treat various cancers. PTX was successful encapsulated by a film hydration method. Micelles encapsulated more than 70% of the PTX and the size of the PTX-encapsulated micelles (PTX-PM) was less than 150 nm. In vitro experiments indicated that the micelles were unstable below pH 6.5. After encapsulation of PTX within the micelles, dynamic light scattering (DLS) studies indicated that low pH had a similar demicellization effect. An in vitro release study indicated that PTX was slowly released at pH 7.4 (normal body conditions) but rapidly released under weakly acidic conditions (pH 6.0). We demonstrated the safety of micelles from in vitro cytotoxicity tests on HeLa cells and the in vivo anti-tumor activity of PTX-PM in B16F 10 tumor-bearing mice. We concluded that these pH-sensitive micelles have potential as carriers for anti-cancer drugs.