• Title/Summary/Keyword: Evidence-based imaging

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Current Trends in the Treatment of Osteochondral Lesion of the Talus: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey (거골 골연골병변 치료 동향: 대한족부족관절학회 회원 설문조사 분석)

  • Cho, Byung-Ki;Cho, Jaeho;Young, Ki Won;Lee, Dong Yeon;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.4
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    • pp.149-156
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    • 2021
  • Purpose: Given the lack of definite evidence-based guidelines in clinical practice, there may be a wide variation in treatment protocols for osteochondral lesions of the talus (OLT). Based on the Korean Foot and Ankle Society (KFAS) member survey, this study aimed to report the current trends in the management of OLT. Materials and Methods: A web-based questionnaire containing 30 questions was sent to all KFAS members in September 2021. The questions were mainly related to clinical experience and preferences in diagnosis, conservative, and surgical treatments for patients with OLT. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: Sixty-two (11.3%) of the 550 surgeons queried responded to the survey. The responses to 9 (30.0%) of the total of 30 questions established a tendency. Answers exhibiting a tendency were as follows; additional diagnostic tools except for plain radiograph (magnetic resonance imaging), most common conservative treatment method (oral medication, rest), most important radiological factor in decision making for surgical treatment and method (size of the lesion, ankle instability, loose bodies), most important patient factors in decision making for surgical treatment and method (age, activity or occupation), infrequently requiring posterior arthroscopy (less than 3%), most common revision surgery for failed bone marrow stimulation procedure (osteochondral autograft transplantation [OAT]), not requiring additional procedure for donor site in OAT, the main reason for unsatisfactory result after OAT (persistent pain without radiological abnormality), no generalization of autologous chondrocyte implantation or chondrogenesis using stem cells. Conclusion: This study presents updated information on current trends in the management of OLT in Korea. Both consensus and variations in the approach to patients with OLT were revealed through this survey. Since recent biologic efforts to regenerate cartilage have been unsuccessful, further studies to identify clinical evidence would be needed.

Functional Neuroimaging of General Fluid Intelligencein Prodigies

  • Lee, Kun-Ho
    • Proceedings of the Korean Society for the Gifted Conference
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    • 2003.05a
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    • pp.137-138
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    • 2003
  • Understanding how and why people differ is a fundamental, if distant, goal of research efforts to bridge psychological and biological levels of analysis. General fluid intelligence (gF) is a major dimension of individual differences and refers to reasoning and novel problemsolving ability. A conceptual integration of evidence from cognitive (behavioral) and anatomical studies suggeststhat gF should covary with both task performance and neural activity in specific brain systems when specific cognitive demands are present, with the neural activity mediating the relation between gF and performance. Direct investigation of this possibility will be a critical step toward a mechanistic model of human intelligence. In turn, a mechanistic model might suggest ways to enhance gF through targeted behavioral or neurobiological intervent ions, We formed two different groups as subjects based on their scholarly attainments. Each group consists of 20 volunteers(aged 16-17 years, right-handed males) from the National Gifted School and a local high school respectively. To test whether individual differences in general intelligence are mediated at a neural level, we first assessed intellectual characteristics in 40 subjects using standard intelligence tests (Raven's Advanced Progressive Matrices, Wechsler Adult Intelligence Scale, Torrance Tests of Creative Thinking) administered outside of the MR scanner. We then used functional magnetic resonance imaging (fMRl) to measure task-related brain activity as participants performed three different kinds of computerized reasoning tasks that were intended to activate the relevant neural systems. To examine the difference of neural activity according to discrepancy in general intelligence, we compared the brain activity of both extreme groups (each, n=10) of the participants based on the standard intelligence test scores. In contrast to the common expectation, there was no significant difference of brain region involved in high-g tasks between both groups. Random effect analysis exhibited that lateral prefrontal, anterior cingulate and parietal cortex are associated with gF. Despite very different task contents in the three high-g-low-g contrasts, recruitment of multiple regions is markedly similar in each case, However, on the task with high 9F correlations, the Prodigy group, (intelligence rank: >99%) showed higher task-related neural activity in several brain regions. These results suggest that the relationship between gF and brain activity should be stronger under high-g conditions than low-g conditions.

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Effect of Acupressure Massage on Temperatures of Acupoints, Severity of Facial Paralysis, Subjective Symptoms, and Depression in Bell's Palsy Patients

  • Lee, Jeongsoon;Chung, Younghae
    • Journal of Korean Biological Nursing Science
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    • v.17 no.2
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    • pp.140-149
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    • 2015
  • Purpose: Bell's palsy is a nerve paralysis disease that causes functional impairments and affects psychological and aesthetical parts. This study aimed to examine whether acupressure massage had positive effects on facial paralysis, subjective symptoms, and depression in Bell's palsy patients. Methods: This study was conducted by a nonequivalent control group pretest-posttest design. Participants were 60 patients with Bell's palsy. 30 patients were assigned to the experimental group and the remaining 30 patients were assigned to the control group. The period of the study was from October 1, 2008 to July 30, 2009. Acupressure massage was offered to the experimental group for 20 minutes per day for two weeks (a total of six times). A SPSS/Win 12.0 program was used for data analysis. Results: A difference in Digital Infrared Thermographic Imaging (DITI) between affected and unaffected sides was less in the experimental group having acupressure massage than in the control group and the score of the recovery of facial paralysis was also increased in the experimental group. The Facial Nerve Grade Systems by Brackmann score that is a more objective index showed a significant difference between two groups (F=26.81, p<.001). Subjective symptom and depression scores were more decreased in the acupressure massage group than in the control group. Conclusion: Based on the results, it is considered that acupressure massage can be applied to Bell's palsy patients as an alternative therapy. It can be used as an evidence-based East-West nursing intervention to improve patients' physical and mental functions.

SEJONG OPEN CLUSTER SURVEY (SOS) - V. THE ACTIVE STAR FORMING REGION SH 2-255 - 257

  • LIM, BEOMDU;SUNG, HWANKYUNG;HUR, HYEONOH;LEE, BYEONG-CHEOL;BESSELL, MICHAEL S.;KIM, JINYOUNG S.;LEE, KANG HWAN;PARK, BYEONG-GON;JEONG, GWANGHUI
    • Journal of The Korean Astronomical Society
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    • v.48 no.6
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    • pp.343-355
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    • 2015
  • There is much observational evidence that active star formation is taking place in the Hii regions Sh 2-255 – 257. We present a photometric study of this star forming region (SFR) using imaging data obtained in passbands from the optical to the mid-infrared, in order to study the star formation process. A total of 218 members were identified using various selection criteria based on their observational properties. The SFR is reddened by at least E(B −V ) = 0.8 mag, and the reddening law toward the region is normal (RV = 3.1). From the zero-age main sequence fitting method it is confirmed that the SFR is 2.1 ± 0.3 kpc from the Sun. The median age of the identified members is estimated to be about 1.3 Myr from a comparison of the Hertzsprung-Russell diagram (HRD) with stellar evolutionary models. The initial mass function (IMF) is derived from the HRD and the near-infrared (J, J −H) color-magnitude diagram. The slope of the IMF is about Γ = −1.6 ± 0.1, which is slightly steeper than that of the Salpeter/Kroupa IMF. It implies that low-mass star formation is dominant in the SFR. The sum of the masses of all the identified members provides the lower limit of the cluster mass (169M). We also analyzed the spectral energy distribution (SED) of pre-main sequence stars using the SED fitting tool of Robitaille et al., and confirm that there is a significant discrepancy between stellar mass and age obtained from two different methods based on the SED fitting tool and the HRD.

The Effects of Ginsenoside Rg3 as a Potent Inhibitor of Ca2+ Channels and NMDA-gated Channels in the Peripheral and Central Nervous Systems (말초 및 중추신경계에서 칼슘채널 및 NMDA 매개 채널의 억제제로의 진세노사이드 Rg3의 효과)

  • Rhim, Hye-Whon
    • Journal of Ginseng Research
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    • v.27 no.3
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    • pp.120-128
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    • 2003
  • Alternative medicines such as herbal products are increasingly being used for preventive and therapeutic purposes. Ginseng is the best known and most popular herbal medicine used worldwide. In spite of some beneficial effects of ginseng on the nervous system, little scientific evidence shows at the cellular level. In the present study, I have examined the direct modulation of ginseng total saponins and individual ginsenosides on the activation of $Ca^{2+}$ channels and NMDA-gated channels in cultured rat dorsal root ganglion (DRG) and hippocampal neurons, respectively. In DRG neurons, application of ginseng total saponins suppressed high-voltage-activated $Ca^{2+}$ channel currents and ginsenoside Rg$_3$, among the 11 ginsenosides tested, produced the strongest inhibition on $Ca^{2+}$ channel currents. Occlusion experiments using selective $Ca^{2+}$ channel blockers revealed that ginsenoside Rg$_3$ could modulate L-, N-, and P/Q-type currents. In addition, ginsenoside Rg$_3$ also proved to be an active component of ginseng actions on NMDA receptors in cultured hippocampal neurons. Application of ginsenoside Rg$_3$ suppressed NMDA-induced [Ca$^{2+}$]$_{i}$ increase and -gated channels using fura-2-based digital imaging and patch-clamp techniques, respectively. These results suggest that the modulation of $Ca^{2+}$ channels and NMDA receptors by ginsenoside Rg$_3$ could be part of the pharmacological basis of ginseng actions in the peripheral and central nervous systems.ous systems.

Neural Substrates and Functional Hypothesis of Acupuncture Mechanisms - Neural substrates and humoral-, neural-, and immune-responses related to acupuncture stimulation- (침의 치료기전에 대한 신경기반 및 신경기능 가설 -침자극과 관계된 신경기반 및 체액성 반응, 신경적 반응, 면역반응-)

  • Cho, Z.H;Hwang, S.C;Wong, E.K.;Son, Y.D;Kang, C.K;Park, T.S;Bai, S.J;Sung, K.K
    • Journal of Acupuncture Research
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    • v.20 no.5
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    • pp.172-186
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    • 2003
  • Acupuncture therapy has demonstrated efficacy in several clinical areas, and of these areas the understanding of pain has progressed immensely in the last two decades. The underlying mechanisms of acupuncture in general and the analgesic effect in particular are still not clearly delineated. The leading hypothesis include the effects of local stimulation, neuronal gating, release of endogenous opiates, and the placebo effect. Accumulating evidence suggests that the central nervous system(CNS) is essential for the processing of these effects, via its modulation of the autonomic nervous system, neuro-immune system, and hormonal regulation. These processes tap into basic survival mechanisms. As such, understanding the effects of acupuncture within a neuroscience-based framework becomes vital. We propose a model which incorporates the stress-induced hypothalamus-pituitary-adrenal axis(HPA-axis) model of Akil et al., the cholinergic anti-inflamatory observations of Tracey et al., and Petrovic et al.

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Current status and installation standard of dental PACS

  • Park Chang-Seo;Kim Kee-Deog;Park Hyok;Jeong Ho-Gul
    • Imaging Science in Dentistry
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    • v.34 no.4
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    • pp.175-178
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    • 2004
  • Purpose: Picture Archiving and Communication System (PACS) is difficult to implement in the best of situations, but evidence is growing that the benefits are significant. The aims of this study are to analyze the current status of full PACS and establish successful installation standard of dental PACS. Materials and Methods : Materials and methods were based on the investigation of current working status and installation standard of PACS, and observation of variable issues to installation of dental PACS. Results: By September 30,2004, full PACS implementations in their facilities were 88.1 % in specialized general hospitals (37 installations out of total 42 hospitals), 59.8% in general hospitals (144 installations out of total 241 hospitals), 12.3% in medical hospitals (116 installations out of total 941 hospitals) and 3.6% in dental hospitals (4 installations out of total 11 0 hospitals) Only 4 university dental hospitals currently have installed and are operating full PACS. Major obstacle to wide spread of dental PACS is initial high investments. Conclusions: Clinical environments of dental PACS differed from medical situation. Because of characteristic dental practice, the initial investments for dental PACS are generally much greater than those of medical PACS. Also new economic crisis makes users scruple. The best way to overcome these limitations is to establish an economic installation standard for dental PACS. Also the clear technical communication between the customer and the supplier before both sides are committed to the obstacles are critical to its success.

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Acute disseminated encephalomyelitis in children: differential diagnosis from multiple sclerosis on the basis of clinical course

  • Lee, Yun-Jin
    • Clinical and Experimental Pediatrics
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    • v.54 no.6
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    • pp.234-240
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    • 2011
  • Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of the central nervous system (CNS) that typically presents as a monophasic disorder associated with multifocal neurologic symptoms and encephalopathy. ADEM is considered an autoimmune disorder that is triggered by an environmental stimulus in genetically susceptible individuals. The diagnosis of ADEM is based on clinical and radiological features. Most children with ADEM initially present with fever, meningeal signs, and acute encephalopathy. The level of consciousness ranges from lethargy to frank coma. Deep and subcortical white-matter lesions and gray-matter lesions such as thalami and basal ganglia on magnetic resonance imaging (MRI) are associated with ADEM. In a child who presents with signs of encephalitis, bacterial and viral meningitis or encephalitis must be ruled out. Sequential MRI is required to confirm the diagnosis of ADEM, as relapses with the appearance of new lesions on MRI may suggest either multiphasic ADEM or multiple sclerosis (MS). Pediatric MS, defined as onset of MS before the age of 16, is being increasingly recognized. MS is characterized by recurrent episodes of demyelination in the CNS separated in space and time. The McDonald criteria for diagnosis of MS include evidence from MRI and allow the clinician to make a diagnosis of clinically definite MS on the basis of the interval preceding the development of new white matter lesions, even in the absence of new clinical findings. The most important alternative diagnosis to MS is ADEM. At the initial presentation, the 2 disorders cannot be distinguished with certainty. Therefore, prolonged follow-up is needed to establish a diagnosis.

Effects of Decompression Therapy for 6 Cases with Lumbar Herniated Disc (감압치료가 요추간판탈출 6(증)례에 미치는 영향)

  • Kwon, Won-An;Lee, Seung-Ho;Lee, Jae-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.5
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    • pp.2133-2141
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    • 2012
  • The Purpose of this study was to report magnetic resonance imaging(MRI) changes of six cases of Lumbar herniated disc which was treated with spinal decompression therapy, oriental medical therapy. 'Disc heights' were measured on sagittal view of $T_2$-weighted MRI. Size of the herniated disc was measured by MRI and 'disc herniations index'. The grading system and algorithm for 'disc degeneration' were based on MRI signal intensity, disc structure, distinction between nucleus and anulus, and disc height. Data for disc height, disc herniations index and disc degeneration grade were collected before and after the treatment together with calculation from the MRI. Case studies were showed that decompression therapy for the herniated disc has an positive effect on disc herniations index, disc regeneration, not disc heights. The clinical evidence for the use of decompression in herniated disc remains inconclusive because of limited researches. Further trials, which give attention to these areas, are needed before any firm conclusions may be made.

Visual Evoked Potentials in Retrochiasmal Lesion; Correlation with Neuroimaging Study (시각유발전위 검사상 후-시신경교차부위병변을 보인 환자들의 뇌 영상 결과와의 연관성)

  • Kim, Sung Hun;Cho, Yong-Jin;Kim, Ho-Jin;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.2 no.1
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    • pp.13-20
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    • 2000
  • Background and Objective : Visual evoked potentials(VEPs) is considered to be a reliable diagnostic procedure for examining patients with anterior visual pathways. Some abnormalities in the recordings on monocular stimulation have been said to indicate retrochiasmal lesion, but less consistent results have been reported. This study is to evaluate the positive predictability of VEP for the detection of retrochiasmal lesion. Methods : We reviewed VEPs that could be interpreted as indicative of a retrochiasmal lesions, based on amplitude or latency asymmetry recorded on the left(O1) and right(O2) occipital regions. Bilateral absent VEPs on both recording(O1 and O2) without evidence of prechiasmal lesion were included. During 5 years, we identified 31 patients who met the above criteria and who had undergone magnetic resonance imaging(MRI) of brain(one patient underwent computerized tomography). Twenty three patients underwent pattern reversal VEPs and others underwent flash goggle VEPs. Results : Brain imagings were abnormal in 29 and were normal in 2. Of the 29 abnormal scans, lesions in posterior visual pathway were detected in 21 scans(predictive value=68%). The predictive value was not significantly different between flash goggle VEP(75%) and pattern reversal VEP(68%). The predictive value was higher in patient with visual field defect(100%) than those without visual field defect(25%). The pathologic nature of lesion also showed close relations to the predictive value. VEPs is usually paradoxically lateralized(78%), but not in all patients. Conclusion : VEPs abnormalities suggesting retrochiasmal lesion were usually corresponded with brain MRI findings. Diagnostic reliability could be increased when considering the visual field defect and nature of lesion. Therefore, the authors suggest that VEPs studies could be useful in evaluating the patients with the retrochismal lesion.

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