• Title/Summary/Keyword: Hospital Phase

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Computer Tomography and Magnetic Resonance Image Manifestations of Primary Hepatic Neuroendocrine Cell Carcinomas

  • Huang, Juan;Yu, Jian-Qun;Sun, Jia-Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2759-2764
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    • 2014
  • Aim: This study aims to investigate the manifestation of CT, MRI and dynamic enhanced scans for primary hepatic neuroendocrine cell carcinoma. Methods: CT or MRI arterial and venous phase scan images of 19 cases of pathologically confirmed PHNEC were retrospectively analyzed. Results: 14 cases (73.68%) with single lesion, 5 cases (26.3%) with multiple lesions, with an average diameter of 13.2 cm. Some 12 cases (63.16%) showed inhomogeneous enhancement, seven cases (36.8%) showed homogeneous enhancement, 13 cases (68.4%) demonstrated significant enhancement in the arterial phase, 13 cases (68.4%) had significantly enhanced portal venous phase including 7 cases (36.8 %) with portal venous phase density or signal above the arterial phase and 5 cases (26.3%) with the portal vein density or signal below the arterial phase. Seven cases (36.8%) had continued strengthened separate shadows in the center of the lesion. Thrombosis were not seen in portal veins. Conclusion: CT and MRI images of liver cell neuroendocrine carcinoma have certain characteristics that can provide valuable information for diagnosis and differential diagnosis.

Recovery Phase Spontaneous Nystagmus, Its Existence and Clinical Implication

  • Lee, Min Young;Son, Hye Ran;Rah, Yoon Chan;Jung, Jae Yun;Suh, Myung-Whan
    • Journal of Audiology & Otology
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    • v.23 no.1
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    • pp.33-38
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    • 2019
  • Background and Objectives: Determination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed. Results: We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.

Recovery Phase Spontaneous Nystagmus, Its Existence and Clinical Implication

  • Lee, Min Young;Son, Hye Ran;Rah, Yoon Chan;Jung, Jae Yun;Suh, Myung-Whan
    • Korean Journal of Audiology
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    • v.23 no.1
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    • pp.33-38
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    • 2019
  • Background and Objectives: Determination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed. Results: We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.

Imbalance in the spinal serotonergic pathway induces aggravation of mechanical allodynia and microglial activation in carrageenan inflammation

  • Junxiu Jin;Dong Ho Kang;Jin Jeon;Hyung Gon Lee;Woong Mo Kim;Myung Ha Yoon;Jeong Il Choi
    • The Korean Journal of Pain
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    • v.36 no.1
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    • pp.51-59
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    • 2023
  • Background: This study investigated the effect of an excess and a deficit of spinal 5-hydroxytryptamine (5-HT) on the mechanical allodynia and neuroglia activation in a rodent pain model of carrageenan inflammation. Methods: Male Sprague-Dawley rats were implanted with an intrathecal (i.t.) catheter to administer the drug. To induce an excess or deficit of 5-HT in the spinal cord, animals were given either three i.t. 5-HT injections at 24-hour intervals or a single i.t. injection of 5,7-dihydroxytryptamine (5,7-DHT) before carrageenan inflammation. Mechanical allodynia was measured using the von Frey test for 0-4 hours (early phase) and 24-28 hours (late phase) after carrageenan injection. The changes in the activation of microglia and astrocyte were examined using immunofluorescence of the dorsal horn of the lumbar spinal cord. Results: Both an excess and a deficit of spinal 5-HT had no or a minimal effect on the intensity of mechanical allodynia during the early phase but prevented the attenuation of mechanical allodynia during the late phase, which was observed in animals not treated with i.t. 5-HT or 5,7-DHT. Animals with an excess or deficit of 5-HT showed stronger activation of microglia, but not astrocyte, during the early and late phases, than did normal animals. Conclusions: Imbalance in the descending 5-HT pathway in the spinal cord could aggravate the mechanical allodynia and enhance the activation of microglia, suggesting that the spinal 5-HT pathway plays an essential role in maintaining the nociceptive processing in balance between facilitation and inhibition in inflammatory pain caused by carrageenan inflammation.

Gross tumor volume dependency on phase sorting methods of four-dimensional computed tomography images for lung cancer

  • Lee, Soo Yong;Lim, Sangwook;Ma, Sun Young;Yu, Jesang
    • Radiation Oncology Journal
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    • v.35 no.3
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    • pp.274-280
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    • 2017
  • Purpose: To see the gross tumor volume (GTV) dependency according to the phase selection and reconstruction methods, we measured and analyzed the changes of tumor volume and motion at each phase in 20 cases with lung cancer patients who underwent image-guided radiotherapy. Materials and Methods: We retrospectively analyzed four-dimensional computed tomography (4D-CT) images in 20 cases of 19 patients who underwent image-guided radiotherapy. The 4D-CT images were reconstructed by the maximum intensity projection (MIP) and the minimum intensity projection (Min-IP) method after sorting phase as 40%-60%, 30%-70%, and 0%-90%. We analyzed the relationship between the range of motion and the change of GTV according to the reconstruction method. Results: The motion ranges of GTVs are statistically significant only for the tumor motion in craniocaudal direction. The discrepancies of GTV volume and motion between MIP and Min-IP increased rapidly as the wider ranges of duty cycles are selected. Conclusion: As narrow as possible duty cycle such as 40%-60% and MIP reconstruction was suitable for lung cancer if the respiration was stable. Selecting the reconstruction methods and duty cycle is important for small size and for large motion range tumors.

Review of Clinical Cancer Research Methodology of Botanical Agents (한약 및 천연물의 항암 임상연구 방법론에 대한 고찰)

  • Oh, Hye Kyung;Lee, Jee Young;Ryu, Han Sung;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.20 no.1
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    • pp.11-21
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    • 2015
  • Objectives : The cancer incidence and cancer burden is increasing. In addition, the use of botanical agents in cancer care is increasing. This article aims to review a research strategy for botanical agents. Methods : The clinical studies of anticancer botanical agents and the papers about clinical research methodology of botanical agents were reviewed. Results : In phase I study, safety confirmation, optimal dose determination and drug interaction study are important. Most botanical agents have low toxicity and some have non-monotone dose response. Therefore, dose-response curve must be evaluated separately from the dose-toxicity curve to determine optimal dose. Although anticancer botanical agents can't shrink tumor size rapidly, they do extend survival. So, in phase II study, response should be evaluated by the survival. Conclusions : Clinical research of botanical agents in cancer is different from traditional methods and strategies. Considering the characteristics of botanical agents and experimental mechanism is necessary in conducting botanical based clinical trials.

A novel method for the management of proximal segment using computer assisted simulation surgery: correct condyle head positioning and better proximal segment placement

  • Lee, Yong-Chan;Sohn, Hong-Bum;Kim, Sung-Keun;Bae, On-Yu;Lee, Jang-Ha
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.21.1-21.8
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    • 2015
  • Computer Assisted Simulation Surgery (CASS) is a reliable method that permits oral and maxillofacial surgeons to visualize the position of the maxilla and the mandible as observed in the patient. The purpose of this report was to introduce a newly developed strategy for proximal segment management according to Balanced Orthognathic Surgery (BOS) protocol which is a type of CASS, and to establish the clinical feasibility of the BOS protocol in the treatment of complex maxillo-facial deformities. The BOS protocol consists of the following 4 phases: 1) Planning and simulation phase, 2) Modeling phase, 3) Surgical phase, and 4) Evaluation phase. The surgical interventions in 80 consecutive patients were planned and executed by the BOS protocol. The BOS protocol ensures accuracy during surgery, thereby facilitating the completion of procedures without any complications. The BOS protocol may be a complete solution that enables an orthognatic surgeon to perform accurate surgery based on a surgical plan, making real outcomes as close to pre-planned outcomes as possible.

A study on the Preconditions of Space Program Validation of Healthcare Architecture for Application of BIM Technology (병원건축의 BIM적용을 위한 공간프로그램유효성평가의 전제조건에 관한 연구)

  • Seong, Joonho;Kim, Khilchae
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.19 no.2
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    • pp.19-30
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    • 2013
  • Purpose: The planning and design of hospital generally requires the participation and consultation of skilled experts since it has more complex space program than any other buildings. Therefore, the BIM systems for the planning of hospital have been tried continuously. The purpose of this study is to identify the precondition for space Program validation of healthcare architecture based on BIM, which is recently receiving wide attention. Method: For this study, United States, Australia and Finland's guidelines were analyzed among the description space program validation system in 14 overseas BIM Guidelines. And the propose precondition that can be applied to healthcare architecture from among these description of space program validation items, target, process etc for General building. Result: 1) spatial program validation is the following four evaluation phase. Step 1: Standard setting phase Step 2: BIM model accuracy assessment phase Step 3: space validation phase Step 4: Performance evaluation phase 2) The standards for the building elements at Standards Setting stage is considered to the standards for the architectural elements of General building. 3) Healthcare Architecture Area calculation method is considered to be reasonable that borrowing the area calculation standard of general architecture according to the UIA of international standards. However, Be proposed of measuring method that reflect the efficiency of the design process step-by-step area calculation method. The performance assessment indicators of reflect the Hospital uniqueness have to developed. And the research needs to be carried out continuously according to the purpose for healthcare architecture of feature-oriented. Implications: In this paper like to understanding that precondition of space program validation considering the BIM. As a result, understanding to condition about step of the evaluation, the evaluation standards. Is expected to keep the focus on the development of performance indicators that reflect the uniqueness of the hospital for the efficient evaluation of the Hospital building.

A Case Study of Functional Electrical Stimulation(FES) for Paraplegic Patients (척수손상인의 기능적 전기자극을 이용한 보행)

  • Lee, Jae-Ho;Kim, Tack-Hoon
    • Physical Therapy Korea
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    • v.3 no.3
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    • pp.32-43
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    • 1996
  • The purpose of this case study was to introduce functional electrical stimulation(FES) for paraplegic patients. FES provides the ability to rise from sitting to standing, maintenance of a standing position, and the ability to walk with a reciprocal gait. Six channels of electrical stimulation are sufficient for synthesis of a simple reciprocal gait pattern in these patients. During the double-stance phase, knee extensor muscles of both knees are stimulated, providing sufficient support for the body. Only one knee extensor muscle group is excited during the single-stance phase. The swing phase of the contralateral lower extremity is accomplished by eliciting the synergic flexor muscle response through electrical stimulation of afferent nerves. The transition from the double-stance phase to the swing phase is controlled by two hand switches used by the therapist or built into the handles of the walking frame for using by the patient. A twenty-five years old male was with a T9/T9 spinal cord injury due to a traffic accident and admitted to Yonsei Rehabilitation Hospital for comprehensive treatment. After 30 days of training using the Parastep(R) he was able to stand for 10 minutes. After 43 days, he was able to walk and at discharged he could walk for 100 meters.

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Artery to Collecting System Communication after Abdominal Trauma (복부 외상 후 발생한 동맥-집뇨계 간 연결)

  • Lee, Chang Ug;Kwon, O Jung;Bang, Sung Hak;Choi, Nak Young;Lee, Chang Sub;Ahn, Seung Hyun
    • Journal of Trauma and Injury
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    • v.19 no.2
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    • pp.192-195
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    • 2006
  • Degenerative vascular disease, previous arterial surgery, long-term ureteral stenting, pelvis surgery, and radiotheraphy are reported as causes of artery-to-collecting-system communication.. Artery-to-collecting-system- communication associated with blunt trauma is rare, but potentially fatal. The diagnosis is very difficult and requires a high degree of suspicion. We were able to make the diagnosis based on the characteristic finding of contrast-enhanced computed tomography (CT) obtained in the early phase, equivalent to the finding obtained in the corticomedullary phase of the kidney. We report a case of artery to collecting system communication due to blunt abdominal trauma following a fall, which was treated by embolization.