• Title/Summary/Keyword: Protocol Analysis

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Ultrasound-Guided Local Steroid Injection Therapy for Acute Calcific Tendinitis of Shoulder (초음파를 이용한 급성 극상근 석회화 건염의 스테로이드 국소 주사 요법)

  • Kim, Jung-Man;Nam, Ho-Jin;Ra, Ki-Hang;Kang, Min-Ku
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.2
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    • pp.85-89
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    • 2009
  • Purpose: To analyze the clinical outcome after ultrasound guided multiple dry needlings and local steroid injection for acute calcific tendinitis of shoulder. Materials and Methods: Twenty patients with acute episode of pain by calcific tendinitis of shoulder with average age 58.2 (50~70 years) and follow-up of 18 months in average (range, 12~24) were included in study. There were 18 patients with right and 2 with left sided involvement. All patients had calcific deposits in the supraspinatus tendon. All patients underwent standardized nonoperative treatment protocol, consisting of 5~12 MHz high resolution ultrasound guided multiple dry needlings with 18 guage needle, followed by 2% lidocaine 1cc and 40 mg/ml depomedrol 1cc injection at site of calcific tendinitis. The outcome was assessed by UCLA shoulder score, range of motion and VAS score. A statistical analysis with ANOVA and Tukey's post-hoc test with the significance level at 5% was performed using SAS 9.1 software (SAS Institute, Cary, NC). Results: All patients got continuous relief of pain right after the procedures until final follow-up. Before the procedures, the UCLA scores were fair in 15 patients and poor in 5. After the procedures, the UCLA scores were excellent in 16 patients and good in 4. All cases revealed no limitation of shoulder function. The average VAS score decreased from 8.9 before the procedures to 0.5 at final follow-up (p<0.0001). No complication was encountered. Conclusion: An ultrasound guided local steroid injections following multiple dry needlings would be one of the useful treatment modality for the acute calcific tendinitis of shoulder.

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Clinical Outcomes of Ultrasound-Guided Subacromial Bursal Steroid Injection in Shoulder Impingement Syndrome (견관절 충돌 증후군에서 초음파하 견봉하 점액낭내 스테로이드 국소 주사의 임상적 결과)

  • Kim, Jung-Man;Nam, Ho-Jin;Ra, Ki-Hang;Park, Bum-Suk
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.2
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    • pp.68-73
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    • 2009
  • Purpose: We retrospectively studied the outcomes of the shoulder impingement syndrome for the treatment of the ultrasound-guided subacromial bursal steroid injection. Materials and Methods: Sixty-six shoulders of sixty-two patients with shoulder impingement syndrome treated from March, 2006 to April, 2009 were involved in this study. All cases underwent standardized, nonoperative treatment protocol consisting of 5~12 MHz high resolution ultrasound-guided local steroid injection into the subacromial bursa in modified Crass position. The shoulder range of motion, VAS score and impingement signs were evaluated during the initial and 1year visits. After injection, shoulder elevation exercise was encouraged. Statistical analysis with ANOVA model and Tukey's post-hoc test with the significance level at 5% were performed using SAS program. Results: All cases showed improved range of motion without limitation of shoulder function at immediate post-injection, 6-week, 3-month and 1year visits. The average VAS score at one year follow-up decreased to 2.85 from 6.47 before injection. In all cases the impingement signs became negative immediate after injection. However, 6 cases showed positive impingement signs after 6-week, which became negative after reinjection. The range of motion and VAS score were improved at one-year follow-up compared to initial visit (p<0.0001). No complication was noted at all follow-up period. Conclusion: Ultrasound-guided subacromial steroid injection alleviated the need of surgery, because it was successful in all our cases to improve pain and function of the shoulders until one year follow-up period.

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Treatment and Results of Olfactory Neuroblastoma (후각신경아세포종의 치료 및 결과)

  • Wu Hong-Gyun;Kim Il Han
    • Radiation Oncology Journal
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    • v.18 no.3
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    • pp.177-181
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    • 2000
  • Purpose : Rarity of olfactory neuroblastoma makes it difficult for treating Physician to Practice with a consistent protocol. This study is peformed to analyze our experience with various treatment modalities for patients with olfactory neuroblastoma. Discussion includes review of some recently published literatures. Methods and Materials : Between June of 1979 and April of 1997, 20 patients were treated under the diagnosis of olfactory neuroblastoma at Seoul National University Hospital. There were 14 male and 6 female patients. Age at initial treatment ranged from l3 to 77 years with median or 24 years. fifteen or 20 patients had Kadish stage C. They were treated with various combinations of surgery, radiation therapy and chemotherapy; surgery+postoperative radiation therapy+adjuvant chemotherapy for 2 patients, surgery+postoperative radiation therapy for 6, neoadjuvant chemotherapy+surgery for 1, surgery+adjuvant chemotherapy for 1, surgery only for 2, neoadiuvant chemotherapy+ radiation therapy for 3, radiation therapy+adjuvant chemotherapy for 1, radiation therapy only for 3, and no treatment for 1 patient. Results : Follow-up ranged from 2 month to 204 months with mean of 39.6 months. The overall 5- and 10-year survival rates are 20% and 10%, respectably. Four patients are alive at the time of data analysis. One of four living patients was treated with radical surgery, postoperative radiation therapy and adjuvant chemotherapy, two patients with radical surgery and postoperative radiation therapy, and one with radical surgery only. Conclusion : Multidisciplinary approach, including radical surgery, pre- or post-operative radiation therapy and chemotherapy, should be addressed at the initial time of diagnosis. Although limited by small number of the patients, this study suggests importance of local treatment modality, especially radical surgery in the treatment of lofactory neuroblastoma.

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Quantitative Analysis of GBCA Reaction by Mol Concentration Change on MRI Sequence (MRI sequence에 따른 GBCA 몰농도별 반응에 대한 정량적 분석)

  • Jeong, Hyun Keun;Jeong, Hyun Do;Kim, Ho Chul
    • Journal of the Institute of Electronics and Information Engineers
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    • v.52 no.2
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    • pp.182-192
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    • 2015
  • In this paper, we introduce how to change the reaction rate as mol concentration when we scan enhanced MRI with GBCA(Gadolinium Based Contrast Agent), Also show the changing patterns depending on diverse MRI sequences which are made by different physical principle. For this study, we made MRI phantom ourselves. We mixed 500 mmol Gadoteridol with Saline in each 28 different containers from 500 to 0 mmol. After that, MR phantom was scanned by physically different MRI sequences which are T1 SE, T2 FLAIR, T1 FLAIR, 3D FLASH, T1 3D SPACE and 3D SPCIR in 1.5T bore. The results were as follows : *T1 Spin echo's Total SI(Signal Intensity) was 15608.7, Max peak was 1352.6 in 1 mmol. *T2 FLAIR's Total SI was 9106.4, Max peak was 0.4 1721.6 in 1 mmol. *T1 FLAIR's Total SI was 20972.5, Max peak was 1604.9 in 1 mmol. *3D FLASH's Total SI was 20924.0, Max peak was 1425.7 in 40 mmol. *3D SPACE 1mm's Total SI was 6399.0, Max peak was 528.3 in 3 mmol. *3D SPACE 5mm's Total SI was 6276.5, Max peak was 514.6 in 2 mmol. *3D SPCIR's Total SI was 1778.8, Max peak was 383.8 in 0.4 mmol. In most sequences, High signal intensity was shown in diluted lower concentration rather than high concentration, And also graph's max peak and pattern had difference value according to the each different sequence. Through this paper which have quantitative result of GBCA's reaction rate depending on sequence, We expect that practical enhanced MR protocol can be performed in clinical field.

Analysis of Telomere Length and Telomerase Activity of Tissues in Korean Native Chicken (한국 재래닭의 주령별 각 조직의 텔로미어 함량과 텔로머레이스 활성도 분석)

  • Jung G.S.;Cho E.J.;Choi D.S.;Lee M.J.;Park C.;Jeon I.S.;Sohn S.H.
    • Korean Journal of Poultry Science
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    • v.33 no.2
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    • pp.97-103
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    • 2006
  • Telomeres are essential for chromosome stability and are related with cell senescence, apoptosis and cancer. Even though telomere length and telomerase activity have been studied extensively, very little is known to analyze the telomere dynamics in chicken cells. This study was carried out to analyze the telomere distribution and telomerase activity of Korean Native Chicken cells along with aging. The cells were collected from brain, heart, liver, kidney and germinal tissues during physiological stages. Telomere distribution was analyzed by Quantitative-Fluorescence in situ Hybridization (Q-FISH) techniques using the chicken telomeric DNA probe. Telomerase activity was performed by Telomeric Repeat Amplification Protocol (TRAP) assay. In results, the telomeres of chicken were found at the ends of all chromosomes with the interstitial telomeres on chromosomes 1, 2 and 3. The amount of telomeres on chicken cells was decreased along with aging in most tissues. Furthermore, the telomere quantity was significantly different among tissues. The relative amount of telomeres in proliferous cells such as testis cells had much more than those of liver, brain, heart, blood and kidney cells. The telomerase activity was down-regulated in cells of brain, heart and liver tissues. Whereas gonadal cells showed a constitutive activity of telomerase during all stage of life. In conclusions, the telomere quantity and telomerase activity in chicken are closely relate to cell proliferation and tissue specificity during developmental stages and aging. There is also closely correlated between the amounts of telomeric DNA and telomerase activity in chicken tissues.

Usefulness of Low Dose Oral Contrast Media in $^{18}F-FDG$ PET/CT ($^{18}F-FDG$ PET/CT에서 저용량 경구용 조영제의 유용성)

  • An Young-Sil;Yoon Joon-Kee;Hong Seon Pyo;Joh Chul-Woo;Yoon Seok-Nam
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.5
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    • pp.257-262
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    • 2006
  • Purpose: The standard protocol using large volume of oral contrast media may cause gastrointestinal discomfort and contrast-related artifacts in PET/CT. The aim of this study was to evaluate the usefulness of low dose oral contrast in $^{18}F-FDG$ PET/CT. Materials and Methods: We retrospectively reviewed the whole-body PET/CT images in a total of 435 patients. About 200 ml of oval contrast agent (barium sulfate) was administered immediately before injection of $^{18}F-FDG$. The FDG uptake of intestines was analyzed by visual and semi- quantitative method on transaxial, coronal and saggital planes. Results: Seventy (16%, 113 sites) of 435 images showed high FDG uptake (peak SUV > 4); 50 (74%, 84 sites) with diffuse and 20 (15%, 29 sites) with focal uptake. The most commonly delivered site of oral contrast media was small bowel (n=27, 39%). On PET/CT images, FDG uptake coexisted with oral contrast media in 26 patients (54%, 38 sites) with diffuse pattern and 9 (45%, 9 sites) with focal pattern, and by sites, those were 38 (45%) and 9 (31%), respectively. In small bowel regions, the proportion of coexistence reached as high as 61% (29/47 sites). A visual analysis of available non-attenuation corrected PET images of 27 matched regions revealed no contrast-related artifact. Conclusion: We concluded that the application of low dose contrast media could be helpful in the evaluation of abdominal uptake in the FDG PET/CT image.

GnRH Agonist Stimulation Test (GAST) for Prediction of Ovarian Response in Controlled Ovarian Stimulation (COH) (난소기능평가를 위한 Gonadotropin Releasing Hormone Agonist Stimulation Test (GAST)의 효용성에 관한 연구)

  • Kim, Mee-Ran;Song, In-Ok;Yeon, Hye-Jeong;Choi, Bum-Chae;Paik, Eun-Chan;Koong, Mi-Kyoung;Song, Il-Pyo;Lee, Jin-Woo;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.2
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    • pp.163-170
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    • 1999
  • Objectives: The aims of this study are 1) to determine if GAST is a better indicator in predicting ovarian response to COH compared with patient's age or basal FSH level and 2) to evaluate its role in detecting abnormal ovarian response. Design: Prospective study in 118 patients undergoing IVF-ET using GnRH-a short protocol during May-September 1995. Materials and Methods: After blood sampling for basal FSH and estradiol $(E_2)$ on cycle day two, 0.5ml (0.525mg) GnRH agonist ($Suprefact^{(r)}$, Hoechst) was injected subcutaneously. Serum $E_2$ was measured 24 hours later. Initial $E_2$ difference $({\Delta}E_2)$ was defined as the change in $E_2$ on day 3 over the baseline day 2 value. Sixteen patients with ovarian cyst or single ovary or incorrect blood collection time were excluded from the analysis. The patients were divided into three groups by ${\Delta}E_2$; group A (n=30):${\Delta}E_2$<40 pg/ml, group B (n=52): 40 pg/ml${\leq}{\Delta}E_2$<100 pg/ml, group C (n=20): ${\Delta}E_2{\leq}100$ pg/ml. COH was done by GnRH agonist/HMG/hCG and IVF-ET was followed. Ratio of $E_2$ on day of hCG injection over the number of ampules of gonadotropins used ($E_2hCGday$/Amp) was regarded as ovarian responsiveness. Poor ovarian response and overstimulation were defined as $E_2$ hCGday less than 600 pg/ml and greater than 5000 pg/ml, respectively. Results: Mean age $({\pm}SEM)$ in group A, B and C were $33.7{\pm}0.8^*,\;31.5{\pm}0.6\;and\;30.6{\pm}0.5^*$, respectively ($^*$: p<0.05). Mean basal FSH level of group $A(11.1{\pm}1.1mlU/ml)$ was significantly higher than those of $B(7.4{\pm}0.2mIU/ml)$ and C $(6.8{\pm}0.4mIU/ml)$ (p<0.001). Mean $E_2hCGday$ of group A was significantly lower than those of group B or C, i.e., $1402.1{\pm}187.7pg/ml,\;3153.2{\pm}240.0pg/ml,\;4078.8{\pm}306.4pg/ml$ respectively (p<0.0001). The number of ampules of gonadotropins used in group A was significantly greater than those in group B or C: $38.6{\pm}2.3,\;24.2{\pm}1.1\;and\;18.5{\pm}1.0$ (p<0.0001). The number of oocytes retrieved in group A was significantly smaller than those in group B or C: $6.4{\pm}1.1,\;15.5{\pm}1.1\;and\;18.6{\pm}1.6$, respectively (p<0.0001). By stepwise multiple regression, only ${\Delta}E_2$ showed a significant correlation (r=0.68, p<0.0001) with $E_2HCGday$/Amp, while age or basal FSH level were not significant. Likewise, only ${\Delta}E_2$ correlated significantly with the number of oocytes retrieved (r=0.57, p<0.001). All four patients whose COH was canceled due to poor ovarian response belonged to group A only (Fisher's exact test, p<0.01). Whereas none of 30 patients in group A (0%) had overstimulation, 14 patients among 72 patients (19.4%) in group B and C had overstimulation (Fisher's exact test, p<0.01). Conclusions: These data suggest that initial $E_2$ difference after GAST may be a better prognostic indicator of ovarian response to COH than age or basal FSH level. Since initial $E_2$ difference demonstrates significant association with abnormal ovarian response such as poor ovarian response necessitating cycle cancellation or overstimulation, GAST may be helpful in monitoring and consultation of patients during COH in IVF-ET cycle.

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Comparative Analysis of Double Bundle and Single Bundle ACL Reconstruction with Tibialis Anterior Allograft (동종건을 이용한 단일다발 및 이중다발 전방십자인대 재건술의 비교 분석)

  • Kim, Deok-Weon;Lee, Kang;Kim, Young-Woo;Yang, Sang-Jin;Seo, Jeong-Gook;Kim, Jin-Goo
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.198-204
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    • 2008
  • Purpose: The purpose of this study is to analyze the merits and demerits of double bundle reconstruction and achieve improvements hereafter, by comparing the results of double bundle and single bundle reconstruction using tibialis anterior allograft. Materials and Methods: Twenty seven patients were divided to undergo either double bundle(n=14) or single bundle(n=13) reconstruction with tibialis anterior allograft tendon. The evaluation methods were AP laxity with KT-2000 arthrometer, isokinetic knee strength measurements, pivot-shift test, IKDC subjective score, Lysholm knee score, Tegner activity score, radiographic evaluations with postoperative MRI, and second look arthroscopy. Results: Lysholm knee score and Tegner activity score were significantly better in double bundle reconstruction. In pivot-shift test, single bundle reconstruction was evaluated as grade 0 in 10 of the knees, grade 1 in 1, and grade 2 in 2. Double bundle reconstruction was evaluated as grade 0 in 13, and grade 2 in 1. In second look arthroscopy, single bundle was evaluated as excellent in 6 of the knees, fair in 7, anteromedial bundle of double bundle reconstruction was excellent in 13 and fair in 1, and posterolateral bundle was excellent in 4, fair in 9, and poor in 1. There were no significant differences in other evaluations. Conclusion: Favorable outcome may be expected with double bundle reconstruction of ACL. However there are still need for improvement in terms of reconstruction technique and rehabilitation protocol to reduce PL bundle injury.

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Usefulness of Flow Composite Image in Raynaud Scan ($^{201}Tl$) ($^{201}Tl$을 이용한 레이노 검사에서 동적 Composite 영상의 유용성)

  • Kim, Dae-Yeon;Shin, Gyoo-Seol;Oh, Eun-Jung;Kim, Gun-Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.101-104
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    • 2010
  • Purpose: Raynaud scan is divided to flow, blood pool and local-delay image. Usually, we evaluate comparison through blood pool and local-delay image. We will evaluate about usability when comparative observe blood image and local-delay image in Raynaud scan that used $^{201}Tl$ as making flow image to one sheet of images. Materials and Methods: We have selected 29 Raynaud phenomenon patients aged 14~68 years who visited department of vascular surgery between Feb. 2008 and Aug. 2009. An intravenous injection $^{201}Tl$ of 111 MBq (3 mCi) to opposite side diagonal line limbs above an internal auditing department. Equipment used Philips gamma camera forte A-Z, and collimator used LEHR. Matrix size set up to each $64{\times}64$, $128{\times}128$, $256{\times}256$ and zoom factor used to full field. Protocol of dynamic is 2 second to 155 frames. Blood pool and delay count to 300 second. We set up ROI by a foundation to data acquired in PEGASYS processing program. Each results were analyzed with the SPSS 12.0 statistical software. Results: Each averages of count ratio (Rt / Lt) to have been given at composite image, a blood pool image, delay images analyzed at Raynaud phenomenon patients is $1.25{\pm}0.39$, $1.20{\pm}0.33$, $1.11{\pm}0.17$. The sample analysis results of blood pool image and delay image contented itself with p<0.029. Also, there don't have been each difference, and blood pool image, delay image regarding composite image was able to know. Conclusion: We were able to give help for comparison to evaluate a blood pool image and a local delay image at the Raynaud scan which used $^{201}Tl$ while making a flow image to one sheet image. Identification to be visual too was possible. If you are proceeded a researcher that there was further depth, you are more appropriate for, and you may get useful information.

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Signal to Noise Ratio of MR Spectrum by variation echo time : comparison of 1.5T and 3.0T (Echo time에 따른 MR spectrum의 SNR: 1.5T와 3.0T비교)

  • Kim, Sung-Gil;Lee, Kyu-Su;Rim, Che-Pyeong
    • Journal of the Korean Society of Radiology
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    • v.5 no.6
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    • pp.401-407
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    • 2011
  • The purpose of this study is to know the differences of MR spectra, obtained from normal volunteers by variable TE value, through the quantitative analysis of brain metabolites by peak integral and SNR between 1.5T and 3.0T, together with PRESS and STEAM pulse sequence. Single-voxel MR proton spectra of the human brain obtained from normal volunteers at both 3.0T MR system (Magnetom Trio, SIEMENS, Germany) and 1.5T MR system (Signa Twinspeed, GE, USA) using the STEAM and PRESS pulse sequence. 10 healthy volunteers (3.0T:3 males, 2 females; 1.5T : 3 males, 2 females) with the range from 22 to 30 years old (mean 26 years) participated in our study. They had no personal or familial history of neurological diseases and had a normal neurological examination. Data acquisition parameters were closely matched between the two field strengths. Spectra were recorded in the white matter of the occipital lobe. Spectra were compared in terms of resolution and signal-to-noise ratio(SNR), and echo time(TE) were estimated at both field strengths. Imaging parameters was used for acquisition of the proton spectrum were as follow : TR 2000msec, TE 30ms, 40ms, 50ms, 60ms, 90ms, 144ms, 288ms, NA=96, VOI=$20{\times}20{\times}20mm3$. As the echo times were increased, the spectra obtained from 3.0T and 1.5T show decreased peak integral and SNR at both pulse sequence. PRESS pulse sequence shows higher SNR and signal intensity than those of STEAM. Especially, Spectra in normal volunteers at 3.0T demonstrated significantly improved overall SNR and spectral resolution compared to 1.5T(Fig1). The spectra acquired at short echo time, 3T MR system shows a twice improvement in SNR compared to 1.5T MR system(Table. 1). But, there was no significant difference between 3.0Tand 1.5T at long TE It is concluded that PRESS and short TE is useful for quantification of the brain metabolites at 3.0T MRS, our standardized protocol for quantification of the brain metabolites at 3.0T MRS is useful to evaluate the brain diseases by monitoring the systematic changes of biochemical metabolites concentration in vivo.