• Title/Summary/Keyword: Recovery Time Objective

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Application of Segmental Phase Angle for Assessment of Post-Stroke Complex Regional Pain Syndrome (뇌졸중 후 복합부위통증증후군에서 부위별 위상각을 이용한 평가)

  • Park, Se-Heum;Kim, Woo-Jin;Jo, Geun-Yeol;Kwon, Jun-Koo
    • Clinical Pain
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    • v.19 no.1
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    • pp.23-27
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    • 2020
  • Our objective is to evaluate the applicability of segmental phase angle (PhA) via bioelectrical impedance analysis (BIA) for post-stroke complex regional pain syndrome (CRPS). Due to its noninvasiveness and convenience, various studies have used BIA in clinical conditions. We measured segmental PhA in 4 patients at the time of CRPS diagnosis and repeated 4 weeks after 2 weeks of steroid pulse therapy. In 3 cases, the affected-to-unaffected ratio of the upper limb PhA decreased at the time of diagnosis. In 2 cases with improvement of more than 5 points in the CRPS severity score (CSS), increased ratios were observed. In other 2 cases with improvement of less than 4 points in the CSS, no remarkable changes in the ratios were found. We suggest that the segmental PhA can be helpful in assessment of post-stroke CRPS and its recovery.

The Evaluation of Resolution Recovery Based Reconstruction Method, Astonish (Resolution Recovery 기반의 Astonish 영상 재구성 기법의 평가)

  • Seung, Jong-Min;Lee, Hyeong-Jin;Kim, Jin-Eui;Kim, Hyun-Joo;Kim, Joong-Hyun;Lee, Jae-Sung;Lee, Dong-Soo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.58-64
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    • 2011
  • Objective: The 3-dimensional reconstruction method with resolution recovery modeling has advantages of high spatial resolution and contrast because of its precise modeling of spatial blurring according to the distance from detector plane. The aim of this study was to evaluate one of the resolution recovery reconstruction methods (Astonish, Philips Medical), compare it to other iterative reconstructions, and verify its clinical usefulness. Materials and Methods: NEMA IEC PET body phantom and Flanges Jaszczak ECT phantom (Data Spectrum Corp., USA) studies were performed using Skylight SPECT (Philips) system under four different conditions; short or long (2 times of short) radius, and half or full (40 kcts/frame) acquisition counts. Astonish reconstruction method was compared with two other iterative reconstructions; MLEM and 3D-OSEM which vendor supplied. For quantitative analysis, the contrast ratios obtained from IEC phantom test were compared. Reconstruction parameters were determined by optimization study using graph of contrast ratio versus background variability. The qualitative comparison was performed with Jaszczak ECT phantom and human myocardial data. Results: The overall contrast ratio was higher with Astonish than the others. For the largest hot sphere of 37 mm diameter, Astonish showed about 27.1% and 17.4% higher contrast ratio than MLEM and 3D-OSEM, in short radius study. For long radius, Astonish showed about 40.5% and 32.6% higher contrast ratio than MLEM and 3D-OSEM. The effect of acquired counts was insignificant. In the qualitative studies with Jaszczak phantom and human myocardial data, Astonish showed the best image quality. Conclusion: In this study, we have found out that Astonish can provide more reliable clinical results by better image quality compared to other iterative reconstruction methods. Although further clinical studies are required, Astonish would be used in clinics with confidence for enhancement of images.

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Evaluation of Radiation Dose according to Aneurysm Size and Location during Cerebral Aneurysm Coil Embolization (뇌동맥류 코일 색전술 시술 시 동맥류 크기 및 위치에 따른 방사선량 평가)

  • An, Hyun
    • Journal of radiological science and technology
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    • v.45 no.5
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    • pp.407-412
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    • 2022
  • Cerebral aneurysm coil embolization has the advantages of accurate, low patient burden, and fast recovery time, but efforts are needed to reduce dose due to the burden of exposure radiation dose during interventional procedures. In this study, the area dose product(DAP/Gy·cm2) and fluoro time(min) according to the size of the aneurysm and the location of aneurysm were investigated according to insurance recognition regulations aneurysm classification cerebral aneurysm coil embolization. According to the research method, classification according to the size and location of the aneurysm is first, the size of the aneurysm is divided into less than 4mm, more than 4mm to less than 8mm, and more than 8mm, and second, the dose to the area based on the location site (DAP/Gy·cm2) and fluoro time(min) based on the location site were observed. As a result, the location of the cerebral aneurysm procedure was found to be the Paraclinoid site. During cerebral aneurysm coil embolization, the area dose was 107 Gy·cm2 and fluoro time was 47.41 minutes, showing lower results than domestic studies, and when comparing the area dose product with foreign studies, the area dose product results were similar to that of Turkey and Saudi Arabia. It is expected that it can be used as an objective analysis indicator to establish diagnostic reference levels (DRLs) and patient radiation defense guidelines according to the size of cerebral aneurysm and location of cerebral aneurysm procedures during interventional procedures.

CLINICAL STUDY OF SENSORY ALTERATIONS AFTER SAGITTAL SPLIT RAMUS OSTEOTOMY (하악지 시상분할 절단술 후 감각 변화에 관한 연구)

  • Choi, Jun-Young;Yoo, Jun-Yeol;Yoon, Bo-Keun;Leem, Dae-Ho;Shin, Hyo-Keun;Ko, Seung-O
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.141-148
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    • 2010
  • The bilateral sagittal split ramus osteotomy (BSSRO) is preferred method of surgical correction for mandibular prognathism, retrognathism and asymmetry. This technique performed from primarily an intraoral incision to avoid a scar. After forward movement of the distal segment of the mandible, healing of bone by primary or secondary intention is easily accomplished through large areas of cancellous bony overlap. When rigid fixation is used for the BSSRO, it is possible to open the mouth during the immediate post-operative period because it promotes the healing process. Although this surgical procedure has been well-documented, the incidence of postoperative trigeminal neurosensory disorder in the region of the inferior alveolar nerve and the mental nerve remains one of the major complication. However, evaluation of objective methods for sensory recovery patterns is insufficient although most patients find their sensory return. Neurometer electrodiagnostic device performs automated neuroselective sensory nerve conduction threshold evaluation by determining current perception threshold (CPT) measures. The purpose of this study was to evaluate the sensory recovery patterns of inferior alveolar and mental nerve over time. Nerve examination with a neurometer was performed in 30 patients undergoing the BSSRO at pre-operative, post-operative 1-, 2-, 4- week, and 2-, 3-, 4-, 5-, 6- month follow-up visits after the osteotomy to compare the differences of nerve injury and recovery patterns after the BSSRO with or without genioplasty and sensory recovery patterns associated with the kind of nerve fiber.

A Clinical Study of a Stroke Patient with a Worsened Gait Pattern after Discontinuing Rehabilitation (재활치료 중단 후 보행 양상이 다시 악화된 뇌졸중 환자 1례에 관한 고찰)

  • Kim, Cheol-hyun;Moon, Yeon-ju
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.118-124
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    • 2017
  • Objective: This study describes the case of a patient with a left basal ganglia (BG) infarct who had made almost a complete recovery upon discharge from the hospital in 2014 but who was re-admitted after 31 months with a worsened hemiplegic gait. Methods: The patient had undergone no rehabilitation treatment in the 31 months since his discharge. When the patient was re-admitted to our hospital in 2017, stance and gait data were collected on the patient using a treadmill gait analysis system. In addition, the patient underwent a manual muscle test (MMT) evaluation, and his Motricity index (MI) and modified Barthel index (MBI) scores were recorded. After rehabilitation for one month, the patient was reassessed, and the results were compared to those on the day of re-admission and those recorded in 2014. Results: Compared to the 2014 evaluation results, the patient's stance parameters and gait parameters had worsened at re-admission. However, there was no significant change in the patient's MMT grade or MI and MBI scores in comparison to the results of the 2014 evaluation. After one month of rehabilitation, the patient was re-evaluated again, but there was no significant change in comparison to the evaluation results at re-admission. Conclusion: Some of the stroke patients who have passed six months since the onset of their stroke may require ongoing rehabilitation although the functions of them is almost recovered. Because there is a possibility that recovered functions get worse again without any rehabilitation for a long time. And once the recovered functions get worse, re-recovery of them is not easy.

Incidence and Risk Factors of Acute Postoperative Delirium in Geriatric Neurosurgical Patients

  • Oh, Yoon-Sik;Kim, Dong-Won;Chun, Hyoung-Joon;Yi, Hyeong-Joong
    • Journal of Korean Neurosurgical Society
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    • v.43 no.3
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    • pp.143-148
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    • 2008
  • Objective: Postoperative delirium (POD) is characterized by an acute change in cognitive function and can result in longer hospital stays, higher morbidity rates, and more frequent discharges to long-term care facilities. In this study, we investigated the incidence and risk factors of POD in 224 patients older than 70 years of age, who had undergone a neurosurgical operation in the last two years. Methods: Data related to preoperative factors (male gender, >70 years, previous dementia or delirium, alcohol abuse, serum levels of sodium, potassium and glucose, and co-morbidities), perioperative factors (type of surgery and anesthesia, and duration of surgery) and postoperative data (length of stay in recovery room, severity of pain and use of opioid analgesics) were retrospectively collected and statistically analyzed. Results: POD appeared in 48 patients (21.4%) by postoperative day 3. When we excluded 26 patients with previous dementia or delirium, 17 spontaneously recovered by postoperative day 14, while 5 patients recovered by postoperative 2 months with medication, among 22 patients with newly developed POD. The univariate risk factors for POD included previously dementic or delirious patients, abnormal preoperative serum glucose level, pre-existent diabetes, the use of local anesthesia for the operation, longer operation time (>3.2 hr) or recovery room stay (>90 mini, and severe pain (VAS>6.8) requiring opioid treatment (p<0.05). Backward regression analysis revealed that previously dementic patients with diabetes, the operation being performed under local anesthesia, and severe postoperative pain treated with opioids were independent risk factors for POD. Conclusion: Our study shows that control of blood glucose levels and management of pain during local anesthesia and in the immediate postoperative period can reduce unexpected POD and help preventing unexpected medicolegal problems and economic burdens.

Analysis of Investment in Equipment Capital for Fattening Cattle Farms (한우 비육우 전업농가 시설투자한계 분석)

  • Kim, Jae-Hwan;Kim, Sang-Woo;Cho, Won-Mo;Kang, Hee-Seol;Cho, Young-Moo
    • Journal of Animal Environmental Science
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    • v.2 no.2
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    • pp.155-164
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    • 1996
  • The objective of this study was to estimate the investment limit in equipment capital by Capital Recovery Method. The data used was collected from 23 Hanwoo(Korean Native Cattle) farms in 1994. The necessary time for herd size expansion was average 5 years from opening(9.7 heads) to 50 heads, 4 years from 50 to 100heads, 3 years from 100 to 150 heads, and 2 years from 150 to 200 heads, respectively. It took 14 years from opening to 200 heads of herd size. The debts for fattening cattle farms were 15.2million won for the size of 50 heads, 37.1 million won for the size of 100 heads and 89.0 million won for the size 200 heads, respectively. Average rates of debt interest were 5.1 % 7.2 and 10.8, correspendingly. As the hear size increased, debt interest rates also increased due to government funds limit. The investment limits in equipment capital perfarm household were 77.7 million won for 50 heads, 135.1 for 100 heads, and 294.3 for 200 heads for 5,500 won per kg liveweight, 70.7 million won for 50 heads, 122.6 for 100 heads and 269.3 for 200 heads for 5,000 won per kg liveweight, 63.6 million won for 50 heads 110.0 for 100 heads and 244.2 for 200 heads for 4,500 won per kg liveweight.

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A Design of All-Digital QPSK Demodulator for High-Speed Wireless Transmission Systems (고속 무선 전송시스템을 위한 All-Digital QPSK 복조기의 설계)

  • 고성찬;정지원
    • Journal of Korea Society of Industrial Information Systems
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    • v.8 no.1
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    • pp.83-91
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    • 2003
  • High-speed QPSK demodulator has been in important design objective of any wireless communication systems, especially those offering broadband multimedia service. This paper describes all-digital QPSK demodulator for high-speed wireless communications, and its hardware structures are discussed. All-digital QPSK demodulator is mainly composed of symbol time circuit and carrier recovery circuit to estimate timing and phase-offsets. There are various schemes. Among them, we use Gardner algorithm and Decision-Directed carrier recovery algorithm which is most efficient scheme to warrant the fast acquisition and tacking to fabricate FPGA chip. The testing results of the implemented onto CPLD-EPF10K100GC 503-4 chip show demodulation speed is reached up to 2.6[Mbps]. If it is implemented a CPLD chip with speed grade 1, the demodulation speed can be faster by about 5 times. Actually in case of designing by ASIC, its speed my be faster than CPLD by 5 times. Therefore, it is possible to fabricate the all-digital QPSK demodulator chipset with speed of 50[Mbps].

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Targetting Balance and Gait Rehabilitation with Multichannel Transcranial Direct Current Stimulation in a Sub-Acute Stroke Survivor-A Case Report

  • Gakhar, Kazal;Arumugam, Narkeesh;Midha, Divya
    • Physical Therapy Rehabilitation Science
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    • v.11 no.1
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    • pp.8-15
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    • 2022
  • Objective: Post stroke motor recovery is facilitated by the brain reorganization or the neuroplastic changes. The therapeutic approach mentioned in the current case is one of the approaches for enhancing motor recovery by stimulating the damaged neural networks directing the motor behaviour of a person. The aim of the present study was to establish the changes in the balance and gait pattern of an individual through multi target stimulation of areas of cerebral cortex by utilising multichannel trans cranial direct current stimulation (M-tDCS) in a sub-acute stroke survivor. Design: A Case Report Methods: The present patient was the participant of the trial (CTRI/2021/02/031044).The patient was intervened with M-tDCS (anodes over left primary motor cortex that is C3 point and left dorsolateral prefrontal cortex i.e., F3 point and cathodes over supraorbital areas, Intensity - 1.2mA) for the duration of 20 minutes along with turbo med extern - an AFO to facilitate ankle dorsi flexion and conventional physiotherapy rehabilitation. The Fugl-Meyer assessment lower extremity (FMA-LE), Berg Balance Scale (BBS), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures were used for outcome assessment. Baseline assessment was done on day 0 followed by assessment on 10 and 20 post intervention. Results: Improvement was seen in all the tools i.e. (FMA -LE), BBS, SSQOL and WGS over the time period of 20 days. Conclusions: M-tDCS resulted in improvement in gait parameters, balance and motor functions of lower extremity of the patient.

A Study on Degradation and Recovery Mechanisms of Composites under the Moisture Environment (복합재료의 수분에 의한 열화 및 회복 메커니즘에 관한 연구)

  • Kim, Yun-Hae;Kim, Kook-Jin;Han, Joong-Won;Jo, Young-Dae;Bae, Sung-Youl;Moon, Kyoung-Man
    • Composites Research
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    • v.21 no.2
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    • pp.8-14
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    • 2008
  • Decrease of strength in composite material is generally caused by water absorption. It makes fracture of material, and loss of money or human lives. The objective of this study is to investigate the causes of decrease in strength by water absorption. Mechanism of water absorption was supposed as three steps. This mechanism is consisted of absorption into resin, absorption between resin and surface treatment agent, and delamination between fiber and resin. Conditions of test were supplied differently; kinds of fiber and resin, immersion time etc. Both of reversible reaction and irreversible reaction occurred simultaneously. Most of decrease in strength was finished at 2.5% water absorption, and the strength was recovered. At 4% water absorption, most of decrease was caused by irreversible reaction, therefore, there was a tendency not to be recovered in strength.