• Title/Summary/Keyword: clinical device

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Therapeutic Effect of Combined Radiotherapy and Hyperthermia in Primary Hepatocellular Carcinoma (원발성 간암의 방사선치료및 온열요법의 병용치료 효과)

  • Kang Ki Mun;Choi Ihl Bohng;Kay Chul Seung;Choi Byung Ok;Chung Su Mi;Kim In Ah;Han Sung Tae;Sun Hee Sik;Chung Kyu Won;Shinn Keyong Sub
    • Radiation Oncology Journal
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    • v.12 no.2
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    • pp.191-199
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    • 1994
  • Purpose : This study was undertaken to show the clinical results of combined radiotherapy and hyperthermia in primary hepatoma Materials and Methods : Between December 1989 and March 1993, 50 patients with hepatomas were treated by combined radiotherapy and hyperthermia. Among them, we analyzed retrospectively 33 patients who received the complete course of treatment. The ages of the patients ranged from 36 to 75(mean age: 55.5 years). Twenty-six patients ($78.8\%$) were men, and 7 ($21.2\%$ were women. According to Child's classification, nine patients ($27.3{\%}$) were A group, 9 ($27.3\%$) were B group, 15 ($45.4\%$) were C group. Radiation therapy was done by a 6 MV and 15 MV linear accelerator. Patients were treated with daily fractions of 150-180 cCy to doses of 2550 cGy -4950 cGy (median : 3000 cGy). Local hyperthermia was done by 8 MHZ RF capacitive heating device (Cancermia. Green Cross Co., Korea), 50-60 min/session, 1-2 sessions/wk, and 8.5 sessions (median number)/patient. We analyzed the prognostic factors including age, sex, tumor type, Child's classification, $\alpha$-fetoprotein, liver cirrhosis, ascites, portal vein invasion, esophageal varix, number of hyperthermia, chemotherapy, total bilirubin level, Karnofsky perfomance status. Results : The overall 1-year survival was $24.2\%$, with a mean survival of 10months. Of 33 patients, tumor regression (PR+MR) was seen in $30.4\%$, no response was seen in $52.2\%,\;17.4\%$ patient was progressed. In patients who had tumor regression, the overall 1-year survival was $42.1\%$ with a mean survival of 14 months. Factors influencing the survival were sex (p=0.05), tumor type (p=0.0248), Child's classification (p=0.0001), liver cirrhosis (p=0.0108), ascites (p=0.0009), and Karnofsky perfomance status (p=0.0028). Complications developed in 28 patients, including 18 hot pain,5 fat necrosis, 3 transient fever, 2 nausea and vomiting. Conclusion : In this study, the results suggests that combined radiotherauy and hyperthermia may improve the survival rate of hepatoma.

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A Study of Intrinsic Alpha Rhythm, Electroencephalography, and Heart Rate Variability Index as Indicators of Cognitive Function and Health in Elderly Adults (노년기 인지기능 및 건강상태를 반영하는 지표로써 Alpha 고유리듬과 뇌파 및 HRV 지표와의 관계 연구)

  • Shim, Jun-Young
    • Science of Emotion and Sensibility
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    • v.22 no.3
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    • pp.21-34
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    • 2019
  • This study was an examination of the relevance and clinical significance of electroencephalographic (EEG) indexes (e.g., mental/physical stress and attention) and indexes of heart rate variability (HRV) with regard to cognitive function and physiological health conditions in elderly people. A device was used to record two-channel EEGs of the frontal lobe and a one-channel ECG simultaneously. Subjects were 76 people average aged 73. The significant findings are as follows: First, subjects whose intrinsic alpha rhythm had high amplitude, regardless of peak, showed higher resistance to mental stress and lower physical stress than did subjects with low-amplitutde intrinsic alpha rhythm. Second, HRV, SDNN, and RMSSD indexes showed strong positive correlations between the two groups of subjects regardless of the division of groups. Third, the alpha asymmetry of the left and right sides of the brain in subjects with low-amplitude intrinsic alpha rhythm was larger, and the delta/alpha ratio (reflecting physical stress) and theta/sensorimotor rhythm (SMR) ratio (showing the decline in attention) were bigger. Fourth, the subjects in whom intrinsic alpha rhythm peak occurred during slow rhythm had a higher theta/SMR ratio than did subjects whose peak occurred during fast rhythm, which was related to a steeper decline in attention. Therefore, the presence or absence of intrinsic alpha rhythm peak and amplitude on quantitative EEG may be an index reflecting the cognitive function and physiological health of elderly people.

Effects of Posttraumatic MgSO4 Injection and Hypothermia an Animal Model of Traumatic Brain Injury(TBI) (실험적 외상성 뇌손상모델에서 외상 후 저체온과 MgSO4의 효과)

  • Han, Seong Rok;Hyun, Dong Keun;Park, Chong Oon;Ha, Young Soo;Kim, Joon Mee
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1296-1302
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    • 2000
  • Objective : Traumatic brain injury including diffuse axonal injury has been shown to result in a decrease in brainfree magnesium concentration, an endogenous inhibitor of calcium entry into neuron, that is associated with the development of neurological motor deficits. The goal of this study is to establish the therapeutic window during which the therapy with $MgSO_4$ and/or hypothermia improve damaged neurons by TUNEL stain. Method : Moderate brain injury was induced in 64 adult Sprague-Dawley rats, weighing 350 to 450gm each, by using a simple weight-drop device(Marmarou model). The animals were randomly assigned to four groups(sixteen rats each, a control group, a group treated with $MgSO_4$, a group treated with hypothermia, and a group treated with $MgSO_4$ and hypothermia) and the rats in each group were sacrificed and studied after 12 hrs, 24 hrs, 1 wk, and 2 wks after insult. In hypothermic group, these rats were subjected to hypothermia after injury, with their rectal temperatures maintained at $32^{\circ}C$ for 1 hour. After 1-hour period of hypothermia, rewarming to normothermic level was accomplished over 30-minute period. In the groups treated $MgSO_4$, hypothermia and $MgSO_4$ were subsequently treated with $MgSO_4$($750{\mu}moles/kg$) infused intra-muscularly at 30 minutes after trauma. Result : In all treated groups, a significant reduction in TUNEL positive cells was found in comparison with the control group each time(p<0.001). Between treatment groups, No differnce was seen 12hrs, 24hrs, and 1wk. However, hypothermic group treated with or without $MgSO_4$ showed more significant reduction in apoptotic cells than group treated with $MgSO_4$ 2 weeks after trauma(p<0.05). However, hypothermic group treated with $MgSO_4$ showed no significant reduction in apoptotic cells compared with hypothermic group(p>0.05). Conclusion : These findings suggest that both hypothermia and $MgSO_4$ significantly improve pathological changes. Otherwise simultaneously $MgSO_4$ and hypothermia treatment groups is failed to provide additional neuroprotection. These results may be relevant to the design of future clinical trials of therapeutic hypothermia and $MgSO_4$ for traumatic brain injury.

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The Change of Blood Pressure according to the Number of Measurements and the Number of Visits (측정 횟수 및 방문 횟수에 따른 혈압 변화)

  • Park, Ji-Eun;Lee, Min-Hee;Ryu, Yeon-Hee;Liu, Yan;Jung, Hee-Jung;Hong, Sang-Hoon;Lee, Seung-Deok;Kim, Nam-Kwen;Choi, Sun-Mi
    • Korean Journal of Oriental Medicine
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    • v.18 no.3
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    • pp.111-118
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    • 2012
  • Objective : The aim of this study was to investigate the number of measurements and visits for blood pressure measurement. We also analyzed the change of blood pressure based on the measurement method and measurement interval. Methods : Data of three clinical trials evaluating the effect of acupuncture, moxibustion, and qigong for pre and mild essential hypertension were used. Blood pressure was measured 3 times each visit with 1 or 5 minutes interval, and it was checked until $3^{rd}$ visit. Two trials used sphygmomanometer and another one trial used automatic device for blood pressure measurement. Results : The mean difference between $1^{st}$ and $2^{nd}$, and $2^{nd}$ and $3^{rd}$ measurement were significant in systolic (p<0.001) and diastolic blood pressure (p<0.001). However, in automated measurement or measuring with 1 minute interval, the difference between $2^{nd}$ and $3^{rd}$ was not significant. The mean of $1^{st}$ and $2^{nd}$ measurements was also significantly different from the mean of all three measurements in both systolic (p<0.001) and diastolic blood pressure (p<0.001). While the difference between each visit was not significant in diastolic blood pressure, the systolic blood pressure difference was significant between $1^{st}$ and $2^{nd}$ visit in automated and manual measurement. Conclusion : The mean of two measurements and three measurements were significantly different. The change of blood pressure was different according to the method and interval of blood pressure measurement.

Design of a SQUID Sensor Array Measuring the Tangential Field Components in Magnetocardiogram (심자도용 접선성분자장 측정방식 스퀴드 센서열 설계)

  • Kim K.;Lee Y. H;Kwon H;Kim J. M;Kim I. S;Park Y. K;Lee K. W
    • Progress in Superconductivity
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    • v.6 no.1
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    • pp.56-63
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    • 2004
  • We consider design factors for a SQUID sensor array to construct a 52-channel magnetocardiogram (MCG) system that can be used to measure tangential components of the cardiac magnetic fields. Nowadays, full-size multichannel MCG systems, which cover the whole signal area of a heart, are developed to improve the clinical analysis with high accuracy and to provide patients with comfort in the course of measurement. To design the full-size MCG system, we have to make a compromise between cost and performance. The cost is involved with the number of sensors, the number of the electronics, the size of a cooling dewar, the consumption of refrigerants for maintenance, and etc. The performance is the capability of covering the whole heart volume at once and of localizing current sources with a small error. In this study, we design the cost-effective arrangement of sensors for MCG by considering an adequate sensor interval and the confidence region of a tolerable localization error, which covers the heart. In order to fit the detector array on the cylindrical dewar economically, we removed the detectors that were located at the corners of the array square. Through simulations using the confidence region method, we verified that our design of the detector array was good enough to obtain whole information from the heart at a time. A result of the simulation also suggested that tangential-component MCG measurement could localize deeper current dipoles than normal-component MCG measurement with the same confidence volume; therefore, we conclude that measurement of the tangential component is more suitable to an MCG system than measurement of the normal component.

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Comparison of Radiofrequency Ablation and Cryoablation for the Recovery of Atrial Contractility and Survival

  • Kim, Kang Min;Chung, Suryeun;Kim, Sang Yoon;Kim, Dong Jung;Kim, Jun Sung;Lim, Cheong;Park, Kay-Hyun
    • Journal of Chest Surgery
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    • v.51 no.4
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    • pp.266-272
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    • 2018
  • Background: Limited comparative data are available on the efficacy of cryoablation versus radiofrequency ablation in patients with atrial fibrillation. This study aimed to compare radiofrequency ablation and cryoablation with regard to clinical outcomes and the restoration of sinus rhythm or atrial contractility. Methods: A total of 239 patients who underwent surgical ablation between August 2003 and December 2016 at our institution were included. The patients were divided into 2 groups according to the energy device that was used (group A: n=140, radiofrequency ablator; group B: n=99, cryoablator). Echocardiographic data, overall survival, and major cardiovascular and cerebrovascular event (MACCE)-free survival were compared between the 2 groups. Results: At 1 year of follow-up, the atrial contractility recovery rate was 32.2% (19 of 59) in group A and 48.8% (21 of 44) in group B. In addition, cryoablation was found to be a predictive factor for the recovery of atrial contractility (cryoablation vs. radiofrequency ablation: odds ratio, 2.540; 95% confidence interval, 1.063-6.071; p=0.036). The left ventricular ejection fraction was significantly higher in group B ($53.1%{\pm}11.5%$ vs. $59.1%{\pm}6.3%$, p=0.001). The median follow-up duration was 36 months. The 5-year overall survival rate was $80.1%{\pm}3.6%$ in group A and $92.1%{\pm}2.9%$ in group B (p=0.400). The 5-year MACCE-free survival rate was $70.3%{\pm}4.0%$ in group A and $70.9%{\pm}5.6%$ in group B (p=0.818). Conclusion: Cryoablation was associated with a higher atrial contractility restoration rate and better left ventricular function than radiofrequency ablation. However, no significant relationship was observed between the energy source and overall or MACCE-free survival.

Finite-element investigation of the center of resistance of the maxillary dentition (상악 치아군의 저항중심의 위치에 관한 3차원 유한요소 해석)

  • Jeong, Gwang-Mo;Sung, Sang-Jin;Lee, Kee-Joon;Chun, Youn-Sic;Mo, Sung-Seo
    • The korean journal of orthodontics
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    • v.39 no.2
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    • pp.83-94
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    • 2009
  • Objective: The aim of this study was to investigate the 3-dimensional position of the center of resistance of the 4 maxillary anterior teeth, 6 maxillary anterior teeth, and the full maxillary dentition using 3-dimensional finite element analysis. Methods: Finite element models included the whole upper dentition, periodontal ligament, and alveolar bone. The crowns of the teeth in each group were fixed with buccal and lingual arch wires and lingual splint wires to minimize individual tooth movement and to evenly disperse the forces to the teeth. A force of 100 g or 200 g was applied to the wire beam extended from the incisal edge of the upper central incisor, and displacement of teeth was evaluated. The center of resistance was defined as the point where the applied force induced parallel movement. Results: The results of study showed that the center of resistance of the 4 maxillary anterior teeth group, the 6 maxillary anterior teeth group, and the full maxillary dentition group were at 13.5 mm apical and 12.0 mm posterior, 13.5 mm apical and 14.0 mm posterior, and 11.0 mm apical and 26.5 mm posterior to the incisal edge of the upper central incisor, respectively. Conclusions: It is thought that the results from this finite element models will improve the efficiency of orthodontic treatment.

Acute Occlusal Change Following Acute Anterior Disc Displacement without Reduction: A Case Report (급성 비정복성 관절원판 변위에 따른 급성 교합변화의 증례)

  • Jung, Jae-Kwang;Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.205-211
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    • 2012
  • A 35 year-old female presented with the complaint of sudden occurrence of bite change and concurrent opening limitation, as well as pain in the right temporomandibular joint (TMJ) during mouth opening. From her history it was revealed that she had simple clicking of right TMJ for several years before onset of these symptoms, and that the clicking sound subsided recently after development of opening limitation. On clinical examination, anterior open bite, midline shift of the mandible to right, and premature contacts on left posterior teeth were observed. Maximum mouth opening and lateral movement to left were also restricted. On magnetic resonance images, the right TMJ showed anterior disc displacement without reduction and the posterior joint space is greatly collapsed by retrusion of the condyle. It was thought that the sudden occurrence of occlusal change would be resulted from abrupt displacement of the mandible associated with development of the anterior disc displacement without reduction. The stabilization appliance traction therapy was performed initially for first 3 months along with physical and pharmacologic therapy. However, the anterior open bite and opening limitation didn't resolve and the position of mandible still remained altered. So the stabilization appliance was changed to intermaxillary traction device. Then the mandible returned progressively to normal position and the occlusion became more stable and comfortable. After 5 months of intermaxillary traction therapy, the anterior open bite was dissolved completely and the occlusion became stabilized satisfactorily along with recovery of normal mouth opening range. On post-treatment magnetic resonance image, remodeling of condylar head was observed.

Report of the 3rd Japan-Korea Workshop on Acupuncture and EBM;Protocol development for the acupuncture trial on the osteoarthritis of the knee

  • Jang, Jun-Hyouk;Kenji, Kawakita;Hahn, Seo-Kyung;Park, Hi-Joon;Lee, Seung-Deok;Kim, Yong-Suk;Norihito, Takahashi;Toshiyuki, Shichidou;Kazunori, Itoh;Eiji, Sumiya;Eiji, Furuya;Hitoshi, Yamashita;Hiroshi, Tsukayama
    • Journal of Acupuncture Research
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    • v.23 no.6
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    • pp.239-254
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    • 2006
  • The 3rd Japan-Korea Workshop on Acupuncture and EBM was held at Kanazawa on June $16^{th}$. From Korea team, 4 papers were presented. Dr. Hahn introduced a new approach of data analysis on series of n-of-1 trials using the Bayesian statistics. It offered important information for the future n-of-1 trials. Dr. Park clearly demonstrated the significance of various sham devices proposed and stressed the importance of research questions when we choose the control intervention in RCT. Dr. Lee reported the results of survey in Korean Medical Doctors (KMD) for their point selection and techniques to the distal and local points. Dr. Kim presented the results of face to face survey on the KMD with 28 items for acupuncture treatment on the knee OA. Finally, a draft of protocol was introduced by Dr. Kim. The title was "multi-center, a randomized, single blinded, two arms, parallel-group study to compare the effectiveness and safety of 'individualized acupuncture' and 'standardized minimal acupuncture' in Korean and Japanese patients with knee osteoarthritis (Phase IV)". From Japan team, 7 speakers presented their comments and proposals on the protocol. Dr. Takahashi introduced several issues regarding n-of-1 trials and pointed out the importance of obtaining generalizability from n-of-1 trials. Dr. Shichidou pointed the importance of research design, selection of outcome measures and reduction of biases. Dr. Itoh presented the results of point selection for the knee OA based on the literature survey. Dr. Sumiya introduced several differences between KMD and Japanese acupuncturists based on the questionnaire used in KMD survey. Dr. Furuya demonstrated a result of press tack needle and its sham device on shoulder stiffness. Dr. Yamashita introduced the results of literature survey regarding adverse events occurred by acupuncture on knee OA. Dr.Tsukayama stressed the importance of responsibility of Institutional Review Board (IRB) for the conduction of clinical trials. After several issues were discussed, the need of continued meeting for final protocol development was agreed, then the workshop was closed.

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A Study on the Development of Convergence Education Program for workers in Health and Medical Industry in preparation for the forth industrial revolution (4차 산업혁명 대비 보건의료 산업분야종사자를 위한 융합교육 프로그램에 관한 연구)

  • Kim, Sun-Jung;Kim, Yeon-Sun;Kim, Ji-Hoon;Lee, Jung-Hwa;Chang, Kyung-Eun
    • Journal of the Korea Convergence Society
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    • v.9 no.5
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    • pp.43-52
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    • 2018
  • The purpose of this study is to conduct a survey on awareness of the fourth industrial revolution being much debated recently and suggest the educational program for adult learner in order to create a new demand of university according to the social change. Based on earlier researches, the survey was conducted on employees working in the health and medical industry with questionnaire including the relevant educational field, areas of turnover and educational needs from July 1 to July 31, 2017. As a result, the bio-medical device, senior-friendly industry, environment and safety, clinical counselor and food service industry(coffee industry) were identified as necessary education areas. To enhance the validity of research results, in-depth interviews of relevant experts in each field were conducted from August 19 to September 22, 2017, and presented necessary education programs driven by the advent of the fourth industrial revolution and changes in each areas.