• Title/Summary/Keyword: invasive pattern

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Crossed Cerebellar Hyperperfusion on Ictal Tc-99m HMPAO Brain SPECT: Clinical Significance for Differentiation of Mesial or Lateral Temporal Lobe Epilepsy and Related Factors for Development (발작기 Tc-99m HMPAO 뇌 SPECT에 나타난 교차소뇌과혈류: 내외측 측두엽간질의 감별에 대한 임상적 의의와 발생에 영향을 주는 요인)

  • Park, Soon-Ah;Lee, Dong-Soo;Kim, Seok-Ki;Lee, Sang-Gun;Jang, Myoung-Jin;Sohn, Myung-Hee;Lim, Seok-Tae;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.4
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    • pp.312-321
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    • 2000
  • Purpose: The aim of this study was to determine whether crossed cerebellar hyperperfusion (CCH) was helpful in discriminating mesial from lateral temporal lobe epilepsy (TLE) and what other factors were related in the development of CCH on ictal brain SPECT. Materials and Methods: We conducted retrospective analysis in 59 patients with TLE (M:41, F:18; $27.4{\pm}7.8$ years old; mesial TLE: 51, lateral TLE: 8), which was confirmed by invasive EEG and surgical outcome (Engel class I, II). All the patients underwent ictal Tc-99m HMPAO brain SPECT and their injection time from ictal EEG onset on video EEG monitoring ranged from 11 sec to 75 sec ($32.6{\pm}19.5sec$) in 39 patients. Multiple factors including age, TLE subtype (mesial TLE or lateral TLE), propagation pattern (hyperperfusion localized to temporal lobes, spread to adjacent lobes or contralateral hemisphere) and injection time were evaluated for their relationship with CCH using multiple logistic regression analysis Results: CCH was observed in 18 among 59 patients. CCH developed in 29% (15/51) of mesial TLE patients and 38% (3/8) of lateral TLE patients. CCH was associated with propagation pattern; no CCH (0/13) in patients with hyperperfusion localized to temporal lobe, 30% (7/23) in patients with propagation to adjacent lobes, 48% (11/23) to contralateral hemisphere. Multiple logistic regression analysis revealed that propagation pattern (p=0.01) and age (p=0.02) were related to the development of CCH. Conclusion: Crossed cerebellar hyperperfusion in ictal brain SPECT did not help differentiate mesial from lateral temporal lobe epilepsy. Crossed cerebellar hyperperfusion was associated with propagation pattern of temporal lobe epilepsy and age.

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A Study For Optimizing Input Waveforms In Radiofrequency Liver Tumor Ablation Using Finite Element Analysis (유한 요소 해석을 이용한 고주파 간 종양 절제술의 입력 파형 최적화를 위한 연구)

  • Lim, Do-Hyung;NamGung, Bum-Seok;Lee, Tae-Woo;Choi, Jin-Seung;Tack, Gye-Rae;Kim, Han-Sung
    • Journal of Biomedical Engineering Research
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    • v.28 no.2
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    • pp.235-243
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    • 2007
  • Hepatocellular carcinoma is significant worldwide public health problem with an estimated annually mortality of 1,000,000 people. Radiofrequency (RF) ablation is an interventional technique that in recent years has come to be used for treatment of the hepatocellualr carcinoma, by destructing tumor tissues in high temperatures. Numerous studies have been attempted to prove excellence of RF ablation and to improve its efficiency by various methods. However, the attempts are sometimes paradox to advantages of a minimum invasive characteristic and an operative simplicity in RF ablation. The aim of the current study is, therefore, to suggest an improved RF ablation technique by identifying an optimum RF pattern, which is one of important factors capable of controlling the extent of high temperature region in lossless of the advantages of RF ablation. Three-dimensional finite element (FE) model was developed and validated comparing with the results reported by literature. Four representative Rf patterns (sine, square, exponential, and simulated RF waves), which were corresponding to currents fed during simulated RF ablation, were investigated. Following parameters for each RF pattern were analyzed to identify which is the most optimum in eliminating effectively tumor tissues. 1) maximum temperature, 2) a degree of alteration of maximum temperature in a constant time range (30-40 second), 3) a domain of temperature over $47^{\circ}C$ isothermal temperature (IT), and 4) a domain inducing over 63% cell damage. Here, heat transfer characteristics within the tissues were determined by Bioheat Governing Equation. Developed FE model showed 90-95% accuracy approximately in prediction of maximum temperature and domain of interests achieved during RF ablation. Maximum temperatures for sine, square, exponential, and simulated RF waves were $69.0^{\circ}C,\;66.9^{\circ}C,\;65.4^{\circ}C,\;and\;51.8^{\circ}C$, respectively. While the maximum temperatures were decreased in the constant time range, average time intervals for sine, square, exponential, and simulated RE waves were $0.49{\pm}0.14,\;1.00{\pm}0.00,\;1.65{\pm}0.02,\;and\;1.66{\pm}0.02$ seconds, respectively. Average magnitudes of the decreased maximum temperatures in the time range were $0.45{\pm}0.15^{\circ}C$ for sine wave, $1.93{\pm}0.02^{\circ}C$ for square wave, $2.94{\pm}0.05^{\circ}C$ for exponential wave, and $1.53{\pm}0.06^{\circ}C$ for simulated RF wave. Volumes of temperature domain over $47^{\circ}C$ IT for sine, square, exponential, and simulated RF waves were 1480mm3, 1440mm3, 1380mm3, and 395mm3, respectively. Volumes inducing over 63% cell damage for sine, square, exponential, and simulated RF waves were 114mm3, 62mm3, 17mm3, and 0mm3, respectively. These results support that applying sine wave during RF ablation may be generally the most optimum in destructing effectively tumor tissues, compared with other RF patterns.

PRESENT SITUATION AND PROSPECT OF PEDIATRIC DENTISTRY IN KOREA - FOCUSED ON MANAGEMENT OF DENTAL CARIES - (한국 소아치과의 현재와 전망 - 치아우식증관리 분야를 중심으로 -)

  • Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.206-225
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    • 2012
  • General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.

The Effect of Circle Lens and Soft Contact Lens with Identical Material in Clinical Application on the Eyes (써클 및 동일 재질 콘택트렌즈의 임상 적용시 눈에 미치는 영향)

  • Park, Sang Hee;Kim, So Ra;Park, Mijung
    • Journal of Korean Ophthalmic Optics Society
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    • v.16 no.2
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    • pp.147-157
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    • 2011
  • Purpose: The present study was conducted to investigate the actual condition of circle lens wear and the differences caused by the pigmentation in blinking rate, non-invasive tear break-up time (NIBUT), and lens surface between circle and soft contact lens wear during clinical application. Methods: Eighty subjects were surveyed to know the actual condition of wearing circle lens. Blink rate, NIBUT of 20 subjects in twenties were measured after separately wearing soft contact lens and circle lens for 5 days. Their lens surfaces were also observed by scanning electron microscope. Results: Fifty percent of circle lens wearers answered that major reason for changing circle lens was discomfort and 67% of answerers wore circle lens more than 6 hours a day. The tendency of increased blink rates in both wearers of circle and soft contact lens at 30 minutes later when tear film stabilized and 3 hour after lens wearing was shown on the 1st, 3rd and 5th day with expanding wearing time. Especially at 3 hours after lens wearing on the 3rd and 5th day, the difference of blink rates was statistically different in circle lens wear and soft contact lens wear. The NIBUTs of soft contact lens wearers and circle lens wearers were 6.0 and 3.7 secs, respectively, at 30 min later on 1st day and were significantly different. NIBUTs of soft contact lens wearers and circle lens wearers were also statistically different 3 hrs after lens wearing on the 1st day and the similar pattern of NIBUTs was shown on the 3rd and 5th day. The roughness of both surfaces in soft contact lens and front surface in circle lens was same. However, pigmented front surface of circle lens was rougher and uneven. Conclusions: As the results, the circle lens wearers might feel discomfort in clinical application since the difference in lens surface of circle lens would change lens wettability during wearing. The difference by tinting contact lens was shown from the result, which could help better wearing circle lens.

Rapamycin and PF4 Induce Apoptosis by Upregulating Bax and Down-Regulating Survivin in MNU-Induced Breast Cancer

  • Al-Astani Tengku Din, Tengku Ahmad Damitri;Shamsuddin, Shazana Hilda;Idris, Fauziah Mohamad;Wan Mansor, Wan Nor Ariffin;Abdul Jalal, Muhammad Irfan;Jaafar, Hasnan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.9
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    • pp.3939-3944
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    • 2014
  • Background: To elucidate the role of rapamycin and PF4 on apoptosis regulation via Bax (pro-apoptosis), Bcl-2 (anti-apoptosis) and survivin activation on the growth in the 1-methyl-1-nitrosourea-induced invasive breast carcinoma model. Materials and Methods: Thirty five female Sprague Dawley rats at age 21-day old were divided into 4 groups; Group 1 (control, n=10), Group 2 (PF4, n=5), Group 3 (rapamycin, n=10) and Group 4 (rapamycin+PF4, n=10). MNU was administered intraperitionally, dosed at 70mg/kg body weight. The rats were treated when the tumors reached the size of $14.5{\pm}0.5mm$ and subsequently sacrificed after 5 days. Rapamycin and PF4 were administered as focal intralesional injections at the dose of $20{\mu}g$/lesion. The tumor tissue was then subjected to histopathological examinations for morphological appraisal and immunohistochemical assessment of the pro-apoptotic marker, Bax and anti-apoptotic markers, Bcl-2 and survivin. Results: The histopathological pattern of the untreated control cohort showed that the severity of the malignancy augments with mammary tumor growth. Tumors developing in untreated groups were more aggressive whilst those in treated groups demonstrated a transformation to a less aggressive subtype. Combined treatment resulted in a significant reduction of tumor size without phenotypic changes. Bax, the pro-apoptotic marker, was significantly expressed at higher levels in the rapamycin-treated and rapamycin+PF4-treated groups compared to controls (p<0.05). Consequently, survivin was also significantly downregulated in the rapamycin-treated and rapamycin+PF4-treated group and this was significantly different when compared to controls (p). Conclusions: In our rat model, it could be clearly shown that rapamycin specifically affects Bax and survivin signaling pathways in activation of apoptosis. We conclude that rapamycin plays a critical role in the induction of apoptosis in MNU-induced mammary carcinoma.

Correlation between Head-Up Tilt Test and Spontaneous Baroreflex Sensitivity in a Supine Position on the Diagnosis of Orthostatic Hypotension (기립성 저혈압 진단에 있어 기립경사검사와 누운 자세에서 측정한 자발성 압수용기반사 민감도의 상관관계)

  • Ha, Eun-Ok;Kim, Young-Soo;Park, Ki-Jong;Kim, Soo-Kyoung;Kang, Hee-Young;Choi, Nack-Cheon;Kwon, Oh-Young;Lim, Byeong-Hoon;Yoo, Nam-Tae
    • Annals of Clinical Neurophysiology
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    • v.12 no.2
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    • pp.61-65
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    • 2010
  • Background: Orthostatic hypotension (OH) refers to a fall in systolic blood pressure (BP) of 20 mmHg or more, or in diastolic BP of 10 mm Hg or more within 3 minutes of standing up. The head-up tilt test (HUT) is the most useful, but potentially invasive test for the diagnosis of OH. The purpose of this study was to identify the usefulness of spontaneous baroreflex sensitivity (sBRS). Methods: Ninety one patients with orthostatic intolerance, in whom the HUT data were available, were included in the study. Patients were classified into HUT-positive (group I) and HUT-negative (group II) group. Twenty five healthy volunteers served as normal controls, and were designated as group III. In all subjects, beat-to-beat BP and heart rate were recorded using BeatScope 1.1a. We collected the 50 sBRS data in each patient in a supine position. The average value of one to ten of 50 sBRS data was defined as sBRS10, one to twenty as sBRS20, one to thirty as sBRS 30, one to forty as sBRS 40, and one to fifty as sBRS 50. Differences in sBRS10 and sBRS50 levels were statistically analyzed and compared between groups I, II, and III. Results: No significant difference in the sBRS50 level was found between Groups II and III. sBRS50 was significantly lower in Group I than in Groups II and III (p<0.05), and the same pattern of differences was observed for sBRS40, sBRS30, sBRS20, and sBRS10. Conclusions: Patients with OH showed significantly lower sBRS levels than HUT-negative patients or normal controls. Our study implies that a supine-position sBRS would provide additional diagnostic information for OH.

Distribution Status of Paspalum distichum Community at the Nakdong-River Estuary (낙동강 하구언 일대의 물참새피군락 분포 현황)

  • Lim, Jeong-Cheol;Jeong, Hyun-Gi;Lee, Cheol-ho;Choi, Byoung-Ki
    • Korean Journal of Ecology and Environment
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    • v.50 no.2
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    • pp.195-206
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    • 2017
  • We described a spatial distribution pattern and floral diversity on the Paspalum distichum community occurring at the ecological parks of Hwamyeong, Daejeo, Samnak, and Maekdo in the Nakdong river estuary. A total distribution area of P. distichum community was $303,462.6m^2$. Its largest area was found in Samnak eco-park ($185,910.1m^2$). The most richness of knotgrass patches in each ecological park was determined Maekdo eco-park (87). Cover class level-5 shows the largest area ($260,663.2m^2$). A total of 73 taxa (34 families, 55 genus, 65 species, and 8 varieties) were listed up on the P. distichum community. A welldeveloped population of knotgrass was found predominantly at sites linked into human impacts at the riverine floodplain, the stream courses flowing through the parks, and the man-made channels and wetlands. Finally we proposed an ecological management strategy for knotgrass population in the study area.

Use of Sonography in the Differential Diagnosis between Phylloides Tumor and Giant Fibroadenoma (엽상육종과 거대 섬유선종의 초음파 소견의 비교)

  • Choi, Jong-O;Kim, Jae-Woon;Park, Won-Kyu;Hwang, Mi-Soo;Park, Bok-Hwan
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.295-301
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    • 1996
  • Phylloides tumor is very similar to giant fibroadenoma in that they have benign appearance in breast radiologic image. Fibroadenoma has no malignant potential, but phylloides tumor is locally recurrent, invasive and may occasionally metastasize. It thus appears that evaluation of the differential point of the two tumor groups by radiologic study is very important. We retrospectively compared sonographic findings of 6 cases of phylloides tumor with those of 4 cases of fibroadenoma, which proved pathologically in Yeungnam University Hospital from 1984 to 1986. The mean age of the patients were 31.8 years old(from 14 to 41 years old) in phylloides tumor and 28.8 years old (from 17 to 40 years old) in giant fibroadenoma, respectively. The viewpoints of this analysis were size, shape and contour of the masses, internal echo pattern, posterior enhancement, and especially the existence of peripheral cyst or septal band echo. We found that diffenentiation of these two tumors by sonography was difficult. But peripheral cyst was found only in phylloides tumor and septal band echo was found largely in giant fibroadenoma. Although the existence of peripheral cyst or septal band echo in the breast mass was not pathognomonic findings, we suggest that the existence of septal band echo is preferential finding to fibroadenoma, and peripheral cyst is preferential finding to phylloides tumor.

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Consolidative Bronchioloalveolar Carcinoma Presenting as Pneumonia, and This Led to a Late Diagnosis due to the Improvement after Antibiotic Therapy (항생제 치료 후 호전을 보여 진단이 늦어진 폐선암/세기관지폐포암 1예)

  • Jeong, Ina;Heo, Eun Young;Lee, Jae Seok;Yoon, Ho Il;Lee, Jae Ho;Lee, Choon-Taek;Kang, Young Ae
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.2
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    • pp.147-151
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    • 2008
  • Non-resolving or slowly resolving pulmonary infiltrates in spite of administering adequate antimicrobial therapy are a clinical diagnostic challenge for physicians. The rate of radiographic resolution varies with the patients' age, the underlying comorbidities, the extent of radiographic involvement, the functional status and the causal pathogens. It is important to differentiate non-resolving or slowly resolving bacterial pneumonia from other uncommon infectious pneumonias or malignancies that require invasive diagnostic techniques to confirm the diagnosis. Bronchioloalveolar carcinoma can present with various clinical and radiographic features. Unfortunately, the radiographic similarity of consolidative BAC to pneumonia often leads to an incorrect diagnosis of pneumonia and possibly significant delays in obtaining appropriate diagnostic studies. We describe here a case of a mixed adenocarcinoma and bronchioloalveolar carcinoma that was initially diagnosed as pneumonia due to the consolidation pattern on the radiography and the patient's initial improvement with antibiotic treatment.

Vegetation Classification and Distributional Pattern in Damyang Riverine Wetland (담양하천습지의 식생유형과 분포양상)

  • Ahn, Kyunghwan;Lim, Jeongcheol;Lee, Youlkyung;Choi, Taebong;Lee, Kwangseok;Im, Myoungsoon;Go, Youngho;Suh, Jaehwa;Shin, Youngkyu;Kim, Myungjin
    • Journal of Environmental Impact Assessment
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    • v.25 no.2
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    • pp.89-102
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    • 2016
  • Damyang riverine wetland was designated as a wetland protected area in 2004; that is located in the Yeongsan river mainstream. Total 30 phytosociological releves at field studies were classified with 22 vegetation types including of 101 species (unidentified 1 species). Legends of actual vegetation map were separated by 6 types; riparian forest, substitute vegetation, synanthropic vegetation, wet meadow vegetation, open water, an area of wetland vegetation is about 35 % ($386,841.86m^2$). Results of this study area as follows. The plant society of Damyang riverine wetland was conjectured that it was formed by rapidly water environment change with installed weir on the upstream of protected area and operating of Damyang dam on top of the basin. Until recently, the terrace land on the river was used to cultivate, but that would be formed fallow vegetation scenery on riverfront caused by no cultivation after designated protected area. Paspalum distichum var. indutum community designated as invasive alien plant by Korea Ministry of Environment was widely developed and Myriophyllum spicatumunrecorded in the country as newly alien species was discovered in the study zone. The plants as lapped over developing environment for Leersia japonica must be occupied habitat of native plant species having similar niche. The various plant society in Damyang riverine wetland should be developed because of environmental changes, disturbances and damages of stream.