• Title/Summary/Keyword: multimodal treatment

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Development of a Brain Phantom for Multimodal Image Registration in Radiotherapy Treatment Planning

  • H. S. Jin;T. S. Suh;R. H. Juh;J. Y. Song;C. B. Y. Choe;Lee, H .G.;C. Kwark
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.450-453
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    • 2002
  • In radiotherapy treatment planning, it is critical to deliver the radiation dose to tumor and protect surrounding normal tissue. Recent developments in functional imaging and radiotherapy treatment technology have been raising chances to control tumor saving normal tissues. A brain phantom which could be used for image registration technique of CT-MR and CT-SPECT images using surface matching was developed. The brain phantom was specially designed to obtain imaging dataset of CT, MR, and SPECT. The phantom had an external frame with 4 N-shaped pipes filled with acryl rods, Pb rods for CT, MR, and SPECT imaging, respectively. 8 acrylic pipes were inserted into the empty space of the brain phantom to be imaged for geometric evaluation of the matching. For an optimization algorithm of image registration, we used Downhill simplex algorithm suggested as a fast surface matching algorithm. Accuracy of image fusion was assessed by the comparison between the center points of the section of N-shaped bars in the external frame and the inserted pipes of the phantom and minimized cost functions of the optimization algorithm. Technique with partially transparent, mixed images using color on gray was used for visual assessment of the image registration process. The errors of image registration of CT-MR and CT-SPECT were within 2mm and 4mm, respectively. Since these errors were considered within a reasonable margin from the phantom study, the phantom is expected to be used for conventional image registration between multimodal image datasets..

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Spinal Joint Pain Syndrome (척추관절통증증후군)

  • Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.21 no.1
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    • pp.1-10
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    • 2008
  • Spinal joint pain syndrome is composed of atlanto-occipital, atlanto-axial, facet, and sacro-iliac joints pain. The syndrome is characterized as referred pain which is originated from deep somatic tissues, which is quietly different from radicular pain with dermatomal distribution originated from nerve root ganglion. The prevalence of facet joint pain in patients with chronic spinal pain of cervical, thoracic, and lumbar regions has been known 56%, 42%, and 31% as in order. It is generally accepted in clinical practice that diagnostic blocks are the most reliable means for diagnosing spinal joints as pain generators. The sacroiliac joint has been shown to be a source of 10% to 27% of suspected cases with chronic low back pain utilizing controlled comparative local anesthetic blocks. The treatment of spinal joints ideally consists of a multimodal approach comprising conservative therapy, medical management, procedural interventions, and if indicated.

Impact of Enhanced Recovery Program on Colorectal Cancer Surgery

  • Lohsiriwat, Varut
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3825-3828
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    • 2014
  • Surgical outcomes of colorectal cancer treatment depend not only on good surgery and tumor biology but also on an optimal perioperative care. The enhanced recovery program (ERP) - a multidisciplinary and multimodal approach, or so called 'fast-track surgery' - has been designed to minimize perioperative and intraoperative stress responses, and to support the recovery of organ function aiming to help patients getting better sooner after surgery. Compared with conventional postoperative care, the enhanced recovery program results in quicker patient recovery, shorter length of hospital stay, faster recovery of gastrointestinal function, and a lower incidence of postoperative complications. Although not firmly established as yet, the enhanced recovery program after surgery could be of oncological benefit in colorectal cancer patients because it can enhance recovery, maintain integrity of the postoperative immune system, increase feasibility of postoperative chemotherapy, and shorten the time interval from surgery to chemotherapy. This commentary summarizes short-term outcomes and potential long-term benefits of enhanced recovery programs in the treatment of colorectal cancer.

Neuroblastoma (신경모세포종)

  • Kang, Hyoung-Jin;Ryu, Kyung-Ha;Shin, Hee-Young;Ahn, Hyo-Seop
    • Advances in pediatric surgery
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    • v.14 no.1
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    • pp.75-82
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    • 2008
  • Neuroblastoma arises from the primitive neural crest cells, and is a common malignancy in childhood. The clinical features are characterized by biological heterogeneity. Neuronal degeneration and differentiation occur in some patients. However treatment in the high risk group accounting for approximately half, has not been satisfactory despite a multimodal approach. Therefore, effective treatment is determined by the risk group of prognostic factors, such as age at diagnosis, stage of disease, pathological finding and N-myc amplification. Neuroblastoma can be diagnosed prenatally, which suggests its origin during the normal embryogenesis. Recent knowledge of molecular biology, such as Trk genes, and the concept of cancer stem cells have given us some improved understanding on this disease. Currently, targeted therapies based on the molecular biology of neuroblastoma are under investigation and increasing survival rate and decreasing late complications could be appreciated.

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Current Status and Consensus on Esophageal Cancer Management (식도암의 치료, 어디까지 와 있는가?)

  • Joon Han Jeon;Dae Young Cheung
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.17-23
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    • 2013
  • Over the decades, the treatment of the esophageal cancer has been debated. Multimodal therapy is a important keystone in advanced esophageal cancer. Neoadjuvant chemoradiation therapy is now known to provide advantages for treating stage II and stage III esophageal squamous cell cancer and can also be considered for the esophageal adenocarcinoma. Definitive chemoradiation therapy results in long-term survival compared with surgery alone. This review aims to provide recent consensus recommendations based on the data and literatures.

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Early Detection and Gemcitabine/Cisplatin Combination Positively Effect Survival in Sarcomatoid Carcinoma of the Urinary Bladder

  • Baseskioglu, Barbaros;Duman, Berna Bozkurt;Kara, I. Oguz;Can, Cavit;Yildirim, Mustafa;Acikalin, Mustafa
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5729-5733
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    • 2012
  • Background and Objectives: This study aimed to present the clinicopathological characteristics and treatment of patients with bladder carcinoma with sarcomatoid differentiation at our institution. Methods: Between 1995-2009, 950 patients were followed-up for bladder carcinoma. Among them, 14 patients with sarcomatoid carcinoma were retrospectively reviewed, and their clinical, pathological features and treatment were recorded. Results: Median age of the patients was 65 years (range: 41-86 years), 12 (86%) being male and 2 (14%) female. All the patients presented with hematuria and 11 (88%) had a history of smoking. The tumor growth pattern was solid in 10 patients, papillary in 2, and mixed in 2. In all, 5 of the patients had urothelial carcinoma with sarcomatoid differentiation and 9 were diagnosed with sarcomatoid carcinoma. Five patients underwent radical cystectomy with ileal conduit surgery, 2 patients refused cystectomy, and 8 patients underwent re-TUR. Following diagnosis, 12 of the patients died in mean 10.7 months (range: 1-48 months). Conclusion: Urothelial carcinomas with sarcomatoid features are aggressive and are usually at advanced stage at the time of diagnosis. The outcomes of multimodal treatment are not satisfactory. Significant findings of the present study are that early diagnosis positively affect survival and that gemcitabine and cisplatin in combination can positively affect survival.

Effect of Combined Traditional Acupuncture, Pharmacopuncture and Applied Kinesiology on Lumbar Diseases of Resident Patients

  • Lee, Sang-Ju;Ahn, Chang Beohm
    • Journal of Pharmacopuncture
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    • v.22 no.3
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    • pp.184-191
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    • 2019
  • Objectives: Recently several Korean medical doctors have begun practicing applied kinesiology (AK). Although the efficacy of combining traditional acupuncture (TA) and pharmacopuncture (PP) on lumbar diseases such as lumbar spinal stenosis (LSS) and lumbar herniation of intervertebral disk (LHID) has been examined, the possible benefits of combining TA, PP and AK approaches have not been examined. Therefore the aim of this study was to develop effective treatment for lumbar disorders by combining TA, PP, and AK treatments. Methods: Twenty-four patients hospitalized at Samse Korean Traditional Medicine Hospital between March and September 2018 with L5 or S1 root radiculopathy associated with LSS and LHID were included in this study. They were treated for 10 days with TA, PP and AK approaches that included category block, manipulation and strain/counterstrain treatments. The primary outcomes were mainly assessed using Japanese Orthopedic Association lumbar scores (JOALS). JOALS were determined before the start of treatment as well as five and 10 days after treatment started. Results: The treatments improved the lumbar condition of the patients based on JOA pain score. Conclusion: The combined TA, PP and AK treatments were effective in treating spinal diseases of resident patients. Prospective, controlled, and relevant protocols using multimodal strategies to define the role of TA, PP and AK are needed.

Diagnostic evaluation and educational intervention for learning disabilities (학습장애의 진단 평가와 교육학적 개입)

  • Hong, Hyeonmi
    • Journal of Medicine and Life Science
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    • v.19 no.1
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    • pp.1-7
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    • 2022
  • Learning disabilities (LD), also known as learning disorders, refers to cases in which an individual experiences lower academic ability as compared to the normal range of intelligence, visual or hearing impairment, or an inability to peform learning. Children and adolescents with learning disabilities often have emotional or behavioral problems or co-existing conditions, including depression, anxiety disorders, difficulties with peer relationships, family conflicts, and low self-esteem. In most cases, attention deficit and hyperactivity disorder coexists. As learning disabilities have the characteristics of a difficult heterogeneous disease group that cannot be attributed to a single root cause, they are diagnosed based on an interdisciplinary approach through medicine and education, such as mental health medicine, education, psychology, special education, and neurology. In addition, for the accurate diagnosis and treatment of learning disabilities, the diagnosis, prescription, treatment, and educational intervention should be conducted in cooperation with doctors, teachers, and psychologists. The treatment of learning disabilities requires a multimodal approach, including medical and educational intervention. It is suggested that educational interventions such as the Individualized Education Plan (IEP) and the Response to Invention (RTI) should be implemented.

Accuracy Evaluation of Three-Dimensional Multimodal Image Registration Using a Brain Phantom (뇌팬톰을 이용한 삼차원 다중영상정합의 정확성 평가)

  • 진호상;송주영;주라형;정수교;최보영;이형구;서태석
    • Journal of Biomedical Engineering Research
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    • v.25 no.1
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    • pp.33-41
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    • 2004
  • Accuracy of registration between images acquired from various medical image modalities is one of the critical issues in radiation treatment planing. In this study, a method of accuracy evaluation of image registration using a homemade brain phantom was investigated. Chamfer matching of CT-MR and CT-SPECT imaging was applied for the multimodal image registration. The accuracy of image correlation was evaluated by comparing the center points of the inserted targets of the phantom. The three dimensional root-mean-square translation deviations of the CT-MR and CT-SPECT registration were 2.1${\pm}$0.8 mm and 2.8${\pm}$1.4 mm, respectively. The rotational errors were < 2$^{\circ}$ for the three orthogonal axes. These errors were within a reasonable margin compared with the previous phantom studies. A visual inspection of the superimposed CT-MR and CT- SPECT images also showed good matching results.