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Effect of He-Ne laser intravascular irradiation in treatment of cerebral infarction (뇌경색(腦硬塞)에 대(對)한 He-Ne laser 정맥혈관내(靜脈血管內) 조사(照射)의 효과(效果))

  • Park, Yang Chun;Ann, Taek Won;Kim, Dong Hee;Kim, Byeong Tak
    • Journal of Haehwa Medicine
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    • v.9 no.1
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    • pp.387-397
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    • 2000
  • Background : Intravascular Laser Irrardiation of Blood(ILIB) is used in disorder of cerebral and peripheral blood circulation, dysfunction of brain, atherosclerosis etc., but there are little study about ILIB in oriental medicine. We wished to assess the efficacy of ILIB for the treatment of cerebral infarction. Method : The study group comprised 40 patients who arrived at hospital during 48 hours after attack. All patient were divided into two group. The control group was treated with Uhuangcheongsimhuan(牛黃淸心丸), Seonghyangjeonggisan(星香正氣散), acupuncture therapy only, while the ILIB group was treated with above therapy plus 5 days of irradiation of He-Ne Laser(1.8~2.5mW, 50min. per day). In rat model of middle cerebral artery(MCA) occlusion, the control group was not treated, while the ILIB group was treated with irradiation of He-Ne Laser(1.8~2.5mW, 24sec.). Result : 1. Symptom improve scores did not showed significant difference between control and ILIB group. 2. Vasoreactivity of carotid siphon did not showed significant difference between control and ILIB group. 3. Vasoreactivity of radial artery did not showed significant difference between control and ILIB group. 4. PT a-PTT did not showed significant changes between before and after treatment in both group. Fibrinogen significantly increased after treatment in ILIB group(p<0.05)), but it was in normal degree. 5. ILIB showed a significant decrease of brain ischemic area and edema in rat model of middle cerebral artery(MCA) occlusion. Conclusion : These findings suggest that additional treatment of ILIB is not more useful than traditional therapy only in acute cerebral infarction. But ILIB showed potential effect in rat model of MCA occlusion. So further investigation will be necessary.

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Indication of Bone Marrow Aspiration in Acute Idiopathic Thrombocytopenic Purpura in Children (소아 급성 특발성 혈소판 감소성 자반증에서 골수흡인 검사의 적응)

  • Kim, Won-Duck;Hah, Jeong-Ok
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.239-245
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    • 2001
  • Background: Acute idiopathic thrombocytopenic purpura(ITF) is one of the common hematologic disorders in children. Bone marrow aspiration (BMA) is often performed in children with acute ITP to rule out leukemia, aplastic anemia or other hematologic diseases. However, whether BMA is needed in children with typical clinical and hematological features of acute ITP have been questioned. This study was performed to examine the proper indication of BMA in acute childhood ITF. Materials and Methods: The medical records and BMA reports of children with the provisional diagnosis of acute ITP were reviewed from January 1984 to December 2000. Patients were divided into two groups, one with typical and another with atypical clinical and hematological features of acute ITP. Typical acute ITP group was characterized by the history of previous viral infection, well being appearance, no hepatosplenomegaly, no lymphadenopathy, normal Hb, WEC, neutrophil count and peripheral blood smear except thrombocytopenia. A platelet count of $50{\times}l0^9/L$ or lower was the cutoff level. Results: Total 120 children with the provisional diagnosis of acute ITP were included. One hundred eighteen of them were confirmed to have acute ITP by BMAs. Of these, 66 had typical and 54 had atypical features. All of typical features and 52 of 54 with atypical features of acute ITP were confirmed to have acute ITP by BMAs. Two patients with atypical features of acute ITP were diagnosed as aplastic anemia and myelodyspalstic syndrome, respectively, by BMAs. Conclusion: This study concludes that BMA is not needed for the children with typical features of acute ITP but it is needed for the children with atypical features of acute ITP to rule out other hematologic disorders.

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Dose Distribution and Design of Dynamic Wedge Filter for 3D Conformal Radiotherapy (방사선 입체조형치료를 위한 동적쐐기여과판의 고안과 조직내 선량분포 특성)

  • 추성실
    • Progress in Medical Physics
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    • v.9 no.2
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    • pp.77-88
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    • 1998
  • Wedge shaped isodoses are desired in a number of clinical situations. Hard wedge filters have provided nominal angled isodoses with dosimetric consequences of beam hardening, increased peripheral dosing, nonidealized gradients at deep depths along with the practical consequendes of filter handling and placement problems. Dynamic wedging uses a combination of a moving collimator and changing monitor dose to achieve angled isodoses. The segmented treatment tables(STT) that monitor unit setting by every distance of moving collimator, was induced by numerical formular. The characteristics of dynamic wedge by STT compared with real dosimetry. Methods and Materials : The accelerator CLINAC 2100C/D at Yonsei Cancer Center has two photon energies (6MV and 10MV), currently with dynamic wedge angles of 15$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$ and 60$^{\circ}$. The segmented treatment tables(STT) that drive the collimator in concert with a changing monitor unit are unique for field sizes ranging from 4.0cm to 20.0cm in 0.5cm steps. Transmission wedge factors were measured for each STT with an standard ion chamber. Isodose profiles, isodose curves, percentage depth dose for dynamic wedge filters were measured with film dosimetry. Dynamic wedge angle by STT was well coincident with film dosimetry. Percent depth doses were found to be closer to open field but more shallow than hard wedge filter. The wedge transmission factor were decreased by increased the wedge angle and more higher than hard wedge filters. Dynamic wedging probided more consistent gradients across the field compared with hard wedge filters. Dynamic wedging has practical and dosimetric advantages over hard filters for rapid setup and keeping from table collisions. Dynamic wedge filters are positive replacement for hard filters and introduction of dynamic conformal radiotherapy and intensity modulation radiotherapy in a future.

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Development of Quality Assurance Software for $PRESAGE^{REU}$ Gel Dosimetry ($PRESAGE^{REU}$ 겔 선량계의 분석 및 정도 관리 도구 개발)

  • Cho, Woong;Lee, Jaegi;Kim, Hyun Suk;Wu, Hong-Gyun
    • Progress in Medical Physics
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    • v.25 no.4
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    • pp.233-241
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    • 2014
  • The aim of this study is to develop a new software tool for 3D dose verification using $PRESAGE^{REU}$ Gel dosimeter. The tool included following functions: importing 3D doses from treatment planning systems (TPS), importing 3D optical density (OD), converting ODs to doses, 3D registration between two volumetric data by translational and rotational transformations, and evaluation with 3D gamma index. To acquire correlation between ODs and doses, CT images of a $PRESAGE^{REU}$ Gel with cylindrical shape was acquired, and a volumetric modulated arc therapy (VMAT) plan was designed to give radiation doses from 1 Gy to 6 Gy to six disk-shaped virtual targets along z-axis. After the VMAT plan was delivered to the targets, 3D OD data were reconstructed from 512 projection data from $Vista^{TM}$ optical CT scanner (Modus Medical Devices Inc, Canada) per every 2 hours after irradiation. A curve for converting ODs to doses was derived by comparing TPS dose profile to OD profile along z-axis, and the 3D OD data were converted to the absorbed doses using the curve. Supra-linearity was observed between doses and ODs, and the ODs were decayed about 60% per 24 hours depending on their magnitudes. Measured doses from the $PRESAGE^{REU}$ Gel were well agreed with the TPS doses at central region, but large under-doses were observed at peripheral region at the cylindrical geometry. Gamma passing rate for 3D doses was 70.36% under the gamma criteria of 3% of dose difference and 3 mm of distance to agreement. The low passing rate was resulted from the mismatching of the refractive index between the PRESAGE gel and oil bath in the optical CT scanner. In conclusion, the developed software was useful for 3D dose verification from PRESAGE gel dosimetry, but further improvement of the Gel dosimetry system were required.

Time Resolution Improvement of MRI Temperature Monitoring Using Keyhole Method (Keyhole 방법을 이용한 MR 온도감시영상의 시간해상도 향상기법)

  • Han, Yong-Hee;Kim, Tae-Hyung;Chun, Song-I;Kim, Dong-Hyeuk;Lee, Kwang-Sig;Eun, Choong-Ki;Jun, Jae-Ryang;Mun, Chi-Woong
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.1
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    • pp.31-39
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    • 2009
  • Purpose : This study proposes the keyhole method in order to improve the time resolution of the proton resonance frequency(PRF) MR temperature monitoring technique. The values of Root Mean Square (RMS) error of measured temperature value and Signal-to-Noise Ratio(SNR) obtained from the keyhole and full phase encoded temperature images were compared. Materials and Methods : The PRF method combined with GRE sequence was used to get MR temperature images using a clinical 1.5T MR scanner. It was conducted on the tissue-mimic 2% agarose gel phantom and swine's hock tissue. A MR compatible coaxial slot antenna driven by microwave power generator at 2.45GHz was used to heat the object in the magnetic bore for 5 minutes followed by a sequential acquisition of MR raw data during 10 minutes of cooling period. The acquired raw data were transferred to PC after then the keyhole images were reconstructed by taking the central part of K-space data with 128, 64, 32 and 16 phase encoding lines while the remaining peripheral parts were taken from the 1st reference raw data. The RMS errors were compared with the 256 full encoded self-reference temperature image while the SNR values were compared with the zero filling images. Results : As phase encoding number at the center part on the keyhole temperature images decreased to 128, 64, 32 and 16, the RMS errors of the measured temperature increased to 0.538, 0.712, 0.768 and 0.845$^{\circ}C$, meanwhile SNR values were maintained as the phase encoding number of keyhole part is reduced. Conclusion : This study shows that the keyhole technique is successfully applied to temperature monitoring procedure to increases the temporal resolution by standardizing the matrix size, thus maintained the SNR values. In future, it is expected to implement the MR real time thermal imaging using keyhole method which is able to reduce the scan time with minimal thermal variations.

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Detection of Y Mosaicism in Blood and Gonad of Patients with Gonadal Dysgenesis (성선 이형성 환자 혈액 및 성선 조직에서 Y 염색체 모자이시즘의 진단)

  • Kim, Jin-Yeong;Lee, Sang-Joon;Park, Ki-Hyun;Kim, Jung-Yeon;Bai, Sang-Wook;Lee, Byung-Seok;Kim, Se-Kwang;Kim, In-Kyu;Cho, Dong-Je;Song, Chan-Ho;Kim, Jae-Wook;Lee, Ho-Joon
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.3
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    • pp.457-465
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    • 1999
  • Objective: The presence of Y chromosome in patients with gonadal dysgenesis is related to the risk of gonadoblastoma. Since the patients with abnormal sexual differentiation may have cryptic Y mosaicism, it is important to detect the presence of Y material in these patients. But sometimes it is difficult to detect Y material only with karyotyping. This study was performed to evaluate the usefulness of the SRY gene screening in blood and gonad by using PCR in detecting the presence of Y material and possible tissue mosaicism in patients with gonadal dysgenesis as Turner syndrome and 46,XY pure gonadal dysgenesis (PGD, Swyer syndrome). Method: In 26 patients with gonadal dysgenesis, we screened for Y material by using PCR for SRY gene in peripheral leukocytes and in gonadal tissues of some patients. They were 22 cases of Turner syndrome (7 45,XO, 2 46,Xi(Xq), 3 45,XO/46,XX, 5 45,XO/46,Xi(Xq), 1 45, XO/46,XY, 1 45,XO/46,Xi(Yq), 1 45,XO/47,XYY, 1 46,XX,del(X)(q24) and 1 46,X,+mar) and 4 cases of 46,XY pure gonadal dysgenesis. PCR for SRY gene in the gonadal tissue was performed in 5 Turner syndrome and 2 PGD to determine the cryptic Y mosaicism between blood and gonad. Results: By using PCR analysis for SRY, Y chromosome material was detected in the blood of 4 of 22 Turner syndrome patients (45,XO/46,Xi(Xq), 45,XO/46,Xi(Yq), 45,XO/46,XY, and 45, XO/47,XYY), 3 of 4 46,XY pure gonadal dysgenesis. Discrepancy between karyotyping and blood PCR for SRY was noted in 1 Turner syndrome (45,XO/46,Xi(Xq)) and 1 PGD. Laparoscopic gonadectomy was performed in Y containing or SRY positive cases. In addition, PCR analysis for SRY in the gonads of 5 Turner syndrome and 2 PGD showed discrepancy between blood and gonad or between both gonads in 3 Turner syndrome (45,XO/46,Xi(Xq), 45,XO/46,Xi(Y q), 45,XO/46,XY) and 2 PGD patients. Conclusion: In gonadal dysgenesis, PCR analysis for SRY gene is useful to detect the cryptic Y mosaicism that is sometimes undetected by karyotyping. And since there may be tissue mosaicism, it is necessary to evaluate Y mosaicism in various tissues even in the case without Y chromosome on karyotyping.

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Structural Correlates of Hormone Production by the Corpora Allata in the Pine Moth, Dendrolimus spectablis Butler, during Larval-Pupal-Adult Transformations (松蟲變態에 따른 알라타體의 호르몬 生産과 그 構造的變化의 相關)

  • Kim, Chang-Whan
    • The Korean Journal of Zoology
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    • v.16 no.1
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    • pp.25-41
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    • 1973
  • Ultrastructural changes in the cells of the corpora allata of the pine moth, Dendrolimus spectabilis Butler, were studied by electron microscope to know the structural correlates of hormone production by the gland during the larval-pupal-adult transformations. Mitochondria are in active phases from the overwintered to the last instar larvae and from the pupae just after pupation to the 20-day old pupae, while they are in inactive phases from the making cocoon stage to the prepupae just before pupation. The peripheral allatum cells have electron dense granules in the intracellular vacuoles of smooth-surfaced endoplasmic reticulum in the larval life, particularly in the overwintered larvae and in the early adults but the swollen smooth-surfaced intracytoplasmic vacuoles made by expansion of an end of the tubular rough endoplasmic reticulum, some of which contain fibrous proteins, are observed in addition to the vacuoles in the intercellular spaces in which the vacuoles grow by fusing each other from the mature larvae to the prepupae, both of them disappearing during just before pupation. After pupation the cytolasmic vacuoles develop again in the allatum cells so that they seem to begin the secretory activity. The fact that the neurosecretory granules stored within the axons terminated in the corpus allatum are visible only from the 20-day old pupa about two days before abult emergence to the 5-day old adult means that the secretion from the allatum cells is under the control of the brain from the late pupal stage, while the secretion during from the larval to the early pupal life has no relation with the brain, because such granules are not observed within the axons. It is, therefore, suggested that at least two kinds of hormone are released with the ages as far as concerned with the production and secretion mechanisms of the allatum hormone: juvenile hormone is released until the last instar larvae without any direct stimlation of the brain and gonadotropic hormone is secreted from the late pupa to the adult by getting brain's stimulation and that the secretory phases observed from the mature larvae to prepupae are presumably concerned with the biosynthesis of protein owing to the ecdysone and those from the early pupal stage in uncontrolled condition of the brain with the prothoracotropic activity.

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Clinical Features of Oromandibular Dystonia (하악운동이상증의 임상양태)

  • Kang, Shin-Woong;Choi, Hee-Hoon;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.36 no.3
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    • pp.169-176
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    • 2011
  • Oromandibular dystonia (OMD) is a form of focal dystonia that affects the masticatory, facial and lingual muscles in any variety of combinations, which results in repetitive involuntary and possibly painful jaw opening, closing, deviation or a combination of these movements. This study aimed to investigate clinical features and treatment type of OMD patients. By retrospective chart review, the study was conducted to consecutive OMD patients who visited a department of Oral Medicine and Orofacial Pain Clinic in a university dental hospital during Aug 2007 to Apr 2010. 78 OMD patients were identified with female preponderance (M:F=1:3.6) and a mean age of 72 years. Their mean duration of OMD was about 10 months. The most common chief complaints at the first visit was jaw ache, followed by uncontrolled, repetitive movement of the jaw and/or oral tissues, pain in the oral region(p=0.000). The most common subtype of OMD was lateral jaw-deviation dystonia, followed by combination and jaw-closing dystonia(p=0.001). While no apparent cause was recognized in over 60% of the OMD patients, peripheral trauma including dental treatment such as prosthetic treatment and extraction was the most frequently reported as precipitating factor(p=0.000). Medication was the 1st line therapy for our patients and anxiolytics such as clonazepam was given to most of them. Based on the results of this study, OMD is the disease of the elderly, particularly of women and causes orofacial pain and compromises function of orofacial region. Some patients considered dental treatment a precipitating factor. Dentists, therefore, should have knowledge of symptoms and treatment of OMD.

A Study on the Dental Hygienists' Reactions to Noise When Occurred in Dental Clinic (치과병원에서 발생하는 소음에 대한 치과위생사의 반응)

  • Choi, Mi-Suk;Ji, Dong-Ha
    • Journal of dental hygiene science
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    • v.9 no.4
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    • pp.453-459
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    • 2009
  • The purposes of this research were to evaluate the relationships of between characteristics of noise and annoyance of dental hygienist by noise in dental clinic. To investigate the dental clinic workers' reactions to noise when occurred in dental clinic, the noise level test in dental clinic and questionnaire were taken. As a result of noise evaluation, It shows that the range of noise level was 67.7~78.3dB(A) and frequency was very high (more than 4KHz). It's seem to be begins occurrence of stamina-loss, contraction of peripheral blood vessel, decrease of adrenocortical hormones. Most of respondents were affected by noise: 67% of respondents were nervous about noise and the rest of respondents were bearable. Analysis by NR-curve showed that it was exceed the noise permit level in working space. As a result of correlation - test, the more exposed dental hygienist to noise, the more felt the unpleasantness and fatigue. It's hard to sufficient explanation to patients about the dental treatment. So it's thoughts that insufficient explanation will negative impact on the patients' satisfaction and increase competitiveness in dental clinics. To remedy a unpleasantness and fatigue of noise in dental hygienist, it's considered that making an offer the ear protection and choosing the low noise-vib. equipment and using the masking effect. Therefore, It can be provide a pleasant working environment with dental hygienist and It will have a great advantage to dental clinics to improve their competitiveness.

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Clinical Studies about diagnostic Yields according to Variable Diagnostic Methods in Lung Cancer (폐암에서 각종 진단수기에 따른 진단율에 관한 연구)

  • Kang, Dae-Song;Cho, Jin-Ung;Kim, Sang-Gyun;Kim, Mi-Ae;Yang, Sung-Uk;Lee, Tae-Quan;Lee, Tae-Hun;Kim, Kwi-Wan
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.700-708
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    • 1993
  • Background: Lung cancer has become one of the most common cancers in Korea. It is important to determine the accurate histologic types and stages because of different therapeutic modlaity, especially in small cell carcinoma. This study was designed to evaluate diagnostic yields according to variable diagnostic methods in lung cancer. Methods: The records of 683 patients with a confirmed diagnosis of primary lung cancer during the period of 7 years, from January, 1986 until December, 1992 at Presbyterian Medical Center were analyzed retrospectively. Results: 1) Age and sex distributions Male: female sex ratio was 5.57:1 and age distributions were 7th decade 41.4%, 6th decade 30.2%, 8th decade 17.0%, 5th decade 7.9%, 4th decade 2.5%, 9th decade 1.3%, and 3rd decade 0.2% in decreasing order. 2) The frequencies according to histologic cell types were squamous cell carcinoma 44.7%, small cell carcinoma 23.9%, adenocarcinoma 22.8%, alveolar cell carcinoma 2.5%, large cell carcinoma 1.2%. mixed forms 1.2%, undifferenciated cell carcinoma 0.6% and malignant fibrous histiocytoma 0.2%(1 case) in decreasing order. 3) The most common locations of lung cancer were in left upper lobe and right lower lobe, and no differences of diagnostic methods according to locations were noted. 4) In central lesions, bronchoscopic examination was very accurate and frequently used diagnostic method, and in peripheral lesions, transthoracic lung biopsy(TTLB) was apparent1y accurate method. 5) The diagnostic yields of bronchoscopic biopsy, bronchial brushing, sputum cytology, transthoracic lung biopsy and transbronchial lung biopsy(TBLB) were 81.3%, 57.5%, 31.1%, 69.6% and 61.6%, respectively. 6) The concordance rates between the histologic diagnosis with bronchial brushing and sputum-cytology were 91.3% and 98.4%, respectively. 7) It was appropriate in lung cancer to repeat sputum cytology 3 to 5 times. Conclusion: Bronchoscopic examination is important to determine the histologic cell types in lung cancer. In addition, we should be interrested in improving diagnostic yields of sputum cytology as an easy method.

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