This study was performed to investigate the reproducibility of the horizontal and midsagittal planes, and to suggest a stable coordinate system for three-dimensional (3D) cephalometric analysis. Eighteen CT scans were taken and the coordinate system was established using 7 reference points marked by a volume model, with no more than 4 points on the same plane. The 3D landmarks were selected on V works (Cybermed Inc., Seoul, Korea), then exported to V surgery (Cybermed Inc., Seoul, Korea) to calculate the coordinate values. All the landmarks were taken twice with a lapse of 2 weeks. The horizontal and midsagittal planes were constructed and its reproducibility was evaluated. There was no significant difference in the reproducibility of the horizontal reference planes, But, FH planes were more reproducible than other horizontal planes. FH planes showed no difference between the planes constructed with 3 out of 4 points. The angle of intersection made by 2 FH planes, composed of both Po and one Or showed less than $1^{\circ}$ difference. This was identical when 2 FH planes were composed of both Or and one Po. But, the latter cases showed a significantly smaller error. The reproducibility of the midsagittal plane was reliable with an error range of 0.61 to $1.93^{\circ}$ except for 5 establishments (FMS-Nc, Na-Rh, Na-ANS, Rh-ANS, and FR-PNS). The 3D coordinate system may be constructed with 3 planes; the horizontal plane constructed by both Po and right Or; the midsagittal plane perpendicular to the horizontal plane, including the midpoint of the Foramen Spinosum and Nc; and the coronal plane perpendicular to the horizontal and midsagittal planes, including point clinoidale, or sella, or PNS.
There was a research to make it sure that among the contributing factors, the cognitive factor affects on TMD(temporomandibular disorders) or not, we used a questionnaire on new TMD patients who visited the Department of Oral Medicine at Pusan National University of Hospital(PNUH). Research was to identify the patients' understanding of the TMD. 120 patients who visited PNUH from 2007 June to August were tested and following are the results. 1. Those who were in Jr. college or had higher scholarship showed higher understanding than those with final graduation of high school or had lower scholarship(p=0.129). 2. Percentage of high scorers(score of $16{\sim}20$) were in Jr. college or had higher scholarship than those with final graduation of high school or had lower scholarship(p=0.098). 3. Both in those who scored higher than average and in those scored lower than average, there was no difference in the rate of previsit to local dental clinic, selection of special treatment(by professor), and attendance to next visit after their conservative treatment. 4. Patients who claimed that their symptom did not change after conservative treatment showed higher rate of pre-visit to local dentist(p=0.107) and selection of special treatment(by professor)(p=0.101) and many of them were in Jr. college or had higher scholarship(p=0.005). 5. The fact the patients who claimed their symptoms did not changed or got worsen had a tendency of higher scholarship showed that understanding of the TMD has little to do with the improvement of symptom and that TMD is a very complicated disease.
Background : The effects of chemotherapy on pulmonary function are mainly a reduced diffusion capacity and a restrictive ventilatory impairment. Exercise can expose cardiovascular and pulmonary abnormalities not evident at rest. Exercise related cardiopulmonary function is important in patients with malignant disease as a determinant of quality of life. We performed this study to evaluate the changes of body composition and cadiopulmonary exercise perfoemance of patients with locally advanced, non-small cell, lung cancer (NSCLC) before and after chemotherapy. Methods : We evaluated resting pulmonary function, body composition, physiologic performance status, and cardiopulmonary exercise function in 11 patients with locally advanced NSCLC, at diagnosis and prior to the fourth cycle of chemotherapy. Results : After chemotherapy, 4 patients (36.4%) showed partial response and 7 (63.4%) had stable disease. After chemotherapy, diffusion capacity of the lung for carbon monoxide was reduced ($89.7{\pm}34.1%$, vs. $71.9{\pm}20.5%$) but not significantly. There were no significant changes in body composition or the state of physiologic performance after chemotherapy. There was a significant impairment of cardiopulmonary exercise tolerance in patients with NSCLC, evidenced by a reduction of maximal oxygen uptake ($VO_2$max, ml/kg/min, $17.9{\pm}2.6$ : $12.6{\pm}6.1$, <0.05) and $O_2$pulse ($O_2$ pulse, ml/beat, $7.0{\pm}1.7$, $5.2{\pm}2.1$, <0.05). Conclusion : Systemic chemotherapy resulted in a loss of cardiopulmonary exercise function in patients with locally advanced NSCLC within the short-term period, but not a physiologic change of body composition within the same period.
Background : Tuberculosis itself causes not only lung parenchymal destruction but also pulmonary vascular damage. Secondary emphysema also causes pulmonary vascular damage, which can develop as a late sequela of pulmonary tuberculosis. Therefore, pulmonary circulatory impairment tends to be more severe in post-tuberculosis emphysema than in primary emphysema. In post-tuberculosis emphysema, the right ventricular function may play an important role. However, little information regarding the right ventricular function is available. The purpose of this study was to evaluate and compare the right ventricular function between post-tuberculosis emphysema and primary emphysema. Method: Post-tuberculosis emphysema(PTE) or primary emphysema(PE) was diagnosed by history, HRCT finding and pulmonary function. Twenty patients with post-tuberculosis emphysema were matched with 20 patients with primary emphysema according to both $FEV-1$ and FVC. Arterial blood gas analysis and echocardiography were done at rest and immediately after symptom-limited exercise. The right ventricular function was evaluated with the right ventricular ejection fraction using a modification of Simpson's method. Results : There was no significant difference in the demographics and pulmonary function between the two groups. In post-tuberculosis emphysema, the $PaCO_2$ was higher ($42.9{\pm}4.7$ vs $38.8{\pm}3.1\;mmHg$ at rest; $47.9{\pm}7.0$ vs $41.1{\pm}5.9\;mmHg$ after exercise; p<0.01) and the right ventricular ejection fraction was lower ($57.6{\pm}6.5$ vs $61.4{\pm}4.7%$ at rest; $51.1{\pm}10.8$ vs $59.8{\pm}6.6%$ after exercise; p<0.01) both at rest and after exercise. The $PaCO_2$ after exercise was also lower ($65.7{\pm}12.6$ vs $80.2{\pm}14.4\;mmHg$, p<0.01), while the Pa02 at rest tended to be lower($82.9{\pm}12.0$ vs $87.8{\pm}7.5$, p>0.05). In both groups, right ventricular ejection fraction correlated with the $PaCO_2$ after exercise(PTE r=0.536, PE r=0.557), and the $PaCO_2$ at rest(PTE r=-0.576, PE r=-0.588) and after exercise(PTE r=-0.764, PE r=-0.619). Conclusion : Impairment of the right heart function and gas exchange were more serious in post-tuberculosis emphysema than in primary emphysema, and gas exchange may be influenced by the right ventricular function in post-tuberculosis emphysema.
Journal of the Korean Academy of Child and Adolescent Psychiatry
/
v.2
no.1
/
pp.160-175
/
1991
The purpose of this study is to investigate the parental marital relationships and the parent-child relationships of child psychiatric parents and its control group. This study was carried out two questionnaire instruments ; The marital satisfaction inventory(MSI) and the dyadic adjustment scale(DAS). The subjects are parents of the child psychiatric patients. A matched control group and parents of child psychiatric parents in Seoul area which were collected from July 1987 to September 1987, and classified into five subgroups : 1 Psychiatric disorder 2) Neurotic disorder 3) Tic disorder 4) Autistic disorder 5) Mental retardation. The results are as following ; 1) M.S.I scale scores of parents of patients group are lower than that of control group. 2) D.A.S scale score of parents of patients group is significantly lower than that of the control group(P<0.01). 3) The global distress scale(GDS) of the M.S.I. was most positively correlated with affective communication(AFC) and problem-sloving communication(PSC). 4) Female shoed more modern concept of role identification than male but tend to have heavier role assignment especially in child rearing practices which could be characterized by maternal domination. 5) Affective communication and sexual relationship between married couple and child rearing practices are influenced by their own family history of distress. 6) The marital global distress scale(GDS) score was highest in the parents of psychosis, the next in the parents of neurosis, autism, mental retardation, and tic disorder in descending order of severity. 7) The dyadic maladjustment score was highest in the parents of psychosis, the next in the parents of neurosis, tic, autism and mental retardation in descending order of severity. 8) Conflict in child rearing and parenting problems were particularly prominent in parents of the tic patients, and their marital relationship was not significantly disturbed. The above finding suggested that couple adjustment and marital dissatisfaction were closely related with child rearing problems and the children's disorder. So marital dissatisfaction and marital maladjustment seem to play a significant role in the genesis of psychosis and neurosis not much in autism and mental retardation.
To predict the tumor grading, various imaging modalities have been applied clinically. This study determines clinical usefulness of perfusion MRI, using relative cerebral blood volume in grading of the gliomas. We did a retrospective review of 17 patients (mean age, 57.5 years; 11 male, 6 female) who underwent perfusion MR and conventional MRI, and then correlated pathologically after operation. Statistical analysis of regional cerebral blood volume and relative cerebral blood volume(rCBV) was performed by using softwares such as PAT by SIEMENS and Xmap ver 2.0 developed by ourselves. Six patients out of 13 were low-grade gliomas while eleven patients were the high-grade gliomas. Mean relative CBV (m_rCBV/white matter) in the low-grade gliomas was 1.62, and mean relative CBV(m_rCBV/cortex) was 0.12. In the high-grade gliomas, mean relative CBV(m_rCBV/white matter) and mean relative CBV(m_rCBV/cortex) were 33.53 and 0.96. Mean relative CBV of gliomas were elevated with a statistical difference(P<.05), compared with contralateral white matter(P=.019) or cortex(P=.025). Furthermore mean relative CBV(m_rCBV/white matter) was much higher than mean relative CBV(m_rCBV/cortex). Perfusion MRI using regional cerebral blood volume and rCBV is very useful imaging modality for grading the glioma.
Purpose : The patients who visited this department for pulmonary disease and need CT scans for Follow-up to observe change of CT value, evaluation of image quality and decrease of radiation dose as change of kVp. Subjects and Methods : Subjects were the patients of 20 persons visited this department for pulmonary disease and Somatom Sensation 16(Semens, Enlarge, Germany) was used. Measurement of CT value as change of kVp was done by setting up ROI diameter of 1cm at the height of thyroid, aortic arch, right pulmonary artery in arterial phase image using 100 kVp, measuring 3 times, and recorded the average. CT value of phantom was measured by scanning phantoms which means contrast media diluted by normal saline by various ratio with tube voltage of 80 kVp, 100 kVp, 120 kVp, 140 kVp and recorded the average of 3 CT values of center of phantom image. In analysing radiation dose, CTDIVOL values of the latest arterial phase image of 120 kVp and as this research set that of 100 kVp were analyzed comparatively. 2 observers graded quality of chest images by 5 degrees (Unacceptable, Suboptimal, Adequate, Good, Excellent). Results : CT value of chest image increased at 100 kVp by 14.06%~27.26% in each ROI than 120 kVp. CT value of phantom increased as tube voltage lowered at various concentration of contrast media. CTDIVOL decreased at 100 kVp(5.00 mGy) by 36% than 120 kVp(7.80 mGy) in radiation dose analysis. here were 0 Unacceptable, 1 Suboptimal, 3 Adequate, 10 Good, 6 Excellent in totally 20 persons. Conclusion : Chest CT scanning with low kilo-voltage for patients who need CT scan repeatedly can bring images valuable for diagnose, and decrease radiation dose against patients.
Purpose : Among perinatal risk factors, neonatal seizures are one of the strongest independent discriminators of adverse outcome, representing high risks of mortality and neurologic morbidity. This study was undertaken to evaluate the neurologic outcome of neonatal status epilepticus according to underlying etiology, seizure pattern, onset time, and duration. Methods : We reviewed retrospectively 36 neonates(19 males, 17 females) with status epilepticus who were admitted to the neonatal intensive care unit, Inha Hospital between July, 1988 and June, 2003. They were evaluated with neurologic examination, laboratory data, EEG findings, and neuroimaging studies etc. Results : The mean gestational period of the patients was $37.0{\pm}3.6$ weeks and birth weight was $2.70{\pm}0.82$ kilogram. Fifty two point eight percent of the neonates were male and 66.7 percent were born at term. The most common cause of neonatal status epilepticus was hypoxic-ischemic encephalopathy. In preterm babies, intracranial hemorrhages showed an especially high frequency(P=0.034). Gestational age and birth weight did not show a correlation with neurologic complications. The incidence of neurological sequelae were significantly related to prolonged seizures lasting more than 1 hour(P=0.002). Neonates with seizures within the first 72 hours tended to be more frequent among those who developed adverse outcomes(P=0.016). Generalized tonic seizures had the worst prognosis, whereas those children who had subtle seizures had better outcomes than any other type(P<0.05). Generalized tonic seizures were primarily represented on EEG by abnormal background, whereas subtle seizure showed a significantly more normal EEG than any other seizures(P<0.05). Conclusion : Our results indicate that neonatal status epilepticus with early onsets, prolonged durations. And generalized tonic types can predict an increased risk for neurologic sequelae. So, those seizures must be perceived as medical emergencies and treated aggressively with antiepileptic drugs.
Purpose : To evaluate the usefulness of cerebral blood flow measurement applied to perfusion weighted image with short-scan time single shot gradient echo-planar technique in measuring cerebral blood volume(rCBV) of normal rabbits. Materials and methods : With 2.1-3.6 kg weighted rabbits, image is acquired when they are in supine position in children positioner. Perfusion weighted image is acquired to 44 seconds per 1 second successively. After 4 seconds later, Gd-DTPA 2ml are injected into int. jugular vein with 2 ml per second and normal saline is also injected after that. Same technique is applied 2 times per 30 minites in same rabbit. After Image is obtained in two part of cerebral cortex at vertex, convexity, in one of basal ganglia with choosing about $3-5{\textrm{mm}^2}$ areas. Curve of signal intensity changes in time sequence is drawn. After this images are transmitted by PC and software IDL, regional cerebral blood volume is measured with imaging processing program made by us. Results : With 22 of 24 rabbits, satisfactory 1-2 signal intensity versus time curve is made. Cerebral blood capacity and contrast media stay time (ST) is measured in two cerebral cortex and basal ganglia refering in parietal cerebral cortex. Mean focal cerebral blood flow capacity ratio in cortex was $0.97{\pm}0.35$ and in basal ganglia, $0.99{\pm}0.37$, mean contrast media stay time in cortex was $9.83{\pm}1.63$ sec and in basal gaiglia, $9.42{\pm}1.14$ sec, but there was no statistically significant difference between two areas ($\rho$=0.05). Conclusion : In cerebral cortex and basal ganglia, there is no difference in mean focal blood volume and mean contrast stay time. Therefore, PWI is useful in cerebral blood flow and early diagnosis, prognosis of cerebral ischemic disease. Hereafter, it is helpful in analysing cerebral blood flow changes with comparison difference in rCBV between normal tissue and ischemic tissue, and that with DWI finding in infarcted patient.
The aim of this study was to evaluate the change of bone mineral density according to distal radius rotation and the correlations of the lowest BMD measured by DXA at the lumba versus distal radius. The eleven males were projected distal radius by DR X-ray and the measurement of BMD by DXA of the appropriate position of the forearm were performed on 21 males. The healthy 11 and 21 volunteers without any history of operations, anomalies, or trauma were enrolled. The experiment was performed by two methods. First, The DR X-ray was measured distal radius of 11 males in pronation and supination with three, six and nine degrees, including a neutral position. The ROI was measured by the m-view program on the PACS monitor. Second, The DXA was measured distal radius of 21 males in pronation and supination with five and ten degrees, including a neutral position to evaluate the changes of BMD according to the rotation. A correlation of the BMD in the distal radius with BMD that lumbar spine was performed, along with analysis of the data by SPSS 12.0v. The mean rotation angle of the distal radius about eleven males DR X-ray measured $7^{\circ}$ of pronation (82%, n = 9), $6^{\circ}$ of supination and $0^{\circ}$ of neutral of (9%, n = 1), The total average rotation angle in 11 male was $5.1^{\circ}$ of pronation. The rotation angle of the distal radius about twenty one males on DXA measured $7.2^{\circ}$ of pronation (43%, n = 9), $7^{\circ}$ of supination (24%, n = 5), and $0^{\circ}$ of neutral (33%, n = 7), The total average rotation angle in 21 people was $4.1^{\circ}$ of pronation. The correlation of the analysis of lumba and distal radius were r = 3.0, p = 0.18. consequently, The correlation was not significance. Because BMD of lumba was not coverd for BMD of the distal radius, with a neutral position, Pronation is needed for BMD in the distal radius with the rotation angle measuring at the lowest BMD. the rotation angle about five degrees of pronation of the distal radius is recommended.
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