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Development of the Multi-Parametric Mapping Software Based on Functional Maps to Determine the Clinical Target Volumes (임상표적체적 결정을 위한 기능 영상 기반 생물학적 인자 맵핑 소프트웨어 개발)

  • Park, Ji-Yeon;Jung, Won-Gyun;Lee, Jeong-Woo;Lee, Kyoung-Nam;Ahn, Kook-Jin;Hong, Se-Mie;Juh, Ra-Hyeong;Choe, Bo-Young;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.21 no.2
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    • pp.153-164
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    • 2010
  • To determine the clinical target volumes considering vascularity and cellularity of tumors, the software was developed for mapping of the analyzed biological clinical target volumes on anatomical images using regional cerebral blood volume (rCBV) maps and apparent diffusion coefficient (ADC) maps. The program provides the functions for integrated registrations using mutual information, affine transform and non-rigid registration. The registration accuracy is evaluated by the calculation of the overlapped ratio of segmented bone regions and average distance difference of contours between reference and registered images. The performance of the developed software was tested using multimodal images of a patient who has the residual tumor of high grade gliomas. Registration accuracy of about 74% and average 2.3 mm distance difference were calculated by the evaluation method of bone segmentation and contour extraction. The registration accuracy can be improved as higher as 4% by the manual adjustment functions. Advanced MR images are analyzed using color maps for rCBV maps and quantitative calculation based on region of interest (ROI) for ADC maps. Then, multi-parameters on the same voxels are plotted on plane and constitute the multi-functional parametric maps of which x and y axis representing rCBV and ADC values. According to the distributions of functional parameters, tumor regions showing the higher vascularity and cellularity are categorized according to the criteria corresponding malignant gliomas. Determined volumes reflecting pathological and physiological characteristics of tumors are marked on anatomical images. By applying the multi-functional images, errors arising from using one type of image would be reduced and local regions representing higher probability as tumor cells would be determined for radiation treatment plan. Biological tumor characteristics can be expressed using image registration and multi-functional parametric maps in the developed software. The software can be considered to delineate clinical target volumes using advanced MR images with anatomical images.

Follow-Up Study of 6-Month Short Course Chemotherapy for Pulmonary Tuberculosis with 2SKHRZ/4HRZ (폐결핵에서 6개월 단기 항결핵 화학요법의 추구검사)

  • Koh, Hyung Ki;Kang, Yun Jung;Lim, Seong Yong;Shin, Jong Wook;Choi, Jae Sun;Yoo, Ji Hoon;Park, In Won;Choi, Byoung Whui;Hue, Sung Ho;Seo, Seung Chun
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.852-861
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    • 1996
  • Background : Many clinicians have experienced the difficulty of decision on termination of antituberculosis chemotherapy after the 6th month due to relapse of disease. There is still controversy in the effect of 2S(K)HRZ/4HRZ 6-month short course chemotherapy including pyrazinamide for 6 months in patiems with pulmonary tuberculosis. And there is no long term follow-up study of 6-month short course chemotherapy for pulmonary tuberculosis in korea. So we had performed the study to find the result of 6-month antituberculosis chemotherapy for 4 years. Method : We studied prospectively the effect of 2S(K)HRZ/4HRZ in one hundred-fifty patients with pulmonary tuberculosis and followed up fifty-nine patients for more than 1 year to 4 years after the completion of 6-month short course therapy. Results : 1) Out of one hundred-fifty patients, seventy-two patients(48%) completed the prescribed 6-month chemotherapy. Sixty-eight patients(45.3%) have experienced premature discontinuation and the most common cause of premature discontinuation was drop-out against advice(thirty-six patients, 24%). Ten patients(6.7%) were treated beyond the 6 months mainly due to irregular treatment. 2) Fifty-nine patients(81.9%) among seventy-two patients with completed treatment have been followed up for more than 1 year and 32 patients(44.4%) for more than 4 years. There was three relapse patients of whom two patients have experienced relapse of pulmonary tuberculosis within 1 year after the termination of chemotherapy. 3) Among one hundred-thirty-four patients who have been assessible for more than two months of chemotherapy, including the patients who experienced within 2 months, there were eighty-two patients(61.2%) who have experienced adverse reactions and the treatment regimen was changed only in thirteen patients(9.7%). The most frequent cause of adverse reactions was arthralgia and/or hyperuricemia, which had occurred in 33 patients(24.6%). Conclusion : In a university hospital in Korea, 6-month shot course chemotherapy of 2S(K)HRZ/4HRZ had unnegligible relapses and premature discontinuation. Therefore, change of the regimen might be carefully considered by drug susceptibility results. Close monitoring of patients, retrial of sputum exam and radiologic evaluation during treatment might be required in the endemic area of drug resistant strains like in Korea. Further study about the effect of 6-month short course chemotherapy including pyrazinamide for 6-month might be needed.

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Ultrastructural Effects of Irradiation on Squamous Cell Carcinoma of the Uterine Cervix (자궁경부의 편평상피암의 방사선치료에 수반되는 초미형태학적 변화)

  • Kim Jin Hee;Kim Ok Bae;Choi Tae Jin;Lee Sang Sook;Park Kwan Kyu;Kwon Kun Young;Suh Young Wook;Lee Tae Sung;Lee Tak;Cha Soon Do
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.303-310
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    • 1991
  • Nineteen patients with previously untreated invasive squamous cell carcinoma of the uterine cervix were treated by irradiation alone at the Keimyung University Hospital from January, 1990 to July, 1991. The serial samplings of the tissue taken before and during radiation of the uterine cervix were studied by light and electron microscopic examination. Radiation-induced cellular changes, particularly nuclear degeneration was pronounced. The tumor invasion pattern remained unchanged but the number of mitosis and tumor cells decreased, The number of infiltrating inflammatory cells, multinucleated giant cells and karyolytic cells were increased with radiation. Fibrosis was also increased. Electron microscopically, the amount of tonofilament in the tissue samplings was increased in the postirradiated state, but the desmosomes were decreased in numbers. Fibroblasts began to appear after an irradiation dose of 2700 cGy. After an irradiation dose of 3000 cGy or more, tumor cells were nearly completely degenerated and displaced with mature fibrotic tissue. There was an increase of activated fibroblasts and collagen fibers but a decrease of inflammatory cells in the interstitial tissue. Swelling of the mitochondria and endoplasmic reticulum, loss of intercellular bridges and an increased number of secondary lysosomes were also found with radiation.

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A survey of body shape perception and weight control of adolescent girls in three areas of Korea (청소년기 여학생의 외모에 대한 인식 및 체중조절 실태 조사)

  • Lee, Yoon;Shin, Hye-Kyoung;Choi, Byung-Min;Eun, Baik-Lin;Park, Sang-Hee;Lee, Kee-Hyoung;Shin, Chol
    • Clinical and Experimental Pediatrics
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    • v.51 no.2
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    • pp.134-144
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    • 2008
  • Purpose : This study aimed to investigate body shape perception, weight control behaviors and eating habits of adolescent girls in urban, suburban and rural areas of Korea to obtain basis for establishing adequate weight control program for adolescent. Methods : From May 2002 to November 2002, a cross-sectional questionnaire survey and physical examination were conducted to examine body shape perception, weight control behaviors, eating habits and health status of 2,891 adolescent girls and 891 boys in Seoul, Ansan and Paju. Results : The proportion of underweight adolescent girl was decreased in rural area than in urban area. 46.3% of girls considered themselves to be somehow or very obese. Notably 3.2% of underweight girls considered themselves obese. 57.9% were unsatisfied with their own body shape. The proportion of dissatisfaction increased with age and body mass index (BMI), but there were no differences among area. The experiences of weight control increased by age, BMI and dissatisfaction of own body shape. The eating attitudes test-26 (EAT-26) score of girls was significantly higher than that of boys. The girls with high risk of eating disorder were 10.9%. And risk factors of eating disorder were living in urban area, severe stress for weight control excessive expenditure for appearance and think themselves unhealthy. Conclusion : The findings of this study demonstrate that there were serious impairment of body shape perception of adolescent girls and unhealthy, inadequate weight control behaviors were widely done. Therefore adequate weight control program for adolescent girl should be established promptly.

The Development of the Korean Form of Childhood Attention Problem(CAP) Scale: A Study on the Reliability and Validity (한국형 소아기 집중력 문제척도: 신뢰도 및 타당도 연구)

  • Seo, Wan-Seok;Lee, Jong-Bum;Park, Hyung-Bae;Suh, Hyea-Soo;Lee, Kwang-Hun;SaKong, Jeong-Kyu
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.123-136
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    • 1997
  • The purpose of this study was to examine the reliability and validity of a Korean form of Childhood Attention Problem(CAP) scale. CAP were administered to 98 normal elementary school students as control group and 98 attention deficit hyperactivity disorder patients. Male students showed high scores than female students in both subscale and total scores, but not statistically significant. There were no significant difference in CAP scale between male students and female students in attention deficit hyperactivity disorder patients. In the reliability test, the test-retest reliability coefficient was highly satisfactory and that of inattention subscale was 0.83, impulsivity subscale was 0.70 and total score was 0.82. In the reliability test by internal consistency, the Cronbach $\alpha$ coefficient was highly satisfactory and that of inattention subscale was 0.91, overactivity subscale was 0.89(p<0.05). The concurrent validity between CAP scale and ADDES-BV scale was 0.85 in attention deficit hyperactivity disorder patient group and 0.73 in normal control group(p<0.05). In discriminant validity test between attention deficit hyperactivity disorder patient group and normal control group, the patient group showed higher score(p<0.05). The total discriminant capacity of the patient group in CAP was 93.4%. In this point of view, CAP scale showed high reliability and validity in applying to Korean subjects and was proved to be the good and simple screening test tool for attention deficit hyperactivity disorder research and can help many young patient to treat early.

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A Prospective Clinical Trial on the Mg Oxidized Clinical Implants (마그네슘 양극산화 임플란트의 성공률에 관한 전향적 임상연구)

  • Im, So-Min;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra;Um, Heung-Sik;Lee, Jae-Kwan
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.1
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    • pp.25-39
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    • 2011
  • In animal studies, Magnesium (Mg) - incorporated oxidized implants showed significant enhancement of the bone response. This prospective clinical trial was performed to investigate the success rate, implant stability and marginal bone loss of Mg oxidized clinical implant. The experimental protocol was approved by Institutional Review Board of the Gangneung-Wonju National University Dental Hospital. Fifty healthy patients had partial edentulism were included in this study. Mg oxidized clinical implants (Implant M, Shinhung, Korea) were installed and restored with conventional protocol. The patients were recalled at 1, 3, 6 months after functional loading. Implant stability quotient (ISQ) was measured and periapical radiographic images were obtained. Amount of marginal bone loss was calculated with calibrated images from periapical radiographs. Repeated measured analysis of variance and post hoc Tukey test were used to compare the mean ISQ and bone level. A total of 101 implants were analyzed. The mean ISQ values increased continuously with time lapse from 68.4 at fixture installation to 71.5 at 6 months after loading. Implant stability was correlated with gender, fixture diameter, bone quality and implant sites. The mean marginal bone loss during 6 months after loading was 0.26 mm. There was no failed implant and six-month success rate was 100%. Within the limitations of this study, the six-month success rate of Mg oxidized implant was satisfactory. The implant stability and marginal bone level were excellent. However, further longer clinical studies will be needed to confirm the success of Mg oxidized clinical implant.

Analysis of State-Trait Anxiety Inventory for Patients Diagnosed with Insomnia in an Outpatient Department (상태-특성 불안척도를 이용한 불면 장애 환자 군들에 대한 분석)

  • Lee, Sang Don;Ryu, Seung-Ho;Ha, Jee Hyun;Jeon, Hong Jun;Park, Doo-Heum
    • Sleep Medicine and Psychophysiology
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    • v.26 no.2
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    • pp.104-110
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    • 2019
  • Objectives: Insomnia patients who visited the psychiatric outpatient of a university department, were divided into those patients with insomnia alone and those with depression or anxiety disorder, along with insomnia. The study analyzed their demographic characteristics and the differences in State-Trait Anxiety Inventory (STAI) results among the patient groups. Methods: Patients who visited the psychiatric department in Konkuk University hospital from 1 January 2006 to 31 December 2018. If they were diagnosed with insomnia disorder based on DSM IV-TR and had undergone STAI, their electronic records were retrospectively analyzed. Based on the records, the patients were classified into those with insomnia disorder only, those with insomnia and anxiety disorder, and those with insomnia and depressive disorder. This study analyzed the demographic characteristics and STAI results of each group, and compared the differences among those groups. Results: During the period, 99 of 329 insomnia disorder patients who had performed STAI were diagnosed with depressive concurrent disorder and 61 with concurrent anxiety disorder. There was no difference in demographic characteristics of age and sex ratio among the three patient groups, and all had greater than 70% proportions of patients aged from 50s to 70s (71.8%, 77.1%, and 73.8% respectively). The average scores of STAI-I were 51.85 ± 10.15 for the patients with anxiety disorders and 54.18 ± 10.32 for those with depressive disorders, both of which were higher than the score of the patients with insomnia alone (44.55 ± 8.89). However, the score difference was not statically significant between the anxiety and depression groups. Similarly, in the STAI-II comparison, the averages of patients with anxiety or depressive disorders along with insomnia were 49.98 ± 8.31 and 53.19 ± 10.13 respectively, which were higher than that of the insomnia only group (42.71 ± 8.84), but there was no significant difference between the anxiety and depressive disorder groups. Conclusion: Although there were no differences in demographic data between the patients with insomnia only and those with accompanying depressive or anxiety disorder, the STAI-I and II scores were lower in the insomnia only group. In the future, it is necessary to consider other demographic characteristics including comorbidities and to conduct similar analyses with a larger sample.

Renal Anomalies in Children with Turner Syndrome (Turner 증후군 환자에서 신기형에 관한 연구)

  • Kim, Ji Young;Hong, Sun Young;Park, Young Mi;Park, Yong Hoon;Chung, Woo Yeong
    • Clinical and Experimental Pediatrics
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    • v.45 no.7
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    • pp.891-895
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    • 2002
  • Purpose : The prevalence of renal anomalies in Turner syndrome(TS) has been reported to vary from 33% to 60%. The purpose of this study was to clarify the true incidence of renal malformations in Korean TS. Methods : We evaluated 33 patients with Turner syndrome diagnosed by karyotype in Inje University Busan Paik hospital and Youngnam University from January 1995. Intravenous pyelography(IVP) was performed on all patients; abdominal ultrasonography and 99mTc-DMSA renal scan were performed on some. Cytogenetic analysis was performed on all patients with peripheral blood lymphocytes. Results : Of the total 33 patients, the karyotype showed 45, X in 18(54.5%) patients, mosaicism in 11(33.3%) patients and structural aberration in 4(12.2%) patients. The overall incidence of renal anomalies was 36.4%. The renal anomalies included four cases of horeshoe kidney, six cases of abnormal renal collecting system one case of single kidney and one case of malrotation. The incidence of renal anomalies in 45, X karotype(44.4%) showed a higher rate than that of mosaicism and structural aberration(26.7%), but there is no statistical significance. Conclusion : The incidence of renal anomalies in Korean TS reveals 36.4%. This rate is similar to other foreign TS studies. We recommend that renal ultrasonography or IVP for investigation of renal anomalies should be done as a screening procedure for the better quality of life in patients with TS.

Clinical and Bronchoscopic Features in Endobronchial Tuberculosis (기관지 결핵의 임상상과 기관지 내시경 소견)

  • An, Jin Young;Lee, Jang Eun;Park, Hyung wook;Lee, Jeong hwa;Yang, Seung Ah;Jung, Sung Soo;Kim, Ju Ock;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.532-539
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    • 2006
  • Background : The incidence of pulmonary tuberculosis has been reducing, but endobronchial tuberculosis continues to be a signigicant heath problem. We performed prospectively bronchoscopy in patients diagnosed with pulmonary tuberculosis in order to evaluate the frequency of endobronchial tuberculosis and its related findings. Follow-up bronchoscopy was also performed after treatment to evaluate the incidence of endobronchial complications such as stenosis and remaining lesions. Methods : From January, 1999 to December, 2003, bronchoscopy was performed on patients newly diagnosed with pulmonary tuberculosis. Results : 458 patients were enrolled in this study, out of 699 patients with pulmonary tuberculosis from 1999 to 2003. 234(51%) had endobronchial tuberculosis. The frequency was 40.3% in males and 66.3% in females, The most common symptom was nonspecific cough and sputum, and the main radiologiy finding was patchy infiltration. The most common subtype of endobronchial tuberculosis was the edema-hyperemic form. The right lung was involved more frequently than the left, and the left upper lobe was the most commonly involved site. 58 patients underwent follow-up bronchoscopy and most of been cured without major sequels. However, 8 patients had a stenosis of trachea and main bronchus, and 6 patients had still had endobronchial lesions. Therefore the treatment was prolonged for 3 months. Conclusion : Endobronchial tuberculosis of pulmonary tuberculosis has been remained of high incidence. bronchoscopic and follow-up bronchoscopy examination needs to evaluate the incidence of endobronchial tuberculosis and its related findings and major complication despite of treatment.

Epidemiologic study of rotaviral gastroenteritis in Daejeon, Korea, 2001-2005 (대전 지역에서 로타바이러스 위장관염의 역학적 연구(2001-2005년))

  • Chae, Joo-Hee;Kim, Min-Ji;Kim, Do-Hee;Lee, Kyung-Yil;Kang, Jin-Han;Lee, Joon-Sung
    • Pediatric Infection and Vaccine
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    • v.14 no.2
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    • pp.155-161
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    • 2007
  • Purpose : We evaluated the epidemiologic characteristics of rotavirus gastroenteritis in Daejeon, Korea from January 2001 through December 2005. Methods : We retrospectively analyzed 540 medical records of children with gastroenteritis, who had been hospitalized at The Catholic University of Korea, Daejeon St. Mary's Hospital and were tested positive by rotavirus stool examinations (latex agglutination or immunechromatography). Results : The mean age was $21.8{\pm}15.3$ months (ranged from 2 months to 9 years of age) and the distribution of children were 144 cases (26.7%) in <1 year of age, 228 (42.2%) in 1 year of age, and 93 (17.2%) in 2 years of age, and the 505 children (93.5%) were less than 4 years of age. The male-to-female ratio was 1.4:1. The mean annual number of cases was 108, with a relative even occurrence in each year. Although the patients with rotaviral gastroenteritis occurred through the year, a higher rate of occurrence was seen in spring (March to May, 40.8%) and winter season (December to February, 37.9%), without significant differences in each year. Conclusion : In Daejeon, Korea, rotaviral gastroenteritis have occurred in children less than 4 years of age, with slight annual variations and similar seasonal occurrence in the recent years. The data indicate that the recent trend in peak rotavirus activity is different from that observed decades ago in Korea.

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