This study purposed to analyze the determinants of length of stay for patients having alzheimer dementia in geriatric hospitals. Sample data was collected from the National Patient Sample (NPS) produced by the Health Insurance Review & Assessment Service (HIRA) in 2009. Total 538 alzheimer inpatients over 65 years were used in the analysis. Patients were classified into 5 risk groups to represent the case-mix differences of patients. Organizational characteristics of geriatric hospitals such as number of beds, doctors, and nurses were included in the analysis model. In multivariate regression analysis, hospital variables were not statistically significant in explaining the length of stay. Two risk group were statistically significant in analysis, However, their signs of relationship with the dependent variable were opposite to the expectations. These results suggest that the characteristics of patients and hospitals did not have impacts on the length of stay. There will be needs to test the effects of other factor such as social needs which represents the socio-economic status of the family for the patients.
Background: The present study was undertaken to evaluate the incidence of chronic persistent post-surgical pain (CPPP) and the role of signal transduction genes in patients undergoing staging laparotomy for carcinoma ovary. Methods: The present observational study was undertaken following institutional ethical committee approval and informed consent from all the participants. A total 21 patients of ASA grade I to III with age 20-70 years, scheduled for elective staging laparotomy for carcinoma ovary were included. Patients were excluded if had other causes of pain, cognitive dysfunction or chronic neurological disorders. Statistical analysis of pool data was done using SPSS version-17. For various scales like GPE, PDQ, NPSI, the visual analogue scale (VAS), global perceived effect (GPE), the pain DETECT questionnaire (PDQ), and neuropathic pain symptoms inventory (NPSI), one factor repaeted measure ANOVA applied with simple contrast with baseline as on post-operative day 1 (considered as reference and compared with subsequent time-interval), and the P values were adjusted according to "Bonferroni adjustments". In patients with CPPP, the ${\Delta}ct$ values of mRNA expressions of genes at the end of postoperative day 90 were compared with the baseline control values by one factor repeated ANOVA. P value < 0.005 significant. Results: The present study demonstrates 38.1% (8 out of 21 patients) incidence of CPPP. The functional status and quality of life as were observed to be significantly diminished in all patients with chronic pain. An up-regulation in the mRNA expression of signal transduction and a positive correlation was noted between the mRNA expression of signal transduction genes and VAS score in all patients with CPPP at the end of postoperative day 90. Conclusions: The reported incidence of CPPP in patients with carcinoma ovary was 38.1%. An up-regulation and positive correlation between mRNA expression of signal transduction genes and VAS score depicts its potential role in the pathogenesis of CPPP.
Youn, Hanbean;Baek, Cheol Ha;Jeon, Hosang;Kim, Jinsung;Nam, Jiho;Lee, Jayoung;Lee, Juhye;Park, Dahl;Kim, Wontaek;Ki, Yongkan;Kim, Donghyun;Won, Jong Hun;Kim, Ho Kyung
Journal of Biomedical Engineering Research
/
v.38
no.3
/
pp.116-122
/
2017
Physical breast phantoms would be useful for the development of a dedicated breast computed tomography (BCT) system and its optimization. While the conventional breast phantoms are available in compressed forms, which are appropriate for the mammography and digital tomosynthesis, however, the BCT requires phantoms in uncompressed forms. Although simple cylindrical plastic phantoms can be used for the development of the BCT system, they will not replace the roles of uncompressed phantoms describing breast anatomies for a better study of the BCT. In this study, we have designed a numerical voxel breast phantom accounting for the random nature of breast anatomies and applied it to the 3D printer to fabricate the uncompressed anthropomorphic breast phantom. The numerical voxel phantom mainly consists of the external skin and internal anatomies, including the ductal networks, the glandular tissues, the Cooper's ligaments, and the adipose tissues. The voxel phantom is then converted into a surface data in the STL file format by using the marching cube algorithm. Using the STL file, we obtain the skin and the glandular tissue from the 3D printer, and then assemble them. The uncompressed breast phantom is completed by filling the remaining space with oil, which mimics the adipose tissues. Since the breast phantom developed in this study is completely software-generated, we can create readily anthropomorphic phantoms accounting for diverse human breast anatomies.
Objective : "Paraclinoid" aneurysms include those aneurysms arising from the internal carotid artery between the site of emergence of the carotid artery from the roof of the cavernous sinus and the origin of the posterior communicating artery. The authors reviewed and analysed the results of surgical approaches to paraclinoid aneurysms treated with transcranial surgery and endovascular surgery. Methods : Between January 1998 and May 1999, 14 patients were treated surgically through ipsilateral and contralateral pterional approaches, and anterior interhemispheric approach, and endovascular surgery for paraclinoid aneurysms. All transcranial approaches were performed by same surgeon. The medical records, neuroimaging studies and videotapes which had been recorded operations were reviewed retrospectively. Results : Twelve patients presented with subarachnoid hemorrhage and ICH. Nine of fourteen patients had multiple aneurysms. Thirteen cases were small and one was a large aneurysm. Six patients were treated through ipsilateral approaches, six contralateral pterional approaches, one anterior interhemispheric approach and one primarily by GDC embolization. All aneurysms treated through contralateral approaches were multiple aneurysms. Neck clipping was performed in 9(69.2%) of the thirteen aneurysms, wrapping in four cases, among them three cases were followed by GDC embolization. The surgical outcomes were : Glasgow Outcome Scale(GOS) I 71.4%, GOS II 21.4% and GOS V 7.1%. Conclusion : The surgical approaches to paraclinoid aneurysms should be chosen after careful anatomical evaluation of aneurysm and its neighboring structures. 3D-CT angiography and/or the raw data of MR angiography were useful. This study supports the usefulness of the contralateral approach to paraclinoid aneurysm associated with multiple aneurysms, unruptured and small aneurysms whose dome projecting medially, superiorly and dorsally. The determination of contralateral approach to small and medially projecting paraclinoid aneurysm may be stressful to operator, thus we believe anterior interhemispheric approach is better alternated. Also we recommend the endovascular surgery after reinforcement of aneurym neck and dome in the case with difficulty in clipping.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.26
no.5
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pp.462-469
/
2000
Positron Emission Tomography(PET) is a new diagnostic method that can create functional images of the distribution of positron emitting radionuclides, which when administered intravenously in the body, makes possible anatomical and functional analysis by quantity of biochemical and physiological process. After genetic and biochemical changes in initial stage, malignant tumor undergoes functional changes before undergoing anatomical changes. So, early diagnosis of malignant tumors by functional analysis with PET can be achieved, replacing traditional anatomical analysis, such as computed tomography(CT) and magnetic resonance image(MRI), etc. Similarly, PET can identify malignant tumor without confusion with scar and fibrosis in follow up check. In the Korea Cancer Center Hospital(KCCH) from October 1997 to September 1999, clinical study was performed in 79 cases that underwent 89 times PET evaluation with [18F]-Fluorodeoxyglucose for diagnosis of oral and maxillofacial tumors, and the data was analysed by Bayesian $2{\times}2$ Classification Table. The results were as follows : Evaluation for initial diagnosis with FDG-PET (P<0.005) 1. Agreement rate or accuracy rate is 88.9%. 2. Sensitivity is 95.2%, and specificity 66.7%. 3. Positive predictive rate is 90.9%, and negative predictive rate 80.0%. 4. In consideration of tumor stage, diagnostic rate in less than stage II was 90% and in greater than stage III 100%. 5. In consideration of tumor size, diagnostic rate in less than T2 was 92.3% and in greater than T3 100%. After primary treatment, evaluation for follow up check with FDG-PET (P < 0.001) 1. Agreement rate or accuracy rate is 85.4%. 2. Sensitivity is 87.5%, and specificity 82.4%. 3. Positive predictive rate is 87.5%, and negative predictive rate 82.4%. 4. In 24 recurred cases, 6 had distant metastasis, and 5 of them were diagnosed with FDG-PET, resulting in diagnostic rate of FDG-PET of 83.3%. From the above results, Positron Emission Tomography with [18F]- Fluorodeoxyglucose appears to be more sensitive and accurate for detecting the presence of oral and maxillofacial tumors, and has various clinical applications such as early diagnosis of tumor in initial and follow up check and detection of distant metastasis.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.35
no.1
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pp.26-30
/
2009
Background and Objectives: To determine the anatomic position of the inferior alveolar nerve (IAN) canal in patients with mandibular prognathism using the cone-beam CT (CBCT). Materials and Methods: Fifty rami from 25 patients were evaluated. The images were taken by i-CAT and reconstructed 3-dimensionally using the Simplant 11 program. The linear distances between the IAN canal to the buccal cortex (a, $a^{\dag}$ and $a^{\ddag}$), from the IAN canal to the alveolar crest (b and $b^{\dag}$) and the anterior margin ($b^{\ddag}$) and finally the buccal cortical thickness (c, $c^{\dag}$ and $c^{\ddag}$) were measured at three reference planes (VP, OP and HP). Results: On the left side, the average distance of a, b and c were 7.12, 15.96 and 3.60 mm on the VP plane, respectively. On the OP, the distance of $a^{\dag}$, $b^{\dag}$ and $c^{\dag}$ was 6.11, 8.83 and 2.63 mm. For the HP, the distance of $a^{\ddag}$, $b^{\ddag}$ and $c^{\ddag}$ was 4.84, 10.11 and 2.30 mm. On the right side, the distance of a, b and c, on the VP, was 7.10, 16.13 and 3.42 mm, respectively. On the OP, the distance of $a^{\dag}$, $b^{\dag}$ and $c^{\dag}$ was 4.77, 8.75 and 2.68 mm. On the HP, the distance of $a^{\dag}$, $b^{\dag}$ and $c^{\ddag}$ was 4.55, 9.84 and 2.38 mm. Regarding the difference between genders, the distance in male's was longer than female's on the VP (p=0.019), and was thicker in males than females on the HP (p=0.002). Conclusion: The CBCT data provided accurate information about the location and course of the IAN.
Purpose: To investigate the effects of epidermal growth factor receptor (EGFR), cytokeratin 19 (CK19), cytokeratin 20 (CK20) and survinin gene expression on local control (LC) and overall survival (OS) in patients with locally advanced head and neck cancer (LAHNC) who were administered radiotherapy (RT). Materials and Methods: Twenty-six patients who were admitted to Uludag University Medical Faculty Department of Radiation Oncology with a diagnosis of LAHNC (GIII-GIV) were included in this study. Gene expression was evaluated in tumor tissues and peripheral blood. RNA isolation was performed on paraffinized tumor tissues and peripheral blood samples obtained before RT (BR). The densities of the obtained RNAs were analyzed at 260/280 nm. cDNA samples obtained from total RNA,EGFR, CK19, CK20 and survinin gene expression levels were assessed via the Sybr Green method and data were analyzed with the ${\Delta}{\Delta}Ct$ method. The same process was repeated for peripheral blood samples taken after RT (AR). Results: The female/male ratio was 3:23 and the mean age was 56.5 years (38-75years). After radiotherapy, CK19 and CK20 levels in the peripheral blood were found to be correlated according to Pearson correlation analysis(p=0.049). This result indicates a possibility of remaining positive for CK19 and CK20 in the peripheral blood even after RT in patients with CK19, CK20, and EGFR positive tumors before RT. There was a statistically significant correlation between survinin levels measured BR and AR (p=0.028). Conclusions: In this study, we found that patients with any EGFR, CK19, CK20 or survinin positivity in their peripheral blood obtain less benefit from radiotherapy. A wider patient population and advanced protein analyses are necessary in order to increase the reliability of our findings.
Purpose: The objective of this study was to evaluate the accuracy of a stereolithographic surgical guide that was made with information from intraoral digital impressions and cone beam CT (CBCT). Materials and methods: Six sets of resin maxilla and mandible models with missing teeth were used in this study. Intraoral digital impressions were made. The virtual models provided by these intraoral digital impressions and by the CBCT scan images of the resin models were used to create a surgical guide. Implant surgery was performed on the resin models using the surgical guide. After implant placement, the models were subjected to another CBCT scan to compare the planned and actual implant positions. Deviations in position, depth and axis between the planned and actual positions were measured for each implant. Results: The mean deviation of the insertion point and angulation were 0.28 mm and $0.26^{\circ}$, apex point were 0.11 mm and 0.14 mm respectively. The implants were situated at a mean of 0.44 mm coronal to the planned vertical position. Conclusion: This study demonstrates that stereolithographic surgical guides created without the use of impressions and stone models show promising accuracy in implant placement.
In dental radiography, panoramic views cause distortion and thus may bring about inaccurate results in the process of quantitative analysis. In this connection, there has recently been an increasing use of cone beam computed tomography (CBCT) that is known to provide high-resolution images and positional information. In this study, a dental computed tomography unit, 'DCT-90-P IMPLAGRAPHY (Vatech, Korea)', was applied to 20 patients for 24 seconds respectively, with a tube voltage of 85kVp and a tube current of 7mA. The data of CBCT were three-dimensionally reconstructed by use of a computer program, and were histomorphometrically analyzed. The results showed that the diameter of mandibular canal is less distorted at a certain inclination of the mandibular body. The image tends to seem more distended in proportion to the distance between the subject and film. Also, the image tends to be affected according as it is out of focus. In conclusion, it requires that the image should be reconstructed in light of anatomic position and structure.
The purpose of this study was to investigate the kinematic characteristics of the $5^{th}$ and $6^{th}$ hurdle clearances during the final of the 100-m hurdles event at the IAAF World Championships, Daegu 2011. To this end, the hurdling motions of the top 4 ranked female hurdlers in the competition were analyzed. A total of 12 cameras were used to record their motions, with a sampling frequency of 120 Hz. The cameras were calibrated using $11{\times}2{\times}1\;m$ control objects that covered all of the lanes ($1^{st}{\sim}8^{th}$ lanes). After analyzing all the data, we arrived at the following results. For the take-off phase, a negative relationship between the take-off time (CT) and athlete's rank was found. In addition, the average distances from the hurdle to take-off (L1) were shown to be 2.23 m and 2.17 m for the $5^{th}$ and $6^{th}$ hurdles, respectively. For the distance from the hurdle to landing (L2), Pearson ($1^{st}$ rank) and Carruthers($2^{nd}$ rank) showed inconsistent patterns whereas Harper ($3^{rd}$ rank) and Porter ($4^{th}$ rank) showed consistent patterns. All althetes revealed similar 3 steps patterns between hurdles, which consisted of a shorter $1^{st}$ step, longer $2^{nd}$ step and shorter $3^{rd}$ step.
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