• Title/Summary/Keyword: Combined modality

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Multimodality and Application Software (다중영상기기의 응용 소프트웨어)

  • Im, Ki-Chun
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.2
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    • pp.153-163
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    • 2008
  • Medical imaging modalities to image either anatomical structure or functional processes have developed along somewhat independent paths. Functional images with single photon emission computed tomography (SPECT) and positron emission tomography (PET) are playing an increasingly important role in the diagnosis and staging of malignant disease, image-guided therapy planning, and treatment monitoring. SPECT and PET complement the more conventional anatomic imaging modalities of computed tomography (CT) and magnetic resonance (MR) imaging. When the functional imaging modality was combined with the anatomic imaging modality, the multimodality can help both identify and localize functional abnormalities. Combining PET with a high-resolution anatomical imaging modality such as CT can resolve the localization issue as long as the images from the two modalities are accurately coregistered. Software-based registration techniques have difficulty accounting for differences in patient positioning and involuntary movement of internal organs, often necessitating labor-intensive nonlinear mapping that may not converge to a satisfactory result. These challenges have recently been addressed by the introduction of the combined PET/CT scanner and SPECT/CT scanner, a hardware-oriented approach to image fusion. Combined PET/CT and SPECT/CT devices are playing an increasingly important role in the diagnosis and staging of human disease. The paper will review the development of multi modality instrumentations for clinical use from conception to present-day technology and the application software.

Ewing's Sarcoma of the Stomach; Rare Case of Ewing's Sarcoma and Suggestion of New Treatment Strategy

  • Kim, Hyo-Sin;Kim, Sungsoo;Min, Young-Don;Kee, Keun-Hong;Hong, Ran
    • Journal of Gastric Cancer
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    • v.12 no.4
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    • pp.258-261
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    • 2012
  • Ewing's sarcoma is a neoplasm of the undifferenciated small round cells, which generally affects the bone and deep soft tissues of children and adolescents. We present a case of gastric Ewing's sarcoma; a 35-year-old female who had no symptoms. While she was at a routine medical checkup, a protruding mass in her gastric antrum was incidentally found on esophagogastroduodenoscopy. Endoscopic ultrasonogram showed a submucosal mass on the same lesion and a laparosopic wedge resection was done. Pathologic gross findings showed a granular grape appearance tissue and histoloigc examination revealed a small round cell tumor with CD 99 immunoexpression positive. In general, a combined modality therapy for Ewing's sarcoma such as surgical resection with chemotherapy, is accepted as an effective method. However, this patient had no adjuvant chemotherapy after surgery and she has no recurrence for eleven months.

A Study of the Giving and Receiving Verbs in TOUSEISYOUSEIKATAGI (『当世書生気質』에 나타난 수수동사에 관한 고찰 - 'やる·あげる·さしあげる'와 'くれる·くださる'를 중심으로)

  • Yang, Jung Soon
    • Cross-Cultural Studies
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    • v.19
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    • pp.271-293
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    • 2010
  • Japanese Give and Receive Verbs are divided into "YARU", "MORAU" and "KURERU". These are influenced by the subject, speaker's viewpoint and meaning. Three verbs are used in a different way depending on who is the giver and who is the taker. I analyze "YARU" and "KURERU" Verbs used in TOUSEISYOUSEIKATAGI. It focus on politeness, gender, and meaning when combined with 'TE'. As an expression of politeness, 'Yaru' is to give to a person of lower social status or an animal or plant. 'Ageru' is to give to an equal ora person of lower social status nowadays. However, 'Ageru' which is treated as elegance of the language remained expression of respect, 'Yaru' is used when the receiver is a person of lower social status and equal social status in TOUSEISYOUSEIKATAGI. 'Kureru' is used when the receiver is a person of lower social status and equal social status, 'kudasaru' is used when a person of higher social status gives the speaker something in TOUSEISYOUSEIKATAGI. Women speakers use 'oyarinasai' 'oyariyo' 'ageru' 'okureru' and men speakers use 'yaru' 'kureru'. Speech patterns peculiar to men are 'kuretamae' 'kurenka'. If the verbs are joined to "TE", they obtain abstract meaning as well as a movement of things. They express some modality for action of the preceeding verbs. The modality has the following meanings ; good will, goodness, benefits, kindness, hopeness, expectation, disadvantage, injury, ill will and sarcasm. In addition, 'TE YARU' expresses the speaker's strong will, 'TE KURERU' expresses the speaker's request.

The Result of Combined Modality Treatment for Limited Stage Small Cell Lung Cancer (국소성 소세포 폐암에 대한 복합화학요법 및 방사선 병용치료의 효과)

  • Kim Jae Cheol;Jang Yang Suk;Ryu Samuel;Park In Kyu
    • Radiation Oncology Journal
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    • v.7 no.2
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    • pp.205-211
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    • 1989
  • From July 1984 to September 1988, 27 patients with limited stage small cell lung cancer were treated with combined modality (combination chemotherapy Plus radiotherapy) at the Department of Therapeutic Radiology in Kyungpook National University Hospital. Of the 27 patients, 19$(70\%)$ achieved a complete response, 6$(22\%)$ a partial response, and 2$(8\%)$ no response. Female, performance status HO, serum enolase level below 30ng/ml, radiation dose over 4500 cGy, and 4 or more cycles of chemotherapy had a favorable effect on the rates of complete response, although there were no statistical differences according to the variables. Median survival time was 10 months and overall 1- and 2-year survival rates were $40,7\%$ and $12.2\%$, respectively. Complete response (p<0.05), performance status HO (p<0.05), 4 or more cycles of chemotherapy (p<0.05), and radiation dose over 4500 cGy had a significantly favorable effect on 2-year survival rate. Prophylactic cranial irradiation or sex had no effect on survival. The results of this study suggest that radiation treatment should be combined with combination chemotherapy in the therapeutic strategy of SCLC of limited stage.

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Combined Treatment with 2-Deoxy-D-Glucose and Doxorubicin Enhances the in Vitro Efficiency of Breast Cancer Radiotherapy

  • Islamian, Jalil Pirayesh;Aghaee, Fahimeh;Farajollahi, Alireza;Baradaran, Behzad;Fazel, Mona
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8431-8438
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    • 2016
  • Doxorubicin (DOX) was introduced as an effective chemotherapeutic for a wide range of cancers but with some severe side effects especially on myocardia. 2-Deoxy-D-glucose (2DG) enhances the damage caused by chemotherapeutics and ionizing radiation (IR) selectively in cancer cells. We have studied the effects of $1{\mu}M$ DOX and $500{\mu}M$ 2DG on radiation induced cell death, apoptosis and also on the expression levels of p53 and PTEN genes in T47D and SKBR3 breast cancer cells irradiated with 100, 150 and 200 cGy x-rays. DOX and 2DG treatments resulted in altered radiation-induced expression levels of p53 and PTEN genes in T47D as well as SKBR3 cells. In addition, the combination along with IR decreased the viability of both cell lines. The radiobiological parameter (D0) of T47D cells treated with 2DG/DOX and IR was 140 cGy compared to 160 cGy obtained with IR alone. The same parameters for SKBR3 cell lines were calculated as 120 and 140 cGy, respectively. The sensitivity enhancement ratios (SERs) for the combined chemo-radiotherapy on T47D and SKBR3 cell lines were 1.14 and 1.16, respectively. According to the obtained results, the combination treatment may use as an effective targeted treatment of breast cancer either by reducing the single modality treatment side effects.

Nonoperative Management of Blunt Liver Trauma (둔상성 간 손상환자의 비수술적 치료)

  • Baik, Jung Ju;Kim, Jung Il;Choi, Seung Ho;Choi, Young Cheol;Jun, Si Youl;Lee, Jun Ho;Hwang, Seong Youn
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.161-171
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    • 2005
  • Background: The management of hepatic injuries has changed dramatically during the past two decade after the technologic breakthroughs in radiologic imaging techniques. Recently, the non-operative management of blunt hepatic trauma has become the standard of care in hemodynamically stable patients. We reviewed our experience of the non-operative management of blunt hepatic trauma. And the purpose of this study was to examine the prognostic factors and indicators affecting the decision for treatment modality of emergent hepatic trauma. Methods: The medical records of 84 patients who were treated for blunt hepatic injury at Masan Samsung Hospital from January 2002 to December 2003. The patients were divided two groups, non-operative(Non-OP) and operative(OP), according to the treatment modality. The two groups were compares for age, sex, mechanism of injury, grade of liver injury scale, combined injury, systolic blood pressure, pulse rate, hemoglobin, hematocrit, WBC count, S-GOT, S-GPT, ALP, transfusion amount during initial 24 hours, amount of infused crystalloid fluid, length of ICU stay, length of ward care, morbidity and mortality. The grade of the liver injury were determined by using the organ injury scale(OSI). Results: Among the 84 patients, 46 cases(54.8%) were managed non-surgically, and 3 cases of Non-OP group were treated by transarterial embolization. Between the two groups, there were significant difference in age, injury grade, combined injury, hemoglobin, hematocrit, initial systolic blood pressure, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, and length of ICU care, morbidity and mortality.(p<0.05) The overall mortality rate was 8.3%, but 2.2% mortality in the non-operative group. Conclusion: Non-operative management may be considered as a first choice in hemodynamic stable patients with blunt liver trauma. The reliable indicators affecting the treatment modality of blunt hepatic trauma were systolic BP, Hb, Hct, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, liver injury grade and combined injury. Strict selection of treatment madality and aggresive monitoring with intensive care unit were more important.

A Case Report of a Chronic Schizophrenia Treated with Combined Treatment of Korean and Western Medicine

  • Park, Na-Eun;Park, Jun-Hyun;Kim, Dae-Eok;Seo, Young-Min;Kim, Sang-Ho;Chung, Dae-Kyoo
    • Journal of Oriental Neuropsychiatry
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    • v.26 no.4
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    • pp.349-356
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    • 2015
  • Objectives: Schizophrenia is difficult to treat effectively and the antipsychotics used have many side effects. However, few studies have focused on the combined treatment of Korean and Western medicine as an alternative. In this study, we reported an inpatient with chronic schizophrenia who was treated by a combination of Korean and Western medicine. Methods: We experienced a case of a diagnosed schizophrenia patient as whose chief complaint was avolition, diminished emotional expression and hallucination. The patient was treated with Western medicine and Korean traditional treatment including acupuncture, moxa and herbal medicine. The Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS) were used for assessment. Results: After treatment, symptoms involving avolition, diminished emotional expression and hallucination were improved; furthermore, the scores of the BPRS and the PANSS were decreased by approximately 50%, respectively. In addition, there were no notable side effects. Conclusions: The combined treatment of Korean and Western medicine can be an effective and well-tolerated treatment modality for patients with chronic schizophrenia.

Increased Prevalence of Chronic Disease in Back Pain Patients Living in Car-dependent Neighbourhoods in Canada: A Cross-sectional Analysis

  • Zeglinski-Spinney, Amy;Wai, Denise C.;Phan, Philippe;Tsai, Eve C.;Stratton, Alexandra;Kingwell, Stephen P.;Roffey, Darren M.;Wai, Eugene K.
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.5
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    • pp.227-233
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    • 2018
  • Objectives: Chronic diseases, including back pain, result in significant patient morbidity and societal burden. Overall improvement in physical fitness is recommended for prevention and treatment. Walking is a convenient modality for achieving initial gains. Our objective was to determine whether neighbourhood walkability, acting as a surrogate measure of physical fitness, was associated with the presence of chronic disease. Methods: We conducted a cross-sectional study of prospectively collected data from a prior randomized cohort study of 227 patients referred for tertiary assessment of chronic back pain in Ottawa, ON, Canada. The Charlson Comorbidity Index (CCI) was calculated from patient-completed questionnaires and medical record review. Using patients' postal codes, neighbourhood walkability was determined using the Walk Score, which awards points based on the distance to the closest amenities, yielding a score from 0 to 100 (0-50: car-dependent; 50-100: walkable). Results: Based on the Walk Score, 134 patients lived in car-dependent neighborhoods and 93 lived in walkable neighborhoods. A multivariate logistic regression model, adjusted for age, gender, rural postal code, body mass index, smoking, median household income, percent employment, pain, and disability, demonstrated an adjusted odds ratio of 2.75 (95% confidence interval, 1.16 to 6.53) times higher prevalence for having a chronic disease for patients living in a car-dependent neighborhood. There was also a significant dose-related association (p=0.01; Mantel-Haenszel chi-square=6.4) between living in car-dependent neighbourhoods and more severe CCI scores. Conclusions: Our findings suggest that advocating for improved neighbourhood planning to permit greater walkability may help offset the burden of chronic disease.

A Case of Combined Pregnancy Following GIFT with Microsurgery (나팔관 인공수정 및 미세난관 성형수술 후 발생된 병합임신 1례)

  • Kim, E.I.;Song, J.S.;Yoo, J.J.;Mok, Y.J.
    • Clinical and Experimental Reproductive Medicine
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    • v.16 no.1
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    • pp.103-106
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    • 1989
  • Gamete intrafollopian transfer, a varient of IVF, is becoming increasingly popular as a treatment modality for infertility in women with at least one healthy follopian tube. Although GIFT has recently been poprlarized as a safe and effective treatment in selected infertile couples, little discussion of potential complications has been published. Whereas a tubal pregnancy rate of approximately 5% has been noted for IVF, early reports of GIFT have noted ectopic pregnancy to be relativiely rare. We experienced a case of combined pregnancy following GIFT with microsurgery and now present it with brief review of related literatures.

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Exophagectomy Combined with Resectiion of Invaded Aorta for T4 Esophageal Carcinoma. (대동맥 침습이있었던 식도암의 절제수술)

  • 신화균;이두연;김상진;김부연;이성수;금기창
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.103-106
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    • 2000
  • Advanced esophageal carcinoma which invades into adjacent organs are classified as T4 esophageal cancer,. Its complete resection without residual tumor would be difficult. Preoperative chemoradiotherapy and combined modality therapy are being tried to improve survival in patients with T4 esophageal carcinoma. In a 74-year-old man a 6cm squamous cell carcinoma of the esophagus with invasion of the thoracic aorta was detected (T4). After neoadjuvant chemoradiotherapy the patient was operated on using bio-pump with aorto-femoral cannulation. The invased segment of descending aorta was resected and reconstructed with a graft. The tumor was resected and EG anastomosis was done. The postoperative period was uneventful the patient was discharged after good condition and has been well to now.

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