• Title/Summary/Keyword: Diagnosis delay

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Patients with brain metastases the usefulness of contrast-enhanced FLAIR images after delay (뇌전이 환자의 조영 증강 후 지연 FLAIR 영상의 유용성)

  • Byun, Jae-Hu;Park, Myung-Hwan;Lee, Jin-Wan
    • Korean Journal of Digital Imaging in Medicine
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    • v.16 no.1
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    • pp.13-19
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    • 2014
  • Purpose: FLAIR image is beneficial for the diagnosis of various bran diseases including ischemic CVS, brain tumors and infections. However the border between the legion of brain metastasis and surrounding edema may not be clear. Therefore, this study aims to investigate the practical benefits of delayed imaging by comparing the image from a patient with brain metastasis before a contrast enhancement and the image 10 minutes after a contrast enhancement. Materials and methods: Of the 92 people who underwent MRI brain metastases in suspected patients 13 people in three patients there is no video to target the 37 people confirmed cases, and motion artifacts brain metastases in our hospital June-December 2013, 18 people measurement position except for the three incorrect patient (male: 11 people, female: 7 people, average age: 60 years) in the target, test equipment, 3.0T MR System (ACHIEVA Release, Philips, I was 8ChannelSENSE Head Coil use Best, and the Netherlands). TR 11000 ms, TE 125 ms, TI2800 ms, Slice Thickness 5 mm, gap 5 mm, is a Slice number 21, the parameters of the 3D FFE, T2 FLAIR variable that was used to test, TR 8.1 ms, TE 3.7 ms, Slice number 240 I set to. The experiment was conducted by acquiring the FLAIR prior to contrast enhancement (heretofore referred to as Pre FLAIR), and acquiring the 3D FFE CE five minutes after the contrast enhancement, and recomposing the images in an axial plane of S/T 3mm, G 0mm (heretofore referred to as MPR TRA CE). Using the FLAIR 10 minutes after the contrast enhancement (heretofore referred to as Post FLAIR) and Pi-View, a retrospective study was conducted. Using MRIcro on the image of a patient confirmed for his diagnosis, the images before and after the contrast media, as well as the CNR and SNR of the MPR TRA CE images of the lesion and the site absent of lesion were compared and analyzed using a one-way analysis of variance. Results: CNR for Pre FLAIR and Post FLAIR were 34.35 and 60.13, respectively, with MPR TRA CE at 23.77 showing no significant difference (p<0.050). Post-experiment analysis shows a difference between Pre FLAIR and Post FLAIR in terms of CNR (p<0.050), but no difference in CNR between Post FLAIR and MPR TRA CE (p>0.050), indicating that the contrast media had an effect only on Pre FLAIR and Post FLAIR. The SNR for the normal site Pre FLAIR was 106.43, and for the lesion site 140.79. Post FLAIR for the normal site was 107.79, and for the lesion site 167.91. MPR TRA CE for the normal site was 140.23 and for the lesion site 183.19, showing significant difference (p<0.050), and post-experiment analysis shows that there was a difference in SNR only on the lesion sites for Pre FLAIR and Post FLAIR (p<0.050). There was no difference in SNR between the normal site and lesion site for Post FLAIR and MPR TRA CE, indicating no effect from the contrast media (p>0.050). Conclusions: This experiment shows that Post FLAIR has a higher contrast than Pre FLAIR, and a higher SNR for lesions, It was not not statistically significant and MPR TRA CE but CNR came out high. Inspection of post-contrast which is used in a high magnetic field is frequently used images of 3D T1 but, since the signal of the contrast medium and the blood flow is included, this method can be diagnostic accuracy is reduced, it is believed that when used in combination with Post FLAIR, and that can provide video information added to the diagnosis of brain metastases.

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Diagnostic Accuracy and Evaluation of Myocardial Viability by Cardiac Magnetic Resonance Imaging in Acute Myocardial Infarction: A Comparison with Thallium-201 Myocardial SPECT (급성심근경색증에서의 심장자기공명영상술의 진단 정확도와 심근 생존력 평가: TI-201 심근관류 SPECT와의 비교)

  • Kim Hye-seon;Park Dong Woo;Kim Yongsoo;Kim Young-sun;Choi Yo Won;Jeon Seok Chul;Seo Heung Suk;Hahm Chang Kok;Kim Soon Kil;Ahn You hern;Choi Yoon Young;Park Choong-Ki
    • Investigative Magnetic Resonance Imaging
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    • v.7 no.2
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    • pp.100-107
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    • 2003
  • Purpose : To assess the usefulness of cardiac MR imaging (MRI) in the diagnosis of acute myocardial infarction and in the assessment of myocardial viability in comparision with T1-201 SPECT. Materials and Methods : We retrospectively studied 17 patients who complained of chest pain and dyspnea with cardiac MRI . The patients were evaluated for the presence or absence of high signal intensity on T2-weighted image (T2wI), abnormal wall motion on 2D-FIESTA, perfusion defect on Gd-DTPA enhanced T1WI, and delayed myocardial enhancement on 15-minutes delay Gd-DTPA enhanced T1WI. The results were correlated with the images on T1-201 SPECT, taken at rest and stress, through which reversibility of perfusion defect was assessed. Results : Both cardiac MRI and T1-201 SPECT proved to be useful methods for diagnosing acute myocardial infarction. In order of decreasing correspondence, T2WI, T1-201 SPECT, delayed enhancement study, and wall motion images all showed significant statistical correlation with the clinical diagnosis of myocardial infarction. Perfusion MRI, on the other hand, showed no significant statistical difference was found between T1-201 SPECT and cardiac MRI. The results on T2WI showed high accordance with those on Tl-201 SPECT, while delayed myocardial enhancement and wall motion studies showed no agreement with Tl-201 SPECT. Conclusion : Cardiac MRI is useful method for diagnosis of acute myocardiac infarction. With respect to the assessment of myocardial viability, the results obtained on cardiac MRI showed high agreement with those on Tl-201 SPECT. However, further study is necessary at this point for standardization and establishment of the methods for assessing myocardial viability on cardiac MRI.

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Clinical Evaluation of Surgical Treatments for Ten Cases of Tuberculous Spondylitis (결핵성 척추염 10례의 수술적 치료에 관한 임상적 고찰)

  • Whee, Sung Mock;Eoh, Whan;Nam, Do Hyun;Lee, Jung Il;Kim, Jong Soo;Hong, Seung-Chyul;Shin, Hyung Jin;Park, Kwan;Kim, Jong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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    • pp.1314-1319
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    • 2001
  • Objects : Because of the nonspecific nature of symptoms in tuberculous spondylitis, a delay in the diagnosis can result in progressive neurologic deficits. The authors evaluate the clinical and the radiological results of the 10 cases of surgically treated tuberculous spondylitis. Clinical materials & Methods : We retrospectively analyzed the medical records of 10 patients with tuberculous spondylitis who were treated between February 1996 and March 2000. Six patients were female, and four were male. Mean age was 43 years old, and mean follow-up period was 20.5 months. All patients were treated with 12 months of antituberculous medication postoperatively, and were followed by complete blood count, ESR, spine X-ray and MRI. Results : The lumbar spine was involved in 5 patients, the thoracic in 4, and the thoracolumbar in one. The infected vertebral bodies were 2.8 in average. The associated lesions were pulmonary tuberculosis in 3 cases, and renal tuberculosis in one. Five patients were treated by anterior debridement and fusion with bone graft using anterior instrumentation, 2 with anterior debridement and fusion with bone graft(Hong Kong procedure only), 1 with Hong Kong procedure with posterior spinal instrumentation, and 2 were managed with posterior debridement and posterior spinal instrumentation. All patients improved after operation, and the average kyphotic angle decreased postoperatively. Postoperatively, one patient had a fistula at the operative site. Conclusion : The debridement and minimal level fusion of motion segment with instrument fixation is one of surgical option for tuberculous spondyltis to preserve the spine motion segment as much as possible. Spine instability and kyphosis were prevented by anterior and posterior spinal instrumentation. But, large number of cases and longer period follow-up study in future will be needed to confirm the long term results.

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Malunion of the Jaw Fractures Complicated Following the Primary Managements (악골절 치료후 부정유합에 관한 임상적 연구)

  • Kim, Dae-Sung;Kim, Myung-Rae;Choi, Jang-Woo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.356-360
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    • 1999
  • PURPOSE : This is to review the complicated jaw fractures that had been referred for revision of the unsatisfactory results, and to provide proper managements for the easily complicated jaw fractures. MATERIALS & METHODS : Twenty-nine patients who had been revised due to malunion or complicated fractures of facial bones for last 3 years were reviewed. The main problems required for revision, type of fractures complicated, the primary managements to be reclaimed, the specialties to be involved, the management to be reclaimed, time elapsed to seek reoperation, type of revision surgeries, residual complication were analysed with medical records, radiographs and final examinations. RESULTS: The major complaints were malocclusion(79.3%), facial disfigurement(41.3%), TMJ problems (13.7%), neurologic problems(10.3%), non-union(10.3%), and infection(6.8%). Unsatisfactory results were occurred most frequently after improper management of the multiple fractures of the mandible (62.2%), combined fractures of maxilla and mandible (20.6%), fracture of zygomatico-maxillary complex and midpalate (17.2%). The complications to be corrected were widened or collapsed dental arches (79.3%), improperly reduced condyles (41.3%), painful TMJ (34.4%), limited jaw excursion (31.0%), over-reduction of zygoma (13.7%), and nonunion with infection(13.7%). and dysesthesia (10.3%). The primary managements were nendereet by plastic surgeons in 82.7%(24/29) and by oral surgeons in 7.6%(2/29). Main causes of malunion are inadequate ORIF in 76%, unawareness & delay in 17%, and delayed due to systemic cares in 17%. 76% of 29 patients had been in state of intermaxillary fixation for over 4 weeks. Revision were done by means of "refracture and ORIF"in 48.2%(14/29), orthognathic osteotomies with bone grafts in 55.1%(16/29), and camouflage countering & alloplastic implantations in 37.9%(11/29), TMJ surgeries in 17.2%, micro-neurosurgeries in 11.6%. Residual complications were limited mouth opening in 24.1% (7/29), paresthesia in 13.7%, resorption of reduced condyle in 10.3%. CONCLUSIONS : Failure of initial treatment of jaw fractures is due to improper diagnosis and inadequate treatment with lack of sufficient knowledge of stomatognathic system. It is crucial to judge jaw fracture and patients accurately, moreover, the best way of treatments has to be selected. Consideration of these factors in treatment could minimize the complication of jaw fractures.

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A Pediatric Fall-Risk Assessment Tool for Hospitalized Children (입원 아동의 낙상 위험 예측 도구)

  • Shin, Hyeon Ju;Kim, Young Nam;Kim, Ju Hee;Son, In Sook;Bang, Kyung-Sook
    • Child Health Nursing Research
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    • v.20 no.3
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    • pp.215-224
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    • 2014
  • Purpose: This study was conducted to identify risk factors in hospitalized children, and to develop and validate a fall-risk assessment tool for hospitalized children. Methods: A retrospective chart review was performed at one university children's hospital, and an analysis was done of the characteristics of all patients who fell during a 44-month period (n=48). These patients were compared with another 149 hospitalized children who did not fall. Results: Significant predictors of falls as identified in a multivariate logistic regression analyses were age of less than 3 years old, neurological diagnosis including epilepsy, children's dependency of ADL, physical developmental delay, multiple usage of fall-risk-increasing drugs. The respective odds ratios ranged from 2.4 to 7.1 with 95% confidence interval (p<0.05). Accordingly, defining patients with either 5 risk factors as fall-prone hospitalized children provided a sensitivity of 93.6% and specificity of 16.2%. Conclusion: The results show that this tool has an acceptable level of sensitivity to assess the risk factors of fall in hospitalized children even though the specificity was low, suggesting that this tool may enable nurses to predict the risk level of childhood falls, and develop preventive strategies against pediatric falls in children's units.

Immune reconstitution after allogeneic hematopoietic stem cell transplantation in children: a single institution study of 59 patients

  • Kim, Hyun O;Oh, Hyun Jin;Lee, Jae Wook;Jang, Pil-Sang;Chung, Nack-Gyun;Cho, Bin;Kim, Hack-Ki
    • Clinical and Experimental Pediatrics
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    • v.56 no.1
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    • pp.26-31
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    • 2013
  • Purpose: Lymphocyte subset recovery is an important factor that determines the success of hematopoietic stem cell transplantation (HSCT). Temporal differences in the recovery of lymphocyte subsets and the factors influencing this recovery are important variables that affect a patient's posttransplant immune reconstitution, and therefore require investigation. Methods: The time taken to achieve lymphocyte subset recovery and the factors influencing this recovery were investigated in 59 children who had undergone HSCT at the Department of Pediatrics, The Catholic University of Korea Seoul St. Mary's Hospital, and who had an uneventful follow-up period of at least 1 year. Analyses were carried out at 3 and 12 months post-transplant. An additional study was performed 1 month post-transplant to evaluate natural killer (NK) cell recovery. The impact of pre- and post-transplant variables, including diagnosis of Epstein-Barr virus (EBV) DNAemia posttransplant, on lymphocyte recovery was evaluated. Results: The lymphocyte subsets recovered in the following order: NK cells, cytotoxic T cells, B cells, and helper T cells. At 1 month post-transplant, acute graft-versus-host disease was found to contribute significantly to the delay of $CD16^+/56^+$ cell recovery. Younger patients showed delayed recovery of both $CD3^+/CD8^+$ and $CD19^+$ cells. EBV DNAemia had a deleterious impact on the recovery of both $CD3^+$ and $CD3^+/CD4^+$ lymphocytes at 1 year post-transplant. Conclusion: In our pediatric allogeneic HSCT cohort, helper T cells were the last subset to recover. Younger age and EBV DNAemia had a negative impact on the post-transplant recovery of T cells and B cells.

Parenting experiences of mother in children with developmental disabilities (발달장애 아동 어머니의 양육 경험)

  • Yeo, Yeong-Nam;Park, Hae In;Shin, Jeoung-Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.8
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    • pp.283-294
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    • 2018
  • The purpose of this study is to understand and describe in depth the meaning of parenting experiences of mothers with children with developmental disabilities through phenomenological methods. Participants of this study were selected by convenience sampling 11 mothers who were taking care of children with developmental disabilities who were being treated at the Welfare Center for the Disabled in C city. Data were collected from February to April, 2018 by using in-depth interview and tape-recording. The interview data were analyzed by the phenomenological analysis method of Giorgi. As the result of analysis, the following seven constituents were emerged; Regreting to delay the uncertain diagnosis, Difficulty in accommodating children with disabilities, Unbearable gaze around, Family disagreements due to children with disabilities, Adopting and dedicated to child care for disabled childre, Tiring of raising children with disabilities, Accepting children with disabilities. In conclusion, the parenting attitude of mother with developmental disability is influenced not only by the children with developmental disabilities but also by the social contact opportunities of daily life and interpersonal relationship including mothers' emotional stability and social isolation, It is considered that medical and welfare should be systematically introduced for physical, psychological and emotional support for mothers.

A Study on the Interface between DAS and SCADA by using Direct Method (직접연계방법에 의한 DAS-SCADA 연계 연구)

  • Park, So-Young;Shin, Chang-Hoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.9 no.5
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    • pp.1154-1163
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    • 2008
  • DAS and SCADA system are main systems, which operate and manage the power system by using computer and communication technology. But DAS and SCADA have been operated independently in Korea, so there was some time delay in the fault handling and live-line work. To improve that problems, studies on the interface between DAS and SCADA have been needed. From November 2005 to December 2007, the pilot project has been performed in KEPCO's branch offices, as a result, direct method will be applied widely all over the country until 2010 because the operation information of substation users want can be transmitted fast and it is possible to control 43RC directly although the expense for direct method is about 1.3 times larger than that for web method. To improve problems revealed during the pilot project, substation object to object communication method is proposed and interface database automatic generation and interface system diagnosis and logging functions are developed. Interface data point and communication data type are defined, substation single line diagram automatic generation or manual editing function, SCADA monitoring and controlling function, log data managing function are developed in SCADA HMI program. It is expecting to reduce the average time for each outage about 33% and to improve the reliability, efficiency of operation, execution of DAS from automatic load transfer under a fault, and to contribute to export project.

The Objective Image Analysis for HCC and HH with a Axial Image of Liver CT Scan (Liver CT 단면영상에서 간세포암과 간혈관종의 객관적 영상분석)

  • Hwang, In-Gil;Ko, Seong-Jin;Choi, Seok-Yoon
    • The Journal of the Korea Contents Association
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    • v.15 no.9
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    • pp.411-417
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    • 2015
  • To distinguish between HCC and HH is one of the important test methods in determining the treatment method by determining the treatment method by distinguishing malignant growth and benign tumors in liver CT scan. Currently, the specialist is reading CT images by their subjective judgment. So, the purpose of this study is to treat reading the CT images even more objective way. The test times after injection contrast medium in this study are the before injection phase(Pre.), artery phase(35sec), portal phase(70sec) and delay phase(180sec). The general pattern change of HCC in change of contrast enhancement pattern shows 26.6% matching. And the case of HH shows 16.6% matching. In order to observe the change of HU value between HCC and HH, each average values and standard deviation was confirm and as a result, it shows the lagre difference between artery and portal phase in lesion.(HCC$19.76{\pm}23.52$, HH$60.23{\pm}29.43$). And it shows the 76.6% matching in HCC and 80.0% matching in HH. Thorough this study, to suggest a HU value as objective analysis method and if the anlaysis method was used in clinical will assist in the diagnosis.

A Case of Squamous Cell Carcinomatous Lung Abscess with Multiple Metastatic Abscesses (다발 전이성 농양을 일으킨 편평상피세포암성 농양 1예)

  • Lim, Ju Eun;Kim, Eun Young;Jang, Ji Eun;Son, Ji-Young;Jung, Ji Ye;Park, Byung Hoon;Lee, Kyung Jong;Yoon, Yeo Wun;Byun, Min Kwang;Lee, Sa Rah;Kang, Young Ae;Moon, Jin Wook;Park, Moo Suk;Kim, Young Sam;Jang, Joon;Park, Young Nyun;Kim, Se Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.5
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    • pp.390-395
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    • 2009
  • Among the bronchogenic carcinomas, especially squamous cell carcinoma and large cell carcinoma frequently present with cavitation, which may result from tumor necrosis. Cavitary lesions of the tumor are occasionally associated with infection and misdiagnosed as benign lung abscess owing to the partial responsiveness to antibiotics. It is very difficult to distinguish the carcinomatous abscess from the benign lung abscess, because of their similar clinical and radiologic features. Delay in diagnosis of underlying lung cancer may result in poor outcome. Therefore, clinicians should remember that the patients with highly suspicious carcinoma of the lung should undergo further precise examinations to find out malignant cells.