• Title/Summary/Keyword: clinical grading

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The Clinical Research of Cervical Chuna Treatment's Effects on Bell's Palsy (벨마비에 미치는 경추 추나요법의 영향에 대한 임상적 고찰)

  • Jeong, Jae Yoeb;Lee, Eun Sol;Seo, Dong Goon;Shin, So Yeon;Kim, Shin Young;Kwon, Hyung Keun;Kim, Cheol Hong;Jang, Kyung Jeon;Yoon, Hyun Min
    • Journal of Acupuncture Research
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    • v.31 no.3
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    • pp.45-55
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    • 2014
  • Objectives : The purpose of this study is to investigate the effect of cervical Chuna treatment for Bell's palsy. Methods : We investigated 30 patients with Bell's palsy who had visited at Department of Acupuncture & Moxibustion, of Korean Medicine Hospital Dong-Eui University from June $1_{st}$, 2013 to April $15_{th}$, 2014. Subjects were randomly divided into two groups. Group A(experimental group) was treated by Korean-Western combination treatment with Cervical Chuna treatment and group B(control group) was treated by Korean-Western combination treatment without it. The cervical Chuna treatment was done twice a week, for a total of 8 times. We evaluated the change of each group by using Yanagihara's unweighed grading system. Results : Yanagihara's score in group A was significantly improved during each period from the first visit to four weeks later. However, Yanagihara's score in group B was significantly improved except during first week. The improvement of Yanagihara's score in group A is higher than group B during every period. And significant differences were shown after two weeks from the first visit between the two groups. Conclusions : These results suggest that cervical Chuna treatment may be effective for Bell's palsy.

The Protective Effect of Green Tea Extract on Alpha-amanitin Induced Hepatotoxicity (알파 아마니틴에 의한 간독성에 대한 녹차 추출물의 보호 효과)

  • An, Su Hwan;Sun, Kyung Hoon;Hong, Ran;Lee, Byoung Rai;Park, Yongjin
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.2
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    • pp.58-65
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    • 2019
  • Purpose: Alpha-amanitin induces potent oxidative stress and apoptosis, and may play a significant role in the pathogenesis of hepatotoxicity. This study examined the mechanisms of α-amanitin-induced apoptosis in vitro, and whether green tea extract (GTE) offers protection against hepatic damage caused by α-amanitin (AMA) induced apoptosis in vivo. Methods: The effects of GTE and SIL on the cell viability of cultured murine hepatocytes induced by AMA were evaluated using an MTT assay. Apoptosis was assessed by an analysis of DNA fragmentation and caspase-3. In the in vivo protocol, mice were divided into the following four groups: control group (0.9% saline injection), AMA group (α-amanitin 0.6 mg/kg), AMA+SIL group (α-amanitin and silibinin 50 mg/kg), and AMA+GTE group (α-amanitin and green tea extract 25 mg/kg). After 48 hours of treatment, the hepatic aminotransferase and the extent of hepatonecrosis of each subject was evaluated. Results: In the hepatocytes exposed to AMA and the tested antidotes, the cell viability was significantly lower than the AMA only group. An analysis of DNA fragmentation showed distinctive cleavage of hepatocyte nuclear DNA in the cells exposed to AMA. In addition, the AMA and GTE or SIL groups showed more relief of the cleavage of the nuclear DNA ladder. Similarly, values of caspase-3 in the AMA+GTE and AMA+SIL groups were significantly lower than in the AMA group. The serum AST and ALT levels were significantly higher in the AMA group than in the control and significantly lower in the AMA+GTE group. In addition, AMA+GTE induced a significant decrease in hepatonecrosis compared to the controls when a histologic grading scale was used. Conclusion: GTE is effective against AMA-induced hepatotoxicity with its apoptosis regulatory properties under in vitro and in vivo conditions.

Development and Validation of Figure-Copy Test for Dementia Screening (치매 선별을 위한 도형모사검사 개발 및 타당화)

  • Kim, Chobok;Heo, Juyeon;Hong, Jiyun;Yi, Kyongmyon;Park, Jungkyu;Shin, Changhwan
    • 한국노년학
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    • v.40 no.2
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    • pp.325-340
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    • 2020
  • Early diagnosis and intervention of dementia is critical to minimize future risk and cost for patients and their families. The purpose of this study was to develop and validate Figure-Copy Test(FCT), as a new dementia screening test, that can measure neurological damage and cognitive impairment, and then to examine whether the grading precesses for screening can be automated through machine learning procedure by using FCT imag es. For this end, FCT, Korean version of MMSE for Dementia Screening (MMSE-DS) and Clock Drawing Test were administrated to a total of 270 participants from normal and damaged elderly groups. Results demonstrated that FCT scores showed high internal constancy and significant correlation coefficients with the other two test scores. Discriminant analyses showed that the accuracy of classification for the normal and damag ed g roups using FCT were 90.8% and 77.1%, respectively, and these were relatively higher than the other two tests. Importantly, we identified that the participants whose MMSE-DS scores were higher than the cutoff but showed lower scores in FCT were successfully screened out through clinical diagnosis. Finally, machine learning using the FCT image data showed an accuracy of 73.70%. In conclusion, our results suggest that FCT, a newly developed drawing test, can be easily implemented for efficient dementia screening.

Interpretation of Complete Tumor Response on MRI Following Chemoradiotherapy of Rectal Cancer: Inter-Reader Agreement and Associated Factors in Multi-Center Clinical Practice

  • Hae Young Kim;Seung Hyun Cho;Jong Keon Jang;Bohyun Kim;Chul-min Lee;Joon Seok Lim;Sung Kyoung Moon;Soon Nam Oh;Nieun Seo;Seong Ho Park
    • Korean Journal of Radiology
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    • v.25 no.4
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    • pp.351-362
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    • 2024
  • Objective: To measure inter-reader agreement and identify associated factors in interpreting complete response (CR) on magnetic resonance imaging (MRI) following chemoradiotherapy (CRT) for rectal cancer. Materials and Methods: This retrospective study involved 10 readers from seven hospitals with experience of 80-10210 cases, and 149 patients who underwent surgery after CRT for rectal cancer. Using MRI-based tumor regression grading (mrTRG) and methods employed in daily practice, the readers independently assessed mrTRG, CR on T2-weighted images (T2WI) denoted as mrCRT2W, and CR on all images including diffusion-weighted images (DWI) denoted as mrCRoverall. The readers described their interpretation patterns and how they utilized DWI. Inter-reader agreement was measured using multi-rater kappa, and associated factors were analyzed using multivariable regression. Correlation between sensitivity and specificity of each reader was analyzed using Spearman coefficient. Results: The mrCRT2W and mrCRoverall rates varied widely among the readers, ranging 18.8%-40.3% and 18.1%-34.9%, respectively. Nine readers used DWI as a supplement sequence, which modified interpretations on T2WI in 2.7% of cases (36/1341 [149 patients × 9 readers]) and mostly (33/36) changed mrCRT2W to non-mrCRoverall. The kappa values for mrTRG, mrCRT2W, and mrCRoverall were 0.56 (95% confidence interval: 0.49, 0.62), 0.55 (0.52, 0.57), and 0.54 (0.51, 0.57), respectively. No use of rectal gel, larger initial tumor size, and higher initial cT stage exhibited significant association with a higher interreader agreement for assessing mrCRoverall (P ≤ 0.042). Strong negative correlations were observed between the sensitivity and specificity of individual readers (coefficient, -0.718 to -0.963; P ≤ 0.019). Conclusion: Inter-reader agreement was moderate for assessing CR on post-CRT MRI. Readers' varying standards on MRI interpretation (i.e., threshold effect), along with the use of rectal gel, initial tumor size, and initial cT stage, were significant factors associated with inter-reader agreement.

Modified application of SAMe-TT2R2 scoring system in Asian patients with atrial fibrillation for the selection of oral anticoagulants

  • Seong Won Jeon;Nuri Lee;Ki Hong Lee;Minjeong Ha;Changhyun Kim;Yoo Ri Kim;Nam Sik Yoon;Hyung Wook Park
    • The Korean journal of internal medicine
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    • v.39 no.3
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    • pp.458-468
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    • 2024
  • Background/Aims: The SAMe-TT2R2 score is used for assessing anticoagulation control (AC) quality with warfarin. However, it is hard to apply SAMe-TT2R2 score in Asian patients with atrial fibrillation (AF), because it has not been proven in those populations. This study aimed to validate the SAMe-TT2R2 score in Asian patients with AF and suggest a modified SAMe-TT2R2 score for this population. Methods: We analyzed 710 Korean patients with AF who were using warfarin. The AC quality was assessed as the mean time in therapeutic range (TTR). Each component of SAMe-TT2R2 score was evaluated for the relationship with AC. Further clinical factors that predict AC were analyzed. Identified factors were re-assorted and constructed as SA2Me-TTR scoring system. Results: Of the components of the SAMe-TT2R2 score, female, age, and rhythm control were associated with AC. Heart failure and renal insufficiency were newly identified factors associated with AC. The modified SA2Me-TTR score was reconstructed with the relevant risk factors (S, female gender, 1 point; A, age < 60 yr, 2 points; Me, medical history of heart failure, 1 point; T, treatment for rhythm control, 1 point; T, history of stroke or transient ischemic attack, 1 point; R, renal insufficiency, 1 point). The modified SA2Me-TTR score demonstrated an excellent relationship with the grading of AC. The modified SA2Me-TTR score ≤ 1 identified patients with good AC (hazard ratio 2.46, 95% CI 1.75-3.47). Conclusions: The modified SA2Me-TTR score was useful for guiding oral anticoagulants selection in Asian patients with AF.

Clinical Experience with 3.0 T MR for Cardiac Imaging in Patients: Comparison to 1.5 T using Individually Optimized Imaging Protocols (장비 별 최적화된 영상 프로토콜을 이용한 환자에서의 3.0T 심장 자기공명영상의 임상경험: 1.5 T 자기공명영상과의 비교)

  • Ko, Jeong Min;Jung, Jung Im;Lee, Bae Young
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.2
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    • pp.83-90
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    • 2013
  • Purpose : To report our clinical experience with cardiac 3.0 T MRI in patients compared with 1.5 T using individually optimized imaging protocols. Materials and Methods: We retrospectively reviewed 30 consecutive patients and 20 consecutive patients who underwent 1.5 T and 3 T cardiac MRI within 10 months. A comparison study was performed by measuring the signal-to-noise ratio (SNR), the contrast-to-noise ratio (CNR) and the image quality (by grading each sequence on a 5-point scale, regarding the presence of artifacts). Results: In morphologic and viability studies, the use of 3.0 T provided increase of the baseline SNRs and CNRs, respectively (T1: SNR 29%, p < 0.001, CNR 37%, p < 0.001; T2-SPAIR: SNR 13%, p = 0.068, CNR 18%, p = 0.059; viability imaging: SNR 45%, p = 0.017, CNR 37%, p = 0.135) without significant impairment of the image quality (T1: $3.8{\pm}0.9$ vs. $3.9{\pm}0.7$, p = 0.438; T2-SPAIR: $3.8{\pm}0.9$ vs. $3.9{\pm}0.5$, p = 0.744; viability imaging: $4.5{\pm}0.8$ vs. $4.7{\pm}0.6$, p = 0.254). Although the image qualities of 3.0 T functional cine images were slightly lower than those of 1.5 T images ($3.6{\pm}0.7$ vs. $4.2{\pm}0.6$, p < 0.001), the mean SNR and CNR at 3.0 T were significantly improved (SNR 143% increase, CNR 108% increase, p < 0.001). With our imaging protocol for 3.0 T perfusion imaging, there was an insignificant decrease in the SNR (11% decrease, p = 0.172) and CNR (7% decrease, p = 0.638). However, the overall image quality was significantly improved ($4.6{\pm}0.5$ vs. $4.0{\pm}0.8$, p = 0.006). Conclusion: With our experience, 3.0 T MRI was shown to be feasible for the routine assessment of cardiac imaging.

Usefulness of $^{99m}Tc$-MDP Bone Scintigraphy for Assessing Vascular Ingrowth on Hydroxyapatite Ocular Implant ($^{99m}Tc$-MDP 골신티그라피를 이용한 Hydroxyapatite 안구 보충물의 혈관 신생 평가 및 임상적 유용성)

  • Kang, Bong-Joo;Sohn, Hyung-Sun
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.6
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    • pp.484-492
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    • 1999
  • Purpose: This study was to evaluate the clinical usefulness of $^{99m}Tc$-MDP bone scintigraphy for assessing vascular ingrowth into the ocular implants after enucleation or evisceration. Materials and Methods: Twenty-four patients (M:F=7:17, mean age: 36 years), who buried a coralline hydroxyapatite after uncomplicated enucleation or evisceration surgery were studied. Dynamic and static scintigraphy on the orbit fossa were obtained after injection of 740 MBq $^{99m}Tc$-MDP to evaluate the status of vascularization. The study was performed from the 3 to 33 weeks after surgery. According to the visual analysis, activity greater than nasal bridge was graded as 4, equal to the nasal bridge as 3, less than nasal bridge but greater than normal orbit as 2, greater than normal orbit but less than grade 2 as 1. Uptake ratio was also calculated by measuring the implants activity (H) and contralateral orbit activity (N). Grading score and uptake ratio were compared with clinical outcome of vascularization. Additionally, we also analyzed the vascularization status as time lapse between primary surgery and scintigraphic study and surgical methods. Results: Twenty-one patients who had bone scintigraphy at 11 weeks after surgery showed increased uptake above grade 2 and greater H/N ratio than 1.16. Of these, 19 patients who had drilling surgery for permanent peg application showed adequate bleeding during the procedure. The activity grade and uptake ratio were inversely correlated with vascular ingrowth. Higher than grade 2 or greater than 1.56 in H/N ratio seemed to be an indicator for better prognosis. Accomplishment of vascularization was not affected by the surgical way such as enucleation or evisceration. Conclusion: $^{99m}Tc$-MDP bone scintigraphy can be a useful method to evaluate the vascularized status of implants. Adequate time for $^{99m}Tc$-MDP bone scintigraphy may be 11-20 weeks after enucleation or evisceration.

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The Study of Normal Tissue Complication Probability(NTCP) for Radiation Pneumonitis by Effective Volume Method (유효체적 방법과 임상분석을 통한 방사선에 의한 정상 폐조직의 부작용 확률에 관한 연구)

  • Ahn Seung Do;Choi Eun Kyung;Yi Byong Yong;Chang Hyesook
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.243-249
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    • 1997
  • Purpose : In radiation therapy, NTCF is very importart indicator of selecting the optimal treatment plan. In our study, we tried to find out usefullness of NTCP in lung cancer by comparng the incidence of radiation pneumonitis with NTCP. Materials and Methods : From August 1993 to December 1994, thirty six patients with locally advanced non=small cell lung cancer were treated by concurrent chemoradiation therapy. Total dose of radiation therapy was 6480cGy (120cGy, bid) and chemotherapeutlc agents were mitomycin C. vinblastion, cisplatin (2 cycles, 4 weeks interval). We evaluated the development of raniation pneumonitis by CT scan, chest x-rar and clinical symptoms. We used grading system of South Western Oncology Group (SWOG) for radiation pneumanitis. Dose Volume Histograms (DVH) were analyzed for ipsilateral and whole lung, Non uniform DVH was translated to uniform DVH by effective volume method. With these data, we calculated NTCP for ipsilateral and whole lung. Finally we compared the clinical results to NTCP. Results : Eight of thrity six patients developed radiation pneumonitis. Of these 8 patients , 6 had grade I severity and 2 had grade II. The average NTCP value cf the patients who showed radiation pneumonitis was significantly higher than that uf the patients without pneumonitis $(66\%\;vs.\;26.4\%)$. But the results of pulmonary function test was not correlated with NTCP. Conclusion : NTCP of lung is very good indicator for selecting rival treatment planning in lung cancer. According to the results of NTCP, it may be possible to adjust target volume and optimize target dose. In the near future, we are going to anaiyze the effect of hyperfractionation and concurrent chemotherapy in addition to NTCP.

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The Effects of Object Size and Reaching Distance on Upper Extremity Movement (물체 크기와 뻗기 거리가 상지 움직임에 미치는 영향)

  • Bae, Su-Young;Kim, Tae-Hoon
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.1
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    • pp.51-61
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    • 2020
  • Objectives : The purpose of this study is to investigate the effect of object size and reaching distance on kinematic factors of the upper limb while performing arm reaching for normal subjects. Methods : The subjects of this study were 30 university students who were in D university in Busan, and the measuring tool was CMS-70P(Zebris Medizintechnik Gmbh, Germany), a three-dimensional motion analyzer. The task had six conditions. The average velocity of motion, average acceleration, maximum velocity, and the velocity definite number of movements were measured according to changes in object size(2cm, 10cm) and reaching distance(15%, 37.5%, 60%) when they performed arm reaching. The general characteristics of the subject were technical statistics. One-way ANOVA measurement was used to compare variables when the arm reaching task was performed from two object sizes to three reaching distance, and the post-test was conducted with Tukey test. In addition, an independent t-test was used to analyze the kinematic differences according to the two object sizes at three reaching distances. A two-way ANOVA measurement (3×2 Two-way ANOVA measurement) was performed to identify the interaction of the reaching distance(15%, 37.5%, 60%) and the object size(2cm, 10cm). The statistical significance level α was set to .05. Results : When the size of the object increased, the velocity and maximum velocity also increased, but the definite number of velocity decreased. When the reaching distance increased, the velocity and maximum velocity increased, whereas the definite number of velocity decreased. Conclusion : The clinical significance of this study could be utilized as the baseline data for grading object size and reaching distances when the reaching training is implemented for patients whose central nervous system was damaged.

1 year follow-up results of prenatally diagnosed unilateral hydronephrosis according to renal sonographic findings at 1 month of age (산전 초음파로 발견된 일측성 수신증의 생후 1개월 때의 초음파 소견에 따른 1년 추적 결과)

  • Yoon, Hoe-Soo;Yum, Mi Sun;Lee, Joo Hoon;Park, Young Seo;Kim, Kun Seok;Yoon, Chong Hyun;Moon, Dae Hyuk;Hahn, Hyewon
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.64-70
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    • 2006
  • Purpose : The natural courses of prenatally diagnosed hydronephrosis(HN) are diverse. Our purpose was to determine if the findings of renal ultrasonography(USG) in patients with prenatal HN at 1 month of age can predict the 1 year follow-up results and determine the guideline of follow-up study. Methods : Among 462 hydronephrotic patients registered between 1996 and 2004, 153 unilateral hydronephrotic renal units were enrolled in this study, bilateral HN, vesicoureteral reflux and other associated anomaly were excluded. These were classified into four groups respectively, according to anterior posterior pelvic diameter(APPD) or Society for Fetal Urology(SFU) grading by USG findings at 1 month after birth. Renal USG and $Tc^{99m}$-mercaptoacetyl triglycerine(MAG3) scan were done according to a set protocol. Results : Most cases improved or remained stationary. No one underwent an operation SFU grade 1,2 groups and only one case of SFU grade 3 group was operated. Thirty two cases(64 percent) were operated on among the 50 cases of SFU grade 4 group. 0/2(0 percent), 5/11(45.5 percent), 11/17(64.7 percent) and 16/20(80 percent) were operated on in each group with APPD <10, 10-19, 20-29, >30 mm, and the operation risk is higher as the APPD is increased. Conclusion : In group with SFU grade below 3 and APPD below 10 mm, we can delay the follow-up study beyond existing set protocol. Operations are recommended immediately if diuretic renogram show the obstructive pattern or decreased renal function in SFU grade 4 group with APPD over 10 mm.