• Title/Summary/Keyword: treatment effectiveness

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A Study of Guide System for Cerebrovascular Intervention (뇌혈관 중재시술 지원 가이드 시스템에 관한 연구)

  • Lee, Sung-Gwon;Jeong, Chang-Won;Yoon, Kwon-Ha;Joo, Su-Chong
    • Journal of Internet Computing and Services
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    • v.17 no.1
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    • pp.101-107
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    • 2016
  • Due to the recent advancement in digital imaging technology, development of intervention equipment has become generalize. Video arbitration procedure is a process to insert a tiny catheter and a guide wire in the body, so in order to enhance the effectiveness and safety of this treatment, the high-quality of x-ray of image should be used. However, the increasing of radiation has become the problem. Therefore, the studies to improve the performance of x-ray detectors are being actively processed. Moreover, this intervention is based on the reference of the angiographic imaging and 3D medical image processing. In this paper, we propose a guidance system to support this intervention. Through this intervention, it can solve the problem of the existing 2D medical images based vessel that has a formation of cerebrovascular disease, and guide the real-time tracking and optimal route to the target lesion by intervention catheter and guide wire tool. As a result, the system was completely composed for medical image acquisition unit and image processing unit as well as a display device. The experimental environment, guide services which are provided by the proposed system Brain Phantom (complete intracranial model with aneurysms, ref H+N-S-A-010) was taken with x-ray and testing. To generate a reference image based on the Laplacian algorithm for the image processing which derived from the cerebral blood vessel model was applied to DICOM by Volume ray casting technique. $A^*$ algorithm was used to provide the catheter with a guide wire tracking path. Finally, the result does show the location of the catheter and guide wire providing in the proposed system especially, it is expected to provide a useful guide for future intervention service.

The Analysis of Risk Factors and Significance of Tumor Necrosis Factor(TNE)-$\alpha$ in Henoch-$Sch\ddot{o}nlein$ Nephritis (Henoch-$Sch\ddot{o}nlein$ 자반증 환아에서 신침범에 대한 위험인자 분석 및 tumor necrosis factor-$\alpha$의 의의)

  • Song Young-Jun;Ha Tae-Sun
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.40-47
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    • 2000
  • Purpose: Renal involvement is the most important prognostic factor of HSP. Therefore, the pathogenesis and prognostic factors in renal involvement have been studied by many researchers. The aim of this study was to evaluate the clinical risk factors and the role of TNF-$\alpha$ in renal involvement of HS purpura. Methods: The subjects of this study were 12 patients of HS purpura, 7 patients of HS nephritis, and 5 age-matched controls. We have analysed the rist factors for renal involvement in clinical symptoms and collected the sera and urines of all subjects in acute and convalescent stage. The concentration of TNF-$\alpha$ in the collected sera and urines were measured by sandwich ELISA and compared with that of age-matched controls. Results: Statistical analysis showed that persistent purpura increased the risk of developing renal involvement (P=0.0018). and serum TNF-$\alpha$ levels in the acute stage of patients with renal involvement($11.45{\pm}7.01$ pg/ml) were significantly higher than those of without renal involvement($6.32{\pm}1.31$pg/m1) and of age-matched controls($5.99{\pm}1.34$pg/m1)(P=0.012, 0.027, respectively). However, urine TNF-$\alpha$ levels have no correlation with renal involvement. On investigation of serum TNF-$\alpha$ levels in acute stage of HS purpura, persistent purpura had a significantly higher increase(P=0.038). Conclusion: Serum concentration of TNF-$\alpha$ is a risk factor and has a predictable value along with clinical risk factors, such as, persistent purpura for renal involvement in HS purpura. Also, the effectiveness of the specific treatment fur antagonizing TNF-$\alpha$ in HS nephritis may need further study.

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Incidence and Risk Factors for Extended-Spectrum ${\beta}-Lactamase-Producing$ Escherichia coli in Community-acquired Childhood Urinary Tract Infection (지역사회 획득 소아 요로 감염에서 Extended-Spectrum ${\beta}-Lactamase$ 생성)

  • Lee Jung-Won;Shin Jee-Sun;Seo Jeong-Wan;Lee Mi-Ae;Lee Seung-Joo
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.214-222
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    • 2004
  • Purpose: Appropriate antibiotic therapy is important in childhood urinary tract infection and the selection of anibiotics is based on antimicrobial sensitivity of Escherichia coli. Extended-Spectrum ${\beta}-Lactamase(ESBL)$ is an enzyme produced by gram-negative bacilli that has the ability to hydrolyse penicillins, broad-spectrum cephalosporin and monobactam. There have been many reports of outbreaks of hospital infection by ESBL-producing organism. However, community-acquired infection with ESBL-producing organism are rare. This study was performed to retrospectively identify the incidence, characteristics and risk factors of ESBL (+) E. coli in community-acquired childhood UTI. Methods: In 288 children admitted in Ewha Womans University Hospital with E. coli UTI from Mar 2001 to February 2003, ESBL was isolated. ESBL was confirmed by the utilization of an automatized machine(Vitek GNS 433 card) using liquid medium dilution method according to National Committee for Clinical Laboratory Standard. The clinical characteristics, risk factors, antimicrobial resistance and treatment effectiveness were compared with ESBL(-) E. coli UTI. Results: Of 288 E. coli isolates, 31(10.8%) produced ESBL and 93.5%(29/31) occurred in infants younger than 6 month of age(P<0.01). No significant differences were noted in prior antibiotic use, prior admission history and underlying urogenital anomaly. Antimicrobial resistance was significantly higher in ESBL(+) E. coli compared with control patients (P<0.05). Although ceftriaxone showed 100% resistance in ESBL(+) E. coli, bacteriologic sterilization rate after ceftriaxone therapy was higher(96.8%). However, the recurrence rate of febrile UTI within 6 months was higher(25.8%) than control patients(6.6%). Conclusion: Epidemiologic study is required to find out any new risk factors of community-acquired ESBL(+) E. coli UTI and changes in selection of empirical antibiotics should be considered.

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Clinical Characteristics of Influenza B Virus in Children and the Efficacy of Oseltamivir: Data from Two University Hospitals (소아에서 B형 인플루엔자 바이러스의 감염에서 oseltamivir 치료의 유용성: 2개 병원에서 조사된 환자들을 대상으로)

  • Youn, Song Ee;Chun, Ji Hye;Lee, Kyung Suk;Rha, Yeong Ho;Choi, Sun Hee
    • Pediatric Infection and Vaccine
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    • v.21 no.3
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    • pp.199-206
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    • 2014
  • Purpose: There has been little research regarding the effectiveness of oseltamivir for influenza B infections. We sought to identify the different clinical manifestations between patients treated with and without oseltamivir. Methods: We retrospectively studied the medical records of 72 inpatients or outpatients from two medical centers diagnosed with influenza B infections by either a rapid antigen test or multiplex reverse transcriptase PCR between January 2012 and July 2012. We compared gender, age, past medical history, admission period, total fever duration, fever duration after hospitalization, post-oseltamivir medication peak temperature, laboratory test, chest X-ray, antibiotic medication, and the presence of concomitant viral or bacterial infections. Results: The number of subjects in our study was 72 who were diagnosed with influenza B pneumonia, acute bronchitis, acute bronchiolitis, croup, and mean age was $3.6{\pm}2.8$ year old. The demographic characteristics and clinical manifestations of oseltamivir and the non-oseltamivir groups, including hospitalization period ($4.18{\pm}2.10$ vs $4.79{\pm}1.49$ days, P=.17) and total fever duration ($5.32{\pm}2.07$ vs $6.41{\pm}3.25$ days, P =.09), demonstrated no significant differences. Notably, the oseltamivir group did have significantly reduced usage of antibiotic treatment than the non-oseltamivir group (P=.04). When we limited our patient group to patients under the age of three, similar results were seen. The group prescribed oseltamivir within 48 hours of fever onset had less antibiotic usage, in addition to a shorter fever duration. Conclusion: Oseltamivir appeared to have no benefit in improving the clinical course. However, if it is prescribed within the first 48 hours of symptoms, it may be more effective.

Long-term Results of Modified Lecompte Procedure for the Anomalies of Ventriculoarterial Connection (심실대혈관 연결 이상에 대한 변형된 Lecompte 술식의 장기 성적)

  • 임홍국;한국남;김웅한;이정렬;노준량;김용진
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.727-734
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    • 2004
  • The Lecompte procedure for transposition of the great arteries has an advantage because it obviates the need for an extracardiac conduit for the reconstruction of the pulmonary outflow tract. We evaluated the effectiveness and the application of the Lecompte procedure. Material and Method: A retrospective review was conducted of the records of 46 patients who underwent the Lecompte procedure during the past 15 years. Mean age at operation was 29.2$\pm$20.3 (range: 3∼83) months. The diagnoses involved anomalies of the ventriculoarterial connection with ventricular septal defect and pulmonary outflow tract obstruction, such as transposition of the great arteries, double-outlet right ventricle, and double-outlet left ventricle. Result: Early mortality was 4.4% (2 of 46 patients) and late mortality was 6.8% (3 of 44). The mean follow-up was 11.2$\pm$6.9 years. Eighteen patients (43.9% of survivors, n=41) had pulmonary stenosis (pressure gradient above 30 mmHg), the main reason for which was a calcified monocusp valve (n=15, 83.3%). Seventeen of 46 patients (37.0%) underwent reoperation: 15 for pulmonary stenosis, 5 for residual ventricular septal defect, 4 for left ventricular outflow tract obstruction, 3 for pulmonary insufficiency, and 4 for other causes. The cumulative survival rates were 91.3$\pm$4.2%, and 87.0$\pm$5.8% at 10 and 15 years, respectively. The actuarial probabilities of freedom from reoperation for pulmonary stenosis were 90.6$\pm$4.5%, 73.9$\pm$7.3%, and 54.0$\pm$10.4% at 5, 10, and 15 years, respectively. Conclusion: The Lecompte procedure is an effective treatment modality. Repair in early age is possible with acceptable morbidity and mortality, but recurrent right ventricular outflow tract obstruction caused by degeneration of the monocusp valve is a problem that needs resolution.

Hyeongok's Bopyeo-tang Combined According to the Theory of Properties and Tastes of Herbal Medicines (현곡(玄谷) 보폐탕(補肺湯)의 구성한약과 그 기미배오(氣味配伍) 분석)

  • Shin, Soon-Shik;Park, Sun-Dong;Kim, Gyeong-Cheol
    • The Journal of Korean Medicine
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    • v.28 no.3 s.71
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    • pp.37-44
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    • 2007
  • Objectives : The objectives of this study lie in theoretical establishment of Bopyeo-tang for treating asthenic syndrome of the lung through analyzing the component medicines and combination principles of Hyeongok's Bopyeo-tang, and furthermore, maximizing the clinical effectiveness of Bopyeo-tang. Methods : This study analyzed the component medicines and combination principles of Hyeongok's Bopyeo-tang based on the theory for properties and tastes of herbal medicines from the ${\ulcorner}$Yellow Emperor's Canon of Internal Medicine${\lrcorner}$, the theory for principal herbal medicine, assistant herbal medicine, adjuvant herbal medicine, dispatcher herbal medicine, and the five elements doctrine. Hyeongok's Bopyeo-tang is an unusual prescription, composed of 7 kinds of ingredients. Results : There are three methods for curing asthenic syndrome of the lung according to the five elements doctrine: invigorating the lung, invigorating the spleen and purging the heart. There are two available methods to invigorate the lung, taste and property invigoration, according to the theory for properties and tastes of herbal medicines. They each imply the sour taste and the cool property invigorate the lung. In the case of taste invigoration, two herbal medicines with sour taste, Sarcucarpium Corni and Fructus Schisandrae, are combined into the principal and assistant herbal medicine, respectively. For property invigoration, two herbal medicines with the cool property, Colla Corii Asini and Radix Ophiopogonis, are combined into adjuvant herbal medicines. There are likewise two methods to invigorate the spleen, including taste and property invigoration according to the theory for properties and tastes of herbal medicines. They each mean the sweet taste and the warm property invigorate the spleen. Therefore, it is important to use sweet herbal medicines for taste invigoration and warm ones for property invigoration. Both sweet and warm herbal medicines, Radix Ginseng and Rhizoma Atractylodis Macrocephalae, are combined into adjuvant herbal medicines. Lastly, there are two methods to purge the heart, which include taste and property purgation according to the theory for properties and tastes of herbal medicines. Taste purgation means to purge the heart with sweet taste and property purgation to purge the heart with cold property. Therefore, it is important to use sweet herbal medicines for taste purgation and cold ones for property purgation. Both sweet and cold herbal medicines, Colla Corii Asini and Radix Ophiopogonis, were combined to purge the heart and invigorate the lung. In addition, Radix Glycyrrhizae Praeparata is added as a dispatcher herbal medicine, harmonizing all the other herbal medicines comprising the formula. Conclusions : First, to treat asthenic syndrome of the lung, the methods of invigorating the lung and the spleen and purging the heart should be used according to the five elements doctrine. Secondly, herbal medicines appropriate for those treatment methods should be chosen according to the theory for properties and tastes of herbal medicine and thirdly, the combination of those herbal medicines should be carried out according to the theory for principal herbal medicine, assistant herbal medicine, adjuvant herbal medicine, and dispatcher herbal medicine. As a good example, Hyeongok's Bopyeo-tang is combined according to the above theories. In conclusion, this formula was created by applying the theory of properties and tastes of herbal medicines.

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Studies on the Control of Bud Bright of Mulberry Tree when Intermediate-Cutting Harvest in Autumn (추기 중간벌채수확 뽕나무의 아고병방제에 관할 연구)

  • 유근섭
    • Journal of Sericultural and Entomological Science
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    • v.16 no.2
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    • pp.99-109
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    • 1974
  • These studies aimed to establishment of controlling measure of the bud blight of mulberry tree when intermediate cutting harvest in autumn. The results obtained as following. 1. Effect of chemicals a) Results of 1972 (1) Of the seventeen chemicals tested. according to in vitro, the mycelial growth of Gibberella lateritium f. sp. mori was highly inhibited by PTAB and Benlate. PTAB and Benlate were also highly effective under the conditions of pathogen inoculated to the piece of mulberry tree and fungicidal action of these chemicals were stronger than the others. (2) Topsin-M. organic fungicide and plant growth regulator were not effective to inhibition of mycelial growth. (3) The effectiveness of fungicides were reduced gradually as the time after treatment increased. PTAB and Benlate retained approximately 50 percent of the original activity even after 15 days. (t) Of the twelve chemicals tested in fold, Benlate combination of PTAB with Apion, Apion and PTAB were the most effective fungicides for the control of bud blight of mulberry tree. (5) There is a sigificant difference between the timing on spraying, but it is not greatly effective for the control of bud blight of mulberry tree. b) Results of 1975 (1) Of the ten chemicals tested, according to in vitro RH 893, combination of Benlate with TMTD and TMTD were the most effective to inhibition of mycelial growth, followed by Benlate and combination of Benlate with Topsin M. (2) Of the eleven chemicals tested, Benlate, combination of Benlate with Kinondu, combination of Benlate with Topsin-M and Topsin M were highly effective under the renditions of pathogen inoculated to the piece of mulberry tree. (3) Of the eleven chemical evaluation tests were conducted in 3 experiment fold of Seoul, Chuncheun and Pusan, Benlate, Topsin-M, Apion, TMTD. combination of Benlate with Topsin-M, combination of Benlate with TMTD, combination of Benlate with Apion were highly effective chemicals for the control of bud blight of mulberry tree. (4) There is no difference between the timing on the chemical spraying after intermediate cutting harvest mulberry tree in autumn. 2. Ecological Control. When the mulberry shoot were cut off one to two buds from the top of intermediate cutting from 15th to 30th on October, bud blight of mulberry tree was greatly reduced in next spring compared with the effective chemical spraying. 3. Economical analysis on the results of chemical and ecological tests. When the expenses of ecological control for bud blight of mulberry tree per one ha was 100. thats of chemical control was from 159 to 254 according to spraying machines.

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Complementary and Alternative Medical Therapies in Children and Adolescent with Chronic Disease : Utilizations and Patterns (만성 질환을 가진 소아, 청소년에게 시행되는 보완대체요법의 실태 연구)

  • Kim, Young Bin;Song, Jun Ho;Jang, Myoung Wan;Yoo, Hwang Jae;Kim, Cheol Hong;Lee, Hyun Hee
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.929-934
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    • 2005
  • Purpose : This study describes how often complementary and alternative medical(CAM) therapies, what patterns of CAM therapies utilization, what types of CAM therapies and why CAM therapies are used in children and adolescent with chronic disease. Methods : We interviewed and filled out questionnaires with parents of patients suffering from asthma, atopic dermatitis, congenital myopathy, epilepsy and so on from Mar 2004 to Aug 2004. Results : Two hundred fifty two parents answered questionnaires; 160 cases(63.5 percent) had used CAM therapies. Utilization of CAM therapies according to each chronic disease was as follows : congenital myopathy(100 percent), atopic dermatitis(91.1 percent), asthma(72.5 percent), chronic diarrhea (50.0 percent), epilepsy(17.1 percent) etc. Types of CAM therapy were as follows : dietary supplement (31.1 percent), herb medicine(23.4 percent), massage(14.2 percent), acupuncture(4.6 percent) etc. Sixty four(40.0 percent) case underwent more than two types of CAM therapies simultaneously. One hundred thirty three(83.1 percent) case were asked through non-medical prescription. Ninety nine(61.9 percent) case were recognized positive effect of CAM therapies. Parents' and childrens' ages were influential factors in CAM therapies utilization : the older the parents and the younger the children, the higher the utilization. Conclusion : Although patients receive treatment with western medicine, many of them not only undergo CAM therapies, especially more than two types, but also recognize the positive effects of CAM therapies. As a result, we suggest that it is easy to use of CAM therapies, and the positive effects of CAM therapies are prominent, domestically. Therefore, medical approach and study about the effectiveness and side effects of CAM therapies is necessary to avoid the imprudent use of such therapies.

The Efficacy of Ultrasonography-guided S1 Selective Nerve Root Block (초음파를 이용한 제 1천추 선택적 신경근 차단술의 유용성)

  • Jeon, Young Dae;Kim, Tae Gyun;Shim, Dae Moo;Kim, Chang Su
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.2
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    • pp.113-119
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    • 2014
  • Purpose: This study was to evaluate effect and efficiency of S1 selective nerve root block using ultrasonography-guided compared with fluoroscopy-guided for lumbar disc herniation or spinal stenosis patients. Materials and Methods: Between February 2012 and December 2013, 38 patients who were with lower leg radiating pain for more than 1months and underwent S1 selective spinal nerve root block in our institution, were reviewed. They divided into two groups: Group A included 18 patients with ultrasonography-guided and Group B included 20 patients with fluoroscopy-guided. Treatment effectiveness was assessed using a visual analogue scale (VAS) and the Korea Modified Oswestry Disability Index (K-MODI). They were evaluated its preoperatively, postoperatively and 1 month later. We were recorded whole procedure time. Results: VAS was improved from 7.4 to 4.7 at 1 month in group A and from 7.39 to 4.36 at 1month in group B. K-MODI was improved from 72.8 to 43.3 at 1month in group A and from 73.8 to 44.1 at 1month in group B. Whole procedure time were $477.53{\pm}115.02s$, $492.47{\pm}144.38s$ in group A, group B, respectively. But there was no significant difference in VAS and K-MODI between two groups. Conclusion: Ultrasonography-guided sacral nerve root block is effective and accurate method in sacral radiating pain.

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A Domestic Outbreak of Bacterial Dysentery Caused by Extended-Spectrum β-Lactamase(ESBL)-producing Shigella sonnei (집단 발생한 Extended-spectrum β-lactamase(ESBL) 생산 Shigella sonnei 감염에 의한 세균성 이질에 관한 연구)

  • Lim, Hyun Taek;Lee, So Hee;Lee, Jung Hwa;Kim, Jeong Eun;Kim, Kyo Sun;Jeong, Eun Ju;Lee, Seung Hyun;Kang, Chang Gyu;Hong, Seong Jin
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1107-1115
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    • 2005
  • Purpose : An outbreak of ESBL-producing Shigella sonnei enteritis was unprecedented not only in Korea but throughout the world in the past. We intended to devise a management guideline for ESBL-producing shigellosis based on analysis of clinical manifestations and response to therapy. Methods : We analyzed 103 patients who were admitted to the hospital with acute GI symptoms and were shown positive result for S. sonnei on stool culture. We performed sensitivity test to the antibiotics and DNA sequencing of ESBL gene in the isolated S. sonnei colonies. In addition, we retrospectively analyzed their clinical characteristics, laboratory results, and clinical and microbiological responses to the antibiotics. Results : Among the clinical manifestations, fever was the most frequent(96.1%), followed by diarrhea(93.2%), abdominal pain(76.7%), headache(71.8%), vomiting(65.0%), and nausea(41.7%). The fever was sustained for average of 2.0 days and diarrhea for 3.9 days. Watery diarrhea was the most common(69%) followed by mucoid(26%), and bloody stool(5%). On peripheral blood smear, leukocytosis was noted in 53.4% of patients, and 78.6% of patients tested positive for serum CRP response. On stool direct smear, 11.7% of patients showed more than 50 WBCs/HPF, and 9.7% of patients between 5 to 20 WBCs/HPF. Stool occult blood was positive in 71% of patients. Production of CTX-M-14 type ESBL was reported for all S. sonnei strains isolated from this outbreak. Microbiological eradication rates to various antibiotics were as follows : 100%(9/9) to ciprofloxacin, 100% 5/5) to azithromycin, 6.9%(5/72) to cefdinir, 0%(0/8) to ceftriaxone, 12.5%(1/8) to ceftizoxime, 0%(0/ 8) to TMP/SMX, 42.9%(3/7) to ampicillin/sulbactam, 20%(1/5) to amoxicillin/clavulanic acid, and 68.8 %(11/16) to imipenem/cilastatin. Conclusion : It is presumed that azithromycin can be an attractive option for the treatment of ESBL-producing S. sonnei enteritis in pediatric population, given its cost-effectiveness and safety. Although ciprofloxacin is another cost-effective agent, its use in pediatric population may be a bit too premature.