PURPOSE: We studied enhanced method to view the vessels in the brain using Magnetic Resonance Angiography (MRA). Noticing that Maximum Intensity Projection (MIP) image is often used to evaluate the arteries of the neck and brain, we propose a new method for view brain vessels to stereo image in 3D space with more superior and more correct compared with conventional method. MATERIALS AND METHODS: We use 3T Siemens Tim Trio MRI scanner with 4 channel head coil and get a 3D MRA brain data by fixing volunteers head and radiating Phase Contrast pulse sequence. MRA brain data is 3D rotated according to the view angle of each eyes. Optimal view angle (projection angle) is determined by the distance between eye and center of the data. Newly acquired MRA data are projected along with the projection line and display only the highest values. Each left and right view MIP image is integrated through anaglyph imaging method and optimal stereoscopic MIP image is acquired. RESULTS: Result image shows that proposed method let enable to view MIP image at any direction of MRA data that is impossible to the conventional method. Moreover, considering disparity and distance from viewer to center of MRA data at spherical coordinates, we can get more realistic stereo image. In conclusion, we can get optimal stereoscopic images according to the position that viewers want to see and distance between viewer and MRA data. CONCLUSION: Proposed method overcome problems of conventional method that shows only specific projected image (z-axis projection) and give optimal depth information by converting mono MIP image to stereoscopic image considering viewers position. And can display any view of MRA data at spherical coordinates. If the optimization algorithm and parallel processing is applied, it may give useful medical information for diagnosis and treatment planning in real-time.
Angiography ; Arteries ; Brain ; Eye ; Head ; Linear Energy Transfer ; Magnetic Resonance Angiography ; Neck

The anterior fusion became the popular measure in the treatment of the tuberculosis of the spine. We analysed the 208 cases of the tuberculosis of the spine (174 anterior fusion) who were treated at our department during the period of 1966 to 1973 and compared these results with that obtained during the period of 1957 to 1966. Following has been observed from this comparison. 1. Spine was the most common site in bone and joint tuberculosis (51.7%) but with decreasing tendency. And it was followed by hip, knee, ankle and sacroiliac joints of order. 2. Common age incidence was below 30 years (72.7%) and most common in below 5 years (20.7%). 3. Average duration of disease was 2 years and 2 months. This value was 6 months lower than in previous study. 4. The most common site was changed from lumbar to thoracic vertebrae. 5. The incidence of sinus, cold abscess formation decreased but paraplegia increased in incedence due to high prevalence in thoracic vertebrae. 6. Anterior fusion was performed in 86.1% of the cases. 7. Postoperative complications was found in 17.2%. Adequate rnanagement of chest tube in thoracic areas and blood vessels in lumbosacral areas may be necessary.
Abscess ; Ankle ; Blood Vessels ; Chest Tubes ; Hip ; Incidence ; Knee ; Paraplegia ; Postoperative Complications ; Prevalence ; Sacroiliac Joint ; Spine ; Thoracic Vertebrae ; Tuberculosis ; Tuberculosis, Osteoarticular

PURPOSE: To report a transient myopia with severe chemosis associated with systemic lupus erythematosus. METHODS: A 31-year-old woman was referred for decreased visual acuity of both eyes for 1 week. The patient came to the emergency medical center for facial edema and fever. She was examined and treated for systemic lupus erythematosus. Three years previously the patient underwent LASIK in both eyes, and maintained emmetropia postoperatively. RESULTS: At admission, spherical equivalent was -0.75D in the right eye and -6.5D in the left eye. On the 3rd day, the spherical equivalent was -11.0D in the right eye and -10.0D in the left eye and progressively decreased to -2.0D both eyes by the 12th hospital day. The mean corneal power was 39.8D in the right eye and 39.9D in the left eye on the 2nd hospital day and decreased to 38.8D in the right eye and 38.9D in the left eye by the 12th hospital day. The axial length change was not parallel with myopic changes. The anterior chamber depth was 2.14 mm in the right eye and 1.94 mm in the left eye on the 3rd hospital day and increased to 2.96 mm in the right eye and 2.84 mm in the left eye by the 12th hospital day. Under cycloplegic refraction, ciliary spasm was not evident. The bulbar conjunctivas were markedly chemotic on the 3rd hospital day, but after systemic steroid therapy the chemosis subsided and the conjunctivas became normal by the 12th hospital day. The patient was diagnosed with systemic lupus erythematosus and after medical treatment, was discharged from the hospital.
Adult ; Anterior Chamber ; Conjunctiva ; Edema ; Emergencies ; Emmetropia ; Female ; Fever ; Humans ; Keratomileusis, Laser In Situ ; Lupus Erythematosus, Systemic* ; Myopia* ; Spasm ; Visual Acuity

BACKGROUND: A policy development research project entitled "Feasibility study and development of clinical pathology laboratory inspection and accreditation system and its impact" was funded by the Ministry of Health and Welfare, Republic of Korea in 1998 to standardize and improve laboratory performances, hence to accomplish cost effectiveness of laboratory testing throughout the country. METHODS: The authors developed applicable inspection standards including 1) qualification and the role of laboratory director, 2) quality control and quality improvement, 3) facility and safety, and 4) inspection application requirements and detailed checklists for each laboratory discipline were developed accordingly. The College of American Pathologists Inspection and Accreditation Program was used as the model. Checklists for laboratory areas contain questionnaires with corresponding scores. The score is assigned from 2 to 4 according to the impact of the question to the outcome of the test. Checklists are for laboratory management (203 questions), hematology (146), routine chemistry (126), special chemistry (198), urinalysis (85), microbiology (282), immunology and serology (70), blood bank (246), HLA laboratory (117), flow cytometry (102), cytogenetics (137), molecular biology (232), and independent laboratory (542). The philosophy involved in the program was fairness, consistency, courteousness, consultation, and providing guidelines for future developments. Experts' consensus on subject matter was obtained before checklists were in use. Cut-off for accreditation was based on a score of 80%. Three dry and four wet workshops were held to produce 69 trained inspectors. While conducting wet workshops, 2 CAP accredited university hospital laboratories and 1 non-accredited university hospital laboratory as well as 1 CAP accredited large commercial laboratory were inspected by using newly developed checklists. RESULTS: All 4 laboratories were accredited with the mean score of 94%. The most common deficiencies were lack of proper documentation on quality control, outdated reagents in use, etc. CONCLUSIONS: The laboratory I and A program was successfully tested for its feasibility and we confirmed that its nationwide implementation was ready.
Accreditation* ; Allergy and Immunology ; Blood Banks ; Checklist ; Chemistry ; Consensus ; Cost-Benefit Analysis ; Cytogenetics ; Education ; Financial Management ; Flow Cytometry ; Hematology ; Indicators and Reagents ; Korea* ; Laboratories, Hospital ; Molecular Biology ; Pathology, Clinical* ; Philosophy ; Policy Making ; Quality Control ; Quality Improvement ; Republic of Korea ; Urinalysis ; Surveys and Questionnaires

BACKGROUND: TNF-alpha is related to the generation of lung fibrosis in patients with UIP. The precise mechanism leading to lung fibrosis by TNF-alpha is unknown. However, the activation of a transcription factor like AP-1(down stream of c-jun N-terminal kinase, JNK) by TNF-alpha may be related to the induction of fibrogenic cytokines like PDGF or IGF-I. Furthermore, JNK was reported to be activated in the radiation-in-duced lung fibrosis model. This study examined JNK activity in patients with UIP. METHODS: The expression of phosphorous JNK(p-JNK), macrophage/moncoyte specific markers, CD68, and cytokeratin was evaluated by immunohistochemical (IHC) staining of lung tissues from patients with UIP and lung cancer. An in vitro kinase assay was performed with alveolar macrophages obtained by a bronchollung cancer. An in vitro kinase assay was performed with alvolar macrophages obrtained by a bronchol avleolar lavage from patients with UIP and healthy persons as the control. RESULTS: The IHC stain showed that p-JNK is expressed in the almost all of the alveolar macrophages and smooth muscle cells in patients with UIP. In case of the normal areas of the lung from patients with lung cancer, the alveolar macrophages showed little p-JNK expression. Interestingly, increased JNK activity was not found in the in vitro kinase assay of the alveolar macrophages obtained from both patients with UIP and healthy persons as the control. Furthermore, 10 ng/ml of TNF-alpha failed to increase the JNK activity of the alveolar macrophages in both patients with UIP and healthy people. CONCLUSION: The JNK was activated constitutionally in patients with UIP. However, the role of JNK in the pathogenesis of lung fibrosis needs to be clarified.
Constitution and Bylaws ; Cytokines ; Fibrosis ; Humans ; Insulin-Like Growth Factor I ; JNK Mitogen-Activated Protein Kinases* ; Keratins ; Lung ; Lung Neoplasms ; Macrophages ; Macrophages, Alveolar ; Myocytes, Smooth Muscle ; Phosphotransferases ; Rivers ; Therapeutic Irrigation ; Transcription Factors ; Tumor Necrosis Factor-alpha

We experienced 150 cases of spontaneous intracerebral hematoma which were confirmed by CT scan in Gang Nam Sacred Heart Hospital from November 1980 to October 1982. The analysis is based on 110 patients with primary intracerebral hematoma on whom operation was performed in 44 cases and conservative treatment was done in 66 cases. The CT scan of brain allows the clinical diagnosis of intracerebral hematom, and size, location, extension, ventricular penetration and evolution of hemorrhage are accurately portrayed. The results of the treatment were affected by conscious level, location and volume of hematoma, ventricular penetration and blood pressure. The operative treatment was better than conservative management in followings : 1. semicomatose and drowsy mental state, 2. subcortical hemorrhage, 3. more than 20 cc in volume, 4. progressively deteriorating neurological function and consciousness. We have obtained the best results in operating cases between 4th and 7th day after the stroke.
Blood Pressure ; Brain ; Consciousness ; Diagnosis ; Heart ; Hematoma* ; Hemorrhage ; Humans ; Stroke ; Tomography, X-Ray Computed

We experienced 150 cases of spontaneous intracerebral hematoma which were confirmed by CT scan in Gang Nam Sacred Heart Hospital from November 1980 to October 1982. The analysis is based on 110 patients with primary intracerebral hematoma on whom operation was performed in 44 cases and conservative treatment was done in 66 cases. The CT scan of brain allows the clinical diagnosis of intracerebral hematom, and size, location, extension, ventricular penetration and evolution of hemorrhage are accurately portrayed. The results of the treatment were affected by conscious level, location and volume of hematoma, ventricular penetration and blood pressure. The operative treatment was better than conservative management in followings : 1. semicomatose and drowsy mental state, 2. subcortical hemorrhage, 3. more than 20 cc in volume, 4. progressively deteriorating neurological function and consciousness. We have obtained the best results in operating cases between 4th and 7th day after the stroke.
Blood Pressure ; Brain ; Consciousness ; Diagnosis ; Heart ; Hematoma* ; Hemorrhage ; Humans ; Stroke ; Tomography, X-Ray Computed

BACKGROUND: The Korean Society of Laboratory Medicine (KSLM) Laboratory Inspection and Accreditation Program (IAP) has been developed after one year of study supported by a research grant from the Ministry of Health and Welfare (MOHW) of the Republic of Korea from June 1998 to May 1999 to assess objectively the quality of laboratory work and assist the laboratories in improving the quality of their work. The IAP is based on peer review and voluntary participation. The IAP has been continuously improved since the first laboratory inspection began in May 1999 and it was soon expanded nationwide. The improvement was made by updating the inspection checklists to reflect feedback from inspection activities and holding frequent inspectors training workshops. This paper describes the progress and outcome of the IAP. METHODS: The IAP has been implemented nationwide through the following steps: 1) preliminary review of application papers including laboratory quality control policies and external proficiency survey results, as well as on-site inspection by inspectors; 2) addition of newly approved "Inpatient Interpretive Summary Report"checklist (IISR); 3) inspectors training workshop for the "IISR"checklist; 4) continuation of the IAP for all checklist areas including "IISR"; and 5) the first revision of checklists. RESULTS: One hundred nineteen laboratories were accredited during the first year of the IAP. Due to the implementation of the MOHW approved health insurance reimbursement item for laboratory physicians, the "IISR"checklist was created. The mean score of the laboratory inspection results was 92.8 and hospital laboratories showed a higher score on routine testing areas, however, commercial reference laboratories showed a better score on special testing areas. The checklists were revised according to the feedback from the first round of inspections. CONCLUSIONS: The nationwide implementation of the KSLM laboratory IAP was accomplished through this study. The IAP appears to have provided a firm basis for the improvement of quality and efficiency of clinical laboratories in the country.
Accreditation* ; Checklist ; Education ; Financing, Organized ; Insurance, Health, Reimbursement ; Korea ; Laboratories, Hospital ; Peer Review ; Quality Control ; Republic of Korea

BACKGROUND: The Korean Society of Laboratory Medicine (KSLM) Laboratory Inspection and Accreditation Program (IAP) has been developed after one year of study supported by a research grant from the Ministry of Health and Welfare (MOHW) of the Republic of Korea from June 1998 to May 1999 to assess objectively the quality of laboratory work and assist the laboratories in improving the quality of their work. The IAP is based on peer review and voluntary participation. The IAP has been continuously improved since the first laboratory inspection began in May 1999 and it was soon expanded nationwide. The improvement was made by updating the inspection checklists to reflect feedback from inspection activities and holding frequent inspectors training workshops. This paper describes the progress and outcome of the IAP. METHODS: The IAP has been implemented nationwide through the following steps: 1) preliminary review of application papers including laboratory quality control policies and external proficiency survey results, as well as on-site inspection by inspectors; 2) addition of newly approved "Inpatient Interpretive Summary Report"checklist (IISR); 3) inspectors training workshop for the "IISR"checklist; 4) continuation of the IAP for all checklist areas including "IISR"; and 5) the first revision of checklists. RESULTS: One hundred nineteen laboratories were accredited during the first year of the IAP. Due to the implementation of the MOHW approved health insurance reimbursement item for laboratory physicians, the "IISR"checklist was created. The mean score of the laboratory inspection results was 92.8 and hospital laboratories showed a higher score on routine testing areas, however, commercial reference laboratories showed a better score on special testing areas. The checklists were revised according to the feedback from the first round of inspections. CONCLUSIONS: The nationwide implementation of the KSLM laboratory IAP was accomplished through this study. The IAP appears to have provided a firm basis for the improvement of quality and efficiency of clinical laboratories in the country.
Accreditation* ; Checklist ; Education ; Financing, Organized ; Insurance, Health, Reimbursement ; Korea ; Laboratories, Hospital ; Peer Review ; Quality Control ; Republic of Korea

BACKGROUND: Dexmedetomidine has a sedative analgesic property without respiratory depression. This study evaluated the efficacy of dexmedetomidine as an appropriate sedative drug for monitored anesthesia care (MAC) in outpatients undergoing cataract surgery on both eyes compared with combination of propofol and alfentanil. METHODS: Thirty-one eligible patients were randomly divided into two groups on the first operation day. Dexmedetomidine was administered in group D at 0.6 microg/kg/h, and propofol and alfentanil was infused concomitantly in group P at a rate of 2 mg/kg/h and 20 microg/kg/h, respectively. Sedation was titrated at Ramsay sedation score 3. Iowa satisfaction with anesthesia scale (ISAS) of the patients was evaluated postoperatively. Systolic blood pressure (SBP), heart rate (HR), respiration rate (RR), and peripheral oxygen saturation (SpO2) were recorded throughout the surgery. For the second operation, the group assignments were exchanged. RESULTS: Postoperative ISAS was 50.3 (6.2) in group D and 42.7 (8.7) in group P, which was statistically significant (P < 0.001). SBP was significantly lower in group D compared with group P from the beginning of the operation. HR, RR, and SpO2 were comparable between the two groups. There were 8 cases (25.8%) of hypertension in group P, and 1 case (3.2%) in group D (P < 0.05). In contrast, 1 case (3.2%) of hypotension and 1 case (3.2%) of bradycardia occurred in group D. CONCLUSIONS: Compared with the combined use of propofol and alfentanil, dexmedetomidine could be used appropriately for MAC in cataract surgery with better satisfaction from the patients and a more stable cardiovascular state.
Alfentanil ; Anesthesia ; Blood Pressure ; Bradycardia ; Cataract ; Dexmedetomidine ; Eye ; Heart Rate ; Humans ; Hypertension ; Hypotension ; Iowa ; Outpatients ; Oxygen ; Propofol ; Respiratory Insufficiency ; Respiratory Rate