Objective: This study aimed to develop texture-modified soups and classify them based on the International Dysphagia Diet Standardization (IDDSI) and National Dysphagia Diet (NDD) criteria. Methods: Ten soups were selected, and a xanthan gum-based thickener was added to adjust their viscosity. Flow tests with a 10 ml syringe and viscosity measurements using a rheometer were carried out according to the IDDSI and NDD criteria. Results: The addition of 1 g of thickener to the selected commercial soups resulted in different viscosity levels depending on the soup type. Under the IDDSI framework, seven soups (R SMG, BMG, KHG, SLT, B SUG, BGG, DGT) were categorized as level 1, two soups (B MYG, ADG) as level 2, and one soup (R DJJ) as level 3. As per NDD guidelines, seven soups (R SMG, BMG, KHG, SLT, B SUG, BGG, DGT) were classified as Nectar-like and three soups (R DJJ, B MYG, ADG) as Honey-like. However, the addition of 2 g of thickener decreased the fluidity of the soups, with two soups (R SMG, SLT) being classified as level 2 and eight soups (R BMG, DJJ, KHG, B SUG, MYG, ADG, BGG, DGT) as level 3 under the IDDSI criteria. Meanwhile, all soups were classified as Honey-like under the NDD criteria. Conclusion The viscosity was different due to the varying compositions of guk/tang/jjigae, the concentration of the thickener, and time. Swallowing standardsands and other guidelines applicable specifically to Korean-food for dysphagia patients need to be developed in a further study.

Onychomycosis is a relatively common fungal infection. Treatment modalities include oral and topical antifungals, surgical treatment or a combination of these therapies. But treatment failure is common and oral drugs may cause toxicity and potential drug interactions. Currently, there are few publications about the treatment of onychomycosis using photodynamic therapy or laser therapy. We report two cases of toenail onychomycosis treated by 1,064 nm Nd:YAG laser.
Drug Interactions ; Laser Therapy ; Nails ; Onychomycosis ; Photochemotherapy ; Treatment Failure

BACKGROUNDS/AIMS: The prognosis of hepatic resection for hepatocellular carcinoma (HCC) in patients with cirrhosis is worse than in those without cirrhosis. In Korea, the hepatitis B virus prevalence rate is higher than in other countries. Therefore, we investigated patients' clinicopathologic and metabolic factors that affect the postoperative outcomes of hepatic resection for HCC in our hospital in Korea. METHODS: From August 2000 to December 2012, 171 HCC patients underwent hepatic resections at our institution. Two operative mortality cases and two short-term follow up cases were excluded. Data was collected from a retrospective chart review. There were 133 males (79.6%) and 34 females (20.3%), with a mean age of 58.2+/-10.2 years (range, 22-81 years), and the relationship between clinicopathologic and metabolic factors and the prognosis of patients with HCC undergoing hepatic resection were evaluated by univariate and multivariate analysis. RESULTS: Hypertension, major surgery, perioperative transfusion, resection with radiofrequency ablation (RFA) or cryoablation, and resection margin were risk factors for overall survival, and hypertension, albumin, resection with RFA or cryoablation, perioperative transfusion, and tumor size were risk factors for disease-free survival. CONCLUSIONS: We found that hypertension, perioperative transfusion, and resection with RFA or cryoablation were risk factors for both disease-free and overall survival after hepatic resection in HCC patients. Further study is required to clarify the influence of metabolic and other clinicopathologic factors on the prognosis of HCC.
Carcinoma, Hepatocellular* ; Catheter Ablation ; Cryosurgery ; Disease-Free Survival ; Female ; Fibrosis ; Follow-Up Studies ; Hepatitis B virus ; Humans ; Hypertension ; Korea ; Male ; Mortality ; Multivariate Analysis ; Prevalence ; Prognosis* ; Retrospective Studies ; Risk Factors

No abstract available.
Steatocystoma Multiplex

OBJECTIVE: It is still the important subject that 3D visualizing of medical images to help patient diagnose. There were many challenges for fast 3D visualization but it has some limitations that volume rendering without high price's hardware and software. Some techniques through the web were suggested to construct high quality's 3D visualization even though it was an only poor personal computer. This technique could share the volume rendering board and diagnose 3D images together. However there are some problems to construct web based 3D visualization. These are network delay, optimized visualization and security etc. The purpose of this paper was to visualize and control the 3D medical image having a high quality on the web. METHODS: To construct this system, we used mainly three tools which were VolumePro1000 board, WMV9(Windows Media Video 9 Codec) and socket functions based on TCP(Transmission Control Protocol). VolumePro1000 board could calculate quickly heavy matrixes of 3D images using phong's shading and shear-warp factorization. WMV9 was able to compress efficiently live images and to apply image streaming technique. Socket functions based on TCP transmitted messages to control the 3D images. RESULTS: We developed 3D visualization system and evaluated about image qualities and transmission conditions of different compression rates on unfixed network condition. CONCLUSION: It was big advantages that WMV9 encoder could decode automatically in many platforms(desk top, PDA, notebook, cellular phone, etc) without installing specific decoding programs if they only have Windows Media player. We expect 3D visualization system to be utilized various biomedical fields such as IIGS(Interactive Image Guided Surgery), CAD(Computer Aided Diagnosis) and Tele-medicine technologies.
Cellular Phone ; Humans ; Microcomputers ; Rivers*

OBJECTIVES: To assess the degree of quality improvement (QI) implementation and to identify its associated factors. METHODS: A mailed questionnaire survey of the QI staffs at hospitals with 400 beds or more was conducted between September 15 and October 30, 2000. Of the 108 hospitals eligible for inclusion in our study, 79 participated, yielding a response rate of 73.1%. After excluding 12 hospitals that did not perform any QI activities, 117 responses from 67 hospitals were used in our analysis. The degree of QI implementation was measured using the Malcolm Baldrige National Quality Award Criteria (MBNQAC). Factors evaluated for association with the degree of QI implementation were cultural, technical, strategic, and structural factors of the hospitals. RESULTS: The average QI implementation score across the 7 dimensions of MBNQAC was 3.34 on a 5-point scale, with the highest score for the area of customer satisfaction (3.88) followed by information and analysis (3.59) and quality management (3.35). The results of regression analysis showed that hospitals with a etter information system (p<0.05) and using scientific and systematic problem solving approach (p<0.01) tended to perform a higher degree of QI implementation. While statistically insignificant, positive associations were observed for the factors of group or developmental culture, the degree of employee empowerment, and the use of prospective strategy. CONCLUSIONS: It appears that the most important factors contributing to active implementation of QI in Korean hospitals were the use of scientific skills in decision making, and having a quality information system to produce precise and valid information.
Awards and Prizes ; Decision Making ; Information Systems ; Postal Service ; Power (Psychology) ; Problem Solving ; Qi ; Quality Improvement* ; Questionnaires

CT and MR appearance of the brain in three children with ornithine transcarbamylase (OTC) deficiency are described. They showed clinical signs of vomiting and convulsion and were diagnosed by measurement of plasma ammonium, amino acids, acid-base balance, and urinary orotic acid levels. CT and MR were performed within one month from the onset of the symptom. CT and MRI demonstrated brain swelling with small ventricles and diffuse low density of white matter, which indicated cerebral hypoperfusion secondary to elevated intracranial pressure. With more prolonged survival hyperammonemia may cause cerebral atrophy. CT and MR appearance in these cases resembled a hypoxic brain damage and this finding should be included in the differential diagnosis.
Acid-Base Equilibrium ; Amino Acids ; Ammonium Compounds ; Atrophy ; Brain ; Brain Edema ; Child ; Diagnosis, Differential ; Humans ; Hyperammonemia* ; Hypoxia, Brain ; Intracranial Hypertension ; Magnetic Resonance Imaging* ; Ornithine Carbamoyltransferase Deficiency Disease* ; Ornithine Carbamoyltransferase* ; Ornithine* ; Orotic Acid ; Plasma ; Seizures ; Vomiting

No abstract available.
Adiponectin ; Caspase 14 ; Humans ; Keratinocytes

Objective: Thickening agents used in dysphagia diets to adjust the viscosity of foods adversely affect the inherent food flavors and colors. Chopped and ground foods have unfamiliar flavors, colors and textures, causing a loss of appetite. Therefore, this study aimed to develop a savory and easy-to-make dysphagia diet without changing the appearance and taste of foods, and evaluate the suitability of the newly developed diet for patients with dysphagia. Methods: Twenty participants aged 55-85 years (8 patients with dysphagia and 12 healthy elderly) were recruited.The diet consisted of fried rice, hamburger steak, and soybean paste soup, where the solid foods were categorized as International Dysphagia Diet Standardisation Initiative (IDDSI) Level 5 (Minced and Moist), and the liquid foods were categorized as IDDSI Level 2 (Mildly Thick). To develop the dysphagia diet, textural modifications to the ingredients and viscosity adjustments were applied. A sensory evaluation was conducted by the panel to measure the extent of chewing, swallowing, adhesiveness, choking, and overall flavor and preference. Results: No significant differences in textural properties, such as chewing, swallowing, adhesiveness and choking, were observed between the control and patient groups, but the flavor and preferences in the patient group were statistically significant. Conclusion The modified and newly designed dysphagia foods positively impacted easy swallowing for patients with dysphagia. Therefore, customized dysphagia foods should be considered in terms of flavor-enhancement to provide tailored diets for patients with dysphagia.

Background: Botulinum toxin type A (BTX-A) injection is being widely used off-label for muscular hypertrophy, including deltoid muscle hypertrophy. However, very few studies have evaluated the optimal dosage and its clinical response. Objective: This study aimed to assess the efficacy and safety of different doses of Prabotulinum toxin A (PBoNT) for treating deltoid muscle hypertrophy. Methods: Twelve particiapants with bilateral deltoid muscle hypertrophy were enrolled and randomly received either 16 U or 32 U of PBoNT. In each participant, the same dose was administered to both deltoid muscles. Both participants and evaluators were blinded. Deltoid muscle thickness and upper arm circumference were measured on day 0, and weeks 2, 4, and 12 after the PBoNT injection. Results: Upper arm circumference significantly decreased in both groups; however, deltoid muscle thickness was reduced in the 16 U group only. No major complications were reported in both groups. However, a few minor complications were reported in the 16 U injection group. Conclusion Both 16 U and 32 U of PBoNT intramuscular injections are safe and effective in treating deltoid hypertrophy.