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- 저자 : Sheng-Feng Sung (검색결과 4 건)
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Lin Feng-Sheng,Shih Po-Yuan,Sung Chao-Hsien,Chou Wei-Han,Wu Chun-Yu 대한마취통증의학회 2024 Korean Journal of Anesthesiology Vol.77 No.1
Background: The bispectral index (BIS) may be unreliable to gauge anesthetic depth when dexmedetomidine is administered. By comparison, the electroencephalogram (EEG) spectrogram enables the visualization of the brain response during anesthesia and may prevent unnecessary anesthetic consumption. Methods: This retrospective study included 140 adult patients undergoing elective craniotomy who received total intravenous anesthesia using a combination of propofol and dexmedetomidine infusions. Patients were equally matched to the spectrogram group (maintaining the robust EEG alpha power during surgery) or the index group (maintaining the BIS score between 40 and 60 during surgery) based on the propensity score of age and surgical type. The primary outcome was the propofol dose. Secondary outcome was the postoperative neurological profile.Results: Patients in the spectrogram group received significantly less propofol (1585 ± 581 vs. 2314 ± 810 mg, P < 0.001). Fewer patients in the spectrogram group exhibited delayed emergence (1.4% vs. 11.4%, P = 0.033). The postoperative delirium profile was similar between the groups (profile P = 0.227). Patients in the spectrogram group exhibited better in-hospital Barthel’s index scores changes (admission state: 83.6 ± 27.6 vs. 91.6 ± 17.1; discharge state: 86.4 ± 24.3 vs. 85.1 ± 21.5; group–time interaction P = 0.008). However, the incidence of postoperative neurological complications was similar between the groups.Conclusions: EEG spectrogram–guided anesthesia prevents unnecessary anesthetic consumption during elective craniotomy. This may also prevent delayed emergence and improve postoperative Barthel index scores.
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Registry-based stroke research in Taiwan: past and future
Cheng-Yang Hsieh,Darren Philbert Wu3,,Sheng-Feng Sung 한국역학회 2018 Epidemiology and Health Vol.40 No.-
Stroke registries are observational databases focusing on the clinical information and outcomes of stroke patients. They play an important role in the cycle of quality improvement. Registry data are collected from real-world experiences of stroke care and are suitable for measuring quality of care. By exposing inadequacies in performance measures of stroke care, research from stroke registries has changed how we manage stroke patients in Taiwan. With the success of various quality improvement campaigns, mortality from stroke and recurrence of stroke have decreased in the past decade. After the implementation of a nationwide stroke registry, researchers have been creatively expanding how they use and collect registry data for research. Through the use of the nationwide stroke registry as a common data model, researchers from many hospitals have built their own stroke registries with extended data elements to meet the needs of research. In collaboration with information technology professionals, stroke registry systems have changed from web-based, manual submission systems to automated fill-in systems in some hospitals. Furthermore, record linkage between stroke registries and administrative claims databases or other existing databases has widened the utility of registry data in research. Using stroke registry data as the reference standard, researchers have validated several algorithms for ascertaining the diagnosis of stroke and its risk factors from claims data, and have also developed a claims-based index to estimate stroke severity. By making better use of registry data, we believe that we will provide better care to patients with stroke.
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Moon, Woo Kyung,Chang, Jie-Fan,Lo, Chung-Ming,Chang, Jung Min,Lee, Su Hyun,Shin, Sung Ui,Huang, Chiun-Sheng,Chang, Ruey-Feng Elsevier 2018 Computer methods and programs in biomedicine Vol.154 No.-
<P><B>Abstract</B></P> <P><B>Background and Objective</B></P> <P>Breast density at mammography has been used as markers of breast cancer risk. However, newly introduced tomosynthesis and computer-aided quantitative method could provide more reliable breast density evaluation.</P> <P><B>Methods</B></P> <P>In the experiment, 98 tomosynthesis image volumes were obtained from 98 women. For each case, an automatic skin removal was used and followed by a fuzzy c-mean (FCM) classifier which separated the fibroglandular tissues from other tissues in breast area. Finally, percent of breast density and breast volume were calculated and the results were compared with MRI. In addition, the percent of breast density and breast area of digital mammography calculated using the software Cumulus (University of Toronto, Toronto, ON, Canada.) were also compared with 3-D modalities.</P> <P><B>Results</B></P> <P>Percent of breast density and breast volume, which were computed from tomosynthesis, MRI and digital mammography were 17.37% ± 4.39% and 607.12 cm<SUP>3</SUP> ± 323.01 cm<SUP>3</SUP>, 20.3% ± 8.6% and 537.59 cm<SUP>3</SUP> ± 287.74 cm<SUP>3</SUP>, and 12.03% ± 4.08%, respectively. There were significant correlations on breast density as well as volume between tomosynthesis and MRI (<I>R</I> = 0.482 and <I>R</I> = 0.805), tomosynthesis and breast density with breast area of digital mammography (<I>R</I> = 0.789 and <I>R</I> = 0.877), and MRI and breast density with breast area of digital mammography (<I>R</I> = 0.482 and <I>R</I> = 0.857) (all <I>P</I> values < .001).</P> <P><B>Conclusions</B></P> <P>Breast density and breast volume evaluated from tomosynthesis, MRI and breast density and breast area of digital mammographic images have significant correlations and indicate that tomosynthesis could provide useful 3-D information on breast density through proposed method.</P> <P><B>Highlights</B></P> <P> <UL> <LI> We proposed a quantitative method to estimate breast density and compared tomosynthesis with MRI and digital mammography. </LI> <LI> An automatic skin removal was adopted and a FCM classifier was used to separate the fibroglandular tissues from breast area. </LI> <LI> There were significant correlations between tomosynthesis with MRI and with digital mammography values < . </LI> <LI> Tomosynthesis could provide useful 3-D information on breast density through proposed method. </LI> <LI> We discovered and solved the problem of the different expression of aggregated fibroglandular tissue in different modalities. </LI> </UL> </P>
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