The Use of MR Perfusion Imaging in the Evaluation of Tumor Progression in Gliomas

Snelling, Brian,Shah, Ashish H.,Buttrick, Simon,Benveniste, Ronald The Korean Neurosurgical Society 2017 Journal of Korean neurosurgical society Vol.60 No.1

Objective : Diagnosing tumor progression and pseudoprogression remains challenging for many clinicians. Accurate recognition of these findings remains paramount given necessity of prompt treatment. However, no consensus has been reached on the optimal technique to discriminate tumor progression. We sought to investigate the role of magnetic resonance perfusion (MRP) to evaluate tumor progression in glioma patients. Methods : An institutional retrospective review of glioma patients undergoing MRP with concurrent clinical follow up visit was performed. MRP was evaluated in its ability to predict tumor progression, defined clinically or radiographically, at concurrent clinical visit and at follow up visit. The data was then analyzed based on glioma grade and subtype. Resusts : A total of 337 scans and associated clinical visits were reviewed from 64 patients. Sensitivity, specificity, positive and negative predictive value were reported for each tumor subtype and grade. The sensitivity and specificity for high-grade glioma were 60.8% and 87.8% respectively, compared to low-grade glioma which were 85.7% and 89.0% respectively. The value of MRP to assess future tumor progression within 90 days was 46.9% (sensitivity) and 85.0% (specificity). Conclusion : Based on our retrospective review, we concluded that adjunct imaging modalities such as MRP are necessary to help diagnose clinical disease progression. However, there is no clear role for stand-alone surveillance MRP imaging in glioma patients especially to predict future tumor progression. It is best used as an adjunctive measure in patients in whom progression is suspected either clinically or radiographically.

Treatment of Cerebral Vasospasm in an Infant Using a Modified Dotter Technique

Brian M. Snelling,Eric C. Peterson,Samir Sur,Sumedh S. Shah 대한뇌혈관외과학회 2017 Journal of Cerebrovascular and Endovascular Neuros Vol.19 No.1

An 8-month old female presented with spontaneous subarachnoid hemorrhage and was treated successfully with endovascular coil embolization of the ruptured aneurysm. Transcranial Doppler ultrasound performed four days later demonstrated middle cerebral artery (MCA) velocities greater than 350 cm/sec on the right and greater than 200 cm/sec on the left, despite medical management. The patient demonstrated no focal neurological deficits, though examination was limited by our patient's sedation and intubation. Angiography revealed severe vasospasm of the supraclinoid internal carotid and MCA territories, bilaterally. The vasospasm was refractory to the administration of intra-arterial verapamil. Balloon angioplasty was attempted, but the device could not be advanced safely due to the small size of the patient's vessels and the stiffness of the device. A microcatheter (0.0165'' diameter) was advanced over a J-shaped soft microwire (0.014'' diameter) to perform mechanical angioplasty in the internal carotid artery and MCA vessels bilaterally. Dramatic improvement was seen angiographically and on transcranial Doppler, and no complications were seen.

기존醫藥品의 새로운 適應症

Snell, Eric·s. 藥業新聞社 1986 (月刊) 醫藥情報 Vol.1986 No.12

중도 장애 학생의 상징적 및 비상징적 보완ㆍ대체 의사소통에 관한 최근 중재 연구 검토

Snell, Martha E.,Hoover, Kathy 국립특수교육원 2003 국제세미나 자료집 Vol.- No.10

본 논문에서는 1997년과 2003년 사이 영어로 출간된 중도장애 학생을 위한 상징적 및 비상징적 보완·대체 의사소통(AAC)과 관련한 중재 연구를 학술적으로 검토한 데이터베이스 에 대해 설명하고자 한다. 중등도에서 최중도에 이르는 정신지체, 자폐증 및 이러한 범주에 속하는 기타 장애가 있는 사람들을 가리켜 중도 장애인이라고 규정한다. 데이터베이스의 모든 연구 자료는 단일 주제 실험 구조와 정의된 교육적 중재, AAC 반응에 대한 신뢰할 수 있는 종속적인 평가 방법 등을 사용하였다. 데이터베이스 검토를 통한 효과적인 중재 전략을 이용하여 교사들은 학생들의 의사소통 능력은 물른 일반화를 촉진시킬 수 있는 가능성을 높이고 자연주의적인 접근 및 통합교육에 융화될 수 있는 기회를 제공할 수 있다.

A Review fo Recent Intervention Research on Nonsymbolic and Symbolic Augmentative and Alternative Communication with Others by Students who have Severe Disabilities

Snell, Martha E.,Hoover, Kathy 국립특수교육원 2003 국제세미나 자료집 Vol.- No.10

This paper describes the database of current peer reviewed intervention research on nonsymbolic and symbolic augmentative and alternative communication (AAC) for school-aged individuals with severe disabilities published in English between 1997 and 2003. Those with severe disabilities were defined to include individuals with moderate to profound mental retardation, autism, and other labels that fall into these categories. All studies in the database used single subject experimental design, a defined educational intervention, and reliable dependent measures of AAC responses. The effective intervention strategies resulting from this review were discussed in terms of their use by teachers with their students to advance communication skills, their likelihood of promoting generalization, and their compatibility with naturalistic approaches and inclusion.

Eyes on the World: Using Global Issues in the EFL Classroom

Robert Snell 부산 외국어 대학교 2006 外大論叢 Vol.32 No.-

Tennessee Williams is one of the most important playwrights in the 20th century American Theatre. He chose women as main characters in many plays written from 1945 to 961. His attitude toward female characters in his major plays was very different in comparison to other playwrights. This unusual feminity was rooted in his unfortunate childhood, he could depict the women's condition in the male dominated society exceptionally better than any other male writers. His feministic plays show that patriarchism subordinates the female to the male and defines the female as an inferior being. He has often revealed the oppressions that women suffer from and exposed the women's isolation from the harsh patriarchy. However, as time passed by, his new attitude concerning life made it possible to create the female characters who struggle desperately against the established patriarchal society. The purpose of this thesis is to study of the women's self-recognition with Tennessee Williams' major plays of The Glass Menagerie(1944), A Streetcar Named Desire(1947). In The Glass Menagerie, Williams describes Amanda and Laura as a victim of patriarchy capitalism. Amanda, who fails to make Laura independent by pursuing a career, is frustrated again when she finds Laura can't be a chosen girl by a man. In the end, the contradiction of patriarchy drives Amanda and Laura to despair and desperation. Blanche conflicts with Stanley who Symbolizes patriarchy in A Streetcar Named Desire. She resists being treated as subordinate being to men and challenges Stanley's repression desperately. However, Blanche who doesn't attain financial self-existence is blamed as a prostitute and punished by patriarchy's sexual violence.

How has 2020 Covid 19 Impacted Smart City Development

Julie Snell 국토교통부, 국토교통과학기술진흥원 2021 스마트시티 탑 아젠다(Smart City Top Agenda) Vol.1 No.E

Reversible Adrenal Insufficiency Induced by Ketoconazole

Stuart Tucker, W.,Snell, Barbara B.,Island, Donald P.,Gregg, Clark R. MediMedia Korea 1986 JAMA-Korea Vol.1 No.6

2020년 코로나19는 스마트시티 개발에 어떤 영향을 미쳤는가?

줄리 스넬(Julie Snell) 국토교통부, 국토교통과학기술진흥원 2021 스마트시티 탑 아젠다(Smart City Top Agenda) Vol.1 No.1

언어장애인을 위한 보완·대체의사소통용 어휘· 상징체계 수립에 관한 문헌연구

박은혜(Eun Hye Park),Martha Snell, Jane Allaire 한국언어청각임상학회 2004 Communication Sciences and Disorders Vol.9 No.3

국내에서 중도의 의사소통장애학생에게 보완?대체의사소통 체계를 사용하는 경우가 점차로 증가하는데 비하여, 실제로 이를 위해 적합한 어휘나 상징체계를 선택하는데 필요한 진단 과정이나 고려할 변인들에 대한 기초연구는 많이 이루어지지 않았다. 이에 본 논문은 먼저 최근 AAC 분야에서 많이 사용되는 세 가지 진단 모델(참여 모델, 사회-의사소통 필터 모델, 사회연결망 모델)을 분석하여 공통된 진단 개념을 파악하고, 관련 문헌을 통하여 어휘선정 및 상징체계 선택에 대하여 보다 구체적으로 알아보았다. 마지막으로 이를 토대로 우리나라에서 AAC를 사용하기 위해 어휘와 상징체계를 개발하는데 필요한 진단의 기본적 틀을 잡아보고자 하였다. 개인의 언어, 신체, 인지 능력 외에도 의사소통에 관련된 상황적 변인의 고려와 국내에서 사용가능한 다양한 상징체계에 대한 인식 및 개발의 필요성 등이 논의되었다. Increasing numbers of studies have recently been reported from Korea regarding AAC application. However, relatively little information about vocabulary, symbol selection issues and procedures have been reported. This study tried to suggest a basic framework that can be used for developing future AAC assessment protocol. First, three important AAC assessment models were reviewed: The participation model, the social filter model, and the social network model. The common concepts of those assessment models were then extracted: The assessment of the specific abilities of the AAC user and the ecological variables, and inclusion and assessment consideration for beginning communicators(or users with severe disabilities) were done. Second, specific issues and procedures of AAC vocabulary and symbol selection were studied by reviewing related literature. Concepts such as coverage vocabulary, developmental vocabulary, symbol iconicity, and symbol transparency are explained. Third, the basic AAC vocabulary and symbol assessment frame work for Korean special educators and speech therapists are discussed, and this is based on the previous AAC assessment concepts that we reviewed. Future research on the development of more specific and practical AAC assessment protocol is suggested.