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Pharmacokinetic Profiles of Isoniazid and Rifampicin in Korean Tuberculosis Patients (한국인 결핵환자에서 Isoniazid와 Rifampicin의 약동학)

  • Ahn, Seok-Jin;Park, Sang-Joon;Kang, Kyeong-Woo;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.;Cha, Hee-Soo;Kim, Myoung-Min;Choi, Kyung-Eob
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.442-450
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    • 1999
  • Background : Isoniazid(INH) and rifampicin(RFP) are the most effective anti-tuberculosis drugs which make the short-course chemotherapy possible. Although prescribed dosages of INH and RFP in Korea are different from those recommended by American Thoracic Society, there has been few study about pharmacokinetic profiles of INH and RFP in Korean patients who receive INH, RFP, ethambutol(EMB) and pyrazinamide(PZA) simultaneously. Methods : Among the patients with active tuberculosis from Dec. 1997 to July 1998, we selected 17 patients. After an overnight fast, patients were given INH 300mg, RFP 450mg, EMB 800mg and PZA 1500mg daily. Blood samples for the measurement of plasma INH(n=15) and RFP(n=17) level were drawn each at 0, 0.5, 1, 1.5, 2, 4, 6, 8 and 12hrs, and urine was also collected. INH and RFP level in the plasma and the urine were measured by high-performance liquid chromatography(HPLC). Pharmacokinetic parameters such as peak serum concentration(Cmax), time to reach to peak serum concentration(Tmax), half-life, elimination rate constant(Ke), total body clearance(CLtot), nonrenal clearance(CLnr), and renal clearance(CLr) were calculated. Results : 1) Pharmacokinetic parameters of INH were as follows: Cmax; $7.63{\pm}3.20{\mu}g/ml$, Tmax; $0.73{\pm}0.22hr$, half-life; $2.12{\pm}0.84hrs$, Ke; $0.83{\pm}0.15hrs^{-1}$, CLtot; $17.54{\pm}8.89L/hr$, CLnr; $14.74{\pm}8.35L/hr$, CLr; $2.79{\pm}1.31L/hr$. 2) Pharmacokinetic parameters of RFP were as follows: Cmax; $8.93{\pm}3.98{\mu}g/ml$, Tmax; $1.76{\pm}1.13hrs$, half-life; $2.27{\pm}0.54hrs$, Ke; $0.32{\pm}0.08hrs^{-1}$, CLtot; $14.63{\pm}6.60L/hr$, CLr; $1.04{\pm}0.55L/hr$, CLnr; $13.59{\pm}6.21L/hr$. 3) While the correlation between body weight and Cmax of INH was not statistically significant (r=-0.514, p value>0.05), Cmax of RFP was significantly affected by body weight of the patients(r=-0.662, p value<0.01). Conclusion : In Korean patients with tuberculosis, 300mg of INH will be sufficient to reach the ideal peak blood level even in the patients over 50kg of body weight However, 450mg of RFP will not be the adequate dose in the patients who weigh over 50~60kg.

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The Palliative Radiation Therapy in Malignant Extra-Hepatic Biliary Obstruction (간외 폐쇄성 황달 환자에서 고식적 방사선치료의 결과)

  • Kay Chul-Seoung;Jang Hong-Suk;Kim Sung-hwan;Ryu Mi-Ryeong;Kim Yeon-Shil;Chung Su-Mi;Yoon Sei-Chul
    • Radiation Oncology Journal
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    • v.17 no.3
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    • pp.209-216
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    • 1999
  • Purpose : To evaluate the effectiveness of external radiation therapy and the prognostic factors, we retrospectively analyzed therapeutic results of malignant extrahepatic biliary obstruction (EHBO). Methods and Materials : We analyzed the results of the external radiation therapy in 59 patients of inoperable malignant EHBO who had been treated with more than 10 Gy of external radiation therapy from April 1984 to December 1990. There were 21 stomach cancer ($35.6\%$), 12 pancreas cancer ($20.3\%$), 15 extrahepatic biliary cancer ($18.0\%$) and 11 another cancer ($18.0\%$). Their pathologies were confirmed in 31 patients ($52.5\%$). They divided into 27 adenocarcinoma and 4 nonadenocarcinoma. Their chief complaints were jaundice in 47 patients ($79.7\%$) and abdominal pain in 15 patients ($49.2\%$). Twelve patients had slightly increased bilirubin level in liver function test without jaundice. We treated twenty four patients ($40.6\%$) with percutaneous transhepatic biliary drainage (PTBD) and 32 patients ($54\%$) with systemic chemotherapy (CT). We performed external radiation therapy (ERT) upto $10.8\~55.8$ Gy (median 37.8 Gy) with palliative aim. Results : Overall median survival duration was $7.80\pm1.15$ months. The response rates of jaundice were $81.8\%$ in PTBO group and $66.7\%$ in non-PTBD group without statistical significance. The improving rate of jaundice was not significantly different in decreased ratio of total bilirubin level. But abdominal pain was more decreased in CT group than non-CT group (p<0.05). The significant prognostic factors were high performance status (Karnofski Performance Status >70), total radiation dose more than 35 Gy and good response of pain after therapy. There were increased in bacterial cholagitis in PTBD group and gastrointestinal complications in CT group. Conclusion : External radiotheapy could improve jaundice and abdominal pain in malignant EHBO patients, Overall survival duration was prolonged in patients with higher performance status and patients who had been treated with more than 35 Gy of total radiation dose. In the future, we expect not only better palliative role but also the prolongation of survival of using the ERT combined with other treatment method. But to achieve certain conclusion, we need luther study consisted with many kinds of treatment methods including new technologies in RT.

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Radiation-induced Pulmonary Toxicity following Adjuvant Radiotherapy for Breast Cancer (유방암 환자에서 보조적 방사선치료 후의 폐 손상)

  • Moon, Sung-Ho;Kim, Tae-Jung;Eom, Keun-Young;Kim, Jee-Hyun;Kim, Sung-Won;Kim, Jae-Sung;Kim, In-Ah
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.109-117
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    • 2007
  • [ $\underline{Purpose}$ ]: To evaluate the incidences and potential predictive factors for symptomatic radiation pneumonitis (SRP) and radiographic pulmonary toxicity (RPT) following adjuvant radiotherapy (RT) for patients with breast cancer. A particular focus was made to correlate RPT with the dose volume histogram (DVH) parameters based on three-dimensional RT planning (3D-RTP) data. $\underline{Materials\;and\;Methods}$: From September 2003 through February 2006, 171 patients with breast cancer were treated with adjuvant RT following breast surgery. A radiation dose of 50.4 Gy was delivered with tangential photon fields on the whole breast or chest wall. A single anterior oblique photon field for supraclavicular (SCL) nodes was added if indicated. Serial follow-up chest radiographs were reviewed by a chest radiologist. Radiation Therapy Oncology Group (RTOG) toxicity criteria were used for grading SRP and a modified World Health Organization (WHO) grading system was used to evaluate RPT. The overall percentage of the ipsilateral lung volume that received ${\geq}15\;Gy\;(V_{15}),\;20\;Gy\;(V_{20})$, and $30\;Gy\;(V_{30})$ and the mean lung dose (MLD) were calculated. We divided the ipsilateral lung into two territories, and defined separate DVH parameters, i.e., $V_{15\;TNGT},\;V_{20\;TNGT},\;V_{30\;TNGT},\;MLD_{TNGT}$, and $V_{15\;SCL},\;V_{20\;SCL},\;V_{30SCL},\;MLD_{SCL}$ to assess the relationship between these parameters and RPT. $\underline{Results}$: Four patients (2.1%) developed SRP (three with grade 3 and one with grade 2, respectively). There was no significant association of SRP with clinical parameters such as, age, pre-existing lung disease, smoking, chemotherapy, hormonal therapy and regional RT. When 137 patients treated with 3D-RTP were evaluated, 13.9% developed RPT in the tangent (TNGT) territory and 49.2% of 59 patients with regional RT developed RPT in the SCL territory. Regional RT (p<0.001) and age (p=0.039) was significantly correlated with RPT. All DVH parameters except for $V_{15\;TNGT}$ showed a significant correlation with RPT (p<0.05). $MLD_{TNGT}$ was a better predictor for RPT for the TNGT territory than $V_{15\;SCL}$ for the SCL territory. $\underline{Conclusion}$: The incidence of SRP was acceptable with the RT technique that was used. Age and regional RT were significant factors to predict RPT. The DVH parameter was good predictor for RPT for the SCL territory while $MLD_{TNGT}$ was a better predictor for RPT for the TNGT territory.

Clinical Outcome after Breast Conserving Surgery and Radiation Therapy for Early Breast Cancer (초기 유방암의 유방 보존수술 후 방사선 치료 결과)

  • Cho, Heung-Lae;Kim, Cheol-Jin;Park, Sung-Kwang;Oh, Min-Kyung;Lee, Jin-Yong;Ahn, Ki-Jung
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.204-212
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    • 2008
  • Purpose: This study was performed to evaluate the disease-free survival and risk factors of recurrence in early breast cancer patients who have undergone breast conserving surgery and radiation therapy. Materials and Methods: From March 1997 to December 2002, 77 breast cancer patients who underwent breast conserving surgery and radiation therapy were reviewed retrospectively. The median follow-up time was 58.4 months (range $43.8{\sim}129.4$ months) and the mean subject age was 41 years. The frequency distribution of the different T stages, based on the tumor characteristics was 38 (49.3%) for T1, 28 (36.3%) for T2, 3 for T3, 7 for T is and 1 for an unidentified sized tumor. In addition, 52 patients (67.5%) did not have axillary lymph metastasis, whereas 14 patients (18.1%) had $1{\sim}3$ lymph node metastases and 3 (0.03%) had more than 4 lymph node metastases. The resection margin was negative in 59 patients, close (${\leq}2\;mm$) in 15, and positive in 4. All patients received radiation therapy at the intact breast using tangential fields with a subsequent electron beam boost to the tumor bed at a total dose ranging from 59.4 Gy to 66.4 Gy. Patients with more than four positive axillary lymph nodes received radiation therapy ($41.4{\sim}60.4\;Gy$) at the axillary and supraclavicular area. Chemotherapy was administered in 59 patients and tamoxifen or fareston was administered in 29 patients. Results: The 5 year overall survival and disease-free survival rates were 98.08% and 93.49%, respectively. Of the 77 patients, a total of 4 relapses (5.2%), including 1 isolated supraclavicular relapse, 1 supraclavicular relapse with synchronous multiple distant relapses, and 2 distant relapses were observed. No cases of local breast relapses were observed. Lymph node metastasis or number of metastatic lymph nodes was not found to be statistically related with a relapse (p=0.3289) nor disease-free survival (p=0.1430). Patients with positive margins had a significantly shorter disease-free survival period (p<0.0001) and higher relapse rates (p=0.0507). However, patients with close margins were at equal risk of relapse and disease-free survival as with negative margins (p=1.000). Patients younger than 40 years of age had higher relapse rates (9.3% vs. 0%) and lower disease-free survival periods, but the difference was not statistically significant (p=0.1255). The relapse rates for patients with tumors was 14% for tumor stage T2, compared to 0% for tumor stage T1 tumors (p=0.0284). A univariate analysis found that disease-free survival and relapse rates, T stage, positive resection margin and mutation of p53 were significant factors for clinical outcome. Conclusion: The results of this study have shown that breast conservation surgery and radiation therapy in early breast cancer patients has proven to be a safe treatment modality with a low relapse rate and high disease-free survival rate. The patients with a positive margin, T2 stage, and mutation of p53 are associated with statistically higher relapse rates and lower disease-free survival.

Breast Conservation Therapy Versus Mastectomy - Preliminary Results of Pattern of Failure and Survival Rate in Early Breast Cancer (조기유방암에서 유방보존치료와 유방전절제술의 치료결과 및 실패양상 비교)

  • Kim Yeon-Sil;Yoon Sei-Chul;Chung Su-Mi;Ryu Mi-Ryeong;Jung Sang-Sul;Choi Ihl-Bohng
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.115-123
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    • 2004
  • Purpose : This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy In early breast cancer. Materials and Methods : We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. in the BCT group, all patients received whole breast irradiation to a total dose of 45$\~$50 Gy/5$\~$6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1$\%$) patients in BCT and 40 (45.5$\%$) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19$\~$111 months). Log rank test was used to estimate the prognostic factors for treatment failure. Results : Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5$\%$)in the mastectomy group and 10 patients (11.8%$\%$ in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT Five patients fatted at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of S BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2$^{nd}$ primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade In the mastectomy group were risk factors for treatment fallure (p < 0.05). Concousion : Although further careful follow-up is necessary to confirm the trends evident In this serles, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.

Clinical Outcomes of Corrective Surgical Treatment for Esophageal Cancer (식도암의 외과적 근치 절제술에 대한 임상적 고찰)

  • Ryu Se Min;Jo Won Min;Mok Young Jae;Kim Hyun Koo;Cho Yang Hyun;Sohn Young-sang;Kim Hark Jei;Choi Young Ho
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.38 no.2
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    • pp.157-163
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    • 2005
  • Background: Clinical outcomes of esophageal cancer have not been satisfactory in spite of the development of surgical skills and protocols of adjuvant therapy. We analyzed the results of corrective surgical patients for esophageal cancer from January 1992 to July 2002. Material and Method: Among 129 patients with esophageal cancer, this study was performed in 68 patients who received corrective surgery. The ratio of sex was 59 : 9 (male : female) and mean age was $61.07\pm7.36$ years old. Chief complaints of this patients were dysphagia, epigastric pain and weight loss, etc. The locations of esophageal cancer were 4 in upper esophagus, 36 in middle, 20 in lower, 8 in esophagogastric junction. 60 patients had squamous cell cancer and 7 had adenocarcinoma, and 1 had malignant melanoma. Five patients had neoadjuvant chemotherapy. Result: The postoperative stage I, IIA, IIB, III, IV patients were 7, 25, 12, 17 and 7, respectively. The conduit for replacement of esophagus were stomach (62 patients) and colon (6 patients). The neck anastomosis was performed in 28 patients and intrathoracic anastomosis in 40 patients. The technique of anastomosis were hand sewing method (44 patients) and stapling method (24 patients). One of the early complications was anastomosis leakage (3 patients) which had only radiologic leakage that recovered spontaneously. The anastomosis technique had no correlation with postoperative leakage, which stapling method (2 patients) and hand sewing method (1 patient). There were 3 respiratory failures, 6 pneumonia, 1 fulminant hepatitis, 1 bleeding and 1 sepsis. The 2 early postoperative deaths were fulminant hepatitis and sepsis. Among 68 patients, 23 patients had postoperative adjuvant therapy and 55 paitents were followed up. The follow up period was $23.73\pm22.18$ months ($1\~76$ month). There were 5 patients in stage I, 21 in stage 2A, 9 in stage IIB, 15 in stage III and 5 in stage IV. The 1, 3, 5 year survival rates of the patients who could be followed up completely was $58.43\pm6.5\%,\;35.48\pm7.5\%\;and\;18.81\pm7.7\%$, respectively. Statistical analysis showed that long-term survival difference was associated with a stage, T stage, and N stage (p<0.05) but not associated with histology, sex, anastomosis location, tumor location, and pre and postoperative adjuvant therapy. Conclusion: The early diagnosis, aggressive operative resection, and adequate postoperative treatment may have contributed to the observed increase in survival for esophageal cancer patients.

Standard Chemotherapy with Excluding Isoniazid in a Murine Model of Tuberculosis (마우스 결핵 모델에서 Isoniazid를 제외한 표준치료의 예비 연구)

  • Shim, Tae Sun;Lee, Eun Gae;Choi, Chang Min;Hong, Sang-Bum;Oh, Yeon-Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Woo Sung;Kim, Dong Soon;Cho, Sang-Nae;Kim, Won Dong
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.3
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    • pp.177-182
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    • 2008
  • Background: Isoniazid (INH, H) is a key drug of the standard first-line regimen for the treatment of tuberculosis (TB), yet some reports have suggested that treatment efficacy was maintained even though INH was omitted from the treatment regimen. Methods: One hundred forty C57BL/6 mice were infected with the H37Rv strain of M. tuberculosis with using a Glas-Col aerosol generation device, and this resulted in depositing about 100 bacilli in the lung. Four weeks after infection, anti-TB treatment was initiated with varying regimens for 4-8 weeks; Group 1: no treatment (control), Group 2 (4HREZ): 4 weeks of INH, rifampicin (R), pyrazinamide (Z) and ethambutol (E), Group 3: 1HREZ/3REZ, Group 4: 4REZ, Group 5: 4HREZ/4HRE, Group 6: 1HREZ/3REZ/4RE, and Group 7: 4REZ/4RE. The lungs and spleens were harvested at several time points until 28 weeks after infection, and the colony-forming unit (CFU) counts were determined. Results: The CFU counts increased steadily after infection in the control group. In the 4-week treatment groups (Group 2-4), even though the culture was negative at treatment completion, the bacilli grew again at the 12-week and 20-week time points after completion of treatment. In the 8-week treatment groups (Groups 5-7), the bacilli did not grow in the lung at 4 weeks after treatment initiation and thereafter. In the spleens of Group 7 in which INH was omitted from the treatment regimen, the culture was negative at 4-weeks after treatment initiation and thereafter. However, in Groups 5 and 6 in which INH was taken continuously or intermittently, the bacilli grew in the spleen at some time points after completion of treatment. Conclusion: TThe exclusion of INH from the standard first-line regimen did not affect the treatment outcome in a murine model of TB in the early stage of disease. Further studies using a murine model of chronic TB are necessary to clarify the role of INH in the standard first-line regimen for treating TB.

Study the Analysis of Comparison with AROI and MROI Mode in Gated Cardiac Blood Pool Scan (게이트심장혈액풀 스캔에서 자동 관심영역 설정과 수동 관심영역 설정 모드의 비교 분석에 관한 고찰)

  • Kim, Jung-Yul;Kang, Chun-Koo;Kim, Yung-Jae;Park, Hoon-Hee;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.3
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    • pp.222-228
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    • 2008
  • Purpose: The objectives of this study were to compare the left ventricle ejection fraction (LVEF) from gated cardiac blood pool scan (GCBP) for analysis auto-drawing region of interest mode (AROI) and manual-drawing region of interest mode (MROI), respectively. To evaluation the relationships between values produced by both ROI modes. Materials and Methods: Gated cardiac blood pool scan using in vivo method Tc-99m Red Blood Cell were performed for 33 patients (mean age: $53.2{\pm}13.2\;y$) with objective of chemotherapy using single head gamma camera (ADAC Laboratories, Milpitas, CA). Left ventricular ejection fraction was automatically and manually measured, respectively. Results: There was significant difference statistically between AROI and MROI ($LVEF^{AROI}$: $71.4{\pm}12.4%$ vs. $LVEF^{MROI}$: $65.8{\pm}5.9%$, p=0.003). Intra-observer agreements in AROI was higher than MROI ($\gamma^{AROI}=0.964$, Cronbach's $\alpha^{AROI}=0.986$ vs. $\gamma^{MROI}=0.793$, Cronbach's $\alpha^{MROI}=0.911$), either. Additionally, there was no significant difference statistically at best septal view (${\Delta}LVEF^{BSV}=0.7{\pm}2.3%$, p=0.233), however statistically significant difference was found at badly separated septal view (${\Delta}LVEF=10.9{\pm}11.4%$, p=0.001). Moreover, Intra-observer agreements in best septal view was higher than badly separated septal view ($\gamma^{BSV}=0.939$, Cronbach's $\alpha^{BSV}=0.978$; $\gamma=0.948$, Cronbach's $\alpha=0.981$ at AROI, $\gamma^{BSV}=0.836$, Cronbach's $\alpha^{BSV}=0.936$; $\gamma=0.748$, Cronbach's $\alpha=0.888$ at MROI). Conclusion: When best septal view was acquired, LVEF by AROI and MROI indicated not different. Comparing Intra-observer agreements with AROI and MROI, the AROI tended to show higher. Therefore, it is considered that the AROI than MROI is valuable in reproducibility and objective when ROI analysis by acquire left ventricular of best septal view.

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The Comparison of Quantitative Indices by Changing an Angle of LAO View in Multi-Gated Cardiac Blood Pool Scan (게이트 심장 혈액풀 스캔에서 좌전사위상 각도의 변화에 따른 정량적 지표 비교)

  • Yoon, Soon-Sang;Nam, Ki-Pyo;Ryu, Jae-Kwang;Kim, Seong-Hwan
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.57-61
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    • 2012
  • Purpose: The multi-gated cardiac blood pool scan is to evaluate the function of left ventricle (LV) and usefully observe a value of ejection fraction (EF) for a patient who is receiving chemotherapy. To calculate LVEF, we should adjust an angle of left anterior oblique (LAO) view to separate both ventricles. And by overlapped ventricles, it is possible to affect LVEF. The purpose of this study is to investigate and compare quantitative indices by changing an angle of LAO view. Materials and methods: We analyzed the 49 patients who were examined by multi-gated cardiac blood pool scan in department of nuclear medicine at Asan Medical Center from June to September 2011. Firstly, we acquired "Best septal" view. And then, we got images by addition and subtraction of angle for LAO view to anterior and lateral. We compared three LAO views for 20 people by 5 degrees and 39 people by 10 degrees. And we analyzed quantitative indices, EF, end diastole and end systole counts, by automated and manual region of interest (ROI) modes. Results: Firstly, we analyzed quantitative indices by automated ROI mode. In case of 5 degrees, the averages of EF are $61.0{\pm}7.5$, $62.1{\pm}7.1$, $60.9{\pm}6.7%$ ($p$=0.841) in LAO, LAO $-5^{\circ}$ and LAO $+5^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). In case of 10 degrees, the averages of EF are $62.4{\pm}9.5$, $62.3{\pm}10.8$, $61.6{\pm}.9.3%$ ($p$=0.938) in LAO, LAO $-10^{\circ}$ and LAO $+10^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). Secondly, we analyzed quantitative indices by manual ROI mode. In case of 5 degrees, the averages of EF are $62.8{\pm}7.1$, $63.6{\pm}7.5$, $62.7{\pm}7.3%$ ($p$=0.903) in LAO, LAO $-5^{\circ}$ and LAO $+5^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). In case of 10 degrees, the averages of EF are $65.5{\pm}9.0$, $66.3{\pm}8.7$, $63.5{\pm}.9.3%$ (p=0.473) in LAO, LAO $-10^{\circ}$ and LAO $+10^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). Conclusion: When an image is nearly "Best septal" view, the difference of LAO angle would not affect to change LVEF. Although there was no difference in quantitative analysis, deviations could happen when to interpret wall motion qualitatively by reading physicians.

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Purification of antigenic proteins of Paragonimus westermani and their applicability to experimental cat paragonimiasis (폐(肺)디스토마(Paragonimus westermani) 감염(感染) 고양이 혈청(血淸)에 대(對)한 ELISA 항체가(抗體價)의 의의(意義))

  • Choi, Won-Young;Yoo, Jae-Eul;Nam, Ho-Woo;Choi, Hyung-Rak
    • The Korean Journal of Parasitology
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    • v.24 no.2
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    • pp.177-186
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    • 1986
  • This study was designed to evaluate the partially purified antigens which were fractionated from crude extract of Paragonimus westermani and to monitor the enzyme-linked immunosorbent assay (ELISA) in experimental cat paragonimiasis during the course of infection as well as before and after chemotherapy. Crude extract of 6-month-old adult P. westermani was fractionated to 5 antigens by successive applications of ammonium sulfate precipitation, ion exchange chromatography and gel filtration. And the cats, 10 in each group, were infected with 60, 30, 15, and 5 metacercariae, then the half of each group was treated with praziquantel 2 times in one day of 100mg per kilogram of weight on 150 days after the infection. Sera were collected every 10 days. ELISA was performed with the concentration of $2{\mu}g/ml$ antigen, 100 times diluted sera and 1,000 times diluted alkaline phosphatase conjugated anti-cat IgG. The results were as follows: 1. Absorbance by ELISA with proteins precipitated by differential concentration of ammonium sulfate was the highest at $51{\sim}65%$ precipitate (PA2), followed by $0{\sim}50%$ precipitate (PAl), $66{\sim}80%$ precipitate (PA3), and $81{\sim}90%$ precipitate (PA4). Unprecipitated protein over 90% ammonium sulfate (PA5) showed the lowest antigenicity. 2. Fractionation of PA1, PA2, and PA3 through the DEAE-cellulose column did not differentiate the antigenic proteins. 3. By passing through the Sephadex G-200 column, PA1 and PA2 were fractionated to high molecular weight proteins and those of low molecular weight which showed high absorbance by ELISA (PA1-I, II and PA2-I, II). But PA3 was shown to have a fraction of high molecular weight proteins (PA3-I) which showed high antigenicity. 4. SDS-polyacrylamide gel electrophoresis of PA1-I, P A1-II, PA2-I, PA2-II, PA3-I, and crude extract was performed. Fraction PA1-I was composed of proteins which had the molecular weight of 270 kilodaltons(KD) to 196 KD; of them 220KD protein was major band. Fraction PA2-I was composed of $255{\sim}225\;KD$, and PA3-I, $255{\sim}240\;KD$, respectively. Fraction PA1-II and fraction PA2-II consisted of 30 KD proteins. 5. Absorbance by ELISA began to increase within $10{\sim}20$ days after the infection and reached the highest on $140{\sim}180$ days, then made plateau thereafter. 6. Absorbance by ELISA decreased after praziquantel treatment. In 60 metacercariae infection group, the absorbance had been decreasing, but remained within the positive range during observation period, while those of 30, 15, and 5 metacercariae infection groups turned to negative range. 7. Fraction PA1-II showed the highest antigenicity in ELISA, then fraction PA2-I, fraction PA1-I, fraction PA2-II, fraction PA3-I and crude extract followed. In early phase of infection, the absorbance of fraction PA1-II showed more rapid increase than those of the other fractions and it came to positive range at $20{\sim}30$ days after infection.

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