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Quantitative Evaluation of Regional Cerebral Blood Flow by Visual Stimulation in $^{99m}Tc-HMPAO$ Brain SPECT ($^{99m}Tc-HMPAO$ 뇌 SPECT에서 시각자극에 의한 국소 뇌 혈류변화의 정량적 검증)

  • Juh, Ra-Hyeong;Suh, Tae-Suk;Kwark, Chul-Eun;Choe, Bo-Young;Lee, Hyoung-Koo;Chung, Yong-An;Kim, Sung-Hoon;Chung, Soo-Kyo
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.3
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    • pp.166-176
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    • 2002
  • Purpose: The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of $^{99m}Tc-HMPAO$ (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. Materials and Methods: The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRI and $^{99m}Tc-HMPAO$ SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the legion of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map (SPM99). Results: The mean regional cerebral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipital lobe was $32.50{\pm}5.67%$. The significant activation sites using a statistical parameter of brain constructed a rendering image and image fusion with SPECT and MRI. Conclusion: Visual activation was revealed significant increase through quantitative analysis in visual cortex. Activation region was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area (Ba18,19) of Brodmann.

Tertiary Cytoreduction for Recurrent Epithelial Ovarian Cancer: a Multicenter Study in Turkey

  • Arvas, Macit;Salihoglu, Yavuz;Sal, Veysel;Gungor, Tayfun;Sozen, Hamdullah;Kahramanoglu, Ilker;Topuz, Samet;Demirkiran, Fuat;Iyibozkurt, Cem;Bese, Tugan;Ozgu, Burcin Salman;Vatansever, Dogan;Tokgozoglu, Nedim;Berkman, Sinan;Turan, Hasan;Bengisu, Ergin;Sofiyeva, Nigar;Demiral, Irem;Meydanli, Mutlu
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1909-1915
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    • 2016
  • Background: The purpose of this study was to determine the benefit of tertiary cytoreductive surgery (TC) for secondary recurrent epithelial ovarian cancer (EOC), focusing on whether optimal cytoreduction has an impact on disease-free survival, and whether certain patient characteristics could identify ideal candidates for TC. Materials and Methods: Retrospective analysis of secondary recurrent EOC patients undergoing TC at three Turkish tertiary institutions from May 1997 to July 2014 was performed. All patients had previously received primary cytoreduction followed by intravenous platinum-based chemotherapy and secondary cytoreduction for first recurrence. Clinical and pathological data were obtained from the patients' medical records. Survival analysis was caried out using the Kaplan Meier method. Actuarial curves were compared by the two tailed Logrank test with a statistical significance level of 0.05. Results: Median age of the patients was 49.6 years (range, 30-67) and thirty-eight (72%) had stage III-IV disease at initial diagnosis. Twenty six (49%) had optimal and 27 (51%) suboptimal cytoreduction during tertiary debulking surgery. Optimal initial cytoreduction, time to first recurrence, optimal secondary cytoreduction, time interval between secondary cytoreduction and secondary recurrence, size of recurrence, disease status at last follow-up were found to be significant risk factors to predict optimal TC. Optimal cytoreduction in initial and tertiary surgery and serum CA-125 level prior to TC were independent prognostic factors on univariate analysis. Conclusions: Our results and a literature review clearly showed that maximal surgical effort should be made in TC, since patients undergoing optimal TC have a better survival. Thus, patients with secondary recurrent EOC in whom optimal cytoreduction can be achieved should be actively selected.

Arthroscopic Treatment of Meniscal Cyst (슬관절 반월상 연골 낭종의 관절경적 치료)

  • Bae, Dae-Kyung;Yoon, Kyung-Ho;Kwon, Oh-Soo;Shin, Dong-Jun;Im, Yang-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.14-20
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    • 2002
  • Purpose : To analyze the clinical result of the arthroscopic decompression of meniscal cyst and meniscus resection or repair of meniscus tear. Materials and Methods : From April 1994 and October 2001, 19 patients with diagnosis of meniscal cyst associated with tears of the meniscus were treated by arthroscopic meniscal resection or repair with decompression of the cyst. The mean age was 39.8 years(range, 22-58years). The follow-up period ranged from 3 months to 36 months with an average of 18 months. Seven of 19 patients had tenderness over the joint line with palpable mass. Treatment consists of arthroscopic resection or repair of meniscal tear with decompression of the cyst through transmeniscal approach. Open excision of cyst was performed in one case. Clinical evaluation was performed using Lysholm knee score and Tegner activity. All cases were executed proper treatment using arthroscopy. Results : Twelve cysts involved the lateral meniscus$(64\%)$ and seven cysts were on medial cyst$(36\%)$. Most of lateral meniscal cysts were located in anterior one-third and medial meniscal cyst were on posterior one-third. Meniscal tear were observed in seventeen cases$(89.5\%)$ and most tears were horizontal$(79\%)$. Preoperative symptom disappeared and no cyst recurrences were observed at last follow-up(mean follow-up: 18 months). Conclusion : Meniscal cysts involved lateral side in $64\%$ and most of them were associated with meniscus tear$(89.5\%)$ which consists of mainly horizontal component$(79\%)$.

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The Role Behaviors of Oncology Nurse Specialist (종양전문간호사의 역할규명을 위한 연구)

  • Kim, Min-Young;Park, Sung-Ae
    • Asian Oncology Nursing
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    • v.3 no.1
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    • pp.24-44
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    • 2003
  • The purposes of this study was to identify and propose the expected role of the oncology nurse specialist by embodying role theory to oncology nurse specialist. The subjects of this study were 149 persons in 14 hospitals, who were classified to 4 groups, oncology nurse specialists(ONS) group, head nurses and charge nurses(HN & CN) group in hemato-oncology ward, registered nurses(RN) group in hemato-oncology ward, and hematologists & oncologists(H&O) group. The questionnaire which was consisted of 89 items for role of oncology nurse specialist, was made by researcher with a field study and literature review about role of oncology nurse specialist and verified by matrix delphi technique about content validity and construct validity. The data were collected from October 22, 2002 to November 5, 2002. All 4 groups proposed that ONS should perform an expert practitioner role first of all. But ONS group, RN group and H&O group proposed orderly expert practitioner, educator, researcher, consultant, and administrator & change agent, but HN & CN group did expert practitioner, educator, consultant, researcher, administrator & change agent. Expert practitioner had the most highest necessary degree in all groups and most highest performance degree in ONS group. That was consistent with results that all groups proposed role of expert practitioner at first. 4 items out of 20 items showed the meaningful differences between groups. For role of educator, oncology nurse specialist group proposed necessary degrees over 4.0 point out of 5.0 in all items. 4 items out of 18 items showed the meaningful differences between groups. For role of researcher, 3 nurses groups proposed a high necessary degree, but performance of ONS group was most lowest among 5 roles. 6 items out of 14 items showed the meaningful differences between groups. The role of consultant had high necessary degree in some items related to hematopoietic stem cell transplantation. 2 items out of 17 items showed the meaningful differences between groups. In nursing behaviors of administrator & change agent, those items about enacting principle, cost development and participation of professional academy had a high necessary degree. 4 items out of 18 items showed the meaningful differences between groups. Oncology nurse specialists group performed 5 roles orderly, expert practitioner, consultant, educator, administrator & change agent, researcher. This result was different from expected role of themselves as well as the other groups. There was a different necessary degree between role and embodied nursing behaviors of role. ONS group and RN group proposed orderly educator, researcher, administrator & change agent, expert practitioner, consultant, but the other groups did educator, expert practitioner, researcher, consultant, administrator & change agent. The expected standards of oncology nurse specialist in this study were usually master's degree, total career of 5-7 years, oncology career of 3-5 years and certification. But for the post, qualification and qualification institution, various opinions were suggested. In the conclusion, there was a different necessary degree between role and embodied nursing behaviors of role. All groups proposed expert practitioner at first in abstract role, but educator at first in embodied nursing behaviors of role. So we have to consider this difference carefully in the future research. ONS acted the role of expert practitioner first of all, but we should develope and expand the roles of researcher, and administrator & change agent. We should enact roles by role behaviors induced from mutual agreements in necessary degree and performance degree, and bargain the role behaviors that showed the meaningful differences between groups But, we should consider carefully which group's opinion we have to select. I suggested 36 items out of 89 items, in which ONS proposed necessary degree over 4.0 out of 5.0 and half of them performed as the nursing behaviors of oncology nurse specialist that did not induce role stress. For the future, We should role bargain the role with other groups based on these items.

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Properties of Quercus variabilis bio-oil prepared by sample preparation (시료 조건에 따른 굴참나무 바이오오일의 특성)

  • Chea, Kwang-Seok;Jo, Tae-Su;Choi, Seok-Hwan;Lee, Soo-Min;Hwang, Hye-Won;Choi, Joon-Weon
    • Journal of the Korean Applied Science and Technology
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    • v.32 no.1
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    • pp.148-156
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    • 2015
  • In this study the differences in the sample size and sample input changes as characteristics of bio-oil oak(Quercus variabilis), the oak 0.5~2.0 mm of the oak weighing 300~900g was processed into bio-oil via fast pyrolysis for 1.64 seconds. In this study, the physico-chemical properties of biooil using oak were investigated. Fast pyrolysis was adopted to increase the bio-oil yield from raw material. Although the differences in sample size and sample input changes in the yield of pyrolysis products were not significantly noticeable, increases in the yield of bio-oil accounted for approximately 60.3 to 62.1%, in the order of non-condensed gas, and biochar. When the primary bio-oil obtained by the condensation of the cooling tube and the seconary bio-oil obtained from the electric dust collector were measured separately, the yield of primary bio-oil was twice as higher than that of the secondary bio-oil. However, HHV (Higher Heating Value) of the secondary bio-oil was approximately twice as higher than that of the primary bio-oil by up to 5,602 kcal/kg. The water content of the primary bio-oil was more than 20% of the moisture content of the secondary bio-oil, which was 10% or less. In addition, the result of the elemental analysis regarding the secondary bio-oil, its primary carbon content was higher than that of the primary bio-oil, and since the oxygen content is low, the water content as well as elemental composition are believed to have an effect on the calorific value. The higher the storage temperature or the longer the storage period, the degree of the viscosity of the secondary bio-oil was higher than that of the primary bio-oil. This can be the attributed to the chemical bond between the polymeric bio-oil that forms during the storage period.

Repetition of Apoptosis Induced by Amiloride Derivatives in Human Umbilical Vein Endothelial Cells (제대정맥 내피세포에서 Amiloride 유도체에 의한 Apoptosis 반복)

  • Park, Kyu Chang;Park, Kyu Sang;Moon, Soo Jee
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.56-66
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    • 2003
  • Purpose : Human umbilical vein endothelial cells(HUVECs) play an important role in regulating blood flow by releasing vasoactive substances. It has been reported that endothelial impairment and dysfunction might be a primary cause of placental vascular disease, which is manifested clinically as preeclampsia in mother and intrauterine growth restriction in fetus. Furthermore, the frequency of apoptotic changes is increased in umbilical and placental tissues from growth-restricted pregnancies. However, the various mechanisms of umbilical endothelial cell apoptosis have not been broadly proposed. We investigate the effects of amiloride derivatives on apoptotic death of HUVECs and identify their ionic mechanism. Methods : HUVECs were purchased from Clonetics, and cultured on endothelial cell growth medium. MTT assay and flow cytometry were used for assessing cytotoxic effect and confirming the apoptosis. Changes in intracellular ion concentrations were measured with specific fluorescent dyes and fluorescence imaging analysis system. Results : Amiloride derivatives elicited cytotoxic effects on HUVECs with dose-dependent manners and the rank order of potency is HMA($IC_{50}\;11.2{\mu}M$), MIA>EIPA>>amiloride. HMA-induced cytotoxicity is dependent on extra- and intracellular pH, that is, increase extra- and intracellular pH augmented the cytotoxic effects of HMA. HMA dose-dependently reduced intracellular major ions, such as $K^+$ and $Cl^-$. Interestingly, the depletion of intracellular ions induced by HMA was also significantly enhanced at alkaline extracellular pH. Conclusion : Amiloride derivatives induce apoptosis of HUVECs with dose and pH dependent manners. They reduce intracellular $K^+$ and $Cl^-$ concentration, which is also extracellular pH dependent.

Ototoxicity in children receiving cisplatin chemotherapy (Cisplatin을 포함한 항암치료를 받은 소아에서 이독성)

  • Jang, Hee Jin;Cho, Hyung Rae;Lee, Jae Hee;Bae, Kun Yuk;Seo, Jong Jin;Moon, Hyung Nam;Im, Ho Joon
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.210-214
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    • 2010
  • Purpose : Cisplatin is highly effective for the treatment of solid tumors in children. However, the clinical use of cisplatin is limited by its ototoxicity. The aim of this study was to evaluate the ototoxicity in children treated with cisplatin. Method : We performed a single institution retrospective analysis of pediatric oncology patients who received cisplatin therapy between January 2001 and January 2008. Thirty-seven patients with sufficient medical and audiologic data were included in this study. Results : The median age at the time of diagnosis was 10.7 (range 3.8-6.7) years. There were 16 males and 21 females. The underlying diseases were osteosarcoma (15 cases), medulloblastoma (14 cases), germ cell tumors (7 cases), and hepatoblastoma (1 case). The median individual dose was $100mg/m^2$/cycle (56-200). The median cumulative dose was $480mg/m^2$ (200-1,490). Sixteen patients (43%) received cranial radiotherapy. Of the 37 patients, 17 developed hearing loss, leading to an overall incidence of 46%. Logistic regression showed that age at treatment (P =0.04) and cumulative dose of cisplatin (P =0.005) were the significant risk factors in predicting hearing loss in children treated with cisplatin. In all the patients who had hearing loss, there was neither improvement nor aggravation during the follow-up (3-8 months). Conclusion : The cumulative dose of cisplatin (>$500mg/m^2$) and younger age at treatment (<12 years) were 2 most important risk factors for ototoxicity in patients treated with cisplatin. Serial audiometric evaluations are needed in the patients with risk factors during and after cisplatin treatment.

Risk factors associated with complicated methicillin-resistant Staphylococcus aureus bacteremia in neonates (신생아의 MRSA 균혈증에서 합병증 발생과 연관된 위험인자)

  • Lee, Young Jin;Kim, Hyen Jin;Byun, Shin Yun;Park, Su Eun;Park, Hee Ju
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.173-177
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    • 2010
  • Purpose : Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen that causes nosocomial infection in NICU. It contributes to neonatal morbidity and mortality with variable complications. This study was conducted to identify the risk factors associated with complicated MRSA bacteremia in neonates. Methods : We reviewed the medical records of 44 neonates with positive blood culture for MRSA who were admitted to the NICU of Pusan National University Hospital from January 2002 to December 2007. We compared various factors of the complicated and uncomplicated MRSA bacteremia cases. Results : Of the 44 neonates, 31 were male and 13, female. The mean gestational age and birth weight were $33.2{\pm}4.9$ weeks and $1,859.9{\pm}962.2g$, respectively. Twenty-one of infants were treated with a mechanical ventilator during a mean of $8.8{\pm}13.8$ days. There were 13 cases of complicated and 31 cases of uncomplicated MRSA bacteremia. Between the 2 groups, we compared the following variables: gestational age, birth weight, ventilator use, umbilical catheter use and central catheter insertion, $O_2$ inhalation, first oral feeding day after birth, underlying disease, transfusion, and initial vancomycin use. The underlying disease and transfusion were the risk factors related to complicated MRSA bacteremia. Conclusion : Complicated MRSA bacteremia is related to underlying disease and transfusion. Since this was a retrospective study with a small sample size, it offered limited capacity to compare complicated and uncomplicated MRSA bacteremia. A prospective study with a larger population is needed to determine the exact characteristics of MRSA bacteremia in NICU.

The characteristic laboratory findings of non-responsiveness to intravenous immunoglobulin in children with Kawasaki disease (가와사끼병 재 치료군의 특징적인 검사 지표)

  • Cho, Han Gil;Cho, Young Kuk;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.228-234
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    • 2010
  • Purpose : Although intravenous immunoglobulin (IVIG) treatment is an effective first-line treatment for Kawasaki disease, 10-20% of the patients develop persistent fever or coronary artery complications. Medical records of Kawasaki disease patients were reviewed to assess the characteristic laboratory findings of IVIG nonresponsiveness. Methods : We reviewed the clinical records of 118 children with Kawasaki disease who were treated at the Chonnam National University Hospital from March 2003 to February 2008. The laboratory findings of the IVIG-responder group (n=110) and the IVIG-nonresponder group (n=8) were compared at admission day and at 48 hours and 14 days after IVIG administration. Results : At admission, the level of creatine kinase (CK) was lower (P =0.03) and that of total protein was higher (P <0.01) in the nonresponders than in the responders. At 48 hours after IVIG administration, the white blood cell (WBC) count (P =0.04) and neutrophil% (P <0.01) was higher in the nonresponders than in the responders. The neutrophil% (P <0.01) and CK (P =0.01) level at admission was lower than that at 48 hours after IVIG administration in the responders; this decrease was not as apparent in the nonresponders. Conclusion : IVIG nonresponders have lower CK and higher total protein levels at admission and higher WBC count and neutrophil% at 48 hours after IVIG administration. The decrease in the neutrophil% and CK level between at admission and at 48 hours after IVIG administration is remarkably higher in responders than in nonresponders.

Transforming growth factor-β promoted vascular endothelial growth factor release by human lung fibroblasts (인간 폐섬유아세포에서 TGF-β 자극에 의한 VEGF 분비)

  • Park, Sang-Uk;Shin, Joo-Hwa;Shim, Jae-Won;Kim, Deok-Soo;Jung, Hye-Lim;Park, Moon-Soo;Shim, Jung-Yeon
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.879-885
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    • 2008
  • Purpose : The human lung fibroblast may act as an immunomodulatory cell by providing pro-inflammatory cytokines and chemokines, which are important in airway remodeling. Vascular endothelial growth factor (VEGF) induces mucosal edema and angiogenesis. Thymus and activation regulated chemokine (TARC) induces selective migration of T helper 2 cells. We investigated whether human lung fibroblasts produced VEGF and TARC, and the effects were augmented with the co-culture of fibroblasts and human bronchial smooth muscle cells (HBSMC), and whether dexamethasone can inhibit the proliferation and the release of VEGF in lung fibroblasts. Methods : Human lung fibroblasts were cultured with and without HBSMC, growth-arrested in serum-deprived medium, and pretreated with dexamethasone for 16 hours. After 24-hour stimulation with platelet derived growth factor-BB (PDGF-BB) and/or transforming growth factor-${\beta}$ (TGF-${\beta}$), culture supernatant was harvested for assays of VEGF and TARC. Cell proliferation was assayed using BrdU cell proliferation ELISA kit. Results : 1) The release of VEGF was significantly increased after stimulation with TGF-${\beta}$, and its release was augmented when co-stimulated with PDGF and TGF-${\beta}$. 2) VEGF release induced by PDGF or TGF-${\beta}$ was inhibited by dexamethasone. 3) There was no synergistic effect on the release of VEGF when human lung fibroblasts were co-cultured with HBSMC. 4) Dexamethasone did not suppress human lung fibroblasts proliferations. 5) Neither TGF-${\beta}$ nor PDGF induced TARC release from lung fibroblasts. Conclusion : Human lung fibroblasts may modulate airway remodeling by release of VEGF, but they have no synergistic effects when co-cultured with HBSMC. Dexamethasone suppresses VEGF release, not proliferation of lung fibroblast.