• Title/Summary/Keyword: Clinical Anatomy

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Comparison of using CBCT with CT Simulator for Radiation dose of Treatment Planning (CBCT와 Simulation CT를 이용한 치료계획의 선량비교)

  • Kim, Dae-Young;Choi, Ji-Won;Cho, Jung-Keun
    • The Journal of the Korea Contents Association
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    • v.9 no.12
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    • pp.742-749
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    • 2009
  • The use of cone-beam computed tomography(CBCT) has been proposed for guiding the delivery of radiation therapy. A kilovoltage imaging system capable of radiography, fluoroscopy, and cone-beam computed tomography(CT) has been integrated with a medical linear accelerator. A standard clinical linear accelerator, operating in arc therapy mode, and an amorphous-silicon (a-Si) with an on-board electronic portal imager can be used to treat palliative patient and verify the patient's position prior to treatment. On-board CBCT images are used to generate patient geometric models to assist patient setup. The image data can also, potentially, be used for dose reconstruction in combination with the fluence maps from treatment plan. In this study, the accuracy of Hounsfield Units of CBCT images as well as the accuracy of dose calculations based on CBCT images of a phantom and compared the results with those of using CT simulator images. Phantom and patient studies were carried out to evaluate the achievable accuracy in using CBCT and CT stimulator for dose calculation. Relative electron density as a function of HU was obtained for both planning CT stimulator and CBCT using a Catphan-600 (The Phantom Laboratory, USA) calibration phantom. A clinical treatment planning system was employed for CT stimulator and CBCT based dose calculations and subsequent comparisons. The dosimetric consequence as the result of HU variation in CBCT was evaluated by comparing MU/cCy. The differences were about 2.7% (3-4MU/100cGy) in phantom and 2.5% (1-3MU/100cGy) in patients. The difference in HU values in Catphan was small. However, the magnitude of scatter and artifacts in CBCT images are affected by limitation of detector's FOV and patient's involuntary motions. CBCT images included scatters and artifacts due to In addition to guide the patient setup process, CBCT data acquired prior to the treatment be used to recalculate or verify the treatment plan based on the patient anatomy of the treatment area. And the CBCT has potential to become a very useful tool for on-line ART.)

Comparison of using CBCT with CT simulator for radiation dose of treatment planning (CBCT와 Simulation CT를 이용한 치료계획의 선량비교)

  • Cho, jung-keun;Kim, dae-young;Han, tae-jong
    • Proceedings of the Korea Contents Association Conference
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    • 2009.05a
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    • pp.1159-1166
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    • 2009
  • The use of cone-beam computed tomography(CBCT) has been proposed for guiding the delivery of radiation therapy. A kilovoltage imaging system capable of radiography, fluoroscopy, and cone-beam computed tomography(CT) has been integrated with a medical linear accelerator. A standard clinical linear accelerator, operating in arc therapy mode, and an amorphous-silicon (a-Si) with an on-board electronic portal imager can be used to treat palliative patient and verify the patient's position prior to treatment. On-board CBCT images are used to generate patient geometric models to assist patient setup. The image data can also, potentially, be used for dose reconstruction in combination with the fluence maps from treatment plan. In this study, the accuracy of Hounsfield Units of CBCT images as well as the accuracy of dose calculations based on CBCT images of a phantom and compared the results with those of using CT simulator images. Phantom and patient studies were carried out to evaluate the achievable accuracy in using CBCT and CT stimulator for dose calculation. Relative electron density as a function of HU was obtained for both planning CT stimulator and CBCT using a Catphan-600 (The Phantom Laboratory, USA) calibration phantom. A clinical treatment planning system was employed for CT stimulator and CBCT based dose calculations and subsequent comparisons. The dosimetric consequence as the result of HU variation in CBCT was evaluated by comparing MU/cCy. The differences were about 2.7% (3-4MU/100cGy) in phantom and 2.5% (1-3MU/100cGy) in patients. The difference in HU values in Catphan was small. However, the magnitude of scatter and artifacts in CBCT images are affected by limitation of detector's FOV and patient's involuntary motions. CBCT images included scatters and artifacts due to In addition to guide the patient setup process, CBCT data acquired prior to the treatment be used to recalculate or verify the treatment plan based on the patient anatomy of the treatment area. And the CBCT has potential to become a very useful tool for on-line ART.)

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The influence of some intrauterine growth variables on neonatal blood pressure (태아기 자궁내 성장지표와 신생아 혈압과의 관련성)

  • Min, Jungwon;Park, Eun Ae;Kong, Kyoungae;Park, Bohyun;Hong, Juhee;Kim, Young Ju;Lee, Hwayoung;Ha, EunHee;Park, Hyesook
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.966-971
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    • 2006
  • Purpose : 'Programming' describes the process that stimulus at a critical period of development has lifelong effects. The fact that low birth weight links to the risk of elevated blood pressures in adult life is well known. This study aims to examine whether this link is evident in the newborn by investigating the relationship of the intrauterine growth indices and neonatal blood pressure(BP). Methods : We studied 127 neonates who were born at Ewha Womans' Hospital and their mothers enrolled our cohort study during pregnancy. Data on the mothers and details of the birth records were tracked and collected from medical charts. Neonatal BP was measured within 24 hours after birth. Results : Neonatal SBP was positively correlated to intrauterine growth indices; birth weight(BW)(r=0.4), head circumference(HC)(r=0.4), and birth height(r=0.3). However, an inverse relationship existed, between HC/BW ratio and neonatal SBP(r=-0.4). After adjusting for the baby's sex, maternal BP, and gestational age, neonatal SBP still associated with intrauterine growth indices. SBP was 7 mmHg higher in the highest BW group(${\geq}90percentiles$) compared to the lowest group(<10 percentiles). On the other hand, SBP was 17 mmHg lower in the highest HC/BW group(${\geq}90percentiles$) compared in the lowest group(<10 percentiles). Conclusion : This study could not find the evidence that intrauterine growth retardation affect on elevated neonatal BP. It suggests that the initiating events of BP programming may occur during postnatal growth period. To identify the critical starting period that intrauterine growth retardation leads to elevated BP, a study tracking BP changes from birth to childhood is required.

PULPAL AND PERIAPICAL REACT10N TO FORMOCRESOL AND DEPULPIN® IN THE RAT TEETH (백서에서 Depulpin®과 Formocresol에 대한 치수와 치근단 조직의 반응)

  • Moon, Hyung-In;Kim, Sun-Ho;Hwang, Yun-Chan;Oh, Byung-Ju;Hwang, In-Nam;Kim, Sun-Hun;Jeong, Sun-Wa;Youn, Chang;Oh, Won-Mann
    • Restorative Dentistry and Endodontics
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    • v.27 no.4
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    • pp.355-362
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    • 2002
  • One fifth dilution of formocresol is usually used for pulpotomy of the primary teeth and emergency pulpotomy of the permanent teeth. However the use of formaldehyde has been subjected to criticism because it may be absorbed into the blood stream and become distributed systemically, it nay also alter the pulp tissue rendering it immunologically active, and have carcinogenic potential. Recently Depulpin$^{\circledR}$(VoCo., Germany) gains popularity as a devitalizing agent during root canal therapy in spite of high concentration of 49 % paraformaldehyde because it facilitate devitalization of pulp and make root canal therapy easier But there have been not enough publications about the reaction of pulp and periapical tissue caused by Depulpin. This study was performed to evaluate the histological changes in pulp and periapical tissue of rats after pulpotomy using formocresol and Depulpin and to elucidate the toxic effects of these agents. Thirty six Sprague-Dawley rats were anesthetized by intraperitoneal injection of ketamine Maxillary first molar teeth were used for pulpotomy with formocresol and Depulpin. Rats were sacrificed after 2 days, 4 days, 1 week, 2 weeks, 3 weeks and 4 weeks respectively. Specimens were histologically observed by light microscope changes in pulp and periapical tissue. The obtained results were as follows. 1. Formocresol group A zone of fixed tissue. in which odontoblasts could clearly be defined, was present directly underneath the pulpotomy dressing in almost all teeth of this group. This was followed by an area of necrotic tissue which resembled dried out fibrous tissue with no cellular detail except some pyknotic nuclei. In the specimens of after 2 days, 4 days, 1 week, 2 weeks in which vital tissue was present, it was separated from the fibrous area by a zone of inflammation. In the specimens of after 3 weeks and after 4 weeks, inflammatory infiltrate was in the periodontal ligament adjacent to the apical foramina of the teeth. 2. Depulpin$^{\circledR}$ group The area of necrotic tissue which had no cells and fibers, was present adjacent to the dressing. This was followed by dried out fibrous tissue with no cellular details except some pyknotic nuclei, A short stump of vital pulp with odontoblasts was present at the end of the canal after 2 days. Inflammatory infiltrate was in the periodontal ligament after 4 days and after 1week. Severe root resolution and necrosis of periapical tissue opposite the root resorption site were defined after 2 weeks and after 3 weeks. Periapical lesion which consist of necrotic tissue surrounded by a fibrous connective wall, was found after 4 weeks. The results indicated that Depulpin can cause more adverse reaction to the dental pulp and periapical tissue than formocresol, and further studies are needed for its clinical use with safety.

The Chewing Efficiency of Occlusal Stabilization Appliances by Anatomy of the Occlusal Surface (교합안정장치 교합면의 모양에 따른 저작효율)

  • Im, Yeong-Gwan;Choi, Choong-Ho;Kim, Jae-Hyeong;Rhee, Chong-Ouk;Kim, Byung-Gook
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.361-373
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    • 2005
  • Occlusal appliance therapy has been proven to be very useful and effective in reducing signs and symptoms of patients with TMD. However, there are no reports about the masticatory efficiency of the occlusal appliance. The purpose of this study was, first, to investigate the masticatory efficiency of the conventional stabilization appliance experimentally in normal healthy subjects, by comparing it with that of their natural dentition; and, second, to develop a modified stabilization appliance as an attempt to increase masticatory efficiency. Eleven subjects (mean age 25.3 years, range from 23 to 33) participated in this study. Six were men and five were women. They were healthy and had complete or near―complete natural dentition, and did not present with signs or symptoms of TMD. Two kinds of occlusal appliances―the conventional flat maxillary stabilization appliance (i.e., FSA) and a modified maxillary stabilization appliance with additional anatomic structures on its occlusal surface (i.e., ASA)―were made for every subject. Subjects chewed peanuts that were selected as a food to test the three masticatory conditions of the natural dentition, the ASA, and the FSA. The number of chewing strokes was counted during each 1-minute chewing period. Chewed peanut boluses were recovered and their hardness was measured by texture analysis. Statistical tests were performed. The following results were obtained. 1. The masticatory efficiency of the FSA was 38.6 percent that of the natural dentition. The efficiency of the ASA was 78.2 percent that of the natural dentition. 2. The number of chewing strokes in the natural dentition condition was measured to be 1.5 strokes per second. It decreased to 90 percent in the ASA and FSA conditions. These results indicate that the ASA could serve an improved masticatory capacity as well as its therapeutic effects in TMD. A clinical application of the ASA should be considered to extend the management of TMD patients.

A Study of Content Analysis on ICU(Intensive Care Unit) Nurses' Knowledge of Basic Nursing Sciences (중환자실 간호사의 기초간호과학 지식의 필요성 분석)

  • Byeon, Young-Soon;Choe, Myoung-Ae;Kim, Hee-Seung;Park, Mi-Jung;Seo, Wha-Sook;Lee, Kyung-Sook;Choi, S-Mi;Hong, Hae-Sook
    • Journal of Korean Biological Nursing Science
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    • v.4 no.1
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    • pp.41-49
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    • 2002
  • The purpose of this study was to identify the knowledge contents of basic nursing sciences needed by nurses in the practices of the intensive care unit(ICU). To attain the goal of this study, the nurses working at 10 hospitals in the areas of Seoul and Kangwon Province were randomly selected. They were primarily interviewed, and the open question was secondarily put to them through the questionnaire. In the process of the 1st interview, the interviewees were asked of the question, "What is the knowledge of basic sciences such as anatomy, pathology, physiology. microbiology, pharmacology and the like thought to be lacking when you communicate with doctors in the ICU and when you carry out your nursing practices in it?" The contents of the interview were tape-recorded. The period of data collection ranged from May 1, 2001 to Sept 30. The interviews were conducted with total of 20 nurses. The open-end questionnaire was secondarily mailed to nurses. 113 questionnaires were returned. 100 questionnaires except 13 ones thought to be poorly completed in content were used for data analysis. Three coders classified data obtained from the interview and the questionnaire research into 5 detailed items relating to such as anatomical physiology, pathology, pharmacology. microbiology and basics of nursing. The three coders had experiences in nursing education of 18 years, 8 years and 6 years, respectively, and of them one coder was professor in basic nursing sciences. Data were statistically treated using frequency analysis and percentage by the SAS program. As a result, the following findings were obtained : It was found that the contents that ICU nurses responded were most needed in the field of Human structure and function were water and electrolytic balance(38%), blood and circulatory system(20%), changer in the patient's skin(12%), the arrangement of the human body(10%) and the endocrine system(10%), nervous system(6%), and assessment of the state of the patient's consciousness(4%). It was found that the contents that ICU nurses responded were most needed in the field of pathology were found to be the process of the progress of the disease(32%), symptoms of the disease(27%), prognosis of the disease(22%), followed by the injury-healing process, clinical pathological examination, and examination by radiation. It was found that the contents that nurses responded were most needed in the field of pharmacology were the effect of drug(25%), the side effect of drug(22%), the relationship between diseases and drug(20%), the relationship between disease-causing bacteria and drug(20%) and chemotherapy(2%). It was found that the contents that ICU nurses responded were most needed in the field of microbiology were the relationship between diseases and disease-causing bacteria(45%), Kinds and characteristics of disease-causing bacteria(18%), infection control(16%), application of the aseptic technique(12%), isolation(9%) and the like. It was found that the basic knowledge that ICU nurses responded were needed were the identification of the patient's current state(36%), understanding of the therapeutic process(22%), the operating principle of medical equipment and instrument(20%), medical terminology(9%), equipment and instrument management(7%), calculation of the dose of injection(2%) and the like.

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Mitochondrial DNA Mutation (3243A→G,1555A→4G,7445A→G) in Noise-Induced (소음성 난청에서의 Mitochondrial DNA A3243G, A1555G, A7445G 돌연변이)

  • Hong Young-Seoub;Nishio Hisahide;Lee Myeong-Jin;Kwak Ki-Young;Hwang Chan-Ho;Shin Dong-Hoon;Kwak Jong-Young;Lee Yong-Hwan;Kim Jong-Min;Kim Joon-Youn
    • Journal of Life Science
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    • v.14 no.6 s.67
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    • pp.913-919
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    • 2004
  • Mitochondrial DNA mutations have been reported in recent years in association with sensorineural hering loss. The purpose of this study is to identify the association between the noise-induced sensorineural hearing loss and the A to G mutation at nucleotide 3243, 1555, 7445 of mitochondrial DNA. Study subjects were established by history and chart review, and audiological and clinical data were obtained. Blood was sampled from 214 normal controls, 102 noise-induced hearing loss, and 28 sensorineural hearing loss. The DNA of these individuals were extracted, and mitochondrial DNA fragments were analyzed by polymerase chain reaction. Subsequently, the coding sequence of mitochondrial DNA 3243, 1555, 7445 were sequenced, and compared to the normal sequence, and all sequence variations were analyzed by restriction enzymes. Mitochondrial DNA mutations $(3243A{\rightarrow}G,\;1555A{\rightarrow}4G,\;7445A{\rightarrow}G)$ were not detected by polymerase chain reactions in any patients with noise-induced hearing loss, sensorineural hearing loss, and normal controls. The DNA sequencing of PCR products did not revealed an A to G substitution at nucleotide 3243, 1555, 7445 of mitochondrial DNA. The noise-induced sensorineural hearing loss was not associated with mitochondrial DNA mutation $(3243A{\rightarrow}G,\;1555A{\rightarrow}4G,\;7445A{\rightarrow}G)$.

Effect of maternal thyroxine treatment on the offspring's brain development with fetal alcohol effects in the rats (모체 thyroxine 투여가 새끼 흰쥐 대뇌의 태아 알코올 효과에 미치는 영향)

  • Fu, Jin;Chung, Yoon Young;Park, Sang Kee
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.677-685
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    • 2006
  • Purpose : This study aimed to investigate whether exogenous thyroxine($T_4$) treatment to alcohol-fed dams would ameliorate the detrimental effects of alcohol on the postnatal development of neuropeptide-Y(NPY)-containing neurons of the cerebral cortex and hippocampus of the offspring. Methods : Time-pregnant rats were divided into three groups. An alcohol-fed group A received 35 calories of liquid alcohol diet daily from gestation day 6; control group B was fed a liquid diet in which dextrin replaced alcohol isocalorically; and alcohol+$T_4$ group C received 35 calories of liquid alcohol diet and exogenous thyroxine subcutaneously. The features of the growth and maturation of rat brain tissue were observed at 0, 7, 14, 21 and 28 postnatal days via immunohistochemistry. Results : Group C showed prominent NPY immunoreactivity in the cerebral cortex compared to group A and B at P7. In group C, NPY-containing neurons were widely distributed in the all layers of cerebral cortex after P14. Also, numerical decreases of NPY-containing neuron were not found according to increasing age in group C. A decrease of NPY-containing neurons, however, was clearly observed in group A compared to group C at P28. In the hippocampus, similar patterns appeared in groups B and C after P7. Especially, in groups B and C, NPY-containing fibers formed plexus in the cerebral cortex and hippocampus at P14. Conclusion : These results suggest that the increase of NPY synthesis caused by maternal administration of exogenous thyroxine may convalesce fetal alcohol effects, one of the effects of the dysthyroid state following maternal alcohol abuse.

Changes of c-Fos Immunoreactivity in Midbrain by Deep Pain and Effects of Aspirin (심부통증이 흰쥐 중뇌에 미치는 c-Fos 면역반응성의 변화와 아스피린의 효과)

  • Jung, Jin A;Yoo, Ki Soo;Hwang, Kyu Keun
    • Clinical and Experimental Pediatrics
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    • v.46 no.7
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    • pp.695-701
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    • 2003
  • Purpose : It had been suggested that pain arising from deep somatic body regions influences neural activity within periaqueductal gray(PAG) of midbrain via distinct spinal pathways. Aspirin is one of the popular non-steroidal anti-inflammatory drugs used in the management of pain. Fos expression was used as a marker for neuronal activity throughout central neurons following painful peripheral stimulation. This study was prepared to investigate changes of c-Fos immunoreactivity in midbrain by deep pain and effects of aspirin. Methods : Male Sprague-Dawley rats were injected with 0.1 mL of 5% formalin in the plantar muscle of the right hindpaw. For experimental group II, aspirin was injected intravenously before injection of formalin. An aspirin-untreated group was utilized as group I. Rats were sacrificed at 0.5, 1, 2, 6 and 24 hours after formalin injection. Rat's brains were removed and sliced in rat brain matrix. Brain slices were coronally sectioned at interaural 1.00-1.36 mm. Serial sections were immunohistochemically reacted with polyclonal c-Fos antibody. The numbers of c-Fos protein immunoreactive neurons in ventrolateral periaqueductal gray(VLPAG) and dorsomedial periaqueductal gray(DMPAG) were counted and analyzed statistically with Mann-Whitney U tests. Results : Higher numbers of c-Fos protein immunoreactive neurons were found in VLPAG. In both VLPAG and DMPAG of formalin-treated group, the numbers of c-Fos protein immunoreactive neurons were significantly higher at all time points than the formalin-untreated group, which peaked at two hours. The numbers of c-Fos immunoreactive neuron of the aspirin-treated group were less compared to the aspirin-untreated group at each time point. Conclusion : These results provide some basic knowledge in understanding the mechanism of formalin-induced deep somatic pain and the effects of aspirin.

Effect of Xanthine Oxidase Inhibitor on Cerebral Hypoxia-Ischemia in Neonatal Rats (Xanthine Oxidase Inhibitor가 저산소성-허혈성 뇌손상이 유도된 신생쥐에 미치는 영향)

  • Choi, Dae-Ho;Oh, Yeon-Kyun;Park, Seung-Tak
    • Clinical and Experimental Pediatrics
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    • v.45 no.6
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    • pp.732-742
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    • 2002
  • Purpose : In order to evaluate the hypoxia-ischemia(H-I) induced neurotoxicity and the protective effect of xanthine oxidase(XO) inhibitor(allopurinol), cell number, cell viability, lactate dehydrogenase(LDH), protein synthesis(PS) and protein kinase C(PKC) activity were measured in cerebral neurons and astrocytes. Methods : Cytotoxic effect was measured by in vitro assay at 12-72 hours after H-I on cerebral neurons and astrocytes derived from 7-day old neonatal rats which were subjected to unilateral common carotid artery occlusion and exposed to hypoxic condition for 3 hours. The protective effect of XO inhibitor was examined by the cell number, cell viability, LDH and PS on 14 days after H-I with allopurinol intraperitoneal injection 15 minutes prior to H-I. In addition, the effect of allopurinol on PKC activity in hypoxic conditions was examined in neurons. Results : 72 hours from H-I, the cell numbers and viability were decreased significantly in time-dependent manner on neurons and those of astrocytes also decreased slightly, compared with control. In neonatal rats treated with H-I, the cell number, cell viability, and PS in neurons were decreased, but LDH was increased significantly compared with control. In neonatal rats pretreated with allopurinol, the cell number and viability, and PS in neurons were increased and LDH was decreased significantly compared with H-I. PKC was increased remarkably after hypoxic condition. But PKC was decreased significantly against hypoxic condition after allopurinol pretreatment. Conclusion : From these results, it is suggested that H-I is more toxic in neurons than astrocytes and allopurinol is very protective with increasing of PS, and decreasing of LDH and PKC in neurons from hypoxic-ischemic condition.