Background: The present experiment was conducted to identify the cooperative effect of serine histogranin (SHG) and noradrenaline in alleviating peripheral neuropathic pain. Methods: Chronic constriction injury of the right sciatic nerve was used to induce chronic neuropathic pain. For drug delivery, a PE10 tube was inserted into the subarachnoid space. Acetone drops and a $44^{\circ}C$ water bath were used to evaluate the cold and heat allodynia, respectively. Placing and grasping reflexes were used to assess the locomotor system. Results: SHG at 0.5 and $1{\mu}g$significantly (P < 0.05) decreased the thermal allodynia. The cold allodynia was also significantly reduced by intrathecal injections of 0.5 (P < 0.05) and $1{\mu}g$(P < 0.001) of SHG. $1{\mu}g$of noradrenaline, but not $0.5{\mu}g$, significantly alleviated the cold (P < 0.01) and thermal (P < 0.05) allodynia. The ameliorating effect of noradrenaline or SHG disappeared when the two compounds were administrated in equal concentrations. A significant difference (P < 0.01 in the acetone and P < 0.05 in the heat) was observed in the groups under equal doses of the two compounds, with a lower effectiveness of the combination therapy. Conclusions: Our findings suggest that the simultaneous administrations of noradrenaline and SHG do not result in synergistic analgesia, and combination therapy may not be a good approach to the treatment of chronic neuropathic pain syndrome.
Obstetrics and Gynecology include gynecology which is concerned with the treatment for the disease based on physiology and pathology of women, and obstetrics which is concerned with pregnancy delivery. These obstetrics and gynecology can be said to da-te from the birth of human beings. This pap-er has carried on the studies about the deve-loping process of obstetrics and gynecology of Ming and Qing age. The results of this study are as follows: In Ming age, Many Obstetrics and Gynecology books including "Nukecuoyao"("女科撮要"), "Xiaozhufurenliangfang"("校注婦人良方"), "Wanshifurenke"("萬氏婦人科") and "Nukezhingzhizhunsheng"("女科證治准繩") were published Distinction in Ming age we-re equal development on theory and clinic t-aking a serious view of the differentiation of symptoms and signs, fashion of medicine th-ought of reactionism under the influence of "lixue"(理學). The refore Obstetrics and Gyn-ecology were influenced by these points. And for this example, as treatment contents on "Xiaozhufurenliangfang"("校注婦人良方") and the theory about "fetuse-energy"(胎氣) in "Furengui"("婦人規"), theoretic system with a view point's change of women's disease were established on Obstetrics and Gynecology. But it was restricted on a field of diagnosis under the influence of feudal "lixue"(理學), so the the number of obstetrics doc-tors who were mostly men at that time had fallen greatly and maternity who were short of expert medical knowledge appeared. In Qing age, an explosive increase in po-pulation called greater demand on medicine book and generation after generation extre-mely much Obstetrics and Gynecology books including "NukeChanhoubian"("女科産後編"), "Yetianshinuke"("葉天士女科"), and "Shenshinukejiyao"("沈氏女科輯要") were p-ublished, and it is studied that application of "eight extra-channel"(奇經八脈) theory and the study of drug attributive on extra-chan-nel were progressed. Besides, it is studied that existing traditional Obstetrics and Gyn-ecology changed newly under the influence of the school of combination of traditional Chinese medicine and western medicine which was appeared in the late Qing age.
The purpose of this study is to evaluate the developed dose verification program for in vivo dosimetry based on transit dose in radiotherapy. Five intensity modulated radiotherapy (IMRT) plans of lung cancer patients were used in the irradiation of a homogeneous solid water phantom and anthropomorphic phantom. Transit dose distribution was measured using electronic portal imaging device (EPID) and used for the calculation of in vivo dose in patient. The average passing rate compared with treatment planning system based on a gamma index with a 3% dose and a 3 mm distance-to-dose agreement tolerance limit was 95% for the in vivo dose with the homogeneous phantom, but was reduced to 81.8% for the in vivo dose with the anthropomorphic phantom. This feasibility study suggested that transit dose-based in vivo dosimetry can provide information about the actual dose delivery to patients in the treatment room.
Background: Safety culture, acting as the oil necessary in an efficient safety management system, has its own weaknesses in the current conceptualization and utilization in practice. As a new approach, resilience safety culture (RSC) has been proposed to reduce these weaknesses and improve safety culture; however, it requires a valid and reliable instrument to be measured. This study aimed at evaluating the reliability and validity of such an instrument in measuring the RSC in sociotechnical systems. Methods: The researchers designed an instrument based on resilience engineering principles and safety culture as the first instrument to measure the RSC. The RSC instrument was distributed among 354 staff members from 12 units of an anonymous petrochemical plant through hand delivery. Content validity, confirmatory, and exploratory factor analysis were used to examine the construct validity, and Cronbach alpha and test-retest were employed to examine the reliability of the instrument. Results: The results of the content validity index and content validity ratio were calculated as 0.97 and 0.83, respectively. The explanatory factor analysis showed 14 factors with 68.29% total variance and 0.88 Kaiser-Meyer-Olkin index. The results were also confirmed with confirmatory factor analysis (relative Chi-square = 2453.49, Root Mean Square Error of Approximation = 0.04). The reliability of the RSC instrument, as measured by internal consistency, was found to be satisfactory (Cronbach ${\alpha}=0.94$). The results of test-retest reliability was r = 0.85, p < 0.001. Conclusion: The results of the study suggest that the measure shows acceptable validity and reliability.
Journal of The Korea Institute of Healthcare Architecture
/
v.25
no.3
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pp.15-23
/
2019
Purpose: As the medical laboratories in general hospitals have made an efforts on quality management and employee health, they recognized the need of design guideline for clinical laboratory. As laboratories are prohibited to patients, their environments are becoming more congested and deteriorated as time goes by. So, this study investigates the current status of facility and equipment of laboratory medicine focusing on less than three hundred patient bed hospitals, and searches the improving matters. Methods: Questionnaires to technologist captains and field surveys to medical laboratories in korean hospitals have been conducted for the data collection. 18 answers have been analysed statistically by MS Excel program. Results: The result of this study can be summarized into followings. Clinical laboratory functions are all hematology, clinical chemistry, immunology, transfusion and urine microscopy, and except for three including microbiology for infection and bio safety level. Average man power of lab are 12.3 man including lab director and captain. Patient bed number, space area and total specimen numbers are not correlated with each other, but specimen numbers and employee number are correlated with. Work space distances are usually good, but exit distances are not adequate for escape owing to obstacles. Specimen delivery system by courier, test method by automatic analyzer, access floor for exposed plumbing and electricities are more practical. Open lab layed out in the center and lab support layed peripheral in space diagram. Lab space configuration by SD method showed that lab support area and employee support area are dissatisfied. Implications: Specialized hospital and yearly total specimen numbers are related to the space area and organization for laboratory planning and design.
Deep learning (DL) is a subset of machine learning and artificial intelligence that has a deep neural network with a structure similar to the human neural system and has been trained using big data. DL narrows the gap between data acquisition and meaningful interpretation without explicit programming. It has so far outperformed most classification and regression methods and can automatically learn data representations for specific tasks. The application areas of DL in radiation oncology include classification, semantic segmentation, object detection, image translation and generation, and image captioning. This article tries to understand what is the potential role of DL and what can be more achieved by utilizing it in radiation oncology. With the advances in DL, various studies contributing to the development of radiation oncology were investigated comprehensively. In this article, the radiation treatment process was divided into six consecutive stages as follows: patient assessment, simulation, target and organs-at-risk segmentation, treatment planning, quality assurance, and beam delivery in terms of workflow. Studies using DL were classified and organized according to each radiation treatment process. State-of-the-art studies were identified, and the clinical utilities of those researches were examined. The DL model could provide faster and more accurate solutions to problems faced by oncologists. While the effect of a data-driven approach on improving the quality of care for cancer patients is evidently clear, implementing these methods will require cultural changes at both the professional and institutional levels. We believe this paper will serve as a guide for both clinicians and medical physicists on issues that need to be addressed in time.
The Hi-Art system for TomoTherapy allows only three (1.0 cm, 2.5 cm, 5.0 cm) field widths and this can produce different dose distribution around the end of PTV (Planning target volume) in the direction of jaw movement. In this study, we investigated the effect of field width on the dose difference around the PTV using DQA (Delivery quality assurance) phantom and real clinical patient cases. In the analysis with DQA phantom, the calculated dose and irradiated films showed that the more dose was widely spreaded out in the end region of PTV as increase of field width. The 2.5 cm field width showed a 1.6 cm wider dose profile and the 5.0 cm field width showed a 4.2 cm wider dose profile compared with the 1.0 cm field width in the region of 50% of maximum dose. The analysis with four patient cases also showed the similar results with the DQA phantom which means that more dose was irradiated around the superior and inferior end of PTV as an increase of field width. The 5.0 cm field width produced the remarkable high dose distribution around the end region of PTV and we could evaluate the effect quantitatively with the calculation of DVH (Dose volume histogram) of the virtual PTVs which were delineated around the end of PTV in the direction of jaw variation. From these results, we could verify that the margin for PTV in the direction of table movement should be reduced compared with the conventional margin for PTV when the large field such as 5.0 cm was used in TomoTherapy.
Proceedings of the Korean Society of Medical Physics Conference
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2002.09a
/
pp.248-251
/
2002
The intensity modulated radiation therapy (IMRT) with a multileaf collimator (MLC) requires the conversion of a radiation fluence map into a leaf sequence file that controls the movement of the MLC during radiation treatment of patients. Patient dose verification is clinically one of the most important parts in the treatment delivery of the radiation therapy. The three dimensional (3D) reconstruction of dose distribution delivered to the target helps to verify patient dose and to determine the physical characteristics of beams used in IMRT. A new method is presented for the pretreatment dosimetric verification of two dimensional distributions of photon intensity by means of Beam Intensity Scanner System (BISS) as a radiation detector with a custom-made software for dose calculation of fluorescence signals from scintillator. The scintillator is used to produce fluorescence from the irradiation of 6MV photons on a Varian Clinac 21EX. The BISS reproduces 3D- relative dose distribution from the digitized fluoroscopic signals obtained by digital video camera-based scintillator(DVCS) device in the IMRT. For the intensity modulated beams (IMBs), the calculations of absorbed dose are performed in absolute beam fluence profiles which are used for calculation of the patient dose distribution. The 3D-dose profiles of the IMBs with the BISS were demonstrated by relative measurements of photon beams and shown good agreement with radiographic film. The mechanical and dosimetric properties of the collimating of dynamic and/or step MLC system alter the generated intensity. This is mostly due to leaf transmission, leaf penumbra and geometry of leaves. The variations of output according to the multileaf opening during the irradiation need to be accounted for as well. These phenomena result in a fluence distribution that can be substantially different from the initial and calculative intensity modulation and therefore, should be taken into account by the treatment planning for accurate dose calculations delivered to the target volume in IMRT.
This Study has attemped to compare the health care systems of South and North Korea. There has been a wide difference in the health care System between the South and North of Korea. In this paper, I have also shown that each health care system has its own unique response to the social, political, and economic conditions of the country. Therefore the author analyzed and summarized the important difference of health care system between the South and the North of Korea as follows. 1. Compared with the Laissez-faire health care system of South Korea, North Korea has the state socialistic health care system which provide health care services to the people free of charge. And the North Korea is marking positive efforts toward the scientification and systemization of Oriental Medicine which is called Dongui-Hak in the North-on the basis of Ju-Che idea. 2. North Korea's health care system appears to be strongly geared toward extensive and preventive treatment and launched the massive sanitary propagation campaign. which have resulted in a great success. North Korea has a system of universal comprehensive care for its population. The government has a central role in planning and regulating health care. 3. The government also employs physicians, nurses, and other professionals to provide health care to patients at public expense. In North Korea, health professionals are government employees. They work for a salary and the system is funded through general taxation. 4. In the North Korea, health services area system of the cities and countre's unit is strictly conducted along with the doctor's area responsibility system. And so without referal card, patients can not use the upper-grade medical facilities. The health care delivery system of North Korea is made up of the fourth level procedue unlike South Korea. 5. General office of Oriental Medicine, Academy of Oriental Medical Science and Guidance Bureau of Oriental Medicine are established in the organization of the Department of Health in the North Korea. And nowadays much emphasis are equally placed on the Oriental Medicine as well as Western Medicine. Both South and North Korea have faced with a critical moment of developing a mutually agreeable and acceptable system of health care for the unified nation.
The editorials of the leading newspapers may reflect as well as help formulate the public opinions to a significant degree. Bearing this in mind, this study was carried out to provide information useful in formulating such public health policies that could practically meet the social interests and demands in health appearing in the editorials of the newspapers. This analysis covered the editorials of 5 leading newspapers such as Donga Ilbo, Chungang Ilbo, Hankook Ilto, Chosun Ilbo and Seoul Shinmoon for about 10 years from Jan. 1st, 1970 through Oct. 31th, 1979. The major findings are as follows: 1. The total number of health-concerned editorials in the five daily papers for the period was 1,768 or occupied 6.4% of the total editorials of the same sources. The increasing trend of frequnecy of the health-concerned editorials since 1976 indicates the increment of social interests and demands in health. Analysing the contents, environmental pollution received the greatest attention in those editorials, which was followed by medical affairs, environmental sanitation, and disease control in order in terms of frequency of appearance. However, there was a tendency that the interests in the environmental pollution, medical affairs and social welfare tended to increase year by year, whereas those in environmental hygiene and disease control comparatively decreased. 2. Motives of dealing with the health-concerned editorials were provided by announcement of the governmental policies and implementation for 25.6% and by out-breaks of the relevant events for 23.9%. This tendency coincides with the general characteristics of the editorials that reflect the timely issues. Closely analysing, however, the fact that the motives engendered by the out-breaks of the relevant events or by the season concerned comparatively tended to decrease as years pass by, indicates that the editorials tend more to seek the future-oriented demands in health rather than the current issue-oriented. 3. The editorials appeared to be more concerned with the governmental policies. 95.7% of all the editorials analysed were addressed to the government. This signifies the role of government in the field of public health and medical affairs. Their attitudes toward health-related policies of the government were much more negative than the other editorials that were addressed to the government in other fields. This suggests that the governmental interests in health were neither sufficient nor fair. 4. What the editorials most stressed were; (1) increment of governmental interests in health, (2) improvement of the governmental health administration, (3) enriching the basic statistics, and (4) development of various technologies pertinent to health affairs and disease control, and so forth. However, must of their suggestions were not concrete but rather abstract and conceptual. 5. The editorials also expressed strong interests in research area. The areas of the needed research most suggested by items are; (1) development of effective health care delivery system, (2) establishment of more practical system of calculating medical cost, (3) implementation of effective policies to control degenerative diseases, (4) division of medical care services and pharmaceutical services systems, (5) effective ways to prevent Co poisoning accidents, (6) changing status of environmental pollution and its effects upon health, and (7) status of occupational diseases, and so forth. 6. There were some editorials -not small in quantity -that have risk to mislead the public opinions as well as the health policies due to lack of professional knowledge of the writers. It is desirable to establish some kind of mechanism that screens the erroneous contents of the editorials to help prevent misleading opinions.
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