• Title/Summary/Keyword: Multi-therapy

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A study on the accuracy of source position in HDR brachytherapy according to the curvature of Universal applicator transfer tube and applicator type (원격 후 장전치료기를 사용한 고선량률 근접치료시 기구의 형태와 선원 전달 도관의 곡률 변화에 따른 선원위치 정확성에 관한 고찰)

  • Shin, Hyeon Kyung;Lee, Sang Kyoo;Kim, Joo Ho;Cho, Jeong Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.2
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    • pp.123-129
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    • 2015
  • Purpose : The goal of this study was to verify and analyze the source position according to the curvature of the universal applicator and 4 different angle applicators when using RALS(Remote After Loading System). Materials and Methods : An interval of 1 cm and 15 second dwell times in each source position were applied for plan. To verify the accuracy of source position, we narrowed the distance between MultiSource container and GAFCHROMIC$^{(R)}$ EBT3 film by 5 cm, 10 cm, 20 cm so that the universal applicator transfer tube had some curvature. Also 4 applicators(Intrauterine tube: $0^{\circ}$, $15^{\circ}$, $30^{\circ}$, Ovoid tube: $65^{\circ}$) were used in the same condition. The differences between desired and actual source position were measured by using Image J. Results : In case of using 4 different angles of applicator with the straight universal applicator transfer tube, the average error was the lowest for $0^{\circ}$ applicator, greatest for $65^{\circ}$ applicator. However, All average errors were within ${\pm}2mm$ recommended in TG-56. When MultiSource container was moved 5 cm, 10 cm, 20 cm towards the EBT3 film, the average errors were beyond ${\pm}2mm$. The first dwell position was relatively located in accuracy, while the second and third dwells were displaced by an increasing magnitude with increasing curvature of the transfer tube. Furthermore, with increasing the angle of applicators, the error of all other dwell positioning was increased. Conclusion : The results of this study showed that both the curvature of universal applicator transfer tube and the angle of applicators affect the source dwell position. It is recommended that using straight universal applicator transfer tubes is followed in all cases, in order to avoid deviations in the delivered source dwell position. Also, It is advisable to verify the actual dwell position, using video camera quality control tool prior to all treatments.

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Evaluation of Absorbed Dose and Skin Dose with MDCT Using Ionization Chamber and TLD (이온 전리함 및 TLD 법을 이용한 Multi-Detector Computed Tomography의 흡수선량 및 체표면 선량 평가)

  • Jeon, Kyung Soo;Oh, Young Kee;Baek, Jong Geun;Kim, Ok Bae;Kim, Jin Hee;Choi, Tae Jin;Jeong, Dong Hyeok;Kim, Jeong Kee
    • Progress in Medical Physics
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    • v.24 no.1
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    • pp.35-40
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    • 2013
  • Recently, the uses of Multi-Detector Computed Tomography (MDCT) for radiation treatment simulation and planning which is used for intensity modulated radiation therapy with high technique are increasing. Because of the increasing uses of MDCT, additional doses are also increasing. The objective of this study is to evaluate the absorbed dose of body and skin undergoing in MDCT scans. In this study, the exposed dose at the surface and the center of the cylindrical water phantom was measured using an pencil ionization chamber, 30 cc ionization chamber and TL Powder. The results of MDCT were 31.84 mGy, 33.58 mGy and 32.73 mGy respectively. The absorbed dose at the surface showed that the TL reading value was 33.92 mGy from MDCT. These results showed that the surface dose was about 3.5% from the MDCT exposure higher than a dose which is located at the center of the phantom. These results mean that the total exposed dose undergoing MDCT 4 times (diagnostic, radiation therapy planning, follow-up et al.), is about 14 cGy, and have to be considered significantly to reduce the exposed dose from CT scan.

Characteristics of Methicillin-resistant Staphylococcus aureus Nasal Colonization Among Neonatal Unit Staff and Infection Control Measures (일개 병원 신생아실 근무 의료인에서 시행한 비강 내 MRSA 집락의 특성 및 전파예방에 관한 보고)

  • Kim, Dong Hwan;Kim, Sun Mi;Park, Ji Young;Cho, Eun Young;Choi, Chang Hee
    • Pediatric Infection and Vaccine
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    • v.16 no.2
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    • pp.131-141
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    • 2009
  • Purpose : In February 2007, an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections occurred in two newborns in the neonatal unit of Sahmyook Seoul Hospital. We performed this study to investigate the characteristics of MRSA nasal carriage among neonatal unit staffs and the effective infection control measures. Methods : Nasal swab specimens were obtained from the neonatal unit staff for the presence of MRSA. MRSA-colonized staffs were offered decolonization therapy with oral trimethoprim-sulfamethoxazole or 2% mupirocin ointment. Every 2-4months after decolonizaton, repeat nasal swab specimens were obtained. Also, samples from the neonatal unit environment and room air were collected. Results : Successful decolonization was achieved in 92% of the cases in 2 weeks after decolonization therapy, but most of the staffs were recolonized after several months. The nature of antibiotic susceptibility was changed from multi-drugsusceptible to multi-drug-resistant. The most frequently contaminated objects were dressing carts, computer keyboards, bassinets and washbowls. In environmental cultures using the settle microbe count method, the colony counts were decreased significantly at the last study period compared with the first study period in the neonatal room, breastfeeding room, service room, and dressing room (P <0.05). Conclusion : Effective control of sustained MRSA transmission within an institution may require prompt identification, treatment, and monitoring of colonized and/or infected staffs. However, nasal decolonization therapy may induce multi-drugresistant MRSA infection and had no effect on decreasing the MRSA nasal carriage rate in our study. Other factors might be more important, such as improving staff education, increasing hand hygiene practices, and environmental sterilization for controlling MRSA infections.

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Ceftizoxime-induced immune hemolytic anemia associated with multi-organ failure (Ceftizoxime 투약 후 면역용혈빈혈 및 다발장기부전)

  • Huh, Jin-Young;Ahn, Ari;Kim, Hyungsuk;Kwon, Seog-Woon;An, Sujong;Lee, Jae Yong;Kwon, Byoung Soo;Oh, Eun Hye;Park, Do Hyun;Huh, Jin Won
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.123-127
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    • 2017
  • Drug-induced immune hemolytic anemia (DIIHA) is a rare side effect of drugs. DIIHA may cause a systemic inflammatory response that results in acute multi-organ failure and death. Ceftizoxime belongs to the class of third generation cephalosporins, which are the most common drugs associated with DIIHA. Herein, we present a case of a 66-year-old man who developed fatal DIIHA after receiving a second dose of ceftizoxime. He was admitted to receive photodynamic therapy. He had a history of a single parenteral dose of ceftizoxime 3 months prior to admission. On the day of the procedure - shortly after the infusion of ceftizoxime - the patient's mental status was altered. The blood test results revealed hemolysis. Oliguric acute kidney injury developed, and continuous renal replacement therapy had to be applied. On the suspicion of DIIHA, the patient underwent plasmapheresis. Diagnosis was confirmed by a detection of drug-dependent antibody with immune complex formation. Although his hemolysis improved, his liver failure did not improve. He was eventually discharged to palliative care, and subsequently died.

Molecular Target Therapy of AKT and NF-kB Signaling Pathways and Multidrug Resistance by Specific Cell Penetrating Inhibitor Peptides in HL-60 Cells

  • Davoudi, Zahra;Akbarzadeh, Abolfazl;Rahmatiyamchi, Mohammad;Movassaghpour, Ali Akbar;Alipour, Mohsen;Nejati-Koshki, Kazem;Sadeghi, Zohre;Dariushnejad, Hassan;Zarghami, Nosratollah
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4353-4358
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    • 2014
  • Background: PI3/AKT and NF-kB signaling pathways are constitutively active in acute myeloid leukemia and cross-talk between the two has been shown in various cancers. However, their role in acute myeloid leukemia has not been completely explored. We therefore used cell penetrating inhibitor peptides to define the contributions of AKT and NF-kB to survival and multi drug resistance (MDR) in HL-60 cells. Materials and Methods: Inhibition of AKT and NF-kB activity by AKT inhibitor peptide and NBD inhibitor peptide, respectively, resulted in decreased expression of mRNA for the MDR1 gene as assessed by real time PCR. In addition, treatment of HL-60 cells with AKT and NBD inhibitor peptides led to inhibition of cell viability and induction of apoptosis in a dose dependent manner as detected by flow cytometer. Results: Finally, co-treatment of HL-60 cells with sub-optimal doses of AKT and NBD inhibitor peptides led to synergistic apoptotic responses in AML cells. Conclusions: These data support a strong biological link between NF-kB and PI3-kinase/AKT pathways in the modulation of antiapoptotic and multi drug resistant effects in AML cells. Synergistic targeting of these pathways using NF-kB and PI3-kinase/AK inhibitor peptides may have a therapeutic potential for AML and possibly other malignancies with constitutive activation of these pathways.

Evaluation on the Quality of Research Field with Traditional Herbal Prescriptions for Dementia Therapy (치매 치료용 한약 처방의 연구성과에 대한 정성평가)

  • Heo, Eun-Jung;Kang, Jong-Seok;Kang, Hyung-Won;Jeon, Won-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.23 no.1
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    • pp.93-114
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    • 2012
  • Objective : This study aimed to review the performance of traditional herbal prescriptions for treating dementia and present a strategy for research on dementia therapy utilizing herbal medicine. Methods : A definition was made to clarify the technology regarding the development of herbal prescriptions for treating dementia. The queries were compounded based on the initial keywords provided by experts in the field, then applied to the Web of Science database search engines from January 1986 to September 2011 to search related scientific articles. Before performing the analysis, papers were extracted from the initial search reviewed by experts and 80 articles were selected. Then, the selected papers were analyzed in terms of publish year, country, and type of herbal prescriptions. Furthermore, the research performance evaluation for treating dementia by herbal prescriptions was also created in terms of country and organization based on forward citation analysis. In addition to, for the evaluation regarding research quality, we classified and reviewed papers into two types: clinical studies and experimental studies. Results : According to the quantitative information analysis of 80 articles, the number of papers has increased by 21.9% per the yearly mean from 1995, and Japan had the largest portion within this research field. There were 34 kinds of traditional herbal prescriptions, among them Ukgansan had the highest number of studies followed by Jodeungsan, Dangkisoosan and so on. In addition, quality index as calculated by cites per paper is higher than average in Switzerland, Turkey and Japan. In the view of the evaluation on quality there were 12 clinical studies, 8 RCT reported that herbal prescriptions had efficacy at cognition, behavioral & psychological symptoms (BPSD) and activity of daily life (ADL) in various type of dementia. In experimental studies most of the studies were performed using animal models. The studies using Ukgansan were aimed at improving BPSD. The papers studied with Jodeungsan and Dangkisoosan targeted vascular dementia. Conclusions : In this study, research to develop traditional herbal prescriptions for treating dementia has the potential to improve symptoms since herbal medicines work as both multi-function and multi-target in dementia with multiple pathological or neurotoxic pathways. Therefore, the results of the research should be used in order to establish strategies to develop technology for treating dementia with traditional herbal prescriptions in the future.

Head and neck extra nodal NHL (HNENL) - Treatment Outcome and Pattern of failure - A Single Institution Experience

  • Giridhar, Prashanth;Mallick, Supriya;Bhasker, Suman;Pathy, Sushmita;Mohanti, Bidhu Kalyan;Biswas, Ahitagni;Sharma, Atul
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6267-6272
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    • 2015
  • Background: Extra nodal lymphoma (ENL) constitutes about 33 % of all non-Hodgkin's lymphoma. 18-28% develops in the head and neck region. A multimodality treatment with multi-agent chemotherapy (CT) and radiotherapy (RT) is considered optimum. Materials and Methods: We retrieved the treatment charts of patients of HNENL treated in our institute from 2001-2012. The charts were reviewed and the demographic, treatment details and outcome of HNENL patients were retrieved using predesigned pro-forma. Results: We retrieved data of 75consecutive patients HNENL. Median age was 47years (Range: 8-76 years). Of the 75 patients 51 were male and 24 were female. 55patients were evaluable. The patient and tumor characteristics are summarized in Table 1. All patients were staged comprehensively with contrast enhanced computed tomography of head, neck, thorax, abdomen, pelvis and bone marrow aspiration and biopsy 66 patients received a combination multi-agent CT with CHOP being the commonest regimen. 42 patients received 4 or lesser number of cycles of chemotherapy whereas 24received more than 4 cycles chemotherapy. Post radiotherapy, 41 out of 42 patients had a complete response at 3 months. Only 21patients had a complete response after chemotherapy. All patients received radiation (mostly involved field radiation) as a part of the treatment. The median radiation dose was 45 Gray (Range: 36 Gray-50 Gray). The radiation was planned by 2D fluoro simulation based technique in 37cases and by 3 Dimensional conformal radiation therapy (3DCRT) in 36 cases. Two patients were planned by the intensity modulated radiation therapy (IMRT) technique. IMRT was planned for one thyroid and one nasal cavity primary. 5 patients experienced relapse after a median follow up of 19 months. The median survival was not reached. The estimated two and three year survival were 92.9% (95%CI- 68.6- 95.35) and 88% (95%CI- 60.82 - 92.66) respectively. Univariate analysis revealed higher stage and poorer baseline performance status to be significantly associated with worse progression free survival. 5 patients progressed (relapse or primary disease progression) after treatment. Of the 5 patients, two patients were primary orbital NHL, two patients had NHL nasal cavity and one was NHL thyroid. Conclusions: Combined modality treatment in HNENL confers excellent disease control with acceptable side effects.

A Case Study on Vocal Aerobic Treatment Voice Therapy Development and Application for Classical Singers (성악가를 위한 VAT 음성치료 개발 및 적용 사례연구)

  • Yoo, Jae-Yeon;Lee, Ha-Na
    • 재활복지
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    • v.22 no.1
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    • pp.157-168
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    • 2018
  • The purpose of this study is to investigate the impact of semi-closed vocal training-based Vocal Aerobic Treatment on the voice improvement of soprano. Study subject was one soprano who appealed to the suffering of her voice problem due to vocal cord nodule. A study method of conducting pre/post acoustic evaluation and subjective voice evaluation to compare the measures was used; Vocal Aerobic Treatment was carried out twice a week for a total of 32 session. In the acoustic evaluation, MDVP (multi-dimensional voice program) and VRP (voice range profile) were used to evaluate the pitch, voice quality, and voice range; in the subjective voice evaluation, SVHI (singing voice handicap index) was used to assess voice satisfaction. As a result of the pitch evaluation, the soprano maintained a proper Fo. As a result of the voice quality evaluation, the jitter, shimmer, and the noise harmonic ratio numbers decreased compared to the numbers shown before the treatment. As a result of the voice range evaluation, the scope of the range was broadened, with the number of semitone increasing from 30 to 35. As for the subjective voice evaluation, the result of the total score obtained after the survey report divided by the number of questions showed a decrease from 3.6 to 0.6. The soprano herself reported of having a minor extent of a voice problem. The summary of the above results reflects that Vocal Aerobic Treatment is useful in the voice improvement of vocalists However, as this study is case research regarding the Vocal Aerobic Treatment effect on one soprano, further research on the treatment effect covering many other vocalists is necessary. Also, there is a need for follow-up studies regarding voice management and voice treatment program on not only the vocalists but also the voice users in many other professions.

Implementing a Virtual Reality Forest Healing System Using Multisensory Modules (다감각 모듈을 사용한 가상현실 산림 치유 시스템 구현)

  • Sohui Kim;Jewon Myung;YoungBeom Park;Sun-Jeong Kim
    • Journal of the Korea Computer Graphics Society
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    • v.30 no.4
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    • pp.31-39
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    • 2024
  • This study applied virtual reality systems for forest therapy to reduce motion sickness and enhance immersion using multi-sensory elements. In applying virtual reality systems, multi-sensory elements were utilized to reduce motion sickness while providing a more immersive experience. Among these elements, tactile and olfactory devices utilizing wind and scent were developed and employed. The program was developed using Unity3D's HDRP (High Definition Render Pipeline), and both HMD (Head Mounted Display) and non-HMD systems were established to determine if visual motion induces motion sickness. An air circulator was placed to provide a sense of wind and allow users to smell scents through the olfactory device. An experiment was designed to examine whether tactile and olfactory stimuli influence user satisfaction with the virtual reality forest therapy system. The results showed that the tactile device significantly reduced motion sickness, while the developed olfactory device did not yield significant results in reducing motion sickness for participants.

A survey of leisure participation and leisure exploration of community dwelling stroke patients (지역사회 거주 뇌졸중 환자의 여가 참여 및 여가 탐색 조사)

  • Jeong, Eun-Hwa
    • Journal of Industrial Convergence
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    • v.18 no.4
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    • pp.41-49
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    • 2020
  • The purpose of this study was to provide basic information on leisure participation and leisure exploration of community-dwelling stroke patients through a multi-dimensional leisure participation evaluation tool. The subjects in this study were 35 people living with stroke in the community. As a result of study, the most involved leisure activities were in order of watching TV, communicating, and exercise alone. Most of the satisfaction level of leisure participation was 7-10 points, but exercise alone was 5.2 points due to the purpose of health management. Leisure exploration was the most frequent exercise alone and sports, and interest was 8-10 points. The most important obstacles for leisure participation were physical problems depending on the nature of the stroke disease. Through the results of this study, it is necessary to activate a stroke patient's discharge plan and activate a community stroke patient's leisure intervention program so that they can participate in leisure activities of their choice through voluntary leisure exploration.