• 제목/요약/키워드: Primary Medical Center

검색결과 1,503건 처리시간 0.036초

광자극발광선량계와 이온함을 이용한 두경부 원발종양 및 림프절 전이성 종양의 선량 측정: 산란판과 볼루스의 비교 (Measurement of Tumor Dose Using Optically Stimulated Luminescence Detectors (OSLDs) and Ionization Chambers for Primary and Metastatic Lymph Node Cancers with Head and Neck: Comparison of Beam Spoiler and Bolus)

  • 이정옥;이재승;정동혁
    • Journal of Radiation Protection and Research
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    • 제36권3호
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    • pp.160-167
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    • 2011
  • 본 연구는 두경부 방사선치료에서 산란판(beam spoiler)과 볼루스(bolus)를 사용함에 따라 깊이가 다른 원발종양과 림프절 전이성 종양의 선량 변화를 이온함과 광자극발광선량계(optically stimulated luminescence detectors. OSLDs)를 이용하여 치료계획검증 방법으로 교차 비교하였다. 치료계획검증은 치료계획시스템에서 얻은 동일 조사 조건을 검출기가 삽입 가능한 고체 팬텀에 모사하는 방법으로 산란판과 0.5, 1 cm 볼루스를 비교하였으며 두 선량계의 교차비교는 측정 오차가 ${\pm}$2% 미만일 때 신뢰성이 있다고 판단하였다. 연구 결과 0.5 cm 두께의 산란판과 피부간 거리가 10 cm 일 때 최적의 선량분포를 얻을 수 있었으며 볼루스에 비하여 피부선량이 작고 중심부 원발종양 선량의 감소가 작았다. 또한 두 선량계의 교차 비교는 ${\pm}$1% 이내로 유의한 결과를 보였다. 두경부 종양의 방사선치료시 산란판을 사용함으로써 피부 부작용을 줄이면서 종양에 최적의 선량분포를 달성할 수 있다고 판단되었으며 향후 임상에 적용하기 위한 연구가 시행되어야 할 것이다.

Comparison of the Change in the Prevalence and Intensity of Schistosoma haematobium Infection Between High and Low Prevalence Areas of White Nile State, Sudan

  • Cha, Seungman;Hong, Sung-Tae;Lee, Jin-Su;Jeong, Hoo Gn;Kwon, In-Sun;Saed, Abd Al Wahab;Elhag, Mousab Siddig;Ismail, Hassan Ahmed Hassan Ahmed;Amin, Mutamad;Lee, Young-Ha
    • Parasites, Hosts and Diseases
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    • 제58권4호
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    • pp.421-430
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    • 2020
  • This study aimed to investigate whether mass drug administration (MDA) intervention has an equivalent effect on reducing the prevalence and intensity of Schistosoma haematobium infection regardless of the baseline values. A repeated cross-sectional survey was performed targeting students of 12 primary schools in Al Jabalain and El Salam districts of White Nile State, Sudan, at both 1 week before and 8 months after the MDA. Prior to the baseline survey, schoolaged children in Al Jabalain had received MDA interventions twice in 4 years, while those in El Salam had not. The baseline prevalence was 9.1% in Al Jabalain and 35.2% in El Salam, which were reduced to 1.8% and 5.5% at 8 months after the MDA, respectively. The corresponding reduction rates were 80.3% and 84.4%, not significant difference between both districts. However, changes in the geometric mean intensity (GMI) of egg counts were significantly different between both districts. The baseline GMIs were 14.5 eggs per 10 ml of urine (EP10) in Al Jabalain and 18.5 EP10 in El Salam, which were reduced to 7.1 and 11.2 EP10 after treatment, respectively. The corresponding reduction rates were 51.0% and 39.5%. In conclusion, MDA interventions were found to bring about similar relative reduction in prevalence regardless of the baseline value; however, the relative reduction in infection intensity was more salient in the district with a low baseline value for both prevalence and intensity. This clearly points to the importance of repeated MDA interventions in endemic areas, which will eventually contribute to schistosomiasis elimination.

개정된 가이드라인에 따른 아세트아미노펜 급성 중독환자 치료 기준의 검증 (Evaluation of Cut-off Values in Acute Acetaminophen Intoxication Following the Revised Guideline of the United Kingdom)

  • 박성진;차경만;소병학;김형민;정원중
    • 대한임상독성학회지
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    • 제16권2호
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    • pp.68-74
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    • 2018
  • Purpose: In 2012, a revised guideline for acute acetaminophen overdose was proposed in the UK, recommending that the treatment threshold should be lowered to 100 mcg/ml at 4 hours after ingestion without risk stratification of hepatotoxicity. However, the poison centers in some developing countries do not have laboratory resources to provide serum drug levels in time. The primary aim of the study is to evaluate the cut-off value of reported dose per kilogram to determine when N-acetylcysteine treatment is warranted under the revised guideline. Methods: Data were collected retrospectively from the toxicology registry of an urban emergency medical center between 1st January 2010 and 30th June 2017. Inclusion criteria were single acute overdose of more than 75 mg/kg in 15 hours from ingestion and over 14 years of age. Subgroups were created by 25 mg/kg increments of reported dose, then sensitivity, specificity, positive predictive value and negative predictive value were calculated for the cut-off values of 100 mg/kg, 125 mg/kg, 150 mg/kg and 175 mg/kg for toxic serum level over '100-treatment line'. Results: A total of 99 patients were enrolled in the study; 24 patients showed toxic serum levels (24.2%). Zero of 17 patients with an ingestion dose under 100 mg/kg showed toxic level (0%), and 0 of 15 under 125 mg/kg (0%), 2 of 14 under 150 mg/kg (14.3%), and 4 of 12 under 175 mg/kg (33.3%) had toxic levels. The higher the ingested dose per kilogram of weight, the higher the frequency of the toxic serum concentration on the first test (${\chi}^2$ test for trend, ${\chi}^2=22.66$, p-value<0.001) and the sensitivity of each value was 100%, 100%, 92% and 76%. Conclusion: In acute single acetaminophen intoxication, the ingestion dose of 100 mg/kg of weight will be useful in determining the need for the N-acetylcysteine antidote in the indigent laboratory environment.

Gintonin influences the morphology and motility of adult brain neurons via LPA receptors

  • Kim, Do-Geun;Kim, Hyeon-Joong;Choi, Sun-Hye;Nam, Sung Min;Kim, Hyoung-Chun;Rhim, Hyewhon;Cho, Ik-Hyun;Rhee, Man Hee;Nah, Seung-Yeol
    • Journal of Ginseng Research
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    • 제45권3호
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    • pp.401-407
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    • 2021
  • Background: Gintonin is an exogenous ginseng-derived G-protein-coupled lysophosphatidic acid (LPA) receptor ligand. LPA induces in vitro morphological changes and migration through neuronal LPA1 receptor. Recently, we reported that systemic administration of gintonin increases blood-brain barrier (BBB) permeability via the paracellular pathway and its binding to brain neurons. However, little is known about the influences of gintonin on in vivo neuron morphology and migration in the brain. Materials and methods: We examined the effects of gintonin on in vitro migration and morphology using primary hippocampal neural precursor cells (hNPC) and in vivo effects of gintonin on adult brain neurons using real time microscopic analysis and immunohistochemical analysis to observe the morphological and locational changes induced by gintonin treatment. Results: We found that treating hNPCs with gintonin induced morphological changes with a cell rounding following cell aggregation and return to individual neurons with time relapses. However, the in vitro effects of gintonin on hNPCs were blocked by the LPA1/3 receptor antagonist, Ki16425, and Rho kinase inhibitor, Y27632. We also examined the in vivo effects of gintonin on the morphological changes and migration of neurons in adult mouse brains using anti-NeuN and -neurofilament H antibodies. We found that acute intravenous administration of gintonin induced morphological and migrational changes in brain neurons. Gintonin induced some migrations of neurons with shortened neurofilament H in the cortex. The in vivo effects of gintonin were also blocked by Ki16425. Conclusion: The present report raises the possibility that gintonin could enter the brain and exert its influences on the migration and morphology of adult mouse brain neurons and possibly explains the therapeutic effects of neurological diseases behind the gintonin administration.

음악요법이 치매노인의 인지기능, 초조행동, 불안 및 우울에 미치는 효과: 체계적 고찰 및 메타분석 (Effects of Music Therapy on Cognitive function and Agitation, Anxiety and Depression in Dementia Elderly: a Systematic Review and Meta-analysis of Randomized Controlled Trials)

  • 채공주;이미경;남은숙;이호연
    • 한국산학기술학회논문지
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    • 제22권1호
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    • pp.520-530
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    • 2021
  • 목표: 본 연구는 음악요법이 치매 노인의 인지기능, 초조행동, 불안, 우울에 미치는 영향을 규명하는 것을 목적으로 한다. 방법: 2010년부터 2019년까지 PubMed, EMBASE, Cochrane Library, CINAHL, Web of Science, Google scholar, PsycINFO에서 종합적인 문헌검색을 하였고 메타분석에서는 RevMan 5.4 프로그램을 사용하여 표준화된 평균 차이(Hedge's g)와 95% 신뢰 구간은 요약 측정으로 산출하고 랜덤 효과 모델과 역분산 방법을 적용하였다. 총 13개의 연구가 포함되었으며, 모두 오류 위험 평가를 위한 코크란 평가도구를 근거로 질 평가를 하였다. 결과: 효과 크기(Hedge's g)는 1차 결과 변수인 인지기능 0.31[95% CI:-0.02, 0.65], 초조행동 -0.03[95% CI: -0.17, 0.11], 2차 결과 변수인 불안 -0.61[95% CI: -1.17, -0.05], 우울 -0.44[95% CI: -0.88, 0.00]이었다. 음악중재 유형별 하위그룹 분석 결과 복합음악요법이 치매 환자의 인지기능(g=0.45[95% CI: 0.03, 0.87])에 유의한 증가 효과가 있는 것으로 나타났다. 결론: 음악요법은 불안과 우울을 감소시키는 데 유의한 효과를 보였으며, 복합음악치료는 치매 환자의 인지기능 개선 효과를 보였다.

Pretreatment Neutrophil-to-Lymphocyte Ratio and Smoking History as Prognostic Factors in Advanced Non-Small Cell Lung Cancer Patients Treated with Osimertinib

  • Park, Ji Young;Jang, Seung Hun;Lee, Chang Youl;Kim, Taehee;Chung, Soo Jie;Lee, Ye Jin;Kim, Hwan Il;Kim, Joo-Hee;Park, Sunghoon;Hwang, Yong Il;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • 제85권2호
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    • pp.155-164
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    • 2022
  • Background: The remarkable efficacy of osimertinib in non-small cell lung cancer (NSCLC) with acquired T790M mutation has been widely documented in clinical trials and real-world practice. However, some patients show primary resistance to this drug. Even patients who initially show a favorable response have inconsistent clinical outcomes later. Therefore, the aim of this study was to identify additional clinical predictive factors for osimertinib efficacy. Methods: A prospective cohort of patients with acquired T790M positive stage IV lung adenocarcinoma treated with osimertinib salvage therapy in Hallym University Medical Center were analyzed. Results: Sixty-one eligible patients were analyzed, including 38 (62%) women and 39 (64%) who never smoked. Their mean age was 63.3 years. The median follow-up after treatment with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) was 36.0 months (interquartile range, 24.7-50.2 months). The majority (n=45, 74%) of patients were deceased. Based on univariate analysis, low baseline neutrophil-to-lymphocyte ratios (NLR), age ≥50 years, never-smoking history, stage IVA at osimertinib initiation, and prolonged response to previous TKIs (≥10 months) were associated with a significantly longer progression-free survival (PFS). Multivariate analysis showed that never-smoking status (hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.30-0.98; p=0.041) and a baseline NLR less than or equal to 3.5 (HR, 0.23; 95% CI, 0.12-0.45; p<0.001) were independently associated with a prolonged PFS with osimertinib. Conclusion: Smoking history and high NLR were independent negative predictors of osimertinib PFS in patients with advanced NSCLC developing EGFR T790M resistance after the initial EGFR-TKI treatment.

SPECT/CT 영상에서 에너지창 기반 산란보정과 CT 기반 산란보정 방법의 정량적 정확성 비교 (The Comparison of Quantitative Accuracy between Energy Window-Based and CT-Based Scatter Correction Method in SPECT/CT Images)

  • 김지현;이주영
    • 대한방사선기술학회지:방사선기술과학
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    • 제45권2호
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    • pp.135-143
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    • 2022
  • In SPECT image, scatter count is the cause of quantitative count error and image quality degradation. This study is to evaluate the accuracy of CT based SC(CTSC) and energy window based SC(EWSC) as the comparison with existing Non SC. SPECT/CT images were obtained after filling air in order to acquire a reference image without the influence of scatter count inside the Triple line insert phantom setting hot rod(99mTc 74.0 MBq) in the middle and each SPECT/CT image was obtained each separately after filling water instead of air in order to derive the influence of scatter count under the same conditions. For EWSC, 9 sub-energy windows were set additionally in addition to main energy window(140 keV, 20%) and then, images were acquired at the same time and five types of EWSC including DPW(dual photo-peak window)10%, DEW(dual energy window)20%, TEW(triple energy window)10%, TEW5.0%, TEW2.5% were used. Under the condition without fluctuations in primary count, total count was measured by drawing volume of interest (VOI) in the images of the two conditions and then, the ratio of scatter count of total counts was calculated as percent scatter fraction(%SF) and the count error with image filled with water was evaluated with percent normalized mean-square error(%NMSE) based on the image filled with air. Based on the image filled with air, %SF of images filled with water to which each SC method was applied is non scatter correction(NSC) 37.44, DPW 27.41, DEW 21.84, TEW10% 19.60, TEW5% 17.02, TEW2.5% 14.68, CTSC 5.57 and the scatter counts were removed the most in CTSC and %NMSE is NSC 35.80, DPW 14.28, DEW 7.81, TEW10% 5.94, TEW5% 4.21, TEW2.5% 2.96, CTSC 0.35 and the error in CTSC was found to be the lowest. In SPECT/CT images, the application of each scatter correction method used in the experiment could improve the quantitative count error caused by the influence of scatter count. In particular, CTSC showed the lowest %NMSE(=0.35) compared to existing EWSC methods, enabling relatively accurate scatter correction.

Association of Pre- and Perinatal Risk Factors With Tourette Syndrome or Chronic Tic Disorders in a Korean School-Age Population

  • Wooseok Choi;Soon-beom Hong;Johanna Inhynag Kim;Jung Lee;Soomin Jang;Yebin D Ahn;You Bin Lim;Sumin Kim;Mee Rim Oh;Bung-Nyun Kim
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제34권1호
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    • pp.37-44
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    • 2023
  • Objectives: Tic disorders are highly heritable; however, growing evidence suggests that environmental factors play a significant role in their pathogenesis. Studies on these factors have been inconsistent, with conflicting results. Therefore, this study aimed to examine the associations of pre- and perinatal exposure to Tourette syndrome (TS) or chronic tic disorders (CTD) in Korean school-aged children. Methods: This case-control study used data from a large prospective cohort study. The primary outcome was TS/CTD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria and Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version. Demographic, pre-, and perinatal information was obtained from the maternal questionnaires. Data between the TS/CTD and control groups were compared using the chi-squared or Student's t-test, as appropriate. Two-step logistic regression analyses were used to test the association between TS/CTD and pre- and perinatal risk factors. Results: We included of 223 children (78 with TS/CTD and 145 controls). Significant differences in the demographic data between the two groups were observed. The male sex ratio, mean parental age, parental final education level, and family history of tics were included as confounders. In the final adjusted multivariable model, TS/CTD was significantly associated with antiemetic exposure during pregnancy (odds ratio [OR]=16.61, 95% confidence interval [CI] 1.49-185.22, p=0.02) and medically assisted reproduction (OR=7.89, 95% CI 2.28-27.28, p=0.01). Conclusion: Antiemetic exposure and medically assisted reproduction are significantly associated with the risk of TS/CTD. These results should be replicated in future prospective and gene-by-environment studies.

Hematological Characteristics of the Cultured Eel, Anguilla japonica by Vibration Stress

  • Kim, Dae-Hee;Nam, Myung-Mo;Lee, Si-Woo;Kang, Kyoung Ho;Kang, Yue Jai;Hur, Jun Wook
    • 한국해양생명과학회지
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    • 제3권2호
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    • pp.81-86
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    • 2018
  • The purpose of this study is to determine the effects of vibration on primary (e.g. plasma cortisol), secondary (e.g. plasma glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), Na+, K+ and Cl- and tertiary (e.g. mortality) stress responses in cultured eel, Anguilla japonica. For this purpose, three groups (including one control group and two stress groups) were set up. The control group was made exposed to vibration corresponding to 48 decibel (dB, V) (produced using electric vibrators) for 15 minutes per hour every day, and the two stress groups was made exposed to vibration corresponding to 58 and 68 dB (V) (produced using the same electric vibrators), equally, for 15 minutes per hour every day. Blood was sampled at day 0 (before starting vibration stress tests, BS), and days 1, 3, 5, 7, 9 and 11 (after starting vibration stress tests). As a result, plasma cortisol showed trend to continuously rise by consecutive stress from 4.1±0.1 ng/ml in BS. In 48 dB group (control), cortisol showed the highest level with 7.6±0.9 ng/ml after 7 days (p<0.05), but at 9 and 11 days was not significantly compared with BS level. In 58 dB group, the cortisol showed the highest level with 43.1±4.8 ng/ml after 1st day. Cortisol of 68 dB group increased significantly during the experimental period (14.4±2.3~32.0±5.7 ng/ml) (p<0.05). In 58, and 68 dB groups during the experimental period differed significantly compared to 48 group (p<0.05). Glucose in 48 dB were increased from 42.0 ±5.7 (BS) to 52.5±2.1 (1 day), the level was not significantly from 1 to 11 days. Glucose in 58 and 68 dB groups was increased significantly than BS during experimental period (p<0.05). K+ in 68 dB increased significantly (p<0.05) from 2.3±0.2 mE/ql (BS) to 3.3±0.5 mE/ql at 5 days. In 48 and 58 dB groups during the experimental period differed significantly (p<0.05). Na+ and Cl- levels were not differed significantly during the experimental period. AST and ALT in 58 and 68 dB groups showed trend to continuously rise by consecutive stress. At 7 and 9 days in AST, between 48, 58 and 68 dB groups differed significantly (p<0.05). In 48, 58 and 68 dB groups at 1 day, blood hematocrit increased significantly higher than BS. The 11 days after vibration stress, the mortality in 48, 58 and 68 dB groups was 1.1, 5.1 and 5.8%, respectively. The present results have shown that A. japonica exhibited ''typical'' physiological responses when exposed to chronic vibration stress. These data suggested that chronic vibration stress caused substantial stress in the fish; especially the persisting elevated plasma AST and ALT levels observed would be expected to adverse effect. In conclusion, chronic vibration stress could greatly affects the hematological characteristics in A. japonica.

Diagnostic Performance of Spin-Echo Echo-Planar Imaging Magnetic Resonance Elastography in 3T System for Noninvasive Assessment of Hepatic Fibrosis

  • Se Woo Kim;Jeong Min Lee;Sungeun Park;Ijin Joo;Jeong Hee Yoon;Won Chang;Haeryoung Kim
    • Korean Journal of Radiology
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    • 제23권2호
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    • pp.180-188
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    • 2022
  • Objective: To validate the performance of 3T spin-echo echo-planar imaging (SE-EPI) magnetic resonance elastography (MRE) for staging hepatic fibrosis in a large population, using surgical specimens as the reference standard. Materials and Methods: This retrospective study initially included 310 adults (155 undergoing hepatic resection and 155 undergoing donor hepatectomy) with histopathologic results from surgical liver specimens. They underwent 3T SE-EPI MRE ≤ 3 months prior to surgery. Demographic findings, underlying liver disease, and hepatic fibrosis pathologic stage according to METAVIR were recorded. Liver stiffness (LS) was measured by two radiologists, and inter-reader reproducibility was evaluated using the intraclass correlation coefficient (ICC). The mean LS of each fibrosis stage (F0-F4) was calculated in total and for each etiologic subgroup. Comparisons among subgroups were performed using the Kruskal-Wallis test and Conover post-hoc test. The cutoff values for fibrosis staging were estimated using receiver operating characteristic (ROC) curve analysis. Results: Inter-reader reproducibility was excellent (ICC, 0.98; 95% confidence interval, 0.97-0.99). The mean LS values were 1.91, 2.41, 3.24, and 5.41 kPa in F0-F1 (n = 171), F2 (n = 26), F3 (n = 38), and F4 (n = 72), respectively. The discriminating cutoff values for diagnosing ≥ F2, ≥ F3, and F4 were 2.18, 2.71, and 3.15 kPa, respectively, with the ROC curve areas of 0.97-0.98 (sensitivity 91.2%-95.9%, specificity 90.7%-99.0%). The mean LS was significantly higher in patients with cirrhosis (F4) of nonviral causes, such as primary biliary cirrhosis (9.56 kPa) and alcoholic liver disease (7.17 kPa) than in those with hepatitis B or C cirrhosis (4.28 and 4.92 kPa, respectively). There were no statistically significant differences in LS among the different etiologic subgroups in the F0-F3 stages. Conclusion: The 3T SE-EPI MRE demonstrated high interobserver reproducibility, and our criteria for staging hepatic fibrosis showed high diagnostic performance. LS was significantly higher in patients with non-viral cirrhosis than in those with viral cirrhosis.