• 대한방사선치료학회지
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• 제28권2호
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• pp.179-186
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• 2016

목 적 : 분할치료간(Interfraction) 움직임에 의한 오류가 많은 직장과 방광 그리고 전립선의 변화를 MR영상을 기반으로 분석하여 보정치료계획(adaptive plan) 없이 SBRT 선량제한을 충족하는지 알아보고자 하였다. 대상 및 방법 : 본원에서 ViewRay MRIdian System(ViewRay, ViewRay Inc., Cleveland, OH, USA)을 이용하여 전립선암에 총 선량이 70 Gy, 28회의 분할치료인 IMRT 치료를 시행한 환자 5명을 대상으로 하였다. 기존 치료방법을 가정하기 위해 ViewRay 모의치료계획과 동일한 날짜와 조건으로 촬영한 전산화단층촬영(Computed Tomography, 이하 CT)영상에 초기 치료계획을 생성하였고, 전산화치료계획은 Eclipse(Ver 10.0.42, Varian, USA)를 이용하였다. 분할치료간(Interfraction) 장기 변화를 분석하기 위해 치료계획용 CT영상에 각 5회 치료 자기공명영상(Magnetic Resonance Imaging, 이하 MRI)을 Registration 한 후, 초기 치료계획을 각 치료영상에 적용하여 선량체적곡선 변화와 각 장기의 절대용적 변화를 측정하였다. 처방선량은 5회에 걸쳐 PTV에 총 선량이 $V_{36.25}$ Gy $${\geq_-}$$ 95%가 되도록 하였고, 전립선 SBRT 선량제한의 충족 여부를 확인하기 위하여 직장과 방광의 $V_{100%}$, $V_{90%}$, $V_{80%}$ $V_{50%}$을 측정하였으며, CTV의 $V_{100%}$, $V_{95%}$, $V_{90%}$도 측정하였다. 결 과 : 총 5회의 CTV, 직장, 방광의 선량평균값은 5명 모두 SBRT 선량제한을 충족하였으나 각 치료 영상을 분석한 결과 1회 이상 선량제한을 초과하는 경우도 나타났다. 초기 치료계획과 분할치료의 MR영상을 비교하여 절대용적 변화를 측정한 결과 직장에서 최대 1.72배, 방광에서 최대 2.0배 차이를 보였다. 직장의 경우 초기 치료계획에서 5명의 측정값이 평균 $V_{100%}=0.32%$, $V_{90%}=3.33%$, $V_{80%}=7.71%$, $V_{50%}=23.55%$로 선량한도 이하로 계획 되었으나, 실제 분할치료 중 최대 3회까지 선량한도를 초과하기도 하였다. 방광의 경우도 초기 치료계획의 절대용적이 평균 117.9 cc 였으나 실제 치료 5회 평균용적은 79.2 cc 로 나타났다. CTV의 경우 방광과 직장의 용적 변화 등으로 인해 5 mm 여백을 포함한 PTV에 치료계획을 세웠음에도 불구하고 100% 처방선량 영역을 벗어나기도 하였다. 결 론 : 본 연구에서는 5회 치료 평균으로 분석한 결과 선량한도를 벗어난 경우는 없었으나, 각각의 분할치료에서는 직장과 방광의 오차가 비교적 큰 것을 확인 할 수 있었다. 그러므로 전립선암 SBRT를 시행하기 위해서는 선량 전달 정확성에 더욱 신중을 기해야 한다. 이를 위해서는 실시간 영상추적과 보정치료계획이 필수적이며 이것은 모든 방사선 치료가 궁극적으로 나아가야 할 방향으로 사료된다.

• Journal of Korean Biological Nursing Science
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• 제15권3호
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• pp.99-106
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• 2013

Purpose: The purpose of this study was to examine the effect on plasma beta endorphin concentration level and the influences on pain score of transcutaneous electrical nerve stimulation (TENS) mediation to patients During a prostate needle biopsy. Methods: TENS was administered to only the experimental group. The electric current was given in high frequency (40-100 pps) and low intensity ($2-50{\mu}s$) from the waiting room stage until the end of the procedure. The average time spent was 35 minutes. Following 10 minutes of retention in the rectum, there was a biopsy. In two groups, the pain score was assessed twice when vas pain penetrated into the rectum, during the needle biopsy. The Beta endorphin concentration level was assessed through blood gathering 2 times in the Nuclear Medicine Labs before and after the test. Results: There was not much difference in pain levels from both groups when a microscope probe penetrated into the rectum and in the time when tissues were collected. However, the average overall pain level was reduced during those two procedures. The plasma beta endorphin level was increased in the TENS medicated group compared with the unmedicated group after the procedures were completed. Conclusion: The research indicates that TENS was desirable to be considered as a non-invasive method for controlling pain.

• 한국어류학회지
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• 제17권4호
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• pp.241-247
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• 2005

왕종개 Iksookimia longicorpa의 공기호흡에 관한 호흡체계를 조사하기 위해 표피 (epidermis)와 소화관 (intestinal tract)를 관찰하였다. 표피는 작은 점액세포 (mucous cell)와 곤봉세포 (club cell)로 이루어진 두 종류의 선세포 (gland cell)을 가진다. 점액세포는 대부분 acid sulfomucin으로 구성되었으나 곤봉상세포는 점액물질에 대한 어떠한 반응도 보이지 않았다. 기저층에는 작은 림파구를 포함하는 lymphocytes가 존재하며, 다량의 모세혈관이 기저층 바로 아래부분에 존해하고 있다. 장( intestinal tract)은 거의 일직선형태이며, 크게 장(intestine)과 직장(rectum)으로 구성된다. 이러한 장은 점액층 (mucosa), 점막하층 (laminal propria-submucosa), 근육층 (musculary), 장막 (serosa) 층으로 구성되었다. 이러한 장은 짧은 fold와 얇은 벽으로 구성되었으며, 점막층은 acid sulfomucin의 점액을 가지고 있다. 공기호흡하는 어류들의 변형된 공기호흡 기관의 특징들과 비교해 볼 때 왕종개는 하천의 가뭄으로 인해 용존산소가 부족할 경우 장에서는 이루어지지않고 표피에서만 공기를 흡입하는 것으로 생각된다.

• 생명과학회지
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• 제18권2호
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• pp.187-192
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• 2008

본 연구는 수분 및 글리세를 섭취가 renin activity, 직장온도, 혈중 전해질 농도에 미치는 효과에 대하여 알아보기 위해 수분 섭취 그룹과 글리세롤 섭취 그룹으로 나누어 측정한 결과는 다음과 같다. renin activity의 경우, 안정시와 비교하여 운동 후 40분에 수분 섭취 그룹과 글리세를 섭취 그룹에서 유의한 증가를 보였다(p<0.01). Osmolality의 경우, 수분 섭취 그룹에서 차이를 보이지 않았으나, 글리세를 섭취그룹에서는 안정 시와 비교하여 운동 후 40분에 차이를 보였다(p<0.05). 직장온도의 경우, 수분 섭취 그룹과 글리세를 섭취 그룹 모두 운동 시간에 따라 점진적으로 증가하는 것을 볼 수 있었다. Na과 K의 경우, 수분 섭취 그룹에서 차이를 보이지 않았으나 글리세를 섭취 그룹에서 차이를 보였다(p<0.05). Ca과 Mg의 경우, 두 그룹 모두 그룹과 운동시기 간에 유의한 차이를 보이지 않았다.

• 대한골관절종양학회지
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• 제14권2호
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• pp.146-151
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• 2008

근골격계와 소화기계에 동반된 다발성 원발성 종양은 매우 드물다. 52세 남자 환자에서 전완부의 점액섬유육종과 직장의 선암이 동반된 동시성 이중성 원발성종양이 발견되었다. 환자는 1년전부터 발생한 전완부의 통증 및 부종을 주소로 내원하였다. 전완부의 병변은 조직학적으로 점액섬유육종으로 확진되었다. 전신적 검사상 결장경 검사에서 직장의 선암이 발견되었으며 CT 검사상 폐로의 전이와 심장내 종양이 발견되었다. 병리학적 확정진단 후에 전완부의 수술적 절제술과 술 전,후 항암화학요법을 시행하였으며, 환자는 술 후 2달 후에 종양 색전에 의한 폐동맥혈전색전증으로 사망하였다. 저자들은 매우 드문 근골격계와 소화기계에 동반된 다발성 원발성 종양 1례를 경험하였기에 이를 문헌고찰과 함께 보고하고자 한다.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.154-156
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• 2002

Brachytherapy has a long history in the treatment of cancer. However, the treatment planning technique for brachytherapy has lagged somewhat behind the corresponding developments for external beam therapy as far as the imaging technique is concerned. Currently, the orthogonal-film-based treatment planning is performed at most institutions even though the CT-based planning is available. The aim of this study is to evaluate the CT-based vs. the orthogonal-film-based treatment planning in cervix cancer. The doses to point A, point B, rectum and bladder points according to ICRU 38 were calculated for the two methods above. In addition, the volumetric studies such as 3D dose computation and DVH were obtained for the CT-based planning. For the bulky tumor, the isodose lines of point A prescription were not fairly covered for the CTV. The CT -based dose planning can overestimate the maximum dose delivered to bladder and rectum by 30%. The CT-based planning has several advantages over the orthogonal-film-based such as 3D dose display, DVH, and more accurate target delineation. It is suggested that the prescription point in cervix cancer be revised especially for the bulky tumor.

• Biomolecules & Therapeutics
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• 제18권1호
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• pp.83-91
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• 2010

Bear bile has been used as a therapeutic for cerebral and coronary thrombosis, convulsion, hepatitis, jaundice, and abscess in traditional oriental medicine. In recent decades, the effects of bile acids on cancer, cholestasis, and liver injury have been investigated in many studies. In this study, we investigated the anti-inflammatory effects of whole bear bile (WBB) and its two major components, chenodeoxycholic acid (CDCA) and ursodeoxycholic acid (UDCA), on rectal inflammation in rats. Bile acids in WBB were quantitatively analyzed by HPLC. Rectal inflammation was induced in male Sprague-Dawley rats by insertion of croton oil-saturated cotton tips. WBB, UDCA or CDCA solution was orally administered to rats one hour after induction of rectal inflammation. Rats were sacrificed 4 or 24 hours after induction of rectal inflammation. The evaluation included measurement of weight and thickness of rectum and histopathologic examination of rectal tissue. Furthermore, we examined the inhibitory effect of WBB, UDCA or CDCA against NO production in LPS-stimulated RAW 264.7 cells. The contents of UDCA and CDCA in WBB were $39.26{\mu}g/mg$ and $47.11{\mu}g/mg$, respectively. WBB treatment significantly reduced the weight and thickness of rectum compared with UDCA or CDCA treatment. The inhibition of NO production by WBB, UDCA and CDCA in LPS-stimulated RAW 264.7 cells was much higher than that by the control. And, WBB treatment suppressed the induction of NO synthase in rectum homogenates. These results suggest that the anti-inflammatory effect of WBB is related to the suppression of NO synthase induction and the inhibition of NO production by UDCA, CDCA and other bile acids of WBB.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3209-3212
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• 2012

Introduction: Colorectal carcinoma (CRC) is the most common gastrointestinal malignancy in the older population, but it is also quite frequent among young adults in developing countries. The aim of this study was to update the trends of clinicopathological features of CRC in young Nepalese. Methods: A retrospective comparative study on the data retrieved from the surgical records of all patients between 20 to 39 years of age with CRC was carried out for periods of 5 years each from 1999 to 2003 (early) and 2004 to 2008 (recent), treated at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Results: The number of young adults with CRC increased from 28 to 34. However, the proportion of young patients in both groups was 28% of all CRC patients. The mean ages were $34{\pm}4.7$ and $31.8{\pm}5.1$ years in early and recent 5 years, respectively, and the male female ratio changed from 2:3 to 4:3. Abdominal pain as the most common presenting symptom was replaced by bleeding per rectum in recent years. The mean duration from onset of symptoms to seeking medical advice decreased from 7.8 months to 5.6 months in recent years. More patients (85.3%) were subjected to endoscopic examination in recent years than early years (60.7%) and right colonic cancer increased from 10.7% to 26.5%. However, the rectum was the commonest site in both early (71.4%) and recent (50%) groups. CRC was detected significantly at an earlier stage (7.1% vs 32.4%) in recent years with large proportion of modified Dukes B stage. Poorly differentiated adenocarcinoma was the predominant histology in both groups (50% vs 60.7%). Curative resection had risen in recent years (39.3% vs 73.6%). Conclusion: CRC among Nepalese young adults accounts for a high incidence (28%) of all CRC cases. Although right sided colonic cancer has been increasing, rectum is the commonest site. There is also an increasing trend for diagnosis at earlier stages of the disease which can be treated with curative intent.

• Asian-Australasian Journal of Animal Sciences
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• 제17권7호
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• pp.919-923
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• 2004

Ultrasonographic study was undertaken to establish the echogenecity and size of reproductive organs of 18 cycling buffaloes of different parities and compared with the sizes measured by palpation per rectum at estrus (day 0), met estrus (day 2), mid diestrus (day 10) and late diestrus (day 16). The overall mean size of cervix, uterine body, right horn, left horn, right ovary and left ovary measured by palpation per rectum were 2.70$\pm$0.43, 2.36$\pm$0.36, 2.17$\pm$0.37, 2.12$\pm$0.38, 2.63$\pm$0.41 and 2.72$\pm$0.37 cm, respectively. The corresponding ultrasonographic observations were 2.10$\pm$0.40, 1.85$\pm$0.30, 1.73$\pm$0.36, 1.64$\pm$0.37, 2.16$\pm$0.36 and 2.29$\pm$0.38 cm respectively. Variations in the size of genitalia due to stages of estrous cycle were non-significant. The size of genitalia measured by palpation per rectum was significantly higher (p<0.05) than by ultrasonography. However, there was linear positive correlation (r=+0.87) in the measurements by the two techniques. The ultrasonographic characteristics of tubular genitalia revealed different echogenic gray shades around the nonechogenic (black) central area of lumen depending upon the stage of cycle. The ovarian stroma appeared as hyperechoic (white) area with nonechogenic (black) follicle. The corpus luteum (CL) exhibited different echogenic texture viz. grayish black, grayish granular and grayish white at met estrus, mid diestrus and late diestrus, respectively. Therefore, ltrasonography can be effectively employed to record the exact size and echotexture of the buffalo genitalia during different stages of estrous cycle.

• Journal of Yeungnam Medical Science
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• 제32권1호
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• pp.31-34
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• 2015

In Korea, cases of direct insertion of foreign bodies into the rectum are rare in the literature. Most cases of rectal insertion of foreign bodies are associated with sexual acts and psychiatric disorder such as schizophrenia. Objects inserted into the anus are usually blunt and shaped like the male genitalia. The removal method can be varied depending on the size and shape of the foreign object, its anatomical location, and the accompanying complications. In cases wherein attempts to remove the object fail or there are rectal perforation and peritonitis complications, immediate laparotomy may be required in order to prevent serious complications such as sepsis. Here, we report on a case of rectal perforation and peritonitis due to insertion of a foreign body in a middle-aged patient, with a literature review. He inserted a sharp pig backbone in his rectum and he only had depression. The patient underwent a Hartmann's operation as well as psychiatric counseling and treatment. Thus, after removal of foreign bodies, psychiatric counseling and treatment should be carried out in order to prevent similar accidents and to minimize the need for trauma medicine.