Kim Yon Lae;Chung Jin Bum;Chung Won Kyun;Hong Semie;Suh Tae Suk
Progress in Medical Physics
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v.16
no.2
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pp.89-96
/
2005
In this study, we investigated the effect of time gating threshold on the delivered dose at a organ with internal motion by respiration. Generally, the internal organs have minimum motion at exhalation during normal breathing. Therefore to compare the dose distribution time gating threshold, in this paper, was determined as the moving region of target during 1 sec at the initial position of exhalation. The irradiated fields were then delivered under three conditions; 1) non-moving target 2) existence of the moving target in the region of threshold (1sec), 3) existence of the moving target region out of threshold (1.4 sec, 2 sec). And each of conditions was described by the moving phantom system. It was compared with the dose distributions of three conditions using film dosimetry. Although the treatment time increased when the dose distributions was obtained by the internal motion to consider the TGT, it could be obtained more exact dose distribution than in the treatment field that didn't consider the internal motion. And it could be reduced the unnecessary dose at the penumbra region. When we set up 1.4 sec of threshold, to reduce the treatment time, it could not be obtained less effective dose distribution than 1 sec of threshold. Namely, although the treatment time reduce, the much dose was distributed out of the treatment region. Actually when it is treated the moving organ, it would rather measure internal motion and external motion of the moving organ than mathematical method. If it could be analyzed the correlation of the internal and external motion, the treatment scores would be improved.
Kang, Min Jae;Mun, Chi-Woong;Lee, Young Ho;Kim, Seong-Ho
Investigative Magnetic Resonance Imaging
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v.18
no.4
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pp.341-351
/
2014
Purpose : In this study, the medication effects of Milnacipran and Pregabalin, as well known as fibromyalgia treatment medicine, in fibromyalgia syndrome patients were compared through the change of BOLD signal in pain related functional MRI. Materials and Methods: Twenty fibromyalgia syndrome patients were enrolled in this study and they were separated into two groups according to the treatment medicine: 10 Milnacipran (MLN) treatment group and 7 Pregabalin (PGB) treatment group. For accurate diagnosis, all patients underwent several clinical tests. Pre-treated and post-treated fMRI image with block-designed pressure-pain stimulation for each group were obtained to conduct the statistical analysis of paired t-test and two sample t-test. All statistical significant level was less than 0.05. Results: In clinical tests, the clinical scores of the two groups were not significantly different at pre-treatment stage. But, PGB treatment group had lower Widespread Pain Index (WPI) and Brief Fatigue Inventory (BFI) score than those of MLN treatment group at post-treatment stage. In functional image analysis, BOLD signal of PGB treatment group was higher BOLD signal at several regions including anterior cingulate and insula than MLN treatment group at post-treatment stage. Also, paired t-test values of the BOLD signal in MLN group decreased in several regions including insula and thalamus as known as 'pain network'. In contrast, size and number of regions in which the BOLD signal decreased in PGB treatment group were smaller than those of MLN treatment group. Conclusion: This study showed that MLN group and PGB group have different medication effects. It is not surprising that MLN and PGB have not the same therapeutic effects since these two drugs have different medicinal mechanisms such as antidepressants and anti-seizure medication, respectively, and different detailed target of fibromyalgia syndrome treatment. Therefore, it is difficult to say which medicine will work better in this study.
Kim, Dae Jung;Kim, Joo Hee;Lim, Joon Seok;Chung, Jae-Joon;Yu, Jeong-Sik;Kim, Myeong-Jin;Kim, Ki Whang
Investigative Magnetic Resonance Imaging
/
v.18
no.4
/
pp.323-331
/
2014
Purpose : To assess the usefulness of rectal filling using ultrasonographic gel in patients with lower rectal cancer. Materials and Methods: Twenty five patients with lower rectal cancer were enrolled. High resolution pelvic MR was performed twice before and after gel filling. Independently and retrospectively, two radiologists reviewed each set of MR images using five-grade scales for sphincter involvement, CRM (circumferential resection margin) involvement and depiction of the tumor. Same two radiologists retrospectively performed consensus review of each set of MR images for tumor distance from the anal verge and T&N staging. Results: Tumor depiction scores from MR with gel filling were significantly higher than those of MR without distention (p<0.001). Compared to MR without distension, MR with gel filling had no significant differences in prediction of CRM or sphincter involvement (p>0.05). Distance from the anal verge was significantly different between MR with gel filling and rigid endoscopy ($6.8{\pm}1.6cm$ vs. $5.8{\pm}1.6cm$, p=0.001). There were no significant differences between pathological staging and MR staging with or without gel filling. Conclusion: MR with gel filling improved tumor depiction. And also MR with gel filling revealed same ability for the predictions of CRM or sphincter invasion in patients with lower rectal cancer, comparing with MR without gel filling.
Purpose: To explore the value of systemic inflammatory markers as independent prognostic factors and the extent these markers improve prognostic classification for patients with inoperable advanced or metastatic gastric cancer (GC) receiving palliative chemotherapy. Methods: We studied the prognostic value of systemic inflammatory factors such as circulating white blood cell count and its components as well as that combined to form inflammation-based prognostic scores (Glasgow Prognostic Score (GPS), Neutrophil-Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), Prognostic Index (PI) and Prognostic Nutritional Index (PNI)) in 384 patients with inoperable advanced or metastatic gastric cancer (GC) receiving first-line chemotherapy. Univariate and multivariate analyses were performed to examine the impact of inflammatory markers on overall survival (OS). Results: Univariate analysis revealed that an elevated white blood cell, neutrophil and/or platelet count, a decreased lymphocyte count, a low serum albumin concentration, and high CRP concentration, as well as elevated NLR/PLR, GPS, PI, PNI were significant predictors of shorter OS. Multivariate analysis demonstrated that only elevated neutrophil count (HR 3.696, p=0.003) and higher GPS (HR 1.621, p=0.01) were independent predictors of poor OS. Conclusion: This study demonstrated elevated pretreatment neutrophil count and high GPS to be independent predictors of shorter OS in inoperable advanced or metastatic GC patients treated with first-line chemotherapy. Upon validation of these data in independent studies, stratification of patients using these markers in future clinical trials is recommended.
Purpose: This study was to examine how decline of visual function affects visual perception by assessing visual perception after improving visual function through visual training, and observing the change in the cognitive ability of visual perception. Methods: This study analyzes the visual perceptual evaluation (TVPS_R) of 23 children below age 13($8.75{\pm}1.66$) who have visual abnormalities, and improves visual function after conducting vision training (vision therapy) of the children. Results: Convergence increased from average $3.39{\pm}2.52{\Delta}$ (prism) to $13.87{\pm}6.04{\Delta}$ in the measurement of long-distance disparate points, and from average $5.48{\pm}3.42{\Delta}$ to $18.43{\pm}7.58{\Delta}$ in the measurement of short-distance disparate points. Short-distance diplopia points increased from $25.87{\pm}7.33cm$ to $7.48{\pm}2.87cm$, and as for accommodative insufficiency, short-distance blur points increased from $19.57{\pm}7.16cm$ to $7.09{\pm}1.88cm$. In the visual perceptual evaluation performed before and after improving visual function, 6 items except visual memory showed statistically significant improvement. By order of significant improvement, response gap was highest with $17.74{\pm}16.94$(p=0.000) in visual closure, followed by $15.65{\pm}17.11$(p=0.000) in visual sequential-memory, $13.65{\pm}16.63$(p=0.001) in visual figure-ground, $12.74{\pm}18.41$(p=0.003) in visual form-constancy, $6.48{\pm}10.07$ (p=0.005) in visual discrimination, and $4.17{\pm}9.33$(p=0.043) in visual spatial-relationship. In the visual perception quotient that added up these scores, the response gap was $15.22{\pm}8.66$(p=0.000), showing a more significant result. Conclusions: Vision training enables efficient visual processing and improves visual perceptual ability. It was confirmed that improvement of visual function through visual training not only improves abnormal visual function but also affects visual perception of children such as learning, perception and recognition.
Purpose : We hypothesized dexrazoxane(DXR) and pentoxifylline(PTX) may prevent myocardial damage in adriamycin(ADR)-induced cardiomyopathic rat model. We also investigated their effects on the myocardial apoptosis and fibrosis in ADR induced cardiomyopathy. Methods : The six-week old female Spregue-Dawley rats were divided into control group(CNT, n=4), ADR group(n=6), ADR+DXR group(DXR, n=5), ADR+PTX group(PTX, n=6), ADR+DXR+PTX group(DXPT, n=5). ADR(5 mg/week, twice) was administrated intravenously to rats except CNT group to induce cardiomyopathy. The PTX(50 mg/kg/day) was administered daily from day-0 to Day-21. The DXR(100 mg/kg) was administered 30 minutes before each ADR injection. On day 21, the rats were sacrificed and the degree of histopathologic changes of hypercontraction band necrosis, cytoplasmic vacuolar change and fibrosis were scored. Immunohistochemical staining for Bcl-2 expression and RT-PCR for $TNF-{\alpha}$ and CTGF were performed. Results : Histopathological scores of myocardial damage were significantly higher in ADR rats than CNT rats(P<0.05), and significantly lower in DXPT rats than ADR rats(P<0.01). Myocardial fibrosis was prevented in both PTX rats and DXPT rats. The expression of Bcl-2 was weaker in ADR rats than that in CNT rats(P<0.05), and stronger in both DXR and DXPT rats than that in ADR rats (P<0.05). $TNF-{\alpha}$ concentration of ADR rats was not different from that of treated groups. Conclusion : DXR prevented myocyte apoptosis with increased Bcl-2 expression, and PTX prevented myocardial fibrosis in ADR induced cardiomyopathic rats. The combination therapy of DXR and PTX showed prevention of cardiomyopathy in ADR induced cardiomyopathy rat model.
You, Je Sung;Cho, Young Soon;Choi, Young Hwan;Kim, Seung Hwan;Lee, Hahn Shick;Lee, Jin Hee
Clinical and Experimental Pediatrics
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v.49
no.7
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pp.726-731
/
2006
Purpose : We reported previously that intramuscular ketamine with adjunctive midazolam is more effective than ketamine alone in pediatric procedural sedation, but with limited satisfactory sedation by suboptimal ketamine dose. The optimal dose of intramuscular ketamine in children has never been studied in Korea. In this study, we investigated the effectiveness and adverse events of ketamine 4mg/kg with adjunctive midazolam in pediatric laceration repair. Methods : From Jan. 2005 to July 2005, we enrolled 60 children, aged 3 months-7 years, who needed laceration repair under sedation. After verbal consent from parents, patients were randomly assigned to KMA group(IM ketamine 4 mg/kg+atropine 0.01 mg/kg+intramuscular midazolam 0.05 mg/kg) or KA group(without midazolam). We compared both groups with the induction time, recovery time, total sedation time, efficacy of sedation, adverse effects, and the satisfaction score of treating physicians. Results : Potentially confounding variables, age, weight, injury site and anxiety score, were similar between groups. The induction time, recovery time and total sedation time were not different statistically. In KMA group, 90.9 percent of patients showed satisfactory sedation compared to 66.7 percent of KA group(P=0.02) and the occurrence rate of significant adverse effect was 0.0 percent and 37.0 percent respectively. Conclusion : We found adjunctive midazolam with ketamine doses of 4 mg/kg IM produced more effective, satisfactory sedation and less adverse effect than without midazolam in pediatric laceration repair. The emergence phenomenon(agitation during recovery) only occurred in 9 KA group patients. In spite of adverse effect, all patients recovered, were discharged and there were no reported delayed events.
Journal of the Korea Academia-Industrial cooperation Society
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v.18
no.10
/
pp.505-512
/
2017
The purpose of this study was to determine the quality of life according to the level of subjective perception as well as to analyze the influencing factors and improve the subjective perception to improve the quality of life. The results of the survey for adult patients in hospitals and neighborhood clinics in the region of Busan for nine months from December 2015 were as follows. Regarding the total symptoms, the women had a score of 1.41, and the younger respondents felt they suffered from no symptoms. An analysis of the quality of life by the general characteristics showed that the respondents who were better educated and had no systemic diseases had a higher score of 54.71 on the OHIP-14. The respondents who were better educated and had no systemic diseases had a higher score of 6.48 when a single item was used to determine their happiness index, and the respondents who were better educated and had no systemic diseases had a higher score of 3.82 when five items were used to rate their happiness index. The factor with the greatest influence on their scores on the OHIP-14 was the total symptoms, followed in order by the happiness index and self-rated oral health status. The variable that exerted the largest influence on the happiness index was the OHIP-14, followed by the self-rated health status, high-school or lower education, and the presence or absence of one or more chronic disease. Therefore, an improvement in the subjective awareness level is required to boost the quality of life, and a variety of health education programs should be prepared to raise the awareness level. In addition, there should be a chance to convey accurate information.
This study aims at investigating the psychosocial factors that influence on the intake of fruits and vegetables according to stage of change in rural children. Total 256 elementary school children, located in Yeongi-Gun, Chungnam-Do were surveyed from May 14 2007 to May 30 2007. Stage of change on the intake of fruits and vegetables of the students was categorized into three stages: precontemplation (PC), contemplation & preparation (CO&PR) and action (AC). Psychosocial factors consist of decisional balance based on pros and cons, process of change of cognitive and behavioral processes, and self-efficacy. The recognition of cons out of decisional balance showed the highest score in the subjects at the stage of PC and lowest score in those action stage. While, no difference was shown in the score of recognition of pros among the stages. Both levels of cognitive and behavioral process of change showed no difference between two pre-action stages, PC and CO&PR. However, the subjects of action stages got higher scores in more number of the variables in both of cognitive and behavioral process of change compared to those of pre-action stages with more remarkable in results vegetables than in fruits. The results of self-efficacy on fruits and vegetables intake showed that the higher stages of change, the higher the self-efficacy score. From the result, it is suggested that the items and level of psychosocial factors are different according to the stage of change and between fruits and vegetables in rural children.
Purpose: The purpose of the study was to evaluate the status of events and importance-performance analysis (IPA) between industry and school foodservices. Methods: The study subjects were dietitians in industry foodservices (n = 73) and nutrition teachers in school foodservices (n = 135) in the Jeonbuk area. Demographic characteristics, status of events, and problems of implementing events were assessed using a self-administered questionnaire. Results: Approximately 67% of industry foodservices had implemented an event a month, whereas 40.7% of school foodservices did not implement events for students. The type of events that industry and school foodservices had implemented most frequently were Sambok event, Dongji event, Daeboreum event, Spring-Namul event, and Chuseok event. The industry foodservices had significantly higher average scores for performance of events than those of the school foodservices (p < 0.001). In the Importance-Performance Analysis (IPA), high importance and high performance (A area: doing great) in industry foodservices were seasonal events, traditional festival day events, anniversary events, traditional seasonal events, and personal memory events, whereas in school foodservices were traditional festival day events, traditional seasonal events, school events, and environment events. Conclusion: These results showed that events are important for the increase in customer satisfaction. Therefore, it is necessary to consider educational programs on event implementation for dietitians and employees in industry and school foodservices.
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