• The Journal of Korean Society for Radiation Therapy
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• v.31 no.1
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• pp.33-41
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• 2019

Purpose : To evaluate the effectiveness of Jaw-tracking(JT) technique in Intensity-modulated radiation therapy(IMRT) and Volumetric-modulated arc therapy(VMAT) for radiation therapy of esophageal cancer by analyzing volume dose of perimetrical normal organs along with the low-dose volume regions. Materials and Method: A total of 27 patients were selected who received radiation therapy for esophageal cancer with using $VitalBeam^{TM}$(Varian Medical System, U.S.A) in our hospital. Using Eclipse system(Ver. 13.6 Varian, U.S.A), radiation treatment planning was set up with Jaw-tracking technique(JT) and Non-Jaw-tracking technique(NJT), and was conducted for the patients with T-shaped Planning target volume(PTV), including Supraclavicular lymph nodes(SCL). PTV was classified into whether celiac area was included or not to identify the influence on the radiation field. To compare the treatment plans, Organ at risk(OAR) was defined to bilateral lung, heart, and spinal cord and evaluated for Conformity index(CI) and Homogeneity index(HI). Portal dosimetry was performed to verify a clinical application using Electronic portal imaging device(EPID) and Gamma analysis was performed with establishing thresholds of radiation field as a parameter, with various range of 0 %, 5 %, and 10 %. Results: All treatment plans were established on gamma pass rates of 95 % with 3 mm/3 % criteria. For a threshold of 10 %, both JT and NJT passed with rate of more than 95 % and both gamma passing rate decreased more than 1 % in IMRT as the low dose threshold decreased to 5 % and 0 %. For the case of JT in IMRT on PTV without celiac area, $V_5$ and $V_{10}$ of both lung showed a decrease by respectively 8.5 % and 5.3 % in average and up to 14.7 %. A $D_{mean}$ decreased by $72.3{\pm}51cGy$, while there was an increase in radiation dose reduction in PTV including celiac area. A $D_{mean}$ of heart decreased by $68.9{\pm}38.5cGy$ and that of spinal cord decreased by $39.7{\pm}30cGy$. For the case of JT in VMAT, $V_5$ decreased by 2.5 % in average in lungs, and also a little amount in heart and spinal cord. Radiation dose reduction of JT showed an increase when PTV includes celiac area in VMAT. Conclusion: In the radiation treatment planning for esophageal cancer, IMRT showed a significant decrease in $V_5$, and $V_{10}$ of both lungs when applying JT, and dose reduction was greater when the irradiated area in low-dose field is larger. Therefore, IMRT is more advantageous in applying JT than VMAT for radiation therapy of esophageal cancer and can protect the normal organs from MLC leakage and transmitted doses in low-dose field.

• Journal of Chest Surgery
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• v.35 no.4
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• pp.261-266
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• 2002

In an attempt to avoid the adverse effects of the cardiopulmonary bypass, off pump coronary artery bypass grafting(Off pump CABG) that has recently been rediscovered and refined. We compared the preoperative risk factors and in-hospital outcomes of patients done Off pump with those done On pump CABG. Material na Method: One hundred seventy eight patients was underwent CABG between January 2001 and July 2001 12 patients whom underwent associated valvular or left ventricular volume reduction surgery were excluded in this study Data were collected for 52 Off pump CABG and 114 On pump CABG for patient and disease risk factors, extent of coronary disease, and in-hospital outcomes. Result: Off pump CABG and On pump CABG groups did not show any differences in their patient and disease risk factors, and extent of coronary disease. Off pump CABG group had significantly lower mean operation time(234 $\pm$ 37 min vs 290 $\pm$ 48 min, p<0.001), lower mean CK-MB level(10.1 $\pm$ 13.5 IU/L vs 33.1 $\pm$ 18.2 IU/L, p<0.001) and mean ventilation time(14.8 $\pm$ 3.5 hours vs 16.2 $\pm$ 4.9 hours, p=0.048) than On pump CABG groups. On pump CABG group had significantly more distal grafts(3.4 $\pm$ 0.9 vs 2.6 $\pm$ 0.8, p<0.001) than Off pump CABG groups. There were no operative mortality in two groups. Off pump) CABG and On pump CABG groups did not show any differences in their postoperative complications and outcomes including perioperative myocardial infarction, stroke, respiratory failure, renal failure, reoperation, the amount of bleeding, the need of intraaortic balloon pump, the need of inotropics, and the stay of intensive care unit and hospital. Two patients were converted to On pump CABG. Conclusion: This study showed that patients having Off pump CABG are not exposed to a greater risks of adverse outcomes and also provided evidence that patients having Off pump CABG have significantly lower operation time, CK-MB, ventilation time and less distal grafts. Although there may be potential benefits to Off pump CABG, further studies must be directed to determine those patients who would benefit from Off pump CABG.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.394-398
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• 2010

Background: The overexpression of transforming growth factor-beta 1 receptor II (TGF-${\beta}1$RII) and transforming growth factor-beta 1 (TGF-${\beta}1$) ligand may be involved in the formation of a bulla. In this study, we tested if serum TGF-${\beta}1$ ligand levels correlated with the expression level of TGF-${\beta}1$RII and TGF-${\beta}1$ in bullous tissues from patients with spontaneous pneumothorax. Material and Method: Bullous lung tissues and blood samples were obtained from 19 patients with spontaneous pneumothorax, 18 males and 1 female, aged 17 to 35 years old. The bullous tissues were obtained by video-assisted thoracic surgery (VATS), fixed in formalin, embedded in paraffin, and cut into $5{\sim}6{\mu}m$ thick slices. Sections were immunohistochemically stained with primary antibodies against TGF-${\beta}1$ or TGF-${\beta}1$RII, and serum levels of TGF-${\beta}1$ in patients and normal controls was measured by enzyme-linked immunosorbent assay (ELISA). Result: Of the 19 patients, 16 were TGF-${\beta}1$ positive and 10 were TGF-${\beta}1$RII positive. Among the 16 TGF-${\beta}1$ positives, 9 were also TGF-${\beta}1RII$ positive. As seen previously, strong immunohistochemical staining of TGF-${\beta}1$RII and TGF-${\beta}$ was detected in the boundary region between the bullous and normal lung tissues. Average TGF-${\beta}1$ blood levels of both TGF-${\beta}1$ and TGF-${\beta}1$RII positive patients was $38.36{\pm}16.2ng/mL$, and that of five controls was $54.06{\pm}15ng/mL$. Conclusion: These results suggest that overexpression of TGF-${\beta}1$ and TGF-${\beta}1$RII expression may be involved in the formation of bullae. TGF-${\beta}1$ blood levels in patients with primary spontaneous pneumothorax is lower than normal people, suggesting that the high level of local TGF-${\beta}1$ expression in the bullous tissue region, but not in the whole blood, may contribute more in the formation of bullae.

• Journal of Chest Surgery
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• v.31 no.4
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• pp.346-352
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• 1998

Rheumatic valvulitis produces at least three distinct pathologic changes, the degree varying widely among the patients: fusion of the valve leaflets at the commissures; fusion and shortening of chordae tendinae: and fibrosis of the leaflets with subsequent stiffening, contraction and calcification. The most extensive changes usually are seen in patients with recurrent attacks of rheumatic fever. We studied on outcome of the surgical treatments of rheumatic valvular diseases that have been experienced for 12 years since 1982 at Pusan National University Hospital. The diagnoses were made by rheumatic fever history, echocardiographic findings, gross operative findings and microscopic findings. Total 502 patients were performed surgery for valvular heart diseases and 440 patients of rheumatic origin have bene analysed. There were more female than male patients as 1.3:1, and the mean age was 37.8 years old. 96.3% of them affected to the mitral valve, 19.8% to aortic valve, 16.3% affected to the tricuspid valve. Most of them underwent valve replacement, and valve repair was done in 3.9% of patients. There were 36 hospital deaths(8.2%) mainly from low cardiac output syndrome, and 15 late deaths equally due to embolism and hemorrhage. Follow up was 90.1% completed(2890 patient- year). Linealized rates of late complication events are follows : thromboembolism 1.3% per patient year; anticoagulant related hemorrhage 0.8% per patient year. Overall actuarial survival including hospital mortality was 92.7＋/-2.9% in 1 year, 88.0＋/-4.5% in 5 year, 82.3＋/-7.7% in 10 year. We conclude that the rheumatic disease is still the most frequent and the most important cause of heart valve disease. So more intensive study is needed in spite of the abrupt decreasing rate of rheumatic fever in U.S.A. and other industrial country.

• Biotechnology and Bioprocess Engineering:BBE
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• v.8 no.2
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• pp.151-157
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• 2003

Obtaining a sufficient amount of healthy keratinocytes from a small tissue is difficult. However, ORS cells can be a good source of epithelium since they are easily obtainable and patients do not have to suffer from scar formation at donor sites. Accordingly, the current study modified the conventional primary culture technique to overcome the low propagation and easy aging of epithelial cells during culturing. In a conventional primary culture, the average yield of human ORS tells is 2.↑ $\times$ 10$^3$cells/follicle based on direct incubation in a trypsin (0.1%)/EDTA(0.02%) solution for 15 min at 37$^{\circ}C$, however, our modified method was able to obtain about 6.9 $\times$ 10$^3$cel1s/follicle using a two-step enzyme digestion method involving dispase (1.2 U/mL) and a trypsin (0.1%)/EDTA (0.02%) solution. Thus, the yield of primary cultured ORS cells could be increasd three times higher. Furthermore, a total of 2.0 $\times$ 10$^{7}$ cells was obtained in a serum-free medium. while a modified E-medium with mitomycin C-treated feeder tells produced a total of 6.3 $\times$ 10$^{7}$ Cel1s over 17 days When Starting With 7.5 $\times$ 10$^4$cells. Finally, We Confirmed the effectiveness of our ORS tell isolation method by presenting their ability for reconstructing the bioartificial skin epithelium in vitro

• Tuberculosis and Respiratory Diseases
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• v.57 no.4
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• pp.358-363
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• 2004

Background : Photodynamic therapy (PDT) involves the use of photosensitizing agents for treatment of malignant disease. PDT is approved by the U.S. Food and Drug Administration for the endobronchial microinvasive nonsmall cell lung cancer and for palliation in patients with obstructing tumors. We report our experience and results of PDT in lung cancer. Method : Ten patients with lung cancer who were diagnosed in Chosun university hospital by histologic confirm through bronchoscopy were included between August 2002 and May 2003. The photosensitizer (Photogem$^{(R)}$, Lomonosov institute of Fine Chemical, Russia/dose 2.0 mg/kg body weight) was injected 48 hours prior to the PDT session. For PDT with the photosensitizer (Photogem$^{(R)}$), Diode LASER system (Biolitec Inc., Germany, wavelength; 633nm) were used. PDTs were done at 48-72 hours after photogem injection. Follow up bronchoscopy and chest X-ray or thorax computerized tomography were done for evaluate PDT response. Results : 9 of 10 patients with endobronchial obstruction showed partial remission with bronchus opening after PDT. Direct reaction of the tumor to PDT was similar in despite of its localization. It was as follows; edema, hyperemia, in-situ bleeding, fibrin film occurrence. Any other complications such as sunburns of skin, inflammation within the PDT zone were not occurred by the end of the fourth week. Conclusion : In the advanced endobronchial disease, PDT has been shown to be useful in treating endobronchial tumors that are causing clinically significant dyspnea or are likely to progress and lead to further clinical complications, such as postobstructive pneumonia.

• Annals of Clinical Neurophysiology
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• v.12 no.1
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• pp.21-26
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• 2010

Background: Although quantitative sensory test (QST) is being used with increasing frequency for measuring sensory thresholds in clinical practice and epidemiologic studies, there has been no age-matched normative data in Korean adults. The objective of this study is to evaluate the value of QST in diabetic polyneuropathy with normal range in Korean adults. Methods: The Computer Aided Sensory Examination IV 4,2 (WR Medical Electronics Co., Stillwater, Minnesota, U.S.A.), with 4,2,1 stepping algorithm was used to determine vibration and cold perception threshold in 70 normal controls and 19 patients with diabetic polyneuropathy aged from 21 to 79 years. The data were used to define age-matched upper and lower normal limits and normal range of side to side difference. We also evaluated the duration of diabetes, serum HbA1C level, and findings of nerve conduction study (NCS) and QST in patients with diabetic polyneuropathy. Results: In normal adults, sensory thresholds slightly increased with age, and a slight side-to-side difference was observed. The diagnostic sensitivity of QST was not higher than NCS in patients with diabetic polyneuropathy (36.8% vs. 42.1%, p=0.716), especially among elderly patients. Conclusions: QST might be used as a complementary test for NCS in the diagnosis of diabetic polyneuropathy. Although the QST is a simple method for the evaluation of peripheral nerve function, there are some limitations. Most of all, because the QST measuring is dependent on the subjective response of patients, the degree of concentration and cooperation of the patients can significantly affect the result. And thus, attention should be paid during the interpretation of QST results in patients with peripheral neuropathy.

• Journal of Korean Academy of Nursing
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• v.15 no.1
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• pp.5-16
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• 1985

This study examined the effects of husband's supportive behavior reinforcement education on stress relief of primigravidas. The purpose was to reinforce husbands' supportive behavior and relieve primigravidas' stress. The purposes of this study were to determine lactors influencing Primigravidas' stress and the effect of husbands' supportive behavior reinforcement education on stress relief of primigravidas. The subjects, consisting of 140 primigravidas who registered or visited in three obstetrics and gynecology clinics in J city, were divided into at random experimental and control groups. Data were collectpe from April To July, 1984 through interviews during hospital visits, and by questionaires. The husbands' supportive behavior reinforcement education and the measurement tools were developed by the investigator from the literature and during pilot study: the instruments to measure primigravidas' stress and husbands' supportive behavior were tested for reliability and validity. Personality characteristisc were measured by Chestnuts' Stress Management instrument. T-test, ANOVA, ω², and Pearson Correlation were used in analysing the data to confirm the intensity of the influence and the relation between general characteristics and primigravidas' stress. Pearson correlation and Stepwise Multiple Regression were used to confirm the predictors of primigravidas' stress. Independent variables were compared by means of t-test and χ³-test to confirm significant discrepancy of experimental and control groups. T-test, paired t-test, pearson correlation were used in analyzing the data to confirm the effect of husband's supportive behavior reinforcement education on stress relief of primigravidas. The results of the study are summarized. Results from analyzing the effect of husbands' supportive behavior reinforcement education: There was no significant difference between the general characteristics of the experimental and control groups. And husbands' supportive behavior, personality, marital Satisfaction, natural abortion variables influenced at primigravidas' stress. A hypothetical test by comparative analysis of the measurement of primigravidas' stress and husbands' support behavior between the experimental and the control group before and after the experiment to confirm the effect of husbands' supportive behavior reinforcement education resulted in the following: The first hypothesis that husbands' supportive behavior reinforcement education will increase husbands' support behavior to relieve primigravidas' stress was supported. The second hypothesis that husbands' supportive behavior reinforcement education will relieve primigravidas' stress was supported. As a result, it u·as shown that husbands' supportive behavior reinforcement education relieved primigravidas' stress, and the hypotheses were supported. The third hypothesis that the higher the degree of husbands' supportive behavior, the lower the primigravidas' stress was supported. It was concluded that husbands' supportive behavior reinforcemen education increase husbands' supportive behavior and relieves Primigravidas' stress.

• Journal of Ginseng Research
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• v.44 no.3
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• pp.475-482
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• 2020

Background: Active natural ingredients, especially small molecules, have recently received wide attention as modifiers used to treat neurodegenerative disease by promoting neurogenic regeneration of neural stem cell (NSC) in situ. 20(S)-protopanaxadiol (PPD), one of the bioactive ingredients in ginseng, possesses neuroprotective properties. However, the effect of PPD on NSC proliferation and differentiation and its mechanism of action are incompletely understood. Methods: In this study, we investigated the impact of PPD on NSC proliferation and neuronal lineage differentiation through activation of the Wnt/glycogen synthase kinase (GSK)-3β/β-catenin pathway. NSC migration and proliferation were investigated by neurosphere assay, Cell Counting Kit-8 assay, and EdU assay. NSC differentiation was analyzed by Western blot and immunofluorescence staining. Involvement of the Wnt/GSK3β/β-catenin pathway was examined by molecular simulation and Western blot and verified using gene transfection. Results: PPD significantly promoted neural migration and induced a significant increase in NSC proliferation in a time- and dose-dependent manner. Furthermore, a remarkable increase in anti-microtubule-associated protein 2 expression and decrease in nestin protein expression were induced by PPD. During the differentiation process, PPD targeted and stimulated the phosphorylation of GSK-3β at Ser9 and the active forms of β-catenin, resulting in activation of the Wnt/GSK-3β/β-catenin pathway. Transfection of NSCs with a constitutively active GSK-3β mutant at S9A significantly hampered the proliferation and neural differentiation mediated by PPD. Conclusion: PPD promotes NSC proliferation and neural differentiation in vitro via activation of the Wnt/GSK-3β/β-catenin pathway by targeting GSK-3β, potentially having great significance for the treatment of neurodegenerative diseases.

• Journal of Korean Clinical Nursing Research
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• v.18 no.3
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• pp.368-380
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• 2012

Purpose: The purpose of this study was to evaluate the effects of a home-based video exercise program on cancer-related fatigue, physiological and psychological status in patients with colon and rectal cancers undergoing chemotherapy. Methods: The study design was a non-equivalent control group non-synchronized design. Data were collected from patients with colo-rectal cancers in Yonsei cancer center from July 5th to October 31st in 2011. There were 40 participants; 20 in the experimental group and 20 in the control group. The structured questionnaire was used to measure fatigue, physical function and emotional status. Data were analyzed using SPSS 18.0 and a chi-squre test, Fisher's exact test, Mann-Whitney U test and Wilcoxon signed- rank test were conducted to examine the homogeneity and the research hypotheses. Results: There was a statistically significant difference in White Blood Cell count in the experimental group compared with that of the control group. The exercise group showed a slight decrease of White Blood Cell count compared with that of the control group after 4 week program (z=-2.935, p=.003). However, there were no significant differences in fatigue, physiological and psychological status between the two groups. Conclusion: In this study, the developed video exercise program was effective in markedly slightly decreasing White Blood Cell count in patients with colo-rectal cancers undergoing chemotherapy. Therefore, utilizing the video exercise program can be an useful method to promote health among patients with cancer in clinical practice.