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Prognostic Analysis of Drug-Eluting Balloon Catheter and Drug-Eluting Stent for In-Stent Restenosis of Drug-Eluting Stent (스텐트 재협착 병변에서 약물코팅 풍선카테터과 약물용출 스텐트의 예후 분석)

  • Lee, Doo Hwan;Song, Jong Nam;Park, Sin eui;Choi, Nam Gil;Han, Jae Bok;Kim, In Soo
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.381-389
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    • 2019
  • Although the development of Drug-eluting stent (DES) improved the ISR significantly more than the Bare metal stent (BMS), the coronary stent restenosis (ISR) treatment still has a high recurrence rate. This study is compared the efficacy of DEB with that of DES implantation in patients with ISR. Among 4,316 patients who underwent coronary stent implantation at the Chonnam National University Hospital between November 2012 and December 2016, 187 patients developed ISR on follow-up coronary angiography ($66.3{\pm}11.0years$, 123 males) were enrolled and divided into two groups according to revascularization method as group I (DEB group; n=127) and group II (DES group; n=60). Primary end point was defined as major adverse cardiac events (MACEs), composite of cardiac death (CD), myocardial infaction (MI), target lesion revascularization (TLR) and stent thrombosis (ST) during two-year follow-up between the two groups. There were no differences in the baseline characteristics and angiographic findings except that prevalence of device length was shorter ($21.1{\pm}5.3$ vs. $25.3{\pm}9.6 mm$, p<0.002) in group I.Two-year MACE were not different in the two groups (8.7%vs.10.0%, p=0.789). The incidences of cardiac death (0%vs.0%, p=1.000), MI (1.6%vs.6.7%, p=0.085), TLR(8.7% vs. 10.0%, p=0.789) and ST (0% vs. 0%, p=1000). DEB demonstrated comparable risk reduction for MACEs compared with DES in patients with ISR during two-year follow-up. DEB might be good alternative for the treatment of ISR in patients with ISR.

Utility Evaluation of Supportive Devices for Interventional Lower Extremity Angiography (인터벤션 하지 혈관조영검사를 위한 보조기구의 유용성 평가)

  • Kong, Chang gi;Song, Jong Nam;Jeong, Moon Taek;Han, Jae Bok
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.613-621
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    • 2019
  • The purpose of this study is to evaluate the effectiveness of supportive devices which are for minimizing the patient's movement during lower extremity angiography and to verify image quality of phantom by analyzing of Mask image, DSA image and Roadmap image into SNR and CNR. As a result of comparing SNR with CNR of mask image obtained by DSA technique using the phantom alone and phantom placed on the supportive devices, there was no significant difference between about 0~0.06 for SNR and about 0~0.003 for CNR. The study showed about 0.11~0.35 for SNR and 0.016~0.031 for CNR of DSA imaging by DSA technique about only water phantom of the blood vessel model and the water phantom placed on the device. Analyzing SNR and CNR of Roadmap technique about water phantom on the auxiliary device (hardboard paper, pomax, polycarbonate, acrylic) and water phantom alone, there was no significant difference between 0.02~0.05 for SNR and 0.002~0.004 for CNR. In conclusion, there was no significant difference on image quality by using supportive devices made by hardboard paper, pomax, polycarbonate or acryl regardless of whether using supportive devices or not. Supportive devices to minimize of the patient's movement may reduce the total amount of contrast, exam-time, radiation exposure and eliminate risk factors during angiogram. Supportive devices made by hardboard paper can be applied easily during angiogram due to advantages of reasonable price and simple processing. It is considered that will be useful to consider cost efficiency and types of materials and their properties in accordance with purpose and method of the study when the operator makes and uses supportive devices.

Comparison of Thyroid Doses for Shielding Material Changes in Neck Computed Tomography (Neck CT에서 차폐체 재료 변화에 따른 Thyroid 선량 비교 연구)

  • Kang, Eun Bo
    • Journal of the Korean Society of Radiology
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    • v.13 no.1
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    • pp.65-71
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    • 2019
  • With regard to current Neck CT, Bismuth shielding boards are often being used to reduce exposure to superficial organs such as the thyroid. However, beam hardening often occurs near superficial organs with Bismuth shielding boards and variations in CT Number, Noise, and Uniformity values occur severely. This study looked into the usefulness of shielding boards made from aluminum and silicone that can be easily obtained and have good machinability by comparing them to the existing Bismuth shielding board. An Aluminum 7.3mm and a Silicone 21.5mm were made with shielding ratios similar to that of the Bismuth(0.06 mmPb). TLD (TLD-100) was placed on the thyroid area of the Phantom (RS-108T) and 5 doses were measured for each. To compare image quality, CT Number and Noise variations in axial images of the thyroid area in Neck CT images were compared. Also, variations in CT Number, Noise, and Uniformity were measured in the AAPM phantom images and compared. In the results, when thyroid doses for each shielding board were compared, the Bismuth shielding board showed a 14% reduction, the Silicone 21.5mm showed a 15% reduction, and the Aluminum 7.3mm showed a 13% reduction compared to the Non-Shield. Statistically, there were no significant differences in comparison with the Bismuth shielding board. In CT Number variations of thyroid area images, variations were largest for the Bismuth shielding board. With Uniformity evaluations of the AAPM phantom, the Bismuth shielding board was found unsuitable and the Aluminum 7.3mm and Silicone 21.5mm satisfied the acceptance criteria. Research results show that the Aluminum 7.3mm and Silicone 21.5mm have a similar shielding ratio to the high-priced Bismuth shielding board that is currently being used clinically and in comparison tests of CT Number attenuation coefficient variations, Noise, and Uniformity which are phantom image evaluation items, they proved to be better than Bismuth shielding boards. If various shielding boards are made using aluminum and silicone, sized appropriately for superficial organs, it would be useful in decreasing patient doses.

Protective Effect of the Ethyl Acetate-fraction of Methanol Extract of Ophiophogon japonicus on Amyloid beta Peptide-induced Cytotoxicity in PC12 Cells (소엽맥문동-에틸아세테이트 분획물의 아밀로이드 베타단백질-유발 세포독성에 대한 억제 효능)

  • Moon, Ja-Young;Kim, Eun-Sook;Choi, Soo-Jin;Kim, Jin-Ik;Choi, Nack-Shik;Lee, Kyoung;Park, Woo-Jin;Choi, Young-Whan
    • Journal of Life Science
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    • v.29 no.2
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    • pp.173-180
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    • 2019
  • Amyloid ${\beta}$-protein ($A{\beta}$) is the principal component of senile plaques characteristic of Alzheimer's disease (AD) and elicits a toxic effect on neurons in vitro and in vivo. Many environmental factors, including antioxidants and proteoglycans, modify $A{\beta}$ toxicity. It is worthwhile to isolate novel natural compounds that could prove therapeutic for patients with AD without causing detrimental side effects. In this study, we investigated the in vitro neuroprotective effects of the ethyl acetate fraction of methanol extract of Ophiophogon japonicas (OJEA fraction). We used an MTT reduction assay to detect protective effects of the OJEA fraction on $A{\beta}_{25-35}$-induced cytotoxicity to PC12 cells. We also used a cell-based ${\beta}$-secretase assay system to investigate the inhibitory effect of the OJEA fraction on ${\beta}$-secretase activity. In addition, we performed an in vitro lipid peroxidation assay to evaluate the protective effect of the OJEA fraction against oxidative stress induced by $A{\beta}_{25-35}$ in PC12 cells. The OJEA fraction had strong protective effects against $A{\beta}_{25-35}$-induced cytotoxicity to PC12 cells and was strongly inhibitory to ${\beta}$-secretase activity, which resulted in the attenuation of $A{\beta}$ generation. In addition, the OJEA fraction significantly decreased malondialdehyde (MDA) content, which is induced by the exposure of PC12 cells to $A{\beta}_{25-35}$. Our results suggested that the OJEA fraction contained active compounds exhibiting a neuroprotective effect on $A{\beta}$ toxicity.

Double-processed ginseng berry extracts enhance learning and memory in an Aβ42-induced Alzheimer's mouse model (Aβ42로 유도된 알츠하이머 마우스 모델에서 이중 가공 인삼열매 추출물의 학습 및 기억 손실 개선 효과)

  • Jang, Su Kil;Ahn, Jeong Won;Jo, Boram;Kim, Hyun Soo;Kim, Seo Jin;Sung, Eun Ah;Lee, Do Ik;Park, Hee Yong;Jin, Duk Hee;Joo, Seong Soo
    • Korean Journal of Food Science and Technology
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    • v.51 no.2
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    • pp.160-168
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    • 2019
  • This study aimed to determine whether double-processed ginseng berry extract (PGBC) could improve learning and memory in an $A\hat{a}42$-induced Alzheimer's mouse model. Passive avoidance test (PAT) and Morris water-maze test (MWMT) were performed after mice were treated with PGBC, followed by acetylcholine (ACh) measurement and glial fibrillary acidic protein (GFAP) detection for brain damage. Furthermore, acetylcholinesterase (AChE) activity and choline acetyltransferase (ChAT) expression were analyzed using Ellman's and qPCR assays, respectively. Results demonstrated that PGBC contained a high amount of ginsenosides (Re, Rd, and Rg3), which are responsible for the clearance of $A{\hat{a}} 42$. They also helped to significantly improve PAT and MWMT performance in the $A{\hat{a}} 42-induced$ Alzheimer's mouse model when compared to the normal group. Interestingly, ACh and ChAT were remarkably upregulated and AChE activities were significantly inhibited, suggesting PGBC to be a palliative adjuvant for treating Alzheimer's disease. Altogether, PGBC was found to play a positive role in improving cognitive abilities. Thus, it could be a new alternative solution for alleviating Alzheimer's disease symptoms.

The Influence of Moral Distress and Moral Sensitivity on Moral Courage in Nursing Students (간호대학생의 도덕적 용기에 대한 도덕적 고뇌와 도덕적 민감성의 관계)

  • YUN, Hye-Young;KIM, Sun-Ki;JANG, Hyo-Eun;HWANG, Sin-Woo;KIM, Sang-Hee
    • Korean Journal of Medical Ethics
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    • v.21 no.4
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    • pp.360-376
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    • 2018
  • Nursing students experience ethical conflicts that lead to moral distress and moral sensitivity in clinical practice. Most nursing students have some difficulty in speaking up when faced with morally challenging situations. Hence, increasing moral courage of these students is important to improve the quality of practice, and carry out nursing responsibilities. However, research on the moral distress, moral sensitivity, and moral courage of nursing students has not been reported in South Korea. The purposes of this study were to (a) identify the levels of moral distress, moral sensitivity, and moral courage of nursing students and (b) examine the influence of moral distress and moral sensitivity on moral courage. Data were collected through a survey using self-reported questionnaires sent to senior nursing students at two nursing colleges in Seoul and Gyeonggido. A total of 138 senior nursing students participated in the survey. The data were analyzed using the IBM SPSS Statistics 23 program by Pearson's correlation coefficients and multiple regression analysis. The mean scores of the moral distress thermometer, moral distress, moral sensitivity, and moral courage were $3.53{\pm}2.18$, $57.33{\pm}43.35$, $134.98{\pm}13.98$, and $56.33{\pm}12.75$, respectively. The significant factors influencing moral courage were the moral distress thermometer and patient-centered nursing, which was a subcomponent of moral sensitivity. The explanatory power of the model was 5%. This study confirms that nursing students, like nurses, experience moral distress. It is therefore important to create organizational environments that support the moral courage of nursing students.

Relationship between intake of soft drinks and current prevalence of adult atopic dermatitis: based on the Korea National Health and Nutrition Examination Survey data (2015-2016) (탄산음료 섭취와 성인 아토피 피부염 진단 및 현재 유병과의 관련성: 국민건강영양조사(2015-2016년) 자료를 바탕으로)

  • Kim, Hye Won;Kim, Ji-Myung
    • Journal of Nutrition and Health
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    • v.54 no.5
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    • pp.501-514
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    • 2021
  • Purpose: The purpose of this study was to provide basic data for the management of atopic dermatitis (AD) in adults by analyzing the relationship between AD and intake of soft drinks in adults. Methods: This study was conducted on 5,931 adults aged 19 to 64 who completed the food frequency questionnaire (FFQ) for participants in the Korea National Health and Nutrition Examination Survey VII-3 and VII-1. Subjects were divided into an AD-diagnosed group and a non-AD group according to the diagnosis of AD. In addition, the group diagnosed with AD was divided into a 'symptom-AD' group and a 'no symptom-AD' group. The amount, frequency of intake, and nutritional status of soft drinks were analyzed using the FFQ. Results: Compared with the nutrient intake per 1,000 kcal of energy consumption, fat intake was higher in the AD-diagnosed group than in the non-AD group, and carbohydrate, dietary fiber, calcium, phosphorus, iron, potassium, vitamin A, thiamin, and vitamin C were lower in AD-diagnosed group. The daily intake of soft drinks and the percentage of 'more than 0.5 servings per day' were also higher in the AD-diagnosed group than in the non-AD group. Also, the frequency of the intake of soft drinks was significantly higher in the AD-diagnosed group than in the non-AD group. The odds ratio of AD symptoms due to the intake of soft drinks increased 2.6 times when the intake was 'less than 0.5 serving per day'. Conclusion: AD in adults appears to be related to malnutrition and excessive consumption of soft drinks, and the current prevalence of AD symptoms may also be related to the intake of soft drinks. Based on these results, we suggest that one of the ways to manage AD in adults would be to limit their intake of soft drinks.

Evaluation of the possibility of clinical application by surface dose measurement of ViewRay in MFW treatment (MFW 치료 시 ViewRay의 표면선량 측정에 따른 임상 적용 가능성 평가)

  • Sun, Geo Jun;Son, Sang Jun;Lee, Yang Hoon;Lee, Je Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.169-176
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    • 2018
  • Purpose : The purpose of this study is to evaluate clinical applicability of Co-60 ViewRay treatment plan to increase the skin dose in case of high skin dose is required such as Malignant Fungating Wound By measuring the presence / absence of Bolus application and skin dose by the treatment device and comparing it Materials and Methods : Nine inner measuring points of 2.5 cm lattice arrangement and all 13 measuring points including upper and lower left and right measuring points touching the chest and skin were marked. After CT was taken, each treatment plan was formulated through Eclipse and ViewRay-TPS, and a Fixed beam-IMRT treatment plan was formulated so that the left chest V2Gy=95 % is delivered. Before measurement QED detector was calibrated and the QED detector was positioned at the 13 measurement points displayed on Phantom and surface dose of each treatment planner was measured using 5 mm Bolus application using True-beam and View-ray before and after, measure three times and compare each before applying 5 mm Bolus. Results : The surface dose of the Co-60 ViewRay and the linear accelerator appeared at $76.8%{\pm}5.2%$ vs. $67.3{\pm}%7.5%$ and the surface dose after application of 5 mm Bolus was $87.6%{\pm}8.9%$ vs. $80.3%{\pm}10.2%$ It was measured at 10.2 % (p<0.001). Conclusion : As a result of the surface dose measurement of each treatment instrument, Co-60 ViewRay confirmed that the surface dose reached 95.6 % of 6 MV Linac with conventional 5 mm bolus, despite not using Bolus (p<0.001). Also, by utilizing magnetic resonance images for each treatment, it is possible to observe the change in the treatment site without the problem of exposure, it is easy to formulate an adaptive treatment plan and it is easy to secure the skin dose, so the size In the case of Malignant Fungating Wound patients who need fast skin changes and need high skin doses, Co-60 ViewRay is considered to be more useful than linear accelerators.

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Comparative study of volumetric change in water-stored and dry-stored complete denture base (공기중과 수중에서 보관한 총의치 의치상의 체적변화에 대한 비교연구)

  • Kim, Jinseon;Lee, Younghoo;Hong, Seoung-Jin;Paek, Janghyun;Noh, Kwantae;Pae, Ahran;Kim, Hyeong-Seob;Kwon, Kung-Rock
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.18-26
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    • 2021
  • Purpose: Generally, patients are noticed to store denture in water when removed from the mouth. However, few studies have reported the advantage of volumetric change in underwater storage over dry storage. To be a reference in defining the proper denture storage method, this study aims to evaluate the volumetric change and dimensional deformation in case of underwater and dry storage. Materials and methods: Definitive casts were scanned by a model scanner, and denture bases were designed with computer-aided design (CAD) software. Twelve denture bases (upper 6, lower 6) were printed with 3D printer. Printed denture bases were invested and flasked with heat-curing method. 6 upper and 6 lower dentures were divided into group A and B, and each group contains 3 upper and 3 lower dentures. Group A was stored dry at room temperature, group B was stored underwater. Group B was scanned at every 24 hours for 28 days and scanned data was saved as stereolithography (SLA) file. These SLA files were analyzed to measure the difference in volumetric change of a month and Kruskal-Wallis test were used for statistical analysis. Best-fit algorithm was used to overlap and 3-dimensional color-coded map was used to observe the changing pattern of impression surface. Results: No significant difference was found in volumetric changes regardless of the storage methods. In dry-stored denture base, significant changes were found in the palate of upper jaw and posterior lingual border of lower jaw in direction away from the underlying tissue, maxillary tuberosity of upper jaw and retromolar pad area of lower jaw in direction towards the underlying tissue. Conclusion: Storing the denture underwater shows less volumetric change of impression surface than storing in the dry air.

A Comparison of the Effects between Eye-Mask and Light-Off Conditions on Psychiatric Patient Sleep (야간 조명 하 안대와 소등의 수면에 대한 효과 비교)

  • Shin, Juyong;Lim, Kyoung-Ok;Cho, Seongnam;Jang, Soyeong;Cha, Seung-Min;Han, Songyi;Kim, Moojin
    • Sleep Medicine and Psychophysiology
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    • v.28 no.1
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    • pp.27-33
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    • 2021
  • Objectives: The purpose of this study is to investigate the difference in the effects of eye-mask and light-off on sleep status according to a commercial fitness tracker and a sleep diary of psychiatric in-patients in correctional facilities where nocturnal light is compulsory. Methods: This study was conducted over 3 consecutive nights. In-patients of the National Forensic Psychiatric Hospital (n = 29) were assigned random subject numbers and slept as usual in the light-on condition on the first night. The subjects slept with eye-masks in the light-on condition on another night and without an eye-mask in the light-off condition on the other night. Subjects were asked to sleep wearing a commercial fitness tracker and to keep a sleep diary. The order of these changes in bedroom lighting condition on the second and third nights was assigned randomly to participants. Results: In comparison of the sleep variables between the light-on condition and the eye-mask condition, the Wakefullness After Sleep Onset (WASO) was shorter and sleep satisfaction was higher in the latter.(respectively, Z = 3.66, p < 0.017 ; Z = 2.69, p < 0.017) In comparison of the sleep variables between the light-on and light-off conditions, the WASO was shorter and sleep efficiency and sleep satisfaction were higher in the latter (respectively, Z = 2.40, p < 0.017 ; Z = 3.02, p < 0.017 ; Z = 3.88, p < 0.017). However, there were no differences in the sleep variables between the eye-mask condition and the light-off condition. Conclusion: Subjective improvements in sleep variables were noted in sleep diaries of institutionalized psychiatric patients under either the 'eye-mask' or 'light-off' condition. However, there were no significant differences between the 'eye-mask' and 'light-off' conditions. Therefore, we suggest that psychiatric patients in correctional facilities use eye-masks when sleeping.