Purpose : In radiotherapy for cervix cancer, both 3-dimensioal radiotherapy (3D-CRT) and intensity-modulated radiation therapy (IMRT) could reduce the dose to the small bowel (SB), while the small bowel displacement system (SBDS) could reduce the SB volume in the pelvic cavity. To evaluate the effect of the SBDS on the dose to the SB in 3D-CRT and IMRT plans, 3D-CRT and IMRT plans, with or without SBDS, were compared. Materials and Methods : Ten consecutive uterine cervix cancer patients, receiving curative radiotherapy, were accrued. Ten pairs of computerized tomography (CT) scans were obtained in the prone position, with or without SBDS, which consisted of a Styrofoam compression device and an individualized custom-made abdominal immobilization device. Both 3D-CRT, using the 4-field box technique, and IMRT plans, with 7 portals of 15 MV X-ray, were generated for each CT image, and proscribed 50 Gy (25 fractions) to the isocenter. For the SB, the volume change due to the SBDS and the DVHs of the four different plans were analyzed using palled t-tests. Results : The SBDS significantly reduced the mean SB volume from 522 to 262 cm$^{3}$ (49.8$\%$ reduction). The SB volumes that received a dose of 10$\~$50 Gy were significantly reduced in 3D-CRT (65$\~$80$\%$ reduction) and IMRT plans (54$\~$67$\%$ reduction) using the SBDS. When the SB volumes that received 20$\~$50 Gy were compared between the 3D-CRT and IMRT plans, those of the IMRT without the SBDS were significantly less, by 6$\~$7$\%$, than those for the 3D-CRT without the SBDS, but the volume difference was less than 1$\%$ when using the SBDS. Conclusion : The SBDS reduced the radiation dose to the SB in both the 3D-CRT and IMRT plans, so could reduce the radiation injury of the SB.
Purpose: To evaluate the efficacy of a belly-board device (BBD) in reducing the volume of small bowel during four-field pelvic irradiation. Materials and Methods: Twenty-two cancer patients (14 uterine cervical cancer, 6 rectal cancer, and 2 endometrial cancer) scheduled to receive pelvic irradiation were selected for this study. Two sets of CT images were taken with and without the belly-board device using the Siemens 16 channel CT scanner. All patients were set in the prone position. The CT images were transferred to a treatment planning system for dose calculation and volume measurements. The external surfaces of small bowel and the bladder were contoured on all CT scans and the 4-pelvic fields were added. The dose-volume-histogram of the bladder and small bowel, with and without the BBD, were plotted and analyzed. Results: In all patients, the total small bowel volume included in the irradiated fields was reduced when the BBD was used. The mean volume reduction was 35% (range, $1{\sim}79%$) and was statistically significant (p<0.001). The reduction in small bowel volume receiving $10{\sim}100%$ of the prescribed dose was statistically significant when the BBD was used in all cases. Almost no change in the total bladder volume involved was observed in the field (<8 cc, p=0.762). However, the bladder volume receiving 90% of the prescribed dose was 100% in 15/22 patients (68%) and $90{\sim}99%$ in 7/22 patients (32%) with the BBD. In comparison, the bladder volume receiving 90% of the prescribed dose was 100% in 10/22 patients (45%), $90{\sim}99%$ in 7/22 patients (32%), and $80{\sim}89%$ in 5/22 patients (23%) without the BBD. When the BBD was used, an increase in the bladder volume receiving a high dose range was observed Conclusion: This study shows that the use of a BBD for the treatment of cancer in the pelvic area significantly improves small bowel sparing. However, since the BBD pushed the bladder into the treatment field, the bladder volume receiving the high dose could increase. Therefore it is recommended to be considerate in using the BBD when bladder damage is of concern.
Hwang, Young Jun;Chung, Kyung Hyun;Choi, Suk Min;Lee, Kyu Hyung
Clinical and Experimental Pediatrics
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v.45
no.5
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pp.609-614
/
2002
Purpose : The purpose of our investigation was to explore the natural course, and the factors that influence the natural course, in ostium secundum atrial septal defect(ASD) diagnosed within the first 4 weeks of life. Methods : We studied patients with ASD diagnosed within the first 4 weeks of life during the period from September 1995 to September 1999 in our hospital. The diagnosis and measuring of the size of ASD was carried out by two-dimensional echocardiogram(2DE, Hewlett-Packard Sonos $2500^{(R)}$) from subcostal long and short axis views. Results : There were 61 patients - 29 males and 32 females. According to the size of their defects, we divided them into four groups; group A(less than 4 mm : 24 cases), group B(four mm-six mm : 27 cases), group C(six mm-eight mm : six cases), group D(more than eight mm : four cases). In groups A and B, 22 of 24 patients(91.7%) and 23 of 27 patients(85.2%) had each closed spontaneously. In group C, four of six patients had closed spontaneously. In group D, no patient had closed spontaneously and three of four patients had been closed surgically. There were significant differences in the rate of spontaneous closure between less than six mm group and more than six mm group in the size of the defect(P<0.05). There were no significant differences in the rate of spontaneous closure between ASD combined with simple cardiac defect and isolated secundum ASD. Conclusion : We conclude that defects smaller than six mm in diameter are very likely to close spontaneously.
A process for manufacturing virally-safe bovine amniotic membrane(BAM) has been developed for biological dressing. BAM was harvested from a healthy bovine placenta, and then the epithelium was removed. The remaining stromal layer was consecutively disinfected with 70% ethanol and 0.05% sodium hypochlorite. The stromal layer was incubated in a decellularization solution containing 0.25%(w/v) trypsin to remove the cellular components. The resulting acelluar BAM was lyophilized to preserve its biochemical and structural integrity. The BAM was packed and exposed to 25 kGy of gamma irradiation for sterilization purpose. Histological, electron microscopical, and biochemical observations showed that the acellualr BAM had intact structural integrity of three dimensional collagen fibers and contained several growth factors, accelerating wound healing, such as EGF (Epidermal growth factor), KGF (Keratinocyte growth factor), and FGF (Fibroblast growth factor). Bovine herpes virus (BHV), bovine viral diarrhoea virus (BVDV), bovine parainfluenza virus type 3 (BPIV-3), and bovine parvovirus (BPV) were chosen as the biological indicators for validation of viral safety of the acellular BAM. Samples from relevant stages of the production process were spiked with each virus and subjected to viral inactivation processes. Viruses were recovered from the samples and then titrated immediately. All the viruses tested were completely inactivated to undetectable levels within 1 h of 70% ethanol treatment. Enveloped viruses such as BHV, BVDV, and BPIV-3 were more effectively inactivated than BPV by 0.05% sodium hypochlorite treatment. BHV, BVDV, and BPIV-3 were completely inactivated to undetectable levels by 25 kGy of gamma irradiation. Also BPV was effectively inactivated by 25 kGy of gamma irradiation. The cumulative log reduction factors of BHV, BVDV, BPIV-3, and BPV were ${\geq}$13.30, ${\geq}$14.32, ${\geq}$15.22, and ${\geq}$7.57, respectively. These results indicate that the production process for acelluar BAM has a sufficient virus-reducing capacity to achieve a high margin of the virus safety.
For the total treatment of skeletal malocclusions, 3-dimensional evaluation and diagnosis are essential. Although anteroposterior discrepancies can be evaluated through various methods, the satisfactory methods for evaluations of facial asymmetry and transverse discrepancies are yet to be found. The adequate diagnosis and treatment of transverse discrepancies may be more important in the maintenance of functional occlusion as well as for the stability of results obtained from orthognathic surgery than the anteroposterior or vertical discrepancies. Since the soft tissue effects from the transverse discrepancies may not be pronounced, especially when combined with anteroposterior or vertical discrepancies which have prominent characteristics, the differentiation of their effects may be difficult from visual inspection alone. Therefore it is essential that the normal facial proportions would be established from the posteroanterior cephalometry as a reference for the accurate diagnosis and treatment. The present study evaluates 76 subjects from Yonsei University freshmen with normal facial symmetry and occlusion. Posteroanterior cephalograms were taken from the subjects and the normal values and facial proportions are obtained. The results are as follows. 1. The transverse and vortical values from posteroanterior cephalometry and their ratio, with means and standard deviations are calculated. 2. The ratio of vertical values to transverse values is 0.837 (male 0.836, female 0.841). 3. The Proportion of maxillary and mandibular widths is 0.747 (male 0.745, female 0.752), with statistically significant correlation. 4. Various degree of significant correlations are observed in the following craniofacial widths; (Cranial width, Bizygomaticofrontal suture width, Facial width, Maxillary width, Upper & Lower Intermolar width, Mandibular width). 5. Although the facial height as well as other line measurements increase as the facial widths increase, angle measurement ($Bj\ddot{o}rk$ Sum, Mandibular Plane Angle, Gonial Angle), decreases and posterior to anterior facial height ratio increases, therefore indicating the tendency for a brachycephalic facial type. These results may be used as references for the treatment planning in orthognathic and orthodontic treatments for the dentofacial deformity patients.
Journal of the Korean Society of Food Science and Nutrition
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v.38
no.3
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pp.384-390
/
2009
Extraction characteristics of citron (Citrus junos Sieb. ex Tanaka) seeds and functional properties of corresponding extract were monitored by response surface methodology (RSM). Maximum extraction yield of 20.23% was obtained at extraction temperature of $50.23^{\circ}C$, extraction time of 3.03 hr, and shaking velocity of 400.06 rpm. At extraction temperature, extraction time, and shaking velocity of $49.88^{\circ}C$, 2.72 hr, and 400.39 rpm, respectively, maximum polyphenol content was 4.37 mg/g. At extraction temperature, extraction time, and shaking velocity of $50.28^{\circ}C$, 3.42 hr, and 399.96 rpm, respectively, maximum electron donating ability (EDA) was 49.69%. Maximum nitrite scavenging activity (NSA) was 47.79% at extraction temperature, extraction time, and shaking velocity of $49.19^{\circ}C$, 0.68 hr, and 602.95 rpm, respectively. Based on superimposition of 3-dimensional RSM with respect to extraction yield, polyphenol, EDA, and NSA, optimum ranges of extraction conditions were extraction temperature of $50^{\circ}C$, extraction time of about 3 hr, and shaking velocity of 400 rpm.
This study examined 191 pregnant women before delivery in an obstetrics and gynecology clinic in North Gyeongsang Province from May to September 2016 by using a questionnaire after obtaining informed consent for voluntary participation in the study. The study was performed to investigate the association of depression with sociodemographic characteristics, pregnancy-related characteristics, social support, sleep quality and Oral Health Impact Profile (OHIP) in pregnant women. The prevalence of depression among the pregnant women was 25.1% in the healthy group and 74.9% in the depression group. The depression level was significantly higher in women in the depression group who were unsatisfied with their marriage life, had no occupation, had lower social support, had poor sleep quality and had higher OHIP scores. The results of the logistic regression analysis indicated that, the risk ratio for more severe depression was significantly higher in the group with no experience of miscarriage and induced childbirth than in the group with childbirth experience. Conversely, the risk ratio for more severe depression was significantly lower in the group with high social support than in the group with low social support. Depression in the respondents significantly positively correlated with sleep quality and OHIP score but significantly negatively correlated with social support. The multiple regression analysis revealed that the depression level was significantly higher by 22.3% among pregnant women with lower marital satisfaction, no childbirth experience, lower social support and higher OHIP scores. In summary, depression was related to marital satisfaction, childbirth experience, social support, and OHIP score, among others, in pregnant women in this study. Therefore, further investigation is warranted to construct programs and measures that will help build positive thinking by designing and verifying a three-dimensional study model by taking into consideration various variables to reduce the incidence of depression in pregnant women.
Yoon, Mee Sun;Kim, Yong-Hyeob;Jeong, Jae-Uk;Nam, Taek-Keun;Ahn, Sung-Ja;Chung, Wong-Ki;Song, Ju-Young
Progress in Medical Physics
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v.23
no.4
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pp.219-228
/
2012
The tangential breast intensity modulated radiotherapy (T-B IMRT) technique, which uses the same tangential fields as conventional 3-dimensional conformal radiotherapy (3D-CRT) plans with physical wedges, was analyzed in terms of the calculated dose distribution feature and dosimetric accuracy of beam delivery during treatment. T-B IMRT plans were prepared for 15 patients with breast cancer who were already treated with conventional 3D-CRT. The homogeneity of the dose distribution to the target volume was improved, and the dose delivered to the normal tissues and critical organs was reduced compared with that in 3D-CRT plans. Quality assurance (QA) plans with the appropriate phantoms were used to analyze the dosimetric accuracy of T-B IMRT. An ionization chamber placed at the hole of an acrylic cylindrical phantom was used for the point dose measurement, and the mean error from the calculated dose was $0.7{\pm}1.4%$. The accuracy of the dose distribution was verified with a 2D diode detector array, and the mean pass rate calculated from the gamma evaluation was $97.3{\pm}2.9%$. We confirmed the advantages of a T-B IMRT in the dose distribution and verified the dosimetric accuracy from the QA performance which should still be regarded as an important process even in the simple technique as T-B IMRT in order to maintain a good quality.
Won Mi-Kyoung;Park Chan-Jin;Chang Kyoung-Soo;Kim Chang-Whe;Kim Yung-Soo;Isa Zakiahbt Mohd;Ariffin Yusnidar Tajul
The Journal of Korean Academy of Prosthodontics
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v.41
no.6
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pp.720-731
/
2003
Statement of problem. The importance of fixture design and surface treatment. Purpose. The clinical success of dental in plants is affected by many factors such like as degree of osseointegration, the effective load dispersion for the prostheses, and a lot of attempts have been made to overcome the difficulties. In this study, efforts were made to find the possibility of clinical acceptance of the dental implants of newly designed surface and resorbable blast media surcace. Materials and methods. In this study, two groups of custom-made, screw-shaped implants were prepared. The first with the consisting of Branemark clone design and the other with the new design. These implants were divided into four groups according to the kinds of surface treatment. Four implants($AVANA^{(R)}$, Osstem, Busan, Korea)of each group were installed in twenty rabbits. Group A was consisted of Branemark done implant left as machined, Group B with Branemark clone implants with RBM(Resorbable blast media) surface, Group C with newly designed implants left as machined and Group D with newly designed implants with RBM surface. One of the twenty rabbits died from inflammation and the observation was made for six weeks. Specimens from four groups were observed using scanning electron microscopy with 40, 100, 1000 magnification power and microsurface structures were measured by white-light scanning interferometry for three dimensional surface roughness measurements(Accura $2000^{(R)}$, Intek-Plus, Korea.). Removal torque was measured in 17 rabbits using digital torque gauge(MGT 12R, Mark-10 corp., NY, U.S.A.) immediately after the sacrifice and two rabbits were used for the histologic preparation(EXAKT $310^{(R)}$, Heraeus Kulzer, wehrheim, Germany) of specimens and observed under light microscope. Resonance frequency measurement($Osstell^{(R)}$) was taken with the 19 rabbits at the beginning of the implant fixation and immediately after the sacrifice. Results. Following results were taken from the experiment. 1. The surface of the RBM implants as seen with SEM had rough and irregular pattern with reticular formation compared to that of fumed specimens showing different surface topographies. 2. The newly designed implant with RBM surface had high removal torque value among four groups with no statistical significance. The average removal torque was $49.95{\pm}6.70Ncm$ in Group A, $51.15{\pm}4.40Ncm$ in Group B, $50.78{\pm}9.37Ncm$ in Group C, $51.09{\pm}4.69Ncm$ in Group D. 3. The RFA values were $70.8{\pm}4.3Hz$ in Group A, $71.8{\pm}3.1Hz$ in Group B, $70.9{\pm}2.5Hz$, $72.7{\pm}2.5Hz$ in Group D. Higher values were noted in the groups which had surface treatment compared to the untreated groups with no statistical significance. 4. The results from the histomorphometric evaluation showed a mean percentage of bone-to-implant contact of $45{\pm}0.5%$ in Group A, $55{\pm}3%$ in Group B, $49.5{\pm}0.5%$ in Group C, and $55{\pm}3%$ in Group D. Quite amount of newly formed bone were observed at the surface RBM-treated implants in bone marrow space.
Statement of problem: There are common clinical cases in which the mandibular first and second molars are missing unilaterally. Purpose: This study was designed to compare and evaluate the magnitude and distribution of stress produced by four kinds of mandibular unilateral free-end removable partial dentures that could be applied clinically in Kennedy class II cases. Material and methods: Four unilateral free-end removable partial dentures using clasp, Konus crown, resilient attachment, and flexible resin were fabricated on the photoelastic models of the Kennedy class II cases. The vertical load of 6㎏ was applied on the central fossa of the first molar of every removable partial denture in the stress freezing furnace and the photoelastic models were frozen according to the stress freezing cycle. After these models were sliced mesio-distally to a thickness of 6mm, the photoelastic isochromatic white and black lines of the sliced specimens were examined with the transparent photoelastic experiment device and photographs were taken with a digital camera. The fringe order numbers at eight measuring points in the photograph were measured with the naked eye. Results: The maximum fringe order number of each sliced specimen and the fringe order number at the residual ridge just below the loading point were in the decreasing order of the unilateral removable partial dentures using flexible resin followed by clasp, resilient attachment, and Konus crown. The fringe order number at the root apex of the second premolar was in the decreasing order of the unilateral removable partial dentures using clasp followed by flexible resin, Konus crown, and resilient attachment. Conclusion: The removable partial denture using Konus crown showed the most equalized stress distribution to the supporting alveolar bone of abutment teeth and residual ridge under the vertical loads. The removable partial denture using flexible resin can be applied to the case that has a better state of residual ridge than abutment teeth.
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