• Title/Summary/Keyword: Brain

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Technical Review of Target Volume Delineation on the Posterior Fossa Tumor : An Optimal Head and Neck Position (후두와 종양의 방사선치료 시 표적용적의 결정을 위한 적절한 치료자세 연구)

  • Yoon Sang Min;Lee Sang-wook;Ahn Seung Do;Kim Jong Hoon;YE Byong Yong;Ra Young Shin;Kim Tae Hyung;Choi Eun Kyung
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.94-99
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    • 2003
  • Purpose : To explore a 3D conformal radiotherapy technique for a posterior fossa boost, and the potential advantages of a prone position for such radiotherapy. Materials and Methods :A CT simulator and 3D conformal radiotherapy Planning system was used for the posterior fossa boost treatment on a 13-year-old medulloblastoma patient. He was placed In the prone position and Immobilized with an aquaplast mask and immobilization mold. CT scans were obtained of the brain from the top of the skull to the lower neck, with IV contrast enhancement. The target volume and normal structures were delineated on each slice, with treatment planning peformed using non-coplanar conformal beams. Results : The CT scans, and treatment In the prone position, were peformed successfully. In the prone position, the definition of the target volume was made easier due to the well enhanced tentorium, In audition, the posterior fossa was located anteriorly, and with the greater choice of beam arrangements, more accurate treatment planning was possible as the primary beams were not obstructed by the treatment table. Conclusion : .A posterior fossa boost, in the prone position, Is feasible in cooperating patients, but further evaluation is needed to define the optimal and most comfortable treatment positions.

A Web-based 'Patterns of Care Study' System for Clinical Radiation Oncology in Korea: Development, Launching, and Characteristics (우리나라 임상방사선종양을 위한 웹 기반 PCS 시스템의 개발과 특성)

  • Kim, Il Han;Chie, Eui Kyu;Oh, Do Hoon;Suh Chang-Ok;Kim, Jong Hoon;Ahn, Yong Chan;Hur, Won-Joo;Chung, Woong Ki;Choi, Doo Ho;Lee, Jae Won
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.291-298
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    • 2003
  • Purpose: We report upon a web-based system for Patterns of Care Study (PCS) devised for Korean radiation oncology. This PCS was designed to establish standard tools for clinical quality assurance, to determine basic parameters for radiation oncology processes, to offer a solid system for cooperative clinical studies and a useful standard database for comparisons with other national databases. Materials and Methods: The system consisted of a main server with two back-ups in other locations. The program uses a Linux operating system and a MySQL database. Cancers with high frequencies in radiotherapy departments in Korea from 1998 to 1999 were chosen to have a developmental priority. Results: The web-based clinical PCS .system for radiotherapy in www.pcs.re.kr was developed in early 2003 for cancers of the breast, rectum, esophagus, larynx and lung, and for brain metastasis. The total number of PCS study items exceeded one thousand. Our PCS system features user-friendliness, double entry checking, data security, encryption, hard disc mirroring, double back-up, and statistical analysis. Alphanumeric data can be input as well as image data. In addition, programs were constructed for IRB submission, random sampling of data, and departmental structure. Conclusion: For the first time in the field of PCS, we have developed a web-based system and associated working programs. With this system, we can gather sample data in a short period and thus save, cost, effort and time. Data audits should be peformed to validate input data. We propose that this system should be considered as a standard method for PCS or similar types of data collection systems.

Analysis of the Imaging Dose for IGRT/Gated Treatments (영상유도 및 호흡동조 방사선치료에서의 영상장비에 의한 흡수선량 분석)

  • Shin, Jung-Suk;Han, Young-Yih;Ju, Sang-Gyu;Shin, Eun-Hyuk;Hong, Chae-Seon;Ahn, Yong-Chan
    • Radiation Oncology Journal
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    • v.27 no.1
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    • pp.42-48
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    • 2009
  • Purpose: The introduction of image guided radiation therapy/four-dimensional radiation therapy (IGRT/4DRT) potentially increases the accumulated dose to patients from imaging and verification processes as compared to conventional practice. It is therefore essential to investigate the level of the imaging dose to patients when IGRT/4DRT devices are installed. The imaging dose level was monitored and was compared with the use of pre-IGRT practice. Materials and Methods: A four-dimensional CT (4DCT) unit (GE, Ultra Light Speed 16), a simulator (Varian Acuity) and Varian IX unit with an on-board imager (OBI) and cone beam CT (CBCT) were installed. The surface doses to a RANDO phantom (The Phantom Laboratory, Salem, NY USA) were measured with the newly installed devices and with pre-existing devices including a single slice CT scanner (GE, Light Speed), a simulator (Varian Ximatron) and L-gram linear accelerator (Varian, 2100C Linac). The surface doses were measured using thermo luminescent dosimeters (TLDs) at eight sites-the brain, eye, thyroid, chest, abdomen, ovary, prostate and pelvis. Results: Compared to imaging with the use of single slice non-gated CT, the use of 4DCT imaging increased the dose to the chest and abdomen approximately ten-fold ($1.74{\pm}0.34$ cGy versus $23.23{\pm}3.67$cGy). Imaging doses with the use of the Acuity simulator were smaller than doses with the use of the Ximatron simulator, which were $0.91{\pm}0.89$ cGy versus $6.77{\pm}3.56$ cGy, respectively. The dose with the use of the electronic portal imaging device (EPID; Varian IX unit) was approximately 50% of the dose with the use of the L-gram linear accelerator ($1.83{\pm}0.36$ cGy versus $3.80{\pm}1.67$ cGy). The dose from the OBI for fluoroscopy and low-dose mode CBCT were $0.97{\pm}0.34$ cGy and $2.3{\pm}0.67$ cGy, respectively. Conclusion: The use of 4DCT is the major source of an increase of the radiation (imaging) dose to patients. OBI and CBCT doses were small, but the accumulated dose associated with everyday verification need to be considered.

An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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Development and Evaluation of Sustainable Housing Teaching-Learning Process Plan for Achieving the Global SDGs by Home Economics in Middle School (중학교 가정교과의 SDGs 교육을 위한 지속가능한 주생활 교수·학습 과정안 개발 및 평가)

  • Kim, Eunkyung;Cho, Jaesoon
    • Journal of Korean Home Economics Education Association
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    • v.32 no.2
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    • pp.77-97
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    • 2020
  • The purpose of this study was to develop and evaluate the sustainable housing teaching-learning process plan aimed to achieve the global SDGs through home economics class in middle school that is based on the ADDIE model. The overall objective of the plan was to contribute to cultivating students' sustainable housing values and to creating sustainable lifestyle through everyday practice. The plan consisting of 4 lessons contained various activity and visual resources(4 individual and 4 team activity sheets, 4 reading texts, 1 homework sheet and 1 evaluation sheet, and 7 videos) for students and (4 sets of ppt and 4 reading texts) for teachers. The theme and team activities of each lesson were related to 2~7 targets of 2~3 SDGs, in total 11 targets of 5 SDGs. The plan was implemented to 4 classes of 127 senior students at Y middle school in Cheongju city during the period from the 29th of August to the 18th of September, 2019. The results showed that students were very positive and highly satisfied with not only practical contents but also adequacy of resources and activities of the whole 4-lessons, so that they actively participated in the lessons more than usual and looked forward to learning more about it. They thoroughly enjoyed various team activities such as brain writing, mandal art, visual thinking, making UCC, and planning the sustainable village as well as writing a short reflective journal at the end of each lesson. Students also reported that they highly accomplished the goal of each lesson and the overall objective. It could be concluded that the teaching-learning process plan of 4-lessons could contribute to cultivating students' sustainable housing values and to creating sustainable lifestyle through practicing everyday life. It indicates that home economics is one of the major subjects to contribute to the attainment of global issue of SDGs for OECD education 2030 and to educate the practically acting global citizen.

The Role of Plasma B-type Natriuretic Peptide Measurements in the Differential Diagnosis of Acute Dyspnea (급성호흡곤란의 감별진단에서 혈장 B-type Natriuretic Peptide의 역할)

  • Moon, Ji Yong;Bae, Joong Ho;Kim, Tae Hyung;Sohn, Jang Won;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.6
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    • pp.656-663
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    • 2005
  • Background : The B-type natriuretic peptide (BNP) is a cardiac neurohormone that is specifically secreted from the ventricles in response to volume expansion and a pressure overload. Differentiating congestive heart failure from the pulmonary causes of dyspnea is very important for patients presenting with acute dyspnea. Methods : A retrospective study was carried out on 261 patients who were admitted to the emergency department of Hanyang University Hospital due to acute dyspnea from March to July 2004. The serum BNP levels of the patients were measured using the ELISA method. Results : The BNP levels were 382, 111-1140 pg/ml (median, interquartile range) in the heart failure group (n=119) and 29, 7-81 pg/ml in the non-heart failure group (n=142). The BNP levels according to the subgroups of heart failure were 820, 354-1620 pg/ml, 1650, 239-1990 pg/ml, and 378, 106-1120 pg/ml for the chronic obstructive pulmonary disease (COPD) with combined left heart failure (n=5), cor pulmonale (n=3), and left heart failure groups (n=111), respectively. The BNP levels according to the subgroups of non-heart failure were 39, 21-101 pg/ml, 59, 10-129 pg/ml, and 15, 6-47 pg/ml for the COPD (n=20), other pulmonary diseases (n=56), and other causes groups (n=66), respectively. The BNP levels were significantly different according to the underlying etiology (p<0.001), and were significantly higher in the COPD patients with left heart failure than in those without (p=0.002). When the patients with no cardiovascular risk factor such as diabetes mellitus, hypertension, smoking or renal failure were analyzed, the BNP levels were also significantly higher in the patients with heart failure than in those without(p<0.001). When 133 pg/ml was designated as the BNP cut-off level the sensitivity for predicting heart failure was 73 percent and the specificity was 87 percent. Conclusion : BNP measurements are useful for determining the presence of heart failure in the patients presenting with acute dyspnea. The possibility of heart failure must be seriously considered in patients with high BNP levels even when they have a pre-existing pulmonary disease such as COPD or no risk factors for heart failure.

Effects of Adenophora triphylla Ethylacetate Extract on mRNA Levels of Antioxidant Enzymes in Human HepG2 Cells (인간 HepG2 Cell에서 항산화 효소의 mRNA 발현에 대한 잔대 에틸아세테이트 추출물 효과)

  • Choi, Hyun-Jin;Kim, Soo-Hyun;Oh, Hyun-Taek;Chung, Mi-Ja;Cui, Cheng-Bi;Ham, Seung-Shi
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.10
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    • pp.1238-1243
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    • 2008
  • The root of Adenophora triphylla is widely used as traditional herbal medicine in Korea. We studied its effects on sodium nitroprusside (SNP) cytotoxicity and antioxidant genes expression in HepG2 cells. To study whether Adenophora triphylla ethylacetate extract (ATea) inhibited NO-induced cell death, HepG2 cells were preincubated for 24 hr with 50 and 100 $\mu$g/mL ATea followed by 24-hr exposure to 0.5 mM SNP (exogenous NO donor). No-induced cytotoxicity was inhibited by pretreatment of ATea, as assessed by mitochondrial dehydrogenase activity (MTT assay). We further investigated the effects of ATea on mRNA levels of various enzymes of the antioxidant system such as Cu, Zn superoxide dismutase (SOD 1), Mn SOD (SOD 2), glutathione peroxidase (GPx), catalase and several enzymes of the glutathione metabolism [glutathione reductase (GR), $\gamma$-glutamyl-cystein synthetase (GCS), glutathione-S-transferase (GST), $\gamma$-glutamyltranspeptidase ($\gamma$-GT), glucose-6-phosphate dehydrogenase (G6PD)] by RT-PCR. CAT, GCS, GR and G6PD mRNA levels were increased after treatment with ATea. The SOD 1, SOD 2, GPx, GST and $\gamma$-GT mRNA levels were not affected in ATea-treated HepG2 cells. We concluded that ATea have an indirect antioxidant effects, perhaps via induction of CAT, GCS, GR and G6PD.

Neuronal Cell Protective Effect of Dendropanax morbifera Extract against High Glucose-Induced Oxidative Stress (High Glucose로 유도된 산화 스트레스에 대한 황칠나무 잎 추출물의 뇌신경세포 보호 효과)

  • Kim, Jong Min;Park, Seon Kyeong;Guo, Tian Jiao;Kang, Jin Yong;Ha, Jeong Su;Lee, Du Sang;Kwon, O-Jun;Lee, Uk;Heo, Ho Jin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.7
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    • pp.938-947
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    • 2016
  • Antioxidant activities and neuroprotective effects of ethyl acetate fraction from Dendropanax morbifera (EFDM) against high glucose-induced oxidative stress and neurotoxicity were investigated to confirm their physiological activities. An 80% ethanolic extract of D. morbifera showed the highest contents of total phenolic compounds as well as 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) and 1,1-diphenyl-2-picrylhydrazyl radical scavenging activities. The extract was fractionated using several solvents, and the ethyl acetate fraction showed the highest activities in ferric reducing/antioxidant power and malondialdehyde inhibitory assays. To evaluate the neuroprotective effect based on antioxidant activities, cell viability was assessed using PC12 and MC-IXC cells in $H_2O_2$- and high glucose-induced cytotoxic assays, respectively. EFDM evidently showed neuroprotective effects in all cells (neuron-like PC12 cells and human brain-originated neuroblastoma MC-IXC cells). Inhibitory effect of the extract on acetylcholinesterase (AChE) as an acetylcholine-hydrolyzing enzyme was performed to examine the effect on cognitive function. EFDM presented an AChE inhibitory effect. Finally, high-performance liquid chromatography analysis showed that the major phenolic compound of EFDM is probably a rutin.

C-FOS EXPRESS10N IN THE RAT TRIGEMINAL SENSORY NUCLEUS COMPLEX FOLLOWING TOOTH MOVEMENT (치아이동에 의한 백서 삼차신경감각핵군내 c-Fos의 발현)

  • Min, Kyung-Ho;Park, Hyo-Sang;Bae, Yong-Chul;Sung, Jae-Hyun
    • The korean journal of orthodontics
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    • v.28 no.3 s.68
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    • pp.441-452
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    • 1998
  • The c-fos is known as neuronal marker of second neurons which is activated by noxious peripheral stimulation. To investigate the changes of c-fos el(pression in the trigeminal nucleus complex during tooth movement, immunohistochemical study was performed. Experimental rats(9 weeks old, 210 gm 21 rats) were divided into seven groups(normal, 1 hour group, 3 hour group, 6 hour group, 12 hour group, 1 day group,3 day group). Rats in the normal group were anesthesized without orthodontic force. Rats in the experimental groups were applied orthodontic force (approximately 30 gm) to upper right maxillary molar. Frozen sections of brain stem were immunostained using rabbit antisera. The changes of c-fos expression were observed with respect to rostrocaudal distribution, laminar organization, md duration of orthodontic force application. The study results were as follows $\cdot$The c-fos nuclei in the dorsal part were observed from ipsilateral transition zone of subnucleus interpolaris and subnucleus caudalis to $C_1$ cervical dorsal horn rostrocaudally. The maximal peak point was the rostral part of subnucleus caudalis. The greatest proportion of c-fos cells were located within lamina I and II. $\cdot$The c-fos nuclei in the dorsal Part were observed from the most caudal part of subnucleus interpolaris to the middle part of the subnucleus caudalis. $\cdot$The number of c-fos immunoreactive dot increased at 1 hour group, reached its maximum at the 3 and 6 hour groups, and showed a decreasing trend after 12 hours. These results imply that nociceptive stimulation caused by continuous orthodontic force might be modulated by transition zone of subnucleus interpolaris and subnucleus caudalis, subnucleus caudalis, $C_1$ spinal dorsal hem.

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THE EFFECT OF REPEATED MATERNAL SEPARATION ON GLUCOCORTICOID RECEPTOR AND CYCLOOXYGENASE-2 IN PREWEANLING RAT BRAIN (반복 모성 분리가 이유 전기 백서 뇌의 Glucocorticoid Receptor와 Cyclooxygenase-2에 미치는 영향)

  • Yoon, Doh-Joon;Chang, Hwan-Il;Song, Ji-Young;Bahn, Geon-Ho;Chung, Joo-Ho;Kim, Jong-Woo;Yoo, Hee-Jeong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.1
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    • pp.91-100
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    • 2004
  • Objectives:The effects of repeated maternal separation on the expression of glucocorticoid receptor (GR) and cyclooxygenase-2(COX-2) in the hippocampus of rat pups at preweanling stage were evaluated. Methods:The experimental, Repeated Maternal Separation group(N=4) was separated from the mother for four hours a day over a period of ten days beginning with postnatal day 4. The Control group(N=4), on the other hand, did not separated from the mother at all. GR and COX-2 expression in the hippocampus was examined by immunohistochemistry on postnatal day 14. Results:It was determined that the number of GR-immunopositive cells in the dentate gyrus of the hippocampus was significantly increased in the Repeated Maternal Separation group. The numbers of COX-2-immunopositive cells in the CA1 and CA3 were also significantly higher in the Repeated Maternal Separation group. Conclusion:These results suggest that maternal separation may be a significant developmental stress that induces GR and COX-2 expression in the hippocampus of developing pups.

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