• Title/Summary/Keyword: Clinical Use

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Histological Analysis of Autologous Pericardial Tissue Used as a Small-Diameter Arterial Graft (소구경 동맥이식편으로 사용한 자가심란의 조직학적 분식)

  • Yang Ji-Hyuk;Sung Sang-Hyun;Kim Won-Gon
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.261-268
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    • 2006
  • Background: Current vascular prostheses are still inadequate for reconstruction of small-diameter vessels. Autologous pericardium can be a good alternative for this purpose as it already possesses good blood compatibility and shows a mechanical behavior similar to that of natural arteries. However, the clinical use of autologous pericardial tissue as a small-diameter vascular graft has limitations due to mixed outcomes from uncertain biological behavior and difficulty to gain reliable patency results in animal experiments. To study this issue, we implanted fresh and glutaraldehyde-treated autologous pericardium as small-diameter arterial grafts in dogs, and compared their time-related changes histologically. Material and Method: As a form of 5mm-diameter arterial graft, one pair of autologous pericardial tissue was used for comparison between the glutaraldehyde-treated and the glutaraldehyde-untreated grafts in the bilateral carotid arteries in the same dog. The patency of the grafts were evaluated at regular intervals with Doppler ultrasonography. After the predetermined periods of 3 days, 2 weeks, 1 month, 3 months and 6 months, the grafts in each animal were explanted. The retrieved grafts were processed for light and electron microscopic analyses following gross observation. Result: Of 7 animals, 2 were excluded from the study because one died postoperatively due to bleeding and the other was documented as one side of the grafts being obstructed. All 10 grafts in the remaining 5 dogs were patent. Grossly, a variable degree of thromboses were observed in the luminal surfaces of the grafts at 3 days and 2 weeks, despite good patency. Pseudointimal smooth blood-contacting surfaces were developed in the grafts at f month and later. By light microscopy, mesothelial cell layers of the pericardial tissue were absent in all explanted grafts. Newly formed endothelial cell layers on the blood-contacting surface were observed in both the glutaraldehyde-treated and fresh grafts at 3 months and later. The collagen fibers became degraded by fragmentation in the fresh graft at 1 month and In the glutaraldehyde-treated graft at 3 months. At 6 months, the collagen layers were no longer visible in either the glutaraldehyde-treated or fresh grafts. By electron microscopy, a greater amount of coarse fibrin fibers were observed in the fresh grafts than in the glutaraldehyde-treated grafts and, more compact and well-arrayed layers were observed in the glutaraldehyde-treated grafts than in the fresh grafts. Conclusion: The glutaraldehyde-treated small-diameter pericardial arterial grafts showed a better endothelialization of the blood-contacting surface and a slower fragmentation of the collagen layers than the fresh grafts, although it has yet to be proven whether these differences are so significant as to affect the patency results between the groups.

Post-operative Radiation Therapy for Esophageal Cancer; Analysis of Failure Pattern (식도암의 수술 후 방사선 치료: 실패 양상 분석)

  • Kim Mi Sook;Kim Jae Young;Yoo Seoung Yul;Zo Chul Goo;Yoo Hyung Jun;Zo Jae Ill;Baek Hee Jong;Park Jong Ho;Choi Soo Yong
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.447-454
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    • 1998
  • Purpose : This study evaluated the survival, local control, prognostic factor, and failure pattern of patients with esophageal cancer treated with operation and adjuvant radiation therapy to use as fundermental data of postoperative radiation therapy. Materials and Methods : A retrospective analysis was undertaken of 82 patients who had locally advanced esophageal cancer treated with operation and adjuvant radiation therapy from January 1988 to December 1995. According to AJCC staging, stage IIA were in 26 patients, stage IIB in 4 patients, and stage III in 52 patients. Squamous cell carcinoma were in 77 patients, adenosquamous carcinoma in 3 patients, and adenocarcinoma in 2 patients. The patients received radiation therapy ranging from 41.0 Gy to 64.8 Gy. Five patients received neoadjuvant chemotherapy. Results : Two-year survival and local control rates for all patients were 36.8$\%$ and 30.4$\%$ respectively. And they were 9.3$\%$ and 26.3$\%$ respectively at 5 years. According to stages, 2-year survival rates were 50.2$\%$ in IIA, 0$\%$ in IIB and 23.3$\%$ in III (p=0.004). Two-year local control rates were 49.2 $\%$ in IIA, 66.6$\%$ in IIB and 24.7$\%$ in III (p=0.01). Sixty patients developed recurrence, which were 3 tumor margin, 23 lymph node recurrence, 4 tumor margin and lymph node, 1 tumor margin and distant metastasis, 9 lymph node and distant metastasis, 17 distant metastasis and 3 unknown metastatic site. Prognostic factors affecting survival were smoking (p=0.02), T-staging (p=0.0092), N-staging (p=0.0045). Prognostic factors affecting local control were T-staging (p=0.019), N-staging (p=0.047). Conclusion : In spite of post-operative radiation therapy, predominant failure pattern was local failure. Especially regional lymph node failure was major cause of local failure. So strategy of aggresive adjuvant radiation therapy to regional lymph node area in post operative treatment should be proposed.

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A Study on Cold Damage(傷寒) in the Compendium of Prescription from the Countryside(鄕藥集成方) - Focusing on citation, medical theory, prescription, medicinal herbs - (조선 의서 『향약집성방』 중에 실린 상한(傷寒) 논의 연구 - 인용 문헌, 의론(醫論), 처방, 본초 등을 중심으로 -)

  • Oh, Chae-Kun
    • The Journal of Korean Medical History
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    • v.25 no.2
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    • pp.121-136
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    • 2012
  • The purpose of this paper is to derive the features of cold damage clinical medicine during the early days of the Chosun(朝鮮) period by analyzing discussions on cold damage published in the official medical book of the Chosun period, Compendium of Prescription from the Countryside(鄕藥集成方, CPC). Cold damage was one of the typical diseases in East Asia where there was constant seeking of the utilization of prescriptions, ways of preparations, and awareness regarding cold damage as shown in Zhang, Zhongjing(張仲景)'s Treatise on Cold Damage Disease(傷寒論, TCDD) below. Traditional Korean medicine which possessed the medical universality of East Asia also was no exception and through an analysis of the part on cold damage in CPC, it is expected that medical features of cold damage in Korea passed down from the Koryo(高麗) Dynasty to the early Chosun period will be revealed. For this, first there needs to be an organization of past discussions on cold damage surrounding the existence of infection and after checking the issues, exploring which of the writings related to TCDD and editions are being utilized through an analysis on citing literature of Cold Damage Disease Literature(傷寒門) and Heat Pathogen Disease Literature(熱病門) which have developed discussions on cold damage in CPC. In addition, by comparing Peaceful Holy Benevolent Prescription(太平聖惠方, PHBP) and Complete Record of Sacred Benevolence(聖濟總錄, CRSB), known to have greatly influenced CPC and Cold Damage Literature and Heat Pathogen Disease Literature, features of form and content used by CPC were analyzed. Features of form were examined through pattern of organization and number of citing literature were examined and for features of content, cold damage infection, classification, syndrome differentiation method, and utilization of materia medica among prescriptions were examined. Discussions on cold damage as being uninfectious as stated in Treatise on the Pathogenesis and Manifestations of All Diseases(諸病源候論) unlike pestilence, epidemic pathogen(時氣), warm pathogen disease(溫病), and heat pathogen disease were excluded in PHBP. PHBP opened the possibility of cold damage infection and later writings, CRSB and CPC also follow this. As a result of analyzing citing literature of the part on cold damage in CPC, it is uncertain which edition of TCDD is being utilized; however, the most distinctive feature was that Classified Emergency Materia Medica(證類本草) and not writings specializing in cold damage are in use. In general, although CPC in terms of form is similar to CRSB, content creation predominantly depended on PHBP. More specifically; first, in terms of the existence of cold damage infection, arguments of PHBP and CRSB are maintained. Second, in terms of cold damage classification, although CRSB is followed, heat pathogen disease is classified separately developing PHBP as is. Third, in terms of method, as Book of Keep Healthy(南陽活人書) and CRSB compiled in later times are cited, it is deemed that arguments were raised to a certain extent regarding six-meridian syndrome differentiation(六經辨證). Fourth, although the majority of utilized materia medica among cold damage prescriptions utilize Materia Medica from the Countryside(鄕藥本草) in CPC and materia medica from Korean Peninsula, this is due to the desire for the compilation performance of CPC to be propagated to ordinary citizens and not the ruling class. CPC as the official medical book compiled in the early days of the Chosun period was greatly influenced by the Song(宋) Dynasty's medical books, PHBP and CRSB shows that cold damage medicine in the early Chosun Period indeed possesses the medical universality of East Asia. Furthermore, the features of published medical theory and prescriptions reveal the existence of the cold damage medical tradition of the Chosun period serving as clues for cold damage research tradition among Korea's medical history.

The Evaluation of Domestic Immunoradiometric Assay Kit for Alpha-fetoprotein (Alpha-fetoprotein 측정용 국산 방사면역측정법 시약의 평가)

  • Won, Kyoung-Sook;Ryu, Jin-Sook;Moon, Dae-Hyuk;Lee, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.4
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    • pp.353-359
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    • 2000
  • Purpose: Although ${\alpha}$-fetoprotein is one of the most commonly used tumor markers in Korea, most of the radioimmunoassay kits for ${\alpha}$-fetoprotein have been imported from foreign countries. The purpose of this study was to evaluate the performance of a recently developed domestic immunoradiometric kit for ${\alpha}$-fetoprotein (Riakey AFP IRMA $CT^R$, Sin-Jin Medics, Seoul, Korea). Materials and Methods: We evaluated intra- and inter-assay precision, recovery rate, parallelism, and sensitivity of serum ${\alpha}$-fetoprotein measurement using Riakey AFP IRMA $CT^R$ kit. The values of ${\alpha}$-fetoprotein measured by Riakey AFP IRMA $CT^R$ kit were compared with those measured by two foreign commercial kits (${\alpha}$-fetoproteina of Radim and ${\alpha}$-feto.riabead of Abbott). Results: Intra-assay coefficients of variation on three different levels were 5.3% for 18.9 ng/ml, 3.4% for 133 ng/ml and 1.6% for 330 ng/ml. Inter-assay coefficients of variation were 9.7% for 20.9 ng/ml, 3.2% for 137 ng/ml and 4.1% for 330 ng/ml respectively. Recovery rate tests on all three different levels showed within $100{\pm}10%$. Parallelism was also good and the sensitivity was 0.63 ng/ml. There was strong correlation between the measurement of ${\alpha}$-fetoprotein by Riakey AFP IRMA $CT^R$ and that by two foreign commercial kits(r=0.98). Conclusion: The first Korean domestic immunoradiometric kit for ${\alpha}$-fetoprotein, Riakey AFP IRMA $CT^R$, performed well for clinical use.

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Quality Assessment and Comparison of Several Radioimmunoassay Kits and Chemiluminescence Immunoassay Methods for Evaluating Serum Estradiol (혈중 Estradiol 농도 측정을 위한 여러 방사면역측정 검사키트 및 화학면역발광 검사법의 성능평가 및 상호비교)

  • Choi, Sung Hee;Noh, Gyeong Woon;Kim, Jin Eui;Song, Yoo Sung;Paeng, Jin Chul;Kang, Keon Wook;Lee, Dong Soo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.1
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    • pp.72-80
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    • 2015
  • Purpose Serum estradiol ($E_2$) measurement is requested for diagnosing menstrual cycles, ovulation induction, infertility, and menopause. $E_2$ is measured using several methods and kits including radioimmunoassay (RIA) and chemiluminescece immunoassay (CLIA). The purpose of this study was to evaluate quality of these methods and to compare them with each other. Materials and Methods Seven radioimmunoassay kits and two CLIA methods were included in the analysis. Using standard samples and patient samples, intra-assay precision, inter-assay precision, correlation between other methods, sensitivity, and recovery rate were evaluated. Results For all tested kits and methods, coefficients of variance (CVs) of intra-assay precision test were 10.9~13.6% in low-level samples and less than 10% in medium and high-level samples. CVs of inter-assay precision test were 10.8~12.3% in low-level samples and less than 10% in medium and high-level samples with all tested kits and methods. Recovery rates were $92.7{\pm}12.4%$ for SIEMENS, $101.4{\pm}18.4%$ for DIAsource, $95.1{\pm}11.5%$ for AMP, $108.4{\pm}18.5%$ for BECKMAN COULTER, $104.2{\pm}13.5%$ for BECKMAN COULTER Ultra Sensitive, $101.3{\pm}11.6%$ for CIS Bio, and $93.1{\pm}13.2%$ for MP kits. Sensitivity was 7.5, 6.2, 5.7, 6.2, 5.3, 4.5, and 5.5 pg/mL for SIEMENS, DIAsource, AMP, BECKMAN COULTER, BECKMAN COULTER Ultra Sensitive, CIS Bio, and MP kits, respectively. The measurement by MP kit was slightly higher than those by other kits in low-level samples, and the measurement by E170 was slightly higher than those of other kits in medium and high-level samples. In the measurement of standard sample for external quality control, SIEMENS kit produced relatively lower values whereas E170, Architect, and MP kits produced relatively higher values compared with other kits. Conclusion All tested kits for $E_2$ measurement have satisfactory performance for clinical use. However, correlation between kits should be considered when test kits are to be changed, because some pairs of kits do not have correlations with each other.

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A Study on the Tendency of Dose value According to Dose calibrator Measurement Depth and Volume (Dose calibrator 측정 깊이와 용량의 변화에 따른 선량 값의 성향에 대한 고찰)

  • Kim, Jin Gu;Ham, Jun Cheol;Oh, Shin Hyun;Kang, Chun Koo;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.24 no.1
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    • pp.20-26
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    • 2020
  • Purpose It is intended to figure out the errors derived from changes in depth and volume when measuring the Standard source and 99mTc-pertechnetate by using a Dose calibrator. Then recommend appropriate measurement depth and volume. Materials and Methods As a Dose calibrator, CRC-15βeta and CRC-15R (Capintec, New Jersey, USA) was used, and the measurement sources were 57Co, 133Ba, 137Cs and 99mTc-pertechnetate was also adopted due to its high frequency of use. The Standard source was respectively measured the changes according to its depth without changing the volume, in a range of 0 cm to 15 cm from the bottom of the ion chamber. 99mTc-pertechnetate was measured at each depth by changing the volume with 0.1 mL, 0.3 mL, 0.5 mL, 0.7 mL and 0.9 mL Respectively. And the depth range was from 0 cm to 15 cm at the bottom of the ion chamber. Results In the case of Standard source 57Co, 133Ba, 137Cs and 99mTc-pertechnetate, there were significant differences according to the measurement depth(p<0.05). 99mTc-pertechnetate has a negative correlation coefficient according to the depth, and the error of the measured value was negligible at a depth from 0 cm to 7 cm at 0.3 mL and 0.5 mL, and the range of error increased as the volume increased. Conclusion In clinical practice, it is sometimes installed differently than the Standard depth recommended by the equipment company. If it's measured at the recommended depth and volume, it could be thought that unnecessary exposure of the operator and the patient will be reduced, and more accurate radiation exams will be possible in quantitative analysis.

A Study on the Sensitivity of Human Rights and the Advocacy Activities of Korean Occupational Therapists (국내 작업치료사의 인권감수성이 옹호활동에 미치는 영향)

  • Kim, Ji-Man;Hong, Ki-Hoon;Lee, Chun-Yeop;Kim, Hee-Jung
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.2
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    • pp.11-24
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    • 2020
  • Objective : The Human Rights constitute one of the basic pillars of every work where persons are involved, such is the case of the occupational therapy field. Methods : In this study we investigate the human rights sensitivity and the advocacy activities of occupational therapists. The differences according to their characteristics, the relationship and the impact of the human rights sensitivity are examined and presented. Making use of online surveys 116 subjects participated in the study. Results : The measured average of human right sensitivity is 69.00 ± 17.67 point, being them distributed according to the following subcategories: to the perception of the situation corresponds 23.25±5.62 points, to the perception of the consequences 22.75±6.54 points and for the perception of the responsibility 23±6.54 points. In all the cases have been taken in account the equal rights, the right to education in disables, the right to pursue the happiness of the elderly, the right of the disables to have personal freedom, the privacy rights and the privacy rights for mental illness people. According to the working area the Human Right sensitiveness is higher in Seoul than in the Gyeongsang province meanwhile the advocacy activities is higher in Seoul and in Gyeonggi province than in Gyeongsang province. Depending of the type of service, general hospitals and rehabilitation/nursing hospitals showed higher human rights sensitivity than other service organizations According to the working field, occupational therapy group focused in elderly showed higher Human Right sensitivity than other fields. Professionals belonging groups of clinical experience from 3 to 5 years and from 6 to 10 years showed higher advocacy activities than professionals with more than 11 years of experience. A positive correlation was showed between the human rights sensitivity and the advocacy activities. For this situation, the human rights sensitiveness was divided in sub-categories in perception of the situation, perception of the consequences and perception of the responsibility. As showed by the result of multiple regression analyses the advocacy activities of human would grow up in accordance with the increase of the human rights sensitiveness of responsibility perception. Conclusion : Due to the actual lack of information, the collection and study of basic data is fundamental for the development of practical human rights educational programs and to emphasize the role of the defense of the human rights.

Synthesis of Ultrasound Contrast Agent: Characteristics and Size Distribution Analysis (초음파 조영제의 합성 및 합성된 초음파 조영제의 특성 분석)

  • Lee, Hak Jong;Yoon, Tae Jong;Yoon, Young Il
    • Ultrasonography
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    • v.32 no.1
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    • pp.59-65
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    • 2013
  • Purpose: The purpose of this study is to establish the methodology regarding synthesis of ultrasound contrast agent imaging, and to evaluate the characteristics of the synthesized ultrasound contrast agents, including size or degradation interval and image quality. Materials and Methods: The ultrasound contrast agent, composed of liposome and SF6, was synthesized from the mixture solution of $21{\mu}mol$ DPPC (1, 2-Dihexadecanoyl-sn-glycero-3-phosphocholine, $C_{40}H_{80}NO_8P$), $9{\mu}mol$ cholesterol, $1.9{\mu}mol$ of DCP (Dihexadecylphosphate, $[CH_3(CH_2)_{15}O]_2P(O)OH$), and chloroform. After evaporation in a warm water bath and drying during a period of 12-24 hours, the contrast agent was synthesized by the sonication process by addition of buffer and SF6 gas. The size of the contrast agent was controlled by use of either extruder or sonication methods. After synthesis of contrast agents, analysis of the size distribution of the bubbles was performed using dynamic light scattering measurement methods. The degradation curve was also evaluated by changes in the number of contrast agents via light microscopy immediate, 12 hours, 24 hours, 36 hours, 48 hours, 60 hours, 72 hours, and 84 hours after synthesis. For evaluation of the role as an US contrast agent, the echogenicity of the synthesized microbubble was compared with commercially available microbubbles (SonoVue, Bracco, Milan, Italy) using a clinical ultrasound machine and phantom. Results: The contrast agents were synthesized successfully using an evaporation-drying-sonication method. The majority of bubbles showed a mean size of 154.2 nanometers, and they showed marked degradation 24 hours after synthesis. ANOVA test revealed a significant difference among SonoVue, synthesized contrast agent, and saline (p < 0.001). Although no significant difference was observed between SonoVue and the synthesized contrast agent, difference in echogenicity was observed between synthesized contrast agent and saline (p < 0.01). Conclusion: We could synthesize ultrasound contrast agents using an evaporation-drying-sonication method. On the basis of these results, many prospective types of research, such as anticancer drug delivery, gene delivery, including siRNA or microRNA, targeted molecular imaging, and targeted therapy can be performed.

Development and Evaluation of Silicon Passive Layer Dosimeter Based Lead-Monoxide for Measuring Skin Dose (피부선량 측정을 위한 Lead-Monoxide 기반의 Silicon Passive layer PbO 선량계 개발 및 평가)

  • Yang, Seung-Woo;Han, Moo-Jae;Jung, Jae-Hoon;Bae, Sang-Il;Moon, Young-Min;Park, Sung-Kwang;Kim, Jin-Young
    • Journal of the Korean Society of Radiology
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    • v.15 no.6
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    • pp.781-788
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    • 2021
  • Due to the high sensitivity to radiation, excessive exposure needs to be prevented by accurately measuring the dose irradiated to the skin during radiation therapy. Although clinical trials use dosimeters such as film, OSLD, TLD, glass dosimeter, etc. to measure skin dose, these dosimeters have difficulty in accurate dosimetry on skin curves. In this study, to solve these problems, we developed a skin dosimeter that can be attached according to human flexion and evaluated its response characteristics. For the manufacture of the dosimeter, lead oxide (PbO) with high atomic number (ZPb: 82, ZO: 8) and density (9.53 g/cm3) and silicon binders that can bend according to human flexion were used. In the case of a dosimeter made of PbO material, the performance degradation has been prevented by using parylene and others due to the presence of degradation due to oxidation, but the previously used parylene is affected by bending, so a new form of passive layer was produced and applied to the skin dosimeter. The characteristic evaluation of the skin dosimeter was evaluated by analyzing SEM, reproducibility, and linearity. Through SEM analysis, bending was evaluated, reproducibility and linearity at 6 MeV energy were evaluated, and applicability was assessed with a skin dosimeter. As a result of observing the dosimeter surface through SEM analysis, the parylene passive layer PbO dosimeter with the positive layer raised to the parylene produced cracks on the surface when bent. On the other hand, no crack was observed in the silicon passive layer PbO dosimeter, which was raised to silicon passive layer. In the reproducibility measurement results, the RSD of the silicon passive layer PbO dosimeter was 1.47% which satisfied the evaluation criteria RSD 1.5% and the linearity evaluation results showed the R2 value of 0.9990, which satisfied the evaluation criteria R2 9990. The silicon passive layer PbO dosimeter was evaluated to be applicable to skin dosimeters by demonstrating high signal stability, precision, and accuracy in reproducibility and linearity, without cracking due to bending.

Cementless Total Hip Arthroplasty Using Ceramic Femoral Head on Cross-Linked Ultra-High-Molecular Weight Polyethylene Liner in Patients Older than 65 Years: Minimum Five-Year Follow-Up Results (세라믹 대퇴 골두 및 교차결합 초고분자량 폴리에틸렌 라이너를 이용한 65세 이상 무시멘트형 인공 고관절 전치환술: 최소 5년 중기 추시 결과)

  • Yun, Ho Hyun;Cheong, Ji Young;Sim, Hyun Bo;Park, Jae Hong
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.490-497
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    • 2018
  • Purpose: To evaluate the utility of ceramic-on-polyethylene articular bearing surface when cementless total hip arthroplasty is performed in patients older than 65 years through an analysis of the minimum five-year follow-up results using the ceramic femoral head and cross-linked polyethylene liner. Materials and Methods: From March 2010 to September 2012, 51 patients (56 hips) who were older than 65 years were enrolled in this retrospective study. The mean age at surgery was $70.9{\pm}5.1years$ old. A clinical assessment was analyzed using the Harris hip score. For the radiographic assessment, the cup inclination and anteversion, stem alignment, and wear amount were measured. The postoperative complications were also determined. Results: The mean Harris hip score was improved from preoperative 48 points to postoperative 87 points (p<0.05). The mean cup inclination was $40.9^{\circ}{\pm}6.4^{\circ}$ and the mean cup anteversion was $20.3^{\circ}{\pm}8.1^{\circ}$. The mean cup anteversion of the elevated liner-used group (16 cases) was $14.3^{\circ}{\pm}7.9^{\circ}$ and the mean cup anteversion of the neutral liner used group (40 cases) was $22.4^{\circ}{\pm}9.1^{\circ}$ (p<0.05). The mean stem alignment angle was $0^{\circ}$ (range, varus $4^{\circ}$-valgus $4^{\circ}$). The mean linear wear amount was $0.458{\pm}0.041mm$ and the average annual linear wear rate was $0.079{\pm}0.032mm/yr$. Six cases (10.7%) of intraoperative periprosthetic femoral fractures were encountered. Conclusion: Based on these results, the use of a ceramic-on-polyethylene articular bearing surface in elderly patients with cementless total hip arthroplasty is beneficial. On the other hand, careful effort is needed to prevent intraoperative periprosthetic femoral fractures.