• Title/Summary/Keyword: Exposure therapy

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Preliminary Application of Synthetic Computed Tomography Image Generation from Magnetic Resonance Image Using Deep-Learning in Breast Cancer Patients

  • Jeon, Wan;An, Hyun Joon;Kim, Jung-in;Park, Jong Min;Kim, Hyoungnyoun;Shin, Kyung Hwan;Chie, Eui Kyu
    • Journal of Radiation Protection and Research
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    • v.44 no.4
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    • pp.149-155
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    • 2019
  • Background: Magnetic resonance (MR) image guided radiation therapy system, enables real time MR guided radiotherapy (RT) without additional radiation exposure to patients during treatment. However, MR image lacks electron density information required for dose calculation. Image fusion algorithm with deformable registration between MR and computed tomography (CT) was developed to solve this issue. However, delivered dose may be different due to volumetric changes during image registration process. In this respect, synthetic CT generated from the MR image would provide more accurate information required for the real time RT. Materials and Methods: We analyzed 1,209 MR images from 16 patients who underwent MR guided RT. Structures were divided into five tissue types, air, lung, fat, soft tissue and bone, according to the Hounsfield unit of deformed CT. Using the deep learning model (U-NET model), synthetic CT images were generated from the MR images acquired during RT. This synthetic CT images were compared to deformed CT generated using the deformable registration. Pixel-to-pixel match was conducted to compare the synthetic and deformed CT images. Results and Discussion: In two test image sets, average pixel match rate per section was more than 70% (67.9 to 80.3% and 60.1 to 79%; synthetic CT pixel/deformed planning CT pixel) and the average pixel match rate in the entire patient image set was 69.8%. Conclusion: The synthetic CT generated from the MR images were comparable to deformed CT, suggesting possible use for real time RT. Deep learning model may further improve match rate of synthetic CT with larger MR imaging data.

Mechanisms Underlying Enterococcus faecalis-Induced Tumor Necrosis Factor-$\alpha$ Production in Macrophages

  • Choi, Eun-Kyoung;Kim, Dae-Eob;Oh, Won-Mann;Paek, Yun-Woong;Kang, In-Chol
    • International Journal of Oral Biology
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    • v.35 no.2
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    • pp.43-49
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    • 2010
  • Enterococcus faecalis, a gram-positive bacterium, has been implicated in endodontic infections, particularly in chronic apical periodontitis. Proinflammatory cytokines, including tumor necrosis factor-$\alpha$ (TNF-$\alpha$), are involved in the pathogenesis of these apical lesions. E. faecalis has been reported to stimulate macrophages to produce TNF-$\alpha$. The present study investigated the mechanisms involved in TNF-$\alpha$ production by a murine macrophage cell line, RAW 264.7 in response to exposure to E. faecalis. Both live and heat-killed E. faecalis induced high levels of gene expression and protein release of TNF-$\alpha$. Treatment of RAW 264.7 cells with cytochalasin D, an inhibitor of endocytosis, prevented the mRNA up-regulation of TNF-$\alpha$ by E. faecalis. In addition, antioxidant treatment reduced TNF-$\alpha$ production to baseline levels. Inhibition of extracellular signal-regulated kinase (ERK) and p38 mitogen-activated protein (MAP) kinase also significantly attenuated E. faecalis-induced TNF-$\alpha$ expression by RAW 264.7 cells. Furthermore, activation of NF-${\kappa}B$ and AP-1 in RAW 264.7 cells was also stimulated by E. faecalis. These results suggest that the phagocytic uptake of bacteria is necessary for the induction of TNF-$\alpha$ in E. faecalis-stimulated macrophages, and that the underlying intracellular signaling pathways involve reactive oxygen species, ERK, p38 MAP kinase, NF-${\kappa}B$, and AP-1.

Leukocyte- and platelet-rich fibrin as an adjuvant to the surgical approach for osteoradionecrosis: a case report

  • Maluf, Gustavo;Caldas, Rogerio Jardim;Fregnani, Eduardo Rodrigues;da Silva Santos, Paulo Sergio
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.2
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    • pp.150-154
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    • 2020
  • We present a case of osteoradionecrosis treated with leukocyte- and platelet-rich fibrin (LPRF) and surgery and followed up with clinical and tomographic investigations. A 65-year-old woman presented with pain in the posterior region of the right palate. Her medical history included cardiovascular disease and squamous cell carcinoma in the anterior region of the floor of the mouth that had been treated with intensity-modulated radiation therapy. Measurements of isodose curves showed a full dosage of 6,462.6 cGy in the anterior mandibular region, whereas that in the posterior region on the right side of the maxilla reached 5,708.1 cGy. Osteotomy was performed using rotary instruments, and debridement and placement of two LPRF membranes were also carried out. New gum tissue with no bone exposure was noted 14 days postoperatively. Tissue repair was complete, and the patient had no further complaints. During a 39-month follow-up period, the oral mucosa remained intact, and the patient was rehabilitated with a new upper denture. Since there is no consensus regarding the best protocol to treat osteoradionecrosis, LPRF might be an interesting adjuvant to a surgical approach. The use of LPRF is simple and reduces operational costs, time of handling, probability of technical failure, and associated morbidities for patients with osteoradionecrosis.

Biological effects of a root conditioning agent for dentin surface modification in vitro

  • Lee, Jue-Yeon;Seol, Yang-Jo;Park, Jang-Ryul;Park, Yoon-Jeong;Chung, Chong-Pyoung
    • Journal of Periodontal and Implant Science
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    • v.40 no.6
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    • pp.257-264
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    • 2010
  • Purpose: Connective tissue reattachment to periodontally damaged root surfaces is one of the most important goals of periodontal therapy. The aim of this study was to develop a root conditioning agent that can demineralize and detoxify the infected root surface. Methods: Dentin slices obtained from human teeth were treated with a novel root planing agent for 2 minutes and then washed with phosphate-buffered saline. Smear layer removal and type I collagen exposure were observed by scanning electron microscopy (SEM) and type I collagen immunostaining, respectively. Cell attachment and lipopolysaccharides (LPS) removal demonstrated the efficiency of the root conditioning agent. Results: SEM revealed that the smear layer was entirely removed and the dentinal tubules were opened by the experimental gel. Type I collagen was exposed on the surfaces of the dentin slices treated by the experimental gel, which were compared with dentin treated with other root planing agents. Dentin slices treated with the experimental gel showed the highest number of attached fibroblasts and flattened cell morphology. The agar diffusion assay demonstrated that the experimental gel also has effective antimicrobial activity. Escherichia coli LPS were effectively removed from well plates by the experimental gel. Conclusions: These results demonstrated that this experimental gel is a useful tool for root conditioning of infected root surfaces and can also be applied for detoxification of ailing implant surface threads.

Research Trends in Complementary Medical Therapy for the Common Cold (감기에 대한 보완 의학적 연구 동향 - Pubmed를 중심으로 -)

  • Lim, Do-Hee;Hwang, Ji-Ho;Yang, Soo-Young;Shim, Jae-Chul;Chae, Eun-Young;Park, Yang-Chun
    • The Journal of Korean Medicine
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    • v.27 no.3 s.67
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    • pp.151-168
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    • 2006
  • Objectives: To help the Oriental medicine clinical studies for the common cold treatment, this study analyzed the tendency of research into complementary medicine on the common cold recently published in PubMed. Methods: This study analyzed 26 research papers on complementary medicine on the common cold published in PubMed Over the past 10 years. It measured annually and for each country the number of papers published, the number of subjects, the period of research, the area of trial, the method of study, the objective of study, and intervention, respectively and intervention, the objective of study, and the result of trials overall. Results: There were research papers concerning treatment, prevention, safety of herbal medicine, inducement, and improvement of symptoms of the common cold in the study objective the most among them concerned treatment of the common cold. There were more positive results compared to negative results for treatment and prevention. The results for safety and symptom improvement were positive, while the results for the inducement were indeterminate. There were research papers about using food and medicine, acupuncture, hydrotherapy, and cold exposure in intervention the most among them were about using food and medicine. The food and medicine interventions were Echinacea preparations, vitamins, zinc preparations, Baptisia, Thuja, the root of North American ginseng, probiotic bacteria, troxerutin, garlic, Andrographis paniculata, and caffeine. The use of Echinacea preparations was the most frequent among them. Conclusions: Recent research results of complementary medicine on the common cold were more positive than negative.

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The Camellia sinensis Inhalation Effects of Pulmonary Structure Protection and Anti-oxidants Enzyme from Cigarette Smoking

  • Kim Sang-Gi;Jung Hyuk;Kim Bo-Ae;Choi Yoong-Suk;Kim Sang-Kook;Choi Gui-Hyang;Park Jong-Seok;Suh Tae-Soo;Kim You-Young
    • Biomedical Science Letters
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    • v.12 no.3
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    • pp.281-287
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    • 2006
  • Cigarette smoke causes atypical structure of pulmonary and oxidative damage. Therefore, we carried out to determine if exposure to cigarette smoke alters pulmonary structure and anti-oxidant related enzyme in a animal model, when natural product extracts using by Nebulizer. The rat were divided into four groups: $H_2O-treated$ (Control), natural product (Camellia sinensis) extracts-treated (CS), natural product extracts-treated with cigarette smoke-exposed (CS+SM) and cigarette smoke-expose (SM). All groups are similar to Control group in weight, but SM group is lower than the other groups. Microscopic image of the pulmonary structure in SM group showed deleterious alterations in the morphology, but the other groups are maintained in normal structure. In anti-oxidant related enzymes, SOD (superoxide dismutase) and catalase, SM group represents the lowest enzyme activity among all groups. But G6PD (glucose-6-phosphate dehydrogenase) and LPO (lipid peroxidation) is SM group represents the highest enzyme activity among all groups. These result indicate that the natural product extracts is an efficient tissue protective substance against smoke-induced lung injury.

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GTP Induces S-phase Cell-cycle Arrest and Inhibits DNA Synthesis in K562 Cells But Not in Normal Human Peripheral Lymphocytes

  • Moosavi, Mohammad Amin;Yazdanparast, Razieh;Lotfi, Abbas
    • BMB Reports
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    • v.39 no.5
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    • pp.492-501
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    • 2006
  • Since differentiation therapy is one of the promising strategies for treatment of leukemia, universal efforts have been focused on finding new differentiating agents. In that respect, we used guanosine 5'-triphosphate (GTP) to study its effects on K562 cell line. GTP, at concentrations between 25-200 ${\mu}M$, inhibited proliferation (3-90%) and induced 5-78% increase in benzidine-positive cells after 6-days of treatments of K562 cells. Flow cytometric analyses of glycophorine A (GPA) showed that GTP can induce expression of this marker in more mature erythroid cells in a time- and dose-dependent manner. These effects of GTP were also accompanied with inhibition of DNA synthesis (measured by [$^3H$]-thymidine incorporation) and early S-phase cell cycle arrest by 96 h of exposure. In contrast, no detectable effects were observed when GTP administered to unstimulated human peripheral blood lymphocytes (PBL). However, GTP induced an increase in proliferation, DNA synthesis and viability of mitogen-stimulated PBL cells. In addition, growth inhibition and differentiating effects of GTP were also induced by its corresponding nucleotides GDP, GMP and guanosine (Guo). In heat-inactivated medium, where rapid degradation of GTP via extracellular nucleotidases is slow, the anti-proliferative and differentiating effects of all type of guanine nucleotides (except Guo) were significantly decreased. Moreover, adenosine, as an inhibitor of Guo transporter system, markedly reduced the GTP effects in K562 cells, suggesting that the extracellulr degradation of GTP or its final conversion to Guo may account for the mechanism of GTP effects. This view is further supported by the fact that GTP and Guo are both capable of impeding the effects of mycophenolic acid. In conclusion, our data will hopefully have important impact on pharmaceutical evaluation of guanine nucleotides for leukemia treatments.

Verification of Periodical Calibration for Iso-center Positions using Quality Assurance System for Irradiation Equipment Position Established at PMRC

  • Yasuoka, Kiyoshi;Ishikawa, Satoko
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.192-194
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    • 2002
  • We present the results on the calibration of iso-center positions using the quality assurance system established at PMRC for determination of center position in X-ray and proton irradiation fields. Details on the system are presented in another presentation in this session. The equipment in the system is mounted on a patient treatment bed in each proton exposure room, G1 or G2. A center of a stainless ball on the equipment is set at a cross of laser markers located around the iso-center and fixed on the room and on the snout in the gantry. A proton beam or an X-ray beam is exposed onto the ball through a brass collimator of 100 mm ${\times}$ 100 mm and projected onto the imaging plate set at I cm behind the ball. On the axis perpendicular to the thrust axis of the gantry on the imaging plate, a distance between a center of the collimator image and a center of the ball image varies as a cosine function of gantry angles unless the ball is set on the iso-center. An amplitude of the cosine curve shows the distance between the ball and the iso-center, an offset the offset of the collimator, and a phase shift at a zero crossing point the ball direction viewed from the iso-center. We present the relation among the iso-center position, the laser maker position, and the center of proton and X-ray irradiation fields. Its stability and its reproducibility are discussed.

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Diagnosis and Management of Acute Renal Failure in Surgical Patient (외과환자에 발생한 급성신부전의 진단과 치료)

  • Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.1 no.1
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    • pp.13-23
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    • 1984
  • Acute renal failure refers to a rapid reduction in renal function that usually occurs in an individual with no known previous renal disease. Development of a complication of acue renal failure in critically ill surgical patients is not unusual, and it causes high morbidity and mortality. Acute renal failure can be divided as Pre-renal (functional), Renal (organic), and Post-renal (obstructive) azotemia according to their etiologies. Early recognition and proper correction of pre-renal conditions are utter most important to prevent an organic damage of kidney. These measures include correction of dehydration, treatment of sepsis, and institution of shock therapy. Prolonged exposure to ischemia or nephrotoxin may lead a kidney to permanent parenchymal damage. A differential diagnosis between functional and organic acute renal failure may not be simple in many clinical settings. Renal functional parameters, such as $FENa^+$ or renal failure index, are may be of help in these situations for the differential diagnosis. Provocative test utilyzing mannitol, loop diuretics and renovascular dilators after restoration of renal circulation will give further benefits for diagnosis or for prevention of functional failure from leading to organic renal failure. Converting enzyme blocker, dopamine, calcium channel blocker, and propranolol are also reported to have some degree of renal protection from bioenergetic renal insults. Once diagnosis of acute tubular necrosis has been made, all measures should be utilized to maintain the patient until renal tubular regeneration occurs. Careful regulation of fluid, electrolyte, and acid-base balance is primary goal. Hyperkalemia over 6.5 mEq/l is a medical emergency and it should be corrected immediately. Various dosing schedules for medicines excreting through kidney have been suggested but none was proved safe and accurate. Therefore blood level of specific medicines better be checked before each dose, especially digoxin and Aminoglycosides. Indication for application of ultrafiltration hemofilter or dialysis may be made by individual base.

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Expression of Ion Channels in Perivascular Stem Cells derived from Human Umbilical Cords

  • Kim, Eunbi;Park, Won Sun;Hong, Seok-Ho
    • Development and Reproduction
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    • v.21 no.1
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    • pp.11-18
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    • 2017
  • Potassium channels, the largest group of pore proteins, selectively regulate the flow of potassium ($K^+$) ions across cell membranes. The activity and expression of $K^+$ channels are critical for the maintenance of normal functions in vessels and neurons, and for the regulation of cell differentiation and maturation. However, their role and expression in stem cells have been poorly understood. In this study, we isolated perivascular stem cells (PVCs) from human umbilical cords and investigated the expression patterns of big-conductance $Ca^{2+}$-activated $K^+$ ($BK_{Ca}$) and voltage-dependent $K^+$ ($K_v$) channels using the reverse transcription polymerase chain reaction. We also examined the effect of high glucose (HG, 25 mM) on expression levels of $BK_{Ca}$ and $K_v$ channels in PVCs. $K_{Ca}1.1$, $K_{Ca}{\beta}_3$, $K_v1.3$, $K_v3.2$, and $K_v6.1$ were detected in undifferentiated PVCs. In addition, HG treatment increased the amounts of $BK_{Ca}{\beta}_{3a}$, $BK_{Ca}{\beta}_4$, $K_v1.3$, $K_v1.6$, and $K_v6.1$ transcripts. These results suggested that ion channels may have important functions in the growth and differentiation of PVCs, which could be influenced by HG exposure.