• Title/Summary/Keyword: External medicine

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Postoperative Radiation Therapy in the Management of Early Cervical Cancer (초기 자궁경부암의 수술 후 방사선치료의 효과)

  • Kim, Jae-Chul
    • Radiation Oncology Journal
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    • v.24 no.3
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    • pp.164-170
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    • 2006
  • [ $\underline{Purpose}$ ]: This study identified the result of postoperative radiation therapy and the prognostic factors to affect survival rates in cancer patients. $\underline{Materials\;and\;Methods}$: One hundred and thirty three patients with cervical cancer who were treated with postoperative radiation therapy following surgery at our institution between June 1985 and November 2002 were retrospectively analyzed. One hundred and thirteen patients had stage IB disease, and 20 patients had stage IIA disease. Histological examination revealed 118 squamous cell carcinoma patients and 15 adenocarcinoma patients. Sixty seven patients were noted to have stromal invasion greater than 10 mm, and 45 patients were noted to have stromal Invasion 10 mm or less. Positive lymphovascular invasion was found in 24 patients, and positive pelvic lymph nodes were noted in 39 patients. Positive vaginal resection margin was documented in 8 patients. All of the patients were treated with external beam radiation therapy to encompass whole pelvis and primary surgical tumor bed. Intracavitary radiation therapy was added to 19 patients who had positive or close surgical margins. $\underline{Results}$: Actuarial overall and disease-free survival rates for entire group of the patients were 88% and 84% at 5 years, respectively. Five-year disease-free survival rates for patients with stromal invasion greater than 10 mm and 10 mm or less were 76% and 97%, respectively (p<0.05). Also there was a significantly lower survival in patients with positive pelvic lymph nodes compared with patients with negative pelvic lymph nodes (p<0.05). However, lymphovascular invasion, positive vaginal resection margins were not statistically significant prognostic factors. Addition of neoadjuvant chemotherapy or type of surgery did not affect disease-free survival. $\underline{Conclusion}$: Postoperative radiation therapy appears to achieve satisfactory local control with limited morbidity in cervical cancer patients with high pathologic risk factors. Distant metastasis was a dominant failure pattern to affect survival in cervical cancer patients after radical surgery and radiation and more effective systemic treatment should be investigated in these high-risk patients.

The 3-Dimensional Analysis of the Efficacy of a Belly-Board Device for the Displacement of Small Bowel During Pelvic Irradiation (골반강 방사선치료 중 소장의 이동을 위한 벨리보드의 효과에 대한 3차원적 분석)

  • Lee, Kyung-Ja
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.271-279
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    • 2008
  • 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.

Anti-aging Effects of the Extracts from Leaf. Stem, Fruit and Seed of Yew (Taxus cuspidata Sieb) by Solvent Extraction Method (용매추출법에 의한 주목의 잎, 줄기, 과실 추출물의 항 노화 효과)

  • Kim, In-Young;Jung, Sung-Won;Ryoo, Hee-Chang;Zhoh, Choon-Koo
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.30 no.2
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    • pp.211-219
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    • 2004
  • Yew (Taxus cuspidata Sieb.) chose that grow as medicine, food, decorative plant in Korea's Kyong-Gi province surroundings. Extracts of yew extracted leaf of 250g and stems of 300g with 1,3-butylene glycol (l,3-BG), propylene glycol (PG) and water. As results, external appearance of leaf extract of yew was slightly brown clear extract. The pH was 5.3${\pm}$0.5, and specific gravity was 1.012${\pm}$0.05, and refractive index was l.375${\pm}$0.05. Also, appearance of stem's extract was slightly brown clear extract, and the pH was 5.4${\pm}$0.5, and specific gravity was 1.016${\pm}$0.05, and refractive index was 1.358${\pm}$0.05. Oil of yew separated from seeds, and extracted polysaccharide high purity from fruits. As a result, specific gravity of oil was 0.987, and obtained 40.0% of yield. Total polyphenols amount of yew extract is detected 0.563% in leaves, 0.325% in stems, whereas total tannins amount contained 0.054% and 0.037% each in leaves and stems. As effect in cosmetics, the anti-oxidative effect by DPPH method is 75.0% in leaves, and stems was 64.0%. Collagen synthesis rate was shown high activity by 54.16% in stem's extract, 33.18% in leaves' extract. Also, PPE-inhibitory activities were 13.7% and 23.5% each in leaves and stems. Anti-inflammatory effect of yew seed oil displayed superior effect of 41% than control. Polysaccharide's molecular weight that is gotten from fruits was 5${\times}$10$^4$-3${\times}$10$\^$5/ dalton, and got 20.0${\pm}$5% of yield.

The Role of Pelvic Irradiation after Hysterectomy in Early Stage Cervical Carcinoma with Pelvic Nodal Metastasis (림프절 전이를 동반한 초기 자궁경부암에서 수술 후 방사선치료의 역할)

  • Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.469-475
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    • 1998
  • Purpose : To determine the role of Pelvic irradiation in stage I or IIA cervical carcinoma with pelvic nodal metastasis after hysterectomy and bilateral pelvic lymphadenectomy. Materials and Methods : This is a retrospective study of 68 cervical carcinoma patients who were found to have pelvic nodal metastasis at hysterectomy and received pelvic irradiation from 1983 to 1996 at Inje University Seoul Paik Hospital. External beam radiation therapy to pelvis was delivered using 4 MeV Linac and intracavitary irradiation was given via vaginal ovoids or cylinders. Five-year survival and disease-free survival were estimated by Kaplan-Meier Method and prognostic factors related to survival were analysed by log-rank test and Cox proportional hazards regression model. Results : Median length of follow-up was 52months. Five-year overall survival and disease-free survival (DFS) were 81.8$\%$ and 81.7$\%$ respectively. Patients with endometrial invasion had a 57.1$\%$ 5-year DFS compared to 87.5$\%$ for those without endometrial invasion (p=0.0074). Multivariate analysis revealed endometrial invasion as an only statistically significant prognostic factor for 5-year DFS. Among total 15 (22$\%$) recurrences. pelvic recurrences occurred in 4 cases and distant metastases occurred in 13 cases. Conclusion : We have been able to confirm previous results demonstrating marked decrease in local recurrence after pelvic irradiation. In view of the high proportion of distant metastasis found in this study, a trial of aggressive adjuvant systemic therapy and irradiation in early stage cervical carcinoma patients with pelvic nodal metastasis, especially with endometrial invasion, appears to be warranted.

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Connection of Dongmu Lee Je-ma's Sa-Sang Theory & Ken Wilber's all-quadrant approach (동무 이제마의 사상설(四象說)과 캔 윌버의 사상한(四象限) 일고(一考))

  • Heo, Hoon
    • Journal of Korean Philosophical Society
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    • v.116
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    • pp.411-435
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    • 2010
  • Ken Wilber(1949~) tries to approach integration of philosophy, emphasising the advent of the perennial philosophy in the exchange of scholarships at the present day. He suggests All Quadrant(四象限) for the first step to reach his integrated approach. In addition, his approach concretizes for AQAL(All Quadrant, All Level). His AQAL approach which can be divide into inside/outside, singular/plural, or interobjectivity/intersubjectivity is applied to a lot of fileds such as ecology, management, criminology, medical treatment and its boundary is getting bigger. The merits of Quadrant is that it can solve the problem of the plain(平原), which resolves the strength of subjective interior(cultural contexts) into the external existence(social system). From view of Dongmu Lee Je-ma(1837~1900), a former philosopher, Sa-Sang theory['Affairs-Mind-body-Objects(事心身物)', 'Heaven-Human-nature-Order(天人性命)] is in accord with Wilber in content. In Dongmu's writing, Quadrant(Affairs-Mind-body-Objects') called Sa-Sang theory(四象學) or Sasang Constitional Medicine(四象醫學) is basic component in order to explain the structure of all nature. 'Heaven-Human-nature-Order'; That is, 'Affairs-Mind-body-Objects' results in 'Heaven-Human-nature-Order' focused on human being(human body) in the universe. In other words, Sa-Sang theory is the same as the Wilver's inclusive perspectives from the universe and human being. Dongmu's Sa-Sang theory is compared with C. G. Jung(1875~1961)'s psychology and it helps both fields confirm the foundation and extend the province of application. Comparision of Dongmu's Quadrant with Wilber's is not just analogical reasoning. In comparison, Dongmu's Sa-Sang theory is more delicated and crystallized than Wilber's in medical prospective. Dongmu regards Quadrant not as diseases, but as origin of Physiology and Pathology. And he explains all of their courses as Quadrant.

Characteristics and Significance of the Huirang Daesa Sculpture at Haeinsa Temple in Hapcheon (합천(陜川) 해인사(海印寺) 희랑대사상(希朗大師像)의 특징과 제작 의미)

  • Jeong, Eunwoo
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.98
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    • pp.54-77
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    • 2020
  • Produced during the Goryeo period (718-1392), the statue of the monk Huirang Daesa at Haeinsa Temple in Hapcheon is almost life-size, with a height of 82.4 cm, a width of 66.6 cm at the knees, and a maximum width of 44 cm at the torso (front and back). Notably, it is the only known example of an East Asian Buddhist sculpture made from wood and dry lacquer that was formed by joining the front and back halves. However, a similar technique was used on a dry lacquer statue of the Medicine Buddha at Cheongnyangsa Temple in Bonghwa, which is estimated to date from the late Goryeo or early Joseon period. As such, this technique is thought to represent this particular time period. In an eighteenth-century travelogue about a trip to Mt. Gayasan, the author describes a sculpture that is believed to be the statue of Huirang Daesa at Haeinsa Temple, based on various unique features that closely correspond to the sculpture's current appearance. For example, the sculpture is said to have a hole in the chest and rough, knobby tendons and bones, two features that can still be seen today. Another sculpture of a Buddhist monk who was active in the western regions during the third and fourth century also has a hole in the chest, which is said to be a symbol of spiritual strength. The travelogue also states that the statue was lacquered black at the time, which means that it must have been painted with its present colors some time in the nineteenth century. Over time, the sculpture has been enshrined in various halls of Haeinsa Temple, including Haehaengdang, Jinsangjeon, and later Josajeon (Hall of the Patriarchs), and Bojangjeon. Records show that images of Buddhist monks, or "seungsang," were produced in Korea as early as the Three Kingdoms period (18 BCE-660 CE), but few of these works have survived. At present, only four such sculptures are extant, including the images of Huirang Daesa from the Goryeo period, and those of Monk Naong and Uisang Daesa from the Joseon period. Of these, the sculpture of Huirang Daesa has special significance for its early production date (i.e., CE. tenth century), outstanding production techniques, and superb artistic quality, realistically capturing both the external appearance and internal character of the subject. The tradition of producing, sanctifying, and worshipping statues of monks was prevalent not only in Korea, but also in China and Japan. However, each country developed its own preferred materials and techniques for producing these unique images. For example, while China has a large number of mummified Buddhist images (yuksinbul), Japan produced diverse images with various materials (e.g., dry lacquer, wood, clay) according to period. But despite the differences in materials and techniques, the three nations shared the same fundamental purpose of expressing and honoring the inherent spirituality of the monks.

A Study on the Development Direction of Medical Image Information System Using Big Data and AI (빅데이터와 AI를 활용한 의료영상 정보 시스템 발전 방향에 대한 연구)

  • Yoo, Se Jong;Han, Seong Soo;Jeon, Mi-Hyang;Han, Man Seok
    • KIPS Transactions on Computer and Communication Systems
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    • v.11 no.9
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    • pp.317-322
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    • 2022
  • The rapid development of information technology is also bringing about many changes in the medical environment. In particular, it is leading the rapid change of medical image information systems using big data and artificial intelligence (AI). The prescription delivery system (OCS), which consists of an electronic medical record (EMR) and a medical image storage and transmission system (PACS), has rapidly changed the medical environment from analog to digital. When combined with multiple solutions, PACS represents a new direction for advancement in security, interoperability, efficiency and automation. Among them, the combination with artificial intelligence (AI) using big data that can improve the quality of images is actively progressing. In particular, AI PACS, a system that can assist in reading medical images using deep learning technology, was developed in cooperation with universities and industries and is being used in hospitals. As such, in line with the rapid changes in the medical image information system in the medical environment, structural changes in the medical market and changes in medical policies to cope with them are also necessary. On the other hand, medical image information is based on a digital medical image transmission device (DICOM) format method, and is divided into a tomographic volume image, a volume image, and a cross-sectional image, a two-dimensional image, according to a generation method. In addition, recently, many medical institutions are rushing to introduce the next-generation integrated medical information system by promoting smart hospital services. The next-generation integrated medical information system is built as a solution that integrates EMR, electronic consent, big data, AI, precision medicine, and interworking with external institutions. It aims to realize research. Korea's medical image information system is at a world-class level thanks to advanced IT technology and government policies. In particular, the PACS solution is the only field exporting medical information technology to the world. In this study, along with the analysis of the medical image information system using big data, the current trend was grasped based on the historical background of the introduction of the medical image information system in Korea, and the future development direction was predicted. In the future, based on DICOM big data accumulated over 20 years, we plan to conduct research that can increase the image read rate by using AI and deep learning algorithms.