• Title/Summary/Keyword: Hospital Phase

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The role of surgical clips in the evaluation of interfractional uncertainty for treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy

  • Bae, Jin Suk;Kim, Dong Hyun;Kim, Won Taek;Kim, Yong Ho;Park, Dahl;Ki, Yong Kan
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.65-70
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    • 2017
  • Purpose: To evaluate the utility of implanted surgical clips for detecting interfractional errors in the treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy (PORT). Methods and Materials: Twenty patients had been treated with PORT for locally advanced hepatobiliary or pancreatic cancer, from November 2014 to April 2016. Patients underwent computed tomography simulation and were treated in expiratory breathing phase. During treatment, orthogonal kilovoltage (kV) imaging was taken twice a week, and isocenter shifts were made to match bony anatomy. The difference in position of clips between kV images and digitally reconstructed radiographs was determined. Clips were consist of 3 proximal clips (clip_p, ${\leq}2cm$) and 3 distal clips (clip_d, >2 cm), which were classified according to distance from treatment center. The interfractional displacements of clips were measured in the superior-inferior (SI), anterior-posterior (AP), and right-left (RL) directions. Results: The translocation of clip was well correlated with diaphragm movement in 90.4% (190/210) of all images. The clip position errors greater than 5 mm were observed in 26.0% in SI, 1.8% in AP, and 5.4% in RL directions, respectively. Moreover, the clip position errors greater than 10 mm were observed in 1.9% in SI, 0.2% in AP, and 0.2% in RL directions, despite respiratory control. Conclusion: Quantitative analysis of surgical clip displacement reflect respiratory motion, setup errors and postoperative change of intraabdominal organ position. Furthermore, position of clips is distinguished easily in verification images. The identification of the surgical clip position may lead to a significant improvement in the accuracy of upper abdominal radiation therapy.

Analgesic Effects of Intrathecal Curcumin in the Rat Formalin Test

  • Han, Yong-Ku;Lee, Seong-Heon;Jeong, Hye-Jin;Kim, Min-Sun;Yoon, Myung-Ha;Kim, Woong-Mo
    • The Korean Journal of Pain
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    • v.25 no.1
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    • pp.1-6
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    • 2012
  • Background: Curcumin has been reported to have anti-inflammatory, antioxidant, antiviral, antifungal, antitumor, and antinociceptive activity when administered systemically. We investigated the analgesic efficacy of intrathecal curcumin in a rat model of inflammatory pain. Methods: Male Sprague Dawley rats were prepared for intrathecal catheterization. Pain was evoked by injection of formalin solution (5%, $50{\mu}l$) into the hind paw. Curcumin doses of 62.5, 125, 250, and $500{\mu}g$were delivered through an intrathecal catheter to examine the flinching responses. The $ED_{50}$ values (half-maximal effective dose) with 95% confidence intervals of curcumin for both phases of the formalin test were calculated from the dose-response lines fitted by least-squares linear regression on a log scale. Results: In rats with intrathecal administration of curcumin, the flinching responses were significantly decreased in both phases. The slope of the regression line was significantly different from zero only in phase 2, and the $ED_{50}$ value (95% confidence interval) of curcumin was $511.4{\mu}g$ (23.5-1126.5). There was no apparent abnormal behavior following the administration of curcumin. Conclusions: Intrathecal administration of curcumin decreased inflammatory pain in rats, and further investigation to elucidate the precise mechanism of spinal action of curcumin is warranted.

Initial experience with intra-articular 188Re-tin colloid as a "radiation synovectomy" agent in various joints

  • Shinto, Ajit S;Indira, VU;Kamaleshwaran, KK;Banka, Vinay Kumar;Aswathy, KK;Thirumalaisamy, SG;Rajamani, V;Mallia, Madhav;Banerjee, Sharmila
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.1 no.2
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    • pp.109-117
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    • 2015
  • Radiation synovectomy has been proposed as a promising palliative therapy for recurrent joint effusions for the last two or three decades. Ionizing radiations emitted by intrarticularly administered radiolabelled colloids. The aim of this study was to assess the effectiveness of radiation synovectomy (RSV) using $^{188}Re$-tin colloid in the treatment of recurrent joint effusions and chronic synovitis of knee joints. Three phase bone scan was acquired for the concerned joint prior to radiosynovectomy. $^{188}Re$-tin colloid was prepared as per the reported protocol. 9 patients, diagnosed with rheumatoid arthritis and suffering from chronic resistant synovitis of the knee, ankle or elbow joints were administered the radiopharmaceuticals, checked for radiochemical purity >95% by intraarticular route. A whole body scan was acquired 2 h post-radiosynovectomy. In all the 9 treatments, no leakage to non-target organs was visible in the whole body scan. Static scans of the joint revealed complete retention of $^{188}Re$-tin colloid in the joints post administration of the agent. Clinically all patients exhibited a complete or partial response. RSV with $^{188}Re$-tin colloid was safe and effective in patients with chronic synovitis of rheumatoid origin.

Risk factors for the occurrence and persistence of coronary aneurysms in Kawasaki disease

  • Jeon, Soo-Kyeong;Kim, Geena;Ko, Hoon;Byun, Joung-Hee;Lee, Hyoung Doo
    • Clinical and Experimental Pediatrics
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    • v.62 no.4
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    • pp.138-143
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    • 2019
  • Purpose: Prognostic factors of coronary aneurysms in Kawasaki disease have been investigated in many studies. The aim of this study was to identify risk factors associated with early and late coronary artery outcomes in treated patients with Kawasaki disease. Methods: A total of 392 patients diagnosed with Kawasaki disease from January 2012 to December 2015 in Pusan National University Children's Hospital were retrospectively selected as subjects of the present study to determine risk factors for coronary aneurysms and persistence of coronary aneurysms after a 1-year follow-up. Results: Coronary aneurysms were detected in 30 of 392 patients within 1 month after the occurrence of Kawasaki disease. Coronary aneurysms persisted in 5 of 30 patients after a 1-year follow-up. A long duration of fever (adjusted odds ratio [OR], 1.47; 95% confidence interval [CI], 1.06-2.02; P=0.018) and high platelet count (adjusted OR, 1.00; 95% CI, 1.00-1.01; P=0.009) were found to be independent factors to predict the development of coronary aneurysms in the early phase. Initial coronary severity (adjusted OR, 46.0; 95% CI, 2.01-1047.80; P=0.016) and a high white blood cell count (adjusted OR, 1.17; 95% CI, 1.01-1.36; P=0.028) were found to be significant factors for the persistence of late coronary aneurysms in univariate analysis. However, no significant factors were found in multivariate analysis. Conclusion: These data are from early and late follow-up of coronary aneurysms in our unit. Further studies are needed to determine the mechanisms involved in the disappearance of coronary aneurysms and related factors.

Hepatic Pseudolymphoma Mimicking a Hypervascular Tumor: A Case Report (과혈관성 종양으로 오인된 간의 가성림프종: 증례보고)

  • Im, Bora;Jang, Suk Ki;Yeon, Jae Woo;Paik, So Ya;Park, Sang Jong;Kim, Hyuk Jung
    • Journal of the Korean Society of Radiology
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    • v.79 no.6
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    • pp.348-353
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    • 2018
  • Hepatic pseudolymphoma is a rare benign liver mass that is characterized by proliferation of non-neoplastic lymphocytes extranodally. To the best of our knowledge, only 46 cases have been reported in the English literature. We described the case of a 75-year-old woman with hepatic pseudolymphoma mimicking a hypervascular tumor. After the histological confirmation of the rectal neuroendocrine tumor, CT scan revealed a 1.0 cm-sized, poorly-defined and low-density nodule in the liver. On MRI, the hepatic nodule showed an arterial enhancement and a low-signal intensity on the hepatobiliary phase. On diffusion-weighted imaging, the hepatic nodule showed a high signal intensity on a high b-value. On fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT, it revealed a high standardized uptake value nodule. The US showed the hypoechoic nodule and the US-guided biopsy confirmed the hepatic pseudolymphoma.

Sepsis induces variation of intestinal barrier function in different phase through nuclear factor kappa B signaling

  • Cao, Ying-Ya;Wang, Zhong-Han;Xu, Qian-Cheng;Chen, Qun;Wang, Zhen;Lu, Wei-Hua
    • The Korean Journal of Physiology and Pharmacology
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    • v.25 no.4
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    • pp.375-383
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    • 2021
  • The intestinal barrier function disrupted in sepsis, while little is known about the variation in different phases of sepsis. In this study, mouse models of sepsis were established by caecal ligation and puncture (CLP). The H&E staining of sections and serum diamine oxidase concentration were evaluated at different timepoint after CLP. TUNEL assay and EdU staining were performed to evaluate the apoptosis and proliferation of intestinal epithelium. Relative protein expression was assessed by Western blotting and serum concentrations of pro-inflammatory cytokines was measured by ELISA. The disruption of intestinal barrier worsened in the first 24 h after the onset of sepsis and gradually recovered over the next 24 h. The percentage of apoptotic cell increased in the first 24 h and dropped at 48 h, accompanied with the proliferative rate of intestinal epithelium inhibited in the first 6 h and regained in the later period. Furthermore, the activity of nuclear factor kappa B (NF-κB) presented similar trend with the intestinal barrier function, shared positive correction with apoptosis of intestinal epithelium. These findings reveal the conversion process of intestinal barrier function in sepsis and this process is closely correlated with the activity of NF-κB signaling.

Profiling of endogenous metabolites and changes in intestinal microbiota distribution after GEN-001 (Lactococcus lactis) administration

  • Min-Gul Kim;Suin Kim;Ji-Young Jeon;Seol Ju Moon;Yong-Geun Kwak;Joo Young Na;SeungHwan Lee;Kyung-Mi Park;Hyo-Jin Kim;Sang-Min Lee;Seo-Yeon Choi;Kwang-Hee Shin
    • The Korean Journal of Physiology and Pharmacology
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    • v.28 no.2
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    • pp.153-164
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    • 2024
  • This study aimed to identify metabolic biomarkers and investigate changes in intestinal microbiota in the feces of healthy participants following administration of Lactococcus lactis GEN-001. GEN-001 is a single-strain L. lactis strain isolated from the gut of a healthy human volunteer. The study was conducted as a parallel, randomized, phase 1, open design trial. Twenty healthy Korean males were divided into five groups according to the GEN-001 dosage and dietary control. Groups A, B, C, and D1 received 1, 3, 6, and 9 GEN-001 capsules (1 × 1011 colony forming units), respectively, without dietary adjustment, whereas group D2 received 9 GEN-001 capsules with dietary adjustment. All groups received a single dose. Fecal samples were collected 2 days before GEN-001 administration to 7 days after for untargeted metabolomics and gut microbial metagenomic analyses; blood samples were collected simultaneously for immunogenicity analysis. Levels of phenylalanine, tyrosine, cholic acid, deoxycholic acid, and tryptophan were significantly increased at 5-6 days after GEN-001 administration when compared with predose levels. Compared with predose, the relative abundance (%) of Parabacteroides and Alistipes significantly decreased, whereas that of Lactobacillus and Lactococcus increased; Lactobacillus and tryptophan levels were negatively correlated. A single administration of GEN-001 shifted the gut microbiota in healthy volunteers to a more balanced state as evidenced by an increased abundance of beneficial bacteria, including Lactobacillus, and higher levels of the metabolites that have immunogenic properties.

Stiffness of the Central Corpus Cavernosum on Shear-Wave Elastography Is Inversely Correlated with the Penile Rigidity Score in Patients with Erectile Dysfunction

  • Joo Yong Lee;Dae Chul Jung;Seungsoo Lee;Nam Gyu Kang;Young Taik Oh;Kyunghwa Han
    • The World Journal of Men's Health
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    • v.39 no.1
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    • pp.123-130
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    • 2021
  • Purpose: To perform real-time quantitative measurements of penile rigidity for patients with erectile dysfunction (ED) using shear-wave elastography (SWE). Materials and Methods: A total of 92 patients with clinically diagnosed ED filled out an abridged five-item version of the International Index of Erectile Function (IIEF-5) questionnaire and underwent SWE as well as penile color Doppler ultrasound (CDUS) after intracavernosal injection for penile erection. Elasticity measurements were repeated on two sites of the corpus cavernosum (central and peripheral elasticity of corpus cavernosum [ECC]) and the glans penis during the erection phase. Correlations between penile elasticity and rigidity scores or IIEF-5 were evaluated statistically. Penile elasticity was also compared with the ED types based on CDUS. Results: The mean age of all patients was 53.5±13.4 years, and the mean IIEF-5 score was 9.78±5.01. The rigidity score and central ECC value demonstrated a significant correlation (r=-0.272; 95% confidence interval: -0.464 to -0.056; p=0.015). The IIEF-5 score was not significantly correlated with penile elasticity. Vascular ED patients showed significantly higher central ECC values than nonvascular ED patients (p<0.001). At a cut-off value of 8.05 kPa, the central ECC had a specificity of 41.5%, a sensitivity of 84.6%, and an area under the ROC curve of 0.720 with a standard error of 0.059 (p=0.019) for predicting vascular ED. Conclusions: Quantitatively measuring Young's modulus of the corpus cavernosum using SWE could be an objective technique for assessing penile erectile rigidity and the vascular subtype in patients with ED.

Usefulness Comparative Experimental Study of the CT and MR Imaging in the Dog Clonorchiasis (잡견 간흡충증의 전산화단층촬영과 자기공명영상의 유용성에 관한 실험적 연구)

  • Goo, Eun-Hoe;Kweon, Dae-Cheol;Kim, Dong-Sung;Choi, Chun-Kyu
    • Journal of radiological science and technology
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    • v.26 no.3
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    • pp.33-39
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    • 2003
  • Purpose : Be aware of clinical possibilities on image quality by comparison of contrast-enhanced dynamic CT and MR imaging applied of MIP technique after the experimentally induced clonorchasis infection in dogs. Materials and Method : Twenty mongrel dogs prepared in zoo-laboratory were followed up with serial CT scans and MR imaging for 13 weeks after the experimental infection in liver. Two-phase helical CT was acquired in the supine position with the following scanning parameters. After the injection of contrast material, the arterial phase was initiated using a bolus-racking method. The portal phase scan was started 15 seconds after the arterial phase scan. CT protocol was determined after single level dynamic scans. MR imaging used the CP body coil and images get a 2D image using HASTE, FLASH, TSE pulse sequence. Bile duct MR imaging were obtained in three plans. Then each image was post processed by using target MIP algorithm. Two experimentation above, as a method of evaluation, one pathologist, three radiologist and five radiological technologist were analyzed visually for evaluation of following findings, enhancement of the bile duct wall, dilatation of bile duct tip, liver parenchyma, background suppression. Results : Five dogs was died of a disease after the infection, the rest one else shows the chronic dilatation of the intrahepatic bile duct with CT and MR imaging. Contrast administration of CT shows the contrast-enhanced of the bile duct walls with live parenchyma. MR imaging calculated of CNR and CR from pulse sequence for comparative evaluation and shows the pattern of the intrahepatic bile duct, dilatation of bile duct tip using MIP technique. CNR of the clonorchiasis, HASTE was $16{\pm}0.83$, TSE $7.06{\pm}3.0$, FLASH $1.19{\pm}0.2$ and CR, HASTE was 73.3%, TSE 62.3%, FLASH 6.4%. Conclusion : CT and MR imaging is very usefulness in diagnosis of dog clonorchiasis.

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Overcoming Langage Barrier by Korean Nurses in U.S. Hospital Settings (한국간호사들이 경험한 미국병원에서의 언어장애 극복 과정)

  • 이명선
    • Journal of Korean Academy of Nursing
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    • v.26 no.2
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    • pp.483-496
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    • 1996
  • The purpose of this study was to describe how Korean nurses overcome the language barrier while working in the U.S. hospital settings. Twelve Korean nurses living in New York metropolitan area were asked open-ended, descriptive questions to collect the data. The interviews were done in Korean. All interviews were audiotaped under the permission of the participants and were transcribed verbatim. The data were analyzed using grounded theory analysis. The research process consisted of two phases. In the first phase 8 Korean nurses were interviewed and analyzed. In the second phase, further data were collected to verify categories and working hypotheses that were emerged from the first phase. The results of this study show that all Korean nurses experienced severe psychological stress such as confusion, anxiety, frustration, loss of self-confidence, embarrassment, guilt, depression, anger, and fear. Among the mode of communication such as listening, speaking, leading, and writing, they had the most difficulty in speaking. Speaking ability was especially important for them because of the emphasis of individualism and self-defense in the U.S. Among the verbal communication modes, non-face-to-face communications such as phone conversation and body language were the most difficu1t for them to overcome. It took at least 2 years for the participants to initially overcome the language barrier in U.S. hospitals. After 2-5 years they began to feel comfortable even in non-face-to-face communication. They could actively search for the better place to work after 5 years. They finally felt comfortable in English and in their job almost after 10 years. The factors that influenced the English improvement were ‘the years of clinical experience in Korea’, ‘the decade they came to the U.S.’ ‘coming to U.S. alone or with other Korean nurses’, ‘racial homogeneity or heterogeneity of the working unit’, and ‘the degree of social support’. The strategies Korean nurses used to overcome the language barrier included depending on the written communication, using ‘nunchi’, working and studying hard, and establishing good interpersonal relationships with co-workers. They also employed assertive behavior of the U.S., such as using more explicit verbal language and employing smiles and eye contact with others during the conversation. The results of the study may help Korean nurses and nursing students who try to work in U.S. hospital settings by understanding problems other Korean nurses faced, factors that influenced their English improvement, and strategies they used. They may also help U.S. nurses and administrators in developing and implementing efficient programs for newly employed Korean nurses by understanding major problems and feelings the Korean nurses experienced and strategies they used to overcome the language barriers.

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